The Effects of Attention Deficit Hyperactivity Disorder on Mathematics Achievement

1
The Effects of Attention Deficit Hyperactivity
Disorder on Mathematics Achievement

• National Council of
• Teachers of Mathematics
• 2005 Annual Meeting and Exposition
• Anaheim, CA
• April 7, 2005

2
The Effects of Attention Deficit Hyperactivity
Disorder on Mathematics Achievement

• Presenter Information
• Kay Haralson
• Associate Professor of
• Developmental Mathematics
• Austin Peay State University
• Clarksville, TN 37044
• haralsonk_at_apsu.edu
• www.apsu.edu/haralsonk

3
What is ADHD? (www.nichcy.org)

• ADHD is a complex, neurobiochemical disorder
  involving differences in brain activity and
  structure in the prefrontal cortex, the basal
  ganglia, and the cerebellum. These areas are know
  to help to inhibit behavior, sustain attention,
  and control mood.
• ADHD is considered a behavioral and mental health
  disorder.

4
Possible Causes of ADHD (www.nichcy.org,
www.ezinearticles.com)

• PET (positron emission tomography) or brain
  scans, indicate less activity and blood flow in
  the part of the brain that inhibits impulsivity.
• Studies have shown there to be an insufficient
  availability of the neurotransmitters dopamine
  and norepinephrine in the central nervous systems
  of children with ADHD. These brain chemicals are
  needed for paying attention and controlling
  behavior.
• Current investigations being done to identify
  abnormalities in the dopamine-transporter gene
  support the theory that ADHD can be genetically
  inherited.

5
Diagnostic Criteria for ADHD (Diagnostic and
Statistical Manual of Mental Disorders, Fourth
Edition, Text Revision, 2000, DMV-IV-TR, American
Psychiatric Association, www.cdc.gov/ncbddd/adhd/s
ymptoms.htm)

• I. Either A or B
• A. Six or more of the following symptoms of
  inattention have been present for at least 6
  months to a point that is disruptive and
  inappropriate for developmental level
• 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.

6
Diagnostic Criteria for ADHD (DSM-IV-TR)

• 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 directions).
• Often has trouble organizing activities.
• Often avoids, dislikes, or doesnt 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.
• Is often easily distracted.
• Is often forgetful of daily activities.

7
Diagnostic Criteria for ADHD (DSM-IV-TR)

• B. Six or more of the following symptoms of
  hyperactivity-impulsivity have been present for
  at least 6 months to an extent that is disruptive
  and inappropriate for developmental level
• 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).

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Diagnostic Criteria for ADHD (DSM-IV-TR)

• Is often on the go or often act as if driven
  by a motor.
• Often has trouble playing or enjoying leisure
  activities quietly.
• Often talks excessively.
• Impulsivity
• Often blurts out answers before questions have
  been finished.
• Often has trouble waiting ones turn.
• Often interrupts or intrudes on others.

9
Diagnostic Criteria for ADHD (DSM-IV-TR)

• 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).

10
Subtypes of ADHD (DSM-IV-TR)

• Based on these criteria, three types of ADHD are
  identified
• 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

11
Prevalence (DSM-IV-TR, www.adhdsupportcompany
.com )

• 3-7 of children suffer from ADHD.
• ADHD is diagnosed approximately three times more
  often in boys than in girls.
• As many as half of those with ADHD also have
  other mental disorders.
• Over half of the children diagnosed with ADHD
  carry the disorder into adulthood.
• A large number of adults who were never diagnosed
  as a child show clear symptoms of ADHD.
• AMAs Special Council Report showed little
  evidence of widespread over-diagnosis of ADHD or
  over-prescription of medication for ADHD.
  (www.nichcy.org)

12
Identifying ADHD and Subtypes
(
www.nimh.nih.gov, www.ets.org)

• The diagnosis of ADHD and the subtypes of ADHD
  should be made by a professional with training in
  the evaluation of ADHD or in the diagnosis of
  mental disorders. Such as
• Child psychiatrists and psychologists
• Developmental/behavioral pediatricians
• Behavioral neurologists
• Neuropsychologists
• Clinical teams with educational, medical, and
  counseling professionals with training in the
  evaluation of ADHD

