Presented by: Name Month XX, 2012 Is It ADH or Just Inattention? Insert logo of speaker’s organization Insert host logo Insert local partners’ logo 1

Inattention Hyperactivity Impulsivity What Is ADHD? 2

Hyperactive/Impulsive Symptoms 1.Fidgeting and squirming 2.Running or climbing excessively 3.Trouble playing quietly 4.“On the go” or “driven by a motor” 5.Talking excessively 6.Blurting out answers 7.Trouble taking turns 8.Interrupting or intruding 3

Inattentive Symptoms 1.Making careless mistakes 2.Trouble paying attention to a task 3.Not listening 4.Not following instructions 5.Trouble organizing 6.Avoiding or disliking sustained effort 7.Losing things 8.Easily distracted 9.Forgetful 4

Overlap of Symptoms and Co-occurring Disorders 5 Overlapping Symptoms: Inattention Lack of Concentration Anxiety Sadness Opposition Fidgetiness Impulsivity Appetite Loss Lack of Sleep Co-occurring Disorders: Oppositional defiant disorder Anxiety or mood disorders Learning disabilities Conduct disorder Tic disorders

Gender Differences and ADHD Stereotype of ADHD ADHD in girls often presents as more inattentive than hyperactive Girls with untreated ADHD are at risk for: –low self-esteem –underachievement –depression –anxiety Without treatment girls are also more likely to engage in risky behaviors like smoking and unprotected sex while in middle or high school. ½ of ADHD patients have > 2 diagnoses

ADHD Barriers in Middle and High School Multiple teachers Class schedule Independent and long-term assignments Social relationships Long-term goals 7

ADHD and the Brain 8 UCLA Lab of Neuroimaging

Effects of not treating ADHD Immediate: Interferes with learning and social development Reduced instructional time in class Maintains or exacerbates ADHD behaviors Disorganization Difficulty planning and problem solving Difficulty persisting on challenging tasks Depression Anxiety Bullying 9 Long-term: Less schooling & poorer grades Higher expulsion rates Fewer friends Lower self-esteem Higher arrest rates Lower occupational rank Higher job termination rates Riskier driving More accidents

Treatment & Intervention Psychopharmacology Behavioral Interventions –Parent training Functional Behavioral Assessment (FBA) Parent-Child Interaction Therapy (PCIT) Groups –School-based interventions Daily Report Card Para training –Organizational skills training 10

Daily Report Card 11

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13 Instructional Considerations Task duration –Long projects broken into shorter parts with immediate feedback Direct instruction –Teacher-directed work, not independent seat-work Peer tutoring Scheduling –Academic instruction in the morning, if possible Novelty –Increased stimulation (color, shape, texture) reduces activity level Structure and organization –Lecture outline Rule reminders and visual cues Auditory cues –Reminder tones to stay on task

14 Instructional Considerations Pacing of work –When possible, students with ADHD should set their own pace Instructions –Short, specific and direct Productive physical movement –Trip to office, sharpening pencil, watering plants, etc. Active vs. passive involvement –Write on the chalkboard, help with visual aids, etc. Distractions –Out of sight, out of mind Anticipation Contingency management –Token systems, response-cost programs, external reinforcement Time-Out

15 School Accommodations Special Education Services qualifications –“Other Health Impaired” –Learning disability –Social-emotional disorder Section 504 –Plans for individuals with impairments that interfere with major life activities, such as learning –Extra time during testing –Testing in a quiet place to compensate for distractibility

Unproved or untested treatments Play therapy or talk therapy Biofeedback Dietary changes, elimination diets Ginkgo biloba & other supplements Meditation Exercise Metronome Vision training Sensory integration therapy 16

Where to find help [Include your contact information] [Include your school/district resources] [Add information on resources in your area] Learn more about ADHD on childmind.org 17

Thank you for joining us to Speak Up for Kids! 18