Understanding Students with ADHD: Causes, Accommodations & Strategies

1. Chapter 8 Understanding Students with Attention-Deficit/ Hyperactivity Disorder

2. Chapter 8 Objectives At the end of this chapter you should be able to: • Explain the three types of AD/HD: the predominantly inattentive type, the predominantly hyperactive-impulsive type, and the combined type. • Articulate causes of ADHD • Identify appropriate accommodations for students with AD/HD. • Describe successful instructional practices for students with AD/HD.

3. Defining Attention Deficit/Hyperactivity Disorder • The condition must adversely impact the student’s academic performance to receive services • Students usually receive services under “other health impairments” since there is no IDEA category for AD/HD • APA definition • Persistent pattern of inattention and/or hyperactivity-impulsivity more frequent and severe than typical • Manifest before age 7, duration at least 6 months, present in 2 or more settings, not attributed to other disability

4. Prevalence of AD/HD • Approximately 3 to 8% of school-age children have AD/HD • 4.2% for preschoolers • More boys than girls • Latinos less likely to receive AD/HD diagnosis

5. Three Subtypes of AD/HD • Predominantly inattentive type • Trouble paying attention, forgetful, easily distracted, selective attention • Students may appear lethargic, apathetic, or hypoactive (move or respond too slowly). • May be overlooked • Predominantly hyperactive-impulsive type • Cannot seem to sit still, talk excessively, difficulty playing quietly • Few adolescents or adults have the HI type. • Combined type • Combines features of inattention and hyperactivity • The majority of students with AD/HD are combined type

6. Intellectual Functioning and Academic Achievement • IQ ranges of students with ADHD tend to be 7 - 10 points below the norm (IQ 100) • Approximately 21% of elementary students with ADHD have also been identified as having intellectual disabilities (IQ score 70 and below) • Approximately 20% of students with ADHD are also identified as having a learning disability • Five percent also have a speech/language disorder • Students with ADHD often have impairments associated with motivation, memory, and goal-directed behavior

7. Behavioral, Social, and Emotional Characteristics • May have a co-existing condition, including: • Anxiety disorder, conduct disorder or obsessive-compulsive disorder • Specific challenges may include: • Conflicts with parents, teachers, and peers • Low self-esteem • Increased risk-taking behavior • Higher rates of using alcohol, tobacco, and substance dependence • Significantly higher likelihood of receiving behavior management programs, mental health services, social work services, and family counseling

8. Determining the Causes • Does NOT cause AD/HD • Lack of self control • Poor parenting • Too much television or video games • Too much sugar • Living in a fast-paced culture • Heredity • Focus on dopamine • Brain differences • Other biological causes

9. Determining the Presence • AD/HD determined by a pediatrician and a psychiatrist or psychologist • Teachers may be asked to complete a behavior rating checklist as part of the evaluation • Conner’s Rating Scale - R • Once presence is determined, there are assessments to help to determine the nature and extent of services. • ADDES-3

10. Partnering for Special Education and Related Services • Not every student with AD/HD qualifies for IDEA services • They may be able to receive services through Section 504 • One role of the IEP or 504 team is to develop educational plans that may or may not be used in conjunction with medication • Team members should never suggest a child needs medication. Only a doctor can make that determination. • Teams also cannot make taking medication a requirement of attending school.

11. Determining Supplementary Aids and Services • Arrange the classroom in a consistent manner • It is not always best to seat students with peers • Seat the student in close proximity to the teacher • Do not seat students with hyperactivity/impulsivity close to highly distracting areas • Clearly post daily and weekly schedules • Arrange the classroom to facilitate smooth transitions between classroom activities • Minimize classroom clutter

12. Planning for Universal Design for Learning • Planning for Universal Design for Learning • Students need to learn organization and neatness • Goal setting can improve organization skills • Identify and define a goal • Develop a series of objectives or tasks • Specify actions necessary to achieve desired outcomes • Make goals challenging but obtainable • Planning for Other Educational Needs • Teachers should play a role in monitoring children on medication for changes or side effects

13. Early Childhood Students • Multidisciplinary Diagnostic and Training Program • Multimodal treatments • Medication • Parent Training • Classroom Behavioral Management Interventions

14. Elementary and Middle School Students • Errorless learning • Presents discriminative stimuli and arranges the delivery of prompts in a learning situation in such a way as to ensure that the student gives only correct responses (or only a few incorrect responses) • Prompts can be physical, verbal, or visual • Premise is that learning that occurs without mistakes is stronger and lasts longer • Use “most to least” prompting, most intrusive at first, then, as task is mastered, prompts fade

15. Secondary and Transition Students • Cognitive behavioral and self-control strategies • Teach the use of inner speech, “Self-talk” • The purpose of cognitive behavioral strategies is to modify behavior and thinking patterns • Possible benefits of this method are increased capacity to self-control and self-regulate behavior

16. Measuring Students’ Progress • Progress In the General Curriculum • Curriculum-based management • Goal Attainment Scaling (GAS) process • Progress in Addressing Other Educational Needs • Monitor progress in areas such as social skills, self-control, medication management • T-Charts • Checklists

17. Making Accommodations for Assessment • Issues include attention and concentration problems • May qualify to take extra breaks • May need multiple testing sessions • May request a reduced-distraction testing environment