Learners with Attention Deficit Hyperactivity Disorder (ADHD) Chapter 6 This multimedia product and its contents are protected under copyright law. The following are prohibited by law: any public performance or display, including transmission of any image over a network; preparation of any derivative work, including the extraction, in whole or in part, of any images; any rental, lease, or lending of the program. Copyright © Allyn & Bacon 2003 1 1

Copyright © Allyn & Bacon 2003 Topics Brief History Definition Prevalence Assessment Causes Psychological and Behavioral Characteristics Educational Considerations Medication Considerations Service Delivery Models Early Intervention Transition Copyright © Allyn & Bacon 2003 2 2

Copyright © Allyn & Bacon 2003 Brief History of ADHD Still’s Children with “Defective Moral Control” Goldstein’s brain-injured soldiers of World War I The Strauss Syndrome Cruickshank’s work Minimal brain injury and Hyperactive Child Syndrome Copyright © Allyn & Bacon 2003 3 3

Copyright © Allyn & Bacon 2003 Definition of ADHD American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) ADHD, Predominantly Inattentive Type ADHD, Predominantly Hyperactive-Impulsive Type ADHD, Combined Type Copyright © Allyn & Bacon 2003 4 4

Basic Concepts About ADHD ADHD is a developmental disability that becomes apparent before the age of seven. ADHD may have an impact on academic success. ADHD is not hard to spot in the classroom. Many behaviors associated with ADHD may be misunderstood and misinterpreted as lazy, unorganized, and even disrespectful. For 2/3s of individuals with ADHD, the disorder continues to cause problems in adulthood. ADHD occurs across all cultural, racial, and socioeconomic groups.

Copyright © Allyn & Bacon 2003 Prevalence ADHD is the most common childhood psychiatric disorder. Estimates of 3 to 5 percent of school-age population Boys outnumber girls. Girls and children from minority families may be underidentified. Hyperactivity and impulsivity are most likely to be observed in preschool and elementary children; inattention is more common in adolescents. Copyright © Allyn & Bacon 2003 5 5

Prevalence of ADHD Results of one study (Reid et al., 1994) suggested that: approximately 52% are identified as behaviorally disordered (BD). approximately 29% are identified as LD. approximately 9% are identified as MR.

Assessment For years, the diagnosis of ADHD was considered the responsibility of psychologists, psychiatrists, and physicians. The mandates of Section 504 suggest that public school personnel have a responsibility to assess students suspected of having ADHD. Although assessment is performed by trained school personnel, teachers play an important role in the assessment process.

Copyright © Allyn & Bacon 2003 Assessment Components Medical examination Clinical interview Teacher and parent rating scales Observation Review of school records Review of IQ & academic testing results Subjectivity of some components “Doctor’s office effect” Copyright © Allyn & Bacon 2003 6 6

Steps in the Assessment Process (Burnley, 1993) Preliminary Assessment and Initial Child Study Meeting Formal Assessment Process: Follow-Up Meeting of the Child Study Team Collaborative Meeting for Strategy Development Follow-Up and Progress Review

Copyright © Allyn & Bacon 2003 Causes For most children, the precise cause of ADHD is unknown. ADHD is not due to poor parenting. Areas of the brain affected: frontal lobes, basal ganglia, cerebellum Neurotransmitter involved: Dopamine Hereditary factors Family studies Twin studies Molecular genetic factors Toxins and medical factors Copyright © Allyn & Bacon 2003 7 7

Psychological and Behavioral Characteristics Barkley’s model of ADHD Behavioral inhibition Executive functions Persistent goal-directed behavior Adaptive skills Problems socializing with peers Co-existing conditions Learning disabilities Emotional or behavioral disorders Substance abuse Copyright © Allyn & Bacon 2003 8 8

Psychological and Behavioral Characteristics Limited sustained attention or persistence of attention to tasks Reduced impulse control or limited delay of gratification Excessive task-irrelevant activity or activity poorly regulated to match situational demands Deficient rule following Greater than normal variability during task performance

Educational Considerations Classroom structure and teacher direction Making instructional modifications Developing students self regulated strategies Use of medication Functional assessment and contingency-based self-management The role of reinforcement Developing IEP Copyright © Allyn & Bacon 2003 9 9

Characteristics of Effective Teachers of Students with ADHD Patience Humor Structured & predictable approach Consistency Firmness Positive attitude toward inclusion Knowledge/willingness to work w/ students w/ exceptional needs Knowledge of effective interventions Positive academic expectations Frequent review Clarity of teaching Flexibility Fairness Active interaction w/ students Responsiveness Warmth Willingness to work collaboratively with other teachers

Service Delivery Models Continuum of placement Difficult to determine Presumption that less than half receive special education Individual determination Copyright © Allyn & Bacon 2003 10 10

Copyright © Allyn & Bacon 2003 Early Intervention Difficult to determine in young children because of behavioral similarity. Children who are identified typically have extreme behaviors and require special management and will need long-term programming. Copyright © Allyn & Bacon 2003 12 12

Transition to Adulthood Diagnosis in adulthood Adult outcomes Employment Marriage and family Importance of coaching Copyright © Allyn & Bacon 2003 13 13