ADHD in the Elementary ADHD in the Elementary Age Student Age Student

Cyndi McCreaCyndi McCrea

University of VirginiaUniversity of Virginia

Table of ContentsTable of Contents

• Characteristics• Treatment• Current Trends• Classroom Strategies• Resources• References

Sound Familiar?Sound Familiar?

• “She seems like she’s daydreaming.”

• “He just can’t sit still.”

• “He can’t seem to remember a simple direction.”

• “She interrupts constantly.”

• “He acts without thinking.”

CharacteristicsCharacteristics

Description

Inattentive, impulsive or hyperactive behavior that is not age-appropriate and the behavior leads to chronic problems in daily functioning and the behavior is innate to the child.

(Reiff, 2004)

What You Might SeeWhat You Might See• Difficulty focusing• Disorganized• Low motivation• Difficulty controlling emotions• Poor memory• Talkative

(Brown, 2005)

• Friendship problems • Unfinished work• Messiness

(Adams, 2005)

• Deficiency in inhibition(Kutscher, 2005)

IdentificationIdentification

• There is no single test to diagnose ADHD.

• A comprehensive evaluation is used to rule out other causes or the presence of co-existing conditions.

• The evaluation includes:• a developmental and social history• medical exam• clinical assessment • symptoms checklists

IdentificationIdentification

DSM-IV Criteria for ADHD • Symptoms present before age 7. • Symptoms present in two or more settings

(e.g. at school/work and at home). • Significant impairment in social, school, or

work functioning. • The symptoms are not better accounted for

by another mental disorder.(CHADD, 2004)

InattentionInattentionSix or more symptoms present for at least 6 months to a point that is

disruptive and inappropriate for developmental level:

• Often does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities.

• Often has trouble keeping attention on tasks or play activities. • Often does not seem to listen when spoken to directly. • Often does not follow instructions and fails to finish schoolwork,

chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions).

• Often has trouble organizing activities. • Often avoids, dislikes, or doesn't want to do things that take a lot

of mental effort for a long period of time (such as schoolwork or homework).

• Often loses things needed for tasks and activities (e.g. toys, school assignments, pencils, books, or tools).

• Is often easily distracted. • Is often forgetful in daily activities.

(CHADD, 2004)

Hyperactivity and ImpulsivityHyperactivity and Impulsivity Six or more of the following symptoms present for at

least 6 months to an extent that is disruptive and inappropriate for developmental level:

• Often fidgets with hands or feet or squirms in seat. • Often gets up from seat when remaining in seat is expected. • Often runs about or climbs when and where it is not

appropriate (adolescents or adults may feel very restless). • Often has trouble playing or enjoying leisure activities quietly. • Is often "on the go" or often acts as if "driven by a motor". • Often talks excessively. • Often blurts out answers before questions have been

finished. • Often has trouble waiting one's turn. • Often interrupts or intrudes on others (e.g., butts into

conversations or games). (CHADD, 2004)

Combination TypeCombination Type

Individual meets both sets of inattention and hyperactive/impulsive criteria.

RisksRisks

• School failure• Family stress• Depression• Substance abuse• Delinquency• Risk for accidental injuries• Job failure• Driving risks• Problems socializing with peers

(Hallahan & Kauffman, 2006)

TreatmentTreatment

Multimodal approach which may include: – parent and child education about the

diagnosis and treatment – behavior management techniques– self-regulation training– medication– special education services

Research IssuesResearch Issues

• Girls with ADHD are typically diagnosed at age 12, five years later than boys (Adams, 2007). Girls are more likely to be unfocused or inattentive.

• Children with both autism and ADHD are four times more likely to bully. These children may have pent up energy that needs to be properly channeled or they may have other underlying behavioral or medical issues that have not been addressed (University of Rochester Medical Center, 2007).

Research IssuesResearch IssuesPublic opinions about ADHD:

• 85% of those interviewed believed that doctors overmedicate children with ADHD and those drugs have long-term harm on a child's development

• 31% believed children with ADHD would pose a danger and

• 45% said rejection at school is likely if a child goes for treatment.

