Chapter 6: AttentionDeficit Hyperactivity Disorder

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Chapter 6 Attention-Deficit/ Hyperactivity
Disorder
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Attention Deficit/Hyperactivity Disorder
Definition

• DSM-IV
• AD/HD is a persistent pattern of inattention and/
  or hyperactivity-impulsivity that is more
  frequent and severe than is typically observed in
  individual at a comparable level of development.
• AD/HD must significantly and negatively affect
  the educational process

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AD/HD Characteristics

• Served under Other Health Impairments category
• Experience developmental delay of inhibition
• Difficulty with self-regulation
• Experience associated positive characteristics

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Three types of AD/HD

• Predominately inattentive- describes students who
  have trouble paying attention in class and are
  forgetful and easily distracted.
• Predominately hyperactive/ impulsive- includes
  students who cannot seem to sit still, often talk
  excessively, and have difficulty playing quietly.
• Combined- describes students who have features of
  inattention and hyperactivity-impulsivity (ADHD)

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Conceptual Model of Self-Regulation
Characteristics

• Most people can use four executive functions that
  help organize and control behavior rather easily.
• Nonverbal working memory- allows students to
  retrieve auditory, visual, and other sensory
  images of the past, making it difficult to learn
  from past experiences.
• Internalization of speech- students with AD/HD
  often think aloud and blurt out comments.
• Self-regulation of affect, motivation, and
  arousal- students lack the drive, in the
  presence of external rewards, that fuels the
  persistence in goal-directed actions.
• Reconstitution- the skill of analyzing and
  synthesizing behaviors.

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Positive Traits

• Creativity and the ability to hyperfocus are
  strengths of many students with AD/HD.
• They also often demonstrate a good sense of
  humor.

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AD/HD Causes and Prevalence

• Causes
• Environmental explanations- research has
  discounted most environmental causes, including
  excessive sugar, too little sugar, aspartame,
  food sensitivity, food additives, lack of
  vitamins, television, video games, poor
  parenting, etc.
• Biological explanations (most likely cause)
• Pre-natal teratogens include maternal smoking and
  alcohol or drug use, poor maternal nutrition,
  mothers exposure to chemical poisons, high blood
  pressure, age and emotional state.

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• peri-, and postnatal trauma- such as brain
  injuries, infections, iron deficiency anemia, and
  exposure to chemical poisons
• Brain differences- a failure in the brain
  circuitry underlying inhibition and self-control
• Genetics- the genetic link suggests that AD/HD is
  not pathological but is a human trait that exists
  on a continuum.

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• Prevalence
• 3 to 7 percent of school-aged children have AD/HD
• 3 to 1 ratio of boys to girls
• As many as 50 of children with AD/HD are
  undiagnosed

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AD/HD Evaluation Process

• Diagnosis by psychologist, psychiatrist, or
  physician often occurs outside the school system
• Assessment Instruments
• Behavioral rating scales- ADHD Rating Scale- IV
• Continuous performance tests (CPTs)
• Child Behavior Checklist- Direct Observation Form
• New types of brain imaging

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Progress in General Curriculum

• Curricular Goals
• Gaining a sense of self-efficacy
• Regulating motivation
• Improving self-control
• Reducing inappropriate behavior
• Implementation Instruction
• Multimodal approach to remediation
• Academic motivations (relevance, novelty,
  variety, choices, activity, challenge, and
  feedback)

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• Professional organizers or coaches
• Other issues (behavioral, physical, and
  self-efficacy)

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Programs and Practice

• Early Childhood University of Florida
  Multidisciplinary Diagnostic and Training Program
  (MDTP)- increases academic progress and social
  success through the use of multimodal treatments
• Elementary Years Take Charge! Provides
  self-efficacy-related learning activities and
  support to help students enhance self-awareness
  and confidence, build routines, complete
  projects, improve communication skills, and
  prepare for inclusion.

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• Middle and Secondary Years Lehigh University
  Consulting Center (LU-CCADD)- program includes
  inservice training, on-site consultation, and
  follow-up
• Transition and Postsecondary Years Vassar
  College Campus Support Services- comprehensive
  program providing accommodations and emphasizing
  self- efficacy skills

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Encouraging Participation

• Practice Inclusion
• The general education classroom is the
  appropriate placement for most students with
  AD/HD
• Foster Collaboration
• Professional
• Provide the student with consistency
• Monitor the effects of medication
• Family
• Provide support and resources to help families
• Use positive and negative strategies

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• Peers
• A close friend can make a positive difference