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Is Attention Deficit Hyperactive Disorder Masquerading in Your Family?

Enhancing Communications Between Behavior Specialists and Parents Presentation created by Shirley E. Kane Graduate Student at University of Pittsburgh – School of Education Department of Developmental Psychology Copyright 2007

Learner Objectives

• Define ADHD and be able to list the three major types of this disorder • Discuss the steps that may lead up to seeking a diagnosis for a child suspected of having ADHD • Identify interventions that can be implemented and used in both home and school environments copyright 2007, Shirley E. Kane ([email protected]) 2

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Attached to the study guide, which accompanies this presentation, there will be a list of Glossary Words. Please familiarize yourself with this list as you follow along throughout the presentation 3 copyright 2007, Shirley E. Kane ([email protected])

Attention Deficit Hyperactive Disorder (commonly known as

ADHD

or

ADD

)

• According to the DSM-IV-TR, ADHD is a disruptive behavior disorder. • It is characterized by the presence of chronic and impairing behavior patterns.

• The patterns display abnormal levels in one of three types: inattention, hyperactivity, or impulsivity. • Most times these behaviors will interfere with daily life skills, school work, and social settings.

Three categories of symptoms to look for in a child experiencing ADHD

1. Inattention

 Fails to give close attention to details  Makes careless mistakes in school work  Appears not to be listening when spoken to  Has difficulty organizing tasks and activities  Easily distracted by external stimuli  Forgetful in doing daily activities copyright 2007, Shirley E. Kane ([email protected]) 5

2. Hyperactivity

 Fidgets with hands and feet or squirms in seat  Often leaves seat in the classroom  Runs about or climbs excessively  Often talks excessively or out of turn

3. Impulsiveness

Prevalence

• Prevalence of children aged 4-17yrs in the U.S. who have been reported by parents as being ADHD diagnosed has been calculated at 7.8% • In 2003, ADHD was reported 2.5x more frequent among males than females, increasing with age.

• The greatest prevalence noted was among 16 year old males and 11 year old females. • Diagnosis in males reported more often in families with income below poverty threshold (<100%) • 4.3% of diagnosed children were reported taking medication for an ADHD disorder. [all prevalence information obtained from www.cdc.gov ] copyright 2007, Shirley E. Kane ([email protected]) 7

Heading Toward a Diagnosis

• Steps to Seeking a Diagnosis for ADHD  Seek to have the child evaluated: this process can be started by speaking to the child’s school  Encourage the parent to contact their own family physician for the child’s developmental evaluation and a comprehensive physical  A pediatrician, psychiatrist, or other mental health professional could conduct an ADHD assessment  The child’s history files may need to be reviewed and interviews could be done at this time copyright 2007, Shirley E. Kane ([email protected]) 8

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Suppose you had been observing a child you suspected of exhibiting symptoms of ADHD . To support your observations you began gathering some basic data using assessment recording tools.

Look at the action worksheet included in the study guide and check off any of the actions you would take next.

Legal Aspects of Childhood Mental Disorders • Section 504 a civil rights law that ensures the child with a disability has equal access to an education. This allows the child to receive accommodations and modifications.

• Chapter 14 state regulation that helps explain how children who need special education can get help from school districts • Chapter 15 state regulation that prohibits discrimination against persons with disabilities by school districts and agencies copyright 2007, Shirley E. Kane ([email protected]) 10

Understanding Section 504 • Part of the Rehabilitation Act of 1973 that prohibits discrimination of disability • School districts have the right and responsibility to establish their own policies and procedures • The child considered must be between ages 3 and 22, must be qualified depending on the program, and must have a mental or physical impairment • Placement decisions are made by a committee after reviewing what the child may need to perform major life activities. (This may or may not include parent input) • Data used include academic history, state assessments scores, observations, discipline reports, attendance records, and health records ( www.schwablearning.org

Understanding Chapter 14

A child is eligible if he/she has mental retardation, hearing impairment, speech or language impairment, visual impairment, serious emotional disturbance, orthopedic impairment, autism, traumatic brain injury, is other health impaired, or has a specific learning disability and because of this, needs specialized instruction. [Education Law Center (Rev. 8/06) 412-391-5225(Pittsburgh ); www.elc-pa.org] copyright 2007, Shirley E. Kane ([email protected]) 12

