Attention Deficit Hyperactivity Disorder Handbook (eBook)

Preface 5
Acknowledgments 7
Contents 8
1 Definition and History of ADHD 15
Brain Damage Syndromes 15
Alternative Terms for ADHD 16
Evolution of Present Concept of ADHD 16
Diagnostic Criteria for ADHD Subtypes 17
Further Diagnostic Criteria 17
ADHD, a Continuum or Medical Syndrome 18
ADHD, a Medical Deficit or Social Deviance 18
Prevalence of ADHD and Gender Factor 19
Age of Onset of ADHD 19
Summary 20
References 20
2 Causative Factors 22
Etiological Classification 22
Evidence for a Neurological Basis for ADHD 23
Role of Genetic Factors in Etiology of ADHD 25
Chromosomal Anomalies Associated with ADHD 26
Molecular Genetic Studies 27
Environmental Factors in Etiology 27
Role of Adverse Home and School Environments 28
ADHD in Adopted Children 28
Biochemical Basis for ADHD 29
Infectious Causes of ADHD 29
Perinatal and Early-Life Risk Factors 29
Postnatal Risk Factors 30
Head Injury as a Cause of ADHD and Learning Disorders 30
Hypoglycemia and ADHD 31
Role of Sugar and Other Dietary Factors in ADHD 31
Feingold Theory of Food Additives as a Cause of ADHD 32
Role of Food Allergy in ADHD 33
Iron Deficiency and ADHD 33
Role of Zinc in ADHD 34
Iodine Deficiency, Thyroid Function and ADHD 34
Lead Exposure as a Cause of ADHD 35
Cocaine-Exposed Infants at Risk of ADHD 36
Fetal Exposure to Alcohol, Marijuana, or Cigarettes and Increased Risk of ADHD 37
PCBs and Other Environmental Toxins as Potential Causes of ADHD 37
Role of Diet During Infancy in the Cause of ADHD 38
Summary 39
References 39
3 Symptoms and Signs of ADHD 44
Occasional Inattentiveness or an Attention Deficit Disorder? 44
Measurement of Attention 45
When Is Hyperactivity Abnormal? 46
Devices Used to Measure Motor Activity 46
Subtle or Soft Neurological Signs 47
Developmental Coordination Disorder Diagnostic Criteria 49
Relation Between Motor Performance and ADHD 50
Summary 50
References 51
4 Diagnosis and Laboratory Tests 52
Significance of History and Examination 52
Questions Asked of Parent in Making ADHD Diagnosis 52
Physical and Neurological Examinations 53
Indications for an EEG in Children with ADHD 54
Indications for an MRI or CT Scan in a Child with ADHD 54
Blood Tests Sometimes Indicated in ADHD 54
Indications for Electrocardiogram and/or Cardiac Consult 55
Tests of Research Interest Only 56
Early Risk Factors for a Diagnosis of ADHD in Childhood 56
Summary 57
References 57
5 Oppositional, Conduct, and Other ADHD Comorbid Disorders 59
Oppositional Defiant Disorder 59
Conduct Disorder 59
Mood Disorders 60
Anxiety Disorders 61
Prevalence of Psychiatric Disorders Among Children with ADHD 61
Relation Between Oppositional Defiant and Conduct Disorders and ADHD 62
Factors That Predispose to Conduct Disorders in Children with ADHD 62
Influence of an Adverse Family Environment on ADHD and Comorbid Disorders 63
Childhood Conduct Disorder and Adult Criminality 63
Relation of Mood and Anxiety Disorders to ADHD 63
ADHD and Drug Abuse Disorders in Adolescents 64
Effect of Stimulant Treatment on Risk of Drug Abuse 65
ADHD and Drug Abuse in Adults Compared to Adolescents 65
Risk of ADHD Persistence into Adolescence 66
ADHD and Risk of Early Cigarette Smoking 66
Neurological Basis for Obsessive Compulsive Disorder 66
Other Comorbid Disorders Associated with ADHD 67
Aspergers Disorder (299.80) and ADHD 67
Sleep Disorders and ADHD 68
Summary 68
References 69
6 Learning and Language Disorders 71
Definitions of Dyslexia 72
Early Signs of Dyslexia 72
The Genetic Factor in Reading Disability 73
Evidence for a Neuroanatomical Basis for Dyslexia 73
Brain Imaging Scanners Used in Dyslexia Research 74
Brain Activation During Reading 75
Evidence for a Visual Pathway Disorder in Dyslexics 76
Articulatory Feedback and Disconnection Theories of Dyslexia 76
