1. Attention Deficit- Hyperactivity Disorder... A Closer Look Presented by Belinda Ingram, School Counselor West Bainbridge Elementary School

2. Definition: According the the National Institute of Mental Health, ADHD is a psychologic condition whose definition has not been fully pinned down. It is a syndrome characterized by inattention, distractibility, impulsivity, and hyperactivity.

3. Three Subtypes: 1. Predominately hyperactive-impulsive type. Behavior marked by hyperactivity but not inattentiveness 2. Predominately inattentive type. Behavior marked by inattentiveness but not hyperactivity/impulsivity 3. Combined type

4. Inattentive Symptoms: Often fails to give close attention to detail, makes careless mistakes Often has difficulty sustaining attention in tasks or play Often does not seem to listen when spoken to Often does not follow through and fails to finish tasks Has difficulty organizing tasks and activities Avoids/dislikes tasks requiring sustained mental effort Often loses things Is often easily distracted by extraneous stimuli

5. Hyperactive-Impulsive Symptoms: Often fidgets or squirms when sitting Has difficulty remaining seated Often runs about or climbs excessively in inappropriate situations Has difficulty playing quietly Is often “on the go”, acts as if “driven by a motor” Often talks excessively Often blurts out answers to questions before they have been completed Has difficulty awaiting turn Often interrupts or intrudes on others

6. Diagnostic Criteria: Has six or more symptoms of inattention or hyperactivity/impulsivity for at least 6 months which are maladaptive and inconsistent with developmental level Onset of symptoms before age 7 Symptoms occur in two or more settings Clear evidence of significant impairment in social or academic functioning Not caused by another disorder

7. Diagnosing ADHD in Children 1. Gather enough info to rule out other possible causes of abnormal behavior 2. Assess intellectual, academic, social,and emotional functioning 3. Parents and/or teacher fills out rating scale

8. Statistical Information: Affects between 4% and 12% (or 2 million) of school-age children in America Affects 2-3 times more boys than girls In 50% of cases, ADHD continues into adulthood

9. Causes/Risk factors: The precise cause is not known, but increasing evidence points to biological factors. One study has shown that there are differences in the brains of individuals with ADHD. Scientists recently discovered that parts of the brain’s frontal lobe and basal ganglia are reduced by about 10% in size and activity in ADHD children. This decreased activity level on some parts of the brain which cause inattention. The following information is based on current scientific research.

10. Causes/Risk factors continued: In some studies, brain scans reveal that the right side of the brain is smaller in ADHD children than in non-ADHD children. Abnormalities in important areas in this part of the brain may cause problems associated with impulsivity.

11. Causes/Risk factors continued: Evidence suggests that ADHD or the tendency toward the disorder may have a genetic component. For example, most ADHD kids have at least one blood relative with the disorder. ADHD is often associated with problem pregnancies and difficult deliveries. Maternal smoking during pregnancy is associated with a higher risk for ADHD. Exposure to environmental toxins during pregnancy is associated with a higher risk for ADHD. Infant malnutrition

12. What Probably Does Not Cause ADHD? Dysfunctional families Too much television Poor schooling Refined sugar Food additives Undetected brain damage or minor head trauma Although there is still controversy, the following have been disproved by some recent scientific research.

13. Treatment Alternatives Psychostimulant medication - at least four of these are federally approved to treat ADHD. They are : Ritalin, Dexedrine, Cylert, and Adderall Studies suggest that about 80% of children with ADHD respond positively to these medications and improvement is usually noticed within a week after treatment begins. Although there is no cure for ADHD, a number of approaches have proven to be effective. These include:

14. Other Treatments: Psychotherapy: helps individuals to accept themselves and their disorder and to explore more positive ways to channel emotions Cognitive-Behavioral Therapy: helps people learn to manage their behavior by finding more realistic and practical ways to change their behaviors. Then they can better cope with problems Social Skills Training: Teaches people to improve their behavior with others through modeling and role-playing appropriate behaviors.

15. Other Treatments: Family Therapy: the child, parents, and siblings are supported emotionally and guided to find better ways to handle disruptive behaviors and to promote change. Parent Skills Training: special discipline techniques are taught to help the child control problem behaviors

16. Possible Effects of Untreated ADHD Four times more likely to drop out of school Increased risk of substance abuse, suicide, and accidental injuries Reduced academic achievement Interpersonal problems and involvement in Juvenile justice system Depression, low self-esteem, and emotional problems

17. Educating Children With ADHD Seating away from distractions Allowing the release of excess energy in designated areas/activities Establishing rules Rewarding appropriate behavior Make accommodations such as:

18. The Good News Two federal laws- the Individuals with Disabilities Education Act (IDEA) and Section 504 of the National Rehabilitation Act- ensure that children with ADHD who need special services receive them