2. Developmental Disorders
Chapter 13

3. Attention Deficit Hyperactivity Disorder (ADHD): An Overview
Nature of ADHD
Central features – Inattention, overactivity, and impulsivity
Associated with behavioral, cognitive, social, and academic problems
DSM-IV and DSM-IV-TR Symptom Clusters
Cluster 1 – Symptoms of inattention (Inattentive Subtype)
Cluster 2 – Symptoms of hyperactivity and impulsivity cluster – (Hyperactive/Impulsive Subtype)
Either cluster 1 or 2 must be present for a diagnosis
Can be combined subtype (inattentive & hyperact/impul)

4. ADHD: Facts and Statistics
Prevalence
Occurs in 4%-12% of children who are 6 to 12 years
of age
Symptoms are usually present around age 3 or 4
68% of children with ADHD have problems as adults
Gender Differences
Boys outnumber girls 4 to 1

5. ADHD Etiology Genetic heritability is very high (.80+)
Neurological dysfunction
Cormorbidity with learning disorders, conduct problems
Overall smaller brain volume (frontal cortex, basal ganglia, cerebellar vermis)
No evidence of food colors, preservatives as causal
Maternal smoking during pregnancy is risk factor
More negative interaction patterns with parents and teachers appear to be result of ADHD, not cause
Probability of ADHD diagnosis is greatest in the United States

6. ADHD Treatment Biological treatment through stimulant medication
Ritalin or Concerta (methylphenidate), Cylert (pemoline) and Dexedrine (D-amphetamine), Adderall
Non-stimulant – Straterra
Medication effects directly target poor attention & concentration (most effective method), but do not target social problems
Side effects a concern, but with careful monitoring can be minimized
Approximately 25-30% do not respond to medication

7. ADHD Treatment (cont’d)
Psychological Treatment
Behavior Therapy – parent training, contingency management at home and in school, social skills training, problem-solving, anger control
Coordination of treatment at home & school works best
Behavior therapy has the best effect on reducing inappropriate behaviors, improving social functioning, improving academic functioning (in short-term)
Combination Treatments
MTA study – 5 sites over 5 years compared medication alone, BT alone, and combination treatment
Best outcome on the widest number of areas is with combination treatments (but medication had best specific effect on increasing attention)

8. Learning Disorders: An Overview
Scope of Learning Disorders
Problems related to academic performance in reading, mathematics, and writing
Performance is substantially below what would be expected based on cognitive ability
DSM-IV and DSM-IV-TR Reading Disorder
Discrepancy between actual and expected reading achievement
Reading is at a level significantly below that of a typical person of the same age
Problem cannot be caused by sensory deficits
(e.g., poor vision)
Although may learn to read, fluency and comprehension may still not be at expected level

9. Learning Disorders: An Overview (cont.)
DSM-IV and DSM-IV-TR Mathematics Disorder
Achievement below expected performance in mathematics
DSM-IV and DSM-IV-TR Disorder of Written Expression
Achievement below expected performance in writing

10. Learning Disorders: Some Facts and Statistics
Incidence and Prevalence of Learning Disorders
1% to 3% incidence of learning disorders in the United States
Prevalence is highest in wealthier regions of the United States
Prevalence rate is 10% to 15% among school age children
Reading difficulties are the most common of the learning disorders
About 32% of students with learning disabilities drop out of school
School experience for such persons tends to be quite negative

11. Causes of Learning Disorders
Genetic Component
Concordance rate among identical twins almost 100%
Chromosome 6 and 15
Neurological deficits – complex, varied
High comorbidity with ADHD, but distinct
30-50% of those with ADHD have at least 1 learning disorder
30-50% of those with a learning disorder have ADHD

12. Treatment of Learning Disorders
Requires Intense Educational Interventions
Remediation of basic processing problems (e.g., teaching visual skills)
Improvement of cognitive skills (e.g., instruction in listening)
Targeting behavioral skills to compensate for problem areas
Data Support Behavioral Educational Interventions for Learning Disorders
Americans with Disabilities Act and Rehabilitation Act require reasonable accommodations for students with disabilities to ensure equal access to education

13. 2.04 Objective criteria for diagnosis of a "specific learning disability" have yet to be succinctly defined by educational psychologists. OSU embraces the general guidelines suggested by the Oklahoma State Regents for Higher Education in 1991, which acknowledge that while multiple approaches are used in this area, specific criteria for diagnosis of a learning disability include: average to above average intellectual ability; severe processing deficits; severe aptitude achievement discrepancies, despite adequate learning opportunities; and a condition of presumed neurological origin.
- OSU's Policies and Procedures in regard to
Academic Accommodations for Students with Disabilities