Problem 1: ADHD & ASD
What is ADHD?
Attention deficit hyperactivity disorder (ADHD) = a persistent pattern of inattention
and/or hyperactivity-impulsivity that is at a significantly higher rate than would be
expected for a child at their developmental stage
Lack of attention in academic, occupational, or social situations
→ not completing tasks
Hyperactivity manifests as excessive fidgeting, not remaining seated, excessive
running/climbing
Impulsivity manifests as impatience, difficulty in appropriately delaying responses,
interrupting others
→ desire for immediate rewards over delayed rewards
The consequences of ADHD
Their attentional deficits and hyperactivity may make them prone to:
1. Temper outbursts
2. frustration
3. bossiness
4. stubbornness
5. changeable moods
6. poor self-esteem
Family members often see their behavior as intentional and irresponsible → can cause
resentment within the family
Predominantly inattentive symptoms → suffer most in terms of academic
achievements
Predominantly hyperactivity/impulsivity symptoms → most peer rejection and
accidental injuries
Problem 1: ADHD & ASD 1
, In general → difficulty making friends, often singled out and rejected
In adulthood → less success and safety at work, poorer interpersonal relationships,
poorer academic outcomes, poorer general life satisfaction
Theory of mind = the ability to understand one’s own and other people’s mental states
Some theorists argue that children with ADHD have a TOM deficit
→ however studies have shown an executive functioning deficit, rather than a deficit in
social functioning
Diagnosis of ADHD
Are there any criteria that are unclear?
DSM-5 Criteria:
An ongoing pattern of inattention and/or hyperactivity and impulsivity that interferes
with normal functioning or development, as marked by the following:
At least six of the following for at least six months:
Not paying close attention to details or making careless mistakes
Difficulty in maintaining attention in activities
Does not listen when spoken to directly
Ignores instructions
Has difficulty organizing
Dislikes or avoids tasks which require sustained mental effort
Loses things needed for tasks
Easily distractible
Forgetful in daily activities
Hyperactivity and Impulsivity. At least six of the following for at least 6 months:
High level of fidgeting
Not sitting still or leaving seat when expected to it
Problem 1: ADHD & ASD 2
, Runs or climbs in situations where it is inappropriate
Unable to engage in activities quietly
Excessive talking
Blurts out an answer before the question is finished
Has difficulty awaiting their turn
Interrupts or intrudes on others frequently
Symptoms were present before the age of 12
Symptoms are present in at least two settings
Symptoms reduce the quality of educational, social, or occupational ability
Symptoms do not occur during schizophrenia or another psychotic disorder and are not
better explained by another mental disorder
Types of ADHD:
1. ADHD, predominantly inattentive presentation (6< Inattention, 6>
Hyperactivity/Impulsivity)
2. ADHD, predominantly hyperactive/impulsive presentation (6> Inattention, 6<
Hyperactivity/Impulsivity)
3. ADHD, combined presentation
Comorbidity:
Around 50% of those with combined representation will also be diagnosed with
Oppositional defiant disorder or conduct disorder
→ ADHD is associated with the violation of social norms and the basic rights of others
ADHD can be distinguished from conduct disorder, those with conduct disorder are
likely to:
1. Be more aggressive
Problem 1: ADHD & ASD 3
, 2. Live in families with a lower socioeconomic status
3. Have parents who also exhibit antisocial behavior
ADHD can lead to earlier onset of conduct disorder
→ a vicious cycle where their disruptive behavior causes aggressive reactions in others,
and this evokes aggressive and antisocial reactions in the sufferer
Epidemiology:
5% of school-age children → half will carry the diagnosis into adulthood
2.5% of adults
More common in boys in childhood → boys are more likely to be referred for treatment
(identification of girls with ADHD has been hampered by parental and teach bias)
The causes of ADHD
Biological explanations: GENETICS
One of the most heritable psychiatric disorders
→ twin studies report around 76%
Region of chromosome 16 has the most linkage evidence
Any individual gene variant must have a very small individual effect
Genes identified underlie abnormalities in neurotransmitter systems → dopamine,
norepinephrine, and serotonin systems
There is a genes-environment interaction
Biological explanations: NEUROSCIENCE
Children with ADHD have smaller brains and develop more slowly
→ frontal, parietal, temporal, and occipital lobe
Brain areas with decreased volume
Problem 1: ADHD & ASD 4
What is ADHD?
