Predominantly inattentive ADHD (ADHD/I). Marked by difficulty paying attention. Patients may struggle to concentrate and complete tasks and may be forgetful and easily distracted. They tend to have poor organizational skills and may appear to be lethargic, sluggish, shy, anxious or constantly daydreaming. This condition is most often diagnosed in adolescent girls, and is diagnosed if six or more symptoms of inattention have persisted for more than six months, according to the American Psychiatric Association (APA). Predominantly hyperactive/impulsive ADHD (ADHD/HI). Marked by difficulty controlling behavior, with an increased risk for serious aggressive or oppositional behavior and antisocial conduct. Patients often fidget and are excessively restless. They may blurt out comments that are inappropriate and often do not think before they act. This condition is diagnosed if six or more symptoms of hyperactivity and impulsivity have persisted for more than six months. Combined ADHD. Combines symptoms of the other two forms of ADHD. It is the most common form of ADHD. This condition is most often diagnosed in boys of elementary-school age. It is diagnosed when six or more symptoms associated with each of the two major forms of ADHD are present.
Creativity – Children who have ADD/ADHD can be marvelously creative and imaginative. The child who daydreams and has ten different thoughts at once can become a master problem-solver, a fountain of ideas, or an inventive artist. Children with ADD may be easily distracted, but sometimes they notice what others don’t see. Flexibility – Because children with ADD/ADHD consider a lot of options at once, they don’t become set on one alternative early on and are more open to different ideas. Enthusiasm and spontaneity – Children with ADD/ADHD are rarely boring! They’re interested in a lot of different things and have lively personalities. In short, if they’re not exasperating you ( and sometimes even when they are), they’re a lot of fun to be with. Energy and drive – When kids with ADD/ADHD are motivated, they work or play hard and strive to succeed. It actually may be difficult to distract them from a task that interests them, especially if the activity is interactive or hands-on. Keep in mind, too, that ADD/ADHD has nothing to do with intelligence or talent. Many children with ADD/ADHD are intellectually or artistically gifted.
l. Be informed. Learn all you can about ADHD characteristics, it’s effects on learning and behaviors, ect… Parents of ADHD are your best source for help. 2. Move toward a project-based classroom. Allow students to choose from a variety of methods to show what they know – oral presentations, art projects, creative drama, etc.. 3. Offer choices. But don’t offer too many. Offer choices that the students will enjoy carrying out and staying on task with. 4. Give kids the tools to compensate for shortcomings. Let your students use the word processor and spell checker if their writing is not neat and they have a hard time spelling, make checklists of steps your students need to take to complete a certain task or project in which they can physically check off when they accomplish part of the task. 5. Make directions as easy. Always have the students attention before starting to introduce something new. Give students time to begin homework in class before they leave to help answer questions that could arise. 6. Monitor Progress. Look at the students assignment notebooks and/or folders on a regular basis to make sure they are doing what they are suppose to. Ask them to tell you about the goals they have for some of their assignments, feelings about your class, etc… 7. Don’t rely only on the traditional standardized tests where you sit for a long time and fill in bubbles. To an ADHD student that could be torture. Try such ideas as orally giving a test and projects. 8. Your ADHD student could be entitled to a classroom aid or some other type of service under section 504 of the Rehabilitation Act. Check your principal or other resource.
Brain functionOur brain has many neurons that are packed intovarious regions of the brain. Each region has a job andis responsible for a particular function of our body.Some help us interpret things so we know what to sayor do and some interact within our body and helpregulate the function of our organs. Neurotransmittersare produced by the neurons in tiny quantities. Theirjob is to be message carriers. They stimulate theappropriate neuron in the brain so that the messagethat is needed will reach the brain region it is destinedfor.
