Prepared by: Tammy Taypotat

&Suzanne MacArthur

Attention-Deficit /Hyperactivity Disorder (ADHD)

OverviewDefinitionDiagnosis CriteriaCharacteristicsCausesTreatmentEngagement activityClassroom StrategiesEnvironment AccommodationsResources

KWL ChartLet’s see what you know, what you would like to

know and then after what you learnt.Excellent strategy for engaging students in their

own learning and gives you a quick snapshot of what to stress while teaching, and see what they learnt.

Think (give wait time- (25 seconds) this strategy is very important for students with AD/HD).

Pair and share.Jot down what you ‘Know’ and what you ‘Want To

Know’.

Definition of AD/HDAttention-deficit/hyperactivity disorder

describe children who display persistent age-inappropriate symptoms of inattention, hyperactivity, and impulsivity that are sufficient to cause impairment in major life activities.

(American Psychiatric Association [APA], 2000)

CriteriaBecause everyone shows signs of these

behaviours at one time or another, the guidelines for determining whether a person has AD/HD are very specific.

Children - the symptoms must be more frequent or severe than in children of the same age.

Adults - the symptoms must be present since childhood and affect one’s ability to function in daily life.

DSM-IV Criteria for Diagnosis• Six or more inattention symptoms or six or more hyperactivity-

impulsivity symptoms

• Symptoms must be inconsistent with the child’s current developmental level

• Must persist to a degree that is considered maladaptive for at least six months

Additional DSM-IV Criteria• Some symptoms present before age 7

• Impairment from symptoms must be present in at least two types of settings

• Clinically significant impairment in school, social or occupational functioning

• Symptoms do not occur solely during a pervasive developmental disorder or psychotic disorder

• Symptoms are not accounted for better by another mental disorder

Inattention1. Often does not give close attention to details or makes

careless mistakes in schoolwork, work, or other activities

2. Often has trouble keeping attention on tasks or play activities

3. Often does not seem to listen when spoken to directly

4. Often does not follow instructions and fails to finish schoolwork, chores, or duties in the workplace

5. Often has trouble organizing activities

6. Often avoids, dislikes, or doesn't want to do things that take a lot of mental effort for a long period of time

7. Often loses things needed for tasks and activities

8. Is often easily distracted

9. Is often forgetful in daily activities

Hyperactivity1. Often fidgets with hands or feet or squirms in seat

2. Often gets up from seat when remaining in seat is expected

3. Often runs about or climbs when and where it is not appropriate

4. Often has trouble playing or enjoying leisure activities quietly

5. Is often "on the go" or often acts as if "driven by a motor"

6. Often talks excessively

Impulsivity1. Often blurts out answers before questions

have been finished

2. Often has trouble waiting one's turn

3. Often interrupts or intrudes on others (e.g., butts into conversations or games)

Subtypes

Predominantly Inattentive Type

• Children who only meet the criteria for inattention

Predominantly Hyperactive-Impulsive Type

• Children who only meet the criteria for hyperactivity-impulsivity

Combined Type

• Children who meet the criteria for both inattention and hyperactivity-impulsivity

Causes of AD/HD• AD/HD is a medical disorder despite many myths

• Early theories thought minor head injuries or brain damage were the cause

• The exact cause is currently unknown, but it is now thought to be caused by biological factors that influence neurological activity

• Genetic influence

• Toxins in the environment

• The use of drugs/alcohol during pregnancy

• Environmental/family influence

Video on AD/HDhttp://www.youtube.com/watch?v=u82nzTz

L7To&feature=player_detailpage

Treatment• A complete medical evaluation should be

conducted

• The condition can be diagnosed when appropriate guidelines are used

• Multimodal approach

• Treatments include medication, skills training, and behaviour modification

• Considerations include the type and severity of AD/HD, age, overall health, level of physical activity, accompanying medical or psychological issues and family concerns

Empirically Proven Treatments Parent education about AD/HD Psychopharmacology Parent training in child management Family therapy for teens: problem solving,

communication training Teacher education about AD/HD Teacher training in classroom behaviour management Learning support services Regular physical exercise Parent/client support groups

Myth or Fact?Engagement activity/Check in!

Myth or Fact?AD/HD is not a real medical disorder.

Myth or Fact?AD/HD is the result of bad parenting.

Myth or Fact?Children with AD/HD eventually outgrow

their condition.

Myth or FactPeople with AD/HD are stupid or lazy- they

never amount to anything.

Myth or Fact?Children who take AD/HD

medications are more likely to abuse drugs when they become teenagers.

Myth or Fact?Individuals with AD/HD receive more

driving citations and accidents.

Myth or Fact?Children who are given special

accommodations because of their AD/HD are getting an unfair advantage.

Myth or Fact?Elimination Diets-removal of sugar, additives,

etc is an effective treatment for individuals with AD/HD.