Selection of Reading Remediation Methods for Dyslexics 77
Alternative Methods of Reading Remediation 77
Computer-Based Language Exercises 78
Dietary and Pharmacological Therapies 79
Prognosis of Developmental Dyslexia 79
Writing and Arithmetic Learning Disorders 79
Influence of Gender on Attention and Learning Ability 82
Speech and Language Disorders 82
Normal Development of Speech and Language 82
Signs of Language Delay 82
Types of Aphasia and Their Treatment 82
Methods of Treatment of Aphasia 84
Summary 84
References 85
7 Tics, Tourette Syndrome, Seizures, and Headaches 88
Tics and Tourette Syndome 88
Prevalence of Tourette Syndrome 89
Causes of Tics and Tourette Syndrome 89
Genetics of Tourette Syndrome and Tic Disorders 90
Structural Brain Abnormalities and Tourette Syndrome 90
Relation of Streptococcal Infection to Tics and OCD 91
Evidence for Encephalitis as a Cause of Tourette Syndrome 91
Tourette Syndrome and Risk of Learning Disabilities 92
Bipolar Disorder and Tourette Syndrome 92
Treatment of Tourette Syndrome Complicating ADHD 93
Seizures and ADHD 95
Epilepsies Comorbid with ADHD in Children 95
Prevalence and Significance of EEG Abnormalities with ADHD 96
Stimulant Therapy in Comorbid Epilepsy/ADHD 98
Epileptiform EEG and Transient Cognitive Deficit 98
Cognitive Effects of Antiepileptic Drugs 99
EEG Localization, Epilepsy, and Learning Disability 99
Prevalence of ADHD in Children with Epilepsy 99
Behavior Disorders as a Form of Epilepsy 100
Headache Disorders and ADHD 100
Classification of Headaches 100
Prevalence of Headache in Children 101
Classifications of Headache Diagnoses Compared 102
Diagnostic Modifications for Pediatric Migraine 102
Indications for MRI or CT in Children with Headaches 104
Treatment of Headaches with ADHD 104
Psychological Interventions in Management of Headaches 104
Summary 105
References 105
8 Methods of Management of ADHD 108
American Academy of Pediatrics Clinical Practice Guidelines 108
Principal Forms of Therapy of ADHD 110
Roles of the Psychologist and Psychiatrist in the Management of the Child with ADHD 110
Physicians Role in Helping the Parents to Understand and Deal with the Problem of ADHD 111
Useful Advice for Parents in Management of ADHD 111
Motivational Techniques Emphasized in Parent Counseling and Training Sessions 112
The Childs Involvement in Management of ADHD 113
Behavior Modification Therapy: Methods and Results 113
The Role of the Teacher and School System in the Management of ADHD 114
Federal Laws Relating to Educational Rights of Children with ADHD 114
Classroom Accommodations for Children with ADHD and Learning Disorders 115
Public School Special Education Placements for Children with ADHD 115
Professional Support Services in Public Schools 116
Indications for a Private or Therapeutic School Education for Children with ADHD 117
Role of the Tutor in the Education of the Child with ADHD 117
Resource Groups and Associations Available to Parents for Information on ADHD and Learning Disabilities 117
Summary 119
References 119
9 Medications for ADHD 121
Stimulant Medications Recommended for Treatment of ADHD 121
Paradoxical Calming Effect of Stimulant Medications 122
Specific Benefits of Stimulant Medication in ADHD 123
ADHD Patients Most Likely to Respond to Stimulant Medication 124
Creativity and Flexibility of Thinking During Treatment with Methylphenidate 124
Relation of the Dose of Methylphenidate to the Response of ADHD Symptoms 124
Twice Daily Versus Three Times Daily MPH Dose Schedule 126
Safety and Effectiveness of Methylphenidate in Preschool Children with ADHD 126
MPH Effectiveness in ADHD Adolescents 127
Child's Perspective of Stimulant Medication and Its Effect on Peer Relations 127
