ADHD Bridget Connolly

ADHD- Diagnosis-Criteria-Symptoms

Attention Deficit Hyperactivity Disorder is a neurobehavioral disorder characterized by pervasive inattention and/or hyperactivity-impulsivity and resulting in significant functional impairment.

Predominately Inattentive Hyperactive-Impulsive Combined Type

This is a picture of a comparing the brain of an ADHD child and a non-ADHD child (PET scan) http://www.adhd.org.nz/neuro1.html

Diagnostic Criteria of ADHD

6 symptoms of inattention and/or 6 symptoms of hyperactive-impulsive behavior (high frequency)

At least 6-month duration of symptoms Onset of symptoms before age 7 Symptoms occur across two or more settings Symptoms have a significant negative impact on

social, academic, or occupational functioning Another psychiatric disorder (e.g. autism, mood

disorder, anxiety disorder, psychotic disorder) is not the primary cause of symptoms

DSM-IV (the Diagnostic and Statistical Manual of Mental Disorders,

Fourth Edition)

Common Symptoms for ADHD- Predominately Inattentive

Avoids tasks that require sustained attention Daydreams (tends to stare into space) Delays initiation or completion of tasks Has difficulty listening to or following instructions Does not pay close attention to details Displays inconsistent academic performance Forgets or loses materials Demonstrates a slow speed of cognitive processing

(www.CHADD.org)

Common Symptoms for ADHD- Hyperactive-Impulsive

Acts before thinking Begins work before

directions are given Has difficulty delaying

gratification Makes careless mistakes in

schoolwork Does not wait turn in

games or activities Engages in

risk-taking/dangerous behavior

Grabs things from others Interrupts or intrudes on

others Blurts out comments in

class

Runs or climbs excessively Has difficulty remaining

seated Fidgets with nearby objects Taps pencil, feet, or fingers Shifts position in seat

frequently Talks excessively Experiences rapid changes in

mood Overreacts to negative

situations

(www.CHADD.org)

Prevalence Estimates ADHD-Predominately Inattentive Type

-1.3% of school-aged children are diagnosed- ratio for boys to girls = 1:1

ADHD- Hyperactive-Impulsive Type- most children identified are of preschool age

ADHD- Combined Type- ~4% of school-aged children are diagnosed- ratio for boys to girls = 3:1

(www.CDC.org)

Associated Problems ~80% have achievement problems ~20–40% are diagnosed with learning disabilities (more common with ADHD- Inattentive) ~40% exhibit oppositional behavior in childhood (more common with ADHD- Combined) ~65% exhibit oppositional behavior as adolescents (more common with ADHD- Combined) ~25% engage in antisocial behavior (truancy,

physical aggression, stealing- most often ADHD- Combined)

~50% have impaired social relationships ~25% experience co-morbid emotional disorders

(www.CDC.org)

ADHD in Schools As an adolescent, a student may display any

of the following characteristics:- Displays poor organizational skills- Underachieves academically- Exhibits impulsive or risk-taking behavior- Engages in temper outbursts

- Sometimes experiences legal difficulties

School-Based Assessment of ADHD Symptoms

PURPOSE To gather information for a potential

medical diagnosis To determine the extent to which

attentional problems are interfering with a child’s academic, affective, and social needs

To perform a functional analysis of target behaviors for intervention

Assessment Methods Parent and teacher interviews

Information should be obtained from multiple adults

Standardized behavior rating scales Provides a normative perspective to assist in

determining symptom severity

Direct observation Systematic on-task observation and

assessment of environmental and instructional variables

ADHD Treatment -Ineffective Interventions

Herbal supplements/vitamins Biofeedback-although there is growing

research regarding its effectiveness with ADHD, depression and anxiety

Elimination diet (unless there is a sensitivity to food)

Caffeine (may work in short run, but in long run decreases blood flow to brain)

(www.adhd.com)

ADHD Treatment -Effective

Interventions Comprehensive Treatment Approach

Education/Parent Support Groups Medication Behavior Management at Home & School Counseling--Individual & Family Social Skills Training School and Home Support Strategies Physical Activity

(www.CHADD.org)

ADHD MedicationsEffective for 70-90%

(www.adhdnews.com)

Stimulants

Ritalin Dexedrine Adderall Concerta Cylert

Stimulant Side Effects Decreased appetite Weight loss Growth inhibition Insomnia/sleep disturbance Irritability/weepiness Abdominal pain Headaches Dizziness/drowsiness Tics

(www.adhdnews.com)

ADHD: Treatment in Schools Behavior Management

Clear, simple rules & consequences Consistency Eliminate emotion, talking/arguing Giving directions--get attention, be firm, have

repeat back to you, give time limits Visual reminders Break down assignments and homework Keep on task with timer, stop-watch

Behavior Management, cont.

Encouraging Good Behavior

Immediate Feedback, Frequent Rewards/Incentives & Praise

Frequent Change in Reward (Mystery Motivator) Immediate Consequences for Selected Behavior (time-out,

loss of privilege or points)- make them predictable Positive Rewards Before Consequences Priorities--Choose Battles Don’t Personalize Problems Provide clear expectations for appropriate behavior

Post classroom rules Use behavior contracts as needed

Provide specific and frequent verbal feedback Name the specific behavior that was performed well

or should be performed Use if/then statements

If you continue to …, then… Provide brief, matter-of-fact redirections

Suggested Classroom Modifications

Provide preferential seating Give only one or two-step directions at a time Break assignments down in to smaller

segments Use a timer to monitor/ improve timely work

completion Vary instructional style and incorporate

opportunities for active participation Minimize visual distractions Ensure a correct match between the difficulty level of the curriculum and the student’s

abilities Establish non-verbal communication

Parents & Teachers Working Together

Communication Weekly or daily progress reports Assignment notebooks signed by both Phone calls/e-mail Checklists

Homework support Regular time Quiet place Break down assignments/Set timer Breaks--physical activity Materials available Monitor closely & reward good homework behavior Check assignment books regularly

(www.CHADD.org)

ADHD and 504 ADHD and IDEA Consider a 504 plan for

the student who has a medical diagnosis of ADHD and:

Needs regular, ongoing general ed modifications or

Needs regular positive behavioral support or

Takes medication at school

Can a student with ADHD have an IEP? OHI Category Significant impact on

classroom performance Consider if:

Student demonstrates competency on criterion tests, but has failing grades

Student does not have a diagnosable processing disorder at the root of failure

Ongoing general ed modifications are not providing enough support for successful access to the curriculum

Behavior Intervention Plans Describe the target behavior and its severity Describe the function of the target behavior Clearly describe the desired positive behavior Identify how the environment can be changed

to decrease negative behavior Identify reinforcers to maintain positive

behavior Describe the method for monitoring the

behavior plan and who will be responsible

Resources ADDA (Attention Deficit Disorder Association)

www.add.org

ADHD News – Drug Side Effectswww.adhdnews.com

Behavioural Neurotherapy Clinicwww.adhd.com

Center for Disease Control (Attention Deficit-Hyperactivity Disorder) www.cdc.gov/ncbddd/adhd/

CHADD (Children and Adults with Attention Deficit Disorder)www.chadd.org

LIDA (Learning Disabilities Association) www.ldanatl.org

National Resource Center on ADHD www.help4adhd.org