Verified Test Materials
Standardized ADHD assessment scales - Needed from several different resources
(parents, caregivers, teachers, childcare programs, and/or sports and coaches). to ensure
impairment in multiple domains, and other pertinent evaluations, such as school testing and
psychological or other mental health evaluations
Genetics - Research indicates that it is primarily a genetic disorder with environmental
factors that modulate the biochemical predisposition
Neurobiological - Structural and functional imaging demonstrate smaller brain volume in
the accumbens, amygdala, and hippocampus in addition to the caudate and putamen regions.
Anomalous brain development (reductions in gray matter) in preschoolers 4-5 years old
correlated with behavioral symptoms.
ADHD pathophysiology - genetic variations include deletions and duplications in DNA
segment involved with manufacture and regulation of the catecholamine, neurotransmitters,
noradrenaline, and dopamine. There are also less neurotransmitters in certain brain regions.
Dopamine and noradrenaline help alert, maintain attention and appropriate internal arousal
and inhibit external distraction
Environental - Risk factors include alcohol, tobacco use during pregnancy. premature and
low birth wt exposure to lead in pregnancy or early childhood, brain injury and ACEs. Maternal
inflammation during pregnancy is theorized to cause reduced infant brain circuitry thus
affecting key pathways connecting the executive hub and deeper emotional processing regions
and affecting working memory.
Faster paced demands of society impact ADHD - longer school days, increasingly complex
tasks, higher pupil to teacher ration, more lecture vs active learning, and increased homework.
Physical exam for ADHD - general observation of childs behavior may or may not present
with in clinical setting, observe interactions with parent
Skin ADHD - cafe au lait spots, or signs of abuse
Ear Nose and Throat ADHD - signs of past recurring otitis media (scarring of TM), signs of
respiratory allergies, enlarged tonsils, sleep apnea
, Neurologic ADHD - Mental status, speech and language, motor skills, and general
cognition and mental process as appropriate for age
ADHD diagnostic screening tools - Vanderbilt ADHD scales, The ADHD rating scale IV,
Conner parent and teacher rating scales, and the child attention profile. consistent use of one is
recommended. parents and teacher complete independently
Anticipatory Guidance ADHD - routines, rules, and family relationships are key. home
should be a safe place where one feels valued, life with ADHD is stressful for the child and the
family and keeping family ties strong helps ease the stress.
Family meetings AG ADHD - provide opportunity to discuss structure, rewards, and
consequences, as well as to plan and problem solve.
ADHD environment management - a calm, predictable home with clear, consistent
morning and evening routines is extremely helpful for the child with ADHD. an organized place
for everyday things to go is another way to provide structure. homework observe for mental
fatigue
Areas of strength ADHD - Should be developed (music, sports, computer) rather than
always focusing on areas of weakness. Clubs, camps and appropriate work provides avenues for
development of skills and new friendships. Build self-esteem
Stimulants - adverse effects - decreased appetite, weight loss, insomnia, stomachache,
and ha/ may need cardiology if family history
non-stimulant - Atomoxetine (norepinephrine reuptake inhibitor) for children 6+ and
should be given with food. Adverse effects decreased appetite, GI complaints, somnolence,
dizziness, and mild HTN or tachy. There are some reports of liver tox and increased risk of SI.
Classroom behavior management - helps improve attention to instruction and work
productivity as well as decrease disruptive behavior, Common techniques include increased
structure with use of behavior contracts with goals and reinforcements; token economy
(earning or losing points, that can be exchanged for privileges or items); creating periodic
behavior report card daily or weekly, and or study or organizational skills training
Adaptive technology ADHD - can assist the child with ADHD and should be included in
any 504 or IEP. Examples include voice-activated and word prediction software to help with
writing papers, note taking pens that download into a computer, visual thinking tools, electronic
organizers, cellphones, or Ipads with times and reminders and a multitude of apps