What can we do???There is no easy button Remember no one shoe or strategy will fit

all students

Clear Expectations• Classroom expectations • First need teach expectations / rules as well as

the consequence• Stated them clearly, use visuals• Review daily and periodically check up on

them• Make consequences immediate and relevant• Act don’t Yak• Provide frequent feedback for following the

rules• Also students with ADHD need positive

reward/reinforcements

Instruction• Use scaffolded instruction to help students:• Understand the requirements of the task• Identify, plan, and organize the steps needed to

accomplish the task• Select effective and efficient strategies to complete

the task• Use visuals• Agenda on the board• Supplies needed• Week at a Glance• Steps to an assignment• Placing a check mark when completed or scratching off

to do list• State instructions clearly• Ask student to repeat directions out loud or utter

softly to self or check with a neighbour for clarity

Anticipation• Anticipation is the key with children with

AD/HD. This means that teachers must be mindful of planning ahead in managing children with this disorder, particularly during phases of transition across activities or classes

• Ensure students are cognizant of the shift in rules and consequence that are about to occur• Prompt students to recall the rules of conduct in

the upcoming situation, repeat them orally and recall reinforcements and consequences before entering that activity or situation• Think aloud, think ahead.

Classroom Strategies ContinuedVisual scheduleAccess to hand toolsBody toolsProvide frequent physical exercise breaksMulti-modal presentation: videoThink, pair, shareCheck in for understanding: whiteboardStudy-buddy

Classroom Strategies ContinuedUse daily or weekly school attending

behaviour cardMove to self-evaluation after 2+ good

weeks Alternate low appeal with high appeal

activities to maintain interest levelBe animated, theatrical and dramatic when

you teach

Classroom Strategies Continued Schedule the most difficult subjects in first few periods of

the school day when attention span is at its maximum for a student with AD/HD

Use direct instruction, programmed learning, or highly structured or regimented teaching materials that have short assignments, clear goals, and frequent feedback for demonstrating mastery of the material

Be sure the instructional material is at the student’s level and if they require adaptation make sure they are implemented

Structure the classroom so that there is very little down time

Have the student pre-state their work goals (How many problems can you do?) students are more likely to do an assignment they have chosen then one imposed on them

Classroom Strategies ContinuedTrain keyboarding and word processor as early

as possible given the high occurrence of fine motor coordination and handwriting problems associated with AD/HD

Provide extra help sessions, tutoring, books on tape, videos to reinforce concepts or lessons taught

Teach jot notes during lectures and while readingStudents should be taking brief notes of key points in

what they are reading, viewing, or listening to

Accommodations“On the clock” testingVary assignments and testing of knowledge

through other mediums (allow for choice)

OrganizationAllot for time at end of day for organizationProvide written syllabus as handouts/overview to review

and studyFind a “Coach” or “Mentor” at school who will give just 15

minutes to help teen The Coaches’ office is the student’s “locker” Schedule in three 5-minute checkups across each school day

– teens goes to Coach at that time for review of school day, help with staying organized, monitoring a homework assignment sheet, tracking them through a daily behavior report card, and giving them a motivational pep talk to get through to next checkup

Colour code binders and other commercial organizersColour code text using highlighters for marking key points

in the text; then write these highlighted key points down on paper after the reading is done

Environment Seat the student with AD/HD close to teaching area to permit

more supervision and frequent accountability for conduct, and to monitor and reinforce the child’s on-task behaviour.

Seat the student near a student role model. This seat arrangement provides opportunity for student to work cooperatively and learn from their peers in class.

Provide low distraction work areas:Seat student away from distracting windows, doors, or bulletin

boardsMake quiet, distraction free area for quiet study time, test-taking

and break. Students should be directed to this room or area privately and discreetly in order to avoid the appearance of punishment

Limit visually distracting stimuli hanging on walls and ceiling Permit listening to music at a reasonable low level

FidgetsWhy?

Self-regulationOptimize attending behavioursOptimize auditory processingOptimize cognitive process

When?Class discussionsOral lessonAssemblies

Consideration for classroom fidget useConsideration for classroom use

Individual needSafetySoundlessRepetitive, rhythmic actionsActions do not require visionNo goal or end productProvision of proprioceptionLimited emotional appeal

(Yack, 2012)

Physical activityReduces stress and anxiety responsivenessDecreased hyperaroused stateIncreased mood, motivation, self-efficacyIncreases noted in reading comprehension and

arithmetic; enhancements in inhibitory control, allocation of attentional resources and processing speed (Pontifex et al., 2012)

Motivate and enable students to participate in moderate daily physical activity

Provide opportunity for movement breaks throughout the day (> 1 movement break/class)

Exit SlipKWL chart What did you learn or what is one thing you

are going to try?

Free Resources Teaching Children with Attention Deficit Hyperactivity

Disorder: Instructional Strategies and Practices, 2008, http://www.ed.gov, This will lead you to their primary index, in “Search” box in upper right corner, type ‘adhd’, will lead you to list of articles, click on Teaching Children with AttentionDeficity Hyperactivity Disorder… Can be downloaded and printed

How to Teach and Reach Children with ADHD by Sandra Reif The Gift of ADHD by Lara Webb-Hanos The ADHD handbook for Schools by Harvey Parker http:/bced.gov.bc.ca http://education.alberta.ca CHADD: Children and Adults with Attention Deficit

Hyperactivity Disorder, www.chadd.org Russell Barkley Official Website: www.russellbarkley.org Movement breaks:

http://lburridge.pbworks.com/w/page/37694036/Get%20up%20and%20learn%21