ADHD
Wednesday, July 2, 2008

The most common symptoms of ADHD are distractibility, difficulty with concentration and focus, short term memory loss, procrastination, problems organizing ideas and belongings, tardiness, impulsivity, and weak planning and execution. Not all people with ADHD exhibit all symptoms. The Diagnostic and Statistical Manual of Mental Disorders categorises the symptoms of ADHD into two clusters: Inattention symptoms and Hyperactivity/Impulsivity symptoms. Most ordinary people exhibit some of these behaviors but not to the point where they seriously interfere with the person's work, relationships, or studies or cause anxiety or depression. Children do not often have to deal with deadlines, organization issues, and long term planning so these types of symptoms often become evident only during adolescence or adulthood when life demands become greater.

According to an advanced high-precision imaging study at the United States National Institutes of Health's National Institute of Mental Health, a delay in physical development in some brain structures, with a median value of three years, was observed in the brains of 223 ADHD patients beginning in elementary school, during the period when cortical thickening during childhood begins to change to thinning following puberty. The delay was most prominent in the frontal cortex and temporal lobe, which are believed responsible for the ability to control and focus thinking, attention and planning, suppress inappropriate actions and thoughts, remember things from moment to moment, and work for reward, all functions whose disturbance is associated with a diagnosis of ADHD; the region with the greatest average delay, the middle of the prefrontal cortex, lagged a full five years in development in the ADHD patients. In contrast, the motor cortex in the ADHD patients was seen to mature faster than normal, suggesting that both slower development of behavioral control and advanced motor development might both be required for the restlessness and fidgetiness that characterize an ADHD diagnosis. Aside from the delay, both groups showed a similar back-to-front development of brain maturation with different areas peaking in thickness at different times. This contrasts with the pattern of development seen in other disorders such as autism, where the peak of cortical thickening occurs much earlier than normal.[11]

The same laboratory had previously found involvement of the "7-repeat" variant of the dopamine D4 receptor gene, which accounts for about 30 percent of the genetic risk for ADHD, in unusual thinness of the cortex of the right side of the brain; however, in contrast to other variants of the gene found in ADHD patients, the region normalized in thickness during the teen years in these children, coinciding with clinical improvement.[12] Hyperactivity is common among children with ADHD but tends to disappear during adulthood. However, over half of children with ADHD continue to have symptoms of inattention throughout their lives.

Inattention and "hyperactive" behavior are not the only problems with children with ADHD. ADHD exists alone in only about 1/3 of the children diagnosed with it. Many of these co-existing conditions require other courses of treatment and should be diagnosed separately instead of being grouped in the ADHD diagnosis. Some of the associated conditions are: a. Oppositional Defiant Disorder (35%) and Conduct Disorder (26%). These are both characterized by extreme anti-social behaviors. These disorders are frequently characterized by aggression, frequent temper tantrums, deceitfulness, lying, or stealing. b. Primary Disorder of Vigilance. Characterized by poor attention and concentration, as well as difficulties staying awake. These children tend to fidget, yawn and stretch, and appear to be hyperactive in order to remain alert and active. c. Bipolar disorder. As many as 25% of children with ADHD may have bipolar disorder. Children with this combination may demonstrate more aggression and behavioral problems than those with ADHD alone. d. Anxiety Disorders. Commonly accompany ADHD, particularly Obsessive-Compulsive Disorder. OCD is believed to share a genetic component with ADHD, and shares many of its characteristics. Although children with ADHD have an inability to maintain attention, conversely, they may also fixate.[13]

There is evidence of hypothalamic-pituitary-adrenal axis (HPA axis) abnormalities in ADHD patients due to stress.[14]

How To Deal With An ADHD Student

K-12

Having a student in class that has been diagnosed with ADHD can be very frustrating, but there are a few things you, as a teacher, can do to make both of your lives a little easier.

  • Consult the experts: parents, previous teachers, specialists, guidance counselors, psychologist.
  • Have a sense of humor!
  • Promote high self-esteem: be friendly, respect opinions, provide immediate feedback, give reinforcement for any improvement.
  • Establish control: be consistent, follow definite rules, discipline offenses immediately, offer explanations for what rule was violated and be willing to listen to their side of the story.
  • Maximize academic improvement: allow for flexibility in amount of time needed to complete a project, offer alternatives to writing (ex. typing), establish small tasks leading up to the completed project, break it down.
  • Schedule activities to accommodate student's fluctuating energy levels: intermix high and low energy activities throughout the day, send student on errands if he or she has energy to burn, encourage active ways of answering questions during discussions.
  • Provide organizational tools: create checklists in order of priority, develop routine, label anything that is to go home.
  • Open up communication lines with parents: engage in frequent correspondence, encourage parental monitoring of homework, provide parents with a schedule of student' assignments.
  • Reward success: use stickers, post points on a chart, shake hands, smile, use verbal praise.
  • Utilize group work: encourage problem solving, teamwork, and cooperation.
  • Grab the student's attention: eye contact, give short, easy-to-understand instructions, insist that students repeat back information, use non-verbal cues to quite the students such as raising a hand or blinking the lights, give private cues that student is off-task such as a hand on their shoulder.
  • In general: provide variety with learning centers and group projects, test material learned and not attention span, respect students' input.

