Attention Deficit Hyperactivity Disorder

Agenda

• Symptoms of ADHD.

• What symptoms you may observe.

• Effects of ADHD on a student.

• Intervention strategies.

ADHD Fact and Fiction

Fiction• All children with ADHD eventually

outgrow it.

• ADHD is not a medical condition.

• ADHD is caused by bad parenting.

• People with ADHD always have problems with concentration.

• ADHD affects more males than females.

• ADHD can only be treated with medication.

Fact• 60% continue to exhibit symptoms

as adults.

• It’s a medical condition linked to a chemical imbalance in the brain.

• Stems from biological causes, not environmental.

• Sometimes they hyper-focus.

• As children it is diagnosed 4:1 but as many women as men seek treatment as adults.

• Studies show that combining behavioral therapy with medication is most effective.

Symptoms of INATTENTION(six or more of the following)

Have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level.

Inattention

• Often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities

3

- 2

= 5

Inattention

• Often has difficulty sustaining attention in tasks or play activities

Inattention

• Often does not seem to listen when spoken to directly

Say What?

Inattention

• Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)

Inattention

• Often has difficulty organizing tasks and activities

Inattention

• Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (schoolwork or homework)

Inattention

• Often loses things necessary for tasks or activities (school assignments, pencils, books, tools)

Inattention• Is easily distracted by extraneous stimuli

(noises, lights, movement, smells)

Inattention• Is often forgetful in daily activities

IForgot!

Symptoms of HYPERACTIVITY

(Six or more of the following)

Have been present for at least 6 months to a degree that is maladaptive and inconsistent with developmental level.

Hyperactivity• Often fidgets with hands or feet or squirms

in seat

Hyperactivity

• Often leaves seat in classroom or in other situations in which remaining seated is expected

Hyperactivity

• Often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to feelings of restlessness)

Hyperactivity

• Often has difficulty playing or engaging in leisure activities quietly

Hyperactivity

• Is often “on the go” or often acts as if “driven by a motor”

Hyperactivity

• Often talks excessively

Impulsivity

• Often blurts out answers before questions have been completed

• Often has difficulty awaiting turn

• Often interrupts or intrudes on others (e.g., butts into conversations or games)

It’s Maine!

ADHD

• Either Inattention or Hyperactivity-Impulsivity (six symptoms in a section)

• Some Hyperactive-Impulsive or inattentive symptoms that caused impairment were present before age 7 years.

• Clear evidence of clinically significant impairment in social, academic or occupational functioning

Activity

• Talk in small groups about what effects you believe ADHD has on students in the classroom.

• What are their struggles?

• What are their feelings?

• Impact on relationships with other students and teachers?

Effects of ADHD on a student

• Difficulty with delayed gratification.

• Possible depressive symptoms.

• Often present with Oppositional Defiant symptoms.

• Social difficulty – isolation, rejection, set up by peers

Activity

• Talk in small groups about what strategies you have found to be successful coping with ADHD symptoms in the classroom and school environment.

• What has worked?

• What has not worked?

Intervention Strategies• ‘Turn down the noise’. They are easily over-

stimulated.• Seat the student in a location in the room with

the least extraneous stimuli (often the front of the room with back to the rest of the class or at the back of the class).

• Seat near positive role models with a high capacity for attention and concentration.

• Increase distance between students’ desks.• Limit noise distraction by placing tennis balls or

pads under chair and desk feet.• Build in structure, schedules, and routine.• Work in small spurts rather than in long hauls.• Break tasks into smaller amounts.

Intervention Strategies

• Allow regular movement breaks.• Use a combination of audio, visual, and tactile

approaches to academic instruction.• Use a variety of auditory signals (e.g. bell,

musical instrument ) to cue student to transitions or need to focus attention.

• Provide privacy dividers or study carrels.• Allow them to work with another student or in a

group rather than alone.• Allow use of earphones or earplugs.• Provide frequent supervision.

Intervention Strategies

• Coach rather than control.• Allow them to work on computer when feasible.• When giving instruction, highlight key points, both

verbally and visually.• Be sure to have the student’s attention before giving oral

directions; give only one direction at a time, speak in short, simple sentences; provide a visual support for oral directions (i.e. written instructions, samples).

• Act instead of react.• Use of a timer to increase time on task.• Use of tape to distinguish personal work area (young

students).

Intervention Strategies• Develop a discreet, non-shaming way for the

student to ask for or get clarification on missed directions or to cue the student when they are off task.

• Use the student’s name frequently in positive ways (i.e. when giving examples, asking for their expertise).

• Have class repeat instructions to a partner.• Start each day with a detailed review of the

schedule; keep it posed in an easy to see place; refer to the schedule if the student appears disoriented; when activities are completed, cross them off the schedule.

Intervention Strategies

• Write all assignments on the board; provide the student with time to copy the assignments into assignments book.

• Have the student explain how he/she plans to organize an assignment before getting started.

• Have clearly marked, consistently used homework collection bins.

Intervention Strategies

• Allow time during the day for locker and backpack organization; provide “check in” time at the end of the day to make sure the student has what they need. (Some students respond better to not having a locker.)

• Chunk assignments into smaller achievable parts.

• Allow the student to keep one set of materials at home and one at school.

Intervention Strategies

• State and restate clear behavioral expectations for the classroom in general, and for each new task or environment.

• Post behavioral expectations throughout classroom and school for easy reference.

• Establish clear social rules pertaining to social space (i.e. arms length)

• Establish clear classroom routines early in the year and stick to them.

Intervention Strategies

• Design lessons so that students have to actively respond to an assignment – get up, move around, write on the board, respond with thumbs up or thumbs down to statements.

• Allow the student opportunities to stand while working.

• Provide regularly scheduled breaks and/or opportunities for the student to move around in between quiet work times.

Intervention Strategies

• Give the student an in-class outlet for physical restlessness, such as squeeze ball, soothing stone, eraser, Velcro under the desk, pipe cleaners.

• Offer more positive reinforcements than negative consequences (4:1 ratio).

• Integrate physical activity (i.e. shooting hoops, running errands) throughout the school day that is not contingent on good behavior.

Intervention Strategies

• Avoid excessive unstructured time.• Assist the student in beginning new tasks

to decrease impulsivity in their approach.• Provide extra support through transitions;

provide a separate transition time for the student if necessary (i.e. 5 minutes before bell rings).

• Teach the student strategies for waiting their turn (i.e. counting, doodling).

Resources

Websites:

• www.adhd.com

• www.adhdhelp.org

• www.chadd.org

• www.schoolbehavior.com