Nursing Program MCH 223: ADHD in Children

Study Notes

Definition and Prevalence of ADHD

ADHD (Attention Deficit Hyperactivity Disorder) is a common childhood brain disorder that can continue through adolescence and adulthood.
ADHD prevalence worldwide is between 1% to 10%, with a reported 7.2% of children aged 18 and under having ADHD.
ADHD is most prevalent in school-aged children, with up to 3 children in a classroom of 30 having ADHD.
Boys are more often diagnosed with ADHD than girls, while girls are more likely to have the inattentive type of ADHD.

Causes of ADHD

Genetic factors: most researchers suspect that ADHD is caused by genetic or biological factors, with genes inherited from parents.
Environmental factors: studies suggest a link between cigarette smoking and alcohol use during pregnancy, as well as lead exposure, and ADHD in children.
Brain injuries: children who have suffered a brain injury may show some behaviors similar to those of ADHD.

Types of ADHD

ADHD is classified into three types:
Predominantly Inattentive Type: characterized by difficulty paying attention.
Predominantly Hyperactive-Impulsive Type: characterized by hyperactivity and impulsivity.
Combined Type: characterized by both inattention and hyperactivity-impulsivity.

Diagnosis of ADHD

According to the DSM-IV, diagnosis of ADHD requires:
Six or more inattention symptoms or six or more hyperactivity-impulsivity symptoms.
Symptoms must be inconsistent with the child's current developmental level.
Symptoms must have persisted for at least six months to a degree that is maladaptive.
Additional DSM-IV criteria include:
Early onset: at least some symptoms must present prior to age 7 years.
Settings: symptoms must be present in at least two settings.
Impact: symptoms must have a negative impact on the child's academic or social life.
Severity: the behavior in question must occur more frequently in the child than in other children at the same developmental stage.
The basic cause: the symptoms are not entirely caused by another severe physical disorder or mental disorder.

Symptoms of ADHD

Inattention symptoms:
Failure to give close attention to details or makes careless mistakes.
Difficulty sustaining attention in tasks or play activities.
Failure to listen when spoken to directly.
Failure to follow instructions and finish tasks.
Difficulty organizing tasks and activities.
Avoiding tasks that require sustained mental effort.
Losing things necessary for tasks or activities.
Easily distracted by extraneous stimuli.
Forgetfulness in daily activities.
Hyperactivity symptoms:
Fidgeting with hands or feet or squirming in seat.
Leaving seat in classroom or other situations.
Running about or climbing excessively in inappropriate situations.
Difficulty playing or engaging in leisure activities quietly.
Acting as if "driven by a motor".
Talking excessively.
Impulsivity symptoms:
Interrupting or intruding on others.
Blurring out answers before hearing the whole question.
Trouble waiting for one's turn.
Difficulty waiting in lines or taking turns.

Treatment of ADHD

Treatment plans should be tailored to meet the specific needs of each child and their family.
Treating ADHD often requires medical, educational, behavioral, and psychological intervention.

Nurse Role in Helping Children with ADHD

Set realistic goals to avoid frustration of both child and family.
Remain calm and consistent with the child.
Keep short and simple instructions.
Provide praise and rewards whenever possible.
Provide the child with divisional activities suited to their short attention span.
Observe child carefully to prevent self-injury.
Encourage the child to verbalize their feelings freely.
Provide immediate non-threatening feedback for unacceptable behavior.
Establish a trusting relationship with the child.
Empower the child's parent with needed information about their condition and how to support them.

Tips for School and Home

For teachers:
Gain the child's attention before speaking to them.
Work on the most difficult concepts early in the day.
Give directions to one assignment at a time.
Have the child repeat back directions for important tasks.
Focus on discrete rewards and consequences for behavior.
Vary the pace and type of activity to maximize attention.
Structure the student's environment to accommodate their special needs.
For parents:
Focus on discrete rewards and consequences for behavior.
Use movie nights and time-outs as consequences.
Set a daily routine and stick to it.
Use tangible reminders such as clocks, charts, and assignment pads.
Gain the child's attention before speaking to them.
Avoid administering consequences without prior warning or without the child understanding why.

Description

This quiz covers the basics of Attention Deficit Hyperactivity Disorder (ADHD) in children, including its definition, prevalence, causes, types, signs and symptoms, diagnosis, treatment, and the role of nurses in helping children with ADHD.