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ADHD in Children and Adults

By
Annette U. Rickle, PhD
Ronald T. Brown, PhD

Course Outline

Attention-deficit/hyperactivity disorder (ADHD) is a common condition that affects both children and adults, and can have serious consequences for academic, emotional, social, and occupational functioning. When properly identified and diagnosed, however, there are many interventions for the disorder that have established benefits. This volume in the series Advances in Psychotherapy — Evidence-Based Practice provides therapists with practical, evidence-based guidance on diagnosis and treatment from leading experts—and does so in a uniquely “reader-friendly” manner. Readers will gain an understanding of recent advances in the etiology and symptom presentations of ADHD in children and adults, as well as the use of stimulant medications, other psychopharmacological approaches, and psychotherapeutic interventions.

The book is both a compact “how-to” reference, for use by professional clinicians in their daily work, and an ideal educational resource for students and practice-oriented continuing education. It is a compact and easy-to-follow guide covering all aspects of practice that are relevant in real-life. Tables and marginal notes assist orientation, while checklists for copying and summary boxes provide tools for use in daily practice.

About Authors

Annette U. Rickle, PhD, is Professor of Psychology at Cornell University Medical College in New York City and is in clinical practice. She received her Doctorate from the University of Michigan and is a fellow and past President of the American Psychological Association’s Society for Community Research and Action, and was a fellow of the American Council on Education. She was a Senior Congressional Science Fellow in the U.S. Senate from 1992-1994, and served on President Clinton’s Task for National Health Care Reform. Dr. Rickel has received several research awards from institutions such as the National Institute of Mental Health, as well as the MacArthur and Kellogg Foundations. She has been Consulting Editor for the American Journal of Community Psychology, the Journal of Community Psychology, and the Journal of Primary Prevention, and serves on the Board of Directors of many non-profit organizations. Dr. Rickel has authored or coauthored six books, numerous research articles, and chapters that deal with early intervention programs for individuals at high risk for psychopathology.

Ronald T. Brown, PhD, ABPP is Professor of Public Health, Psychology and Pediatrics and is Dean of the College of Health Professions at Temple University. Dr. Brown is a diplomate in Clinical Health Psychology of the American Board of Professional Psychology, and is a fellow of the American Psychological Association, the American Psychological Society, the Society of Behavioral Medicine, and the National Academy of Neuropsychology. Dr. Brown has been the recipient of numerous grant awards from the National Institutes of Health, the Centers for Disease Control and Prevention, the Department of Defense and the Office of Special Education and Rehabilitation Services. Dr. Brown currently is the Editor of the Journal of Pediatric Psychology and serves on the Behavioral Medicine and Intervention Outcomes of the Center for Scientific Review of the National Institutes of Health. He has published over 200 articles, chapters, and books related to childhood psychopathology and health psychology. He also has served on the editorial boards of 11 journals related to child and adolescent psychopathology. Dr. Brown also serves as a liaison to the American Academy of Pediatric subcommittee on the assessment and practice guidelines for attention-deficit/hyperactivity disorder. Dr. Brown also serves as Chair of the Board of Scientific Affairs of the American Psychological Association.

Learning Objectives

After completing this course you’ll be able to:

  1. Describe ADHD and at what age do symptoms emerge.
  2. State the length of time inattention, impulsivity, and over-activity is inappropriate for development.
  3. State approximately the percent of school-aged children in the U.S. who meet criteria for ADHD.
  4. Compare the frequency of boys and girls with ADHD.
  5. State positive outcomes of ADHD in adults.
  6. State the major differential feature between ADHD and other psychiatric disorders.
  7. Describe the problems of sleep difficulties in children, adolescents and adults.
  8. List the steps of diagnosing ADHD.
  9. Discuss briefly the role of genetics in ADHD.
  10. Discuss briefly the neurophysical differences between individuals with and without ADHD.
  11. Discuss Barkley’s model of symptoms associated with ADHD.
  12. Discuss the findings of Knopik et al. (2005) regarding paternal and maternal alcohol dependency.
  13. State why adults refer themselves for evaluations and what the symptoms are.
  14. State the average age of onset for ADHD.
  15. Discuss the outcomes of an ADHD diagnosis during preschool.
  16. List several components of an assessment.
  17. Discuss ways of assessing adults for ADHD.
  18. Describe preparation of clients prior to neuropsychological or achievement tests.
  19. List the four categories of assessment according to Quinlan.
  20. Describe the computerized continuous performance tasks.
  21. Describe the Test of Variables of Attention (TOVA).
  22. Define “subthreshold.”
  23. State the aim of treatment for the individual diagnosed with ADHD and what the first step is.
  24. Describe how stimulants improve symptoms of ADHD.
  25. Discuss the use of stimulant medication and the risk of substance abuse in adulthood.
  26. List and briefly describe several of the medications used for ADHD.
  27. Discuss a “drug holiday.”
  28. Describe behavioral techniques that are helpful for children with ADHD (Table 3).
  29. List the limitations of behavioral interventions according to Brown et al.
  30. Describe the National Institutes of Health Multimodal Treatment for ADHD.
  31. List successful interventions for parents of children with ADHD.
  32. Discuss work and career issues that affect adults with ADHD.
  33. Describe “coaching.”
  34. Describe the Individuals with Disabilities Education Act and Section 504 of the Rehabilitation Act of 1973.
  35. Discuss the use of cognitive training developed by Klingberg.
  36. Describe the Feingold diet and food additives.
  37. Discuss research of stimulant medications for ADHD according to Wilens et al. 2000b.
  38. Discuss Conners (1980) analysis of food additives.
  39. Discuss ADHD and substance abuse disorders.
  40. Describe treatment for comorbid ADHD and tics.
  41. State obstacles to successful treatment of ADHD.

Course Contents

1. Description of Attention-Deficit/Hyperactivity Disorder

1.1 Terminology
1.2 Definition
1.3 Epidemiology
1.3.1 Prevalence
1.3.2 Gender
1.3.3 Age
1.3.4 Problems in Adulthood
1.3.5 Ethnicity
1.4 Course and Prognosis
1.5 Differential Diagnosis
1.6 Comorbidities in AHHD Patients
1.7 Diagnostic Procedures and Documentation

2. Theories and Models of ADHD

2.1 Biological Factors in ADHD
2.1.1 Genetic Contributions
2.1.2 Neurological Factors
2.1.3 Cognitive Determinants
2.2 Perinatal Factors in ADHD
2.3 Psychological Factors in ADHD
2.4 Interactions between Biological and Psychological Factors

3. Diagnosis and Treatment Indications

3.1 Assessment Procedures
3.2 Specific Assessment Techniques
3.3 The Decision-Making Process
3.4 Treatment Considerations

4. Treatment

4.1 Methods of Treatment
4.1.1 Stimulant Medication
4.1.2 Psychotherapy
4.1.3 Combined Pharmacological and Behavioral Interventions
4.1.4 Common Psychological Issues with Adults
4.1.5 Interventions with Teachers and Schools
4.1.6 Social Skills Training
4.2 Mechanisms of Action
4.2.1 Alternative Treatments
4.3 Efficacy and Prognosis
4.4 Variations and Combinations of Methods
4.4.1 Comorbid Conditions
4.5 Problems in Carrying out the Treatments

5. Case Vignettes

6. Further Reading

7. References

8. Appendix: Tools and Resources

Feedback

“A superb, up-to-date summary of ADHD in children and adults along highly useful information on its management that will be of use to both clnical professionals and educated parents alike.”
– Russell A. Barkley, PhD, Research Professior in Psychiatry, SUNY Upstate Medical School and Clinical Professor of Psychiatry, Medical University of South Carolina

“A concise, densely packed overview of current scientific literature on ADHD that proves particularly insightful in dealing with issues of etiology, comorbidity, and treatment. For the busy clinician, I can think of no better source for rapid access to a guide for evidence-based practice.”
– Cecil R. Reynolds, PhD, Professor of Education Psychology and Professor of Neuroscience, Texas A&M University

”An essential and accessible resource for clinicians and students.”
-Randy W. Kamphaus, PhD, Professor and Head of Department of Educational Psychology and Instructional Technology, University of Georgia