This professional development document discusses attention deficit hyperactivity disorder (ADHD) and other health impairments (OHI) in special education. It provides an overview of the agenda, which includes defining OHI, describing ADHD as the most common OHI, explaining the etiology and symptoms of ADHD, demonstrating strategies and interventions, and practicing scenarios. Sample interventions discussed are daily report cards, contingency contracts, movement breaks, and the Zones of Regulation. The goal is to help educators understand and support students with ADHD and OHI.

1. 2014-2015 Professional Development Series
Special Education Disabilities
PD Part 2:
Understanding ADHD
and Other Health Impairments (OHI)
Presented by: Melanie Garcia, Special Education Coordinator
and Christina Saad, School Psychologist

2. Today’s Agenda
1. POP QUIZ!
2. What is OHI?
3. ADHD- Most Common OHI in SPED
4. Etiology of ADHD
5. How ADHD manifests
6. ACTIVITY!
7. Interventions/Supports
8. Vignettes/Scenarios Practice

3. Pick 2 Partners!
Partner A (someone you do not usually work
with):_______________
Partner B (Someone that teachers/their role is
different from yours): ______________

4. Pop Quiz!

5. Other Health Impairment (OHI)
● 1 of 13 Special education categories
● According to IDEA 2004:“Other health impairment means having limited
strength, vitality, or alertness, including a heightened alertness to
environmental stimuli, that results in limited alertness with respect to the
educational environment, that--
Is due to chronic or acute health problems such as asthma,
attention deficit disorder or attention deficit hyperactivity
disorder, diabetes, epilepsy, a heart condition, hemophilia,
lead poisoning, leukemia, nephritis, rheumatic fever, sickle
cell anemia, and Tourette’s syndrome; and Adversely affects a
child's educational performance.”
● Not an exhaustive list
● Adversely affects are the key words
● ADHD (suspected or diagnosed) is the most common OHI

6. ADHD Symptoms and Behaviors
Diagnosis includes ADHD indicators (according to the DSM 5 2014):
● ADHD-Inattention Presentation
● ADHD-Combined Presentation
● ADHD-Hyperactive/Impulsive Presentation
● No longer “ADD vs. ADHD”
Diagnosis:
● Pediatrician will refer to child psychiatrist
● Usually diagnosis happens after age 7 (best practices)
● Most referrals come from school
● SPED gives educational diagnosis (ADHD behaviors impacting education)
● Do not need diagnosis to qualify!
Associated Behaviors:
● Low tolerance for frustration
● mood swings
● temper tantrums
● anger management
● More extreme behaviors = Often develops into Oppositional Defiant Disorder/Conduct Disorder (frequently
comorbid with ADHD)

7. Etiology of ADHD
1. Genetic: Children of adults with ADHD have a two to eightfold increased
risk for the disorder
1. Environment: Toxins, such as exposure to lead, play a role (although a
smaller one)
1. Prenatal care: Smoking and alcohol use during pregnancy that resulted in
prematurity, is a risk factor for ADHD

8. How ADHD Manifests in School
ADHD Checklist: Warning Signs for Educators
Developmentally
Inappropriate
Hyperactivity
❏ Often fidgeting with hands or feet, squirming while seated.
❏ Running in halls, climbing on desks, leaving a seat in situations where sitting or
quiet behavior is expected
❏ When talking, jumping from one topic to another --verbal tangents
Developmentally
Inappropriate Impulsivity
❏ Blurting out answers before hearing the whole question
❏ Having difficulty waiting in line or taking turns
Developmentally
Inappropriate Inattention
❏ Easily distracted by irrelevant classroom activities, sights or sounds
❏ On assignments and when given instructions may not pay attention to details or
makes careless mistakes
❏ May display persistent difficulty following instructions carefully
❏ May misplace, lose or forget pencils, books, and tools needed for a task
❏ May skip from one uncompleted activity to another. This may result in problems
with completing homework.

9. Other common areas of deficit
Social Skills: Problems with impulsivity and inattention often disrupts the social
performance of youth. This may be in the form of interrupting peers already
engaged in a game together, joining a game without asking permission first, not
following rules that are often “implicit”, pay minimal attention to what they are
saying to their peers, etc.
Executive Functions: Often times, children with ADHD will have difficulty
planning, prioritizing, initiating and completing tasks as their typically developing
peers. ADHD affects the regions of the brain associated with impulse control,
working memory and organization. These have a greater impact on academic
performance in school than intelligence. This is why children with ADHD appear
lost, easily frustrated and struggle with turning in homework.

