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Article
Publication date: 26 August 2014

Moshieve Febin Edwin

Adult ADHD is a neuro-developmental disorder. The current prevalence of ADHD in adults is around 1.9-4 per cent. The service for adults with ADHD based on NICE guideline…

Abstract

Purpose

Adult ADHD is a neuro-developmental disorder. The current prevalence of ADHD in adults is around 1.9-4 per cent. The service for adults with ADHD based on NICE guideline recommendation. Hence, the author decides to audit the Adult ADHD case loads against the gold standard set by the NICE. The paper aims to discuss these issues.

Design/methodology/approach

The study was based on a retrospective analysis and collection of data from electronic patient records for a duration of five months between October 2011 and February 2012. The data findings were matched against the NICE standards. There were 15 standards identified. On top of that we used six service outcome questions to improve the Quality of the service provided.

Findings

As the service outcomes were set for 100 per cent, the performance fell short in few areas. The service managed to achieve roughly 80-95 per cent in areas such as medication monitoring, transition service and care plan with shared care guidelines for prescription in primary care. The service under performed in areas on non-pharmacological interventions such as cognitive-behavioural therapy (CBT). The service continues to provide a exceptional service for adults with intellectual disability and ADHD.

Research limitations/implications

The research was limited by information and recall bias due to the retrospective nature of data analysis. There was also over representation of the numbers in co-morbid cases due to more than two diagnosis.

Practical implications

The paper outlines the regional outcome of the audit. However the findings have wider implications. For example the prevalence rate is more common in males than females. CBT is an important resource in the management of ADHD in adults. Priority and importance need to be given for providing a service for CBT in adults with ADHD.

Social implications

The cost of sickness and non-employment due to ADHD is significantly high. Treating this complex group with medications and CBT improves the outcome and get them back in employment and reduce recidivism rates in offenders.

Originality/value

The author feels the adult ADHD service audit has huge service implications. Currently it is a controversial diagnosis significantly under-resourced. The outcome survey had highlighted the areas of need as a neurodevelopmental disorder.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 8 no. 5
Type: Research Article
ISSN: 2044-1282

Keywords

Article
Publication date: 18 January 2013

H. Ayyash, S. Sankar, H. Merriman, C. Vogt, T. Earl, K. Shah and S. Banerjee

Attention deficit hyperactivity disorder (ADHD) is the most commonly studied and diagnosed psychiatric disorder in children. There is a need to engage service development…

Abstract

Purpose

Attention deficit hyperactivity disorder (ADHD) is the most commonly studied and diagnosed psychiatric disorder in children. There is a need to engage service development, commissioning and service managers to address primary care involvement and define service models that will enable effective management of people with ADHD. The purpose of this project is to define recommendations through consensus that can be implemented to improve ADHD management in the UK.

Design/methodology/approach

A set of 40 consensus statements has been developed by a multidisciplinary group of ADHD professionals in the UK. These statements cover ten topics, ranging from commissioning of ADHD services to optimisation of the care pathway. The aim of the project was to define a set of standards that could be tested across a wider clinical population.

Findings

A total of 122 respondents scored each statement on a questionnaire and levels of agreement were summated and analysed. Of 40 statements, only four scored less than 90 per cent agreement, with all statements achieving greater than 74.9 per cent agreement.

Originality/value

Recommendations support the wider integration of ADHD services and the closer involvement of commissioners within the new GP consortia to ensure that the potentially negative societal and personal impacts of ADHD are managed effectively and with appropriate use of resources.

Details

Clinical Governance: An International Journal, vol. 18 no. 1
Type: Research Article
ISSN: 1477-7274

Keywords

Article
Publication date: 28 June 2019

Laura Korb, Bhathika Perera and Ken Courtenay

The purpose of this paper is to illustrate the possible basis of challenging behaviour (CB) can lie in a treatable neurodevelopmental disorder.

Abstract

Purpose

The purpose of this paper is to illustrate the possible basis of challenging behaviour (CB) can lie in a treatable neurodevelopmental disorder.

Design/methodology/approach

Two case studies were used to illustrate the clinical characteristics of attention deficit hyperactivity disorder (ADHD) presenting as CB in people with intellectual disability (ID).

Findings

The findings of this paper show that the appropriate use of drug therapy for ADHD effectively reduced the behavioural challenges.

Research limitations/implications

Limited by two cases. Application of the findings of this paper is limited given it is a case study. This paper highlights an important clinical implications which need to be studied in a larger scale to make clinical recommendations.

Practical implications

Findings from the two case studies may be used when making decisions in clinical practice.

