ADHD

ADHDPresented by:

Bridget ConnollyAssistant Principal of Student ServicesNiles North High School

ADHD Attention Deficit Hyperactivity Disorder is

a neurobehavioral disorder characterized by pervasive inattention and/or hyperactivity-impulsivity and resulting in significant functional impairment.

Predominately Inattentive Hyperactive-Impulsive Combined Type

How is it Manifested in School As an adolescent, a student may display any

of the following characteristics:

Displays poor organizational skills Underachieves academically Exhibits impulsive or risk-taking behavior Engages in temper outbursts Sometimes experiences legal difficulties

Diagnostic Criteria of ADHD

6 symptoms of inattention and/or 6 symptoms of hyperactive-impulsive behavior (high frequency)

At least 6-month duration of symptoms Onset of symptoms before age 7 Symptoms occur across two or more settings Symptoms have a significant negative impact

on social, academic, or occupational functioning

Another psychiatric disorder (e.g. autism, mood disorder, anxiety disorder, psychotic disorder) is not the primary cause of symptoms

Common Symptoms for ADHD- Predominately Inattentive Avoids tasks that require sustained attention Daydreams (tends to stare into space) Delays initiation or completion of tasks Has difficulty listening to or following instructions Does not pay close attention to details Displays inconsistent academic performance Forgets or loses materials Demonstrates a slow speed of cognitive

processing

Common Symptoms for ADHD- Hyperactive-Impulsive Acts before thinking Begins work before directions are given Has difficulty delaying gratification Makes careless mistakes in schoolwork Does not wait turn in games or activities Engages in risk-taking/dangerous behavior Grabs things from others Interrupts or intrudes on others Blurts out comments in class

Common Symptoms for ADHD- Hyperactive-Impulsive (cont.) Runs or climbs excessively Has difficulty remaining seated Fidgets with nearby objects Taps pencil, feet, or fingers Shifts position in seat frequently Talks excessively Experiences rapid changes in mood Overreacts to negative situations

Prevalence Estimates ADHD-Predominately Inattentive Type

1.3% of school-aged children are diagnosed ratio for boys to girls = 1:1

ADHD- Hyperactive-Impulsive Type most children identified are of preschool age

ADHD- Combined Type 4% of school-aged children are diagnosed ratio for boys to girls = 3:1

Associated Problems 80% have achievement problems 20–40% are diagnosed with learning disabilities

(more common with ADHD- Inattentive) 40% exhibit oppositional behavior in childhood

(more common with ADHD- Combined) 65% exhibit oppositional behavior as adolescents

(more common with ADHD- Combined) 25% engage in antisocial behavior (truancy,

physical aggression, stealing- most often ADHD- Combined)

50% have impaired social relationships 25% experience comorbid emotional disorders

School-Based Assessment of ADHD Symptoms PURPOSES To gather information for a potential

medical diagnosis To determine the extent to which

attentional problems are interfering with a child’s academic, affective, and social needs

To perform a functional analysis of target behaviors for intervention

Assessment Methods Parent and teacher interviews

Information should be obtained from multiple adults

Standardized behavior rating scales Provides a normative perspective to assist in

determining symptom severity

Direct observation Systematic on-task observation and

assessment of environmental and instructional variables

Not Proven Effective Interventions

Herbal supplements/vitamins Biofeedback Elimination diet (unless there is a

sensitivity to food) Caffeine (may work in short run, but in

long run decreases blood flow to brain)

ADHD:What Works--Comprehensive Treatment Approach

Education/Parent Support Groups Medication Behavior Management at Home & School Counseling--Individual & Family Social Skills Training School and Home Support Strategies Physical Activity

ADHD Medications

Stimulants (effective for 70-90%)

Ritalin DexedrineAdderall Concerta Cylert

Stimulant Side Effects

Decreased appetiteWeight lossGrowth inhibitionInsomnia/sleep disturbanceIrritability/weepinessAbdominal painHeadachesDizziness/drowsinessTics

Behavior Management Clear, simple rules & consequences Consistency Eliminate emotion, talking/arguing Giving directions--get attention, be firm, have

repeat back to you, give time limits Visual reminders Break down assignments and homework Keep on task with timer, stop-watch

Behavior Management, cont.Encouraging Good Behavior

Immediate Feedback, Frequent Rewards/Incentives & Praise

Frequent Change in Reward (Mystery Motivator)

Immediate Consequences for Selected Behavior (time-out, loss of privilege or points)

Positive Rewards Before Consequences Plan Ahead for Problems Priorities--Choose Battles Don’t Personalize Problems

Behavior Intervention Plans Describe the target behavior and its severity Describe the function of the target behavior Clearly describe the desired positive behavior Identify how the environment can be changed to

decrease negative behavior Identify reinforcers to maintain positive behavior Describe the method for monitoring the behavior

plan and who will be responsible

Suggested Classroom Modifications

Assign seating in close proximity to teacher instruction

Provide the student with a study carrel Give only one or two-step directions at a time Break assignments down in to smaller

segments Use a timer to monitor/ improve timely work

completion Vary instructional style and incorporate

opportunities for active participation Minimize visual distractions Ensure a correct match between the difficulty

level of the curriculum and the student’s abilities

Key Principles Provide clear expectations for appropriate behavior

Post classroom rules Use behavior contracts as needed

Provide specific and frequent verbal feedback Name the specific behavior that was

performed well or should be performed Make consequences predictable Use if/then statements

If you continue to …, then… Provide brief, matter-of-fact redirections

Parents & Teachers Working Together Communication

Weekly or daily progress reports Assignment notebooks signed by both Phone calls/e-mail Checklists

Homework support Regular time Quiet place Break down assignments/Set timer Breaks--physical activity Materials available Monitor closely & reward good homework behavior Check assignment books regularly

Concerns If you have a concern about a student,

please contact the student’s guidance counselor.

The student may or may not be eligible to receive additional support and assistance.

Resources CHADD (Children and Adults with Attention Deficit

Disorder)www.chadd.org

ADDA (Attention Deficit Disorder Association) www.add.org

LIDA (Learning Disabilities Association) www.ldanatl.org