Understanding Chapter 15

A child is eligible if he/she has a physical, mental or other health impairment which substantially limits one or more major life activities such as learning, walking, seeing, hearing, speaking, breathing, or caring for oneself. Must not be eligible for Chapter 14 (must not require specialized instruction) [Education Law Center (Rev. 8/06) 412-391-5225 (Pittsburgh), www.elc-pa.org

AFTER a Child Has Been Diagnosed with

ADHD • Present to the parent, an informational brochure or newsletter, showcasing local resources • Discuss a behavior plan to the parent in detail, sharing various case studies and examples of checklists and goal charts their child can use at home • Suggest the child have some input on the behavior plan and understanding of the self monitoring process copyright 2007, Shirley E. Kane ([email protected]) 14

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Look at the CASE STUDY on 9 year old Alex that accompanies the study guide. Decide your course of action as the child’s Behavior Specialist recruited by the parent.

What would the conversation with the parent sound like?

Interventions Proven To Be Effective:

1. Behavior Therapy

Family Therapy Social Skills Training Individual Education Program

2. Medication Therapy

Using FDA Approved Oral Medications or Skin Patch

3. Combination Behavior & Medication Therapy

Behavior Therapies

• Family Therapy – utilize the support of the client’s experiences and interactions with family. Create a plan that combines home life goals with school life and social situations • Social Skills Training – client can be enrolled in individual or group settings that allow social interaction skills, teach self monitoring, and motivate by using reward programs • Individual Education Program – describes special instruction and related services child will receive, including goals and measurable progress laid out in a behavior plan copyright 2007, Shirley E. Kane ([email protected]) 17

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Meet with the parent and present ideas and professional advice on using data tools such as charts, checklists, and reward programs that will help the parent measure the child’s progress toward positive behavior and goals Look at the example chart and checklist included in the study guide. Be clear and patient with the parent when giving instructions on using these tools.

Remember: some parents may become overwhelmed

Medication Therapy

• FDA Approved Oral Medications: Ritalin (stimulant) Concerta (stimulant) Adderall (stimulant) Dexedrine (stimulant) Strattera (non-stimulant) • FDA Approved Skin Patch Daytrana (skin patch)

*Pamphlets on the above medications can be found at local pharmacies

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Some medications have adverse effects, especially on the small, uninhibited bodies of children. As a Behavior Specialist you can help the parent understand how to monitor their child’s symptoms for extreme changes in behavior once they begin medication therapy. Remind the parent the importance of reporting any changes to their child’s doctor. Help them acquire medication information from pharmacies, websites, and mental health resource agencies.

The study guide includes a Medication Monitoring Checklist created to monitor adverse reactions a child may be experiencing. Review this checklist with the parent and explain the details, giving them examples.

References Arehart-Treichel, J. (January 4, 2002) Problems of ADHD kids don’t end when bell rings. Psychiatric News, vol 7, number 1, p 22.

Centers For Disease Control. (November 2001). Attention deficit hyperactivity disorder diagnostic criteria. (NCBDDD Pub. No); www.cdc.gov Center For Disease Control. (2003). Mental health in the United States: Prevalence of diagnosis and medication treatment for attention deficit hyperactivity disorder relationships & adhd. (NCBDDD Pub No); www.cdc.gov Education Law Center (Rev 8/06) 412-391-5225 (Pgh). www.elc-pa.org; A comparison of the rights of a child with a disability who needs special education and a child who is a protected handicapped student.

Levin, A. (June 16, 2006). ADHD research spreads throughout the brain. Psychiatric News, vol.41, number 12, p 25.

Institute of Health. (n.d.) Attention deficit hyperactivity disorder. Retrieved September 14, 2007 from www.nlm.nih.gov

National Institute of Mental Health. (1994, reprinted 1996, revised 2003, reprinted 2006) Attention deficit hyperactivity disorder (Publication No. 06-3572); www.nimh.nih.gov National Resource Center on ADHD. (n.d.). Frequently asked questions. Retrieved September 14, 2007 from www.help4adhd.org Schwab, C., (Jan. 23, 2004). A parents guide to helping kids with learning difficulties; www.schwablearning.org

Science Daily, (September 24, 2007) Medication for ADHD may help students succeed in school. Retrieved September 22, 2207 retrieved from www.sciencedaily.com

CONTACT INFORMATION

If you wish to duplicate this document or any portion therein, please contact: Shirley Kane at [email protected]