13
ADHD in Adults (www.addresources.org,
www.akrongeneral.org)

• Symptoms of ADHD in adults are similar to the
  diagnostic criteria for children, but may be
  displayed in different ways.
• Inattention
• Poor listening skills
• Easily distracted, forgetful, daydreaming
• Difficulty with making decisions
• Trouble maintaining an organized work/living area
• Easily overwhelmed by tasks of daily living
• Spends excessive time at work because of
  inefficiency
• Frequently losing or misplacing things
• Need for others to organize you

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ADHD in Adults (www.addresources.org,
www.akrongeneral.org)

• Hyperactivity
• Frequently late or rushed
• Easily bored intense need for excitement
• Difficulty with falling asleep or waking up alert
• Difficulty estimating how much time something
  will take
• Poor handwriting
• Performs worse under pressure
• Thoughts jump from one topic to the next
• Strong need to control or have things your way
• An internal sense of anxiety and restlessness

15
ADHD in Adults (www.addresources.org,
www.akrongeneral.org)

• Impulsivity
• Impulsive spending and money management problems
• Frequent, impulsive job changes
• Very impatient, low frustration tolerance
• Tactless, tendency to embarrass others
• Frequent traffic violations
• Trouble with authority
• Mood swings
• Prone to hysterical outbursts
• Tendency to seek conflict, be argumentative

16
ADHD in Adults (www.addresources.org,
www.akrongeneral.org)

• Symptoms that can develop after years of living
  with ADHD
• A sense of failure, not living up to ones
  potential
• A sense of being different, unconventional
• Very sensitive to being told to do something or
  to being criticized
• A tendency to worry needlessly and endlessly
• Difficulty with personal or work relationships
• A tendency toward addictions
• Personal or family history of substance abuse,
  depression, or anxiety

17
Effects of ADHD on Math Achievement

• In mathematics attention to details is critical.
  Overlooking or misreading mathematical symbols,
  key words, or instructions leads to careless
  mistakes.
• Poor organization skills hinder students from
  getting paper, pencil, book, and assignment
  together in one place.
• If students are distracted while completing math
  problems, they lose their focus, skipping
  problems or steps in problems.
• Constant movement of hands, feet, pencils, etc.
  gets the student off track.

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Effects of ADHD on Math Achievement

• Math homework takes a lot of mental effort for a
  long period of time. Students with ADHD learn to
  avoid these types of activities.
• The excessive amount of time it takes for them to
  complete assignments increases their frustration
  level.
• Underestimating the time needed to complete
  assignments means that some go unfinished.
• Students procrastinate and put off completing
  assignments until it is too late.

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Effects of ADHD on Math Achievement

• Students show inconsistent performance.
  Information learned one day, seemingly mastered,
  may be missing the next day.
• Performance is worse under pressure.
• Students have difficulty retrieving information
  on demand, even when thoroughly studied.
• Students become angry with themselves and their
  teachers when they are criticized or when they do
  not do well.

20
Treatment Options (www.hawaii.edu/medicine/pediatr
ics/pedtext/s01c10.html)

• The American Academy of Pediatrics guidelines for
  treatment of ADHD requires understanding of four
  aspects
• ADHD is a chronic condition. Parental, medical,
  and educational support should be provided into
  adulthood.
• Target symptoms need to be addressed. Set
  realistic goals for improvement in specific
  areas.
• Medication and behavior strategies are important.
  A combined approach has been shown to be more
  effective than either strategy alone.
• Close follow-up of target symptoms and medication
  use. Reevaluations and monitoring should be done
  periodically and consistently.

21
Treatment Options (www.nichcy.org)

• A joint study by the NIMH (National Institute of
  Mental Health) and the (OSEP) U.S. Department of
  Educations Office of Special Education Programs
  indicated that a multi-modal treatment approach
  had the greatest positive effect on reducing ADHD
  symptoms.
• The recommended multi-modal treatment approach
  consists of four core interventions
• patient, parent, and teacher education about the
  disorder
• medication (usually from the class of drugs
  called stimulants)
• behavioral therapy and
• other environmental supports, including an
  appropriate school program.