DefinitionAttention Deficit Hyperactivity Disorder (ADHD), sometimes called AttentionDeficit Disorder (ADD), involves hyperactivity, difficulty paying attention and. a tendency to act impulsivelyAttention deficit hyperactivity disorder (ADHD) is one of the mostcommon childhood disorders and can continue through adolescenceand adulthood. According to Oakland and Brue (2002), “From 6% to 8%of school-aged children (approximately 2 to 3 million) are affected in theUnited States.” Treatment of ADHD ranges from many types ofmedications that are stimulants to more natural remedies. In this studywe will take a look at our brain and how it functions with ADHD, thesymptoms of ADHD, treatment options as well as ways to support. children with ADHD
ObjectivesTo describe a child with ADD/ADHDTo explain the signs and symptoms of ADD/ADHDTo discuss the types of teaching tips
Prevalence. begins in childhood and can affect all areas of a patient’s lifeof school-aged children-2 million children in the US (National Institute 5% - 3%((of Mental Health (NIMHBoys outnumber girls 3 to 1 (Mental Health America) However, girls may be.under diagnosed
Defining ADHD: Symptoms•Often fidgets or squirms about when seated•Is easily distracted•Talks out of turn•Has trouble with follow through•Has difficulty staying on task•Shifts rapidly from one task to another withoutcompleting first task or activity•Seems unable to play quietly•Talks excessively•Frequently interrupts or intrudes•Seldom listens attentively•Is disorganized: loses assignments, pencils, toys.•Often seems unaware of consequences and soengages in potentially dangerous behavior. (Allen &Bowdery, 2010)
Three Major Types(Predominantly inattentive (ADHD/I(Predominantly hyperactive/impulsive ADHD (ADHD/HICombined ADHD
(Predominantly inattentive (ADHD/Idifficulty paying attentionstruggles to concentrate and complete tasks forgetful and easily distractedpoor organizational skills, lethargic, sluggish, shy, anxious or constantlydaydreamingmost often diagnosed in adolescent girls, and is diagnosed if six or moresymptoms of inattention have persisted for more than six months, according to(.the American Psychiatric Association (APA
Combined ADHDCombines symptoms of the other two forms of ADHD. the most common form of ADHD. diagnosed in boys of elementary-school agediagnosed when six or more symptoms associated with each of the two major.forms of ADHD are present
Predominantly hyperactive/impulsive ADHD((ADHD/HIdifficulty controlling behavior, with an increased risk forserious aggressive or oppositional behavior and antisocial. conduct. fidget and excessively restless. blurt out comments that are inappropriate and often do not think before they actdiagnosed if six or more symptoms of hyperactivity and impulsivity have persisted for.more than six months
CausesChange in the brain structureGenetic & heredity(Mother is exposed to chemicals during pregnancy (smoke, alcohol, drugsChild exposed to chemicals at young age(environmental toxins – PCBs or Lead)Gender – boys are 3x more likely than girls
Positive TraitsCreativityFlexibilityEnthusiasm and spontaneityEnergy and drive
Treatment Education for the child and family Psychological intervention Drug treatment or natural remedies
Drug TreatmentsThe most popular drug •Popular stimulantstreatments are stimulants.“Stimulant medications work by include:causing the brain to synthesize Ritalinmore nor epinephrine; nonstimulants work by slowing the Concertarate at which nor epinephrine is Aderallbroken down. Once the level is •Non stimulant:where it should be the brainfunctions normally,” (Silver, Straterra2006).
Natural RemediesDietar y supplements are easily accessible and withrelatively no side affects. Essential fatty acids areamong the most popular. Essential fatty acids (Omega3’s) are needed for proper cerebral functioning andmay aid in the transmission of ner ve impulses. Manychildren with ADHD cannot absorb essential fatty. acids nor mallyHerbal medications such as Ginkgo Biloba aresomewhat effective for disorders such as memor yimpair ment. Lemon balm is also an herbal medicationthat is believed to help restore the balance andfunction of the brain and ner ve cells (Br ue & Oakland,( 2002
ADHD and Other Disruptive DisordersODD:Diagnosis •Similar age of onset, course •Likely most frequent comorbidity encountered •(Prompts specialty mental health referral (over-represented •• Treatment implicationsFamily and patient education •Raises caregiver stress more than ADHD or CD •(Psychotherapy choices (PCIT; parenting interventions • (Medication implications (stimulants; non-stimulant ADHD treatments •
ADHD and Other Disruptive DisordersCD• Diagnosis: • Variations in age of onset, course • Comorbidity with significant prognostic impact (increased risk of drug abuse; antisocial behaviors)• Treatment implications • Family likely has significant other risk factors • Psychotherapy choices (PCIT; parenting interventions) • Medication implications (stimulants; non-stimulant ADHD treatments; atypical neuroleptics; possibly mood stabilizers for anti-aggressive effects)
