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Copyright © Allyn & Bacon 2008Chapter 6: Students with Attention Deficit-Hyperactivity Disorder
STUDENTS WITH ATTENTION DEFICIT- HYPERACTIVITY DISORDER
Chapter 6
Copyright © Allyn & Bacon 2008
Copyright © Allyn & Bacon 2008Chapter 6: Students with Attention Deficit-Hyperactivity Disorder
Definition of ADHDA pervasive pattern of inattention, impulsivity, and/or hyperactivity-impulsivity that is more frequent and severe than is typically observed in individuals at a comparable level of development. (American Psychological Association, 2000)
Copyright © Allyn & Bacon 2008Chapter 6: Students with Attention Deficit-Hyperactivity Disorder
Attention-Deficit/Hyperactivity Disorder A. Either (1) or (2): (1) inattention: six (or more) of the following symptoms of inattention have persisted for at least 6 months
to a degree that is maladaptive and inconsistent with developmental level: (a) often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other
activities (b) often has difficulty sustaining attention in tasks or play activities (c) often does not seem to listen when spoken to directly (d) often does not follow through on instructions and fails to finish school work, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions) (e) often has difficulty organizing tasks and activities (f) often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework) (g) often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools) (h) is often easily distracted by extraneous stimuli (i) is often forgetful in daily activities
(2) hyperactivity-impulsivity: six (or more) of the following symptoms of hyperactivity-impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:
(a) often fidgets with hands or feet or squirms in seat (b) often leaves seat in classroom or in other situations in which remaining seated is expected (c) often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness) (d) often has difficulty playing or engaging in leisure activities quietly (e) is often "on the go" or often acts as if "driven by a motor" (f) often talks excessively
Impulsivity (g) often blurts out answers before questions have been completed
(h) often has difficulty awaiting turn (i) often interrupts or intrudes on others (e.g., butts into conversations or games)
B. Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 years.
C. Some impairment from the symptoms is present in two or more settings (e.g., at school [or work] and at home).
D. There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning.
E. The symptoms do not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder and are not better accounted for by another mental disorder (e.g., Mood Disorder, Anxiety Disorder, Dissociative Disorders, or a Personality Disorder).
Copyright © Allyn & Bacon 2008Chapter 6: Students with Attention Deficit-Hyperactivity Disorder
3 Types of ADHD Predominately
inattentive Predominately
hyperactive/impulsive Combined
Copyright © Allyn & Bacon 2008Chapter 6: Students with Attention Deficit-Hyperactivity Disorder
Prevalence
3-5% of the population
2-3 times as many boys identified as girls
No difference in frequency among races
Caucasian children more likely to receive medication for ADHD
Copyright © Allyn & Bacon 2008Chapter 6: Students with Attention Deficit-Hyperactivity Disorder
Key elements of ADHD Neurological Developmental Chronic Not situational Production deficits, not
acquisition deficits
Copyright © Allyn & Bacon 2008Chapter 6: Students with Attention Deficit-Hyperactivity Disorder
Causes of ADHD Physiological causes
Heredity Brain differences
Environmental Causes Lead poisoning Maternal prenatal
smoking and alcohol consumption
Copyright © Allyn & Bacon 2008Chapter 6: Students with Attention Deficit-Hyperactivity Disorder“Copyright© Allyn & Bacon 2006”
Causation
Copyright © Allyn & Bacon 2008Chapter 6: Students with Attention Deficit-Hyperactivity Disorder
Cognitive Characteristics Problems with Executive Functioning
Issues with ability to control impulses Working memory is not efficient Self-directed speech not utilized
effectively Difficulty controlling emotions or
motivation Reconstitution – the ability to break
down what is observed and to combine parts to carry out new actions
Copyright © Allyn & Bacon 2008Chapter 6: Students with Attention Deficit-Hyperactivity Disorder
Academic Characteristics Some students are very successful
academically Other students consistently achieve
below their potential Academic self-concept is important
Copyright © Allyn & Bacon 2008Chapter 6: Students with Attention Deficit-Hyperactivity Disorder
