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Attention-Deficit / Hyperactivity Disorder (AD/HD)

Attention-Deficit / Hyperactivity Disorder (AD/HD). KNR 270. AD/HD. Controversy Hidden disability Estimated 1 out of 20 5% of all school children Adults also may have. CAUSES. Neurochemical or neurobiological Less activity in the area of brain responsible for attending & action

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Attention-Deficit / Hyperactivity Disorder (AD/HD)

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  1. Attention-Deficit / Hyperactivity Disorder (AD/HD) KNR 270

  2. AD/HD • Controversy • Hidden disability • Estimated 1 out of 20 • 5% of all school children • Adults also may have

  3. CAUSES • Neurochemical or neurobiological • Less activity in the area of brain responsible for attending & action • Not connected to intelligence or socioeconomic factors • Genetic

  4. DSM IV • Attention-Deficit/Hyperactivity Disorder • Predominately Inattentive Type • Predominately Hyperactive-Impulsive Type • Combined Type • NOS

  5. DIAGNOSIS • Fairly subjective • Rated on characteristics • Teachers & parents • Psychologist • Doctor, because is a medical diagnosis • Adults diagnosed based on history

  6. DIAGNOSITIC CRITERIA • Developmentally inappropriate • Onset before 7 years • Persists longer than 6 months • Symptoms in 2 types of situations • Not attributable to other disorders (e.g.. LD, depression,etc.) • 50% other disorders • Mostly LD • Tourette’s • Tics

  7. Inattention: At least 6 often apply • Fails to pay close attention to details or makes careless errors • Has trouble keeping attention on tasks or play • Doesn’t appear to listen when being told something • Neither follows through on instructions nor completes tasks

  8. Inattention: At least 6 often apply • Has trouble organizing activities & tasks • Dislikes or avoids task that involve sustained mental effort • Loses materials need for activities • Easily distracted by extraneous stimuli • Forgetful

  9. Hyperactivity-Impulsivity: At least 6 often apply • Squirms in seat or fidgets • Inappropriately leaves seat • Inappropriately runs or climbs • Has trouble quietly playing or engaging in leisure activity • Appears driven or “on the go” • Talks excessively

  10. Impulsivity • Answers questions before they have been completely asked • Has trouble awaiting turn • Interrupts or intrudes on others

  11. Restless Easily distracted Difficulty sustaining attention Problems concentrating Impulsive & impatient Low self-esteem Poor organization Problems completing tasks Mood swings Short tempers Disorganized Procrastinate Chronic lateness Problems planning Forgetfulness Problems with time management ADULTS

  12. UNIDENTIFIED & UNTREATED • People are at increased risks for: • decreased educational performance • decreased self esteem • depression • social problems • family problems • difficulty finding & keeping job

  13. MUST SEE CHILD • As IN TROUBLE • Not CAUSE OF TROUBLE • Child is acting in way that is normal for them • Easier if remember behavior is from disability vs. disobeying

  14. MULTIMODAL TREATMENT • Educational • Behavioral • structure • reward system • Medical • Parental

  15. MEDICAL • Not THE SOLUTION • Part of the solution • Often use stimulants • Ritalin • Dexedrine • Stimulates brain to work at normal rate • Makes person available to learn, attend, or control impulses

  16. MEDICAL cont. • Rebound • Few side effects • decreased appetite • disrupt sleep • Adults may take Ritalin and antidepressants

  17. STUDENTS WITH ADD/ADHDWILL WORK TO: • Get something stimulating or novel • Get out of or away from something that is repetitious or boring • For attention (+ or -)

  18. PROBLEMS INCREASE WHEN • Task is too difficult or tedious • Work is required for extended periods of time • There is little supervision • There are periods of transition

  19. Considerations/Accommodations • Being fair doesn’t mean treating everybody the same • Expect some inappropriate behavior • pick your battles/ignore some • Provide structured/predictable environments • clear rules & consequences • regular schedule • shorter time periods • small ratios

  20. Considerations/Accommodations • Be consistent & respond quickly when needed • Help with transitions • warn when there will be changes • Give clear directions • get attention • give 1-2 step tasks

  21. Considerations/Accommodations • Help develop social skills • establish friendships with peers • gain feeling of acceptance • Look for positive behaviors • reward • praise • give helper roles • sticker charts • accept close approximations of behavior initially

  22. Considerations/Accommodations • Let parents know you see + • Protect child from situations that s/he can’t handle • Find things that interest child • Help develop positive self-esteem • find areas of competence • Provide consequences for behaviors

  23. Considerations/Accommodations • Post daily schedules • Note changes to schedules • Quiet spaces • Verbal & visual instructions • Sports or being on a team can be challenging • May have to distribute medications at programs • Others???

  24. C.H.A.D.D. • Children & Adults with Attention Deficit Disorders • National advocacy group • Chapters in many towns • Good resource

  25. OTHER DISABILITIES With Similar Behaviors • Fetal Alcohol Syndrome (FAS) • Sensory Integration Dysfunction • tactile defensiveness • Learning Disabilities

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