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ADD and ADHD

ADD and ADHD. Joyce A. Hill, Ph.D. New Mexico State University—Alamogordo Colleen M. Hill, B.A. Definitions. ADHD—3 types predominantly inattentive type predominantly hyperactive-impulse type combined type

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ADD and ADHD

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  1. ADD and ADHD Joyce A. Hill, Ph.D. New Mexico State University—Alamogordo Colleen M. Hill, B.A.

  2. Definitions • ADHD—3 types predominantly inattentive type predominantly hyperactive-impulse type combined type • OHI—other health impaired: this is the category that children can be given special education services

  3. Diagnostic Criteria: DSM—diagnostic and statistical manual of mental disorders • 6 or more symptoms of inattention OR hyperactivity-impulsivity that have persisted or at least 6 months to a degree that is maladaptive and inconsistent with developmental level • Symptoms present before age 7 • Impairment in 2 or more settings • Clear evidence of clinically significant impairment in social, academic, occupational functioning • Symptoms not part of another diagnosis

  4. Myths • Careful research has shown that sugar DOES NOT cause hyperactivity • Television and video games are NOT linked to hyperactivity • A diet free of food colorings and additives is not beneficial • ADHD disappears in adulthood—2/3rds continue to have the condition • ADHD is a fad—reports of cases back to mid 19th century

  5. Current Research Evidence • Some indication that ADHD results from neurological dysfunction rather than actual brain damage • Abnormalities in frontal lobes, basal ganglia, cerebellum • Neurotransmitter abnormalities (chemicals that help in the sending of messages between neurons)

  6. Current Research Evidence • Abnormal levels of dopamine • Some toxins related, exposure to lead, abuse of alcohol • Strong hereditary basis

  7. Behavioral CharacteristicsRussell Barkley’s Model • Limitations in behavioral inhibition withholding a response, protecting a response from interruption • Limitations in executive functions self-directed behaviors such as working memory, inner speech, emotional control, analyzing problems • Limitations in goal-directed behavior focus on task, persistence, longer time frames

  8. Meeting needs…What research says. • Allow time between asking a child to do or say something and expecting a response • Avoid overloading working memory by limiting number of steps in directions, explains, etc. • Create routines for transitions • Prepare children in advance for changes

  9. Meeting Need… More strategies • Planning: Divide instructional sequence into meaningful chunks • Clearly Introduce: Let children know the objectives for the day • Modeling: Model steps of instructions, lessons

  10. Behavior Helpers • Frequent breaks • Behavior charts kept by child • Cue charts and reminders on desk • Posted charts of everyday routines • Prepare the child ahead of time for changes in routines, or special events • Visuals to cue working memory

  11. The Medication Controversy

  12. Frequent Questions… • What are some common stimulant medications available for children with ADHD? • What are possible side effects of stimulant medication? • Does stimulant medication help or harm a child? • Alternative treatments for children with ADHD

  13. Common Stimulant Medications… • Ritalin • Adderall • Dexedrine • Concerta • Strattera

  14. Potential Side Effects • Insomnia • Dry mouth • Nausea • Loss of appetite • Headaches • Jitteriness • Increased blood pressure • Growth suppression

  15. How Does Stimulant Medication Harm Children? • Some children never fully stop taking their medication • Side effects for adults are worse • Children become lethargic • Medication alone does not do the trick

  16. How Does Stimulant Medication Help Children? • Enhanced response inhibition • Enhanced item recall • Enhanced performance of paired associate learning tasks

  17. Alternative Treatments • Behavior modification • Parent education • Management training • Classroom environment manipulations • Motivational training

  18. References • Chelonis, J. J., Edwards, M. C., Schulz, E. G., & Baldwin, R. B. (2002). Stimulant medication improves recognition memory in children diagnosed with attention deficit/hyperactivity disorder. Experimental and Clinical Psychopharmacology, 10(4), 400-407. • Diller, L. H. (1996). The run on Ritalin: Attention deficit disorder and stimulant treatment in the 1990s. In M.A. Byrnes (Ed.), Taking sides: Clashing Views on controversial issues in special education (pp. 305- 313). Boston, MA: McGraw/Dushkin. • Hallahan, D.P., & Kauffman, J. M. (2003). Exceptional learners. Boston: Allyn and Bacon.

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