Transcript ADHD Presentation by Tammy and Suzanne Nov 2012

Attention-Deficit /Hyperactivity
Disorder (ADHD)
Prepared by:
Tammy Taypotat
&
Suzanne MacArthur
Overview
 Definition
 Diagnosis Criteria
 Characteristics
 Causes
 Treatment
 Engagement activity
 Classroom Strategies
 Environment Accommodations
 Resources
 KWL Chart
 Let’s see what you know, what you would like to know and
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then after what you learnt.
Excellent strategy for engaging students in their own
learning and gives you a quick snapshot of what to stress
while teaching, and see what they learnt.
Think (give wait time- (25 seconds) this strategy is very
important for students with AD/HD).
Pair and share.
Jot down what you ‘Know’ and what you ‘Want To Know’.
Definition of AD/HD
Attention-deficit/hyperactivity disorder describe children who
display persistent age-inappropriate symptoms of inattention,
hyperactivity, and impulsivity that are sufficient to cause
impairment in major life activities.
(American Psychiatric Association [APA], 2000)
Criteria
 Because everyone shows signs of these behaviours at one time
or another, the guidelines for determining whether a person
has AD/HD are very specific.
 Children - the symptoms must be more frequent or severe
than in children of the same age.
 Adults - the symptoms must be present since childhood and
affect one’s ability to function in daily life.
DSM-IV Criteria for Diagnosis
• Six or more inattention symptoms or six or more hyperactivity-impulsivity
symptoms
•
Symptoms must be inconsistent with the child’s current developmental level
• Must persist to a degree that is considered maladaptive for at least six months
Additional DSM-IV Criteria
• Some symptoms present before age 7
• Impairment from symptoms must be present in at least two types of settings
• Clinically significant impairment in school, social or occupational functioning
• Symptoms do not occur solely during a pervasive developmental disorder or
psychotic disorder
• Symptoms are not accounted for better by another mental disorder
Inattention
1.
Often does not give close attention to details or makes careless mistakes in
schoolwork, work, or other activities
2.
Often has trouble keeping attention on tasks or play activities
3.
Often does not seem to listen when spoken to directly
4.
Often does not follow instructions and fails to finish schoolwork, chores, or
duties in the workplace
5.
Often has trouble organizing activities
6.
Often avoids, dislikes, or doesn't want to do things that take a lot of mental
effort for a long period of time
7.
Often loses things needed for tasks and activities
8.
Is often easily distracted
9.
Is often forgetful in daily activities
Hyperactivity
1. Often fidgets with hands or feet or squirms in seat
2. Often gets up from seat when remaining in seat is expected
3. Often runs about or climbs when and where it is not
appropriate
4. Often has trouble playing or enjoying leisure activities
quietly
5. Is often "on the go" or often acts as if "driven by a motor"
6. Often talks excessively
Impulsivity
1. Often blurts out answers before questions have been
finished
2. Often has trouble waiting one's turn
3. Often interrupts or intrudes on others (e.g., butts into
conversations or games)
Subtypes
Predominantly Inattentive Type
• Children who only meet the criteria for inattention
Predominantly Hyperactive-Impulsive Type
• Children who only meet the criteria for hyperactivity-impulsivity
Combined Type
• Children who meet the criteria for both inattention and
hyperactivity-impulsivity
Causes of AD/HD
• AD/HD is a medical disorder despite many myths
• Early theories thought minor head injuries or brain damage were
the cause
• The exact cause is currently unknown, but it is now thought to be
caused by biological factors that influence neurological activity
• Genetic influence
• Toxins in the environment
• The use of drugs/alcohol during pregnancy
• Environmental/family influence
Video on AD/HD
 http://www.youtube.com/watch?v=u82nzTzL7To&feature
=player_detailpage
Treatment
• A complete medical evaluation should be conducted
• The condition can be diagnosed when appropriate guidelines
are used
• Multimodal approach
• Treatments include medication, skills training, and behaviour
modification
• Considerations include the type and severity of AD/HD,
age, overall health, level of physical activity, accompanying
medical or psychological issues and family concerns
Empirically Proven Treatments
 Parent education about AD/HD
 Psychopharmacology
 Parent training in child management
 Family therapy for teens: problem solving, communication training
 Teacher education about AD/HD
 Teacher training in classroom behaviour management
 Learning support services
 Regular physical exercise
 Parent/client support groups
Myth or Fact?
 Engagement activity/Check in!
Myth or Fact?
 AD/HD is not a real medical disorder.
Myth or Fact?
 AD/HD is the result of bad parenting.
Myth or Fact?
 Children with AD/HD eventually outgrow their
condition.
Myth or Fact
 People with AD/HD are stupid or lazy- they never amount
to anything.
Myth or Fact?
 Children who take AD/HD medications are more
likely to abuse drugs when they become
teenagers.
Myth or Fact?
 Individuals with AD/HD receive more driving citations
and accidents.
Myth or Fact?
 Children who are given special accommodations because of
their AD/HD are getting an unfair advantage.
Myth or Fact?
 Elimination Diets-removal of sugar, additives, etc is an effective
treatment for individuals with AD/HD.
 What can we do???
