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
glsr.it/ADHD4AASC
your participation is kindly requested
a few disclaimers: I’m a doctor but… I don’t internet well... glsr.it/ADHD4AASC
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
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
• discuss in small groups
What do you already know? 3 things
What do you already know? 3 things
pick three members each types one here
Defining ADHD – symptoms and challenges
difficulty paying attention
difficult to even start “attention” activities
difficult to focus on one task
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
video game interaction: every ___ seconds?
hyperactivity: hard to sit still
huge problem = impatience
focus follow through sit still wait
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
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.
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.
ADHD has 18 core symptoms
ADHD has 18 core symptoms
diagnosis: most symptoms, most places
any licensed clinician can apply the diagnostic criteria http://www.helpforadd.com/
Kids with ADHD are nice kids!
https://www.youtube.com/watch?v=Xd6Y6RzTDVc
life challenges due to poor planning skills
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
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
Results review & Recall of 1st question
ADHD Biology – basis and treatments
executive function: mature, adult brain skills
executive function: adult brain is last to develop
adult brain makes us uniquely human
info comes in… ignore, react, respond, or “think about it”
Think and Plan
Automatic Brain
Response Threat
info comes in…
info comes in… ignore, react, respond, or “think about it”
Think and Plan Automatic Brain
Clever Response Input
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__
ADHD brains: different connections (wiring) http://www.additudemag.com/adhd/article/10117.html Brain Tutor App
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
medications enhance neurotransmitter signaling
ADHD Diagnosis
most people inherit their ADHD
ADHD present, not diagnosed
ADHD risk, sub threshold
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
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
behavior therapy tries to train
does diet affect behavior?
• picture taken from http://www.huffingtonpost.com/maria-lossevamalho/kids-sugar-and-behavioura_b_8482324.html
sugar vs. no sugar
sugar vs. no sugar only difference = parent behavior!
other substances might matter more
Kids with ADHD are nice kids! but because they can be cute, and ‘zone in’…
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
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
Workshop: how can AASC members help?
debate and respond to these common comments
he can play his video game for hours!
what can you expect with all this sugar in our kids’ diets?
they just don’t raise kids right anymore
there’s way too many kids on these meds
ADHD is a just a label for normal, active children
all kids eventually grow out of it. adults don’t need medication!
