Learners with Attention Deficit Hyperativity Disorder (AD/HD)

Attention-Deficit/Hyperactivity Disorder Most commonly diagnosed childhood psychiatric disorder Great deal of controversy and misconceptions “He’ll grow out of it” “It’s just a matter of self- control” “Poor parenting” “Food additives” “Fast- paced culture” “Too much TV and Nintendo” Are psychotropic medications given too much? Too little?

New labels for an old disability?

New labels for an old disability? Moral deficit, minimal brain dysfunction, hyperkinesis, hyperactivity, ADD ==  Attention-deficit/hyperactivity disorder [AD/HD] 1902: George Still’s theory of subtle brain injury : The Great Flu Epidemic – left some children with impaired attention, memory, and impulse control (similar to Still’s patients) BIG ISSUE: free will or determinism?

Definitions What does IDEA say about AD/HD? Now mentioned directly in new regs under OHI “is due to... Attention deficit hyperactivity disorder... Adversely affects a child’s educational performance.” Most often, the DSM-IV definition is used:

DSM-IV “The essential feature of AD/HD is a persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequent and severe than is typically observed in individuals at a comparable level of development.” Before age 7 and for 6 months

Characteristics AD/HD kids differ from peers in ability to concentrate and control impulses Not all are hyperactive – some are hypoactive Three main subtypes of AD/HD: (yes, a slash) 1. Predominately inattentive type 2. Predominately hyperactive-impulsive type 3. Combined (inattentive and hyperactive)

1. Predominately Inattentive type Trouble paying attention Easily distracted Forgetful and “spacey” Daydreamers Confused, lost in thought Stares, seems apathetic ADD Often girls

Predominately Hyperactive-Impulsive Cannot seem to sit still Talk excessively Have difficulty playing quietly “Challenging” to parents and teachers Bedwetting, sleep problems Temper tantrums

Combined type ADHD without the slash As many as 85% of AD/HD kids are ADHD Barkley feels that inattentive type is significantly different from the hyperactive/impulsive and the combined types Inattentive’s core problem is focused or selective attention Other 2 have problems with poor goal-directed persistence and interference control (inhibiting distraction) One has problems getting started, other with finishing

A Conceptual Model of Self- regulation Characteristics Barkley now theorizes that difficulty with behavioral inhibition is the big problem here By this, we mean the ability to: A) delay personal gratification or reinforcement B) interrupt an ineffective response to replace it with a more effective behavior C) Continue with a desirable behavior despite interference A,B,C affect executive functions and time perception Disability of performance, not skill

What Are These 4 “Executive Functions?” Not publicly observable Purpose is to internalize behavior to plan for change and the future 1. Nonverbal working memory : Allows students to recover auditory, visual, and other sensory images of the past 2. Internalization of speech : Ability to talk to yourself, plan what you will do or say, recognize when it is appropriate to speak your thoughts out loud.

More executive functions 3. Self-regulation of affect, motivation, and arousal. Barkley: “lack the drive, in the presence of external rewards, that fuels the individual’s persistence in goal-directed actions.” 4. Reconstitution: The skill of analyzing and synthesizing behaviors. Breaking tasks up into component steps

Time Perception This is also a problem, in addition to executive functions Overestimate time intervals Perception that time moves more slowly Procrastinate – think they have more time

Causes of AD/HD Too much sugar? Too little sugar? Aspartame? Food sensitivity? Food additives? Colors? Lack of certain vitamins? TV? Video games? Yeast? Lightning? Fluorescent lights? Allergies?

Environmental Explanations Poor parenting? Research does not support this (Barkley) Often sibs are not AD/HD Perhaps negative behavior of mothers is a reaction to their child’s AD/HD rather than the cause Stress in the family? Too short term, really

Biological Explanations Big area of study right now Two areas of research interest: 1. Pre-, peri-, and postnatal trauma 2. Brain differences resulting from faulty genes

Pre-, peri-, and postnatal trauma Certain teratogens increase the likelihood that a child will develop AD/HD Maternal smoking Alcohol/Drug abuse Poor maternal nutrition Mother’s exposure to chemical poisons Accounts for 20-30% of AD/HD in boys, less in girls