RileyDMFT6104-2

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Northcentral University *

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6104

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Psychology

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Dec 6, 2023

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ADHD Awareness & Understanding Danae Riley
Agenda • What is & is not ADHD? • Prevalence & Demographic Risk Factors • Causes & Course of ADHD • Societal Impact • Parental Preferences for Treatment • Multimodal Approach • Q & A 11/11/22 2
ADHD Diagnosis & Comorbidity
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ADHD Diagnostic Criteria • Inattention • Hyperactivity & Impulsivity • Present prior to age 12 • Occurs in 2+ settings • Causes impairment in functioning Presentation: • Combined Presentation • Predominantly Inattentive Presentation • Predominantly Hyperactive-Impulsive Presentation 11/11/22 4
Assessment Methods • Interviews with: • Child • Parents/Caretakers • School/Daycare • Other social networks • Evaluation of potential comorbidity • Standardized Behavior Rating Scales • Family History & Functioning • Medical, Developmental & Mental Health History 11/11/22 5
Comorbidity 54% - 84% Oppositional Defiance Disorder & possibly Conduct Disorder 19% Substance Use Disorders 25% -35% Learning or Language Disorder Up to 33% Mood Disorder or Anxiety 11/11/22 6
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Prevalence & Demographi c Risk Factors 7
Prevalence Rates For Children • 7% - 10% of children & adolescents • 4.4% of adults • Highly heritable, so family assessment is recommended When diagnosed as a child; • 60 - 85% maintain diagnosis as a teenager • 40% maintain full diagnosis as an adult • 90% maintained at least 5 symptoms as an adult 11/11/22 8
Demographic Risk Factors • Boys 3:1 – Girls 6:1 • Prevalence by race (ages 3-17): • Black: 16.9% • White: 14.7% • Hispanic: 11.9% • Lower income increases likelihood of diagnosis • Parents with higher level education decrease likelihood of diagnosis • Rural areas show higher prevalence than urban/suburban areas 11/11/22 9
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Cause, Course, & Long-Term Effects of ADHD
Causes of ADHD Genetic • Twin studies show 76% estimated heritability • Less activity in prefrontal & frontal lobes • Gray & white matter deficits Neurobiological • Perinatal stress • Low birth weight • Traumatic brain injury • Maternal Smoking • Severe Early Deprivation 11/11/22 11
Duration & Recurrence Rates of ADHD • No cure for ADHD • Keys to successful lifelong management: • Multimodal care team • Individualized treatment • Constant feedback from caretakers, teachers, supervisors, etc. • Clinical assessment quarterly or bi-annually at minimum 11/11/22 12
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Long-Term Risks & Treatment Side- Effects Risks in Adulthood • Impairment may be seen in: • Social Relations • Education • Family Functioning • Occupational Functioning • Self-Sufficiency • Adherence to Social Rules, Norms & Laws Treatment Side Effects • Appetite decrease • Weight loss • Insomnia • Headache • Irritability • Tics 11/11/22 13
Societal Impacts of Living With a Child With ADHD
Stereotypes & Other Societal Challenges • #1 economically & socially costly of all childhood psychiatric disorders • Naysayers and critics of scientific findings denounce the existence of the disorder itself • The longer sufferers wait to seek treatment, the more difficult it is to reduce symptomology 11/11/22 15
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Parental Advocation of Treatment Preferences
To Medicate or to Not Medicate? • Psychoeducation • Psychopharmacological Treatment • Behavioral Therapy • Inclusive of Parent & Child 11/11/22 17
A Multi-Modal Approach to Treating ADHD
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Multimodal Treatment 11/11/22 19
Why Involve An MFT? First, assess therapist competency in ADHD specialized training and education • MFT’s Can Offer: • Multimodal approach • Referral for Medical Evaluation • Psychosocial Assessment • Assessment of Comorbidity • Psychoeducation for Family • Parent Management Training • Family Training 11/11/22 20
Q & A
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References 11/11/22 22 American Psychiatric Association (Ed.). (2013). DSM-5: Neurodevelopmental Disorders. In Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association. Barkley, R. A. (2002). International consensus statement on ADHD. January 2002. Clinical Child and Family Psychology Review , 5 (2), 89–111. https://doi.org/10.1023/a:1017494719205 Hallowell, E. (n.d.). Dr. Hallowell’s blog [Web log]. New Hope Media. (n.d.). ADDitude: Strategies and support for ADHD & LD. Orr, J. M., Miller, R. B., & Polson, D. M. (2005). Toward a Standard of Care for Child ADHD: Implications for Marriage and Family Therapists. Journal of Marital & Family Therapy , 31 (3), 191–205. https://doi.org/10.1111/j.1752-0606.2005.tb01563.x Pliszka, S., M.D. (2007). Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/hyperactivity disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 46 (7), 894-921. doi:10.1097/chi.0b013e318054e724 Reddy, L. A., Springer, C., Files-Hall, T. M., Benisz, E. S., Hauch, Y., Braunstein, D., & Atamanoff, T. (2005). Child ADHD Multimodal Program: An Empirically Supported Intervention for Young Children With ADHD. In Empirically based play interventions for children. (pp. 145–167). American Psychological Association. https://doi.org/10.1037/11086-009
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