ADHD

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ADHD

• Inattention
• Hyperactivity
• Impulsivity
• DSM-IV Criteria
• Either (1) or (2)
• 6 or more symptoms in Inattention
• 6 or more symptoms of Hyperactivity-Impulsivity
• Symptoms present for at least 6 months
• Significant impairment in social, academic, or
  occupational functioning
• Onset prior to 7 years of age
• Impairment in two or more settings

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Comorbid conditions in ADHD
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Rothenburger et al., 2004

• ADHD occurs in 2-5 of children
• 80 are boys
• Distractibility, hyperactivity, and agitation
  occur at all ages
• Forgetful, inpatient, disrupt others
• Difficulty with limits, impulsivity
• Rash decisions, dont think before they act,
  silly, mood swings
• Do better in novel situations that involve
  interaction with others

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Causes of ADHD?

• Brain areas affected
• Cerebellum coordination of movements
• Frontal lobe executive functioning
• Difficulty with neuronal information processing
• Lower levels of dopamine (emotion and behavior)
• Genetics runs in families
• 80 can be traced to genetic factors
• Genes involved in transferring information b/w
  neurons
• Environmental factors
• Prenatal alcohol and nicotine exposure
• Non-supportive school environment
• Martial crisis and parental psychological
  problems
• Poor attachment

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Medication and ADHD

• Target neurotransmitter systems
• Psychostimulants Ritalin
• Medication most effective when combined with
  behavior therapy
• Large US study compared different treatments
  methods among 579 children with ADHD
• Significant improvements (normalized behavior)
• Medication only 25
• Behavior therapy only 34
• Medication with counseling 56
• Medication and behavioral theory 68

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ADHD

• Important to teach children with how to handle
  tasks and their behaviors
• Count to 10, reminders etc.
• Children with ADHD have many positive traits
• Free-spirited, inquisitive, energetic, funny
• Intelligent, creative, spontaneous, helpful,
  sensitive
• Multi-tasking

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Sherman et al., 2006

• Some ADHD behaviors are adaptive
• Impatient, impulsive, distractible, energetic,
  emotionally needy, creative, innovative
• Many historical figures show ADHD characteristics
• Einstein, Poe, Salvador Dali, Ford
• Hartmann (2003) refers to ADHD as a trait rather
  than a disorder (Edison gene)
• These traits were advantageous for
  hunter-gatherer societies and have been passed
  down over time

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• Short attention, poor planning, daydreaming, and
  impatience may be seen as adaptive
• Important for survival of hunter-gatherer
  societies
• Agile, think quickly, monitor environment, act on
  impulse
• Farmer societies are more patient, organized,
  plan ahead, less impulsive
• However, North American classrooms favor farmer
  like traits
• Children must sit in desks quietly, pay
  attention, work on projects for prolonged periods
  of time, keep hands still, information taken in
  by reading, listening, and seeing rather than by
  doing.

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• Children with ADHD seen as polyactive, they can
  work on numerous tasks
• Good brainstormers, eager to please, creative
• Suggestions for Classroom Interventions
• Allow children with ADHD to run class errands
• Have quiet zones, one-on-one interaction
• Call on students frequently, use immediate
  feedback
• Teach to all different intelligences
• Hands on lessons, experiments, visual media, arts
• Break down instruction to smaller manageable
  tasks
• Assist with organization, external structure
• Avoid mundane tasks

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Wang et al. (2004)

• Impact of teacher factors on performance of
  children with ADHD
• Participants 45 7.5 yr old boys with ADHD
• all on ADHD medication, from 12 different after
  school programs
• Children solved puzzles in 3 conditions/modalities
  
• Speech only
• Gesture only
• Speech and Gesture
• 12 trained male teachers (one from each program)

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• Condition order was random, and videotaped
• Dependent variables (in each condition)
• Freq. of childrens responses to teachers
• How long children sustained their attention
• Success on puzzles
• 5 coders independently coded the tapes, 90
  agreement
• Also examined different types of gestures within
  the gesture conditions

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Results

• Children in Gesture conditions (gesture-only or
  speech-gesture) were
• more responsive
• focused longer
• more successful on puzzles
• Conclude that hand gestures are important for use
  with children with ADHD.
• Children with ADHD have attention problems and
  are easily distracted, so speech alone may not be
  sufficient to get their attention.

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Limitations? Confounds?