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ADHD-Inattentive Subtype . Prevalence. Academic Characteristics. Frequently have co-occurring learning disabilities Are more likely to be retained in first grade than students with hyperactivity. Spend more energy trying to avoid homework than in doing it. NOT attentional deficit:
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Academic Characteristics • Frequently have co-occurring learning disabilities • Are more likely to be retained in first grade than students with hyperactivity. Spend more energy trying to avoid homework than in doing it
NOT attentional deficit: But an attentional bias • Seeking stimulation by paying attention to novelty: • externally (sights, sounds, smells, tastes, aggression) • internally (daydreaming, thought, emotionality) • Results in two types of “inattention” (see next slide)
I. Selective Inattention II. Sustained Inattention Attention Characteristics
I. SELECTIVE ATTENTION • Fails to attend to neutral cues and information in new tasks & settings, fails to GET ON TRACK, & can get LOST: • Initially • With details • With descriptions • With overlapping backgrounds (Not paying attention to important information that occurs early in a task, setting, or experience.) • Fails to attend to internal cues, such as thoughts, values, strategies, feelings
II. SUSTAINED INATTENTION Off-task visually Off-task cognitively (daydreams) Off-task verbally--changes topics in conversation Changes activities and does not maintain routines Fails to STAY ON TRACK or persist and shows poor performance on tasks that: • Are long • Are repetitive • Require holding information in mind (mental math, multiple step directions, planning, etc.)
Tasks in Support of Academic Competence • Change of tasks • Less time on task (poems and chapters) • 3. Self-paced tasks (computers)
Tasks (continued) High Interest tasks 1. Adventure, Sci Fi 2. Scary, gross 3. Novel Study of Fables -- 2 versions • Unfamiliar animals (orangutan vs. fox) • Emotional adjectives (angry vs. kind) • Dramatic verbs (swooped vs. walked) • Surprise endings (cut off heads vs. walked home)
Study: Children with attention problems (AP) and reading problems (RP) Better performancewith high than low interest: for both RP and APon 2 high level comprehension questions (e.g., good story title) Normalized performance One comprehension question
Tasks (continued) Color added produces: • 1. Less activity • 2. & improved reading accuracy (color added last 1/3)
Color added to relevant information produces better: 1. Handwriting (on closure of letters) 2. Spelling (on irregular letters) 3. Art (analysis of complex designs)
Do NOT add: 1. Novelty to draw attention away from words (spelling) 2. Conversations during difficult math problem-solving Especially during complex tasks, new tasks, or tasks for young children
Accommodation Summary I. SELECTIVE ATTENTION = reduce to essentialand highlight II. SUSTAINED ATTENTION = short and sweet (e.g., active, interesting)
Intervention: Psychostimulants Pros • Single most effective intervention: 75-80% for sustained attention or rote tasks Cons 1.But Placebos are also effective 40% • No long term child gains in: • Academics • Vocation • Social 3. Poor compliance 2. Can normalize mothers of children with ADHD (no longer as negative, directive)