Originality/value

The paper explores the possibility of ADHD presenting as CB in people with ID.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 13 no. 3/4
Type: Research Article
ISSN: 2044-1282

Keywords

Article
Publication date: 15 September 2022

Cheryl K. McIntosh, Shelia A. Hyde, Myrtle P. Bell and Paul E. Yeatts

The purpose of this study is to examine factors relating to the decision to proactively disclose a diagnosis of attention deficit hyperactivity disorder (ADHD), a…

Abstract

Purpose

The purpose of this study is to examine factors relating to the decision to proactively disclose a diagnosis of attention deficit hyperactivity disorder (ADHD), a concealable stigmatized identity, before experiencing performance issues at work. These factors include stigma consciousness, psychological safety, and job demands. Proactive disclosure is also measured in relation to thriving.

Design/methodology/approach

Data were collected through the online research platform Prolific. Variables of interest were measured using surveys of 166 working adults who have ADHD. Path analysis was used to test the hypotheses.

Findings

The authors hypothesized that stigma consciousness is negatively related to proactive disclosure of ADHD at work and that psychological safety and job demands are positively related to it. The authors further hypothesized that proactive disclosure mediates the relationship between these variables and thriving at work. The results partially support these hypotheses, indicating that stigma consciousness is negatively related to proactive disclosure while psychological safety is positively related. Proactive disclosure fully mediates the relationship between stigma consciousness and thriving and partially mediates the relationship between psychological safety and thriving. Job demands relate to thriving but are not significantly related to proactive disclosure.

Practical implications

Organizations can help employees who have concealable disabilities to proactively disclose them and thrive by providing a psychologically safe environment where disabilities are not stigmatized.

Originality/value

This study diverges from previous studies by measuring positive contextual and individual factors that help employees who have ADHD to thrive in the workplace. A proactive disclosure scale is developed and validated.

Details

Equality, Diversity and Inclusion: An International Journal, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2040-7149

Keywords

Book part
Publication date: 29 August 2012

Robert Reid

Attention deficit hyperactivity disorder (ADHD) is the most commonly diagnosed psychological disorder of childhood. Prevalence of ADHD currently is estimated at 5% among…

Abstract

Attention deficit hyperactivity disorder (ADHD) is the most commonly diagnosed psychological disorder of childhood. Prevalence of ADHD currently is estimated at 5% among school-age children making it a serious concern for educators. One aspect of ADHD, however, that has received comparatively little attention is the academic difficulties that are commonly associated with ADHD. This chapter provides an overview of the extent and nature of academic problems of students with ADHD. First, a theoretical perspective on academic deficits of students with ADHD drawn from Barkley's (2006) theoretical work is presented. Second, the academic status of students with ADHD is discussed. Third, drawing on longitudinal studies, the academic trajectory of students with ADHD is examined. Fourth, possible causal factors for academic problems and core deficit areas of working memory and executive functions are discussed. Next, progress in academic interventions for ADHD is assessed and promising interventions are noted. Finally, some possible directions for future intervention research are provided.

Details

Classroom Behavior, Contexts, and Interventions
Type: Book
ISBN: 978-1-78052-972-1

Book part
Publication date: 18 July 2007

Anna Maria Re and Cesare Cornoldi

The study of 5-year-old children with symptoms of attention-deficit hyperactivity disorder (ADHD) is important because it provides an opportunity to discover early…

Abstract

The study of 5-year-old children with symptoms of attention-deficit hyperactivity disorder (ADHD) is important because it provides an opportunity to discover early intervention strategies for children who are expected to develop severe problems later in life. This chapter presents a research program intended to develop assessment and interventions tools for kindergarten children. Specifically, we present two rating scales (one for teachers and one for parents), two neuropsychological tests, and an intervention program intended to promote controlled attention and working memory. Finally, we present an investigation, with a small group of 5-year-old children with ADHD symptoms, validating the program.

Details

International Perspectives
Type: Book
ISBN: 978-1-84950-503-1

Book part
Publication date: 13 October 2014

Jessica Streeter

I discuss the formal attention deficit hyperactivity disorder (ADHD) diagnosis process and whether the Black–White differences found in this process are the results of…

Abstract

Purpose

I discuss the formal attention deficit hyperactivity disorder (ADHD) diagnosis process and whether the Black–White differences found in this process are the results of unmet needs or conscious decisions.

Design

First, I offer a new analytic framework for understanding the “ADHD process.” The proposed framework breaks ADHD diagnoses down into three stages: the informal diagnosis, the formal diagnosis, and treatment. This approach reveals certain racial trends in the ADHD literature. Second, I use the 2007 National Health Interview Survey (total n = 75,764) to address racial differences.

Findings

I find that blacks are less likely to hold a formal ADHD diagnosis than whites. Third, nested logistic models reveal that this racial difference is not explained by health insurance status, family income, or family educational level. New explanatory models for the black–white difference in ADHD should stray from a strict reliance on the “unmet need” discourse, and instead focus on other factors that may affect the decision-making process in diverse families.

Value

This chapter makes three contributions to the wider literature on ADHD and race.

