1. Inclusion: Effective Practices for All Students, 1e McLeskey/Rosenberg/Westling 0135154340 © 2010 Pearson Education, Inc. All Rights Reserved. 5-1 ADHD - OBJECTIVES Describe the definition and criteria used to identify students with ADHD. Know how many students are identified with ADHD. Identify the educational settings in which students with ADHD are educated. Describe the major characteristics of students with ADHD.

2. Inclusion: Effective Practices for All Students, 1e McLeskey/Rosenberg/Westling 0135154340 © 2010 Pearson Education, Inc. All Rights Reserved. 5-2 OBJECTIVES Describe key issues and challenges related to including students with ADHD in general education classrooms. Explain effective practices for addressing the needs of students with ADHD in elementary and secondary classrooms.

3. Inclusion: Effective Practices for All Students, 1e McLeskey/Rosenberg/Westling 0135154340 © 2010 Pearson Education, Inc. All Rights Reserved. 5-3 WHO ARE STUDENTS WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER? ADHD is “a persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequently displayed and more severe than is typically observed in individuals at comparable levels of development” (APA, 2000, p. 85).

4. Inclusion: Effective Practices for All Students, 1e McLeskey/Rosenberg/Westling 0135154340 © 2010 Pearson Education, Inc. All Rights Reserved. 5-4 WHO ARE STUDENTS WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER? Student must exhibit 6 of 9 explicit behaviors related to either inattention or hyperactivity/impulsivity. These behaviors must be exhibited frequently over a 6 month period. The behaviors must be evident across two or more settings.

5. Inclusion: Effective Practices for All Students, 1e McLeskey/Rosenberg/Westling 0135154340 © 2010 Pearson Education, Inc. All Rights Reserved. 5-5 WHO ARE STUDENTS WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER? The impulsive and inattentive behavior was exhibited before the age of 7. Students may be identified as having ADHD, predominantly inattentive type; ADHD, predominantly hyperactive- impulsive type; or ADHD combined, who exhibit inattentive and hyperactive-impulsive behaviors.

6. Inclusion: Effective Practices for All Students, 1e McLeskey/Rosenberg/Westling 0135154340 © 2010 Pearson Education, Inc. All Rights Reserved. 5-6 HOW ARE STUDENTS WITH ADHD IDENTIFIED? Definition of ADHD (PL 108-446 Regulations) ADHD is included as part of the other health impairments (OHI) category in IDEA. The; other health impairment category is defined as follows: Other health impairments means having limited strength, vitality or alertness, including a heightened alertness to environmental stimuli, that

7. Inclusion: Effective Practices for All Students, 1e McLeskey/Rosenberg/Westling 0135154340 © 2010 Pearson Education, Inc. All Rights Reserved. 5-7 SIX STEP PROCESS OF IDENTIFICATION American Academy of Pediatricians recommends pediatricians 1. Evaluate for ADHD a child from ages 6-12 who is described as unusually inattentive, hyperactive, impulsive; underachieving in school; or exhibiting behavior problems 2. Use the DSM-IV TR criteria 3. Collect evidence from parents or caregivers regarding the symptoms of ADHD across settings

8. Inclusion: Effective Practices for All Students, 1e McLeskey/Rosenberg/Westling 0135154340 © 2010 Pearson Education, Inc. All Rights Reserved. 5-8 SIX STEP PROCESS OF IDENTIFICATION 4. Obtain information from the child’s teacher or other school professionals regarding the symptoms of ADHD the child exhibits in the classroom 5. Conduct an evaluation of any co-existing conditions 6. Other diagnostic tests or psychological tests are not routinely necessary to identify students with ADHD (Reiff, 2004)

9. Inclusion: Effective Practices for All Students, 1e McLeskey/Rosenberg/Westling 0135154340 © 2010 Pearson Education, Inc. All Rights Reserved. 5-9 HOW ARE STUDENTS WITH ADHD IDENTIFIED? If a student is identified as ADHD but is not eligible for special education services, the student still may be eligible for accommodations in the general education classroom as part of Section 504 of the Rehabilitation Act of 1973.

10. Inclusion: Effective Practices for All Students, 1e McLeskey/Rosenberg/Westling 0135154340 © 2010 Pearson Education, Inc. All Rights Reserved. 5-10 HOW ARE STUDENTS WITH ADHD IDENTIFIED? A teacher should not recommend to a parent that a child should be referred to a physician to be evaluated for ADHD or suggest that the student could benefit from medication. A school’s multidisciplinary team should provide information to parents regarding the nature of a child’s difficulty in school and whether these difficulties merit an evaluation by a physician.

11. Inclusion: Effective Practices for All Students, 1e McLeskey/Rosenberg/Westling 0135154340 © 2010 Pearson Education, Inc. All Rights Reserved. 5-11 HOW MANY STUDENTS ARE IDENTIFIED WITH ADHD? Far more boys are identified with ADHD than girls. More than 50% of these students are also identified with another disability (Reiff, 2004).

