ADHD: Attention Deficit/Hyperactivity Disorder Cindy Dollman Peoria Public School District #150 Comprehensive System of Student Support [email protected].

ADHD: Attention Deficit/Hyperactivity Disorder

Cindy DollmanPeoria Public School District #150Comprehensive System of Student [email protected]

Attention Deficit/Hyperactivity Disorder

ADHD

Kinesthetic Learner

Strategies for the Teacher

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

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).

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.

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.

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).

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).

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.

How many children have ADHD?

Approximately 3-7% when diagnosed with the DSM criteria

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

How is it diagnosed?

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

Treatment

Medication Stimulants: Ritalin (70%) Amphetamine: Adderall

Psychosocial Therapy Behavioral Therapy Social Skill Training Support Groups

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)

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

Comorbidities

Oppositional Defiant Disorder Conduct Disorder Learning Disability (1/2 students with

ADHD also have LD)

Oppositional Defiant Disorder Includes the following behaviors that begin

before age 8: Losing one’s 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 one’s own

mistakes or misbehavior

Conduct Disorder aggression towards others in several

settings that usually leads to delinquency or incarceration and requires the assistance of a mental health professional

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

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

Common phrases of the Kinesthetic Learner

That feels right to me. I can’t get a grip on this… Stay in touch. Get in touch with… That doesn’t sit right with me. I have good feelings about this. My gut is telling me… I follow your drift.

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.

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

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

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

Strategies for Academic Instruction: During the Lesson

Be predictable Support the student’s 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

Strategies for Academic Instruction: Concluding Lessons

Provide advance warnings Check assignments Preview the next lesson

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

Strategies for Academic Instruction: PHONICS

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

Strategies for Academic Instruction: WRITING

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

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

Strategies for Academic Instruction: HANDWRITING

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

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

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

Strategies for Academic Instruction: SPECIAL MATH MATERIALS

Number lines Manipulatives Graph paper

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

Time Management:

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

Helpful Study Skills:

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

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

Strategies for Behavioral Intervention:

Behavior Prompts & Instruction

Visual Cues Proximity control Hand Gestures Social Skill Classes Problem solving sessions

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_treatme

nt.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/