Attention deficit hyperactivity disorder is a lifelong neurodevelopmental disorder that affects the brain and results in a variety of inappropriate and maladaptive behaviors. ADHD is not a disease (Kajander 1995) but is a processing deficit that results in children having difficulty with inhibitory control. That is, children with ADHD lack self-control, something they cannot help. In children with ADHD, the parts of the brain that control attention and stop inappropriate behavior are underdeveloped (Barkley 1996; Kajander 1995). ADHD occurs three times more frequently in male students than female students (Reeve et al. 1995) and commonly occurs with other disorders. For example, ADHD occurs in 20 percent to 50 percent of the students with learning disabilities, in 65 percent of the students with oppositional defiant disorder, and in 20 percent to 30 percent of the students with conduct disorder (Reeve et al. 1995; Barkley 1990).

1. Meet a few accomplished people who
have ADHD:
Ozzy Osbourne

2. Albert Einstein

3. Whoopi Goldberg

4. Winston Churchill

5. Walt Disney

6. Understanding
ADHD

7. History of ADHD
Mid-1800s: Minimal Brain Damage
Mid 1900s: Minimal Brain Dysfunction
1960s: Hyperkinesia
1980: Attention-Deficit Disorder
With or Without Hyperactivity
1987: Attention Deficit Hyperactivity Disorder
1994-present: ADHD
Primarily Inattentive
Primarily Hyperactive
Combined Type

8. What is Attention Deficit
Hyperactivity Disorder?
The condition often becomes
apparent when children are in
preschool or when they are in their
early school years.
An estimated 3-5% of children have
ADHD.

9. ADHD Statistics
3-5% of all U.S. school-age children are
estimated to have this disorder.
5-10% of the entire U.S. population
Males are 3 to 6 times more likely to have
ADHD than are females.
At least 50% of ADHD sufferers have
another diagnosable mental disorder.

10. Attention Deficit Hyperactivity
Disorder (ADHD)
Onsets before age seven
The main symptoms are:
INATTENTION
- HYPERACTIVITY
IMPULSIVITY.

11. Diagnosing ADHD: DSM-IV
Inattentiveness:
Has a minimum of 6
symptoms regularly for
the past six months.
Symptoms are present at
abnormal levels for stage
of development
Lacks attention to detail;
makes careless mistakes
has difficulty sustaining
attention
doesn’t seem to listen
fails to follow through/fails
to finish projects
has difficulty organizing
tasks
avoids tasks requiring
mental effort
often loses items necessary
for completing a task
easily distracted
is forgetful in daily activities

12. Diagnosing ADHD: DSM-IV
Hyperactivity/
Impulsivity:
Fidgets or squirms
excessively
leaves seat when
inappropriate
runs about/climbs
extensively when
inappropriate
has difficulty playing
quietly
often “on the go” or “driven
by a motor”
talks excessively
blurts out answers before
question is finished
cannot await turn
interrupts or intrudes on
others
Has a minimum of 6
symptoms regularly for the
past six months.
Symptoms are present at
abnormal levels for stage of
development

13. Diagnosing ADHD: DSM-IV
Additional
Criteria:
Symptoms causing impairment
present before age 7
Impairment from symptoms
occurs in two or more settings
Clear evidence of significant
impairment (social, academic,
etc.)
Symptoms not better accounted
for by another mental disorder

14. It is VERY important that children are
examined and diagnosed by a qualified
professional who will use strict diagnostic
guidelines to determine whether the
behaviors are inappropriate for the child’s
age, and whether the symptoms indicate
ADHD or not.
Talking to your family physician might
be a good start.
ADHD: Getting a
diagnosis

15. Learning
Disabilities
About 20-30% of children with ADHD also have a specific
LD. It is a good idea to have your child with ADHD
assessed for a learning disability.
Several disorders can accompany ADHD. See your family doctor or
specialist if you suspect your child has any of these disorders.
Tourette
Syndrome
A small proportion of children with ADHD also have this
neurological disorder, which can be controlled with
medication. Symptoms include nervous tics and repetitive
mannerisms.
Bipolar
Disorder
Some children with ADHD also have BD. Differentiating
between ADHD and BD in childhood can be difficult, however,
as some symptoms are present in both disorders.
ADHD: Accompanying
disorders

16. Several disorders can accompany ADHD. See your family doctor or
specialist if you suspect your child has any of these disorders.
Oppositional
Defiant Disorder
As many as 1/3 to 1/2 of children with ADHD also have
ODD. Children with ODD are defiant, non-compliant,
belligerent, and stubborn.
Conduct
Disorder
About 20-40% of children with ADHD will develop
CD, which is a more serious pattern of antisocial
behavior. Children with CD are aggressive and
destructive, and are at great risk of getting into trouble
at school or with the police.
Anxiety &
Depression
If co-occurring anxiety or depression is recognized and
treated, children will be better able to handle the
problems that accompany ADHD.
ADHD: Accompanying
disorders

17. BUT… some studies have shown a relationship
between alcohol and tobacco use during pregnancy and
the risk for ADHD in the baby.
So, these activities should be
avoided while pregnant!
What causes ADHD?

