Rose YeshaADHD

Dr.RestaApril 1, 2009

 Let me see if Philip can Phillip this is cruel workBe a little gentleman Table all so bare, and ah!Let me see, if he is able Poor Papa, and Poor MamaTo sit still for once at table: Look quite cross, and wonder howThus Papa bade Phil behave; They shall make their dinner nowAnd Mamma look'd very grave.But fidgety Phil,He won't sit still;He wrigglesand giggles,And then, I declareSwings backwards and forwardsAnd tittles up his chair,Just like any rocking horse; -"Philip! I am getting cross!“See the naughty restless childGrowing still more rude and wild.Till his chair falls over quite.Philip screams with all his might.Catches at the cloth, but thenThat makes matters worse again.Down upon the ground they fall.Glasses, plates, knives, forks and all.How Mamma did fret and frown.When she saw them tumbling down!And Papa made such a face!Philip is in sad disgrace.Where is Philip, where is he?Fairly cover'd up you see!Cloth and all are lying on him;He has pull'd down all upon him.What a terrible to-do!Dishes, glasses, snapt in two!Here a knife, and there a fork!

Fidgety Phillip

Origins of ADHD

-One of the first references to a child with ADHD was “Fidgety Phil” in 1865

-This was done by the poetry of German physician, Heinrich Hoffman who wrote about many of the children he saw in practice who he believed to be hyperactive

-The first two scientific authors in establishing ADHD as a disorder were George Still and Alfred Tredgold

-They both described 43 children who had serious problems with attention.

-There were three major distinct impairments that were focused on

-1) defect of cognitive relationship to the environment

-2)defect of moral consciousness

-3) defect in inhibitory volition.

-Described physical anomalies in these children including an abnormally large head size, malformed palate, or increased epicanthal fold

-In addition he found these a these children were more prone to accidently injuries.

-Most of these (3:1) were male and under the age of 8 years old

-Proposed that the deficits in inhibitory volition, moral control and sustained attention were causally related to the same underlying neurological deficit.

-He speculated that these children had either a low threshold for response inhibition or a cortical disconnection syndrome where intellect was dissociated from will, possibly due to nerve cell changes.

-The children described by Still, and by Tredgold (1908) soon after, would today be diagnosed as suffering from ADHD

Dr. George Still

- In 1917-1918 the symptoms we associated with ADHD were given the name "Post-Encephalitic Behavior Disorder.“ This disorder was noted as a cause of brain damage.

-In the 1950’s the symtpoms associated with ADHD were coined “Hyperkinetic Impulse disorder”

-This disorder was made on the basis that the CNS was deficient in the thalamic area of affected children. This was based on the finding that Metroxol administration with flashes of light induced spikes in the EEG pattern and that hyperactive children required less metrozol to produce an affect.

-In the early 1960s, the disorder was called "Minimal Brain Dysfunction“ This disorder was established by a unitary symptom of brain damage in children.

-The decline of MBD occurred with research which recognized that there was not much neurological evidence and more specific labels were given to children such as “language disorders” “learning disabilities” and “Hyperactivity.

Timeline of ADHD

- At the end of the decade, though, the name of the disorder was changed to "Hyperkinetic Disorder of Childhood.“

-The next event that occurred for ADHD was that new symptoms were added to the criteria for diagnosis of the disorder.

-Added symptoms were lack of focus and spaceyness . Impulsiveness now included verbal, cognitive and motor impulsiveness.

-In 1980, the disorder was given its current name of Attention Deficit Disorder, with or without hyperactivity.

-This was documented in the DSM-III. ADD and ADHD were two different diagnoses.

-Next, in 1987, ADD was changed to Attention Deficit Hyperactivity Disorder. The American Psychiatric Association stated that this was a medical diagnosis, and not only psychological.

-In 1996, a new medication called Adderall was approved by the FDA for the treatment of ADHD.

-In 1999, other medications were added to treat ADHD such as Concerta.

-In 2003, Strattera was introduced as the first ADHD medication that was not a stimulant. This drug increases the amount of norepinephrine in the brain.

RX

http://www.youtube.com/watch?v=q3d1SwUXMc0

References

1) Barkley, R. A. (2006). Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment (3rd ed., pp. 3-12). New York: The Guilford Press.

2) http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/complete-index.shtml

3) http://www.youtube.com/watch?v=q3d1SwUXMc0&feature=player_embedded