Early assessment, treatment, and family support are important for a good prognosis for ADHD.
Emergence of oppositional defiant features can escalate and become worse and more difficult to treat over months and years if there is failure to intervene
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Attention-Deficit Hyperactivity Disorder ADHD |
Common Symptoms in the Diagnosis of ADHD:
- Difficulty sitting still
- Trouble paying attention
- Inconsistent performance
- Disorganized or messy
- Easily distracted
- Difficulty completing tasks
- Trouble waiting turn
- Acts as if driven by a motor
- Frequent fidgeting
- Impulsiveness
- Distractability |
Ernest J. Bordini, Ph.D., Executive Director
Licensed Psychologist
Named a Distinguished Psychologist by the Florida Psychological Association
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This disorder is common yet, it is complex and often misunderstood. Proper diagnosis is the foundation on which effective treatment and management is based.
Children with the disorder may be described as immature, may tend to always be on the go “as driven by a motor”, may be impulsive, and frequently act before thinking. They may suffer frequent reprimands from parents and teachers. Self-esteem is at risk, and they may become rejected by peers.
Adolescents may show less overactivity, but may have difficulty meeting the increased demands of middle school. Trouble with organization, planning, and meeting increased productivity requirements are common.
Adults may continue to have difficulty tolerating routine types of work, may shift jobs more frequently, and may have difficulty attending to details and organizing. There is increased risk for marital difficulties and traffic accidents.
Associated Disorders :
Proper identification and treatment of these disorders, when present, often improves the overall prognosis
Oppositional Defiant Disorder
Motor Skill Deficits
Obsessive-Compulsive Disorders
Learning Disabilities
Anxiety
Social Skills Deficits
Low Self-Esteem
Depression
A great book in terms of strategies and understanding what it is like is Keeping a Head in School : A Student's...
For a more general understanding of the many disorders that often accompany ADHD try the following text: ADHD with Comorbid Disorders: Clinical... |
We have specialized in providing necessary services for behavior and skill deficits which accompany the disorder. A national consensus conference held in 1998 concluded that treatment involving both medication and psychotherapy was superior to either approach alone.
- Information on this Website or others should be considered educational only and is not intended to be medical or psychological advice. Decisions about the care and diagnosis of your child should be made in consultation with your medical physician or psychologist.
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The Following is an example of many articles available in our Articles and Tips section:
A DOZEN TIPS FOR RETURNING THE ADHD CHILD TO SCHOOL
by Ernest J. Bordini, Ph.D. and C. Russell Clifton. Ph.D.
1. Set up positive expectations prior to returning
2. Get the child to identify what they hope to accomplish
3.
Meet the teacher early and set up a daily, or weekly system to obtain
feedback. When there is more than one teacher have one coordinate with
the other teachers.
4. Don't overwhelm the teacher: It's far better to do a little right than to demand the impossible ideal program.
5. Set up a second meeting with the teacher to review the
child's progress.
6. Educate the teacher as to the problems encountered in the past and previously successful means of dealing with them.
7. Invite the teacher to study educational materials.
8. Ask for preferential seating near or at the front of the
class.
9. If possible schedule demanding classes in the morning.
10. Explore the possibility of reducing task length if it is
completed accurately.
11. Discuss possible rewards at home and school for staying on task.
12. Invite professionals and teachers to communicate with each other: Build a team ! |
ATTENTION-DEFICIT HYPERACTIVITY DISORDER & CO-EXISTING CONDITIONS
Ernest J. Bordini, Ph.D. , Licensed Psychologist
Presented to Chadd of Alachua County 3/21/02
ADHD
is the single most prevalent psychiatric disorder among elementary
school children. ADHD is a childhood disorder previously labeled
hyperactivity, hyperkinesis, minimal brain dysfunction, minimal brain
damage, minimal or minor cerebral dysfunction.
Prevalence rates
from 3% to 5% of school age children. Males are over representing from 5
to 10 : 1. Depending on criteria uses some researchers estimate as many
as 10-20% prevalence rates. Longitudinal studies of children with ADHD
into adolescence found continued symptoms in 20% to 80% of probands
studied.
CO-EXISTING CONDITIONS
About half of ADHD
children have a coexisting oppositional or conduct disorder. These
children show temper outbursts, argumentativeness, defiance, and
aggressiveness.
A study by Taylor et al suggested the presence of
oppositional (ODD) or conduct (CD) problems does not affect the
probability of a positive response to stimulants. Children with ADD and
CD respond to stimulant therapy just as well as those without a conduct
disorder. The same study also showed that measures of family function
had no relationship to stimulant response.
A study of 1300
children by Davidson et al., 1992, found no relationship between
symptoms of hyperactivity and injury. But the coexistence of conduct
disorder seemed to be a major risk factor in ADHD children. However, 16
to 22 year old ADHD individuals when matched with controls have almost
four times the number of motor vehicle accidents and four time the rate
of traffic citations (1993)
Nine to 10% (or more) of ADD children
have learning disabilities (Halperin 1984). Up to 30 to 40 % of
learning disabled children may also have ADHD (Levine, 1982, Hobrow,
1986). ADHD children in general tend to be behind in reading and
arithmetic (Holborow and Berfrry 1986). The frequent co-existence of
these disorders suggest that a thorough assessment be completed for
these children.
The frequency of speech and language problems is
inconsistent across studies, but are more likely to involve expressive
rather than receptive language. This might involve dysfluent speech and
problems of articulation. This more likely in those children with ADD
and LD. A finding of reduced verbal fluency in ADHD children, was
reported by Kozill, et. al., 1992.
Steven Henshaw, in a 1992
article in the JCCP, Number 60, 890 - 903 found treatment of behavior
problems in ADHD children with learning problems is often not adequate
if assistance for academic deficiencies is not provided.
Encorporesis and Enuresis are not unusual. Enuresis 43% vs 38% of matched normal children. 56% may have sleep difficulties.
ADD
children may display nonlocalized "soft" neurological signs, poor eye
hand coordination, and perceptual motor dysfunction. Slightly more than
50% ADD children have motor problems relative to a 35% base rate in
normals. They may show motor overflow, motor impersistence, and poor
handwriting. Many Perform poorly on Pegboard tasks.
Up to 25% of
ADHD meet the criteria for anxiety or phobic disorder and 1/3
preadolescent children with anxiety showed 1/3 had ADHD. Higher levels
of anxiety and depressive symptoms in children with attention-deficit
hyperactivity disorder may predict a nonresponse to stimulant
medication. However mild anxiety is not a contraindication to stimulant
treatment.
A study published in the Journal of Abnormal Child
Psychology, in 1993, followed over a thousand children for fifteen years
and found there is no greater than expected association between
allergic disorders and ADHD.
The presence and severity of ADHD
was evaluated in eighteen families with history of "generalized
resistance to thyroid hormone". About 50% of the adults and 70% of the
children met the criteria for ADHD. However, few people with ADHD have
thyroid disorders. It is suggested if ADHD difficulties are present and
there is a family history of thyroid difficulties, further evaluation
may be indicated.
Over 50% of Tourette's syndrome individuals
have attention deficit disorder but only 5% of ADHD children have
Tourette's syndrome. Tourettes children with ADD exhibited significant
differences from non ADD children on SSPT, TMT, and DS (Yates, 1994) |
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