attention%20deficit_hyperactivity%20disorder
ATTENTION DEFICIT/HYPERACTIVITY DISORDER
Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by the presence of impairing levels of inattention, disorganization and/or hyperactivity-impulsivity.
Symptoms that suggest ADHD include hyperactivity, acting without thinking, inattention/daydreaming, fidgety, restless, excessive talking, aggressive behavior, academic underachievement, disorganized and has difficulty in completing tasks.

Patient Education

Parent/Caregiver and Patient Education
  • Provide information about ADHD
    • Identify and eliminate the trigger factors that cause inattention, hyperactivity, or impulsivity
    • Provide information about the disorder, common features, neurologic mechanisms and associated conditions
    • Discuss the expected clinical course and intervention strategies including risks and benefits
    • Review how it can affect behavior, learning, social skills, confidence and family life
    • Inform parent/caregiver about other ways of learning management skills through support groups, advocacy groups and parenting skills training
  • Parent/caregiver is encouraged to:
    • Spend at least 10-15 minutes with child
    • Assure child that he or she is not the problem but his or her behavior
    • Have clear, concise household rules with use of reward and punishment
    • Limit to giving 1-2 clear instructions at a time and child should be able to repeat instructions back
    • Allow child to experience consequences of actions as consistent and predictable
    • Give appropriate disciplinary measures for challenging behavior
    • Have consistent schedules and structure in the child’s everyday activities 
    • Have a private, quiet place for homework or projects
    • Allow the child to have choices
    • Use of time-out to contain child's emotional dysregulation
    • Discuss any concerns that they may have on themselves (particularly if parent/caregiver has ADHD) and on the child 
  • Parent skills training
    • May be done through reading books and individual counseling, or in formal classes
  • Family therapy
    • May be advised for families with extremely disruptive children or presence of significant family pathology thought to be related to the child’s presenting problem
  • For child, tailor ADHD education to age, gender and educational level
    • Include discussion of the child’s strengths and attributes
  • A referral to a child psychiatrist or ADHD specialist may be needed if there is at least moderate impairment with the child’s persisting behavioral problems
  • If a child with ADHD has a coexisting condition, the parent/caregiver should encourage relevant healthcare professional to provide treatment plan and feedback
School Personnel Education
  • Do not assume teacher has knowledge of ADHD
  • Provide information relevant to teacher/school about how ADHD may affect the child in the classroom
    • Should include intervention strategies and environmental modifications for dealing with behavior issues
  • School personnel is encouraged to:
    • Have an orderly and predictable classroom
    • Have clear and concise rules
    • Have classroom strategies eg written notices for homework, schedules
    • Have very interesting multi-sensory learning activities
    • Use of positive reinforcements for good behavior
    • Establish parent-teacher communication
    • Inform parents regarding programs on parent education and training 
    • Help students with self-monitoring, self-reinforcement and development of compensatory/adaptive strategies
    • Provide feedback to the child and his/her parent/caregiver and physicians 
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