I. Diagnostic Criteria
A. Either (1) or (2):
(1) six (or more) of
the following symptoms of inattention have persisted for at least
6 months to a degree that is maladaptive and inconsistent with developmental
level:
Inattention
(a) often fails to give close attention to details or makes careless mistakes
in schoolwork, work or other activities
(b) often has difficulty sustaining attention in tasks or play activities
(c) often does not seem to listen when spoken to directly
(d) often does not follow through on instructions and fails to finish schoolwork,
chores, or duties in the workplace (not due to oppositional behavior or
failure to understand instructions)
(e) often has difficulty organizing tasks and activities
(f) often avoids, dislikes, or is reluctant to engage in tasks that require
sustained mental effort (such as schoolwork or homework)
(g) often loses things necessary for tasks or activities (e.g., toys, school
assignments, pencils, books, or tools)
(h) is often easily distracted by extraneous stimuli
(i) is often forgetful in daily activities
(2) six (or more) of
the following symptoms of hyperactivity-impulsivity have persisted
for at least 6 months to a degree that is maladaptive and inconsistent
with developmental level:
Hyperactivity
(a) often fidgets with hands or feet or squirms in seat
(b) often leaves seat in classroom or in other situations in which remaining
seated is expected
(c) often runs about or climbs excessively in situations in which it is
inappropriate (in adolescents or adults, may be limited to subjective feelings
of restlessness)
(d) often has difficulty playing or engaging in leisure activities quietly
(e) is often "on the go" or acts as if "driven by a motor"
(f) often talks excessively
Impulsivity
(g) often blurts out answers before questions have been completed
(h) often has difficulty awaiting turn
(i) often interrupts or intrudes on others (e.g.; butts into conversations
or games)
B. Some hyperactive-impulsive or inattentive
symptoms that caused impairment were present before age 7 years.
C. Some impairment from the symptoms is present
in two or more settings (e.g.; at school [or work] and at home).
D. There must be clear evidence of clinically
significant impairment in social, academic or occupational functioning.
E. The symptoms do not occur exclusively during
the course of a Pervasive Developmental Disorder, Schizophrenia, or other
Psychotic Disorder and are not better accounted for by another mental disorder.
II. Subtypes
ADHD-C (combined type): if both criteria A1 and
A2 are met for the past 6 months
ADHD-PI (predominately inattentive type): if
criterion A1 is met but criterion A2 is not met for the past 6 months
ADHD-HI (predominately hyperactive-impulsive
type): if criterion A2 is met but criterion A1 is not met for the past
6 months
III. Core characteristics
A. Inattention
B. Impulsivity
C. Hyperactivity
IV. Comorbidity
A. ODD/CD
1. Nearly half of all
children with ADHD also have ODD
2. 30%-50% of children
diagnosed with ADHD will go on to have CD
3. Some researchers believe
that ADHD is one of the most reliable predictors of both ODD & CD
B. Distinguishing ADHD from CD/ODD
C. Children who display a more aggressive subtype of ADHD have a much higher risk for later antisocial behavior.
V. Statistics and Course
A. Age of Onset
B. Risk factors for continuation of ADHD
1. Early age of onset
2. Meets criteria across
all three areas
3. Increased frequency
and intensity of the behavior
4. Aggressive component
C. Gender Differences
VI. Causes of ADHD
A. Genetic
1. Genetic factors can
interact with environmental factors.
B. Neurobiological
1. Deficiencies in dopamine
and/or norepinephrine
2. Reduced neural activity
in the prefrontal region of the brain
C. Familial
1. Parents/relatives
w/ADHD
2. Divorce
3. Parent-Child Interactions
D. Environmental Toxins
VII. Treatment
A. Behavioral Interventions
1. The Attentional Training
System (ATS)
B. Drugs
1. Ritalin