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Students with Attention Deficit/Hyperactivity Disorder. Chapter 14. What is the History of AD/HD?. Early 20 th century - AD/HD was first described. Described children with “defective moral control” 1918 - encephalitis resulting in hyperactivity, impulsivity, and aggression
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Students with Attention Deficit/Hyperactivity Disorder Chapter 14
What is the History of AD/HD? • Early 20th century - AD/HD was first described. • Described children with “defective moral control” • 1918 - encephalitis resulting in hyperactivity, impulsivity, and aggression • 1950s - “minimal brain dysfunction” • 1960s - AD/HD added to APA diagnostic manual • 1970s – focus was more on attention problems • 1990s - AD/HD (three types)
What is the Definition of AD/HD? • “A persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequently displayed and severe than is typically observed in individuals at a comparable level of development” (APA, 2000, p. 85).
What are the Three Types of AD/HD? • Predominantly hyperactive/impulsive • Predominantly inattentive • Combined (both hyperactive/impulsive and inattention)
What are the Symptoms of AD/HD? • Symptoms must be present for at least six months. • Some symptoms must be initially displayed before age seven. • The impairment is exhibited in multiple settings. • Disorder impairs performance in social, academic, or occupational areas. • Symptoms persist to a degree that is maladaptive and inconsistent with the individual’s developmental level.
What is the Prevalence of AD/HD? • Approximately 3-5% of the school-aged population is identified as having AD/HD. • More prevalent in males than females • 20% - hyperactive/impulsive type • 75% of 4- to 6-year-olds have hyperactive/impulsive type. • 70% continue AD/HD into adolescence. • 50% continue AD/HD into adulthood.
Is AD/HD an IDEA 04 Category? • AD/HD is not a separate disability under IDEA 04, but students with AD/HD whose educational performance is significantly affected by this disorder may qualify for special education under another category such as “Other Health Impairment.”
What are Some Causes of AD/HD? • Cause unknown • Primarily considered a neurologically based disorder • Possible premature birth • Maternal smoking and alcohol use • Exposure to lead • Possibly genetic deficits affecting neurotransmitters
What are Age-Related Characteristics of Students with AD/HD? • Preschoolers • Excessive gross motor behavior • School-age • Restless, fidgety, working carelessly, and not finishing work • Adolescents • Withdrawal, inattention • Adults • Distractible, disorganized, mood swings, short tempers, problems planning ahead
What are other Characteristics of AD/HD? • Cognitive • Difficulty planning, organizing, integrating, managing, inhibition, impulsivity, decreased time attending to a task, etc. • Academic • Less time studying, difficulty attending to tasks and organizing academics, difficulty listening to directions, making careless mistakes, lack of independence to work • Social Emotional • Peer relationships, verbal and physical aggression, bullying • Coexistence • AD/HD exists with giftedness, learning disabilities, emotional disturbance, anxiety, etc.
How are Students with AD/HD Identified? • Interviews, questionnaires, checklists • First a medical evaluation by a physician, then interview parents, teachers, and child • Rating scales • Achenbach, Devereux, BASC-II, ADDES, Conners • Academic testing • KTEA-II and WIAT-II • Direct observations and data collection
Behaviors Targeted for Classroom Observations • Problems of inattention, such as becoming easily distracting, making careless mistakes, or failing to finish assignments on time. • Problems of hyperactivity, such as fidgeting, getting out of an assigned seat, running around the classroom excessively, or striking out at a peer. • Problems of impulsivity, such as blurting out answers to the teacher’s questions or interrupting the teacher or other students in the class. • More challenging behaviors, such as severe aggressive or disruptive behavior.
What Should I Teach Students with AD/HD? • General education curriculum • Strategies to support academics • Self-regulation strategies • Parent training • Counseling services for transition
How Should I Teach Students with AD/HD? • Task analysis • Clear consistent rules • Repetitious verbal instructions • Advance organizers • Cognitive (learning) strategies • Direct instruction • Cognitive behavior modification • Precision teaching • Behavioral intervention techniques (reward and retrain)
When Should Medications Be Used? • Use medications only after other procedures have been attempted. • Use medications only after a valid diagnosis of AD/HD has been made. • Carefully monitor the effects and communicate with parents. • Provide strong educational programming along with medication. • Remember, school districts are prohibited from requiring a child to obtain a prescription. • Watch for adverse side effects. • Use behavioral intervention and counseling along with medication.
What Instructional Environment Should be Used to Teach Students with AD/HD? • Establish structure and routine. • Arrange environment to maximize attention on the teacher and lessons. • Minimize distractions. • Establish routines and visual schedules. • Provide study carrels. • Use interactive materials. • Plan purposeful movement. • Provide larger work spaces.
What are Considerations for the Instructional Environment? • The Preschool Classroom • Make the classroom highly structured. • Block distractions from the hallway. • Consider using three-sided carrels for learning centers. • Alternate in- and out-of-seat activities. • Avoid changes to routines. • Elementary and Secondary Classrooms • Reduce clutter. • Provide individual seating and space. • Seat students in front/middle of the room. • Provide study carrels. • Allow opportunities to move.
What are Possible Instructional Groupings? • Large Group Instruction • Peer Tutoring • Classwide peer tutoring(CWPT) • Peer-assisted learning strategies (PALS)
What Instructional Technology Should be Used? • Computers - graphics, words, sounds, games, animation, color, drill and practice • Software - step-by-step instructions, wait for responses, feedback and reinforcement, self-paced • Attention Trainer • Tone-prompt System • Drill-and Practice programs
What are Some Considerations for the General Education Teacher? • Facilitate good discipline. • Establish clear, positive rules and routines. • Use interesting curriculum. • Use positive interventions and reinforcement. • Establish clear expectations. • Intersperse different activities. • Keep observational data and monitor for side effects of medication. • Participate in developing and carrying out a 504 Plan if needed. • Establish strong co-teacher relationship with special educator.