Attention Deficit Hyperactivity
Disorder
EDU381
Immaculata University
Matthew Speicher
6/2/10
Recent Changes in Definition
• For many years, the Diagnostic and Statistical Manual of
Mental Disorders (DSM) used the term attention deficit
disorder (ADD) to refer to all people with the condition, but
it allowed for subtypes of ADD with and without
hyperactivity.
• Recent changes to the DSM have begun using the general
term attention deficit hyperactivity disorder (ADHD) to
refer to all people with the condition. However, ADHD is
now divided into the following subtypes:
– ADHD (Predominantly Inattentive Type)
– ADHD (Predominantly Hyperactive-Impulsive Type)
– ADHD (Combined Type)
Characteristics / Symptoms of
Subtypes
• ADHD (Predominantly Inattentive Type)
– Fails to give close attention to details or makes careless
mistakes.
– Has difficulty sustaining attention.
– Does not appear to listen.
– Struggles to follow through on instructions and finish tasks.
– Has difficulty with organization.
– Avoids or dislikes tasks requiring sustained mental effort.
– Often loses things necessary for tasks and activities
– Is easily distracted.
– Is forgetful in daily activities.
• ADHD (Predominantly Hyperactive-Impulsive Type)
– Fidgets with hands or feet or squirms in chair.
– Has difficulty remaining seated.
– Runs around or climbs excessively during inappropriate
situations.
– Has difficulty engaging in activities quietly.
– Acts as if driven by a motor.
– Talks excessively.
– Blurts out answers before questions have been completed.
– Has difficulty waiting or taking turns.
– Interrupts or intrudes upon others.
• ADHD (Combined Type)
– Meets both inattentive and hyperactive/impulsive criteria.
Diagnosis
• Diagnosing ADHD can be tricky (especially when
taking the three subtypes of the disorder into
account), so most authorities stress the use of
several sources of information before arriving at a
firm diagnosis. These sources include:
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A medical examination
A clinical interview
Teacher and parent rating scales
Behavioral observations
Diagnosis of Subtypes
• ADHD (Predominantly Inattentive Type)
– Six or more of the Inattentive Type symptoms have been
observed for at least six months to a degree that is
maladaptive and inconsistent with developmental level of
the subject.
• ADHD (Predominantly Hyperactive-Impulsive Type)
– Six or more of the Hyperactivity-Impulsive Type symptoms
have been observed for at least six months to a degree
that is maladaptive and inconsistent with developmental
level of the subject.
• ADHD (Combined Type)
– Both the criteria for Inattentive Type and HyperactivityImpulsive Type have been met by the subject.
Potential Causes
• There are five areas of the brain that might be affected
in people with ADHD: the prefrontal lobes, the frontal
lobes, the basal ganglia, the cerebellum, and the
corpus callosum.
• An imbalance of the two following neurotransmitters:
dopamine and norepinephrine.
• Studies have suggested that heredity may be a
significant cause of ADHD.
• Exposure to toxins (such as lead), abuse of substances
(such as tobacco and alcohol), and other medical
factors (such as complications at birth and low birth
weight) have been linked to ADHD.
Interesting Myths and Facts
• Myth: All people with ADHD are hyperactive.
– Why is this not true?
• Myth: The primary symptom of ADHD is
inattention.
– Fact: Although inattention is a symptom of ADHD, the
primary behavioral problems associated with ADHD
are:
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Behavioral inhibition
Issues with executive function
Issues with time awareness and management
Issues with goal-directed behavior
Interesting Myths and Facts
• Myth: ADHD is primarily the result of minimal brain injury.
– Fact: In most cases of ADHD, there is no evidence of actual
damage to the brain.
• Myth: Social problems of students with ADHD are due to
their not knowing how to interact socially.
– Fact: Most people with ADHD know how to interact, but their
problems with behavioral inhibition make it difficult to utilize
socially appropriate behaviors.
• Myth: ADHD is primarily a U.S. phenomenon, due to our
society’s emphasis on achievement and conformity.
– Fact: Evidence strongly suggests that prevalence rates of ADHD
are at least as high in the following countries (among others) as
they are in the United States: Canada, Australia, New Zealand,
Germany, Japan, China, Brazil, and the Netherlands.
Interesting Myths and Facts
• Fact: ADHD is widely recognized as one of the most
frequent reasons children are referred for behavioral
problems to guidance clinics. 30% - 50% of cases referred to
guidance clinics are for ADHD.
