ADHD

 

According to the DSM V

Attention Deficit Hyperactivity Disorder – the diagnosis requires symptoms to be:

  • present for 6+ months,
  • in 2+ different settings,
  • show negative impact on the child’s functioning (in academic/occupational or social realms) and development, and
  • not caused by another mental disorder.
  • Remember this assessment should be made according to the developmental level of the child.
  • Of note, 6+ is for those up to age 16, and 5+ for 17y+ and adults.
  • Symptoms must have been present before 12 years of age.

What are the types?

Inattentive (6+ required up to 16, 5+ for 17 and older)

  • little or no attention to detail, careless mistakes: schoolwork/work/other activities
  • difficulty holding¬†attention on tasks or play activities (must differentiate between something they may find boring and something interesting)
  • doesn’t seem to listen when spoken to directly
  • does not follow through: schoolwork, chores, work duties
  • difficulty organizing tasks and activities
  • avoids/dislikes/reluctant to do tasks that require mental effort over long period of time
  • loses things necessary for tasks and activities
  • easily distracted
  • forgetful in daily activities

Hyperactive/Impulsive (6+ if 16 and under, and 5+ of 17 and over)

  • fidgeting/tapping hands or feet, squirming in seat
  • leave seat in situations where remaining seated is expected
  • runs about or climbs in situations where it is not appropriate
  • unable to play or take part in leisure activities quietly
  • “on the go”, “driven by a motor”
  • talks excessively
  • blurts out answers before question is completed
  • trouble waiting their turn
  • interrupts or intrudes on others

Combined: 

  • 6+ of both types

Severity

They can be graded as mild/moderate/severe, based on the number of symptoms in excess of the ones required to make a diagnosis, and functional impairment within the social or academic/occupational realms.

Scoring

SNAP IV questionnaire:

http://www.myadhd.com/snap-iv-6160-18sampl.html

http://www.crfht.ca/files/8913/7597/8069/SNAPIV_000.pdf

Used at the initial visit and also to gauge effectiveness of medication, once started. This is filled out by both the school and the home.

Other things to think about:

  1. are there comorbidities (i.e., anxiety, depression, learning disability, ASD, other mental health disorder)
  2. social environment
  3. suspect in those who are older and depressed, as this may have been an undiagnosed ADHD and compensation with depression, anxiety and low self esteem may result.
  4. girls tend to be missed more than boys as they tend to have more outbursts at younger ages

MEDICATIONS:

http://www.caddra.ca/pdfs/Medication_Chart_English_CANADA.pdf

caddra-adhd-medications

 

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