Source:Hogan, Dawn. ADHD: A Travel Guide to Success. Childhood Education, Spring 1997, Vol. 73, No. 3.
Submitted by: Kim Thompson

Tokens for Success

For: Attention Deficit Disorder

K-12

This article details how to use the Graduated Reinforcement System to keep students focused on their school work.

  • Identify Target Behaviors
  • On task most of the time
  • Attitude
  • Completes Work
  • Good Relations With Staff and Peers
  • Keeping to Yourself

    Planning for Record Keeping

  • form some type of chart where students can write down assignments and keep track of points for target behaviors
  • develop a point system
  • tally daily and weekly points

    Designate Reinforcement Criteria

  • determine what types of reinforcement will be at each level of criteria

    Awarding the Reinforcer

  • be consistent

Source: Lyon and Lagarde. Teaching Exceptional Children, Tokens for Success: Using the Graduated Reinforcement System Vol. 29 No. 6 July/Aug 1997, p. 52-57.
Julie Beuthien Strategy 3

Strategies for Teaching Children with ADHD

K-6

ADHD stands for Attention Deficit Hyperactivity Disorder and is problem teachers are facing on a regular basis in their classrooms. Dawn Hogan, a 2nd grade teacher from Connecticut, has assembled ideas for teachers to use to make teaching students with ADHD more productive and less stressful.

  • Teachers must be energetic and enthusiastic in regards to the task at hand.
  • Offer activities in which the child excels. This builds self-esteem.
  • Provide a calm, structured, and postitive environment. Be firm, patient, and consistent.
  • Modify assignments and activities to match their learning styles and abilities.
  • Offer opportunities for rest and relaxation for both teacher and student.
  • Organize tasks clearly and number them in order of priority.
  • Develop daily routines.
  • Construct positive relationships with the parents.
  • Reward the students for positive and desired behavior.
  • Encourage a cooperative environment, not competitive.

When teachers have accomplished these objectives, they have arrived at the goal of having children motivated to learn.

Childhood Education, Spring 1997 ADHD: A Travel Guide to Success

Submitted by: J.J. Stout

Using Children's Books to Help ADD Students

Level K-6

Though the typical ADD child is prescribed medication and behavior management programs to deal with their invisible disorder, some teachers and parents are recommending children's literature to help them cope.

Why are books prescribed?

  • they discuss personal problems/concerns of ADD children
  • they illustrate their favorite characters in similar situations as their own

What kinds of issues are addressed?

  • differences/similarities between ADD kids and normal learners
  • handling criticism
  • understanding strengths/weaknesses
  • developing study skills needed to grow socially and emotionally

What process takes place?

  1. Identification-child can identify with characters in the book
  2. Catharsis-child can express feelings and rid of tensions that exist
  3. Insight-child develops an understanding of his/her feelings
  4. Universalization-child recognizes that he/she isn't the only one who struggles and is different

What are the benefits of this strategy?

  • prompts discussion about the disorder
  • helps students vent frustrations/anger
  • helps them realize that they aren't alone and that it's okay to feel sad and angry
  • helps ADD students maximize their full potential

Source: "Teaching Reading." The Reading Teacher, Feb 1997, v50, no.5, 442-445.

Submitted by: Sarah Fosdick

Teaching Children with ADHD

Levels K-6

Consult the experts: meet with the child's parents, the child's previous teachers, and appropriate education specialists. The school nurse and pediatrician will have to be involved if medication is prescribed. Other valuable information may come from the child's cumulative records and Individual Education Plans on file. Be sure to inform art, music, or P.E. teachers of any needed adaptations for the student.

Engage in personal, friendly conversation with the students. Show that you value their opinions, and include them in the decision-making process when possible. Validate their strengths; offer activities in which they can excel. Respond to improvement.