12. Inclusion: Effective Practices for All Students, 1e McLeskey/Rosenberg/Westling 0135154340 © 2010 Pearson Education, Inc. All Rights Reserved. 5-12 WHERE ARE STUDENTS WITH ADHD EDUCATED? Most students with ADHD spend the majority of the school day in general education classrooms. The placement settings for these students are the least restrictive of any category other than speech or language impairments.

13. Inclusion: Effective Practices for All Students, 1e McLeskey/Rosenberg/Westling 0135154340 © 2010 Pearson Education, Inc. All Rights Reserved. 5-13 WHAT ARE MAJOR CHARACTERISTICS OF STUDENTS WITH ADHD? Social and Behavior Problems Some students with ADHD are more negative and unskilled when interacting with peers; some create disruptions in classrooms because of their behaviors. Academic Difficulties Eighty percent have at least some problems with academic achievement in schools (Reiff, 2004).

14. Inclusion: Effective Practices for All Students, 1e McLeskey/Rosenberg/Westling 0135154340 © 2010 Pearson Education, Inc. All Rights Reserved. 5-14 WHAT ARE KEY ISSUES AND CHALLENGES? Since students with ADHD differ significantly, teachers should: Know the particular student Be very proactive and stay on top of things Praise students when they are doing well Have simple strategies to redirect the student, keep the student focused, and help address inattentive, impulsive, and hyperactive behaviors

15. Inclusion: Effective Practices for All Students, 1e McLeskey/Rosenberg/Westling 0135154340 © 2010 Pearson Education, Inc. All Rights Reserved. 5-15 WHAT ARE EFFECTIVE PRACTICES FOR ELEMENTARY STUDENTS? Provide appropriate structure in general education classrooms. Facilitate home-school communication and student support using daily or weekly report cards.

16. Inclusion: Effective Practices for All Students, 1e McLeskey/Rosenberg/Westling 0135154340 © 2010 Pearson Education, Inc. All Rights Reserved. 5-16 WHAT ARE EFFECTIVE PRACTICES FOR SECONDARY STUDENTS? Secondary students with ADHD have Poor skills related to organization, planning, time management and memory Limited study skills that are needed to take notes, complete tests, and so forth Learning from lectures is not conducive to successful learning for students with ADHD Difficulty managing expectations from multiple teachers

17. Inclusion: Effective Practices for All Students, 1e McLeskey/Rosenberg/Westling 0135154340 © 2010 Pearson Education, Inc. All Rights Reserved. 5-17 WHAT ARE EFFECTIVE PRACTICES FOR SECONDARY STUDENTS? Strategies for addressing the instructional needs of adolescents with ADHD in general education classrooms. Keep things simple and doable. Keep things interesting. Keep things organized.

18. Inclusion: Effective Practices for All Students, 1e McLeskey/Rosenberg/Westling 0135154340 © 2010 Pearson Education, Inc. All Rights Reserved. 5-18 WHAT ARE EFFECTIVE PRACTICES FOR STUDENTS WITH ADHD? Evidence based strategies for ensuring student attention. Changing the focus of the task Changing instruction or sequencing of tasks Changing the structure of the task Changing the setting

19. Inclusion: Effective Practices for All Students, 1e McLeskey/Rosenberg/Westling 0135154340 © 2010 Pearson Education, Inc. All Rights Reserved. 5-19 WHAT ARE EFFECTIVE PRACTICES FOR STUDENTS WITH ADHD? The use of medication to address the symptoms of ADHD has produced much controversy. Concerns regarding the use of powerful medications to control student behaviors Concerns that these medications may be used with too many children

20. Inclusion: Effective Practices for All Students, 1e McLeskey/Rosenberg/Westling 0135154340 © 2010 Pearson Education, Inc. All Rights Reserved. 5-20 WHAT ARE EFFECTIVE PRACTICES FOR STUDENTS WITH ADHD? More than 50% of students with ADHD are given medication (U.S. Department of Health and Human Services, 2005). Much research has been conducted regarding the use of medications to control the symptoms of ADHD (Connors, 2006a, 2006b). Stimulant medications are highly effective treatments for symptoms of ADHD

21. Inclusion: Effective Practices for All Students, 1e McLeskey/Rosenberg/Westling 0135154340 © 2010 Pearson Education, Inc. All Rights Reserved. 5-21 WHAT ARE EFFECTIVE PRACTICES FOR STUDENTS WITH ADHD? Classroom teachers play an important role in monitoring student behavior and reaction to medication in the classroom (Rosenberg et al., 2004). Appropriate levels of medication have been show to have a significant impact on the negative behaviors of children and adolescents with ADHD (Connor, 2006a). Medications have proven to be the most effective treatment (MTA, 1999).