 There is no easy button
 Remember no one shoe or strategy will fit all students
Clear Expectations
• Classroom expectations
• First need teach expectations / rules as well as the consequence
• Stated them clearly, use visuals
• Review daily and periodically check up on them
• Make consequences immediate and relevant
• Act don’t Yak
• Provide frequent feedback for following the rules
• Also students with ADHD need positive
reward/reinforcements
Instruction
• Use scaffolded instruction to help students:
• Understand the requirements of the task
• Identify, plan, and organize the steps needed to accomplish the task
• Select effective and efficient strategies to complete the task
• Use visuals
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Agenda on the board
Supplies needed
Week at a Glance
Steps to an assignment
Placing a check mark when completed or scratching off to do list
• State instructions clearly
• Ask student to repeat directions out loud or utter softly to self or
check with a neighbour for clarity
Anticipation
• Anticipation is the key with children with AD/HD. This
means that teachers must be mindful of planning ahead in
managing children with this disorder, particularly during
phases of transition across activities or classes
• Ensure students are cognizant of the shift in rules and
consequence that are about to occur
• Prompt students to recall the rules of conduct in the upcoming
situation, repeat them orally and recall reinforcements and
consequences before entering that activity or situation
• Think aloud, think ahead.
Classroom Strategies Continued
 Visual schedule
 Access to hand tools
 Body tools
 Provide frequent physical exercise breaks
 Multi-modal presentation: video
 Think, pair, share
 Check in for understanding: whiteboard
 Study-buddy
Classroom Strategies Continued
 Use daily or weekly school attending behaviour card
 Move to self-evaluation after 2+ good weeks
 Alternate low appeal with high appeal activities to maintain
interest level
 Be animated, theatrical and dramatic when you teach
Classroom Strategies Continued
 Schedule the most difficult subjects in first few periods of the school day when
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attention span is at its maximum for a student with AD/HD
Use direct instruction, programmed learning, or highly structured or
regimented teaching materials that have short assignments, clear goals, and
frequent feedback for demonstrating mastery of the material
Be sure the instructional material is at the student’s level and if they require
adaptation make sure they are implemented
Structure the classroom so that there is very little down time
Have the student pre-state their work goals (How many problems can you do?)
students are more likely to do an assignment they have chosen then one
imposed on them
Classroom Strategies Continued
 Train keyboarding and word processor as early as possible given
the high occurrence of fine motor coordination and handwriting
problems associated with AD/HD
 Provide extra help sessions, tutoring, books on tape, videos to
reinforce concepts or lessons taught
 Teach jot notes during lectures and while reading
 Students should be taking brief notes of key points in what they are reading,
viewing, or listening to
Accommodations
 “On the clock” testing
 Vary assignments and testing of knowledge through other
mediums (allow for choice)
Organization
 Allot for time at end of day for organization
 Provide written syllabus as handouts/overview to review and study
 Find a “Coach” or “Mentor” at school who will give just 15 minutes to
help teen
 The Coaches’ office is the student’s “locker”
 Schedule in three 5-minute checkups across each school day – teens goes to
Coach at that time for review of school day, help with staying organized,
monitoring a homework assignment sheet, tracking them through a daily
behavior report card, and giving them a motivational pep talk to get through
to next checkup
 Colour code binders and other commercial organizers
 Colour code text using highlighters for marking key points in the text;
then write these highlighted key points down on paper after the reading
is done
Environment
 Seat the student with AD/HD close to teaching area to permit more
supervision and frequent accountability for conduct, and to monitor and
reinforce the child’s on-task behaviour.
 Seat the student near a student role model. This seat arrangement provides
opportunity for student to work cooperatively and learn from their peers in
class.
 Provide low distraction work areas:
 Seat student away from distracting windows, doors, or bulletin boards
 Make quiet, distraction free area for quiet study time, test-taking and break. Students
should be directed to this room or area privately and discreetly in order to avoid the
appearance of punishment
 Limit visually distracting stimuli hanging on walls and ceiling
 Permit listening to music at a reasonable low level
Fidgets
 Why?
 Self-regulation
 Optimize attending behaviours
 Optimize auditory processing
 Optimize cognitive process
 When?
 Class discussions
 Oral lesson
 Assemblies
Consideration for classroom fidget use
 Consideration for classroom use
 Individual need
 Safety
 Soundless
 Repetitive, rhythmic actions
 Actions do not require vision
 No goal or end product
 Provision of proprioception
 Limited emotional appeal
 (Yack, 2012)
Physical activity
 Reduces stress and anxiety responsiveness
 Decreased hyperaroused state
 Increased mood, motivation, self-efficacy
 Increases noted in reading comprehension and arithmetic;
enhancements in inhibitory control, allocation of attentional
resources and processing speed (Pontifex et al., 2012)
 Motivate and enable students to participate in moderate daily
physical activity
 Provide opportunity for movement breaks throughout the
day (> 1 movement break/class)
Exit Slip
 KWL chart
 What did you learn or what is one thing you are going to try?
Free Resources
 Teaching Children with Attention Deficit Hyperactivity Disorder: Instructional
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Strategies and Practices, 2008, http://www.ed.gov, This will lead you to their
primary index, in “Search” box in upper right corner, type ‘adhd’, will lead you to
list of articles, click on Teaching Children with AttentionDeficity Hyperactivity
Disorder… Can be downloaded and printed
How to Teach and Reach Children with ADHD by Sandra Reif
The Gift of ADHD by Lara Webb-Hanos
The ADHD handbook for Schools by Harvey Parker
http:/bced.gov.bc.ca
http://education.alberta.ca
CHADD: Children and Adults with Attention Deficit Hyperactivity Disorder,
www.chadd.org
Russell Barkley Official Website: www.russellbarkley.org
Movement breaks:
http://lburridge.pbworks.com/w/page/37694036/Get%20up%20and%20learn
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