ADD/ADHDADD/ADHDA disorder characterized by A disorder characterized by

inappropriate degrees of inappropriate degrees of attention, impulsiveness, and/orattention, impulsiveness, and/or

hyperactivity. hyperactivity.

► Although these areas are considered to be Although these areas are considered to be core symptoms, all three characteristics are core symptoms, all three characteristics are not necessarily present in those affected. not necessarily present in those affected.

► Symptoms are generally first manifested Symptoms are generally first manifested early in childhood and may persist in early in childhood and may persist in varying degrees throughout adult life.varying degrees throughout adult life.

► The difference between Attention Deficit The difference between Attention Deficit Disorder and Attention Deficit HyperactivityDisorder and Attention Deficit Hyperactivity

Disorder (ADD/ADHD) is the absence or Disorder (ADD/ADHD) is the absence or presence of hyperactivity.presence of hyperactivity.

CHARACTERISTICSCHARACTERISTICS

►Hyperactivity, fidgetiness and/or squirming.Hyperactivity, fidgetiness and/or squirming.► Impulsivity (difficulty staying focused on an Impulsivity (difficulty staying focused on an

immediate task) often described by those with immediate task) often described by those with ADD/ADHD behavior driven by thoughts, ideas, ADD/ADHD behavior driven by thoughts, ideas, or suggestions that race through the mind.or suggestions that race through the mind.

► Inattention for "tedious" or "unexciting" Inattention for "tedious" or "unexciting" mental activity, very obvious with respect to mental activity, very obvious with respect to school work but not limited to formal learning school work but not limited to formal learning experiences. experiences.

►Note body posture and lack of attending Note body posture and lack of attending visually to the task.visually to the task.

► Falling asleep slowly and with great Falling asleep slowly and with great difficulty at night.difficulty at night.

►Waking slowly or, especially in young Waking slowly or, especially in young children, being disorganized and/or grumpy children, being disorganized and/or grumpy in the morning unless anticipating high in the morning unless anticipating high excitement activity.excitement activity.

► Spatial dyslexia (for example, writing mirror-Spatial dyslexia (for example, writing mirror-image reversals of letters, difficulty with left-image reversals of letters, difficulty with left-right discrimination, and difficulty properly right discrimination, and difficulty properly sequencing letters, words or numbers).sequencing letters, words or numbers).

► Episodic explosiveness (also referred to as Episodic explosiveness (also referred to as emotional outbursts or temper tantrums in emotional outbursts or temper tantrums in the very young) manifest as verbal violence the very young) manifest as verbal violence and/or hitting, biting, kicking etc.and/or hitting, biting, kicking etc.

► Frequent bedwetting.Frequent bedwetting.► Unexplained and unreasonable emotional Unexplained and unreasonable emotional

negativity.negativity.► Unexplained irritability or easy frustration Unexplained irritability or easy frustration

over minor issues or matters, often over minor issues or matters, often described as "things bug me."described as "things bug me."

CAUSECAUSE

► The causes of ADD/ADHD are found in the The causes of ADD/ADHD are found in the functioning of the brain. functioning of the brain.

► Attention Deficit Disorder is a limiting Attention Deficit Disorder is a limiting metabolic dysfunction of the brain. When metabolic dysfunction of the brain. When neural building materials are lacking, neural building materials are lacking, neurological demands cannot be fulfilled neurological demands cannot be fulfilled easily.easily.

► This interferes with the efficient processing of This interferes with the efficient processing of information.information.

►Demands for new learning, memory, and the Demands for new learning, memory, and the management of information cannot be management of information cannot be satisfied, which overworks and stresses the satisfied, which overworks and stresses the brain.brain.

►Attention Deficit Disorder (ADD) and Attention Deficit Disorder (ADD) and attention deficit hyperactivity disorder attention deficit hyperactivity disorder (ADHD) are a limiting metabolic (ADHD) are a limiting metabolic dysfunction of the Reticular Activating dysfunction of the Reticular Activating System, the center of consciousness that System, the center of consciousness that coordinates learning and memory, and coordinates learning and memory, and which normally supplies the appropriate which normally supplies the appropriate neural connections necessary for smooth neural connections necessary for smooth information processing and clear,non-information processing and clear,non-stressful attention stressful attention

►When neural building materials are lacking, When neural building materials are lacking, demand for further connectivity cannot demand for further connectivity cannot easily be fulfilledeasily be fulfilled

► This interferes with the efficient processing This interferes with the efficient processing of information, and frustrating the of information, and frustrating the ADD/ADHD individual. ADD/ADHD individual.

