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 ...
Prevalence and Causes of
ADHD
 About 3-7% of school-aged population
 Approximately 75% boys
 50-60% have a coexisting d...
DSM V Definition of ADHD
A persistent pattern of inattention
and/or hyperactivity-impulsivity
that is more frequently disp...
DSM V - Types of ADHD
 Predominantly
Hyperactive-Impulsive
 Predominantly Inattentive
 Combined
Inattention
 Inattention to details / careless mistakes
 Difficulty sustaining attention
 Doesn’t seem to listen
 Fail...
Hyperactivity
 Restless / Fidgets
 Can’t stay in seat
 Runs / climbs when inappropriate
 Difficulty playing quietly
 ...
Impulsivity
 Blurts out answers
 Trouble taking turns
 Interrupts / intrudes
 Impatient / rushes
 Careless errors
 R...
Other Major Characteristics
 Social and behavioral difficulties:
 Difficulty getting along with peers
 Interactions mor...
Identification
 Teacher may consult school psychologist,
if ADHD suspected.
 Multidisciplinary team (NOT teachers)
shoul...
Criteria for Diagnosis
 Six or more symptoms (figure 9.1)
 At least 6 months
 Two or more settings
 Present before age...
Eligibility
 May qualify for special education under
Other Health Impaired if educational
performance adversely affected....
Medication
 Stimulants or amphetamines help control
behavioral symptoms.
 May reduce risk of future substance abuse.
 T...
Classroom Accommodations
 Preferential seating
 Provide movement opportunities / breaks
 Shorter, more frequent tasks o...
Classroom Interventions
 Explicit instruction
 Strategy instruction
 Peer tutoring
 Computer-assisted instruction
 Be...
Classroom Management
 Provide structure, consistency, and predictability
 Prepare students for transitions
 Present ins...
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Chapter 9: Attention Deficity Hyperactivity Disorder

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Attention Deficit Hyperactivity Disorder

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Chapter 9: Attention Deficity Hyperactivity Disorder

  1. 1. Chapter 9: ADHD Adapted from a presentation by James J. Messina, Ph.D.
  2. 2. 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 with ADHD?
  3. 3. Prevalence and Causes of ADHD  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)  Often heredity  Poor parenting is NOT a cause!
  4. 4. DSM V Definition of ADHD A persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequently displayed and more severe than is typically observed in individuals at a comparable level of development.
  5. 5. DSM V - Types of ADHD  Predominantly Hyperactive-Impulsive  Predominantly Inattentive  Combined
  6. 6. Inattention  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
  7. 7. Hyperactivity  Restless / Fidgets  Can’t stay in seat  Runs / climbs when inappropriate  Difficulty playing quietly  On the go – driven  Talks excessively
  8. 8. Impulsivity  Blurts out answers  Trouble taking turns  Interrupts / intrudes  Impatient / rushes  Careless errors  Risk taking / taking dares  Accidents / injury prone
  9. 9. Other Major Characteristics  Social and behavioral difficulties:  Difficulty getting along with peers  Interactions more negative and unskilled  Disruptive in the classroom  Academic difficulties:  70% have problems learning in reading, math, writing, or spelling  Lack of sustained attention, organization, and behavioral control lead to lower achievement.
  10. 10. Identification  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.
  11. 11. 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
  12. 12. Eligibility  May qualify for special education under Other Health Impaired if educational performance adversely affected.  May qualify for accommodations under Section 504.  Usually placed in general education classroom.
  13. 13. Medication  Stimulants or amphetamines help control behavioral symptoms.  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.)
  14. 14. Classroom Accommodations  Preferential seating  Provide movement opportunities / breaks  Shorter, more frequent tasks or tests  Extended time for tests, with breaks if needed  Provide support for organization skills  Increase novelty
  15. 15. Classroom Interventions  Explicit instruction  Strategy instruction  Peer tutoring  Computer-assisted instruction  Behavior modification (e.g., token economy)  Functional behavior assessment  Social skills training  Self-regulation
  16. 16. Classroom Management  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

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