The Effects of Attention Deficit Hyperactivity Disorder on Mathematics Achievement National Council...

The Effects of Attention Deficit Hyperactivity Disorder

on Mathematics Achievement

National Council of

Teachers of Mathematics

2005 Annual Meeting and Exposition

Anaheim, CA

April 7, 2005



Presenter InformationKay Haralson

Associate Professor of Developmental MathematicsAustin Peay State University

Clarksville, TN 37044 [email protected]

www.apsu.edu/haralsonk

mailto:[email protected]

What is ADHD? (www.nichcy.org)

ADHD is a complex, neurobiochemical disorder involving differences in brain activity and structure in the prefrontal cortex, the basal ganglia, and the cerebellum. These areas are know to help to inhibit behavior, sustain attention, and control mood.

ADHD is considered a behavioral and mental health disorder.

http://www.nichcy.org/

Possible Causes of ADHD (www.nichcy.org, www.ezinearticles.com)

PET (positron emission tomography) or brain scans, indicate less activity and blood flow in the part of the brain that inhibits impulsivity.Studies have shown there to be an insufficient availability of the neurotransmitters dopamine and norepinephrine in the central nervous systems of children with ADHD. These brain chemicals are needed for paying attention and controlling behavior. Current investigations being done to identify abnormalities in the dopamine-transporter gene support the theory that ADHD can be genetically inherited.


Diagnostic Criteria for ADHD (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, 2000, DMV-IV-TR, American Psychiatric Association, www.cdc.gov/ncbddd/adhd/symptoms.htm)

I. Either A or B: A. Six or more of the following symptoms of

inattention have been present for at least 6 months to a point that is disruptive and inappropriate for developmental level:

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.

http://www.cdc.gov/ncbddd/adhd/symptoms.htm

Diagnostic Criteria for ADHD (DSM-IV-TR)

4. Often does not follow instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand directions).

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 (such as schoolwork or homework).

7. Often loses things needed for tasks and activities.

8. Is often easily distracted.9. Is often forgetful of daily activities.


B. Six or more of the following symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for developmental level:

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 (adolescents or adults may feel very restless).


4. Is often “on the go” or often act as if “driven by a motor”.

5. Often has trouble playing or enjoying leisure activities quietly.

6. Often talks excessively.Impulsivity

1. Often blurts out answers before questions have been finished.

2. Often has trouble waiting one’s turn.3. Often interrupts or intrudes on

others.


II. Some symptoms that cause impairment were present before age 7 years.

III. Some impairment from the symptoms is present in two or more settings (e.g. at school/work and at home).

IV. There must be clear evidence of significant impairment in social, school, or work functioning.

V. The symptoms do not happen only during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder. The symptoms are not better accounted for by another mental disorder (e.g. Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).

Subtypes of ADHD (DSM-IV-TR)

Based on these criteria, three types of ADHD are identified:

ADHD, Combined Type: if both criteria 1A and 1B are met for the past 6 months ADHD, Predominantly Inattentive Type: If criterion 1A is met but criterion 1B is not met for the past six monthsADHD, Predominantly Hyperactive-Impulsive Type: if Criterion 1B is met but Criterion 1A is not met for the past six months

Prevalence (DSM-IV-TR, www.adhdsupportcompany.com )

3%-7% of children suffer from ADHD.ADHD is diagnosed approximately three times more often in boys than in girls.As many as half of those with ADHD also have other mental disorders.Over half of the children diagnosed with ADHD carry the disorder into adulthood.A large number of adults who were never diagnosed as a child show clear symptoms of ADHD.AMA’s Special Council Report showed little evidence of widespread over-diagnosis of ADHD or over-prescription of medication for ADHD. (www.nichcy.org)

http://www.adhdsupportcompany.com/

Identifying ADHD and Subtypes ( www.nimh.nih.gov, www.ets.org)

The diagnosis of ADHD and the subtypes of ADHD should be made by a professional with training in the evaluation of ADHD or in the diagnosis of mental disorders. Such as:Child psychiatrists and psychologistsDevelopmental/behavioral pediatriciansBehavioral neurologistsNeuropsychologistsClinical teams with educational, medical, and counseling professionals with training in the evaluation of ADHD

http://www.nimh.nih.gov/

http://www.ets.org/

ADHD in Adults (www.addresources.org, www.akrongeneral.org)

Symptoms of ADHD in adults are similar to the diagnostic criteria for children, but may be displayed in different ways.