Provide a calm, structured, positive environment. Establish clear standards of behavior and post realistic, predictable consequences for infractions. Immediate and consistent feedback is important, as well as modeling positive behavior instead of focusing on the negative. Children with ADHD often act without thinking, so help them develop an awareness of their behavior. For example, using "I-messages" to explain feelings to children after they are disruptive helps the child become more conscious. Then, discuss the incident and brainstorm possible solutions together.

Make sure that assigned work is within or just beyond the child's capabilities; material may need modification. At times it may be necessary to put work aside temporarily; try to mix high and low interest tasks. Dividing long assignments into parts make them more manageable.

When ADHD children become upset, a time-out may be helpful to allow them time to think quietly about the conflict and resolve it on their own. Children can rejoin the group when they feel calm and in control.

Fatigue, stress, and pressure can test children's self-control and lead to inappropriate behavior, so provide opportunities for rest and relaxation throughout the day. Examples include stretching or quiet times. Overactive children who need movement can run errands, sharpen pencils, or water plants. Children can stand up, sit down, or raise hands to answer questions. Engage children in interactive learning.

Select a peer partner to model organization skills and offer assistance. Children do not always know how to initiate and complete a task on their own. To help them, organize written assignments by utilizing checklists the children can refer to as they work, numbering items in order of priority. Develop daily routines and prepare students for any change in the procedure to avoid disorientation. Ensure homework gets home by labeling folders as homework, corrected assignments, and teacher/parent correspondence.

Develop positive relationships with parents. Frequent communication is helpful, even daily parent-school reporting. Help parents be involved in the homework by writing the assignment in clear terms, including a homework schedule with due dates and places for parents to sign after work is done. Suggest parents provide a quiet study space at home away from the distractions of tv, video games, and busy family activities. A set time for homework benefits ADHD children's need for structure and predictable routine.

Positive reinforcers can be tangible "prizes" such as stickers or points earned on a displayed chart. Other rewards include a smile, nod, pat on the back, or word of praise, which may be better long-term. Encourage self talk, where students talk about how good behavior is self-gratifying. As a teacher praising the children, use their name and a description of what they did right.

SOURCE: Hogan, Dawn. "ADHD: A Travel Guide to Success." Childhood Education, Spring 1997, Vol. 73, No. 3.

Annalese Racheter

How to Manage Your Students With ADD/ADHD

K-12

The article gives various methods of dealing with ADD and ADHD students. It recommends that before you begin to use these techniques you request an evaluation by a multidisciplinary team, if available, for the student. Along with the guidelines below, the article also lists helpful strategies when teaching reading, writing, phonics/grammar, spelling, and mathematics.

The following are the guidelines found in this article:

  • Seat the student away from distractions.
  • Keep classroom uncluttered and well organized.
  • Give only one direction at a time.
  • Use visual aids to aide

Kristi Viehl

Here are some tips for a teacher who has a student with Attention Deficit Order in his/her class:

  • minimize distractions by putting the child's desk close to yours and in a quiet place
  • provide a strict routine and have small segments of work followed by breaks
  • keep a chart that tracks the student's tasks to keep him/her focused
  • frequently ask the child to repeat oral instructions
  • adjust your expectations and the student's workload; realize that sometimes students with ADD cannot do the same amount of work as other students
  • coach the student on how to make friends and how to play appropriately with others
  • concentrate on only dealing with the serious behavioral problems so that the student does not become overwhelmed
  • keep a behavioral chart and reward the student for good behavior

Source: Learning. January 1992. p. 49
Betsy Posekany

Here are some GREAT tips for helping your students who have ADHD gain achieve more in your classroom!

  1. BE INFORMED. Learn all you can about ADHD - characteristics, it's effects on learning and behaviors, ect... Parents of ADHD children are you best source for help but here are a few more places: 
         Children with Attention Deficit Disorders(CHADD)
       499 Northwest 70th Ave. Suite 308
       Plantation, FL  33317
       (305) 587-3700
       put out newsletters and manuals for parents and teachers
      