18. The cause of ADHD remains unknown, but
most research suggests that the cause lies in
neurobiology (some parts of the brain are
smaller in children with ADHD) or genetics
(ADHD tends to run in families, so there are
likely genetic influences).
Although environmental and social factors
(like child-rearing style) can influence the
severity of the disorder, they do not cause
the disorder.
What causes
ADHD?

19. Several teams of researcher have found
relatively consistent abnormalities in five
areas of the brain in people with ADHD:
Prefrontal Lobes
Frontal Lobes
Basal Ganglia
Cerebellum
Corpus Callosum

20. The Frontal Lobe/Prefrontal
Cortex helps us to:
Focus Concentration
Pay Attention to our tasks
Make good decisions
Plan Ahead
Learn and to remember what
we have learned.
To have proper behavior in
situations where it is required.
Armstrong (2010)

21. The prefrontal cortex is one of the
last areas of the brain to fully
mature. In patients with ADHD it is
hypothesized that they mature at a
slower rate than their peers
without ADHD, sometimes
between two and three years
slower. However it must be said
that children with ADHD do
undergo normal patterns of brain
development they just lag behind
their peers.
Armstrong (2010)

22. Basal Ganglia also helps with movement and motor control.
Dopamine, either too much or too little affects how the Basal Ganglia
communicates to the rest of the brain.
Sweeney (2009), Armstrong (2010)

23. The Cerebellum is responsible for producing coordinated muscle
movements. It also works to sequence thoughts of motion.
Sweeney (2010), Armstrong (2010)

24. ADHD is not caused by:
Will Power
Inadequate Parenting
Lack of Motivation
Lack of Intelligence
Laziness

25.  Medical Examination
 Clinical Interview
 Teacher and Parent Rating Scales
 Behavioral Observations
Four Components in Assessing whether a
student has ADHD

26. Psychological and Behavioral Characteristics:
Behavioral Inhibition (Russell Barkley)
 involves the ability to:
1. Delay a response
2. Interrupt an ongoing response
3. Protect a response from distracting or competing stimuli (Lawrence et al., 2002)
People with ADHD frequently delayed inner speech
Children and adults with ADHD have problems controlling their
emotions and their arousal levels.
Children and adults with ADHD have difficulty analyzing problems
and communicating solution to others.

27. Educational Considerations
Classroom structure and teacher direction
Functional behavioral assessment
 involves determining the consequences, antecedents, and setting events that
maintain inappropriate behaviors (Horner & Carr, 1997)
Contingency-based self-management
 involve having people keep track of their own behavior and then receive
consequences, usually in the form of rewards, based on their behavior (Davies &
Witte, 2000; DuPaul, Arbolino, & Booster, 2009; Shapiro, DuPaul, & Bradley-
Klug, 1998).

28. Stimulants (like methylphenidate or “Ritalin”) seem to be the
most effective class of medication, and are usually considered
quite safe.
They do not make children feel “high” and there is no evidence
that stimulants (when used for the treatment of ADHD) cause
drug abuse or dependence.
Medications have been used to treat ADHD for decades.
Treatment
for ADHD

29. In many people, stimulants reduce hyperactivity and
impulsivity, and improve the ability to focus, work and learn.
About 10% of children are not helped by stimulants, even after
trying several medications at several doses.
Recently, at least one non-stimulant medication has shown
great potential for reducing the symptoms of ADHD
(atomoxetine or “Strattera”).
Treatment
for ADHD

30. Choosing a
Treatment
for ADHD
What does the research show?
Medication seems to be essential for children with ADHD.
The most intensive ADHD treatment study to date found that
long-term management with medication or a combination
treatment of medication and behavioral treatment are superior to
behavioral treatments alone.

31. Which treatment will be
most effective for my
child?
Because no two children are alike, this question must
be answered by each family in consultation with their
health care professional.

32. Although medication works well
for many children, it can cause
undesirable side effects in others,
making it an unacceptable
treatment.
Each child’s needs and personal
history must be carefully
considered.
BUT… no one treatment
is the answer for every
child!

33. If you need more help..
Medication can help a child control
the behavior problems that have led
to trouble with parents and siblings,
but it can take a long time to undo
the frustration, blame and anger that
may have gone on for so long.
ADHD: What else can we
do?

34. Children AND parents might need special help to develop
techniques for managing the patterns of behaviour.
Many intervention approaches are available, including:
psychotherapy, behavioral therapy, social skills training,
support groups and parenting skills training.

35. Try these simple tips…!
(1) Schedule - have the same routine every day, and post the
schedule in the kitchen.
(2) Organize needed everyday items - have a place for
everything, and keep everything in its place.
(3) Use homework/notebook organizers - stress the
importance of writing down assignments and bringing home
needed books.
ADHD: What else can we
do?