Clinical features of ADHD:
ADHD is a developmental deficiency in sustained attention, impulsive control and restlessness exhibited by children and adolescents and impairing their social, emotional and academic achievements.
its clinical presentations divided into :
a) primary features :
1) essential features
2) associated features
b) secondary features:
a) primary features
1) essential features:
-hyperactivity: motoric and/or vocal, usually decreased in adolescence. They may appear to be in constant motion, in less severe forms they are talking excessively, some cases of ADHD are situational (occurring only at home or only at school),they are of better prognosis.
-attention difficulties and short attention span with poor conc., o complaints of (not listening to instructions, not finishing assigned work, becoming bored easily) are frequent.
-disorganized and non-goal directed behavior.
2)associated features:
-impulsivity: rapid inaccurate responding,e.g.: they may interrupt others who might be busy, they may begin tasks before directions are completed.
-cognitive impairment: memory impairment/ perceptual problems?interfere with learning… example= visual and auditory, visual are commoner than the auditory ones, e.g. copying geometric figures resulting in angulation, fragmentation, rotation and distortion,e.g. of auditory perc. problems: can not discriminate between 2 words of similar but not identical sounds (book and brook)/ can not understand rules of games when playing with other children/ Intelligence usually normal but there may be M.R./ easily distractable by unimportant visual or auditory stimuli/ not able to learn from errors.
-delay in motor development due to slow CNS maturation? delay developmental milestones/ problems in laterality (cerebral dominance)/ synkinesis (when he uses one hand, the other one moves involuntarily)/ minor hyper-hyporeflexia/ +ve babniski after12-18 ms.
-low frustration tolerance and temper, there is mood fluctuations.
-interpersonal relationship difficulties with peers, teachers and parents (aggressive).
b)secondary features:
-from parents: in the form of denial, overprotect. and angry reactions.
-from child: feeling of hopelessness/ antisocial behavior/ ? selfesteem /learning problems
in 70-80% / DLD and speech disorders.
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