At the end of this presentation you should be able to: Identify causes of AD/HD.

1. Attention-Deficit/Hyperactivity Disorder Chapter 6 Objectives At the end of this presentation you should be able to: • Identify causes of AD/HD. • Understand the complexities of AD/HD in relation to providing services for students under the IDEA. • Recall the subtypes of AD/HD provided by the American Psychiatric Association. • Describe positive traits associated with AD/HD. • Understand the social, emotional, and behavioral needs of students. • Describe how curricular and instructional choices can be augmented to meet the needs of students with AD/HD. Chapter Objectives

2. Attention-Deficit/Hyperactivity Disorder Understanding Individual Students Who is Kelsey Blankenship? • Nine years old, living with her grandparents who adopted her • Previously very active, surrounded by “commotion,” problems with being patient and attentive • Open to a treatment plan developed by a collaborative team made up of her teacher, therapist, psychiatrist, and grandparents • Worked on developing better problem-solving skills • Began taking prescribed medication • Currently very involved in dramatic competitions and has much better interactions with her peers

3. How Do You Recognize Students with Attention-Deficit/Hyperactivity Disorder? Defining AD/HD How Do You Recognize Students with Attention-Deficit/Hyperactivity Disorder? • AD/HD is not a separate category under IDEA. • Students with AD/HD usually receive services under the category of other health impairments. • AD/HD is defined by the American Psychiatric Association. • Frequency • Severity • To receive services under IDEA, the condition must adversely impact the student’s academic performance. Understand the complexities of AD/HD in relation to providing services for students under the IDEA.

4. How Do You Recognize Students with Attention-Deficit/Hyperactivity Disorder? Defining AD/HD Figure 6-1 Recall the subtypes of AD/HD provided by the American Psychiatric Association.

5. How Do You Recognize Students with Attention-Deficit/Hyperactivity Disorder? Describing the Characteristics • Predominantly inattentive type • Trouble paying attention, forgetful, easily distracted • Students may appear lethargic, apathetic, or hypoactive (move or respond too slowly). • Selective attention • Predominantly hyperactive-impulsive type • Cannot seem to sit still, talk excessively, difficulty playing quietly • Few adolescents or adults have the HI type. • Combined type • Combines features of inattention and hyperactivity • Almost 85% of students with AD/HD are combined type Recall the subtypes of AD/HD provided by the American Psychiatric Association. Recall the subtypes of AD/HD provided by the American Psychiatric Association.

6. How Do You Recognize Students with Attention-Deficit/Hyperactivity Disorder? Describing the Characteristics • Executive functions of behavioral inhibition • Helps plan for the future and organize and control behavior. • Nonverbal working memory • Allows students to retrieve auditory, visual, and other sensory images of the past. • Internalization of speech • Planning what to do and say and knowing when it is appropriate to speak thoughts out loud. • Self-regulation of affect, motivation, and arousal • The continuing drive and persistence to maintain goal-directed actions. • Reconstitution • The skill of analyzing and synthesizing behaviors • Positive traits of AD/HD • Creativity, imagination, ability to hyperfocus, sense of humor Understand the social, emotional, and behavioral needs of students. / Describe positive traits associated with AD/HD.

7. How Do You Recognize Students with Attention-Deficit/Hyperactivity Disorder? Identifying the Causes • Environmental explanations • Research has minimized the possibility of causes such as: too much sugar, too little sugar, aspartame, food sensitivities, food additives/colorings, lack of vitamins, exposure to television or video games, and many other items. • Poor parenting is not the cause of AD/HD. • Biological explanations • Pre-, peri-, post-natal trauma • Exposure to teratogens (environmental substances affecting fetus development) can increase the likelihood of a child developing AD/HD. • Brain differences • Genetics Identify causes of AD/HD.

8. How Do You Recognize Students with Attention-Deficit/Hyperactivity Disorder? Identifying the Prevalence • Approximately 3 to 7% of school-age children have AD/HD. • Estimates vary widely because of differences in interpreting defining characteristics. • Prevalence according to subtype: • Combined type: 55% • Inattentive type: 27% • Hyperactive-impulsive type: 18% • Approximately two-thirds of students with AD/HD have a co-existing condition. Recall the subtypes of AD/HD provided by the American Psychiatric Association.

9. Executive functions of the brain • Nonverbal working memory • Recalling multi-sensory images • Internalization of speech • Self-talk to prepare action • Self-regulation of affect, motivation, and arousal • Self-control with reflection • Reconstitution • Analyzing and synthesizing behaviors

10. Executive Function Deficits • ORGANIZATION • Attention • decision making • Planning • Sequencing • REGULATION • Initiation • Repetition • temper control • UNAWARENESS • “denial” of deficits • unintentional “non-compliance”

11. How Do You Evaluate Students with Attention-Deficit/Hyperactivity Disorder? Evaluating Students How Do You Evaluate Students with Attention-Deficit/Hyperactivity Disorder? • Determining the presence • Usually involves a pediatrician and a psychiatrist or psychologist • Teachers may make a referral, but should never suggest a child needs medication. Only a doctor can make that determination. • Teachers may be asked to complete a behavior rating checklist as part of the evaluation • Determining the nature and extent of general and special education services • Studies have shown only half of students with AD/HD are receiving services. • Some students qualify for 504 plans. Understand the complexities of AD/HD in relation to providing services for students under the IDEA.

