Chapter 7 Children with Attention Deficit/Hyperactive Disorders (ADHD) © Cengage Learning. All rights reserved.

History of the Field Minimum brain damage was an early term used to describe inattentiveness and hyperactivity. Strauss Syndrome was coined in the 1930s to describe these symptoms. Cruickshank was one of the first to develop educational strategies for these students. Today ADHD captures two categories: Inattention: inability to sustain focus Hyperactivity: problems with impulsivity and self-control © Cengage Learning. All rights reserved.

Characteristics of Children with ADHD © Cengage Learning. All rights reserved.

The Information Processing Model © Cengage Learning. All rights reserved.

Defining ADHD IDEA 2004 includes ADHD under “Other Health Impairments.” The DSM-5 includes ADHD in the cluster of Neurodevelopmental disorders. ADHD has a high frequency of comorbidity with other disorders – that is children with other disabilities often have ADHD as well. © Cengage Learning. All rights reserved.

Identifying Students with ADHD Students may receive services under either IDEA 2004 or Section 504 of the Rehabilitation Act. Identification is the same in both cases. Parent and teacher input is a valuable part of the identification process and is collected via rating scales such as the Conners-3. Boys are 2-3 times more likely to be identified as having ADHD than girls. © Cengage Learning. All rights reserved.

Complications with Identification Many rating scales may not be accurate for students from diverse backgrounds. A focus on both ADHD symptoms and a child’s functional behaviors creates a more robust picture of the child’s difficulties. Cognitive and academic tests are also a part of developing an ADHD diagnosis. © Cengage Learning. All rights reserved.

Prevalence of ADHD It is difficult to establish solid numbers of students who have ADHD because they are served in various ways by schools; there is no one “count” of these students. Estimates suggest that 3-7 % (about 5 million) school- age children have some degree of ADHD. Only about 1% of students have severe enough impairment to qualify for special services. © Cengage Learning. All rights reserved.

Causes of ADHD ADHD is caused by a complex interplay of genetics, neurology, and environment. Neurology: Studies have shown differences in the brains of individuals with ADHD including size, development rate, and structures. Genetics: ADHD runs in families; studies are attempting to identify the genes at play. Environment: Exposure to certain substances, premature birth, and brain damage or injury increase the risk for ADHD. © Cengage Learning. All rights reserved.

Comorbidity Between 40 and 60 percent of children with ADHD have an additional area of concern. Almost 1/3 of children with ADHD also have a learning disability. Emotional and behavior disorders, communication disorders, and mental health concerns are all frequently comorbid with ADHD. © Cengage Learning. All rights reserved.

Medication for ADHD About 66% of all children with ADHD receive medication as part of their treatment. Stimulants are the most common class of medication used. Stimulants increase neurotransmitter production which enhances a child’s ability for attention and controlling impulses. Medication usage must be carefully monitored to watch for potentially harmful side effects. © Cengage Learning. All rights reserved.

IDEA 2004 vs. Section 504 Two federal laws ensure a student with ADHD’s right to a FAPE: IDEA 2004 – Offers more intense support and services Section 504 of the Rehabilitation Act of 1973 – Covers some students who may not meet the requirements for IDEA 2004 coverage; good for students who require only minor supports Most students with ADHD are served in the general education classroom. © Cengage Learning. All rights reserved.

Organizational Structures Multimodal Support – 3 pronged approach of pharmacological/medical support, behavior therapies, and academic interventions Positive Behavioral Interventions and Supports (PBIS) and multi-tiered systems of support such as RtI can be combined to meet student’s academic and behavioral needs. Tier I – general classroom modifications Tier II – small group support Tier III – intensive support © Cengage Learning. All rights reserved.

Curriculum and Instruction Teachers must address both academic and behavioral needs in planning instruction for students with ADHD. They should: Identify the strengths and needs of the child. Select appropriate instructional approaches. Implement these consistently. Children with ADHD benefit from instruction that is: Explicit Contextual Strategic © Cengage Learning. All rights reserved.

Learning Strategies that Promote Success 4 variables of successful learning strategies: Time: how much we spend on what elements of instruction; allowing students to work at the right pace Structure: how we organize content; how we present tasks; how we structure the environment Support: direct instruction, targeted interventions, intense interventions Complexity: identifying relationships, analyzing and evaluating information, combining ideas through critical thinking © Cengage Learning. All rights reserved.

Other Instructional Considerations CCSS requires students to engage in complex thinking – potentially challenging for students with ADHD who have difficulty sustaining focus. UDL principles are one strategy for keeping engagement. Assistive technology can provide focus and organizational support. Behavior interventions also improve academic performance. © Cengage Learning. All rights reserved.

The Role of Families Families play an important role in interventions for children with ADHD Family stressors (such as poverty or unsafe living conditions) seem to exacerbate the symptoms of ADHD. Training programs that offer specific strategies to parents for supporting their child with ADHD have shown success in reducing family stress and increasing family confidence. © Cengage Learning. All rights reserved.

Transition Students with ADHD are at higher risk than peers of continued academic and social difficulties, substance abuse problems, and delinquent behavior. With strong supports and interventions during school, students with ADHD can develop the coping skills that will allow them to go on to academic, social, and career success. © Cengage Learning. All rights reserved.