Attention Deficit Hyperactive Disorder
November 7, 2013
What is attention
• Allocation of cognitive resources to external or internal stimuli
• Conscious process – consciously focusing your attention to a task
• Unconscious – focusing on something without necessarily trying to
• Different types of attention
• Sustained attention
• Constantly focusing on a task for a long period of time (10 minutes)
• Continuous performance task – used to assess attention issues
• Divided attention
• Two or more tasks at the same time
• Allocating your attentional resources to more than one task
• Selective attention
• Too many stimuli
• Focusing all your attention to only one or two stimuli
Attentional Networks (brain map from Posner, 2007)
• Boys usually diagnosed before girls
• World wide prevalence is 5.2 % (Polanczyk et al., 2007)
• Different networks in the brain that are responsible for different kinds of attention
• Orienting, alerting and executive networks working together to make this attention
Attention Deficit Hyperactivity Disorder
• Before age 7
• Problematic because symptoms generally start before age 7 but they can start before
• More than just lack of attention that defines ADHD
• Two or more settings
• Home, class, school, etc.
• Must understand that the symptoms are not happening just because of the situation
• (More likely to fidget in school than out with friends)
• Must be happening consistently between different settings
• Significant impairment in social, school, or work functioning.
• Has to interfere with the person’s life
• Three cardinal features: Inattention, Hyperactivity / Impulsivity. • Inattentive type, Hyperactive/Impulsive type or a combination of the two
• Not exclusively in children
• Familial patterns
Predominantly Inattentive Type
• Failure to pay attention to details
• Difficulty in sustaining attention
• Difficulty in listening
• Not finishing homework
• Difficulty in organizing
• No sensory problems
• Cannot allocate their attention to relevant information
• Prone to distraction
Predominantly Hyperactive-Impulsive Type
• On the go
• Excessive motor behaviour/talking
• Trouble taking turns
• Both inattentive and hyperactive/impulsive qualities
• More at risk for developing ODD/conduct disorder if ADHD develops early
How different are they?
• Do they follow different developmental courses?
• Are they associated with different forms of functional impairment?
• Are they associated with different challenges?
Different developmental courses.
• Hyperactivity-impulsivity (HI) symptoms decline from early childhood through
• Inattention symptoms decline less over increasing age.
• Inattention subtype: Age of onset is late, more girls
Associated with different forms of functional impairment.
• Hyperactive-impulsive type:
• Social-peer problems
• Self-regulation/emotion regulation • Inattentive type:
• Slow cognitive tempo
• Working memory problems
Are they associated with different challenges?
• Hyperactive-impulsive type: ODD and CD
• Inattentive type: Internalizing disorders
• Learning disability (14-40%)
• Tic Disorders
• Externalizing Disorders (CD, ODD)
• Anxiety (15-35%, 50%)
• Mood disorders
• Depression (25-30%)-clinical depression related to interpersona