Copyright © Allyn & Bacon 2008 Chapter 6: Students with Attention Deficit-Hyperactivity Disorder Chapter 6 Copyright © Allyn & Bacon 2008

Chapter 6: Students with Attention Deficit-Hyperactivity Disorder A pervasive pattern of inattention, impulsivity, and/or hyperactivity- impulsivity that is more frequent and severe than is typically observed in individuals at a comparable level of development. (American Psychological Association, 2000)

Copyright © Allyn & Bacon 2008 Chapter 6: Students with Attention Deficit-Hyperactivity Disorder  A. Either (1) or (2):  (1) inattention: six (or more) of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:  (a) often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities (b) often has difficulty sustaining attention in tasks or play activities (c) often does not seem to listen when spoken to directly (d) often does not follow through on instructions and fails to finish school work, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions) (e) often has difficulty organizing tasks and activities (f) often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework) (g) often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools) (h) is often easily distracted by extraneous stimuli (i) is often forgetful in daily activities  (2) hyperactivity-impulsivity: six (or more) of the following symptoms of hyperactivity-impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:  (a) often fidgets with hands or feet or squirms in seat (b) often leaves seat in classroom or in other situations in which remaining seated is expected (c) often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness) (d) often has difficulty playing or engaging in leisure activities quietly (e) is often "on the go" or often acts as if "driven by a motor" (f) often talks excessively  Impulsivity  (g) often blurts out answers before questions have been completed (h) often has difficulty awaiting turn (i) often interrupts or intrudes on others (e.g., butts into conversations or games)  B. Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 years.  C. Some impairment from the symptoms is present in two or more settings (e.g., at school [or work] and at home).  D. There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning.  E. The symptoms do not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder and are not better accounted for by another mental disorder (e.g., Mood Disorder, Anxiety Disorder, Dissociative Disorders, or a Personality Disorder).Pervasive Developmental DisorderSchizophreniaMood DisorderAnxiety DisorderDissociative Disorders Personality Disorder

Copyright © Allyn & Bacon 2008 Chapter 6: Students with Attention Deficit-Hyperactivity Disorder  Predominately inattentive  Predominately hyperactive/impulsive  Combined

Copyright © Allyn & Bacon 2008 Chapter 6: Students with Attention Deficit-Hyperactivity Disorder 3-5% of the population 2-3 times as many boys identified as girls No difference in frequency among races Caucasian children more likely to receive medication for ADHD

Copyright © Allyn & Bacon 2008 Chapter 6: Students with Attention Deficit-Hyperactivity Disorder  Neurological  Developmental  Chronic  Not situational  Production deficits, not acquisition deficits

Copyright © Allyn & Bacon 2008 Chapter 6: Students with Attention Deficit-Hyperactivity Disorder  Physiological causes  Heredity  Brain differences  Environmental Causes  Lead poisoning  Maternal prenatal smoking and alcohol consumption

Copyright © Allyn & Bacon 2008 Chapter 6: Students with Attention Deficit-Hyperactivity Disorder “Copyright© Allyn & Bacon 2006”

Copyright © Allyn & Bacon 2008 Chapter 6: Students with Attention Deficit-Hyperactivity Disorder  Problems with Executive Functioning  Issues with ability to control impulses  Working memory is not efficient  Self-directed speech not utilized effectively  Difficulty controlling emotions or motivation  Reconstitution – the ability to break down what is observed and to combine parts to carry out new actions

Copyright © Allyn & Bacon 2008 Chapter 6: Students with Attention Deficit-Hyperactivity Disorder  Some students are very successful academically  Other students consistently achieve below their potential  Academic self-concept is important

Copyright © Allyn & Bacon 2008 Chapter 6: Students with Attention Deficit-Hyperactivity Disorder  Self-esteem is a problem for some, but not all, students with ADHD  Students often have problems coping with social functioning  Developing and maintaining friendships  Rejection by peers

