ADHD: Attention Deficit/Hyperactivity Disorder

1
ADHD Attention Deficit/Hyperactivity Disorder

• Cindy DollmanPeoria Public School District
  150Comprehensive System of Student Support
• cindy.dollman_at_psd150.org

2
Attention Deficit/Hyperactivity Disorder

• ADHD
• Kinesthetic Learner
• Strategies for the Teacher

3
Criteria

• According to the DSM-IV, individuals must have 6
  or more characteristics from either the
  Inattention List of Behaviors and/or the
  Hyperactivity/Impulsivity List of Behaviors

4
INATTENTION

• 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).

5
INATTENTION (continued)

• 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.

6
HYPERACTIVITY

• 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.

7
IMPULSIVITY

• 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).

8
Additional Criteria

• Some symptoms that cause impairment were present
  before age 7 years.
• Some impairment from the symptoms is present in
  two or more settings (e.g. at school/work and at
  home).
• There must be clear evidence of significant
  impairment in social, school, or work
  functioning.
• The symptoms do not happen only during the course
  of a Pervasive Developmental Disorder,
  Schizophrenia, or other Psychotic Disorder. The
  symptoms are not better accounted for by another
  mental disorder (e.g. Mood Disorder, Anxiety
  Disorder, Dissociative Disorder, or a Personality
  Disorder).

9
3 Types of ADHD

• ADHD, Combined Type if both criteria 1A and 1B
  are met for the past 6 months
• ADHD, Predominantly Inattentive Type if
  criterion 1A is met but criterion 1B is not met
  for the past six months 
• ADHD, Predominantly Hyperactive-Impulsive Type
  if Criterion 1B is met but Criterion 1A is not
  met for the past six months.

10
How many children have ADHD?

• Approximately 3-7 when diagnosed with the DSM
  criteria

11
Prevalence of ADHD (2003)

• 4.4 million children between the ages of 4 and 17
  have been diagnosed with ADHD
• 2.5 million of these children are receiving
  medical treatment for their diagnosis
• In Illinois, 6.23 of our students diagnosed with
  ADHD
• 3.32 of students were receiving medical
  treatment for their ADHD

12
How is it diagnosed?

• Physical Exam
• Patient/Parent Interview
• Family History
• Behavior Rating Scales
• Parent/Teacher Questionnaires
• Psych Testing

13
Treatment

• Medication
• Stimulants Ritalin (70)
• Amphetamine Adderall
• Psychosocial Therapy
• Behavioral Therapy
• Social Skill Training
• Support Groups

14
Side effects of Medication

• Decreased appetite - often low in the middle of
  the day and more normal by suppertime. Good
  nutrition is a priority
• Insomnia - may be relieved by taking the drug
  earlier in the day, or adding an antidepressant
• Increased anxiety and/or irritability
• Mild stomach aches or headaches
• Tics (more rare)

15
Competing Characteristics with ADHD

• Effects on peer relations
• Increase chance of injuries
• Upper respiratory infections
• Speech/Language Difficulties
• Anxiety
• Depression/Self-Esteem Issues
• Sleeping Problems

16
Comorbidities

• Oppositional Defiant Disorder
• Conduct Disorder
• Learning Disability (1/2 students with ADHD also
  have LD)

17
Oppositional Defiant Disorder

• Includes the following behaviors that begin
  before age 8
• Losing ones temper a lot
• Arguing with adults or refusing to comply with
  adults rules or requests
• Often getting angry or being resentful or
  vindictive
• Deliberately annoying others easily becoming
  annoyed with others
• Often blaming other people for ones own mistakes
  or misbehavior

18
Conduct Disorder

• aggression towards others in several settings
  that usually leads to delinquency or
  incarceration and requires the assistance of a
  mental health professional

19
Learning Style/Preference

• Learning styles are the different ways students
  learn. They are the different approaches we take
  to absorb information.
• Visual Learner
• Auditory Learner
• Kinesthetic Learner

20
Kinesthetic Learner

• Learn best by touching, doing, moving
• Like hands-on activities
• Like to explore and move about their environment
• THINK movement and touch
• Takes notes, uses highlighters

21
Common phrases of the Kinesthetic Learner

• That feels right to me.
• I cant get a grip on this
• Stay in touch.
• Get in touch with
• That doesnt sit right with me.
• I have good feelings about this.
• My gut is telling me
• I follow your drift.

22
Characteristics of the Kinesthetic Learner

• Use activities that get the learners up and
  moving.
• Play music, when appropriate, during activities.
• Use colored markers to emphasize key points on
  flipcharts or white boards.
• Give frequent stretch breaks (brain breaks).
• Provide toys such as Koosh balls and Play-Dough
  to give them something to do with their hands.
• To highlight a point, provide gum, candy, scents,
  etc. which provides a cross link of scent (aroma)
  to the topic at hand (scent can be a powerful
  cue).
• Provide highlighters, colored pens and/or
  pencils.
• Guide learners through a visualization of complex
  tasks.
• Have them transfer information from the text to
  another medium such as a keyboard or a tablet.

