Case Study
Liam is a 7-year-old Grade 2 student who lives with his parents and younger sister. He is a friendly and energetic child who enjoys sports and spending time with friends. However, his teacher reports that Liam has significant difficulty staying seated in class and is constantly fidgeting, tapping his feet, or playing with objects on his desk. He often blurts out answers before questions are finished, interrupts classmates, and struggles to wait his turn during activities. Liam frequently leaves his seat during lessons and is described as always being “on the go.” At home, his parents report similar behavior, noting that he runs through the house, climbs on furniture, and has difficulty sitting still during meals. Although Liam understands the rules and performs at grade level academically, his impulsive and hyperactive behavior has been present since preschool and occurs both at school and at home.
Liam is diagnosed with ADHD, with Hyperactivity-Impulsivity presentation
What are the three prominent characteristics of ADHD?
Inattentive, hyperactive, and impulsive
What percent of children with ADHD have a comorbid disorder? Bonus points: What percent have 2+ comorbid disorders?
80%; 50%
This class of medications is most commonly used for the treatment of ADHD
What are stimulants?
Nancy is a 13-year-old Grade 8 student in Norman who lives with her parents and older sister. She was referred for evaluation due to ongoing concerns with attention and task completion. Nancy enjoys arts and crafts, drawing, music, swimming, and spending time on social media. However, since early elementary school, she has struggled with inattentiveness, distractibility, and disorganization. She frequently loses materials needed for assignments, forgets instructions, and has difficulty completing homework without repeated reminders. Teachers describe Nancy as cooperative and capable but note that she often seems easily distracted during tasks and takes longer than expected to finish work. Despite having average cognitive abilities, Nancy continues to struggle with reading comprehension and staying focused during academic tasks. She also reports becoming frustrated when she cannot keep up with assignments and sometimes feels anxious about school presentations and social situations. Her parents have also noticed sleep difficulties and negative self-talk, which seem to increase when she feels overwhelmed by school demands.
Nancy is diagnosed with ADHD with possible comorbidity
How long must symptoms persist in order to be diagnosed with ADHD?
6 months
About 50% of children with ADHD also have tic disorders. True or False?
False; about 20% have tic disorders
These three components make up the primary treatment approach for ADHD.
What is stimulant medication, parent management training, and educational intervention?
Jack is a 7-year-old Grade 1 student living in Toronto with his parents, both of whom have post-graduate education, and there is a family history of ADHD and other mental health concerns. He is described as intelligent, caring, and social, and enjoys spending time with friends and participating in physical activities like swimming, running, and skating. Although he generally gets along well with peers, he can be easily influenced by others, seeks attention, and becomes upset when he feels ignored. Jack has difficulty focusing, sitting still, listening, and following instructions in class, and he often blurts out answers and interrupts others even though he knows he should not. Both his parents and teacher report that he is restless and needs frequent reminders to stay on task, and he struggles to follow routines at home. He also shows emotional impulsivity, frustration, and occasional aggressive behaviors such as hitting and crying outbursts. There are behavioral concerns like aggression, lying, arguing, and disruptive behavior that were also reported when he was in preschool.
Jack is diagnosed with ADHD, combined presentation
According to the DSM-5-TR, how many symptoms must be present to diagnose a child with ADHD?
6 symptoms
What is the prevalence of ADHD in children ages 4-17 in North America?
5-9% of children
This treatment program is an 8 week intensive program.
What is the Summer Treatment Program?
Daniel is an 11-year-old who often begins homework but quickly loses focus and leaves assignments unfinished. His parents report that he frequently forgets instructions about what he is supposed to complete and often misplaces materials needed for tasks. Even when reminded, Daniel sometimes struggles to return to the activity. In the past several months, Daniel has also seemed unusually tired and unmotivated. He has stopped participating in activities he previously enjoyed, such as building models and playing video games with friends. When his parents ask about these changes, Daniel says he just doesn’t feel interested anymore.
Daniel is diagnosed with ADHD with possible comorbidity of generalized depression disorder
Which dimension is most commonly presented in the general population, but less referred to clinics?
Inattention
By kindergarten entry, children in the United States who are African American are ___ less likely to be diagnosed with ADHD than otherwise similar White children.
70%
This medication was the first non-stimulant FDA approved for the treatment of ADHD.
What is Strattera?
Lena is a 16-year-old who has recently begun having difficulty staying focused while studying and completing homework. She reports that she frequently procrastinates, becomes distracted by her phone, and struggles to complete assignments on time. Her parents say these difficulties only began within the last year after Lena started taking more challenging courses. During elementary and middle school, Lena performed well academically and had no reported attention or behavioral difficulties.
Lena does not have ADHD. Why?
Name 3 symptoms within the sluggish cognitive temp (SCT) cluster.
Daydreams, sleepy/drowsy, underactive/slow moving, tired/lethargic, easily confused, stares blankly, lost in thoughts, etc.
What comorbid disorder/behavior is more common in girls with hyperactive–impulsive behaviors than girls with inattentive behaviors?
Eating disorders and self harm
This medication schedule is marked by only giving medication on school days.
What is a holiday schedule?