10. Brain function
Our brain has many neurons that are packed into
various regions of the brain. Each region has a job and
is responsible for a particular function of our body.
Some help us interpret things so we know what to say
or do and some interact within our body and help
regulate the function of our organs. Neurotransmitters
are produced by the neurons in tiny quantities. Their
job is to be message carriers. They stimulate the
appropriate neuron in the brain so that the message
that is needed will reach the brain region it is destined
for.

11. Definition
Attention Deficit Hyperactivity Disorder (ADHD), sometimes called Attention
Deficit Disorder (ADD), involves hyperactivity, difficulty paying attention and
. a tendency to act impulsively
Attention deficit hyperactivity disorder (ADHD) is one of the most
common childhood disorders and can continue through adolescence
and adulthood. According to Oakland and Brue (2002), “From 6% to 8%
of school-aged children (approximately 2 to 3 million) are affected in the
United States.” Treatment of ADHD ranges from many types of
medications that are stimulants to more natural remedies. In this study
we will take a look at our brain and how it functions with ADHD, the
symptoms of ADHD, treatment options as well as ways to support
. children with ADHD

12. Objectives
To describe a child with ADD/ADHD
To explain the signs and symptoms of ADD/ADHD
To discuss the types of teaching tips

13. Prevalence
. begins in childhood and can affect all areas of a patient’s life
of school-aged children-2 million children in the US (National Institute 5% - 3%
((of Mental Health (NIMH
Boys outnumber girls 3 to 1 (Mental Health America) However, girls may be
.under diagnosed

14. Defining ADHD: Symptoms
•Often fidgets or squirms about when seated
•Is easily distracted
•Talks out of turn
•Has trouble with follow through
•Has difficulty staying on task
•Shifts rapidly from one task to another without
completing first task or activity
•Seems unable to play quietly
•Talks excessively
•Frequently interrupts or intrudes
•Seldom listens attentively
•Is disorganized: loses assignments, pencils, toys.
•Often seems unaware of consequences and so
engages in potentially dangerous behavior. (Allen &
Bowdery, 2010)

15. Three Major Types
(Predominantly inattentive (ADHD/I
(Predominantly hyperactive/impulsive ADHD (ADHD/HI
Combined ADHD

16. (Predominantly inattentive (ADHD/I
difficulty paying attention
struggles to concentrate and complete tasks forgetful and easily distracted
poor organizational skills, lethargic, sluggish, shy, anxious or constantly
daydreaming
most often diagnosed in adolescent girls, and is diagnosed if six or more
symptoms of inattention have persisted for more than six months, according to
(.the American Psychiatric Association (APA

17. Combined ADHD
Combines symptoms of the other two forms of ADHD
. the most common form of ADHD
. diagnosed in boys of elementary-school age
diagnosed when six or more symptoms associated with each of the two major
.forms of ADHD are present

18. Predominantly hyperactive/impulsive ADHD
((ADHD/HI
difficulty controlling behavior, with an increased risk for
serious aggressive or oppositional behavior and antisocial
. conduct
. fidget and excessively restless
. blurt out comments that are inappropriate and often do not think before they act
diagnosed if six or more symptoms of hyperactivity and impulsivity have persisted for
.more than six months

19. Causes
Change in the brain structure
Genetic & heredity
(Mother is exposed to chemicals during pregnancy (smoke, alcohol, drugs
Child exposed to chemicals at young age
(environmental toxins – PCBs or Lead)
Gender – boys are 3x more likely than girls

20. Positive Traits
Creativity
Flexibility
Enthusiasm and spontaneity
Energy and drive

21. Treatment
Education for the child and family
Psychological intervention
Drug treatment or natural remedies

22. Drug Treatments
The most popular drug •Popular stimulants
treatments are stimulants.
“Stimulant medications work by include:
causing the brain to synthesize Ritalin
more nor epinephrine; non
stimulants work by slowing the
Concerta
rate at which nor epinephrine is Aderall
broken down. Once the level is •Non stimulant:
where it should be the brain
functions normally,” (Silver, Straterra
2006).

23. Natural Remedies
Dietar y supplements are easily accessible and with
relatively no side affects. Essential fatty acids are
among the most popular. Essential fatty acids (Omega
3’s) are needed for proper cerebral functioning and
may aid in the transmission of ner ve impulses. Many
children with ADHD cannot absorb essential fatty
. acids nor mally
Herbal medications such as Ginkgo Biloba are
somewhat effective for disorders such as memor y
impair ment. Lemon balm is also an herbal medication
that is believed to help restore the balance and
function of the brain and ner ve cells (Br ue & Oakland,
( 2002

24. ADHD and Other Disruptive Disorders
ODD
:Diagnosis •
Similar age of onset, course •
Likely most frequent comorbidity encountered •
(Prompts specialty mental health referral (over-represented •
• Treatment implications
Family and patient education •
Raises caregiver stress more than ADHD or CD •
(Psychotherapy choices (PCIT; parenting interventions •
(Medication implications (stimulants; non-stimulant ADHD treatments •