       ADHD WareHouse (800)233-9273
       *puts out books, videos and training programs for ADHD
  2. MOVE TOWARD A PROJECT-BASED CLASSROOM. Allow students to choose from a variety of methods to show what they know - oral presentations, art projects, creative drama, ect..
  3. OFFER CHOICES. But don't offer too many! ADHD students may feel overwhelmed with too many. Offer choices that the students will enjoy carrying out and staying on task with.
  4. GIVE KIDS THE TOOLS TO COMPENSATE FOR SHORTCOMINGS. Let your students use the word processor and spell checker if their writing is not neat and they have a hard time spelling, make checklists of steps your students need to take to complete a certain task or project inwhich they can physically check off when they accomplish part of the task.
  5. MAKE DIRECTIONS AS EASY TO FOLLOW AS POSSIBLE. Always have the students attention before starting to introduce something new. Give students time to beging homework in class before they leave to help answer questions that could arise.
  6. MONITOR PROGRESS. Look at the students assignment notebooks and/or folders on a regular basis to make sure they are doing what they are suppose to. Ask them to tell you about the goals they have for some of their assignments, feelings about your class, ect..
  7. USE ALTERNATIVE ASSESSMENTS TO MEASURE LEARING. Don't rely only on the traditional standardized tests where you sit for a long time and fill in bubbles. To an ADHD student that could be tourture. Try such ideas as orally giving a test, projects like discussed earlier, ect..
  8. ASK FOR HELP. Your ADHD student could be entitled to a classroom aid or some other type of services under section 504 of the Rehabilitation Act. Check with your principal or superintendand to find out how to get help.

From: Weaver, Connie. Eight Tips for Teachers with ADHD Students. Instructor, May/June 1994.
Submitted by: Melissa Gutshall

Five Strategies - Level: K-6

Five strategies that take advantage of student interests to provide motivation, and encourage general and special education teachers to collaborate in ensuring the success of all learners in the classroom. These strategies were used in a class with students who exhibited: ADHD, hyperactivity, disorganization, poor motivation, and lacked a positive self- concept.

  1. Collaboratively assess reading skills. Assess the students' reading word-recognition and comprehension strengths and weaknesses, through informal reading inventories and teacher observation
  2. Assess students' interests and encourage choices
    Present several topics to choose from (if available) to the students. This allows them to choose areas they have had experience with or that interest them.
  3. Gather materials for students' choices
    After the topic has been chosen, the student and teacher begin gathering materials on the topic. Together, they establish learning objectives such as stating basic facts.
  4. Integrate curriculum materials
    A discussion on what has been found on the topic is started. Encouragement for students' listening, oral and written language skills are expressed by the teacher, rather than through skill-and-drill practices.
  5. Plan for exhibits and celebrations
    Plan a "final" activity for the study unit; showcase the students' work, allowing them to "share" their own projects.

Source: Teaching Exceptional Children. "5 Steps to Collaborative Teaching and Enrichment Remediation." v29 n1 Sept/Oct 96 p8-10 written by: Angle, Bernadette
TRICIA LINDENMAN

spelling

Level: K-4

  • Scramble the letters of the words on the child's list and have him/her rearrange the letters to spell the words.
  • Let the child write out his/her spelling words with colored glue onto notecards. When the glue has dried, have the child trace over the letters with his fingers. The success of this has been researched and it has been found that ADHD students "selectively attend to novelty such as color, changes in size, and movement." The color and texture help the child to learn in a way that is specified to his/her needs.

Source: Fachin, katharina. "Teaching Tommy: A second-grader with Attention Deficit Hyperactivity Disorder." Phi Delta Kappan. Feb. 1996. Sheramee Werner

Ensuring Success for Students with ADD

level: K-8

The following strategies can help, whether the student is taking medication or not.

  1. Seat the student near you and maintain frequent eye contact.
  2. Give clear instructions. When giving oral directions, make sure you have the child's attention before speaking.
  3. Teach and model organizational skills. Explain the meaning of specific verbal and nonverbal cues and establish a method of note-taking. Give the student a daily or weekly assignment sheet and use a consistent format for passing out and collecting papers.
  4. Build on the child's strengths. Ask the fidgety child to be your helper so he can move around more.
  5. Acknowledge appropriate behaviors. Provide positive feedback. Try using a reward system to help monitor the child's performance.
  6. Assess the child's progress regularly. Check that assignments have been handed in and that any missed work or tests have been made up.
  7. Work closely with parents and share your observations with them. Take corrective action immdeiately to help the child stay on track.

Source: Anusavice, Sandi. Learning vol.24 no.1 Aug. 1995.

Pam Vande Berg

to help improve the learning environment of the class

Level: K-6


  2. Have the student sit close to the teacher.
  3. Surround the ADHD student with good students to serve as positive role models.
  4. Put extra materials away to minimize distractions.
  5. Enhance listening skills by maintaining good eye contact before giving instructions, placing a hand on the student's shoulder, and making instructions clear and concise.
  6. Establish very specific rules such as "Stay in your seat" and "Do not talk" as opposed to "Be good."
  7. Repond immediately when disruptive behavior occurs.
  8. Establish incentive program based on points or tokens to help in classroom management.
  9. Help them develop self-esteem by smiling, saying pleasant words of praise or recognition, hugging, or giving the student a note of approval.
  10. Establish realistic and achievable goals.
  11. Develop a good relationship with parents.