Attention deficit hyperactivity disorder (ADHD) = a persistent pattern of inattention
and/or hyperactivity-impulsivity that is at a significantly higher rate than would be
expected for a child at their developmental stage
Lack of attention in academic, occupational, or social situations
→ not completing tasks
Hyperactivity manifests as excessive fidgeting, not remaining seated, excessive
running/climbing
Impulsivity manifests as impatience, difficulty in appropriately delaying responses,
interrupting others
→ desire for immediate rewards over delayed rewards
The consequences of ADHD
Their attentional deficits and hyperactivity may make them prone to:
1. Temper outbursts
2. frustration
3. bossiness
4. stubbornness
5. changeable moods
6. poor self-esteem
Family members often see their behavior as intentional and irresponsible → can cause
resentment within the family
Predominantly inattentive symptoms → suffer most in terms of academic
achievements
Predominantly hyperactivity/impulsivity symptoms → most peer rejection and
accidental injuries
Problem 1: ADHD & ASD 1
, In general → difficulty making friends, often singled out and rejected
In adulthood → less success and safety at work, poorer interpersonal relationships,
poorer academic outcomes, poorer general life satisfaction
Theory of mind = the ability to understand one’s own and other people’s mental states
Some theorists argue that children with ADHD have a TOM deficit
→ however studies have shown an executive functioning deficit, rather than a deficit in
social functioning
Diagnosis of ADHD
Are there any criteria that are unclear?
DSM-5 Criteria:
An ongoing pattern of inattention and/or hyperactivity and impulsivity that interferes
with normal functioning or development, as marked by the following:
At least six of the following for at least six months:
Not paying close attention to details or making careless mistakes
Difficulty in maintaining attention in activities
Does not listen when spoken to directly
Ignores instructions
Has difficulty organizing
Dislikes or avoids tasks which require sustained mental effort
Loses things needed for tasks
Easily distractible
Forgetful in daily activities
Hyperactivity and Impulsivity. At least six of the following for at least 6 months:
High level of fidgeting
Not sitting still or leaving seat when expected to it
Problem 1: ADHD & ASD 2
, Runs or climbs in situations where it is inappropriate
Unable to engage in activities quietly
Excessive talking
Blurts out an answer before the question is finished
Has difficulty awaiting their turn
Interrupts or intrudes on others frequently
Symptoms were present before the age of 12
Symptoms are present in at least two settings
Symptoms reduce the quality of educational, social, or occupational ability
Symptoms do not occur during schizophrenia or another psychotic disorder and are not
better explained by another mental disorder
Types of ADHD:
1. ADHD, predominantly inattentive presentation (6< Inattention, 6>
Hyperactivity/Impulsivity)
2. ADHD, predominantly hyperactive/impulsive presentation (6> Inattention, 6<
Hyperactivity/Impulsivity)
3. ADHD, combined presentation
Comorbidity:
Around 50% of those with combined representation will also be diagnosed with
Oppositional defiant disorder or conduct disorder
→ ADHD is associated with the violation of social norms and the basic rights of others
ADHD can be distinguished from conduct disorder, those with conduct disorder are
likely to:
1. Be more aggressive
Problem 1: ADHD & ASD 3
, 2. Live in families with a lower socioeconomic status
3. Have parents who also exhibit antisocial behavior
ADHD can lead to earlier onset of conduct disorder
→ a vicious cycle where their disruptive behavior causes aggressive reactions in others,
and this evokes aggressive and antisocial reactions in the sufferer
Epidemiology:
5% of school-age children → half will carry the diagnosis into adulthood
2.5% of adults
More common in boys in childhood → boys are more likely to be referred for treatment
(identification of girls with ADHD has been hampered by parental and teach bias)
The causes of ADHD
Biological explanations: GENETICS
One of the most heritable psychiatric disorders
→ twin studies report around 76%
Region of chromosome 16 has the most linkage evidence
Any individual gene variant must have a very small individual effect
Genes identified underlie abnormalities in neurotransmitter systems → dopamine,
norepinephrine, and serotonin systems
There is a genes-environment interaction
Biological explanations: NEUROSCIENCE
Children with ADHD have smaller brains and develop more slowly
→ frontal, parietal, temporal, and occipital lobe
Brain areas with decreased volume
Problem 1: ADHD & ASD 4