12. How Do You Evaluate Students with Attention-Deficit/Hyperactivity Disorder? Evaluating Students Figure 6-5 Understand the complexities of AD/HD in relation to providing services for students under the IDEA.

13. How Do You Assure Progress in the General Curriculum? Including Students How Do You Assure Progress in the General Curriculum? • Many students with AD/HD have impaired social relationships. • Steps to improve peer relationships may include: • Observe the student to determine effective, poor, and absent social behaviors. • Focus on one or two behaviors to change. • Directly coach, model, and role-play important behaviors. • Praise and reward the student for appropriate behaviors. Describe how curricular and instructional choices can be augmented to meet the needs of students with AD/HD.

14. How Do You Assure Progress in the General Curriculum? Planning Universally Designed Learning • Augmenting curriculum • Increase motivation to learn with relevance, novelty, variety, choices, activity, challenge, and feedback. • Augmenting instruction • Maintain high expectations and teach skills students need to manage their daily lives. • Help students develop self-efficacy by teaching them how to: • Plan, organize, and manage activities. • Enlist help and resources when needed. • Regulate personal motivation and sustain involvement. • Apply metacognitive knowledge and strategies for task completion. • Acquire knowledge and skills to manage their environment. Describe how curricular and instructional choices can be augmented to meet the needs of students with AD/HD.

15. How Do You Assure Progress in the General Curriculum? Collaborating to Meet Students’ Needs • Students may need to work with a coach or professional organizer. • Coaches may be a peer, a neighbor, or someone specially trained. • The acronym HOPE specifies questions and statements a coach may use: • Help: What help do you need? • Obligations: What’s coming up, and what are you doing to prepare? • Plans: What are your goals? • Encouragement: You are making progress! • Teachers, parents, doctors, and therapists may need to work closely to monitor changes and student needs. Describe how curricular and instructional choices can be augmented to meet the needs of students with AD/HD.

16. What Can You Learn from Others Who Teach Students with Attention-Deficit/Hyperactivity Disorder? Early Childhood What Can You Learn from Others Who Teach Students with Attention-Deficit/Hyperactivity Disorder? The Early Childhood Years • University of Florida MDTP • Inclusion of young children with AD/HD in community programs • Multimodal treatments • Students initially attend diagnostic classrooms, then transition into general classrooms with ongoing support of AD/HD project teachers • Project teachers collaborate with general educators Understand the social, emotional, and behavioral needs of students.

17. What Can You Learn from Others Who Teach Students with Attention-Deficit/Hyperactivity Disorder? Elementary The Elementary Years • Take Charge! • Provides self efficacy-related learning activities and support • Incorporates storytelling, puppets, and dramatic play for elementary-age students • Helps students enhance self-awareness and confidence, build routines, complete projects, improve communication skills, and prepare for inclusion Understand the social, emotional, and behavioral needs of students.

18. What Can You Learn from Others Who Teach Students with Attention-Deficit/Hyperactivity Disorder? Middle and Secondary Learning for the Middle and Secondary Years • Lehigh University’s Consulting Center for Adolescents • Concentrates on coordination of efforts for students with AD/HD • Program provides in-service training, on-site consultation, advanced knowledge dissemination, and follow-up consultation • Collaborative teams are a key component • Participants learn: • School-based self-managements strategies • School-based behavior management skills • Home-based behavior management skills • Medication monitoring • Social skills and problem-solving training Understand the social, emotional, and behavioral needs of students.

19. What Can You Learn from Others Who Teach Students with Attention-Deficit/Hyperactivity Disorder? Transitional and Post Secondary The Transitional and Post-Secondary Years • Peterson’s Colleges with Programs for Students with Learning Disabilities or Attention Deficit Disorders • Helps students make choices about secondary education that will allow them to be successful in their education • Many students with AD/HD continue to have symptoms of AD/HD into adulthood and require specialized attention in college. • Some colleges have specific support services and programs for students with AD/HD to strengthen self-efficacy skills. Understand the social, emotional, and behavioral needs of students.

20. A Vision for Kelsey’s Future • Kelsey would like to be a veterinarian. • Her team supports her dream. • She has begun making small steps toward that goal by succeeding in school, volunteering at the pound, and walking dogs. • Her therapist envisions her developing skills to become a confident self-advocate.