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Help! How Do I Manage These Strong-Willed Hyperactive Kids?. Presented by: Mayra Rodriguez, Ed.S . School Psychologist. ATTENTION DEFICIT DISORDERS. Teachers, child care workers, and school personnel are key to diagnosis and successful outcomes. INTRODUCTION ACTIVITY.
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Help! How Do I Manage These Strong-Willed Hyperactive Kids? Presented by: Mayra Rodriguez, Ed.S. School Psychologist
ATTENTION DEFICIT DISORDERS • Teachers, child care workers, and school personnel are key to diagnosis and successful outcomes
INTRODUCTION ACTIVITY Identify a current student you suspect might have A.D.H.D.
Many Names for A.D.H.D. Early 1900’s....Minimal Brain Damage Early 1900’s....Minimal Brain Dysfunction Mid 1900’s....Hyperkinetic Reaction of Childhood Early 1980’s....Attention Deficit Disorder w/wo Hyperactivity Late 1980’s.....Attention-Deficit Hyperactivity Disorder Present............Attention-Deficit / Hyperactivity Disorder (Type I, Type II, or Combined)
A.D.H.D. STATISTICS • Occurs in 3-5% of school-age children • All socioeconomic, cultural, and racial backgrounds • All intelligence levels • More prevalent in males • 4:1 male to female ratio in general population • 9:1 male to female ratio in clinical population
A.D.H.D. STATISTICS • Symptoms identified in up to 80% of adolescents with A.D.H.D. • Problems continue after childhood in 66% of cases • Hereditary link suggested
Is ADHD Over-Diagnosed? • FACT – 3.5 million children meet criteria for ADHD; only 50% are diagnosed and treated • FACT – 57% of children with ADHD receive accurate diagnosis • FACT – Only 20% of black children with ADHD are diagnosed • FACT – Overall parental knowledge about ADHD among African-American parents may play an important role in delaying diagnosis
The Societal Burden ofNot Treating ADHD • 30% of children in special education • 30% repeat a grade • 25% of adolescents expelled from school • 35% of students drop out of school • 26% arrested • 55% untreated grow up to be substance abusers • Engage in other high risk behaviors, more partners
Children With A.D.H.D. Exhibit Age-Inappropriate Behavior Patterns • Inattention • Impulsivity • Hyperactivity
A.D.H.D. Interferes with School Success Inattention Symptoms: Child experiences difficulty in…. • Starting, staying with, and completing tasks that require sustained attention • Making careless mistakes • Making transitions • Following directions / listening • Performing consistently • Organizing tasks • Losing things / forgetfulness
Impulsivity Symptoms • Low frustration tolerance • Difficulty waiting turn • Interrupts others & ignores boundaries • Blurting out answers before question is completed • Difficulty anticipating outcomes • Often irritable/ impatient; but otherwise quite charming
Impulsivity Symptoms • Cannot keep hands to themselves • Often appear reckless, clumsy, or accident-prone • Often provoke conflict just for the love of excitement!!!! • Can easily produce chaos in class or turn home into a battleground
Fidgeting Rarely seated, or squirms in seat Moving excessively Difficulty playing or working quietly Always “on the go” Excessive talking Varies with age & developmental level Often makes noise during quiet activities Up often during meals Hyperactivity Symptoms
Symptoms often disappear when the child is with another person who is closely scrutinizing him, when confronted with an interesting task, or a novel situation
DSM-V DIAGNOSTIC TERMS Attention-Deficit / Hyperactivity Disorder • Inattentive Type • Hyperactive-Impulsive Type • Combined Type
Persistence, Pattern, and Frequency of Symptoms • A persistent pattern… more frequent & severe than developmentally appropriate • First appeared before age 7 • Persist for 6 months or more • Present in at least 2 settings • Interference with social or academic functioning
Adolescence Restlessness Talks out of turn Problems at school Problems with peers Poor judgment Difficulty getting independence from parents Elementary School Fidgety Excessive talking Erratic performance Bossy Constant demand for attention Easily loses control Symptoms Change Over the Years
TIER 1: Presence of Symptoms Interview parents and teachers Obtain developmental history Review school and medical records Complete behavioral rating scales Observe during an auditory vigilance task. Interview student / self-report DIAGNOSTIC PROCESS
DIAGNOSTIC PROCESS TIER 2: Degree of Impact on Functioning • Classroom observation • Psychoeducational tests
Intervention Strategies Should Target... • Classroom behavior • Academic performance • Social interactions
Classroom Management Strategies • Schedule academic skills subjects in AM • Provide regular and frequent breaks • Agree on “secret signal” for student • Develop “time-to-begin” cues
Classroom Management Strategies • Teach self-monitoring techniques • Devise & practice attention-getting strategies • Divide assignments and present in smaller segments • Use behavioral reinforcement system
Organization Strategies • Orderly, predictable, structured, consistent environment • Minimal distractions, quiet work area, background noise (white noise) • Prominent display of rules, schedules, and assignments • Advanced warning before transition of activity
Curriculum Accommodations • Reduced homework / classwork • Increased time for completing assignments and tests • Mixture of high- and low-interest activities (task novelty) • Curriculum integration • Seek meaning/ purpose
Curriculum Accommodations • Use of computers for written assignments • Teach/ prompt organization and study skills • Interactive instruction vs. lecture • Visual references for oral instructions • Avoid timed tests
Social Skills Strategies/ Impulse Control • Social skills training • Conflict resolution training • Anger management therapy • Compliance training
Family Issues • Parent training to learn how to parent an ADHD child • Parent training to reinforce social skills training • Family therapy to heal damaged relationship issues
What About Psychostimulant Medication? • 70-75% of children with A.D.H.D. improve • Degree of response may vary • Effective dosage may vary
Medication is sometimes useful in helping ADHD children…. • become less irritable & restless • improve attention & motor coordination • become less impulsive, therefor, better liked by others • improve in pro-social & appropriate school behavior
What About Psychostimulant Medication? • Effective with adolescents and adults, although the extent of improvement is smaller than with younger children • Medication is only one part of a total management program
AND…a great deal of prayer!Let your ADHD student know you love them & care about them regardless of how they behave!