Attention Deficit

Disorder and
Attention Deficit
Hyperactivity
Disorder
ADD/ADHD

I have neither given nor

received aid, other than
acknowledged, on this
assignment or test, nor
have I seen anyone else do
so.
Anne Caldwell

What is
ADD/ADHD?

One of the most common neuropsychiatric

disorders in children (Konrad & Eickhoff, 2010)
Characterized by inappropriate behaviors
and inattention, that often results in
performance issues
Referred to as ADHD when accompanied by
hyperactivity & impulsivity
No single test to diagnosis
Must look at other possible conditions prior
to diagnosis

Inattention
Failure to pay attention to details
Makes careless mistakes
Forgetful

What is
ADD/ADHD?

Frequently misplaces belongings

Easily distracted

Untitled, 2015

Does not follow through on instructions

Often has trouble organizing tasks &
activities
Fails to complete schoolwork
(Ball, Bindler, & Cowen, 2012)

Impulsivity

What is
ADD/ADHD?

Blurts out answers before question is

complete
Has difficulty awaiting turn
Interrupts or intrudes on others
(Ball, Bindler, & Cowen, 2012)

Hyperactivity

What is
ADD/ADHD?

Fidgets or wriggles in seat

Unable to stay seated when expected
Runs around or climbs at inappropriate times
Difficult time with leisure activities or being
quiet
Acts as though driven by a motor
Excessive talking
(Ball, Bindler, & Cowen, 2012)

Most likely due to a combination of

genetics & environment Exposure to
high level of lead or mercury in
childhood

What
causes
ADD/ADHD?

Prenatal exposure to alcohol or tobacco

smoke
Impaired placenta functioning
Severe nutritional deficiencies
Impaired oxygenation at birth
Preterm labor
Family history
(Ball, Bindler, & Cowen, 2012)

Primary
Prevention
of
ADD/ADHD

Promote maternal health during pregnancy

Programs that educate against use of
tobacco and alcohol
Reduce environmental toxins: Lead &
Mercury
*Will not eliminate ADHD, will help reduce
incidence*
(Halperin, Bedard, & Curchack-Lichtin, 2012)

Secondary
Prevention
of
ADD/ADHD

Early identification for at risk children

Head Start
The Incredible years
Family education and counseling
(Halperin, Bedard, & Curchack-Lichtin, 2012)
(Sonuga-Barke & Halperin, 2010)

Untitled Web Photo, 2011

Tertiary
Prevention
of
ADD/ADHD

Medications
Parent education
The Triple P (Positive Parenting Program)
New Forest Parenting Program
(Sonuga-Barke & Halperin, 2010)

Caring for
an
ADD/ADHD
child

Multimodal Approach has been shown to be

the most effective (Pellow, Solomon, & Barnard, 2011)
Treatments should be tailored to meet the
needs of the child (Greener, 2014)
Medication therapy
Behavior management
Support groups
School programs

 Minimize environmental distractions

Limit television/video game time

Intervention
s for
ADD/ADHD

Encourage daily physical activity

Set realistic expectations and limits
patients can be easily frustrated
Remain calm and consistent with the child
Keep instructions short and simple
Offer praise and rewards whenever possible
(Ball, Bindler, & Cowen, 2012)

 Stimulant medication & Non stimulant

medications are available

Medication
Therapy for
ADD/ADHD

Available in extended release or short

acting forms
Treatment options should be discussed with
provider
Helps to increase attention span
Teach family about medication side effects
and safety

 Needs frequent monitoring of height,

weight, & blood pressure

Medication
Education
for
ADD/ADHD

May need cardiac evaluation prior to staring

medication
Monitor for abuse
Keep extra medication locked up
Administer only as directed
(Krull, 2014)

 Common side effects:

Anorexia

Medication
Education
for
ADD/ADHD

Dry mouth
Insomnia
Tachycardia
Mood liability
Upset stomach/abdominal pain
Dizziness
(Krull, 2014)

