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Described as a developmental disorder showing inattention, hyperactivity, and impulsivity

Three types: inattentiveness, hyperactive impulsiveness, and a combination of both

Diagnosed by a mental health professional such as a psychologist or psychiatrist, or by a primary care provider with input about behavior from family, caregivers, and teachers

Treatment includes drug therapy with stimulant medications, behavior therapy, and educational interventions.

Reference: Reed, K. (2014). Quick reference to occupational therapy (third edition). Pro-Ed.
Reference: https://www.cdc.gov/ncbddd/adhd/diagnosis.html

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No known specific cause - Potential causes: genetic, biochemical, sensorimotor, physiological, behavioral

Risk factors: birth weight less than 2lbs. 3 oz., head trauma, lead exposure, and prenatal teratogens such as alcohol, tobacco, and cocaine

Evidence suggests abnormalities in dopaminergic and noradrenergic systems, along with decreased activity or stimulation in the upper brainstem and frontal midbrain.

Reference: Reed, K. (2014). Quick reference to occupational therapy (third edition). Pro-Ed.

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ADHD persists from childhood to adolescence in 50%–80% of cases, and into adulthood in 35%–65% of cases.

32.2% of students with the combined type ADHD drop out of high school

Tradition classrooms often increase severity of symptoms.

Social/emotional immaturity may continue.

Poor acceptance by peers and loneliness

Poor prognosis in psychological development, educational outcomes, and occupational ranking.

Strong risk for psychiatric diagnosis later in life

Prognosis depends on factors such as severity of symptoms, comorbidity, intelligence, family circumstances, genetics, adversity, socioeconomic status, and treatment.

Referenece: Reed, K. (2014). Quick reference to occupational therapy (third edition). Pro-Ed.
Reference: https://chadd.org/about-adhd/long-term-outcomes/

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It is very important to have children with ADHD evaluated for mental health conditions as well as other conditions related to ADHD as these comorbidities could add to the struggle of ADHD symptoms.  Knowing other conditions and their effects are important in proper treatment as one condition could exacerbate the other.

63.8 % had at least one comorbidity

51.5 % had behavioral or conduct problems such as Oppositional Defiance Disorder or Conduct Disorder,

32.7 % had anxiety

16.8 % had depression.

13.7 % had autism

1.2 % had Tourette syndrome.

1 % had a substance abuse disorder

Reference: https://chadd.org/about-adhd/general-prevalence/
Reference: https://www.cdc.gov/ncbddd/adhd/conditions.html

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6 million (9.8%) children age 3-17 years old have been diagnosed with ADHD

Age Ranges:

3–5 years: 265,000 (2%)

6–11 years 2.4 million (10%)

12–17 years: 3.3 million (13%).

Boys are (13%) are more likely to be diagnosed with ADHD than girls (6%).

Race/Ethnicity (children ages 2-17):

8.4 % White

10.7 % Black

6.6 % Other

6.0 % Hispanic/Latino

9.1 % Non-Hispanic/Latino

Reference: https://www.cdc.gov/ncbddd/adhd/data.html
Reference: https://chadd.org/about-adhd/general-prevalence/

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Team members work together to help the child with accommodations, modifications, psychosocial, sensory, daily living activities and behavioral interventions.  The team includes professional from other disciplines such as, but not limited to, a child psychiatrist, pediatrician, clinical psychologist, family, therapist, psychotherapist, speech-language pathologist, social worker, teachers and other school staff, parent or caregiver, and occupational therapy personnel.

Reference: Reed, K. (2014). Quick reference to occupational therapy (third edition). Pro-Ed.

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Areas of assessement for occupational therapy services include ADLs, education and work, play and leisure, social participation, sensorimotor, cognitive, psychosocial, and development.

There are many assessment tools for evaluation ADHD in occupational therapy.  Some include:
ADHD Rating Scale
Attention-Deficit/Hyperactivity Disorder Test (ADHDT)
Behavior Rating Inventory of Executive Function (BRIEF)
Brown Attention Deficit Disorder Scales-for children
Child Behavior Checklist (CBCL)
Conners, 3rd ed.
Test of Variables of Attention (TOVA)

Reference: Reed, K. (2014). Quick reference to occupational therapy (third edition). Pro-Ed.