► In other words, neural "hardware" remains In other words, neural "hardware" remains in limited production (there's not enough of in limited production (there's not enough of it), and supply cannot keep up with the it), and supply cannot keep up with the demand (increasing stimulus or "traffic") for demand (increasing stimulus or "traffic") for new neural connections within the Central new neural connections within the Central Nervous System (CNS) Nervous System (CNS)

► Demands for new learning, memory, and the Demands for new learning, memory, and the management of information processing management of information processing cannot be satisfied, and the insufficient cannot be satisfied, and the insufficient "connections" result in existing neural "connections" result in existing neural pathways being repeatedly overworked and pathways being repeatedly overworked and over stressed, often resulting in complete over stressed, often resulting in complete gridlock or shutdown so that nothing gets gridlock or shutdown so that nothing gets processed thereafter. processed thereafter.

► This, most noticeably, generates frustration, This, most noticeably, generates frustration, bewilderment, and behavioral problems in the bewilderment, and behavioral problems in the individual.individual.

► A single cause has not been conclusively proven. A single cause has not been conclusively proven. Some possibilities are:Some possibilities are:

► 1. Genetic/ Hereditary (strongest correlation)1. Genetic/ Hereditary (strongest correlation)► 2. Brain damage (head trauma) before, after or 2. Brain damage (head trauma) before, after or

during birth (twice as likely to have had labor> during birth (twice as likely to have had labor> 13hrs)13hrs)

► 3. Brain damage by toxins (internal: bacterial and 3. Brain damage by toxins (internal: bacterial and viral, external: fetal alcohol syndrome, metal viral, external: fetal alcohol syndrome, metal intoxication, eg lead)intoxication, eg lead)

► 4. Strongly held belief by some people (including at 4. Strongly held belief by some people (including at least one book, Feingold's "Cookbook for least one book, Feingold's "Cookbook for Hyperactive children") that food allergies cause Hyperactive children") that food allergies cause ADD. This has *not* been proven scientifically.ADD. This has *not* been proven scientifically.

Long Range prognosisLong Range prognosis

►ADD/ADHD is often life-long, though ADD/ADHD is often life-long, though hyperactivity usually improves with age. hyperactivity usually improves with age.

►Patients with ADD/ADHD are more likely Patients with ADD/ADHD are more likely than average to use drugs, fail or drop than average to use drugs, fail or drop out of school, have financial or credit out of school, have financial or credit problems and get in trouble with the law;problems and get in trouble with the law;

►They also are rumored to be more They also are rumored to be more creative than average and many creative than average and many function very well. function very well.

►Early treatment allows for better Early treatment allows for better formation of study-habits and social formation of study-habits and social skills. skills.

►20% outgrow it by puberty but other 20% outgrow it by puberty but other problems can interfere. problems can interfere.

►ADD that lasts into Adulthood is ADD that lasts into Adulthood is referred to as ADD-RT (Residual Type).referred to as ADD-RT (Residual Type).

IMPLICATIONS FOR IMPLICATIONS FOR PHYSICAL EDUCATIONPHYSICAL EDUCATION

►Many children with ADD/ADHD experience Many children with ADD/ADHD experience great difficulty in school, where attention, great difficulty in school, where attention, quick cognitive processing, and motor quick cognitive processing, and motor control are virtual requirements for success.control are virtual requirements for success.

► Children with ADD/ADHD tend to have Children with ADD/ADHD tend to have difficulty and overreact to changes in their difficulty and overreact to changes in their environment. environment.

►Whether at home or in school, children with Whether at home or in school, children with ADD/ADHD tend to respond best in ADD/ADHD tend to respond best in structured/predictable environments. structured/predictable environments.

►These environments often have clear and These environments often have clear and consistent rules and expectations with consistent rules and expectations with defined consequences set forth ahead of defined consequences set forth ahead of time and delivered immediately.time and delivered immediately.

► By establishing structure and routines, By establishing structure and routines, parents and teachers can cultivate an parents and teachers can cultivate an environment that encourages the child to environment that encourages the child to independently control his or her behavior independently control his or her behavior and succeed at learning.and succeed at learning.

Adaptations which might be Adaptations which might be helpful (but will not cure helpful (but will not cure

ADD/ADHD) ADD/ADHD) ► 1. Posting daily schedules and assignments1. Posting daily schedules and assignments► 2. Calling attention to schedule changes2. Calling attention to schedule changes► 3. Setting specific times for specific tasks3. Setting specific times for specific tasks► 4. Designing a quiet workspace for use upon 4. Designing a quiet workspace for use upon

requestrequest► 5. Providing regularly scheduled and frequent 5. Providing regularly scheduled and frequent

breaksbreaks► 6. Using computerized learning activities6. Using computerized learning activities► 7. Teaching organization and study skills7. Teaching organization and study skills► 8. Supplementing verbal instructions with visual 8. Supplementing verbal instructions with visual

instructionsinstructions► 9. Modifying test delivery9. Modifying test delivery

Some highlights for use in Some highlights for use in Physical education Physical education

►Be aware Be aware that ADD/ADHD may not be that ADD/ADHD may not be the root of all problems. the root of all problems.

