Attention Deficit Hyperactivity Disorder

And

Attention Deficit Disorder without Hyperactivity

 

 DSM-IV now defines the disorder (ADHD) as:

 

Attention Deficit/Hyperactivity Disorder, Combined Type

 or

 Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type

 or

 Attention-Deficit/Hyperactivity Disorder, Predominantly Hyperactive-Impulsive Type

 

 Diagnostic criteria for ADHD is as follows:

 

   A.Either (1) or (2)

 

   1.Six (or more) of the following symptoms of inattention have persisted for at least 6 months to

      a degree that is maladaptive and inconsistent with developmental level:

 

 Inattention

 

        a.often fails to give close attention to details or makes careless mistakes in

           schoolwork, work, or other activities

        b.often has difficulty sustaining attention in tasks or play activities

        c.often does not seem to listen when spoken to directly

        d.often does not follow through on instructions and fails to finish schoolwork,

           chores or duties in the workplace (not due to ODD or failure to understand

           instructions)

        e.often has difficulty organizing tasks and activities

         f.often avoids, dislikes or is reluctant to engage in tasks that require sustained

           mental effort (such as schoolwork or homework)

        g.often loses things necessary for tasks or activities (toys, schoolwork, pencils,

           books)

        h.is often easily distracted by extraneous stimuli

         i.is often forgetful in daily activities

         j.Six (or more) of the following symptoms of hyperactivity-impulsivity have

           persisted for at least 6 months to a degree that is maladaptive and inconsistent

           with developmental level:

 

 Hyperactivity

 

        a.often fidgets with hands or feet or squirms in seat

        b.often leaves seat in classroom or in other situations in which remaining seated is

           expected

        c.often runs about or climbs excessively in situations in which it is inappropriate (in adults

           or adolescents, may be limited to subjective feelings of restlessness)

        d.often has difficulty playing or engaging in leisure activities quietly

        e.is often "on the go" or often acts as if "driven by a motor"

         f.often talks excessively

 

 Impulsivity

 

        a.often blurts out answers before questions have been completed

        b.often has difficulty awaiting turn

        c.often interrupts or intrudes on others (eg. Butts into conversations or games)

 

 

 

   B.Some hyperactive-impulsive or inattentive symptoms that cause impairment were present

      before age 7 years

   C.Some impairment from the symptoms is present in two or more settings (school [or work], or

      at home)

   D.There must be clear evidence of clinically significant impairment in social academic, or

      occupational functioning

   E.Symptoms do not occur exclusively during the course of a PDD, Schizophrenia, or other

      Psychotic Disorder and are not better accounted for by another mental disorder (mood

      disorder, anxiety…)

 

 Attention-Deficit/Hyperactivity Disorder, Combined Type: if both Criteria A1 and A2 are met for

 the past 6 months

 

 Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type: if Criteria A1 is met but

 Criteria A2 is not met for the past 6 months

 

 Attention-Deficit/Hyperactivity Disorder, Predominantly Hyperactive-Impulsive Type: if Criteria A2

 is met but Criteria A1 is not met for the past 6 months

 

 Reif, S.A. (1993) suggests some of the following characteristics, as well:

 

 

 Frequency of ADHD

 

 Varies widely depending on studies you look at. It is estimated that 3 – 10 percent of school-age

 children are affected. The estimated figures most frequently cited in the literature are 3 – 5 percent,

 however.

 

 Causes

 

 Not known at this time for sure. Some possible causes include:

 

      Genetic: ADHD seems to run in families.

      Biological/Physiological: Some recent research suggests ADHD is a neurological

      inefficiency in the area of the brain which controls impulses and in the area that aids in the

      screening of sensory input and focusing attention.

 

      Dopamine is a chemical that helps transmit neurosensory messages. A lack of or

      imbalance of this chemical may create characteristics labeled as ADHD. Explanation is

      that when we concentrate the brain releases extra neurotransmitters which enable us to

      focus on one thing and block competing stimuli out. People with ADHD seem to have

      a shortage of these neurotransmitters.

 

      Complications or trauma during pregnancy or birth

      Lead poisoning

      Diet: Current research has not given much support to this, but it still remains a controversial

      issue in the medical community. More research is needed to confirm or refute this possible

      cause

      Prenatal alcohol or drug exposure

 

 Critical factors in working with children with ADHD

 

   1.Teacher flexibility, commitment, and willingness to work with the student on a personal level

   2.Training and knowledge about ADHD. Need to remember this is a biological issue and the

      student is not "out to get you".

   3.Close communication between home and school. Both parties need each other. Must keep

      lines of communication open

   4.Providing clarity and structure for the student. They need to know the expectations, rules,

      consequences, etc. Academically, tasks need to be broken down into manageable parts, with

      teacher modeling and guided instructions, clear directions, and feedback. They will need help

      in structuring their materials, desks, lockers, and transition times.

   5.Administrative Support

   6.Modifying assignments, cutting the written workload

   7.Limit the amount of homework

   8.Provide more time on assignment

   9.Teacher sensitivity about embarrassing or humiliating student in front of peers

  10.Environmental modifications

  11.Belief in the student---If plan A,B,C doesn’t work there is always plan D,E,F etc.

 

 Don’ts

 

   1.Don’t assume the child is lazy. There are other reasons for nonperformance.

   2.Don’t be fooled by inconsistency. Inconsistency in performance is a hallmark of children with

      ADHD. Sometimes they can, Sometimes they can’t.

   3.Don’t give up on any child. They can be trying and frustrating to a teacher. As frustrating as it

      is to you it is many times more frustrating to the child.

   4.Don’t give up on behavior modification techniques.

   5.Don’t forget to involve your support staff.

   6.Don’t forget to involve parents

   7.Don’t surround yourself with negative peers

   8.Don’t listen to previous teacher who only want to pass on negative traits about the child

   9.Don’t forget to be fair and make exceptions for students

 

Remember:

Fairness is giving everyone what they need.

Not treating everyone the same.