I am replying to a peer’s post on ADHD

NU-664C-02-23PCS3 FamilyPsychiatric Ment.Hlth I

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5. Week 14: Group-Facilitated Discussion 1 – Group 5

Week 14: Group-Facilitated Discussion 1 – Group 5

To do:Make forum posts: 1

Value: 100 points

Due: Facilitating group to post by Day 1; all other students post to facilitating group discussion prompt by Day 4 and reply to at least two other peer posts by Day 7

Grading Category: Group Facilitated Discussions

Initial Post: Created by Facilitating Group

This is a student-led discussion.

• Please review the Week 7 Get Started: Group-Facilitated Communication Board and Instructions for assignment guidelines for this discussion to ensure that you have met all the criteria.
• The facilitating group should choose one member from their group who will be responsible for the initial post.
• On Day 1 of this week, the chosen group member will create an initial post that is to include the group’s discussion prompts, resources, and the instructions for what your classmates are to do with the resources.
• During this week, each member of your group is to participate in the facilitation of the discussion. This means making certain that everyone is engaged, questions from students are being answered, and the discussion is expanding.
• It is the expectation that the facilitating group will address all initial peer response posts by Day 7.

Reply Posts: Non-Facilitating Students

• If you are not a member of the facilitating group, you are to post a discussion prompt response according to the facilitating group’s instructions by Day 4. Your reply posts should include substantive reflection directed to the presenters.
• You are also expected to respond to at least two other peers’ initial discussion prompt posts.
• Pick out an idea from your peers’ initial post that you find most interesting and tell how you will use this information in practice.

Please refer to the Grading Rubric for details on how this activity will be graded. The described expectations meet the passing level of 80%. Students are directed to review the Discussion Grading Rubric for criteria which exceed expectations.  

This is my peer’s post. I am replying to the  post

Re: Week 14: Group-Facilitated Discussion 1 – Group 5

by William Nichols – Tuesday, 1 August 2023, 6:06 PM

Hi Group 5

Introduction

           Thank you for your insightful post regarding ADHD. This can be a challenging psychiatric diagnosis due to the different developmental stages and children and when assessing we must differentiate normal development behaviors and if the symptoms are related to ADHD. In this post, the three subtypes of ADHD, the age considerations in relation to diagnosis, assessment tool options, and tips for parents and care givers, pharmacotherapy regulations will be discussed to further explore this diagnosis.

What are the three subtypes (presentations) of ADHD?  What is the age cutoff for symptomology presentation?

            The three subtypes of ADHD according to the DSM-5 include combined presentation, predominantly inattentive presentation, and predominantly hyperactive/impulsive presentation. Rule in criteria include six or more of the listed symptoms that have been present for the last six months that is inconsistent with the developmental level and has a prominent impact of occupational, social, and educational settings. Some of the listed symptoms include reluctant to engage in tasks that require sustain mental concentration or effort, easily distracted by internal stimuli, often loses things like textbooks, and does not listen when spoken too, fidgets’ hands, blurts out answers, and cannot sit and stay still for sustained periods of time just to name a few. To meet the combines presentation, within the two criteria inattentive and hyperactivity the client must present with six of the symptoms in each of the category. To meet the predominantly inattentive type the client meets at least six of the listed symptoms in inattentive and just some or non within the hyperactive. To meet the hyperactive subtype, the client must present with at least six of the symptoms under the hyperactive subtype and may only have a few of the inattentive. At least several of the symptoms must be present prior to the age of 12( American psychiatric association, 2013).

 Do you foresee any of these assessment tools being useful in your future practice as a PMHNP? If so, which ones?

            The assessment tools can be very useful to gather required data in different setting including school. Home, patient, and parents or teachers. The Connors scale is beneficial for older children who can answer the questions on their own. This allows them to have a voice during the assessment and allow the provider to get the clients perspective on the symptoms that may differ from parent and teachers. The Vanderbilt score and the Vanderbilt score gives the parent and teacher informant variations to also give the provider a picture of the client’s presentation in those settings (KÄ…dziela-Olech,2014). The American academy of family physicians has found the Connors scale to be moderately sensitive in detecting ADHD in both parent and teacher version ( Gaba & Giordanengo,2019).

 What is the earliest age methylphenidate is FDA-approved to treat ADHD?

            According to Stahl et al. 2021, Methylphenidate in various brands. The minimum age that is FDA approved in six years of ago, and according to nice guidelines, generally when the child is this young, other non-pharmacological methods are recommended to try first which will be discussed in the next prompt (National institute, 2019). Some of the brand names approved for children six and older include Ritalin, concerta, datryana among others (Stahl et al. 2018)

 What are some tips that you would provide for caregivers/teachers about behavioral interventions and environmental changes aimed to regulate the behavior of children with ADHD?

            Some modification that have been shown to improve quality for child and adolescents with ADHD include exercise, integrating into sports and environmental modifications. Modifications include improving lighting and noise around the house or classroom. In the case of school allowing testing accommodation in a more quiet and less distracting area with less people (Alizadeh et al., 2023). Structure is also important to client who have ADHD, including checklist and routine can be very beneficial to keeping the client on task and improve focus (Betker, 2017). Focus tools like stress balls and movement breaks have also been introduced and had great outcomes (Betker, 2017). This may mean discussing with the parent to set up a schedule where they work on homework for 20 minutes then go outside for 15 or twenty minutes.

References

Alizadeh, S., Bridge, C.,  Judd, B & Eapen, V (2023). Home Indoor Environmental Quality and Attention Deficit Hyperactivity Disorder. Sustainability, 15(2899), 2899. https://doi.org/10.3390/su15042899

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

Betker, C. (2017). Environmental strategies for managing attention deficit hyperactivity disorder. Journal of Childhood & Developmental Disorders, 03(04). https://doi.org/10.4172/2472-1786.100062

Gaba, P., & Giordanengo, M. (2019). Attention-deficit/hyperactivity disorder: Screening and evaluation. American Family Physician. https://www.aafp.org/pubs/afp/issues/2019/0601/p712.html

 KÄ…dziela-Olech,H . (2014). The measurement of the symptoms of ADHD in the NICHQ Vanderbilt Assessment Scale for Parent (VADPRS) and for Teacher (VADTRS). Psychiatria i Psychologia Kliniczna, 14(4), 277–283. https://doi.org/10.15557/PiPK.2014.0037

National Institute for Health and Care Excellence. (2019). Attention deficit hyperactivity disorder: Diagnosis and management: Guidance. NICE. https://www.nice.org.uk/guidance/ng87/resources/attention-deficit-hyperactivity-disorder-diagnosis-and-management-pdf-1837699732933

Stahl, S. M., Stahl, S. M., & Stahl, S. M. (2018). Prescriber’s Guide, Children and Adolescents Stahl’s essential psychopharmacology. Cambridge University Press.