Definition and Risk Factors – Attention-deficit/hyperactivity Disorder (ADHD) (Nursing)

00:00 Now we're going to examine attention-deficit hyperactive disorder. Okay, ADHD. We also have attention-deficit hyperactive disorder inattentive type. But right now I'm just going to start with the ADHD. Attention-deficit hyperactivity disorder is, like the other two, a lifelong disorder that typically presents in childhood. And when I say the other two, I am talking about IDD, ASD, and now ADHD. This is identified when there is a persistent pattern of behaviors that reflect impulsivity, hyperactivity, and inattention that interferes with daily functions. I want to make clear that it is a normal part of childhood for a child to be inattentive at times, for a child to be impulsive at times.

01:06 And heaven knows hyperactivity and high energy level are part of a normal childhood.

01:16 The important piece here is that it interferes with the child's daily functions. Their social, academic, interpersonal, these are the function areas that they are suddenly having great difficulty with. ADHD is the most common chronic neurodevelopmental disorder. Risk factors for ADHD are both genetic and physiological. The genetic component says that you are at increased risk if there is a first degree biological relation that has ADHD, for example your father or your mother. Physiological is usually impairments in vision or hearing that can trigger the ADHD epilepsy. Epilepsy comes with a spectrum of other childhood disorders that are part of the epilepsy umbrella. Metabolic abnormalities, thyroid abnormalities, adrenal abnormalities, also deficiencies in nutrition.

02:32 So children who are not eating correctly, who have deficiencies in ingesting the proper amount of food, protein, carbs, and vitamins are at increased risk for having ADHD.

02:47 Also infections in childhood like encephalitis can be a physiological predisposing factor for ADHD. Now, it's not just physiological and genetic, we have environmental factors that also play a factor in developing ADHD. For example, perinatal, around the time of birth. An infant born with low birth weight, an infant who is exposed to alcohol in uterus. That's that fetal alcohol. Mothers who smoke during pregnancy. Neurotoxin exposures, for example if the mom is having exposure to lead during pregnancy. That fetus is then also exposed to the neurotoxin. Also a history of child abuse, maltreatment, neglect, if a child is placed in multiple foster homes or is experiencing trauma. So let's think about those perinatal factors again, that maternal smoking or that intrauterine exposure to toxins or the maternal infection that can actually predispose that child.

04:14 Then the child is born and because of that maternal smoking, that child now is born low birth weight. If that child is born and has a difficult delivery, they may have insults to the brain. It may be a problem during delivery itself or after birth if they are in an environment that there is neglect and maybe they fall, maybe they hit their head, also infections. If they are not being taken care of in early infancy, those early infections can also predispose the child to develop ADHD. Also postnatally, a child who is exposed to lead. There are also the psychosocial influences that we need to be aware of. If there is disruptive family equilibrium, if the child is in a chaotic or disorganized emotional environment. If mom is young, if the person having the baby is only 14 or 15 years old when they themselves have a child, and also we have to consider the maternal psychological state. If mom has depression, anxiety, or if there is a history of antisocial behavior in the environment that this child is coming in to.