Attention Deficit Hyperactivity Disorder EDU381 Immaculata University Matthew Speicher 6/2/10

Recent Changes in Definition For many years, the Diagnostic and Statistical Manual of Mental Disorders (DSM) used the term attention deficit disorder (ADD) to refer to all people with the condition, but it allowed for subtypes of ADD with and without hyperactivity. Recent changes to the DSM have begun using the general term attention deficit hyperactivity disorder (ADHD) to refer to all people with the condition. However, ADHD is now divided into the following subtypes: – ADHD (Predominantly Inattentive Type) – ADHD (Predominantly Hyperactive-Impulsive Type) – ADHD (Combined Type)

Characteristics / Symptoms of Subtypes ADHD (Predominantly Inattentive Type) – Fails to give close attention to details or makes careless mistakes. – Has difficulty sustaining attention. – Does not appear to listen. – Struggles to follow through on instructions and finish tasks. – Has difficulty with organization. – Avoids or dislikes tasks requiring sustained mental effort. – Often loses things necessary for tasks and activities – Is easily distracted. – Is forgetful in daily activities.

ADHD (Predominantly Hyperactive-Impulsive Type) – Fidgets with hands or feet or squirms in chair. – Has difficulty remaining seated. – Runs around or climbs excessively during inappropriate situations. – Has difficulty engaging in activities quietly. – Acts as if driven by a motor. – Talks excessively. – Blurts out answers before questions have been completed. – Has difficulty waiting or taking turns. – Interrupts or intrudes upon others. ADHD (Combined Type) – Meets both inattentive and hyperactive/impulsive criteria.

Diagnosis Diagnosing ADHD can be tricky (especially when taking the three subtypes of the disorder into account), so most authorities stress the use of several sources of information before arriving at a firm diagnosis. These sources include: – A medical examination – A clinical interview – Teacher and parent rating scales – Behavioral observations

Diagnosis of Subtypes ADHD (Predominantly Inattentive Type) – Six or more of the Inattentive Type symptoms have been observed for at least six months to a degree that is maladaptive and inconsistent with developmental level of the subject. ADHD (Predominantly Hyperactive-Impulsive Type) – Six or more of the Hyperactivity-Impulsive Type symptoms have been observed for at least six months to a degree that is maladaptive and inconsistent with developmental level of the subject. ADHD (Combined Type) – Both the criteria for Inattentive Type and Hyperactivity- Impulsive Type have been met by the subject.

Potential Causes There are five areas of the brain that might be affected in people with ADHD: the prefrontal lobes, the frontal lobes, the basal ganglia, the cerebellum, and the corpus callosum. An imbalance of the two following neurotransmitters: dopamine and norepinephrine. Studies have suggested that heredity may be a significant cause of ADHD. Exposure to toxins (such as lead), abuse of substances (such as tobacco and alcohol), and other medical factors (such as complications at birth and low birth weight) have been linked to ADHD.

Interesting Myths and Facts Myth: All people with ADHD are hyperactive. – Why is this not true? Myth: The primary symptom of ADHD is inattention. – Fact: Although inattention is a symptom of ADHD, the primary behavioral problems associated with ADHD are: Behavioral inhibition Issues with executive function Issues with time awareness and management Issues with goal-directed behavior

Interesting Myths and Facts Myth: ADHD is primarily the result of minimal brain injury. – Fact: In most cases of ADHD, there is no evidence of actual damage to the brain. Myth: Social problems of students with ADHD are due to their not knowing how to interact socially. – Fact: Most people with ADHD know how to interact, but their problems with behavioral inhibition make it difficult to utilize socially appropriate behaviors. Myth: ADHD is primarily a U.S. phenomenon, due to our society’s emphasis on achievement and conformity. – Fact: Evidence strongly suggests that prevalence rates of ADHD are at least as high in the following countries (among others) as they are in the United States: Canada, Australia, New Zealand, Germany, Japan, China, Brazil, and the Netherlands.

Interesting Myths and Facts Fact: ADHD is widely recognized as one of the most frequent reasons children are referred for behavioral problems to guidance clinics. 30% - 50% of cases referred to guidance clinics are for ADHD. Fact: Most authorities estimate that between 3% and 7% of all school-age children have ADHD. Fact: ADHD is much more prevalent in boys than girls. Authorities estimate that ADHD affects boys at a rate of 3:1 in comparison to girls. Some gender bias in referral may exist, and it has been noted that boys are more likely to exhibit the more highly noticeable behaviors associated with ADHD, but current research suggests that these factors are not enough to account for the wide disparity in prevalence rates between boys and girls.

Instructional Strategies / SDI Accommodations: These are changes in the way in which the child is treated in order to best accommodate the child's physical, cognitive or emotional challenges. – Extended time for tests (the standard is one and a half times as long as allowed, but for academic tests in most general education classrooms, unlimited time is not uncommon). – Frequent test breaks. – The ability to move around the classroom. – Bathroom breaks when needed. – Special seating (in front of class and/or separated from peers). – A water bottle at the student's desk (some medications create dry-mouth).

Instructional Strategies / SDI Modifications: These change the academic or curricular demands made of a child to better fit the child's ability. – Modified homework. – Limited amount (fewer) words on spelling tests. – Scribing: the teacher or an aide writes the responses as dictated by a child. – Separate / modified tests in content areas. – Alternate forms of assessment: dictating, oral retelling, portfolios, etc. Sample SDI: 0Design%20Instruction.pdf 0Design%20Instruction.pdf

Sample Goals The student will complete assignments in a timely manner with 80% accuracy. – The student will utilize teachers and study skills class to complete assignments and get a better understanding of the material. – The student will bring appropriate supplies to class so that all work can be completed. – The student will raise their hand or approach the teacher to ask for help when they do not have a clear understanding. – When the student is having trouble staying on task, they can take a time out in the hall or use the appropriate suggestions in their behavior plan.

Sample Goals The student will be able to answer inference questions, make predictions, outline, and summarize with 80% accuracy. – The student will be able to use an outline, web, or graphic organizer to get a better understanding of a reading passage. – The student will be able to make predictions and assumptions by organizing their information to get a better understanding.

Parental Strategies Schedule: Keep the same routine every day, from wake-up time to bedtime. Include time for homework, outdoor play, and indoor activities. Keep the schedule on the refrigerator or on a bulletin board in the kitchen. Write changes on the schedule as far in advance as possible. Organize everyday items: Have a place for everything, and keep everything in its place. This includes clothing, backpacks, and toys. Use homework and notebook organizers: Use organizers for school material and supplies. Stress to your child the importance of writing down assignments and bringing home the necessary books. Be clear and consistent: Children with ADHD need consistent rules they can understand and follow. Give praise or rewards when rules are followed: Children with ADHD often receive and expect criticism. Look for good behavior, and praise it.

Video Segments ADHD Facts Video: ADHD Diagnosis Video: ADHD and the Brain: Frontline: “The Medicated Child” – Full Video: – Part 1: – Part 2: – Part 3: – Part 4: – Part 5: – Part 6:

Useful Links /attention-deficit-hyperactivity- disorder/index.shtml /attention-deficit-hyperactivity- disorder/index.shtml /Specially%20Design%20Instruction.pdf /Specially%20Design%20Instruction.pdf See “Video Segments” section for more useful links.