Social/Emotional Characteristics Self-esteem is a problem for some, but
not all, students with ADHD Students often have problems coping
with social functioning Developing and maintaining
friendships Rejection by peers
Copyright © Allyn & Bacon 2008Chapter 6: Students with Attention Deficit-Hyperactivity Disorder
Behavior Characteristics Failure to attend to details Make careless mistakes in work Failure to complete schoolwork Failure to listen when spoken to directly Difficulty organizing tasks and
materials Avoidance of tasks that require
sustained mental effort
Copyright © Allyn & Bacon 2008Chapter 6: Students with Attention Deficit-Hyperactivity Disorder
Comorbidity with Other Disorders ADHD may occur simultaneously with
other disorders such as: Learning disabilities Tourette’s syndrome Emotional disabilities Autism Traumatic brain injury Psychiatric disorders Sleep disorders Substance abuse problems
Copyright © Allyn & Bacon 2008Chapter 6: Students with Attention Deficit-Hyperactivity Disorder
Initial Referral for Eligibility Medical Diagnosis
Pediatrician, family physician, psychiatrist
Diagnosis may occur before child enters school
Educational referrals may come from Child’s classroom teacher Special education teacher
Copyright © Allyn & Bacon 2008Chapter 6: Students with Attention Deficit-Hyperactivity Disorder
Assessments May Include:
Medical assessment Continuous performance tests DISC IV (Diagnostic Interview Schedule
for Children) Parent rating scales and checklists Teacher rating scales and checklists Samples of student’s work Anecdotal information
Copyright © Allyn & Bacon 2008Chapter 6: Students with Attention Deficit-Hyperactivity Disorder
Gifted or ADHD?
Inability to regulate behavior
Question rules and create their own
Problems with Rules
Primary characteristic of ADHD
Good judgment lags behind intellectual development
Impulsivity
Difficulty in most situations
Only in specific situations, e.g., when bored
Poor sustained attention
ADHDGifted StudentsBehavior
Copyright © Allyn & Bacon 2008Chapter 6: Students with Attention Deficit-Hyperactivity Disorder
Eligibility for IDEA Services Does the ADHD “adversely affect”
the student’s educational performance?
Not all students with ADHD are eligible
Students who are not eligible for IDEA may qualify for accommodations under Section 504
Students may be eligible because they also have a learning or emotional disability
Copyright © Allyn & Bacon 2008Chapter 6: Students with Attention Deficit-Hyperactivity Disorder
Early Childhood Education Diagnosis at an early age
is difficult. If children’s symptoms of
ADHD are severe, early intervention is crucial.
Children may need a highly structured environment, immediate and consistent feedback, and age-appropriate rewards.
Copyright © Allyn & Bacon 2008Chapter 6: Students with Attention Deficit-Hyperactivity Disorder
Elementary and Secondary School Services
Many students receive their education in general education classrooms.
Professionals must collaborate with parents to find effective techniques for students with ADHD.
Copyright © Allyn & Bacon 2008Chapter 6: Students with Attention Deficit-Hyperactivity Disorder
Transition and Adulthood
66% of students with ADHD continue to have the disorder into adulthood
Many adults with ADHD are disorganized, impulsive, and have poor work skills
Students need to have a clear understanding of their disorder and learn to advocate for themselves
Copyright © Allyn & Bacon 2008Chapter 6: Students with Attention Deficit-Hyperactivity Disorder
Medication is the Most Clearly Effective Intervention The use of medication is controversial. The decision to prescribe medication
only indirectly involves school personnel.
Medication is helpful for many (70-80%) students for whom it is prescribed.
Medication alone is not sufficient to improve academic performance
Copyright © Allyn & Bacon 2008Chapter 6: Students with Attention Deficit-Hyperactivity Disorder
Psychostimulants Ritalin Concerta Focalin Adderall Strattera
Copyright © Allyn & Bacon 2008Chapter 6: Students with Attention Deficit-Hyperactivity Disorder
Best Educational Practices Parent and professional education Environmental supports for students Behavior interventions
Rewards Token economy systems Structure Quick Pace Variety
Copyright © Allyn & Bacon 2008Chapter 6: Students with Attention Deficit-Hyperactivity Disorder
Supporting Parents of Children with ADHD
Have realistic expectations of parents
Encourage parents to be good role models
Help parents have realistic expectations