ADHD is a Neurodevelopmental Disorder

Goals and Objectives: As a result of Section 3, You will: Review the neuroanatomical and neurochemical advancements which have been made in the last several years which will help you to understand ADHD as a neurodevelopmental disorder. See why ADHD can have serious negative consequences for the student and his/her family when left undiagnosed and untreated.

Tell me who your friends are…. All Mental Disorders are grouped into CLASSIFICATIONS. They identify conditions that have many commonalities in terms of: Genetic Factors Neuroanatomical Deficits Co-occur And I’ll tell you who YOU are……

Attention-deficit/hyperactivity disorder In the DSM-5, ADHD was Re-classified as a Neurodevelopmental Disorder. Other Neurodevelopmental Disorders include: Intellectual disabilities Communication disorders Autism spectrum disorder Attention-deficit/hyperactivity disorder Specific learning disorder Motor disorders Other neurodevelopmental disorders Give out Criteria Set for ADHD

How is a Neurodevelopmental different than other mental health problems?

How are traits Delayed? Delay in the rate of a the development of a normal trait. What distinguishes this child from others is the degree of the delay. Will go through things others go through….but much later. Delay doesn’t mean lag. This is a chronic lag.

Brain matures a Few Years Late in ADHD, but follows Normal pattern In Slide show view, Click on the video below. You may want to watch this a few times. https://www.youtube.com/watch?v=-VRFZpJuWF4 NIH: National Institute of Mental Health, 2007, 2014

NIH: National Institute of Mental Health, 2007, 2014  front of the brain’s outer mantle (cortex), important for the ability to control thinking, attention and planning.  Otherwise, both groups showed a similar back- to-front wave of brain maturation with different areas peaking in thickness at different times. Previous brain imaging studies failed to detect the developmental lag because they focused on the size of the relatively large lobes of the brain.  NIH: National Institute of Mental Health, 2007, 2014

NIH: National Institute of Mental Health, 2007, 2014 Among 223 youth with ADHD Half of 40,000 cortex sites attained peak thickness at an average age of 10.5, compared to age 7.5 in a matched group of youth without the disorder. scanned most of the 446 participants – ranging from preschoolers to young adults – at least twice at about three-year intervals. They focused on the age when cortex thickening during childhood gives way to thinning following puberty, as unused neural connections are pruned for optimal efficiency during the teen years. NIH: National Institute of Mental Health, 2007, 2014

Circuitry in the frontal and temporal areas Areas that integrate information from the sensory areas with the higher-order functions showed the greatest maturational delay in youth with ADHD. One of the last areas to mature, the middle of the prefrontal cortex, lagged five years in those with the disorder. NIH: National Institute of Mental Health, 2007, 2014

What is Delayed? Inhibition: The ability to stop what you are doing Normally develops in preschool years 1st sign is often hyperactivity…..lots of action, lots of words…. Intrusive and disruptive Quickness: do the first thing that comes into their head

What is Delayed? Restlessness declines with age…..by adolescence….nearly gone. by adolescence….it’s an internal state…restless quality.

The motor cortex emerged as the only area that matured faster than normal in the youth with ADHD, in contrast to the late-maturing frontal cortex areas that direct it.

Emotional Upheaval Quickness To Anger Low Frustration Tolerance Display Emotions Much More Quickly Than Others. Failure To Regulate Normal Emotions

11 times more likely to develop Oppositional Defiant Disorder within the onset of ADHD symptoms. ADHD causes ODD…..half of ODD is the inability to manage frustration, impatience and anger. (anger, temper, hostility easily annoyed, irritability.)