Duration of Action of Immediate-Release and Extended-Release Formulations of Stimulant Medications for ADHD 128
Immediate-Release MPH Formulations 128
Intermediate-Release MPH Formulations 129
Extended-Release MPH Formulations 129
Amphetamine and Other Stimulants 131
Duration of Treatment with Stimulant Medication 132
Long-Term Usage of Stimulants and Outcome of ADHD 132
Continuity of Therapy with Immediate-Release cf Extended-Release Methylphenidate 133
Multimodal Treatment Study of ADHD (MTA) 133
Prolonged Usage of MPH Through Adolescence and Young Adulthood and Risks of Motor Vehicle Accidents Related to ADHD 134
Side Effects of Stimulant Medications 134
Side Effects of Methylphenidate and Their Prevalence 134
Effect of Medication on Growth of Children with ADHD 135
Obesity in Children Untreated for ADHD 137
Mood Changes Sometimes Associated with MPH and Their Avoidance 137
Management of Tics Developing During Stimulant Therapy for ADHD 137
Behavioral Rebound Associated with MPH Treatment for ADHD 138
Methylphenidate and Exacerbation of Seizures 138
Unusual Side Effects of Methylphenidate and Other Stimulants 140
Alternative Medications to Stimulants 141
Indications for the Nonstimulant, Atomoxetine (Strattera ), Usage, and Side Effects 142
Long-Term Effects of Strattera on Growth and Blood Pressure in Children with ADHD 142
Dopamine Transporter DAT1 Genotype and Response to Atomoxetine cf Methylphenidate 143
Indications for Clonidine or Guanfacine in ADHD 143
Adverse Effects of Clonidine 144
Guidelines for Use of Clonidine in Treating ADHD 144
Well-Tried Stimulant Medications Versus Novel Less-Established Remedies for ADHD 146
Summary 147
References 147
10 Dietary and Alternative Therapies 152
Reasons Why Parents May Be Convinced of Benefits from Scientifically Unproven Treatments 152
Diets and Diet Supplements Advocated in the Treatment and Prevention of ADHD and Learning Disorders 153
Evidence for and Against a Sugar-Restricted Diet for ADHD 153
Effects of Aspartame and Diet Sodas in ADHD Children 155
Current Medical Opinion of the Additive and Salicylate-Free Diet in ADHD 156
Foods Omitted and Foods Permitted in the Feingold, Additive-Free Diet for ADHD 158
Oligoantigenic Diet for ADHD 158
Food Antigen Desensitization 159
Calming Effect of the Ketogenic Diet in Children with ADHD and Epilepsy 159
Omega-3 Fatty Acids in ADHD and Dyslexia 159
Orthomolecular and Megavitamin Therapy for ADHD and Learning Disorders 159
Mineral and Trace Element Treatment of ADHD 160
Zinc Deficiency and ADHD 161
Iron Deficiency and ADHD 161
Electroencephalographic Biofeedback (Neurotherapy) in the Treatment of ADHD 162
Vestibular and Sensory Integrative Therapy for ADHD 163
Central Auditory Evaluation and Training in ADHD 163
Scientific Basis for Music in Facilitating Learning and Attention 164
Effect of Green Play Settings in Children with ADD 165
Summary 165
References 166
11 Prognosis and Prevention 169
Do Children Outgrow Symptoms of ADHD? 169
Symptoms Associated with ADHD in Adults 170
Does Stimulant Usage in Childhood Lead to an Increased Risk of Substance or Drug Abuse Among Adolescents and Adults with ADHD? 170
Indications of a Good Prognosis in Childhood ADHD 171
Indications of a Guarded or Poor Prognosis 172
Reasons Why It Is Difficult to Predict the Outcome of ADHD 172
Preventive Measures Based on Known Potential Causes of ADHD 172
Summary 173
References 173
12 Management Roles and Research Goals 175
Parents Role in the Management of the Child with ADHD 175
Teacher and Remedial Teacher Roles 175
Role of the Psychologist 176
Role of Nurse Practitioner and Other Healthcare Providers 176
Occupational, Speech, and Social Worker Services 177
Physicians Role in Research and Improved Management of the Child with ADHD 177
Summary 178
References 178
Index 179