Source: McFarland, Dianna L., Rosemarie Kolstad, and L.D. Briggs. "Educating attention deficit hyperactivity disorder children." Education. Summer 1995, v115, no. 4, p597-603.

Submitted by: Dawn Schroeder

Organizational Skills

Levell: K-5

Teachers should place a high priority on being organized even though an ADD or ADHD child may find this difficult. Below you will find a list of ways tto be organized.

  1. Establish rules for neatness early so that students appriciate your concern for quality work.
  2. Spot check desks to encourage cleanliness and order.
  3. Make sure notebooks have proper deviders for different subjects and the student uses clearly identified folders for work which is returned.
  4. Have the students write themselves reminders. This helps them keep on task.
  5. Insist the student use a homework journal.
  6. Keep extra supplies for the student to barrow. This will help them stay on task if they know they have something to look forward to.
  7. Compliment the student when you see improvements in neatness and organization.

Source: The ADD Hyperactivity Handbook for Schools by Harvey C. Parker, Ph.D., Page 188.

Felicity Carpenter

Attention Deficit Disorder: Helping the Whole Student

Level: All Levels

These suggestions go beyond the smiley faces and point strategies teachers often use and help teachers to reflect on the students true nature. Both the home and school can benefit from these ideas!!

  1. Cognitive. Add different skills such as, self-talk, biofeedback training, meditation and visualization to the learning process.
  2. Ecological. Provide learning spaces which use music and art to calm or stimulate. Each child has times where he or she is more alert - find those times and accomplish harder tasks then. Provide a balanced breakfast. Limit television and video games.
  3. Physical. Develop and/or work with the physical education instructor to include martial arts training, physical touch and appropriate movement, physical relaxation techniques, as well as, outdoor activites, noncompetitive sports and games.
  4. Emotional. Build self-esteem by being a positive role model, providing positive images of the future, offering individual psychotherapy and identifying talents, strengths and abilities.
  5. Behavioral. Use personal contracts to help develop each child's learning, consistent rules, routines, and transitions, involve the child in selecting strategies and provide immediate feedback.
  6. Social. Use stress effective comminication skills, class meetings, peer and cross-age tutoring and cooperative learning.
  7. Educational. Use hands-on learning, computers, high stimulating learning resources, creative development, whold language and attention-grabbing activities.

Source: Armstrong, Thomas. A Holistic Approach to Attention Deficit Disorder. Educational Leadership, February 1996. pp34-36.

Melissa Gutshall

Developing organizational skills

Level: K-6

  1. Use a timer to keep kids on schedule. For example, set the timer to let a student know when finish an activity and begin to clean up.
  2. Keep a daily picture schedule. Take photographs of daily events. Then, non-readers can look at it to keep track of the daily activities.
  3. Use index cards to record the proper order for certain procedures. For example, if a student has difficulty remembering how to participate in a classroom discussion, write down the steps (raise your hand, wait to be calledon, speak in soft voice) on an index card. Then tape the card to their desk. When the student shouts in class to get attention, point to the card.

Source: The February 1996 issue of Educational Leadership.

Mindy Miles

Teaching and Rewarding System for a Student Diagnosed with ADHD

Level: Any (Although many techniques are aimed at elementary age)

  1. Offer an activities based curriculum that will tap into the child's energy and creativity.
  2. Teach abstract ideas concretely and contextually. Allow a type of hands on instruction when possible.
  3. Use and adapt behavior modification techniques and relaxation excercises that fit the child's interests and personality.
  4. Get the support of the class in dealing with the child through peer tutoring groups and copperative learning groups.
  5. If necessary, and in extreme cases, get the child on medication for ADHD.

Source: Phi Delta Kappan, Volume 77, Number 6, February 1996.

Jason Dagel

Strategies for teaching children with Attention Deficit Hyperactivity Disorder

  1. Become informed about Attention Deficit Hyperactivity Disorder.
  2. Allow students to use different methods for demonstrating what they have learned. For example, they could give an oral presentation or do an art project.
  3. Offer choices to the students to keep them interested.
  4. Give students tools such as word processors and spellcheckers to make up for shortcomings.
  5. Make directions easy to follow.
  6. Monitor the progess of all students.
  7. Use methods other than standardized testing to measure learning.
  8. Ask for help. An ADHD student may be entitled to a classroom aide or other special services.

Source: Weaver, C. Eight Tips for Teachers with ADHD Students, Instructor. @ May-Jun 1994.

Submitted by: HOLLANDS

Posted byDoc Junhel at 3:45 PM  

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