1 Copyright © Allyn & Bacon 2003 Learners with Attention Deficit Hyperactivity Disorder (ADHD) Chapter 6 (begins p. 185) 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.

Early examples of ADHD wwel/philipp_e.html wwel/philipp_e.html The Story of Fidgety Phillip Johnny-Head-In-Air

2 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

3 Copyright © Allyn & Bacon 2003 Brief History (p ) cases cited with similar characteristics of today Still’s Children with “Defective Moral Control” 1902, inhibitory volition: ability to refrain from engaging in inappropriate behavior (p )- Goldstein’s brain-injured soldiers of World War I (psychological characteristics applied to children) The Strauss Syndrome

Brief History cont. (p ) Cruickshank’s work (sterile environment based on Strauss Syndrome) Minimal brain injury and Hyperactive Child Syndrome Visit CHADD: Children and Adults with Attention Deficit Disorder:

SIMILAR CHARACTERISTICS in reported cases: Disorganized behavior Hyperactivity Perseveration Distractibility Impulsivity

School-age characteristics reported by parents/ teachers Fidgeting Excessive talking Resistance to routines Noisiness Bossiness Less sharing; rough play Easily upset Disruptive noncompliant Less time spent on any one activity Immature social interactions Easily bored Out of seat Interrupts others Off task Erratic productivity Poor persistence

See Josh Bishop, text p. 200: Follow-up Effects of ADHD Diagnosed at age 7 Not identified for IDEA nor Section 504 of the Vocational Rehabilitation Act of 1973 Impulsivity, poor executive functions, social skills resulted in leaving VMI during first year

Characteristics seen in adolescents Less active than younger children with ADHD Restlessness Behavior problems or antisocial conduct Low self-concept Inattentiveness Impulsiveness Impatience, easily frustrated or bored Depression Academic difficulties Problems with relationships Difficulty maintaining jobs No follow-through Difficulty following directions procrastination

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

5 Copyright © Allyn & Bacon 2003 Prevalence (p ) Estimates of 3 to 5 % of school-age population Not recognized as a separate category of special education May be served under IDEA as Other Health Impaired, or served under other primary conditions such as LD, ED, MR… May be served under 504 plans Boys outnumber girls about 3:1 (maybe over or under-identification issue

6 Copyright © Allyn & Bacon 2003 Assessment (p. 192; see p. 194, Table 6.2) Teacher and parent observation, anecdotal logs, rating scales Clinical interview with parents/child Medical examination to rule out other potential causes of characteristics Subjectivity of some components “Doctor’s office effect”

7 Copyright © Allyn & Bacon 2003 Causes (p ) Neurological structural differences Neurological dysfunction Neurochemical differences Hereditary factors Toxins (e.g., exposure to lead) Birth complications Contributing environmental factors

8 Copyright © Allyn & Bacon 2003 Psychological and Behavioral Characteristics (p ) Barkley’s model of ADHD (p. 196) Behavioral inhibition Executive functions & use of inner speech Persistent goal-directed behavior is lacking Adaptive skills At home & school (e.g., more traffic accidents and violations)

Characteristics cont. Problems socializing with peers (frequently rejected; may be greatest problem in life) Co-existing conditions (comorbidity) p. 199 Learning disabilities(10-25% overlap) Emotional or behavioral disorders (25-50% also have EBD) Substance abuse

9 Copyright © Allyn & Bacon 2003 Educational Considerations-p.200-) Classroom structure and teacher direction: need clear, predictable, uncomplicated routine and structure See instructional planning p See p. 208, Table 6.3 for intervention principles

Educational Considerations-p.200-) Functional behavioral assessment (FBA) and contingency-based self- management Determine antecedents, conseequences, and settings that maintain inappropriate behaviors Teach self-monitoring of behavior

10 Copyright © Allyn & Bacon 2003 Service Delivery Models (p. 207) Difficult to determine (not counted for IDEA purposes; could be OHI, Section 504, etc.) Presumption that less than half receive special education Individual determination

11 Copyright © Allyn & Bacon 2003 Medication considerations: pgs Psychostimulants to activate neurological functioning (e.g., Ritalin, Adderall) Controversial Cautions (p. 212)

12 Copyright © Allyn & Bacon 2003 Early Intervention (jp. 213) 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.

13 Copyright © Allyn & Bacon 2003 Transition to Adulthood 2/3’s continue with symptoms into adulthood Diagnosis in adulthood (see p. 216, Table 6.4) Adult outcomes (p. 216) Employment Marriage and family (see p. 217, Table 6.5: Tips) Importance of coaching A therapist or friend to help stay focused