00:01
In this lecture, we will discuss attention
deficit hyperactivity disorder.
00:06
ADHD or attention deficit hyperactivity
disorder is sometimes also called ADD
or attention deficit disorder
when there is less hyperactivity.
00:17
So there are really a few
different types of ADHD
and I want to discuss
them with you.
00:24
It’s basically, in general, an impairment
in functioning in at least two settings.
00:29
Usually, home and school, due to
impulsivity, inattention, or hyperactivity.
00:36
So let’s discuss the three major types.
00:39
We have the combined type
which is the most common.
00:42
Patients with this problem have
difficulty with attention and focus
and have some hyperactive
or impulsive behavior.
00:50
In the inattentive type, which
is the second most common,
they may have difficulty
with attention,
but there is no significant
hyperactive or impulsive behaviors.
00:59
And then in the hyperactive-impulsive
type which is less common,
there’s less problems with attention
and it’s more common
maybe in preschoolers
where they mostly have the
hyperactive component.
01:12
So there seems to be some genetic
predisposition to this problem.
01:17
Boys are much more likely than
girls to get the problem.
01:20
A child of a parent with ADHD has a 25%
chance of developing ADHD themselves.
01:28
Also, there is a 55-90%
monozygotic twin concordance.
01:33
In other words, there seems to be
some strong genetics at work here.
01:37
There are also syndromes that are genetic
that are predisposed to developing ADHD.
01:44
Children with Klinefelter’s, children
with Turner’s, children with fragile X,
children with
neurofibromatosis type 1
or Williams syndrome or
even DiGeorge syndrome
are at increased risk for attention
deficit hyperactivity disorder.
01:59
So there are also, however,
environmental factors at work.
02:05
Patients with lower socioeconomic
status are more prone to the problem,
as our patients with parents
who have mental disorders.
02:13
Children in foster care are
more likely to have ADHD.
02:17
Children who were of low birth weight or
prematurity are more likely to have ADHD.
02:21
And children with acquired traumatic
brain injury may develop ADHD.
02:27
So ADHD may present differently
depending on the age
at which that child is being
brought to attention.
02:34
In the preschool era, hyperactivity
is usually a larger component.
02:39
These patients may be impulsive.
02:41
They are not flexible
with their environment.
02:44
In other words, if something
has significantly changed,
they don’t tolerate
it very well.
02:48
And they may be aggressive
with their peers.
02:51
In the elementary school era,
these children now start to
struggle with listening in class.
02:56
They have poor organizational skills.
02:59
They struggle with social interaction.
03:01
And they may have difficulty
functioning independently.
03:04
And as adolescents,
they have a problem
with academic demands.
03:11
As high school starts and these children
have increased responsibility academically,
they can really start to struggle.
03:18
And they can start to
struggle with attention,
learning, and even executive functioning.