ADHD is diagnosed through clinical history, examination, and sometimes investigations. It is characterized by inattention, hyperactivity, and impulsivity. Treatment includes non-pharmacological options like behavior management as well as pharmacological options like stimulant medications which are the first-line treatment.

1. TUTOR CASE 3: ATTENTION
DEFICIT HYPERACTIVITY
DISORDER (ADHD)
Presented by:
Arwa H. Al-
Onayzan.
ID: 215007943.

2. LEARNING OBJECTIVES
Q5: How is ADHD diagnosed?
Q6: Which treatment options are available for ADHD?
(pharmacological and non-pharmacological).

3. INTRODUCTION
 Attention deficit hyperactivity disorder (ADHD):
 Is a disorder that manifests in childhood with symptoms of
hyperactivity, impulsivity, and/or inattention.
 The symptoms affect:
 Cognitive.
 Academic.
 Behavioral.
 Emotional.
 Social functioning

4. HOW IS ADHD DIAGNOSED?
1- History.
2- Clinical
examination
3-
Investigation.

5. 1- HISTORY
• ADHD is a diagnosis made by clinical history.
 Source of history  History from parents, teachers and other carers.
 Focus of history  Core symptoms of ADHD.
 Family history History of ADHD, substance use, and other psychiatric
illnesses.
 Developmental history  Information about pregnancy, and birth
history.
 Past medical history  Any CNS trauma or infections.
 Psychosocial history  Tensions in the home.
 Past psychiatric history  Learning disabilities, mood disorders.

6. 2- CLINICAL EXAMINATION
1- Mental status examination:
 It’s a part of the diagnostic
evaluation.
 Appearance, orientation,
cognitive.
 Signs of ADHD including:
 Motor restlessness.
 Hyperactivity.
 Inattention.
2- Neuropsychological tests:
 It’s not necessary for the
diagnosis.
 Considered in cases in which it
is important to differentiate
ADHD from:
 Learning disabilities.
 Disorders of language.
 Visual-motor, or auditory
processing.

7. 3- INVESTIGATION
• If medical history of ADHD is unremarkable  laboratory testing is
necessary.
• Some medical conditions can mimic the symptoms of ADHD:
 Traumatic brain injury.
 Encephalopathy.
 Lead exposure, or thyroid disorder.
If these are suspected, specific tests should be
ordered  patients referred to the appropriate
specialists.

8. DSM-5 DIAGNOSTIC CRITERIA FOR
ADHD
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9. CON…
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10. CON…
Reference: Diagnostic and statistical manual of mental
disorders (DSM-5)
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11. TREATMENT OPTIONS FOR ADHD
1) Non-pharmacological treatment:
 Psychoeducation.
 Anticipatory guidance includes:
• Providing proactive strategies to solve adverse effects on learning, school
functioning, social relationships, family life, and self-esteem.
 Behavioral management.
 Social skills training or additional mental health treatments.
• May assist some children with behavior change or preservation of self-
esteem.

12. CON…
2) Pharmacological treatment:
I. Stimulant medications (methylphenidate or amphetamine compounds)
are the first-line agents for treatment of ADHD.
Available in short-acting, intermediate-acting, and long-acting forms.
Preparations include liquid, tablets, capsules, and a transdermal patch.
II. Nonstimulant medications, including atomoxetine (norepinephrine-
reuptake inhibitor), guanfacine, or clonidine (alpha agonists).
Helpful in situations such as:
Nonresponse to stimulant medication or family preference.

13. CON…
Reference: Nelson Essentials of Pediatrics 7th

14. QUIZ TIME!
Q1- The first line of treatment to treat ADHD is:
A- Stimulant medications.
B- Nonstimulant medications.
Q2- Does Thomas fulfill the DSM-5 (ADHD) criteria?
A- Yes.
B- No.

15. SUMMARY
ADHD
General
informati
on.
How to
diagnose
it?
Pharmacologic
al treatment
Non-
Pharmacologi
cal treatment

16. REFERENCE
• American Psychiatric Association. Diagnostic and statistical manual of
mental disorders, 5th ed., (DSM-5). Washington, DC: American Psychiatric
Publishing; 2013.
• Pliszka S, AACAP Work Group on Quality Issues. Practice parameter for the
assessment and treatment of children and adolescents with attention-
deficit/hyperactivity disorder. J Am Acad Child Adolesc Psychiatry.
2007;46:894-921.
• Pineda DA, Puerta IC, Aguirre DC, et al. The role of neuropsychological
tests in the diagnosis of attention deficit hyperactivity disorder. Pediatr
Neurol. 2007;36:373-381.
• Attention-deficit and disruptive behavior disorders. In: Diagnostic and
Statistical Manual of Mental Disorders Fourth Edition Text Revision, 4th,
American Psychiatric Association, Washington, DC 2000. p.85.
• Marcdante, K. (2015). Nelson Essentials of Pediatrics. 7th ed. pp.41-42.