Details

Family Relationships and Familial Responses to Health Issues
Type: Book
ISBN: 978-1-78441-015-5

Keywords

Book part
Publication date: 18 July 2007

Ana Miranda, Rafaela Marco and Dolores Grau

In this chapter, we present the results of a study designed to investigate: (a) the family relations of children with attention-deficit hyperactivity disorder (ADHD), (b…

Abstract

In this chapter, we present the results of a study designed to investigate: (a) the family relations of children with attention-deficit hyperactivity disorder (ADHD), (b) the sources of stress parents in families of children with this disorder experience and (c) the possible modulating role that ADHD subtype and comorbid oppositional defiant disorder (ODD) have on parenting stress level. One hundred and sixty seven families, divided into two groups, an ADHD group (N=114) and a control group (N=53), participated in the study. Parents of both groups completed a Semi-Structured Interview that gathered information on socio-demographics, family structure and the presence of oppositional behaviour symptoms, as well as the Parenting Stress Index Questionnaire (Abidin, 1990) to evaluate parent stress. The results showed that the relations of children with ADHD with their parents and siblings were significantly more tense than those of children without this disorder with their families. Parenting stress was higher in parents with ADHD children than in parents of non-ADHD children in most scales relating to parent personal variables, with even more sharp differences in measures of parenting stress that are triggered by the child's behaviour. Finally, our results evidenced how the ADHD subtype and ODD comorbidity influence the level of stress in parents. The results of the study suggest that interventions focused only on the behaviour of ADHD children are not likely to improve the developmental course of the disorder in the long run.

Details

International Perspectives
Type: Book
ISBN: 978-1-84950-503-1

Book part
Publication date: 1 April 2011

Ana Miranda, María Jesús Presentación, Rebeca Siegenthaler, Carla Colomer and Vicente Pinto

Comorbidity of attention deficit hyperactivity disorder (ADHD) and reading disabilities (RD) is greater than what would occur by chance. Considering the well-documented…

Abstract

Comorbidity of attention deficit hyperactivity disorder (ADHD) and reading disabilities (RD) is greater than what would occur by chance. Considering the well-documented adverse impact of both ADHD and RD on development, the presence of both conditions may lead to particularly poor outcomes for affected people. This chapter, which reviews 43 research studies carried out in the last decade that have focused on the link between ADHD and RD, is divided into two broad nuclei of contents. First, studies are described that contribute information about characteristics of the comorbid phenotype. Second, studies related to procedures directed toward evaluation and intervention in this problem are analyzed. The review carried out does not make it possible to extract definitive results on the exact nature of ADHD and RD comorbidity or, even less, reach conclusions about its causes. However, the literature-based evidence shows a cognitive profile of ADHD+RD characterized by failure of various functions that can produce more severe functional deficits and worse neuropsychological, academic, and behavioral outcomes. Furthermore, the analysis of the set of results from the studies shows a limited efficacy of pharmacological and psychopedagogical treatments, and highlights the need for continued research on this topic. From a clinical and educational standpoint, the conclusions derived from this review underline the importance of performing an exhaustive evaluation of children and adolescents with symptoms of ADHD and/or RD, in order to be able to plan interventions with greater possibilities of success in each case.

Details

Assessment and Intervention
Type: Book
ISBN: 978-0-85724-829-9

Book part
Publication date: 1 October 2013

Manuel Vallée

Since the beginning of the 20th century environmental health researchers have known about the association between toxicant exposure and disease. However, that knoweldge…

Abstract

Purpose

Since the beginning of the 20th century environmental health researchers have known about the association between toxicant exposure and disease. However, that knoweldge has not been well integrated into mainstream medicine. Shedding light on why is the focus of this chapter.

Methodology/approach

To shed light on this issue I analyze the 2011 American Academy of Pediatrics’ clinical practice guidelines for Attention Deficit/Hyperactivity Disorder (ADHD), focusing specifically on the omission of environmental health research pertaining to ADHD symptoms and exposures, such as lead and mercury.

Findings

I found that while environmental researchers have been documenting the link between lead and ADHD for over forty years, the American Academy of Pediatrics has completely omitted this research from its 2012 clinical practice guidelines. Moreover, I argue this omission can be traced to competitive pressures to protect medical jurisdiction, and a reductionist worldview that emphasizes treatment over prevention.

Originality/value of paper

This is the first attempt to analyze the way clinical practice guidelines help reinforce and perpetuate dominant medical perspectives. Moreover, to shed explanatory light, this chapter offers a synthetic explanation that combines materialist and ideological factors.

Research implications

Beyond the specific case of ADHD, this chapter has implications for understanding how and why environmental health research is omitted from other materials produced by mainstream medicine, such as materials found in the medical school curriculum, continuing medical education, medical journals, and on the medical association web sites.

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