InattentionPoor listening skillsEasily distracted, forgetful, daydreamingDifficulty with making decisionsTrouble maintaining an organized work/living areaEasily overwhelmed by tasks of daily livingSpends excessive time at work because of inefficiencyFrequently losing or misplacing thingsNeed for others to organize you

http://www.akrongeneral.org/


HyperactivityFrequently late or rushedEasily bored; intense need for excitement Difficulty with falling asleep or waking up alertDifficulty estimating how much time something will takePoor handwritingPerforms worse under pressureThoughts jump from one topic to the nextStrong need to control or have things your wayAn internal sense of anxiety and restlessness



ImpulsivityImpulsive spending and money management problemsFrequent, impulsive job changesVery impatient, low frustration toleranceTactless, tendency to embarrass othersFrequent traffic violationsTrouble with authorityMood swingsProne to hysterical outburstsTendency to seek conflict, be argumentative



Symptoms that can develop after years of living with ADHDA sense of failure, not living up to one’s potentialA sense of being different, unconventional Very sensitive to being told to do something or to being criticizedA tendency to worry needlessly and endlesslyDifficulty with personal or work relationshipsA tendency toward addictionsPersonal or family history of substance abuse, depression, or anxiety


Effects of ADHD on Math Achievement

In mathematics attention to details is critical. Overlooking or misreading mathematical symbols, key words, or instructions leads to careless mistakes.Poor organization skills hinder students from getting paper, pencil, book, and assignment together in one place.If students are distracted while completing math problems, they lose their focus, skipping problems or steps in problems.Constant movement of hands, feet, pencils, etc. gets the student “off track”.


Math homework takes a lot of mental effort for a long period of time. Students with ADHD learn to avoid these types of activities.

The excessive amount of time it takes for them to complete assignments increases their frustration level.

Underestimating the time needed to complete assignments means that some go unfinished.

Students procrastinate and put off completing assignments until it is too late.


Students show inconsistent performance. Information learned one day, seemingly mastered, may be missing the next day.

Performance is worse under pressure.

Students have difficulty retrieving information on demand, even when thoroughly studied.

Students become angry with themselves and their teachers when they are criticized or when they do not do well.

Treatment Options (

www.hawaii.edu/medicine/pediatrics/pedtext/s01c10.html)

The American Academy of Pediatrics guidelines for treatment of ADHD requires understanding of four aspects:ADHD is a chronic condition. Parental, medical, and educational support should be provided into adulthood.Target symptoms need to be addressed. Set realistic goals for improvement in specific areas.Medication and behavior strategies are important. A combined approach has been shown to be more effective than either strategy alone.Close follow-up of target symptoms and medication use. Reevaluations and monitoring should be done periodically and consistently.

http://www.hawaii.edu/medicine/pediatrics/pedtext/s01c10.html

Treatment Options (www.nichcy.org)

A joint study by the NIMH (National Institute of Mental Health) and the (OSEP) U.S. Department of Education’s Office of

Special Education Programs indicated that a multi-modal treatment approach had the greatest positive effect on reducing ADHD symptoms.

The recommended multi-modal treatment approach consists of four core interventions:

1. patient, parent, and teacher education about the disorder;

2. medication (usually from the class of drugs called stimulants);

3. behavioral therapy; and4. other environmental supports, including an

appropriate school program.


Multi-modal Treatment (www.nichcy.org)

1. Patient, parent, and teacher education about the disorder:

Learn about ADHD and the nature of the challenges it presents.

Understand that the child has troubles and is not the cause of the troubles.

Children with ADHD should learn to be self-advocates but parents and teachers can also be strong advocates for the child


2. Medication (usually stimulants)Since ADHD is neuro-biochemically-based it stands to reason that medication that gets to the core of the problem would be effective.

These medications work to make the brain’s systems work more efficiently, improving attention, memory, executive functions, and inhibition.

The result is better concentration, increased working memory capacity, greater recall, less hyperactivity, and more impulse control.


3. Behavioral TherapyParents and teachers need to be the executives in the child’s life, providing structure, routines, assistive devices, external supports and guides.Develop behavior management strategies. Use positive attention, rules, consequences, and formal systems such as contracts and charts. The main goal is to increase the child’s appropriate behavior and decrease inappropriate behavior.Teach problem solving. Develop skills in the art of negotiation, give and take, and conflict resolution through peaceful means.Use good communication skills. Say what you mean in a firm, loving way.

