Parents don’t understand them; Their teachers can’t stand them; Their peers reject

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Patients with “ADHD” may suffer Because…..

  • Their parents don’t understand them;

  • Their teachers can’t stand them;

  • Their peers reject them;

  • Their spouses and bosses can’t stand their disorganization and intensity;

  • They themselves begin to think: “no matter what I do I can’t win…”

Famous People with Attention Deficit and Learning Disorders

ADHD Diagnosis

  • 5-9% children with this condition

  • 60% of these children go on to adulthood with impairing symptoms

  • Core symptoms are

    • Impulsivity
    • Attentional problems
    • Motor hyperactivity

Visual Images

  • Move in the academic teaching arena to use movies and visual processes as ways of teaching

  • ADHD patients respond better to visual systems rather than talking

    • Auditory processing problems
    • Strengths in visual-spatial ability
    • Ability to see the forest but not the trees


  • An urge that is difficult to resist

    • Dennis the Menace
    • The Simpsons

Dennis the Menace


  • Loss of order and loss of presence of mind

    • Home Alone
    • Inspector Gadget
    • Gilligan’s Island
    • Get Smart

Home Alone 2

Motor Hyperactivity

  • Any movie by

    • Jim Carrey
    • Robin Williams
    • Howie Mandell
    • Tom Cruise


  • You must accept that if ADHD is a lifelong disorder, then your personality must change. The Adult is still having power battles with authority figures which is similar to the power battles within themselves.

  • Different Examples

  • -Officer and a Gentleman

  • -Goodwill Hunting

  • -The Lion King

  • -Mrs. Doubtfire

Good Will Hunting


  • A.D..D.


  • Failure to think of

  • Consequences before

  • acting

  • --------------------------------------------------------------------------------------------------

  • “Combined”

Symptoms of Hyperactivity Often Manifest Differently in Adults

  • DSM-IV Symptom Domain

  • Squirms and fidgets

  • Can’t stay seated

  • Runs/climbs excessively

  • Can’t play/work quietly

  • “On the go”/driven by motor

  • Talks excessively

Symptoms of Inattention Often Manifest Differently in Adults

  • DSM-IV Symptom Domain

  • Difficulty sustaining attention

  • Doesn’t listen

  • No follow-through

  • Can’t organize

  • Loses important things

  • Easily distractible, forgetful

Symptoms of Impulsivity Often Manifest Differently in Adults

  • DSM-IV Symptom Domain

  • Blurts out answers

  • Can’t wait turn

  • Intrudes/interrupts others

ADHD Impairment Persists

Diagnosis of ADHD in Adults: Common Clinical Histories

  • Difficulties in Elementary or Secondary School

    • Comments: “not living up to potential,” “spacey,” “hyper”
    • Behavioral issues: “class clown”
  • Difficulties in College

    • Incomplete degree or longer time to complete degree
    • Difficulty engaging in further education
  • Difficulties at Work

    • Underachievement (mixed reviews)
    • Low efficiency: 4 times longer to complete tasks
  • Difficulties at Home

    • Poor organization, does not complete tasks
    • Strained relationships with spouse and kids (who also may have ADHD)

Sound of Music

Office Presentation

  • Patients with ADULT ADHD:

ADHD and Comorbid Conditions

Clinical Presentation

Comorbid Psychiatric Disturbances Are Common in Adults With ADHD

Officer and A Gentlemen

ADHD Comorbidity in Adults with Other Psychiatric Disorders

Domains of Impairment

Mrs. Doubtfire

ADHD Owners Manual

  • Many people with ADHD don’t realize they have an owner's manual. We help them to learn about themselves. This is the way you are.

  • ---How to maximize your strengths and minimize your weaknesses.

  • It helps people look at themselves in a more positive way and to learn why things have happened.

Potential Areas of Impairment

Sound of Music

Pharmacotherapy in Adults

  • Stimulants

    • Methylphenidate-Ritalin
    • Amphetamine compounds-Dexedrine
    • Magnesium pemoline (not recommended)
    • Long acting stimulants -Ritalin-SR.Ritalin-L.A,Concerta,Adderal XR
  • Atomoxetine (FDA-approved in adults)-Straterra

  • Antidepressants

    • Bupropion-Welbutrin SR
    • Tricyclics
  • Other

  • - Mood Stabilizers: Valproic Acid/Lithium

  • - Atypical Antipsychotics: Resperidone

  • - Clonidine

  • Research

    • Modafinil



  • Compliance

  • Following the rules

  • Percentage of seat work completed

  • Accuracy of seat work

  • Teachers’ rating of behaviour

  • Performance on cognitive laboratory tasks

  • Handwriting

  • Central auditory processing testing

  • Positive attention from mothers



  • Fidgeting

  • Impulsivity

  • Negative social behaviours

  • Vocalizations and noise

  • Controlling behaviour of mothers and teachers

  • Intensity of interactions by teachers

  • Off-task behaviour in class

ADHD, ODD and CD Integrative Interventions

  • Preventative interventions (i.e. preventing the development of comorbid disorders)

  • Patient, parent, spouse training and support

  • Individual counseling and therapy

  • Group counseling and therapy

  • Family counseling and therapy

  • Interventions at school and work place

  • Medication eg. Resperidone

  • Working with correctional systems

Lion King


  • ADHD symptoms are impairing

  • The symptoms continue into adulthood

  • Early problems of attachment lead to a false sense of self

  • Insight to the clinical symptoms has profound implication to treatment and compliance


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