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Resources for Families, Caregivers, and Practitioners

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Resources for Families, Caregivers, and Practitioners

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Websites:
https://www.cdc.gov/ncbddd/adhd/index.html

Books:
Quick Reference to Occupation Therapy. Third Edition. By Kathlyn L. Reed. Available on Amazon.com

Organizations:
Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD)
https://chadd.org/

CHADD- Parenting a Child with ADHD Tip Sheet
https://d393uh8gb46l22.cloudfront.net/wp-content/uploads/2018/04/parenting2015.pdf

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ADHD and Me: An Animated Video for Children

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ADHD and Me: An Animated Video for Children

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Occupational Therapy Intervention- Occupations, and Contexts

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Occupational Therapy Intervention- Occupations, and Contexts

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The most common model of practice used for intervention with ADHD is the sensory integrative model, to reduce the effect of sensory, motor, and perceptual dysfunctions that contribute to ADHD. Strategies may be remedial and compensatory, including but limited to environmental modifications, caregiver education, curriculum modifications, social skills training, and behavioral strategies.

ADLs: dressing (laying clothes out in correct order of dressing), consistent routine, communication (lessen distractions, clear instruction, have child repeat directions, checklists, visual cues, encourage child to think before speaking), medications

Education/work: Assist teacher to make modifications to curriculum or instruction, recommend modifications to the environment to decrease distractions, help parents identify homework barriers at home

Play/leisure and social participation:  activities involving play with peer and practitioner to encourage and facilitate appropriate social functioning and interaction, provide feedback on appropriate social interactions and rule following

Environment: remove distractions

Contexts: Teacher and family education and recommendations

Reference: Reed, K. (2014). Quick reference to occupational therapy (third edition). Pro-Ed.

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Childhood ADHD: What are the signs and symptoms?

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Dr. Blanca Fresno of Children's Physicians Medical Group (CPMG) explains the signs, symptoms and treatment for the different types of childhood ADHD.

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1. What are the main symptoms of ADHD?
a. distracted, emotional outburst, bad grades
b. inattention, hyperactivity, impulsivity
c. oppositional behavior, emotional lability, confusion
d. hyperactivity, confusion, disorganization

2. When working with a child who has ADHD in a school setting it is best to:
a. have the child complete all work before allowing a break
b. Let he/she play with a sensory kit
c. remove as many distractions in the environment as possible and allow breaks in between assignments
d. Reprimand the child while he/she is having a behavior episode

3. All of the following interventions can be used with children who have ADHD except:
a. visual cues and schedule
b. calming techniques
c. social skills play group
d. administer medication

Answer Key: 1.b, 2.c. 3.d

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Parents of children with ADHD often struggle with behaviors at school, getting school and homework done, emotional outburst, and oppositional behavior.  This may lead to parents experiencing stress, depression, and exhaustion.
Ways to help your child and yourself:
*Learn about ADHD
*Get the child an assessment
*Seek out services
*Become your child's educational advocate: form a team, know educational rights and policies, collaborate and communicate with the school
*Join a support group or see professional help
*Tools for discipline management
*See the Parenting Tips PDF in the resourse section below

Reference: https://chadd.org/for-parents/overview/

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Client Factors and Performance Skills Addressed According to the OTPF-4

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Client Factors and Performance Skills Addressed According to the OTPF-4

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Occupations: ADLs, educuation and work, play and leisure, social participation

Environmental factors: Natural environment, distractions, support and relationships, attitudes, services and policies

Personal factors: Age, upbringing and lifestyle, habits, behavioral patterns, comorbidities

Performance patterens: Habits, roles

Performance skills: Sensorimotor, Cognitive, Psychosocial

Reference:Reed, K. (2014). Quick reference to occupational therapy (third edition). Pro-Ed.
Reference: American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process fourth edition. American Journal of Occupational Therapy 74 (suppl. 2)

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Occupational Therapy Intervention- Performance Skills and Client Factors

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Occupational Therapy Intervention- Performance Skills and Client Factors

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Sensorimotor: decrease sensory defensiveness and increase body awareness, increase motor coordination, increase motor planning, activities to enhance tactile/proprioceptive/vestibular processing, eye-tracking activities, coordination, posture

Cognitive: enhance persistence and attention (feedback, redirection, attainable goals, breaks, behavior management program), organization (checklist, visual cues, set up supplies, removed un-needed supplies and distractions), increase safety awareness, time concept (alarms, timers, schedule)

Psychosocial: inhibit impulsivity (encourage slow movements and pre-planning, calming techniques, adult support), social skills training (practice peer relationships, clear boundaries and instruction)