 Give med early in the morning to avoid

alterations in sleep patterns

Managing
Side Effects
of
ADD/ADHD
Medication

Give med with meal to help manage

anorexia
Encourage child to eat nutrient dense foods
as opposed to empty calories
Mood lability can be managed by changing
the dose or using an controlled release
medication
Drug holidays can be discussed with
provider if height and weight are affected
(Krull, 2014)

 Work with parents and teachers to develop

a individualized education plan for the child
Reinforce the importance of a structured
environment

Patient
Teaching
ADD/ADHD

Parents should work together with teachers

to ensure child's success
Counsel parents/teachers:
child may need instructions repeated more
than once or given in different formats
Child needs quiet places with minimal
distraction for school work or tests
(Ball, Bindler, & Cowen, 2012)

 Commonly tried by families in addition or in

place of medications

Alternative or
Complement
ary Therapies
for
ADD/ADHD

Should be discussed with provider prior to

initiation
Chiropractic manipulation
Biofeedback
Elimination Diets (not recommended)
Dietary supplements
(Ball, Bindler, & Cowen, 2012) (Pellow, Solomon, & Barnard, 2011)

Early intervention can help to avoid these

complications
Academic failure

Complicatio
ns of
ADD/ADHD

Poor social relationships

Low self esteem
Behavior problems
Higher risk of injury due to impulsivity
Higher risk for substance abuse later in life
Parents are at risk for caregiver role strain
(Ball, Bindler, & Cowen, 2012) (Krull, 2014) (Halperin, Bedard, & CurchackLichtin, 2012)

References
Ball, J., Bindler, R., & Cowen, K. (2012). Principles of Pediatric Nursing Careing for Children. Upper Saddle River, New Jersey: Pearson Educaiton, Inc.
Greener, M. (2014, July/August). Managing ADHD in children and young people: New insights. British Journal of School Nursing, 9(6), 296-298. Retrieved February 2015
Halperin, J. M., Bedard, A.-C. V., & Curchack-Lichtin, J. T. (2012). Preventive Interventions for ADHD: A Neurodevelopmental Perspective. Neurotherapeutics, 9, 531-541. doi:10.1007/s13311-

012-0123-z

Konrad, K., & Eickhoff, S. B. (2010). Is the ADHD Brain Wired Differently? A Review on Structural and Functional Connectivity in Attention Deficit Hyperactivity Disorder. Human Brain Mapping, 31, 904-16.
doi:doi: 10.1002/hbm.21058.
Krull, K. R. (2014, December 2). Attention Deficit Hyperactivity Disorder in Children and Adolescents: Treatment with Medications. (M. Augustyn, & M. M. Torchia, Editors) Retrieved 2015, from Up To Date:

References

http://www.uptodate.com/contents/attention-deficit-hyperactivity-disorder-in-children-and-adolescents-treatment-with-medications?source=see_link#H2166605
Pellow, J., Solomon, E. M., & Barnard, C. N. (2011). Complementary and Alternative Medical Therapies for Children with Attention-Deficit/Hyperactivity Disorder (ADHD). Alternative Medicine

Review,

16(4), 323-337.
Sonuga-Barke, E. J., & Halperin, J. M. (2010). Developmental Phenotypes and Causal Pathways in Attention Deficit/Hyperactivity Disorder: Potential Targets for Early Intervention? 51(4), 368-389.
doi:10.1111/j.1469-7610.2009.02195.
[Untitled illustration of inattentive child]. Retrieved February 10, 2015 from https://www.boundless.com/psychology/textbooks/boundless-psychology-textbook/psychological-disorders-18/childhood-disorders96/attention-deficit-and-hyperactivity-disorders-365-12900/
[Untilted Web Photo]. Retrieved from http://incredibleyears.com/wp-content/uploads/2011/07/slide-101-220x141.jpg