ADHD and AnxietyDisordersGAD and SAD• Diagnosis: • Tease out age of onset and course of symptoms • “Shared” symptoms (inattention, hyperactivity; academic performance problems; sleep problems) • Unique features (worry; fears; significant somatic complaints)• Treatment implications • Families may be reinforcing avoidances and fears • Psychotherapy choices • Medication implications (stimulants; non-stimulant ADHD treatments; antidepressant options)
ADHD and Anxiety DisordersPTSD• Diagnosis: • Identify stressor event • Tease out age of onset and course of symptoms • “Shared” symptoms (inattention, hyperactivity; academic performance problems; sleep problems)• Treatment implications • Families often have significant other stressors • Psychotherapy choices • Medication implications (stimulants; non-stimulant ADHD treatments; antidepressant options)
ADHD and Mood DisordersMajor Depression/Dysthymia:Diagnosis •Differentiate age of onset, course •Shared” symptoms (inattention, academic performance problems; sleep “ •(problemsTreatment implications •Family and patient education •Psychotherapy choices •Medication implications (stimulants; non-stimulant ADHD treatments; •(antidepressant options
ADHD and Mood DisordersBipolar Disorder:Diagnosis •Differentiate age of onset, course (issues of mixed presentation and of •(rapid cyclingShared” symptoms (attention problems; hyperactivity; increased speech “ •(output; loud; sleep problems; academic performance problemsUnique symptoms (grandiosity; psychotic symptoms; severe mood •labilityTreatment implications •Family and patient education •Medication implications (mood stabilizers; atypical neuroleptic •medications; issue of stimulants; non-stimulant ADHD treatments;(antidepressant options
ADHD and Tic DisordersChronic Tics or Tourette’s Disorder• Onset of ADHD often precedes onset of Tics or TS• Important to inquire about family history and educate parents about stimulants and tics/TSTreatment• Stimulants were considered “contraindicated” in past• Focus now on improving functioning – ADHD may be more impairing than tics• Complex regimens may be used, combining ADHD medications with alpha-agonists and/or atypical neuroleptic medications
:NURSING INTERVENTIONArrange the learning environment in order to minimise distractions, e.g. seat students with ADHD away.from windows, and take care during group work as students can become over-stimulated.Use frequent eye contact.Identify times and places where the student is more focusedGive frequent reminders about how much time is left to complete tasks both short-term (examinations) and(.long-term (assignments and coursework.Use checklists for each assignment and outline the tasks to be completed
Use checklists for each assignment and outline the tasks to be completed.Ensure student attention before giving an instruction and encourage students to verbalise tasks andinstruction - first to the tutor and then silently to themselves. Emphasise critical pieces of information.Include a variety of activities within programmes of study, such as questions, discussions, practicalactivities, etc.Use large fonts on handouts and provide only one or two main points to a page. Avoid the use ofillustrations that are not directly relevant to the task.Ensure student attention before giving an instruction and encourage students to verbalise tasks andinstruction - first to the tutor and then silently to themselves. Emphasise critical pieces of information.
Tips for ParentsBelieve in and support your child. Be consistent.Keep things in perspective. Set a good example.Pay attention to the siblings. Anticipate and avoid problems.Take of yourself. Praise good behavior.Communicate Negotiate and consult with your child.Connect Pick your battles.
Great TipsBe informed. Make directions as easy to follow as possible.Move toward a project-based classroom. Monitor progress.Offer choices. Use alternative assessments to measureGive kids the tools to compensate for learning.shortcomings. Ask for help.
ResourcesYour Total Health http://yourtotalhealth.ivillage.com/relationshipsADD & ADHD in Children: Recognizing the Signs and Symptomshttp://www.helpguide.org/mental/adhd_add_signs_symptoms.htmTeaching Children with ADD/ADHDhttp://www.teachervision.fen.com/add-and-adhd/teaching-methods/5314.html - PlayingForChange. (n.d.(. YouTube - Broadcast Yourself. . YouTubeBroadcast Yourself. . Retrieved February 7, 2011, from http://youtube.comYou tube was used for various illustrations of the brain as well as demonstrations of brain.gym movements. MD, L. S. (n.d.(. Attention deficit diagnosis and treatment information. ADDitudeMagRetrieved February 7, 2011, from http://attitudemag.comADDitute Mag is an online magazine. This resource helps caregivers and parents.understand how to "live well" with ADHD