DNE: Lecture 1**

• Attention Deficit Hyperactivity Disorder (ADHD)


  Neurodevelopmental disorder with problems in attention, hyperactivity, and impulsivity that are not appropriate for the person's age
• ADHD begins in childhood and can continue through adulthood
• Criteria A - Inattention


  • Failure to pay close attention to details or makes careless mistakes
  • Trouble keeping attention on tasks or play activities
  • Often does not seem to listen when spoken to
  • Does not follow through with instructions and fails to finish schoolwork, duties, etc.
  • Trouble organizing activities and tasks
  • Avoids, dislikes, does not want to do things that take a lot of mental effort
  • Often loses things
  • Easily distracted
  • Forgetful in daily activities
• Criteria B - Hyperactivity/Impulsivity


  • Fidgets with hands or feet in seat
  • Out of seat behavior
  • Excessive running or climbing when inappropriate
  • Trouble playing or doing leisure activities quietly
  • Always seeming to be "on the go"
  • Talks excessively
  • Blurts out an answer before a question has been completed
  • Trouble waiting
  • Interrupts or intrude others
• Impact of ADHD in Early Childhood

  • Academic underachievement
  • Poor relationships with family, friends and teachers
  • Injuries
• Causes of ADHD


  • Genetics
  • Environmental factors (alcohol intake, smoking, low birth weight, premature birth, infections, exposure to high level of lead during early childhood, traumatic brain injury)
• Most children with low birth weight do not develop ADHD
• Other possible causes


  • Food allergies
  • Watching too much TV
  • Ineffective parenting
  • Poor schooling
  • Dysfunctional family life
  • Infections
• Possible causes of ADHD

  • Low birth weight, premature birth
  • Infections
  • Exposure to high level of lead during early childhood
  • 30% of traumatic brain injury later develop ADHD
• There is no "cure" for ADHD
• Evidence based treatments for ADHD

  • Medication
  • Behavior therapy
  • Combination of medication and behavioral treatment for comorbid cases
• Medication for ADHD


  Stimulants that decrease impulsivity and hyperactivity and increase attention
• Like any medication, there may be side-effects
• Different stimulant formulations work best for different children
• Limitations of stimulant treatment

  • Individual differences in response - Not all children respond (approximately 80%)
  • Limited impact on domains of functional impairment
  • Does not normalize behavior
  • Family problems beyond the scope of medication
  • No long-term effects established
  • Long-term use is rare
  • Limited parent/teacher satisfaction
  • Some families are not willing to try medication
• Behavior therapy for ADHD

  • Parent training
  • Behavioral classroom management
  • Intensive treatment programs
• Combined treatment (medication and behavior therapy) was superior in terms of parent and teacher satisfaction, normalization of child behavior, and improvements in functional outcomes like family interactions, peer relationships, and academic functioning
• Sensory Integration


  • Visual
  • Auditory
  • Tactile
  • Postural control
  • Equilibrium
• Sensory integration theory


  The neural mechanisms of sensory modulation are adaptable, with direct treatment, sensory reactivity of the child may be diminished
• Sensory Integration Training - Visual


  • Bubble Tubes
  • Dome Acrylic Mirror
  • Spiral Tube
• Sensory Integration Training - Auditory


  • CDs
  • Musical Bells
  • Musical Shape Shakes
• Sensory Integration Training - Tactile


  • Magic bag hides different textures of fruit
  • Shaving cream
  • Bubble Wrap
  • Brush
  • Toothbrush
  • Hand cream
  • Mud
  • Sponge
  • Sensory ball
  • Eggsercizers
• Sensory Integration Training - Equilibrium


  • Barrel Roll
  • Swing
  • Trampoline
  • Rocking Board
  • Bumpy Multi-purpose ball
  • Step Rocking boat
  • Scooter Board
• Sensory Integration Training - Postural control


  • Weighted blanket
  • Bean bag