1. Learners with Other Disorders and Conditions Fall 2010 ED 226

2. Children and Youth w/ Attention Problems Historical Development – 1902—morbid defects in moral control (Still) – Related to brain injury or infections of the central nervous system (Goldstein and Bender) – Minimal brain dysfunction/various combinations of impairments in control of attention, impulse, and motor control, (Clements) – Hyperkinetic disorder (DSM-II, 1968) – Included attention in 1980 – 1987, DSM-III developmentally inappropriate with marked inattention – 1994, focus on dual nature, 3 subtypes: hyperactive- impulsive, inattentive type, and combined type

3. Children and Youth w/ Attention Problems ADHD and IDEA – Despite advocacy group demands, ADHD was noted added as a category to IDEA in 1990 – Students were eligible for services under OHI – Children could receive services under Section 504 of ADA

4. Children and Youth w/ Attention Problems Current ADHD definition is the DSM-IV-TR – Six or more of the inattention symptoms for 6+ months: Often fails to give close attention to detail or makes careless mistakes in schoolwork, work, or other activities Often has difficulty sustaining attention in tasks or play activities Often does not seem to listen when spoken to directly Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace Often has difficulty organizing tasks and activities

5. Children and Youth w/ Attention Problems Current ADHD definition is the DSM-IV-TR – Six or more of the inattention symptoms for 6+ months: Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (school work or homework) Often loses tings necessary for tasks or activities Is often easily distracted by extraneous stimuli Is often forgetful in daily activities

6. Children and Youth w/ Attention Problems Current ADHD definition is the DSM-IV-TR – Six or more of the hyperactive-impulsivity symptoms for 6+ months: Often fidgets with hands or feet or squirms in seat Often leaves seat in classroom or in other situations in which remaining seated is expected Often runs about or climbs excessively in situations in which it is inappropriate Often has difficulty playing or engaging in leisure activities quietly Is often “on the go” or often acts as if “driven by a motor” Often talks excessively

7. Children and Youth w/ Attention Problems Current ADHD definition is the DSM-IV-TR – Six or more of the hyperactive-impulsivity symptoms for 6+ months: – Impulsivity » Often blurts out answers before questions have been completed » Often has difficulty waiting turns » Often interrupts or intrudes on others

8. Children and Youth w/ Attention Problems Current ADHD definition is the DSM-IV-TR – Some hyperactive-impulsive or inattentive symptoms is present in two or more settings – There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning – The symptoms do not occur exclusively during the course of a pervasive developmental disorder, schizophrenia, or other psychotic disorder and are not accounted for by another mental disorder

9. Children and Youth w/ Attention Problems Percentage of Students with ADHD in Each Subtype ADHD Subtypes InattentiveHyperactive/Im pulsive CombinedNo ADHD % of children in each category 20%13%40%27% % of children with ADHD in each subtype 27%18%55%--

10. Children and Youth w/ Attention Problems Levels of Severity – Mild: few if any symptoms in excess of the 6 indictors required to make the diagnosis: minimal or no impairment in school or social settings – Moderate: symptoms or functional impairment intermediate between “mild” and “severe” – Severe: many symptoms in excess of those required to make the diagnosis; significant and pervasive impairment in functioning at home and in schools with like age peers

11. Children and Youth w/ Attention Problems Identification of Learners with ADHD – Structured clinical interviews with parents, teachers, and the student – Direst observation of behaviors – Psychoeductional examination, including IQ and achievement – Rating scales – Pediatric medical examination

12. Children and Youth w/ Attention Problems Prevalence of ADHD – Low-visibility, high-prevalence – 3-10% – More likely in males than females

13. Children and Youth w/ Attention Problems Conditions Associated with ADHD – Organic causes – Birth complications – Intellectual/developmental causes – Psychological issues – Environmental factors

14. Characteristics of Individuals with ADHD Low frustration tolerance Resentment towards family members Mood lability Poor self-esteem Lack of effort Perceived lack of self- responsibility Excess, insistent demands that request be met Temper outbursts Stubbornness Rejection by peers Oppositional behavior Antagonism and aggression bossiness

15. Children and Youth w/ Attention Problems Should ADHD be a separate category in IDEA? Prevalence of ADHD in Various Disability Categories Disability Category Prevalence of Students with ADHD in Category Prevalence of students w/o ADHD in Category Overall Percentage of All Students in Category OHI17.7%2.3%6.6% ED13.8%2.5%8.1% MR12.4%11.9%9.9% LD49.7%48.7%48.3% Speech6.5%34.7%18.7%

16. Children and Youth w/ Attention Problems ADHD as a Social Construct – Neither the category nor the service is needed or justified – Diagnosis is a social invention rather than a disability (Armstrong, 199%) Children learn to control attention/behavior when expected to do so Schools have asked children to do more in the last three decades Lots of stimuli from a very early age

17. Autism Spectrum Disorders A developmental disability significantly affecting verbal and non-verbal communication and social interaction, usually evident before age 3, that adversely affects a child’s educational performance. Other characteristics often associated with autism are engagement in repetitive activities, resistance to environmental change or change in daily routines, and unusual sensory experience.

18. Autism Spectrum Disorders The term does not apply if a child’s educational performance is adversely affected because the child has a serious emotional disturbance.

20. ASD Issues Communication Social Routines

21. Physical and Sensory Disabilities Physical and Health Disabilities – Small but diverse group of students – Orthopedic conditions – Health conditions (asthma, diabetes, cancer, heart conditions, AIDS, epilepsy) – Cerebral Palsy – Spina bifida – Muscular dystrophy – Arthritis – Paralysis – Amputations

22. Physical and Sensory Disabilities Sensory Disabilities – Vision – Hearing – Most of these students are served in general education classrooms

23. Physical and Sensory Disabilities Traumatic Brain Injury – Acquired injury due to external force – Results are varied and no injury is the same – Rehabilitation services

24. Communication Disorders Speech disorders – Articulation, fluency, voice Language disorders – Issues with receptive or expressive language (understanding) 19% of all students receiving services

25. Medication: A Persistent Issue Responsibilities regarding students with medication needs – Being knowledgeable about any medications students are taking – Sharing classroom observations with the parents so that the effect of medication can be monitored – Alerting the school nurse and/or parent if there are changes that may be related to the medication – Being prepared to respond to parents’ queries about the child’s progress while on medicaiton