attention deficit hyperactivity disorder · 2018-04-02 · attention deficit hyperactivity disorder...
TRANSCRIPT
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Attention Deficit Hyperactivity Disorder
Workshop for AASC 22nd August, 2016
David O’Banion, MD Developmental Pediatrician, FAAP
Assistant Professor of Pediatrics
Emory University School of Medicine
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glsr.it/ADHD4AASC
your participation is kindly requested
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glsr.it/ADHD4AASC
a few disclaimers: I’m a doctor but… I don’t internet well...
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Learner Objectives
the active participant will:
1.explain the reason ADHD is a disorder 2.describe how a clinician diagnoses
ADHD 3.define how ADHD symptoms impact a
child and family 4.debate ADHD issues glsr.it/ADHD4AASC
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Today’s Timeline --- 90 minutes
• 5 min opening • 10 min ADHD challenges • 15 min ADHD biology • 20 min ADHD treatment • 20 min ADHD for AASC • 30 min debate club
glsr.it/ADHD4AASC
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What do you already know? 3 things
• discuss in small groups
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What do you already know? 3 things
pick three members each types one here
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Defining ADHD – symptoms and challenges
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difficulty paying attention
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difficult to even start “attention” activities
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difficult to focus on one task
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poll re: video games; which of the following wouldn’t you expect? (evidence that it isn’t ADHD) • driving and texting • crying before starting homework • can play vid games and ignore others • something else • something depression
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video game interaction: every ___ seconds?
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hyperactivity: hard to sit still
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huge problem = impatience
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focus follow through sit still wait
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3 star quest • Gary will sit for an hour playing World of Warcraft
online, but puts off completing his expense report from a recent business trip. He starts working on it late, and can only find one of the receipts he needs
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3 star quest • Jackie would rather stay in her room than play with her
brother outside. She talks back to her mother angrily, and pesters her brother. She’s been kicked out of two daycares for playing too rough.
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3 star quest • Derek cries and says “I’m stupid” when his mother
makes him work on his homework. She knows he can do the work, but he makes many mistakes and doesn’t check his answers. Then, he forgets to turn it in and doesn’t get credit at school.
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ADHD has 18 core symptoms
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ADHD has 18 core symptoms
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diagnosis: most symptoms, most places
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any licensed clinician can apply the diagnostic criteria
http://www.helpforadd.com/
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Kids with ADHD are nice kids!
https://www.youtube.com/watch?v=Xd6Y6RzTDVc
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life challenges due to poor planning skills
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Learner Objectives
the active participant will:
1.explain the reason ADHD is a disorder 2.describe how a clinician diagnoses
ADHD 3.define how ADHD symptoms impact a
child and family 4.debate ADHD issues
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What is the main reason kids get ADHD? • Sucrose (sugar) • Food dyes • Genetics • Brain damage • over stimulating environment • pregnancy problems • something else dietary • video games • something else in the environment
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Results review & Recall of 1st question
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ADHD Biology – basis and treatments
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executive function: mature, adult brain skills
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executive function: adult brain is last to develop
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adult brain makes us uniquely human
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info comes in… ignore, react, respond, or “think about it”
Think and Plan
Automatic Brain
Threat
Response
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info comes in…
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info comes in… ignore, react, respond, or “think about it”
Think and Plan
Automatic Brain
Clever Response
Input
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Which is an example of executive function? a – spaghetti smell reminds you of home b – did you lock the front door? c – you brake just in time d – you ignore the sound of a text because your client is talking e – you’re certain you left your keys right here__
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executive function: think and plan
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ADHD brains are different
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ADHD brains: volume, connections, symmetry differences
Shaw 2007
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brain connections use chemicals to signal
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ADHD brains: different connections (wiring)
Brain Tutor App
http://www.additudemag.com/adhd/article/10117.html
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How do the medications work in ADHD? • over-stimulate an overactive brain • enhance neurotransmitter signaling • cause a kid to only be attentive to one thing at a time • calm a child down by making him/her slightly sleepy • improve blood flow to learning and attention centers in
the brain
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medications enhance neurotransmitter signaling
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most people inherit their ADHD
ADHD Diagnosis
ADHD present, not diagnosed
ADHD risk, sub threshold
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Learner Objectives
the active participant will:
1.explain the reason ADHD is a disorder 2.describe how a clinician diagnoses
ADHD 3.define how ADHD symptoms impact a
child and family 4.debate ADHD issues
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What is the recommended treatment? • medicine: non-stimulants should be first • behavior therapy should be first • improving diet should be tried first • counseling or play therapy • exercise therapy • medicine: stimulants should be tried first • all are effective and should be tried
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behavior therapy tries to train
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does diet affect behavior?
• picture taken from http://www.huffingtonpost.com/maria-lossevamalho/kids-sugar-and-behavioura_b_8482324.html
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sugar vs. no sugar
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sugar vs. no sugar only difference = parent behavior!
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other substances might matter more
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Kids with ADHD are nice kids!
but because they can be cute, and ‘zone in’…
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Resources where you can learn more
.org
http://help4adhd.org/Understanding-ADHD/About-ADHD/Myths-and-Misunderstandings.aspx
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Learner Objectives
the active participant will:
1.explain the reason ADHD is a disorder 2.describe how a clinician diagnoses
ADHD 3.define how ADHD symptoms impact a
child and family 4.debate ADHD issues
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Today’s Timeline --- 90 minutes
• 5 min opening • 10 min ADHD challenges • 15 min ADHD biology • 20 min ADHD treatment • 20 min ADHD for AASC • 30 min debate club
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Workshop: how can AASC members help?
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debate and respond to these common comments
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he can play his video game for hours!
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what can you expect with all this sugar in our kids’ diets?
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they just don’t raise kids right anymore
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there’s way too many kids on these meds
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ADHD is a just a label for normal, active children
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all kids eventually grow out of it. adults don’t need medication!