1. Attention Deficit Hyperactivity Disorder Ronda L. Harrison Kris McCauley Exceptionality in Today’s Schools Exceptionality in Today's Schools PSEL 3, Dr. Soffer

3. Definition of Attention Deficit Hyperactivity Disorder (ADHD)  ADHD as defined by the American Psychiatric Association as:  A 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. Exceptionality in Today's Schools PSEL 3, Dr. Soffer

4. If Jack and Jill Had ADHD  https://youtu.be/rLghxG3mGMM https://youtu.be/rLghxG3mGMM Exceptionality in Today's Schools PSEL 3, Dr. Soffer

5. Key Elements of ADHD Diagnosis  It is considered neurobiological (originates in the brain), and it is developmental beginning in childhood.  It is a developmental impairment of executive function (the ability to comprehend, monitor, and direct one's cognition in order to achieve goals.  It is chronic, long term, and not acquired as the result of accident or injury.  The primary trait is an inability to attend beyond what is typical for peers of comparable age  It is not situational, it just may show more in certain situations.  The problems that scholars have are more likely to be production rather than acquisition.  It is not caused by environmental situations. Exceptionality in Today's Schools PSEL 3, Dr. Soffer

7. The Development of the ADHD Field  1902: First known formal description of ADHD by British physician George Still.  1910’s: Children characterized as highly intelligent but lacking “moral control” when displaying symptoms later known as ADHD.  1930’s: Children with distractibility and impulsivity assumed to have had “sleepy sickness”.  1937: Dr. Charles Bradley reports the effect of stimulants medication to control behavior of children who are distractible and impulsive. Exceptionality in Today's Schools PSEL 3, Dr. Soffer

8. The Development of the ADHD Field  1956: Ritalin identified as an effective medication for children who are impulsive and distractible.  1960: Term minimal brain dysfunction (MBD) used to describe children’s hyperactivity.  1968: Term hyperkinetic disorder of childhood (HDC) replaces MBD to describe children’s hyperactivity.  1970’s: Lack of focus added to identified symptoms of HDC; impulsivity extended to verbal and cognitive as well as motor domain. Exceptionality in Today's Schools PSEL 3, Dr. Soffer

9. The Development of the ADHD Field  1980: Term attention deficit disorder (ADD) with or without hyperactivity introduced by the American Psychiatric Association (APS)  1987: Term attention deficit hyperactivity disorder (ADHD) replaces ADD: APA notes that the condition is a medical disorder.  1996: Adderall approved for the treatment of ADHD.  1999: Concerta approved for the treatment of ADHD.  1999: First report published from the Multimodal Treatment Study of Children with ADHD (MTA), a federally sponsored study of ADHD treatment. Exceptionality in Today's Schools PSEL 3, Dr. Soffer

10. The Development of the ADHD Field  2001: Focalin approved for treatment of ADHD.  2003: Strattera, first non-stimulant ADHD medication approved for use.  2009: Follow-up on the children in the MTA research indicates benefits of medication and other treatments wane over time; many of the children continue to experience social and academic difficulties.  2013: APA revises the definition of ADHD in DSM-V.  2015: CDC publishes first national study on use of behavioral therapy, medication and dietary supplements for ADHD in children. (handout) Exceptionality in Today's Schools PSEL 3, Dr. Soffer

11. Causes of ADHD  People used to think that the causes were as simple as permissive parenting or certain foods.  Many professionals look at physiological factors such as it being hereditary, but these studies are often flawed due to environmental factors and differences.  It has also been found that several parts of the brain perform different in people with ADHD, and some have a lower level of blood flow through brain regions.  Environmental factors are seen as contributing to the disease also, including high levels of lead in the blood and prenatal smoking and alcohol consumption. Exceptionality in Today's Schools PSEL 3, Dr. Soffer

13. Characteristics of ADHD  The parts of the brain that are different in children with ADHD are known to regulate attention.  Behavior inhibition and self-regulation are the primary deficits, not attention.  Behavior inhibition: The ability to regulate ones attention and how often it switches, and the behavior that accompanies this ability; scholars with ADHD have difficulty with behavior inhibition.  Behavior inhibition sets the stage for problems with executive functions: mental activities that help regulate behaviors. Exceptionality in Today's Schools PSEL 3, Dr. Soffer

14. Cognitive Characteristics of ADHD  Working Memory (ex: continuing to get up out of their seat even though they have been told repeatedly not to do so.)  Self-directed speech (that little voice in your head that keeps you on topic, keeps your thoughts from wandering)  Control of emotions and motivation: the ability to set aside frustration and other emotions to complete a task, taking a deep breath to calm down and focus, and possibly taking into account the perspective of others rather than melting down, throwing a tantrum, or storming out the room.  Reconstitution (or planning) refers to the ability to analyze and synthesize.  Analyze: the skill of breaking down what is observed into component parts  Synthesize: the skill of combining parts in order to perform new actions  scholars with ADHD may have difficulty with this because they may not recognize the similarity between one academic task to another or recognize that the conduct rules for the classroom should be followed outside of the classroom (i.e.. lunchroom or library) Exceptionality in Today's Schools PSEL 3, Dr. Soffer

