Understanding ADHD Webinar Notes

Introduction

• Speaker: Lisa Burke, Department of Rural Health, University of Melbourne
• Acknowledgment of traditional owners of the land and respect to Aboriginal and Torres Strait Islander people.
• Introduction of Professor Dave Koval, expert in ADHD research and treatment.

ADHD Overview

• ADHD (Attention-Deficit/Hyperactivity Disorder) symptoms:
  • Hyperactivity and impulsivity (often co-occur).
  • Inattention.
• Diagnosis requires:
  • Symptoms must be persistent over time.
  • Symptoms must be pervasive across different settings (e.g., school, home).
  • Symptoms must cause significant impairment in daily life.
• Prevalence:
  • Affects approximately 5% of children and 2% of adults worldwide.
  • Often under-recognized and under-treated, particularly in females and adults.

Historical Context of ADHD

• Reference to "Fidgety Phil" and "Johnny Head in the Air" from Dr. Heinrich Hoffman's book (1845).
• ADHD has been documented throughout history.

ADHD Statistics

• Prevalence data indicate no significant increase in ADHD over time; rather, increased recognition and diagnosis.
• Approximately 800,000 Australians have ADHD.
• Diagnosis rates vary by region, with some areas over-diagnosing ADHD.

ADHD Impact

• ADHD affects various aspects of life:
  • Social and academic performance.
  • Interpersonal relationships.
  • Family dynamics and self-worth.
• Untreated ADHD leads to:
  • Poor educational attainment.
  • Difficulties in the workplace.
  • Increased risk of substance misuse and accidental injuries.
  • Higher rates of suicidal behavior and mortality.
• Economic cost of ADHD in Australia estimated at over $20 billion annually.

Causes of ADHD

• Multifactorial origins:
  • Genetic factors (high heritability).
  • Environmental influences.
  • Neurodevelopmental differences.
• No single gene for ADHD, but genetic complexities exist.

Assessment and Diagnosis

• ADHD must be assessed by trained professionals (pediatricians, psychiatrists, psychologists).
• Diagnosis should include comprehensive evaluations, not just questionnaires.
• Consideration of co-occurring disorders and differential diagnoses is crucial.

Treatment Approaches

Psychoeducation

• Understanding ADHD and its impacts is critical for management.

Medications

• Two main types of medications:
  • Stimulants (e.g., methylphenidate, dexamphetamine) are most effective.
  • Non-stimulants (e.g., atomoxetine) are less effective for core symptoms but can aid in skill development.
• Treatment should be personalized and may require trial and error.

Non-Medication Strategies

• Lifestyle changes (diet, sleep, physical activity).
• Parent and family training to improve parenting strategies.
• Cognitive-behavioral interventions to address behaviors and emotional regulation.
• ADHD coaching can provide additional support.

Importance of Community Support

• Recognizing and treating ADHD can significantly improve quality of life.
• Awareness and stigma reduction are essential for encouraging diagnosis and treatment.
• Advocacy for better services and legislative support in addressing ADHD issues.

Questions and Answers

• Strategies for teachers:
  • Seat children with ADHD at the front.
  • Provide written and verbal instructions.
  • Allow for breaks and physical activity.
• Support for parents:
  • Understand that ADHD affects a child’s abilities, not their intelligence.
  • Use positive reinforcement rather than punishment.
• Addressing childhood trauma's relationship with ADHD:
  • Children with ADHD may experience higher levels of trauma.
• Workplace accommodations for adults:
  • Similar strategies as for children, including understanding and support from colleagues.

Conclusion

• Overall, ADHD is a complex and common disorder with significant impacts.
• Continued awareness, support, and advocacy are crucial for improving recognition and treatment.