Multi-modal Treatment (www.nichcy.org; Quinn, 1994;

Nadeau, 1994; Murphy, 1995; Amen, 1997)

4. Education Intervention

Provide a structured environmentpreferential classroom seating

pair student with good role models

create a classroom with limited distractions

give a detailed plan of the course activities and requirements, avoid changes in routine

design tasks of low to moderate frustration level, challenge but don’t overwhelm

provide frequent reminders of due dates of assignments and tests dates


Nadeau, 1994; Murphy, 1995; Amen, 1997))

4. Education InterventionEnhance organization skills

encourage the use of a daily/weekly plannersuse a tape recorder for class lecturesmake directions clear and concise, provide direct one-on-one instructiongive out only one task at a timemonitor work frequently, provide feedbackuse handouts to minimize the need for note takingprovide an outline of material on the overheadmaintain frequent communication between home and school with daily/weekly progress reports




Allow accommodations in assessmentextend time to complete tests

provide a distraction free environment for taking tests

alter the response format of tests

allow tests to be taken over a period of time in short intervals

expect no less from students with ADHD, but give them alternative ways to demonstrate their competencies




Be sensitive to the students’ emotional needsbe aware of their low frustration tolerance and stress tolerance

be aware that if they have outbursts of anger, it is generally toward themselves and not toward you

recognize secondary problems such as depression, anxiety, and other emotional problems

Mathematics Individualized Instructional Practices (Teaching Children with Attention Deficit Hyperactivity Disorder:

Instructional Strategies and Practices, 2004)

teach students to recognize patterns when performing operations on whole numbers

use mnemonics for basic computation

color code arithmetic symbols to provide visual cues

use calculators to check basic computation

provide real-life examples of money skills

teach mastery of math symbols, e.g. – or minus means to take away

use computer tutorial games for basic computation

Mathematics Individualized Instructional Practices (Teaching Children with Attention Deficit Hyperactivity Disorder:

Instructional Strategies and Practices, 2004)

use number lines for computing whole number operations

use manipulatives in basic computation skills

use graph paper to help organize columns when performing basic computations

teach students to look for clue words that indicate specific operations

use guiding questions to talk students through the steps of problems

ReferencesADHD Support Company, (2005) Adult ADHD. Available

Internet: www.adhd.supportcompany.com Akron General Medical Center. (2004). Attention deficit

disorder in adults (ADD). Available Internet: www.akrongeneral.org/psychiatry/psychiatry_add.asp

Allen, T. (2005). Attention deficit hyperactive disorder . . . A teacher’s perspective. Available Internet: http://ezinearticles.com

Amen, D. G. (2001). Attention, Doctors. Newsweek. February 26, 2001.

Amen D. G. (1997). Windows in the A.D.D. mind: Understanding and treating attention deficit disorders in the everyday lives of children, adolescents, and adults. Fairfield CA: MindWorks Press.

American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington DC: American Psychiatric Association.

ReferencesAttention Deficit Disorder Resources. (2005). Available Internet:

www.addresources.orgBaker, K. B. (2001). Attention deficit hyperactivity disorder and

reading achievement. Queensland Journal of Educational Research. 17. Available Internet: education.curtin.edu.au/iier/qjer/qjer17/baker.html

Barabasz, A,, Barabasz, M. (1995). Attention deficit hyperactivity disorder: Neurological basis and treatment alternatives. Journal of Neurotherapy. 1(1). Available Internet: www.snr-jnt.org/journalnt/jnt(1-1)1.html.

Fowler, M. (2004). Attention-deficit/hyperactivity disorder, Washington, DC: National Dissemination Center for Children with Disabilities. Available Internet: www.nichcy.org

Kid Source Online. (2000). Teaching children with attention deficit disorder. Available Internet: www.kidsource.com/kidsource/content2.add.html

References

Murphy, K. R., LeVert, S. (1995). Out of the fog: Treatment options and coping strategies for adult attention deficit disorder. New York, NY: Skylight Press.

Nadeau, K. G. (1994). Survival guide for college students with ADD or LD, New York, NY: Magination Press.

National Center on Birth Defects and Developmental Disabilities. (2005). Attention-deficit/hyperactivity disorder. Available Internet: www.cdc.gov/ncbddd/adhd

National Institute of Mental Health. (2003). Attention deficit hyperactivity disorder. Available Internet: www.nimh.nih.gov/Publicat/ADHD.cfm

Okamoto, J. K. (2002). Chapter I.10.Attention deficit/hyperactivity disorder. Department of Pediatrics, University of Hawaii. Available Internet: www.hawaii.edu/medicine/pediatrics/pedtext/s01c10.html

ReferencesQuinn, P. O. (Ed.). (1994). ADD and the college student: A

guide for high school and college students with attention deficit disorder. New York, NY: Magination Press.

The Office of Disability Policy Educational Testing Service. (1999). Policy statement for documentation of attention-deficit/hyperactivity disorder in adolescents and adults. Available Internet: www.ets.org/disability/adhdplcy.html

U.S. Department of Education, Office of Special Education and Rehabilitative Services, Office of Special Education Programs. (2004). Teaching children with attention deficit hyperactivity disorder: Instructional strategies and practices. Washington, D.C



To obtain a copy of this power point presentation go to:

www.apsu.edu/haralsonk

and click on ADHD

or e-mail

Kay at [email protected]

Thank you for your attention!

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