25. ADHD and Other Disruptive Disorders
CD
• Diagnosis:
• Variations in age of onset, course
• Comorbidity with significant prognostic impact (increased risk of drug
abuse; antisocial behaviors)
• Treatment implications
• Family likely has significant other risk factors
• Psychotherapy choices (PCIT; parenting interventions)
• Medication implications (stimulants; non-stimulant ADHD treatments;
atypical neuroleptics; possibly mood stabilizers for anti-aggressive
effects)

26. ADHD and Anxiety
Disorders
GAD and SAD
• Diagnosis:
• Tease out age of onset and course of symptoms
• “Shared” symptoms (inattention, hyperactivity; academic performance
problems; sleep problems)
• Unique features (worry; fears; significant somatic complaints)
• Treatment implications
• Families may be reinforcing avoidances and fears
• Psychotherapy choices
• Medication implications (stimulants; non-stimulant ADHD treatments;
antidepressant options)

27. ADHD and Anxiety Disorders
PTSD
• Diagnosis:
• Identify stressor event
• Tease out age of onset and course of symptoms
• “Shared” symptoms (inattention, hyperactivity; academic performance
problems; sleep problems)
• Treatment implications
• Families often have significant other stressors
• Psychotherapy choices
• Medication implications (stimulants; non-stimulant ADHD treatments;
antidepressant options)

28. ADHD and Mood Disorders
Major Depression/Dysthymia
:Diagnosis •
Differentiate age of onset, course •
Shared” symptoms (inattention, academic performance problems; sleep “ •
(problems
Treatment implications •
Family and patient education •
Psychotherapy choices •
Medication implications (stimulants; non-stimulant ADHD treatments; •
(antidepressant options

29. ADHD and Mood Disorders
Bipolar Disorder
:Diagnosis •
Differentiate age of onset, course (issues of mixed presentation and of •
(rapid cycling
Shared” symptoms (attention problems; hyperactivity; increased speech “ •
(output; loud; sleep problems; academic performance problems
Unique symptoms (grandiosity; psychotic symptoms; severe mood •
lability
Treatment implications •
Family and patient education •
Medication implications (mood stabilizers; atypical neuroleptic •
medications; issue of stimulants; non-stimulant ADHD treatments;
(antidepressant options

30. ADHD and Tic Disorders
Chronic Tics or Tourette’s Disorder
• Onset of ADHD often precedes onset of Tics or TS
• Important to inquire about family history and educate parents
about stimulants and tics/TS
Treatment
• Stimulants were considered “contraindicated” in past
• Focus now on improving functioning – ADHD may be more
impairing than tics
• Complex regimens may be used, combining ADHD
medications with alpha-agonists and/or atypical neuroleptic
medications

31. A Norepinephrine Reuptake
(Inhibitor (NRI

32. Mechanism of Action

33. Strattera: Effects on Dopamine

34. :NURSING INTERVENTION
Arrange the learning environment in order to minimise distractions, e.g. seat students with ADHD away
.from windows, and take care during group work as students can become over-stimulated
.Use frequent eye contact
.Identify times and places where the student is more focused
Give frequent reminders about how much time is left to complete tasks both short-term (examinations) and
(.long-term (assignments and coursework
.Use checklists for each assignment and outline the tasks to be completed

35. Use checklists for each assignment and outline the tasks to be completed.
Ensure student attention before giving an instruction and encourage students to verbalise tasks and
instruction - first to the tutor and then silently to themselves. Emphasise critical pieces of information.
Include a variety of activities within programmes of study, such as questions, discussions, practical
activities, etc.
Use large fonts on handouts and provide only one or two main points to a page. Avoid the use of
illustrations that are not directly relevant to the task.
Ensure student attention before giving an instruction and encourage students to verbalise tasks and
instruction - first to the tutor and then silently to themselves. Emphasise critical pieces of information.

36. Tips for Parents
Believe in and support your child. Be consistent.
Keep things in perspective. Set a good example.
Pay attention to the siblings. Anticipate and avoid problems.
Take of yourself. Praise good behavior.
Communicate Negotiate and consult with your child.
Connect Pick your battles.

37. Great Tips
Be informed. Make directions as easy to follow as
possible.
Move toward a project-based classroom.
Monitor progress.
Offer choices.
Use alternative assessments to measure
Give kids the tools to compensate for learning.
shortcomings.
Ask for help.

38. Resources
Your Total Health http://yourtotalhealth.ivillage.com/relationships
ADD & ADHD in Children: Recognizing the Signs and Symptoms
http://www.helpguide.org/mental/adhd_add_signs_symptoms.htm
Teaching Children with ADD/ADHD
http://www.teachervision.fen.com/add-and-adhd/teaching-methods/5314.html
- PlayingForChange. (n.d.(. YouTube - Broadcast Yourself. . YouTube
Broadcast Yourself. . Retrieved February 7, 2011, from http://youtube.com
You tube was used for various illustrations of the brain as well as demonstrations of brain
.gym movements
. MD, L. S. (n.d.(. Attention deficit diagnosis and treatment information. ADDitudeMag
Retrieved February 7, 2011, from http://attitudemag.com
ADDitute Mag is an online magazine. This resource helps caregivers and parents
.understand how to "live well" with ADHD