• Fact: Most authorities estimate that between 3% and 7% of
all school-age children have ADHD.
• Fact: ADHD is much more prevalent in boys than girls.
Authorities estimate that ADHD affects boys at a rate of 3:1
in comparison to girls. Some gender bias in referral may
exist, and it has been noted that boys are more likely to
exhibit the more highly noticeable behaviors associated
with ADHD, but current research suggests that these
factors are not enough to account for the wide disparity in
prevalence rates between boys and girls.
Instructional Strategies / SDI
• Accommodations: These are changes in the way in which
the child is treated in order to best accommodate the
child's physical, cognitive or emotional challenges.
– Extended time for tests (the standard is one and a half times as
long as allowed, but for academic tests in most general
education classrooms, unlimited time is not uncommon).
– Frequent test breaks.
– The ability to move around the classroom.
– Bathroom breaks when needed.
– Special seating (in front of class and/or separated from peers).
– A water bottle at the student's desk (some medications create
dry-mouth).
Instructional Strategies / SDI
• Modifications: These change the academic or curricular
demands made of a child to better fit the child's ability.
– Modified homework.
– Limited amount (fewer) words on spelling tests.
– Scribing: the teacher or an aide writes the responses as dictated
by a child.
– Separate / modified tests in content areas.
– Alternate forms of assessment: dictating, oral retelling,
portfolios, etc.
• Sample SDI:
http://www.ohio.k12.ky.us/OCEC/information/Specially%2
0Design%20Instruction.pdf
Sample Goals
• The student will complete assignments in a timely
manner with 80% accuracy.
– The student will utilize teachers and study skills class to
complete assignments and get a better understanding of
the material.
– The student will bring appropriate supplies to class so that
all work can be completed.
– The student will raise their hand or approach the teacher
to ask for help when they do not have a clear
understanding.
– When the student is having trouble staying on task, they
can take a time out in the hall or use the appropriate
suggestions in their behavior plan.
Sample Goals
• The student will be able to answer inference
questions, make predictions, outline, and
summarize with 80% accuracy.
– The student will be able to use an outline, web, or
graphic organizer to get a better understanding of
a reading passage.
– The student will be able to make predictions and
assumptions by organizing their information to get
a better understanding.
Parental Strategies
• Schedule: Keep the same routine every day, from wake-up time to
bedtime. Include time for homework, outdoor play, and indoor
activities. Keep the schedule on the refrigerator or on a bulletin
board in the kitchen. Write changes on the schedule as far in
advance as possible.
• Organize everyday items: Have a place for everything, and keep
everything in its place. This includes clothing, backpacks, and toys.
• Use homework and notebook organizers: Use organizers for school
material and supplies. Stress to your child the importance of writing
down assignments and bringing home the necessary books.
• Be clear and consistent: Children with ADHD need consistent rules
they can understand and follow.
• Give praise or rewards when rules are followed: Children with
ADHD often receive and expect criticism. Look for good behavior,
and praise it.
Video Segments
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ADHD Facts Video: http://www.youtube.com/watch?v=iJIU1ybbYWI
ADHD Diagnosis Video: http://www.youtube.com/watch#!v=YBFH81zbCiY
ADHD and the Brain: http://www.youtube.com/watch#!v=ZJHT5XROrBA
Frontline: “The Medicated Child”
– Full Video:
http://www.pbs.org/wgbh/pages/frontline/medicatedchild/parents/
– Part 1: http://www.youtube.com/watch#!v=yCfRqNISQZg
– Part 2: http://www.youtube.com/watch?v=o0GE6VtFrNs
– Part 3: http://www.youtube.com/watch?v=sZyK86_KD-g
– Part 4: http://www.youtube.com/watch?v=LoHv-_Rwu6c
– Part 5: http://www.youtube.com/watch?v=CVcurkmosUQ
– Part 6: http://www.youtube.com/watch?v=3J7QkyS_nCg
Useful Links
• http://www.nimh.nih.gov/health/publications
/attention-deficit-hyperactivitydisorder/index.shtml
• http://www.chadd.org/
• http://www.cdc.gov/ncbddd/adhd/index.html
• http://www.ohio.k12.ky.us/OCEC/information
/Specially%20Design%20Instruction.pdf
• See “Video Segments” section for more useful
links.