Marcus (2007)

Legal ConsiderationsLegal Considerations504

• Faster and easier procedure (than an IEP) for obtaining accommodations and supports.

• Appropriate for students with significant impairments.

• General Curriculum and Classroom

• Adjustments• Modifications • Accommodations

• Typical of best teaching practices.

Individualized Education Program (IEP)

• Specific legal procedures and policies.

• More appropriate if a student has very significant school difficulties.

• Requires medical diagnosis• Listed as Other Health

Impairment (OHI) . • More extensive evaluation.• Specific goals and objectives• Monitoring and compliance

required.(Reiff, 2005)

Aargh…!Aargh…!

• Working with students with ADHD can be:• Demoralizing, • Demanding, • Frustrating• Exhausting

• It can challenge a teacher’s sense of competence.

• Students with ADHD are often unaware of their most disturbing behaviors and…

• when they are aware, they often can’t seem to help themselves (Pfiffner, 1996).

However…However…

Teacher can focus on strategies for handling behaviors so they can enjoy the unique strengths of their ADHD students.

FocusFocus!!• Secure the child’s attention before giving direction by

using direct eye contact (Wodrich, 2000)• Give one direction at a time • Check to ensure understanding of directions. • Monitor frequently while the student is working for both

effort and success.• Provide one on one assistance as needed. • Post rules, daily schedules and assignments• Call attention to schedule changes (Jensen, 2004). • Assign preferential seating, • Use headphones to block noise, • Seat the child near a positive peer model

Organization and Study SkillsOrganization and Study SkillsTeach how to: – create a homework area free of distractions.– organize materials. – create and prioritize schedules and calendars.– take effect notes.– complete, check, and turn in work on time.

• Provide tools and strategies – such as charts, tables, graphic organizers, and calendars

• Organize notebooks using color coded dividers, complete a weekly clean out, and keep a homework folder.

• Keep desk clear (use baskets, folders)

AssignmentsAssignments

• Create assignments that relate to the child’s interest.• Focus on their strengths and learning styles. • Use computerized learning materials.• Use visual cues.• Teach mnemonic devices. • Provide shortened assignments • Highlight sections or alter fonts (Wodrich, 2000). • Provide written outlines or notes, • Provide printed instructions• Give fewer assignments, • Adjust evaluation standards • Use a timing device.

Hyperactive or ImpulsiveHyperactive or Impulsive• Students can be assigned helper activities such as running

errands to the office, the counselor, the janitor, the library or another class.

• Frequent and scheduled breaks. • Buddy to a student in a lower grade. • Get a drink of water. • Do seatwork standing up• Clean the board, • Work at the board activities• Moving and organizing materials (Jensen, 2004). • Prepare for transitions. • Teach them self talk (“I will calm down.”) that they can use as

they come in from outside or have them walk a lap or two before lining up.

• Use positive command like “please walk” instead of don’t run. (Students who are impulsive often only hear what you don’t want them to do when they are given a negative command and not the “don’t” part of the statement.)

Either or Both!Either or Both!• Enforce rules consistently using rewards and

consequences. • Catch them being good.• Teach self advocating skills such as how and when to

ask for help. • Communicate regularly with the parents.

– Use technology such email and answering machines,

– Use student assignment books, – Provide suggestions for parents. – Use written communication such as notes or

progress reports. – Provide an extra set of textbooks for the parents to

use at home. • Teachers also can collaborate with other professional

staff about the student’s strengths and needs.(Council for Exceptional Children, 2007)

Resources for Parents: Resources for Parents: WebsitesWebsites

• www.chadd.org -A national non-profit organization working to improve the lives of affected people through education, advocacy and support.

• www.adhdnews.com - a support community for ADHD with message boards, blogs, free newsletters and articles to help your child.

