Learners with Attention Deficit
Hyperactivity Disorder (ADHD)
Chapter 6 (begins p. 185)
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Early examples of ADHD
• www.fln.vcu.edu/stru
wwel/philipp_e.html
The Story of Fidgety
Phillip
Johnny-Head-In-Air
Topics
• Brief History
• Educational
• Definition
•
• Prevalence
• Assessment
•
• Causes
• Psychological and
Behavioral
Characteristics
•
•
Considerations
Medication
Considerations
Service Delivery
Models
Early Intervention
Transition
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Brief History (p. 186-189) cases cited
with similar characteristics of today
• Still’s Children with “Defective Moral
Control” 1902, inhibitory volition: ability
to refrain from engaging in inappropriate
behavior (p.187-88)• Goldstein’s brain-injured soldiers of
World War I (psychological
characteristics applied to children)
• The Strauss Syndrome
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Brief History cont. (p. 186-189)
• Cruickshank’s work (sterile environment
based on Strauss Syndrome)
• Minimal brain injury and Hyperactive Child
Syndrome
Visit CHADD: Children and Adults with Attention
Deficit Disorder: http://www.chadd.org
http://www.help4adhd.org/en/about
SIMILAR CHARACTERISTICS in
reported cases:
• Disorganized behavior
• Hyperactivity
• Perseveration
• Distractibility
• Impulsivity
School-age characteristics
reported by parents/ teachers
• Fidgeting
• Less time spent on any
• Excessive talking
• Resistance to routines
• Noisiness
• Bossiness
• Less sharing; rough
play
• Easily upset
• Disruptive
• noncompliant
•
•
•
•
•
•
•
one activity
Immature social
interactions
Easily bored
Out of seat
Interrupts others
Off task
Erratic productivity
Poor persistence
See Josh Bishop, text p. 200:
Follow-up
• Effects of ADHD
Diagnosed at age 7
 Not identified for IDEA nor Section 504 of
the Vocational Rehabilitation Act of 1973
 Impulsivity, poor executive functions, social
skills resulted in leaving VMI during first
year

Characteristics seen in
adolescents
• Less active than
•
•
•
•
•
•
younger children with
ADHD
Restlessness
Behavior problems or
antisocial conduct
Low self-concept
Inattentiveness
Impulsiveness
Impatience, easily
frustrated or bored
• Depression
• Academic difficulties
• Problems with
•
•
•
•
relationships
Difficulty maintaining
jobs
No follow-through
Difficulty following
directions
procrastination
Definition (p. 189-190)
Diagnostic Criteria
• American Psychiatric Association’s
Diagnostic and Statistical Manual of
Mental Disorders (DSM-IV)
ADHD, Predominantly Inattentive Type
 ADHD, Predominantly HyperactiveImpulsive Type
 ADHD, Combined Type

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Prevalence (p. 191-192)
• Estimates of 3 to 5 % of school-age
population
• Not recognized as a separate category of
special education


May be served under IDEA as Other Health
Impaired, or served under other primary conditions
such as LD, ED, MR…
May be served under 504 plans
• Boys outnumber girls about 3:1 (maybe over
or under-identification issue
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Assessment (p. 192; see p. 194,
Table 6.2)
• Teacher and parent observation,
anecdotal logs, rating scales
• Clinical interview with parents/child
• Medical examination to rule out other
potential causes of characteristics
• Subjectivity of some components

“Doctor’s office effect”
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Causes (p. 193-196)
• Neurological structural differences
• Neurological dysfunction
• Neurochemical differences
• Hereditary factors
• Toxins (e.g., exposure to lead)
• Birth complications
• Contributing environmental factors
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Psychological and Behavioral
Characteristics (p. 196-200)
• Barkley’s model of ADHD (p. 196)
 Behavioral inhibition
 Executive functions & use of inner speech
 Persistent goal-directed behavior is lacking
• Adaptive skills
 At home & school (e.g., more traffic
accidents and violations)
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Characteristics cont.
• Problems socializing with peers
(frequently rejected; may be greatest
problem in life)
• Co-existing conditions (comorbidity) p.
199
Learning disabilities(10-25% overlap)
 Emotional or behavioral disorders (25-50%
also have EBD)
 Substance abuse

Educational Considerations-p.200-)
• Classroom structure and teacher
direction: need clear, predictable,
uncomplicated routine and structure
See instructional planning p. 202-203
 See p. 208, Table 6.3 for intervention
principles

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Educational Considerations-p.200-)
• Functional behavioral assessment
(FBA) and contingency-based selfmanagement
 Determine
antecedents,
conseequences, and settings that
maintain inappropriate behaviors
 Teach self-monitoring of behavior
Service Delivery Models (p. 207)
• Difficult to determine (not counted for
IDEA purposes; could be OHI, Section
504, etc.)
• Presumption that less than half receive
special education
• Individual determination
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Medication considerations:
pgs. 207-213
• Psychostimulants to activate
neurological functioning (e.g., Ritalin,
Adderall)
• Controversial
• Cautions (p. 212)
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Early Intervention (jp. 213)
• Difficult to determine in young children
because of behavioral similarity.
• Children who are identified typically
have extreme behaviors and require
special management and will need longterm programming.
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Transition to Adulthood
2/3’s continue with symptoms into
adulthood
 Diagnosis in adulthood (see p. 216, Table
6.4)
 Adult outcomes (p. 216)
 Employment
 Marriage and family (see p. 217, Table
6.5: Tips)
 Importance of coaching


A therapist or friend to help stay focused
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