23
ADHD vs. Kinesthetic Learner

• There is no way to determine if a child has ADHD
  or is a Kinesthetic Learner
• However, it is important to notice the
  similarities between the two and provide
  strategies to compensate for learning barriers

24
Strategies in the Classroom

• Sit in the front of the classroom
• Provide a role model
• Keep away from noise and distractions
• Provide opportunities for movement
• Gain eye contact and attention prior to direct
  instruction
• Have student repeat or write oral directions
• Keep directions short, concise, and to the point
• Pair students with a buddy
• Reduce the amount of work required in one sitting
• Segment work into chunks of 15 minutes with a 5
  minute break
• Sit children near a fan/white noise to limit
  distraction of classroom noise
• Only punish major disruptions
• Their perception is misconstrued find cause and
  apologize
• Provide appropriate fidgets
• Praise, praise, praise!
• Specify appropriate positive behavior
• Review behavior expectations and routines weekly

25
Strategies for Academic Instruction Lesson
Introduction

• Use advance organizers
• Review previous lessons
• Set learning expectations
• Set behavior expectations
• State needed materials
• Explain additional resources
• Simplify instructions, choices, scheduling

26
Strategies for Academic Instruction During the
Lesson

• Be predictable
• Support the students participation
• Use audiovisual materials
• Check student performance
• Ask probing questions
• Perform ongoing student evaluation
• Help students correct their own mistakes
• Help students focus
• Follow-up Directions
• Lower noise level
• Divide work into smaller units
• Highlight Key Points
• Eliminate or reduce frequency of timed tests
• Use cooperative learning strategies
• Use assistive technology

27
Strategies for Academic Instruction Concluding
Lessons

• Provide advance warnings
• Check assignments
• Preview the next lesson

28
Strategies for Academic Instruction LANGUAGE
ARTS READING COMPREHENSION

• Silent Reading Time
• Follow-along Reading
• Partner Reading Activities
• Storyboards
• Storytelling
• Playacting
• Word Back
• Board games for comprehension
• Computer games for comprehension
• Recorded Books
• Backup Materials for Home use
• Summary Materials

29
Strategies for Academic Instruction PHONICS

• Mnemonics for phonics
• Word families
• Board games
• Computer games
• Picture-letter cards

30
Strategies for Academic Instruction WRITING

• Set standards for assignments
• Recognizing parts of story
• Post office
• Visualize compositions
• Proofread compositions
• Tape recorders
• Dictate writing assignments

31
Strategies for Academic Instruction SPELLING

• Provide everyday examples of hard to spell words
• Frequently used words
• Dictionary of misspelled words
• Partner spelling activities
• Manipulatices
• Color-coded letters
• Movement activities
• Word Banks

32
Strategies for Academic Instruction HANDWRITING

• Individual chalkboards
• Quiet places for writing
• Spacing words on a page
• Special writing paper
• Structutred programs for handwriting

33
Strategies for Academic Instruction MATH
COMPUTATION

• Teach patterns in math
• Partner for math activities
• Mastery of math symbols
• Mnemonics for basic computation
• Real-life experiences of money skills
• Color coding arithmetic symbols
• Calculators to check basic computation
• Board games
• Computer games
• Magic minute drills

34
Strategies for Academic Instruction SOLVING MATH
WORD PROBLEMS

• Reread the problem
• Clue Words
• Guiding questions for word problems
• Real-life examples of word problems
• Calculators to check word problems

35
Strategies for Academic Instruction SPECIAL MATH
MATERIALS

• Number lines
• Manipulatives
• Graph paper

36
Organizational and Study Skills

• Designate a student advisor
• Assignment notebooks
• Color-coded folders
• Work with a homework partner
• Clean out desks and bookbags
• Visuals aides as reminders

37
Time Management

• Use a clock or watch
• Use a calendar
• Practice sequencing activities
• Create a daily schedule

38
Helpful Study Skills

• Adapt worksheets
• Venn Diagrams
• Note-taking skills
• Checklist of frequent mistakes
• Checklist of homework supplies
• Uncluttered workspace
• Monitor homework assignments

39
Strategies for Behavioral Intervention

• Define appropriate behavior during praise
• Give praise immediately
• Vary praise statements
• Be consistent and sincere
• Selectively ignore inappropriate behavior
• Remove nuisance items
• Provide calming manipulatives
• Allow for escape outlets
• Activity reinforcement

40
Strategies for Behavioral Intervention

• Behavior Prompts Instruction
• Visual Cues
• Proximity control
• Hand Gestures
• Social Skill Classes
• Problem solving sessions

41
References

• American Psychiatric Association Diagnostic and
  Statistical Manual of Mental Disorders, Fourth
  Edition, Text Revision. Washington, DC, American
  Psychiatric Association, 2000.
• http//www.cdc.gov/ncbddd/adhd/
• http//www.cdc.gov/index.htm
• http//psychcentral.com/disorders/adhd/adhd_treatm
  ent.htm
• http//www.adhdinfo.com/info/parents/about/par_how
  _is_adhd_diagnosed.jsp
• http//www.ldpride.net/
• http//www.learning-styles-online.com/
• http//www.drphonics.com/