1. Learners with Attention Deficit Hyperactivity Disorder (ADHD)
Chapter 6
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Topics
Brief History
Definition
Prevalence
Assessment
Causes
Psychological and Behavioral Characteristics
Educational Considerations
Medication Considerations
Service Delivery Models
Early Intervention
Transition
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Brief History of ADHD
Still’s Children with “Defective Moral Control”
Goldstein’s brain-injured soldiers of World War I
The Strauss Syndrome
Cruickshank’s work
Minimal brain injury and Hyperactive Child Syndrome
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Definition of ADHD
American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM)
ADHD, Predominantly Inattentive Type
ADHD, Predominantly Hyperactive-Impulsive Type
ADHD, Combined Type
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5. Basic Concepts About ADHD
ADHD is a developmental disability that becomes apparent before the age of seven.
ADHD may have an impact on academic success.
ADHD is not hard to spot in the classroom.
Many behaviors associated with ADHD may be misunderstood and misinterpreted as lazy, unorganized, and even disrespectful.
For 2/3s of individuals with ADHD, the disorder continues to cause problems in adulthood.
ADHD occurs across all cultural, racial, and socioeconomic groups.

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Prevalence
ADHD is the most common childhood psychiatric disorder.
Estimates of 3 to 5 percent of school-age population
Boys outnumber girls. Girls and children from minority families may be underidentified.
Hyperactivity and impulsivity are most likely to be observed in preschool and elementary children; inattention is more common in adolescents.
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7. Prevalence of ADHD
Results of one study (Reid et al., 1994) suggested that:
approximately 52% are identified as behaviorally disordered (BD).
approximately 29% are identified as LD.
approximately 9% are identified as MR.

8. Assessment
For years, the diagnosis of ADHD was considered the responsibility of psychologists, psychiatrists, and physicians.
The mandates of Section 504 suggest that public school personnel have a responsibility to assess students suspected of having ADHD.
Although assessment is performed by trained school personnel, teachers play an important role in the assessment process.

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Assessment
Components
Medical examination
Clinical interview
Teacher and parent rating scales
Observation
Review of school records
Review of IQ & academic testing results
Subjectivity of some components
“Doctor’s office effect”
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10. Steps in the Assessment Process (Burnley, 1993)
Preliminary Assessment and Initial Child Study Meeting
Formal Assessment Process: Follow-Up Meeting of the Child Study Team
Collaborative Meeting for Strategy Development
Follow-Up and Progress Review

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Causes
For most children, the precise cause of ADHD is unknown.
ADHD is not due to poor parenting.
Areas of the brain affected: frontal lobes, basal ganglia, cerebellum
Neurotransmitter involved: Dopamine
Hereditary factors
Family studies
Twin studies
Molecular genetic factors
Toxins and medical factors
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12. Psychological and Behavioral Characteristics
Barkley’s model of ADHD
Behavioral inhibition
Executive functions
Persistent goal-directed behavior
Adaptive skills
Problems socializing with peers
Co-existing conditions
Learning disabilities
Emotional or behavioral disorders
Substance abuse
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13. Psychological and Behavioral Characteristics
Limited sustained attention or persistence of attention to tasks
Reduced impulse control or limited delay of gratification
Excessive task-irrelevant activity or activity poorly regulated to match situational demands
Deficient rule following
Greater than normal variability during task performance

14. Educational Considerations
Classroom structure and teacher direction
Making instructional modifications
Developing students self regulated strategies
Use of medication
Functional assessment and contingency-based self-management
The role of reinforcement
Developing IEP
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15. Characteristics of Effective Teachers of Students with ADHD
Patience
Humor
Structured & predictable approach
Consistency
Firmness
Positive attitude toward inclusion
Knowledge/willingness to work w/ students w/ exceptional needs
Knowledge of effective interventions
Positive academic expectations
Frequent review
Clarity of teaching
Flexibility
Fairness
Active interaction w/ students
Responsiveness
Warmth
Willingness to work collaboratively with other teachers

16. Service Delivery Models
Continuum of placement
Difficult to determine
Presumption that less than half receive special education
Individual determination
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Early Intervention
Difficult to determine in young children because of behavioral similarity.
Children who are identified typically have extreme behaviors and require special management and will need long-term programming.
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18. Transition to Adulthood
Diagnosis in adulthood
Adult outcomes
Employment
Marriage and family
Importance of coaching
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