Attention Deficit Hyperactivity Disorder

1. Chapter 9: ADHD
Adapted from a presentation by James J. Messina, Ph.D.

2. Chapter 9 Questions
 How common is ADHD and what causes it?
 How is ADHD defined and classified?
 What are the primary characteristics of
students with ADHD?
 How are students with ADHD identified?
 What interventions are effective for students
with ADHD?

3. Prevalence and Causes of
ADHD
 About 3-7% of school-aged population
 Approximately 75% boys
 50-60% have a coexisting disability
 Differences found in frontal brain and brain
chemistry (i.e., neurotransmitters)
 Often heredity
 Poor parenting is NOT a cause!

4. DSM V Definition of ADHD
A persistent pattern of inattention
and/or hyperactivity-impulsivity
that is more frequently displayed
and more severe than is typically
observed in individuals at a
comparable level of development.

5. DSM V - Types of ADHD
 Predominantly
Hyperactive-Impulsive
 Predominantly Inattentive
 Combined

6. Inattention
 Inattention to details / careless mistakes
 Difficulty sustaining attention
 Doesn’t seem to listen
 Fails to follow directions or finish tasks
 Avoids tasks requiring sustained effort
 Easily distracted / daydreams
 Disorganized / forgetful
 Often loses things

7. Hyperactivity
 Restless / Fidgets
 Can’t stay in seat
 Runs / climbs when inappropriate
 Difficulty playing quietly
 On the go – driven
 Talks excessively

8. Impulsivity
 Blurts out answers
 Trouble taking turns
 Interrupts / intrudes
 Impatient / rushes
 Careless errors
 Risk taking / taking dares
 Accidents / injury prone

9. Other Major Characteristics
 Social and behavioral difficulties:
 Difficulty getting along with peers
 Interactions more negative and unskilled
 Disruptive in the classroom
 Academic difficulties:
 70% have problems learning in reading, math,
writing, or spelling
 Lack of sustained attention, organization, and
behavioral control lead to lower achievement.

10. Identification
 Teacher may consult school psychologist,
if ADHD suspected.
 Multidisciplinary team (NOT teachers)
should refer parents to a physician.
 Multidisciplinary team evaluates behavior
and achievement using multiple measures.
 Physician (e.g., psychiatrist, neurologist)
diagnoses using multiple measures.

11. Criteria for Diagnosis
 Six or more symptoms (figure 9.1)
 At least 6 months
 Two or more settings
 Present before age 12
 More extreme than age-level peers
 Significant impairment in social,
academic, or occupational functioning
 Not accounted for by other disorders

12. Eligibility
 May qualify for special education under
Other Health Impaired if educational
performance adversely affected.
 May qualify for accommodations under
Section 504.
 Usually placed in general education
classroom.

13. Medication
 Stimulants or amphetamines help control
behavioral symptoms.
 May reduce risk of future substance abuse.
 Teachers should monitor effects.
 Behavioral interventions help address
academic and social problems.
 Little research on alternative treatments
(diet, supplements, etc.)

14. Classroom Accommodations
 Preferential seating
 Provide movement opportunities / breaks
 Shorter, more frequent tasks or tests
 Extended time for tests, with breaks if needed
 Provide support for organization skills
 Increase novelty

15. Classroom Interventions
 Explicit instruction
 Strategy instruction
 Peer tutoring
 Computer-assisted instruction
 Behavior modification (e.g., token economy)
 Functional behavior assessment
 Social skills training
 Self-regulation

16. Classroom Management
 Provide structure, consistency, and predictability
 Prepare students for transitions
 Present instructions briefly, clearly, and visually
 Provide frequent, systematic and immediate
feedback, rewards, and punishments
 Use more rewards than punishments (3:1 ratio)
 Consequences must be sufficiently potent
 Rewards should be varied