Chapter 9: ADHD
Adapted from a presentation by James J. Messina, Ph.D.
Chapter 9 Questions
How common is ADHD and what causes it?
How is ADHD defined and classified?
What are the primary characteristics of
students with ADHD?
How are students with ADHD identified?
What interventions are effective for students
Prevalence and Causes of
About 3-7% of school-aged population
Approximately 75% boys
50-60% have a coexisting disability
Differences found in frontal brain and brain
chemistry (i.e., neurotransmitters)
Poor parenting is NOT a cause!
DSM V Definition of ADHD
A persistent pattern of inattention
that is more frequently displayed
and more severe than is typically
observed in individuals at a
comparable level of development.
DSM V - Types of ADHD
Inattention to details / careless mistakes
Difficulty sustaining attention
Doesn’t seem to listen
Fails to follow directions or finish tasks
Avoids tasks requiring sustained effort
Easily distracted / daydreams
Disorganized / forgetful
Often loses things
Restless / Fidgets
Can’t stay in seat
Runs / climbs when inappropriate
Difficulty playing quietly
On the go – driven
Other Major Characteristics
Social and behavioral difficulties:
Difficulty getting along with peers
Interactions more negative and unskilled
Disruptive in the classroom
70% have problems learning in reading, math,
writing, or spelling
Lack of sustained attention, organization, and
behavioral control lead to lower achievement.
Teacher may consult school psychologist,
if ADHD suspected.
Multidisciplinary team (NOT teachers)
should refer parents to a physician.
Multidisciplinary team evaluates behavior
and achievement using multiple measures.
Physician (e.g., psychiatrist, neurologist)
diagnoses using multiple measures.
Criteria for Diagnosis
Six or more symptoms (figure 9.1)
At least 6 months
Two or more settings
Present before age 12
More extreme than age-level peers
Significant impairment in social,
academic, or occupational functioning
Not accounted for by other disorders
May qualify for special education under
Other Health Impaired if educational
performance adversely affected.
May qualify for accommodations under
Usually placed in general education
Stimulants or amphetamines help control
May reduce risk of future substance abuse.
Teachers should monitor effects.
Behavioral interventions help address
academic and social problems.
Little research on alternative treatments
(diet, supplements, etc.)
Provide movement opportunities / breaks
Shorter, more frequent tasks or tests
Extended time for tests, with breaks if needed
Provide support for organization skills
Provide structure, consistency, and predictability
Prepare students for transitions
Present instructions briefly, clearly, and visually
Provide frequent, systematic and immediate
feedback, rewards, and punishments
Use more rewards than punishments (3:1 ratio)
Consequences must be sufficiently potent
Rewards should be varied