ATTENTION DEFICIT HYPERKINETIC DISORDER AND TYPES@nursesoutlook

ATTENTION DEFICIT HYPERKINETIC DISORDER

This is a syndrome first described by Heinrich Hoff in 1854.    

             

INCIDENCE:        

It occurs in about 3% of school age children.

Males are 6-8 times more affected.

TYPES OF ATTENTION DEFICIT DISORDER:

They are of 4 types:

1.    Attention deficit disorder with hyperactivity (Hyperkinetic disorder):

                 The characteristic clinical features are:

                                             I.          Poor attention span with distractibility

                                            II.          Hyperactivity

                                            III.          Impulsivity

2.     Attention deficit disorder without hyperactivity

3.    Residual type

4.    Hyperkinetic disorder with conduct disorder

ETIOLOGY:

Many factors like minimal brain damage,maturational lag,genetics,neurotransmitters

Attention-Deficit Hyperactivity Disorder Or ADHD

Attention-deficit hyperactivity disorder or ADHD is a common childhood condition that can be treated. ADHD may affect certain areas of the brain that allow problem solving, planning ahead, understanding others’ actions, and impulse control.

·        The behaviours must appear before age 7.

·        They must continue for at least six months.

·        The symptoms must also create a real handicap in at least two of the following areas of the child’s life:

• in the classroom,
• on the playground,
• at home,
• in the community, or
• in social settings.

If a child seems too active on the playground but not elsewhere, the problem might not be ADHD. It might also not be ADHD if the behaviours occur in the classroom but nowhere else. A child who shows some symptoms would not be diagnosed with ADHD if his or her schoolwork or friendships are not impaired by the behaviours.

Inattention, hyperactivity, and impulsivity are the key behaviors of ADHD. The symptoms of ADHD are especially difficult to define because it is hard to draw the line at where normal levels of inattention, hyperactivity, and impulsivity end and clinically significant levels requiring intervention begin. To be diagnosed with ADHD, symptoms must be observed in two different settings for six months or more and to a degree that is greater than other children of the same age.

The symptom categories of ADHD in children yield three potential classifications of ADHD—predominantly inattentive type, predominantly hyperactive-impulsive type, or combined type if criteria for both subtypes are met^:

Predominantly inattentive type symptoms may include:

• Be easily distracted, miss details, forget things, and frequently switch from one activity to another
• Have difficulty maintaining focus on one task
• Become bored with a task after only a few minutes, unless doing something enjoyable
• Have difficulty focusing attention on organizing and completing a task or learning something new or trouble completing or turning in homework assignments, often losing things (e.g., pencils, toys, assignments) needed to complete tasks or activities
• Not seem to listen when spoken to
• Daydream, become easily confused, and move slowly
• Have difficulty processing information as quickly and accurately as others
• Struggle to follow instructions.

Predominantly hyperactive-impulsive type symptoms may include:

• Fidget and squirm in their seats
• Talk nonstop
• Dash around, touching or playing with anything and everything in sight
• Have trouble sitting still during dinner, school, and story time
• Be constantly in motion
• Have difficulty doing quiet tasks or activities.
•  
  

• and also these manifestations primarily of impulsivity:
• Be very impatient
• Blurt out inappropriate comments, show their emotions without restraint, and act without regard for consequences
• Have difficulty waiting for things they want or waiting their turns in games

TREATMENT:

The management of ADD consists of the following methods:

a)    Behaviour modification

b)    Counselling and supportive psychotherapy

c)     Pharmacotherapy:

Stimulant medication:

                                                Dextro-amphetamine(10-14mg/day) and methylphenidate(10-60mg/day) are the drugs of choice in the treatment of hyperkinetic disorder,with a response rate of nearly 90M  %.