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Multi-modal Treatment (www.nichcy.org)

• Patient, parent, and teacher education about the
  disorder
• Learn about ADHD and the nature of the challenges
  it presents.
• Understand that the child has troubles and is not
  the cause of the troubles.
• Children with ADHD should learn to be
  self-advocates but parents and teachers can also
  be strong advocates for the child

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Multi-modal Treatment (www.nichcy.org)

• Medication (usually stimulants)
• Since ADHD is neuro-biochemically-based it stands
  to reason that medication that gets to the core
  of the problem would be effective.
• These medications work to make the brains
  systems work more efficiently, improving
  attention, memory, executive functions, and
  inhibition.
• The result is better concentration, increased
  working memory capacity, greater recall, less
  hyperactivity, and more impulse control.

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Multi-modal Treatment (www.nichcy.org)

• Behavioral Therapy
• Parents and teachers need to be the executives in
  the childs life, providing structure, routines,
  assistive devices, external supports and guides.
• Develop behavior management strategies. Use
  positive attention, rules, consequences, and
  formal systems such as contracts and charts. The
  main goal is to increase the childs appropriate
  behavior and decrease inappropriate behavior.
• Teach problem solving. Develop skills in the art
  of negotiation, give and take, and conflict
  resolution through peaceful means.
• Use good communication skills. Say what you mean
  in a firm, loving way.

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Multi-modal Treatment (www.nichcy.org Quinn,
1994 Nadeau, 1994 Murphy, 1995 Amen, 1997)

• Education Intervention
• Provide a structured environment
• preferential classroom seating
• pair student with good role models
• create a classroom with limited distractions
• give a detailed plan of the course activities and
  requirements, avoid changes in routine
• design tasks of low to moderate frustration
  level, challenge but dont overwhelm
• provide frequent reminders of due dates of
  assignments and tests dates

26
Multi-modal Treatment (www.nichcy.org Quinn,
1994 Nadeau, 1994 Murphy, 1995 Amen, 1997))

• Education Intervention
• Enhance organization skills
• encourage the use of a daily/weekly planners
• use a tape recorder for class lectures
• make directions clear and concise, provide direct
  one-on-one instruction
• give out only one task at a time
• monitor work frequently, provide feedback
• use handouts to minimize the need for note taking
• provide an outline of material on the overhead
• maintain frequent communication between home and
  school with daily/weekly progress reports

27
Multi-modal Treatment (www.nichcy.org Quinn,
1994 Nadeau, 1994 Murphy, 1995 Amen, 1997)

• Education Intervention
• Allow accommodations in assessment
• extend time to complete tests
• provide a distraction free environment for taking
  tests
• alter the response format of tests
• allow tests to be taken over a period of time in
  short intervals
• expect no less from students with ADHD, but give
  them alternative ways to demonstrate their
  competencies

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Multi-modal Treatment (www.nichcy.org Quinn,
1994 Nadeau, 1994 Murphy, 1995 Amen, 1997)

• Education Intervention
• Be sensitive to the students emotional needs
• be aware of their low frustration tolerance and
  stress tolerance
• be aware that if they have outbursts of anger, it
  is generally toward themselves and not toward you
• recognize secondary problems such as depression,
  anxiety, and other emotional problems

29
Mathematics Individualized Instructional
Practices (Teaching Children with Attention
Deficit Hyperactivity Disorder Instructional
Strategies and Practices, 2004)

• teach students to recognize patterns when
  performing operations on whole numbers
• use mnemonics for basic computation
• color code arithmetic symbols to provide visual
  cues
• use calculators to check basic computation
• provide real-life examples of money skills
• teach mastery of math symbols, e.g. or minus
  means to take away
• use computer tutorial games for basic computation

