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Tuesday, January 4, 2011

Attention Deficit Hyperactivity Disorder


While this is a common mental health disorder for millions of children and adults, a great deal of myth and mystery surround this disorder. Typically a classroom teacher is the first to notice the symptoms. This is most likely due to the structured school environment that requires extended periods of focused concentration and attention. Some behaviors you might observe in adults include distractibility, impulsivity, trouble getting along with co worker and avoiding activities that require sustained attention. In children common behaviors are distractibility, difficulty getting along with or fitting in with peers, impulsivity or hyperactivity and very short attention span.
The DSM IV (The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) is utilized in making a formal diagnosis. Further items that are considered in making a diagnosis are the persistence of the symptoms. The symptoms must have been present over a six month period. Another factor to consider is the number and severity of symptoms. There must be a specific number of symptoms in each criterion and considered by the clinician as maladaptive. Another factor is the age when the symptoms began. The clinician must be able to determine that prior to the age of seven the symptoms were severely impairing a person’s ability to function. The last factor to consider is that the symptoms must be present in two or more settings.
In conjunction with the DSM IV, a clinician will interview client, gather a thorough history, observe client’s behavior, and utilize standardized assessment measures. Some typical standardized tests that are used include parent rating scales, teacher rating scales, self rating scales, WISC and WAIS intelligence scales and family functioning scales. The typical treatment modalities for ADHD are behavioral and cognitive. Behavioral approaches can include positive reinforcement, negative reinforcement, punishment, time out, and extinction. Cognitive approaches include contingency management, parent training, classroom behavior management, academic skills therapy, social skills therapy and multi modal therapy.
Medication is often utilized to treat ADHD. This type of treatment is often utilized when the symptoms are severe enough to impede client’s daily functioning either academically, socially or occupationally. While the research varies on whether or not this is the most effective treatment for ADHD, most clinicians agree that a combination of psychotherapy and medication is the best approach. A licensed child psychiatrist is the most qualified person to determine whether or not medication is appropriate for a minor under the age of eighteen. A licensed psychiatrist can make that determination for an adult.
Jennifer Nadelkov, LMFT

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