• www.Advance.com- answers to your questions about ADHD, has an easy to use “Young Adult” section

• http://kidshealth.org/index.html - health information for parents, kids, and teens

Resources for Parents: Resources for Parents: Children’s BooksChildren’s Books

• Bright, Shiny Skylar by Valerie Tripp and Joy Allen • David Goes to School by David Shannon • Eagle Eyes by Jeanne Gehret• Joey Pigza (series) by Jack Gantos• Learning to Slow Down and Pay Attention by Kathleen G.

Nadeau and Ellen B. Dixon• Otto Learns About His Medicine by Matthew Galvin• Shelly the Hyperactive Turtle by Deborah Moss• Sometimes I Drive My Mother Crazy, But I Know She’s

Crazy About Me by Lawrence Shapiro• Waiting for Mr. Goose by Laurie Lears• Zipper: The Kid with ADHD by Caroline Janover and Rick

Powell

Resources for Parents: Resources for Parents: Books for ParentsBooks for Parents

ADHD: A Complete and Authoritative Guide from the American Academy of Pediatrics

Making the System Work for Your Child with ADHD by Peter Jensen

ADHD: What Every Parent Wants to Know by David Wodrich

*Kids in the Syndrome Mix of ADHD, LD, Asperger’s, Tourettes, and More! By Martin Kutscher

*Great resource for teachers too!

Resources for TeachersResources for Teachers• All About ADHD: The Complete Practical Guide

for Classroom Teachers by Linda Pfiffner, Ph.D.

• Help for the Struggling Student by Mimi Gold

• Innovative Strategies for Unlocking Difficult Children by R. Bowman, T. Carr, K. Cooper, R. Miles and T. Toner.

• Understanding Special Education: A Helpful Handbook for Classroom Teachers by Cynthia Stowe

ReferencesReferencesAdams, Carley (2007). Girls and ADHD: Are you

missing the signs. Retrieved September 5, 2007 from http://content.scholastic.com/browse/article.jsp?id=11532

Brown, T. (2005). Attention deficit disorder: The unfocused mind in children and adults. New Haven: Yale University Press.

Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) (2004). The disorder named AD/HD (WWK!). Retrieved September 5, 2007, from http://www.help4adhd.org/en/about/what/WWK1

Council for Exception Children (2007). Homework practices that support students with disabilities: What we have learned about homework and students with disabilities. Retrieved September 5, 2007 from http://www.cec.sped.org/AM/Template.cfm?Section= Home&CONTENTID=1811& TEMPLATE=/CM/ContentDisplay.cfm

Hallahan, D. & Kauffman, J. (2006). Exceptional learners: An introduction to special education (10th ed.). New York: Pearson Education, Inc.

Jensen, P. (2004). Making the system work for your child with ADHD. New York: The Guilford Press.

Kutscher, M. (2005). Kids in the syndrome mix of ADHD, LD, Asperger’s, Tourette’s, Bipolar, and more! The one stop guide for parents, teachers, and other professionals. Philadelphia: Jessica Kinsley Publishers.

Lehigh University (2007). Nonmedicinal treatment touted for preschoolers with ADHD. Retrieved September 5, 2007 from http://www.sciencedaily.com/releases/ 2007/08/070821143557.htm

Marcus, M. (2007). Public perceptions harsh of kids, mental health. Retrieved September 5, 2007 from http://www.usatoday.com/news/health/2007-04-29-public-perceptions_N.htm

Pfiffner, L. (1996). All about ADHD: The complete practical guide for classroom teachers. New York: Scholastic Professional Books.

Reiff, M. & Tippins, S. (2004). ADHD: A complete authoritative guide. United States of America: American Academy of Pediatrics.

University of Rochester Medical Center (2007). Children with both autism and ADHD often bully, parents say: Researchers caution against labeling. Retrieved September 5, 2007 from http://www.sciencedaily.com/releases/2007/05/070517100417.htm

Wodrich, D. (2000). Attention-deficit/hyperactivity disorder: What every parent wants to know.Baltimore: Paul H. Brookes Publishing Co.

This project was constructed as a part of a course assignment. The information provided in the materials is accurate to the best of our

ability but was not constructed by experts in the field.

On my honor as a student, I have neither given nor received aid or assistance on this assignment.