15. Academic Characteristics of ADHD  ADHD is NOT related to intellectual ability. Therefore, academic ability varies widely in scholars with ADHD.  Some are Gifted and Talented  Some have academic challenges because the ADHD interferes greatly with their ability to function in an educational setting.  Both extremes and all in between need effective interventions, accommodations specific to their needs.  The majority of scholars with ADHD experience difficulty with the structure of school and consistently achieve below their potential.  Regularly available technology can help scholars with ADHD stay organized and complete academic tasks. Exceptionality in Today's Schools PSEL 3, Dr. Soffer

16. Social and Emotional Characteristics of ADHD  Self-esteem often much lower than their typical peers.  Often experience challenges with social demands because they may not realize they need to behave differently in different social situations (i.e.. peer vs. teacher).  Difficulty with developing and maintaining friendships.  More likely to be identifies as either the victim of bullying or as being the bully. Exceptionality in Today's Schools PSEL 3, Dr. Soffer

17. Behavior Characteristics of ADHD  Those with the hyperactive or combined type ADHD usually have more behavior problems that are outward.  Those with the inattentiveness were distracting in class because of constantly misplaced materials and needing the teacher’s assistance to stay on task and complete tasks.  Scholars with ADHD often have issues with working alone or working in large groups.  Attending to task, Listening, Organizing work, Completing assignments are some of the most prevalent behavior issues in the classroom setting. Exceptionality in Today's Schools PSEL 3, Dr. Soffer

19. Assessment and Eligibility  There is not one single test that can be accurate to show ADHD.  Medically, it takes input from medical professionals, school professionals, and parents for a doctor to be able to diagnose as ADHD, questions are asked to determine if the child meets the criteria as described in DSM-IV-TR.  Continuous Performance Tests can be used to see if a scholar can sustain attention in order to respond correctly to questions. Such tests include the Conners' Continuous Performance Test-II or the Integrated Visual and Auditory Continuous Performance Test PLUS (IVA-PLUS)  Parents and teachers can both answer questions or fill out checklists such as the Child Behavior Checklist.  Eligibility for those diagnosed comes down to whether or not the diagnosis effects academic performance. If it does than they can be eligible as OHI. Exceptionality in Today's Schools PSEL 3, Dr. Soffer

20. Educating Scholars with ADHD  Early Childhood Education Programs (daycares and preschools often expel these young scholars due to behavior issues)  Elementary and Secondary school make the scholars eligible for special education services through eligibility for Other Health Impairment (OHI)and 504 accommodations through medical documentation and educational need.  Emphasis should be on inclusive practices in the general education classroom setting. Exceptionality in Today's Schools PSEL 3, Dr. Soffer

21. Educating Scholars with ADHD  Support and collaboration from the special education teachers, school interventionists and specialist, as well as the parents is needed to promote the best outcome for the scholars with ADHD.  Accommodations need to be in place and implemented with fidelity. It’s NOT enough to simply recognize the disability and make allowances. High standards and expectations need to be maintained, as with all other scholars. Exceptionality in Today's Schools PSEL 3, Dr. Soffer

22. Recommended Educational Practices  Medication  The use of Medication is controversial.  The decisions can only indirectly involve school professionals.  It is helpful with symptoms in 70% to 80% of scholars that it is prescribed to. Parent and Professional Education Environmental Supports The classroom should be organized and free of distractions Decorations should be out of the direct line of sight. Clear rules and expectations Post and follow classroom routines Pacing of instruction and scholar movement. Exceptionality in Today's Schools PSEL 3, Dr. Soffer

23. Academic Interventions  Be sure to give CLEAR, CONCISE, and COMPLETE directions  Give them in opportunity to repeat the directions back to you.  Break the assignment into several shorter tasks.  Use as much active responding during instruction as possible.  Use constant reminders when necessary to keep them on task. Exceptionality in Today's Schools PSEL 3, Dr. Soffer

24. Recommended Behavior Intervention  Rewards for appropriate behaviors (points or tokens along with praise)  Low-involvement strategies (intervening to stop a behavior when it’s minor to avoid more intensive intervention. i.e.. Making eye contact, physical proximity, physical touch, hand signal, distracting the scholar with a different task such as helping to pass out papers.)  Behavior chart  Token economy Exceptionality in Today's Schools PSEL 3, Dr. Soffer

26. Helpful Websites / Apps http://www.addvance.com/ http://www.chadd.org/ http://www.additudemag.com/channel/adhd-learning-disabilities/index.html http://www.cdc.gov/ http://www.help4adhd.org/ https://teach.classdojo.com/#/classes/563a6922375f9eb61315e02a/points Exceptionality in Today's Schools PSEL 3, Dr. Soffer