Jacqueline Corcoran, Ph.D.

from: Corcoran, J., & Walsh, J. (2012 2nd ed.). Mental Health in Social Work: A Casebook on Diagnosis and Strengths-Based Assessment. Boston: Allyn & Bacon and updated with DSM-5.

DSM-5Classified as a neurodevelopmental disorder

Persistent pattern of impulsive, hyperactive and/or inattentive behavior

6 mos.

Before 12 years

Can be hyperactive, combined presentation or inattentive only

Conceptualizationcognitive or neuro-

psychological impairment that

is manifested in terms of self-

regulation, behavior inhibition,

and self-control

Prevalence7.8% among children aged 4-17

The lifetime prevalence rate in adults is 8.1%

more prominent among boys by a 2.5:1 ratio

Multi-Modal Treatment Study of

Children with Attention Deficit

Hyperactivity Disorder - only

31.8% of the participants had a

diagnosis of ADHD alone

Co-morbidity

CourseAbout a third (36%) of childhood cases continue into adulthood

70-90%

Genetic influence

Behavioral TherapyChildren learn pro-social behavior through positive reinforcement

Parents are taught to respond to children’s negative behaviors by ignoring or punishing

Parents are taught through didactic instruction, behavioral rehearsal, modeling, and role plays.

12 sessions in either individual or group

Psychoeducation

Primary psychostimulant drugs

are methylphenidate, the

amphetamines, and pemoline

majority of children (71%) with

ADHD take methylphenidate

(Ritalin)

Medication

AlternativesBupropion (Wellbutrin)

Atomoxetine (Strattera), a selective norepinephrine reuptake inhibitor

Concerns with medication

Benefit not diagnostic

Young children’s prefrontal cortex not developed

does not appear to alter the adolescent or adult outcome of ADHD

a majority of participants (64%) experienced any side effect, and a proportion (14%) suffered moderate-to-severe side effects

negative effect of stimulant treatment on growth

for non-stimulant medications, short-term safety data are lacking

lack of long-term evidence that medication is safe when taken over a number of years.

Criteria’s relevance to girls

GPs often involved with diagnosis

Drug company involvement

Prevalence rates higher in US than other developed countries