Understanding ADHD: Signs, Symptoms, and Effective Strategies for Support

1. ADHD Presented by: Bridget Connolly Assistant Principal of Student Services Niles North High School

2. ADHD • Attention Deficit Hyperactivity Disorder is a neurobehavioral disorder characterized by pervasive inattention and/or hyperactivity-impulsivity and resulting in significant functional impairment. • Predominately Inattentive • Hyperactive-Impulsive • Combined Type

3. How is it Manifested in School • As anadolescent, a student may display any of the following characteristics: • Displays poor organizational skills • Underachieves academically • Exhibits impulsive or risk-taking behavior • Engages in temper outbursts • Sometimes experiences legal difficulties

4. Diagnostic Criteria of ADHD • 6 symptoms of inattention and/or 6 symptoms of hyperactive-impulsive behavior (high frequency) • At least 6-month duration of symptoms • Onset of symptoms before age 7 • Symptoms occur across two or more settings • Symptoms have a significant negative impact on social, academic, or occupational functioning • Another psychiatric disorder (e.g. autism, mood disorder, anxiety disorder, psychotic disorder) is not the primary cause of symptoms

5. Common Symptoms for ADHD- Predominately Inattentive • Avoids tasks that require sustained attention • Daydreams (tends to stare into space) • Delays initiation or completion of tasks • Has difficulty listening to or following instructions • Does not pay close attention to details • Displays inconsistent academic performance • Forgets or loses materials • Demonstrates a slow speed of cognitive processing

6. Common Symptoms for ADHD- Hyperactive-Impulsive • Acts before thinking • Begins work before directions are given • Has difficulty delaying gratification • Makes careless mistakes in schoolwork • Does not wait turn in games or activities • Engages in risk-taking/dangerous behavior • Grabs things from others • Interrupts or intrudes on others • Blurts out comments in class

7. Common Symptoms for ADHD- Hyperactive-Impulsive (cont.) • Runs or climbs excessively • Has difficulty remaining seated • Fidgets with nearby objects • Taps pencil, feet, or fingers • Shifts position in seat frequently • Talks excessively • Experiences rapid changes in mood • Overreacts to negative situations

8. Prevalence Estimates • ADHD-Predominately Inattentive Type • 1.3% of school-aged children are diagnosed • ratio for boys to girls = 1:1 • ADHD- Hyperactive-Impulsive Type • most children identified are of preschool age • ADHD- Combined Type • 4% of school-aged children are diagnosed • ratio for boys to girls = 3:1

9. Associated Problems • 80% have achievement problems • 20–40% are diagnosed with learning disabilities (more common with ADHD- Inattentive) • 40% exhibit oppositional behavior in childhood (more common with ADHD- Combined) • 65% exhibit oppositional behavior as adolescents (more common with ADHD- Combined) • 25% engage in antisocial behavior (truancy, physical aggression, stealing- most often ADHD- Combined) • 50% have impaired social relationships • 25% experience comorbid emotional disorders

10. School-Based Assessment of ADHD Symptoms PURPOSES • To gather information for a potential medical diagnosis • To determine the extent to which attentional problems are interfering with a child’s academic, affective, and social needs • To perform a functional analysis of target behaviors for intervention

11. Assessment Methods • Parent and teacher interviews • Information should be obtained from multiple adults • Standardized behavior rating scales • Provides a normative perspective to assist in determining symptom severity • Direct observation • Systematic on-task observation and assessment of environmental and instructional variables

12. Not Proven Effective Interventions • Herbal supplements/vitamins • Biofeedback • Elimination diet (unless there is a sensitivity to food) • Caffeine (may work in short run, but in long run decreases blood flow to brain)

13. ADHD:What Works--Comprehensive Treatment Approach • Education/Parent Support Groups • Medication • Behavior Management at Home & School • Counseling--Individual & Family • Social Skills Training • School and Home Support Strategies • Physical Activity

14. ADHD Medications • Stimulants (effective for 70-90%) • Ritalin • Dexedrine • Adderall • Concerta • Cylert

15. Stimulant Side Effects • Decreased appetite • Weight loss • Growth inhibition • Insomnia/sleep disturbance • Irritability/weepiness • Abdominal pain • Headaches • Dizziness/drowsiness • Tics

16. Behavior Management • Clear, simple rules & consequences • Consistency • Eliminate emotion, talking/arguing • Giving directions--get attention, be firm, have repeat back to you, give time limits • Visual reminders • Break down assignments and homework • Keep on task with timer, stop-watch

17. Behavior Management, cont.Encouraging Good Behavior • Immediate Feedback, Frequent Rewards/Incentives & Praise • Frequent Change in Reward (Mystery Motivator) • Immediate Consequences for Selected Behavior (time-out, loss of privilege or points) • Positive Rewards Before Consequences • Plan Ahead for Problems • Priorities--Choose Battles • Don’t Personalize Problems

18. Behavior Intervention Plans • Describe the target behavior and its severity • Describe the function of the target behavior • Clearly describe the desired positivebehavior • Identify how the environment can be changed to decrease negative behavior • Identify reinforcers to maintain positive behavior • Describe the method for monitoring the behavior plan and who will be responsible

19. Suggested Classroom Modifications • Assign seating in close proximity to teacher instruction • Provide the student with a study carrel • Give only one or two-step directions at a time • Break assignments down in to smaller segments • Use a timer to monitor/ improve timely work completion • Vary instructional style and incorporate opportunities for active participation • Minimize visual distractions • Ensure a correct match between the difficulty level of the curriculum and the student’s abilities

20. Key Principles • Provide clear expectations for appropriate behavior • Post classroom rules • Use behavior contracts as needed • Provide specific and frequent verbal feedback • Name the specific behavior that was performed well or should be performed • Make consequences predictable • Use if/then statements • If you continue to …, then… • Provide brief, matter-of-fact redirections

21. Parents & Teachers Working Together • Communication • Weekly or daily progress reports • Assignment notebooks signed by both • Phone calls/e-mail • Checklists • Homework support • Regular time • Quiet place • Break down assignments/Set timer • Breaks--physical activity • Materials available • Monitor closely & reward good homework behavior • Check assignment books regularly

22. Concerns • If you have a concern about a student, please contact the student’s guidance counselor. • The student may or may not be eligible to receive additional support and assistance.

23. Resources • CHADD (Children and Adults with Attention Deficit Disorder) www.chadd.org • ADDA (Attention Deficit Disorder Association) www.add.org • LIDA (Learning Disabilities Association) www.ldanatl.org