Attention Deficit Hyperactivity Disorder

Lecture 6

Ching-fen Hsu

2013/10/18

Robert Toth • Renowned sculptor &

painter

• Work exhibited in National Portrait Gallery, Lincoln Center, Vatican Museum

• Cannot recall times of the 4th grade repeat

• His mother helped him success in arts

• Artistic giftedness guided him the way to overcome disabilities

ADHD in IDEA 04’ Students with ADHD

• Are not guaranteed eligibility for special education or related services, even with medical diagnoses & medication prescriptions

• Are specially called out under other health impairments category, which does not list every disability and condition

• May be eligible for services under other categories, such as learning disabilities & emotional/behavioural disorders

• May receive special education services if the condition adversely affects educational performance

Historical Context • 1902 Dr. George Still: documents characteristics with

ADHD (some abnormal psychical conditions in children)

inattention/impulsivity

• 1919 Kurt Goldstein: German psychiatrist studied veterans after WWI

never developed strong skills in reading, writing, speaking

• 1937 Alfred Strauss & Heinz Werner: Wayne County Training Center in Michigan

minimal brain damage (Strauss syndrome)

• Late 1930s Laura Lehtinen: developed highly structured teaching routines in Cove School

Challenges That ADHD Presents • Failing at school

• Dropping out of school

• Having high conflict rate

with their families over

doing homework/chores

• Relationships with

classmates for poor social

skills & hyperactivity

• Peers rejection/teachers

dislike

• Loneliness & no friends

Project Eye-To-Eye • Mission: develop a

nationwide partnership with local community

• Provide mentors for SADHD

• Principle: empowerment through building self-esteem

• Meta-cognitive skills development, learning strategies usage, academic accommodations

• Art training

• Parental networking

• Professional development

Defined ADHD • Attention Deficit Disorder (ADD)

• Attention Deficit Hyperactivity Disorder (ADHD)

• Federal government: having limited strength,

vitality, heightened alertness to E stimuli, limited

alertness to educational E, adversely affects

children’s educational performance

• DSM-IV-TR: (1) inattention

(2) hyperactivity

(3) impulsivity

Inattention • Inattention: inability to pay attention or focus

• Unable to follow teachers’ instructions

• Be confused about where they are supposed to be

• Do not know what they are supposed to do

• Cannot focus on learning tasks

• Pay attention to wrong features

• Be distractible

• Have difficulty shifting between tasks

• Have problems transferring between activities

• Inability to learn in an organized/efficient way

hyperactivity • Impaired ability to sit or

concentrate for long

periods of time

• Difficult to define

• Hyper is quite subjective

• Energetic/enthusiastic in

admired activities

• Continue having

daydreaming or ongoing

stream of thoughts

• Reduced excessive activity

& internal restlessness

Impulsivity • Impaired ability to control one’s own behaviour

• Disrupt learning E for an entire class

• Unable to focus relevant components of

problems that needed to be solved/tasks needed

to be accomplished

• Acting before thinking

• Talk out of turn

• Redirect discussion topic in class

• Poor responses from their classmates

• Decreased social acceptance

As A Teacher, You Could… • Assign a classmate to help students stay on tasks

• Tailor pace of instruction to students’ needs

• Arrange more frequent, shorter study periods

• Monitor student learning & modify/supplement

instruction

• Use clear & concise directions, step-by-step

directions

• Give plenty of notices about upcoming changes in

activities to students

• Use predictable & standard schedules

• Promote effective completion of assignments

Education Services for SADHD • General education

no school failure students

extended time on tests & assignments

• Special education

comorbidity: coexisting disabilities

70% SADHD with LD

higher IQ scores even with LD/reading problems

lower standardized achievements

42% SADHD with EBD (1/4 no mental health services: counseling), avoid serious, dangerous, violent situations

• Boys with ADHD with acting out behaviours

Characteristics of ADHD • Undermine success in

school

• Less persistent

• Less effort

• Prefer easier work

• Take less enjoyment in

learning

• Miss details about

assignments

Causes of ADHD • Unknown exact causes

• Inherent differences of brains with ADHD functions

• Biological predisposition (temperament/neurological development) for developing ADHD

• Consensus on biological basis

• Decreased blood flow & electrical activity in the frontal lobes

• Anatomical differences in various regions of brains

• Differences in neurotransmitter levels

• Differences in abilities to track objects visually

• Trouble staying on one line of printed text when reading

High Energy & Low Performance

• Derek, an African American boy

• Always late to classes for having trouble in

remembering the rooms

• Late homework

• Bad quality homework

• Have no ideas about talking content in class

• Boundless energy in gym/on school campus

• Never accomplish what needed to be done

• Have dysfunction family

Overcoming Challenges • Teaching is the first step in helping SADHD

• Medication to help control behaviours & pay

attention

• Reduce school-related problems

• Ritalin/Concerta/Adderall/Dexadrine

• Enhance executive functions in the frontal lobe

• Increase neurotransmitters for brain functioning

• Side effects---reduction in appetite, sleeping

problems, dizziness

• Behaviour & medication should go together

Medicating Young Minds

• 2003 Nov. 3 Times

• Only a few of the newest

drugs developed for

children

• Scientists do not know

long-term effects on

medications

• Pervasive side effects

• Medication is still

controversial

Assessment • Early identification

• Few preschoolers identified as SADHD for (1)

fear of misidentification (2) short attention span &

in constant motion are typical of young children

without ADHD

• Incident causing brain damage

• Pre-referral is important

• Identification (diagnostic interviews, behavioural

rating scales, standardized tests, observations,

medical examinations)

Teaching SADHD • Students with ADHD miss blocks of information

• Experience interruptions in learning process

• Inconsistent access to general education curriculum

• Miss instruction/lack motivation/persistence to make effort

Validated Practices • Planning educational procedures carefully

• Giving rewards

• Making assignments more interesting

• Letting students choose academic alternative

assignments

• Shortening tasks

• Giving clear & precise instructions

• Peer tutoring (>50% academic improvement)

Self-Management Self-regulation strategies

• Self-monitoring

Was I paying attention? Was I on task? Or off task? Was I doing what teacher asked us to do?

• Self-instruction (self-talk)

Double-check my answers. Did I check all of my questions? Just a little bit longer. Stay focused and I can finish this whole sheet.

• Self-reinforcement

• Goal-setting

Let Every Child Pay Attention in Class

Review Objectives After this course, you should be able to….

• Recognize the characteristics of students with

ADHD

• Understand the relationship of ADHD to other

coexisting disabilities

• Understand medical treatments of ADHD

• Discuss the importance of collaborating and

developing partnerships with families and with

other professionals

Questions?