►Oftentimes other impairments like Oftentimes other impairments like vision, communication or hearing can vision, communication or hearing can have similar symptoms. have similar symptoms.

►Addressing the right problem will Addressing the right problem will ensure the most effective results.ensure the most effective results.

StructureStructure

►Structure Structure an environment with an environment with reminders (visual and verbal), clear reminders (visual and verbal), clear directions, and determined limits. directions, and determined limits.

►This will help to ensure a child's This will help to ensure a child's understanding and the ability to pay understanding and the ability to pay attention to important factors of a attention to important factors of a lesson plan instead of an external lesson plan instead of an external environment.environment.

Make simple, posted rulesMake simple, posted rules

►to reassure that children know their to reassure that children know their expectations.expectations.

► Make frequent eye contact so that Make frequent eye contact so that both the child and teacher are aware of both the child and teacher are aware of any daydreaming or lack of attention. any daydreaming or lack of attention.

►This will bring a child “back” to an This will bring a child “back” to an activity and give silent reassurance that activity and give silent reassurance that you are concerned about and you are concerned about and interested in their attention.interested in their attention.

More helpsMore helps

► Repeat directions and important information Repeat directions and important information so that children have many opportunities to absorb so that children have many opportunities to absorb them.them.

► Writing down directions and verbally communicating Writing down directions and verbally communicating them will help to increase a child's understanding.them will help to increase a child's understanding.

► Give frequent feedbackGive frequent feedback; this will help to keep ; this will help to keep them on trackthem on track

► Go for quality Go for quality instead of quantity with an activity instead of quantity with an activity or work.or work.

► Break down large projects Break down large projects into small tasks; this into small tasks; this will decrease an overwhelming project and help to will decrease an overwhelming project and help to increase a child's self confidence and interest in the increase a child's self confidence and interest in the project.project.

RECOMMENDED RECOMMENDED ACTIVITIESACTIVITIES

► Physical Activity helps cleansing; it brings Physical Activity helps cleansing; it brings balance and relieves stress.balance and relieves stress.

• • Mini Trampoline jumping - rebounding!Mini Trampoline jumping - rebounding!• • MeditationMeditation• • Walk or jog in the nature: Forest, Mountain, Walk or jog in the nature: Forest, Mountain,

river /sea / lake side, beachriver /sea / lake side, beach• • Yoga - Meditation, Chinese YogaYoga - Meditation, Chinese Yoga• • Martial Arts: Karate, Judo, Kung Fu, AikidoMartial Arts: Karate, Judo, Kung Fu, Aikido• • Dancing, Aerobics, Gymnastics, StretchingDancing, Aerobics, Gymnastics, Stretching• • Swimming in Swimming in non-chlorinated non-chlorinated water !water !

EFFECTIVE TEACHING EFFECTIVE TEACHING STRATEGIESSTRATEGIES

► Pause and create suspense by looking Pause and create suspense by looking around before asking questions.around before asking questions.

► Randomly pick reciters so the children Randomly pick reciters so the children cannot time their attention.cannot time their attention.

► Signal that someone is going to have to Signal that someone is going to have to answer a question about what is being said.answer a question about what is being said.

► Use the child’s name in a question or in the Use the child’s name in a question or in the material being covered.material being covered.

► Ask a simple question (not even related to Ask a simple question (not even related to the topic at hand) to a child whose attention the topic at hand) to a child whose attention is beginning to wander.is beginning to wander.

In the classroom situationIn the classroom situation

►Develop a private running joke between you and Develop a private running joke between you and the child that can be invoked to re-involve you the child that can be invoked to re-involve you with the child.with the child.

► Stand close to an inattentive child and touch him Stand close to an inattentive child and touch him or her on the shoulder as you are teaching.or her on the shoulder as you are teaching.

►Walk around the classroom as the lesson is Walk around the classroom as the lesson is progressing and tap the place in the child’s book progressing and tap the place in the child’s book that is currently being read or discussed.that is currently being read or discussed.

►Decrease the length of assignments or lessons.Decrease the length of assignments or lessons.► Alternate physical and mental activities.Alternate physical and mental activities.

► Increase the novelty of lessons by using Increase the novelty of lessons by using films, tapes, flash cards, or small group films, tapes, flash cards, or small group work or by having a child call on others.work or by having a child call on others.

► Incorporate the children’s interests into a Incorporate the children’s interests into a lesson plan.lesson plan.

►Structure in some guided daydreaming Structure in some guided daydreaming time.time.

►Give simple, concrete instructions, once. Give simple, concrete instructions, once. ►Use a soft voice to give direction.Use a soft voice to give direction.