10. Symptomatology of ADHD changes throughout
childhood

11. Activity!
https://www.youtube.com/watch?v=nLVObdlI0m0

12. Interventions/Supports
1. Daily Report Card/Adapted System utilizing
current classroom management system
a. Star Systems
b. Dojo
c. Paycheck
2. Contingency Contracts
3. Incorporate movement in your lesson!
4. What has worked for you?

13. Examples: Behavior/Reward Charts

14. Contingency Contracts

15. Functions of Behavior and Interventions
Typical function(s) of behavior Interventions
Avoiding/Escaping task demands Reduce Task demands
Make Task Stimulating
Allow Choice of Task
Attention Breaks Contingent on Task Completion
Others?
Obtaining Attention from peers Reinforce Peers for ignoring
Use Group Contingency
Peer Tutoring
Others?
Obtaining Attention from adults Ignore off-task behavior
Time-Out
Attend to On-task Behavior
Others?

16. Zones of Regulation Strategies!
More of these can be accessed on Google Drive shared folder. Don’t forget our in-house
Zones expert, Dee DiGioua!

17. Other interventions
Teach student to take 'calm-down' break: Students who frequently become angry at peers or
who may be set off by the excitement of large groups may be taught to (1) identify when they are
getting too tense, excited, or angry, and (2) take a short break away from the setting or situation until
they have calmed down sufficiently.
Modeling (Vicarious Learning): While the target child is observing, the teacher gives specific
public praise to children other than the target student when they show appropriate behaviors. When
praising these behaviors, the teacher clearly describes the praiseworthy behaviors. When the target
child 'imitates' the same or similar appropriate behaviors, the teacher immediately praises him or her.
Over-correction: The student is required repetitively to practice a skill that will 'replace' or improve
upon an inappropriate or problem behavior. For example, a student who wanders the halls without
permission when taking an unsupervised bathroom break may have to stay after school one afternoon
and take multiple 'practice' trips to the school bathroom. In this example, the instructor might
accompany the student to monitor how promptly the student walked to, and returned from, the
bathroom and to give the student feedback about how much this target behavior has improved.

18. Let’s Get up!
Find your Partner A and complete Scenario 1
Find your Partner B and complete Scenario 2

19. With Partner A: Scenario # 1
Johnny is a 3rd grader who has already been identified as having
learning problems and is in the process of getting tested for an IEP.
His teacher has made comments to the IEP team that he has
difficulty remembering to turn in his class work when he is
finished. He also has a very disorganized backpack. Sometimes,
he appears to be daydreaming and takes longer than his peers to
finish a task. Johnny will appear fidgety and get up frequently
from his desk, even though most of his peers are seated. His
mother mentioned to his teacher that her husband was “exactly
like that when he was little” according to her mother in law.
● Turn and talk with your partner A
o What supports would you put in place for this student?

20. With Partner B: Scenario # 2
Marie is in the 5th grade. Her teachers are very worried about her.
They are in the process of setting up an SST to come up with
interventions. She currently reads at about a 3rd grade level and
struggles to remember to turn in her homework because she
“forgets”. Her desk is unorganized and she often loses things. In
class she will attempt to answer a question but gets sidetracked and
will go off on tangents. She gets sent to the principal’s office
frequently because she will often yell across the room at her teacher
and peers, disrupting learning. Students have complained that she
gets angry quickly at them, for no apparent reason. Her teachers
conferenced with her parents and they too see anger issues, social
problems, moodiness and apathy regarding school.
● Turn and talk with your partner
o What supports would you put in place for this student?

21. Questions?
Comments?

22. References
Brock, S., & Jimerson, S. (2009). Identifying, assessing, and
treating ADHD at school. New York: Springer.
DuPaul, G., & Stoner, G. (2014). ADHD in the Schools, Third Edition
Assessment and Intervention Strategies. (3rd ed.). New York:
Guilford Publications.
Mash, E., & Barkley, R. (2009). Assessment of Childhood Disorders,
Fourth Edition (4th ed.). New York: Guilford Publications.