30
Mathematics Individualized Instructional
Practices (Teaching Children with Attention
Deficit Hyperactivity Disorder Instructional
Strategies and Practices, 2004)

• use number lines for computing whole number
  operations
• use manipulatives in basic computation skills
• use graph paper to help organize columns when
  performing basic computations
• teach students to look for clue words that
  indicate specific operations
• use guiding questions to talk students through
  the steps of problems

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• References
• ADHD Support Company, (2005) Adult ADHD.
  Available Internet www.adhd.supportcompany.com
• Akron General Medical Center. (2004). Attention
  deficit disorder in adults (ADD). Available
  Internet www.akrongeneral.org/psychiatry/psychiat
  ry_add.asp
• Allen, T. (2005). Attention deficit hyperactive
  disorder . . . A teachers perspective. Available
  Internet http//ezinearticles.com
• Amen, D. G. (2001). Attention, Doctors. Newsweek.
  February 26, 2001.
• Amen D. G. (1997). Windows in the A.D.D. mind
  Understanding and treating attention deficit
  disorders in the everyday lives of children,
  adolescents, and adults. Fairfield CA MindWorks
  Press.
• American Psychiatric Association (2000).
  Diagnostic and statistical manual of mental
  disorders (4th ed., text revision). Washington
  DC American Psychiatric Association.

32

• References
• Attention Deficit Disorder Resources. (2005).
  Available Internet www.addresources.org
• Baker, K. B. (2001). Attention deficit
  hyperactivity disorder and reading achievement.
  Queensland Journal of Educational Research. 17.
  Available Internet education.curtin.edu.au/iier/q
  jer/qjer17/baker.html
• Barabasz, A,, Barabasz, M. (1995). Attention
  deficit hyperactivity disorder Neurological
  basis and treatment alternatives. Journal of
  Neurotherapy. 1(1). Available Internet
  www.snr-jnt.org/journalnt/jnt(1-1)1.html.
• Fowler, M. (2004). Attention-deficit/hyperactivity
  disorder, Washington, DC National Dissemination
  Center for Children with Disabilities. Available
  Internet www.nichcy.org
• Kid Source Online. (2000). Teaching children with
  attention deficit disorder. Available Internet
  www.kidsource.com/kidsource/content2.add.html

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• References
• Murphy, K. R., LeVert, S. (1995). Out of the fog
  Treatment options and coping strategies for adult
  attention deficit disorder. New York, NY
  Skylight Press.
• Nadeau, K. G. (1994). Survival guide for college
  students with ADD or LD, New York, NY Magination
  Press.
• National Center on Birth Defects and
  Developmental Disabilities. (2005).
  Attention-deficit/hyperactivity disorder.
  Available Internet www.cdc.gov/ncbddd/adhd
• National Institute of Mental Health. (2003).
  Attention deficit hyperactivity disorder.
  Available Internet www.nimh.nih.gov/Publicat/ADHD
  .cfm
• Okamoto, J. K. (2002). Chapter I.10.Attention
  deficit/hyperactivity disorder. Department of
  Pediatrics, University of Hawaii. Available
  Internet www.hawaii.edu/medicine/pediatrics/pedt
  ext/s01c10.html

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References

• Quinn, P. O. (Ed.). (1994). ADD and the college
  student A guide for high school and college
  students with attention deficit disorder. New
  York, NY Magination Press.
• The Office of Disability Policy Educational
  Testing Service. (1999). Policy statement for
  documentation of attention-deficit/hyperactivity
  disorder in adolescents and adults. Available
  Internet www.ets.org/disability/adhdplcy.html
• U.S. Department of Education, Office of Special
  Education and Rehabilitative Services, Office of
  Special Education Programs. (2004). Teaching
  children with attention deficit hyperactivity
  disorder Instructional strategies and practices.
  Washington, D.C

35
The Effects of Attention Deficit Hyperactivity
Disorder on Mathematics Achievement

• To obtain a copy of this power point presentation
  go to
• www.apsu.edu/haralsonk
• and click on ADHD
• or e-mail
• Kay at haralsonk_at_apsu.edu
• Thank you for your attention!