Copyright © Allyn & Bacon 2008 Chapter 6: Students with Attention Deficit-Hyperactivity Disorder  Failure to attend to details  Make careless mistakes in work  Failure to complete schoolwork  Failure to listen when spoken to directly  Difficulty organizing tasks and materials  Avoidance of tasks that require sustained mental effort

Copyright © Allyn & Bacon 2008 Chapter 6: Students with Attention Deficit-Hyperactivity Disorder  ADHD may occur simultaneously with other disorders such as:  Learning disabilities  Tourette’s syndrome  Emotional disabilities  Autism  Traumatic brain injury  Psychiatric disorders  Sleep disorders  Substance abuse problems

Copyright © Allyn & Bacon 2008 Chapter 6: Students with Attention Deficit-Hyperactivity Disorder  Medical Diagnosis  Pediatrician, family physician, psychiatrist  Diagnosis may occur before child enters school  Educational referrals may come from  Child’s classroom teacher  Special education teacher

Copyright © Allyn & Bacon 2008 Chapter 6: Students with Attention Deficit-Hyperactivity Disorder  Medical assessment  Continuous performance tests  DISC IV (Diagnostic Interview Schedule for Children)  Parent rating scales and checklists  Teacher rating scales and checklists  Samples of student’s work  Anecdotal information

Copyright © Allyn & Bacon 2008 Chapter 6: Students with Attention Deficit-Hyperactivity Disorder Inability to regulate behavior Question rules and create their own Problems with Rules Primary characteristic of ADHD Good judgment lags behind intellectual development Impulsivity Difficulty in most situations Only in specific situations, e.g., when bored Poor sustained attention ADHDGifted StudentsBehavior

Copyright © Allyn & Bacon 2008 Chapter 6: Students with Attention Deficit-Hyperactivity Disorder  Does the ADHD “adversely affect” the student’s educational performance?  Not all students with ADHD are eligible  Students who are not eligible for IDEA may qualify for accommodations under Section 504  Students may be eligible because they also have a learning or emotional disability

Copyright © Allyn & Bacon 2008 Chapter 6: Students with Attention Deficit-Hyperactivity Disorder  Diagnosis at an early age is difficult.  If children’s symptoms of ADHD are severe, early intervention is crucial.  Children may need a highly structured environment, immediate and consistent feedback, and age-appropriate rewards.

Copyright © Allyn & Bacon 2008 Chapter 6: Students with Attention Deficit-Hyperactivity Disorder  Many students receive their education in general education classrooms.  Professionals must collaborate with parents to find effective techniques for students with ADHD.

Copyright © Allyn & Bacon 2008 Chapter 6: Students with Attention Deficit-Hyperactivity Disorder  66% of students with ADHD continue to have the disorder into adulthood  Many adults with ADHD are disorganized, impulsive, and have poor work skills  Students need to have a clear understanding of their disorder and learn to advocate for themselves

Copyright © Allyn & Bacon 2008 Chapter 6: Students with Attention Deficit-Hyperactivity Disorder  The use of medication is controversial.  The decision to prescribe medication only indirectly involves school personnel.  Medication is helpful for many (70-80%) students for whom it is prescribed.  Medication alone is not sufficient to improve academic performance

Copyright © Allyn & Bacon 2008 Chapter 6: Students with Attention Deficit-Hyperactivity Disorder  Ritalin  Concerta  Focalin  Adderall  Strattera

Copyright © Allyn & Bacon 2008 Chapter 6: Students with Attention Deficit-Hyperactivity Disorder  Parent and professional education  Environmental supports for students  Behavior interventions  Rewards  Token economy systems  Structure  Quick Pace  Variety

Copyright © Allyn & Bacon 2008 Chapter 6: Students with Attention Deficit-Hyperactivity Disorder Have realistic expectations of parents Encourage parents to be good role models Help parents have realistic expectations