EFTA01222886

AD/HD is a neurobiological 
disorder-
. 
" 
0 • 
school-age children. 
■ It nearly always 
persists from 
childhood through 
adolescence. 
■ Many symptoms 
continue into 
adulthood. 
. 
• 
e • - 
VII 
consequences including: 
School failure 
Family stress 
Depression 
Problems with 
relationships 
Substance abuse 
Delinquency 
Job failure 
9% is a new statistic just out - researchers at the Mayo Clinic and Centers for 
Disease Control and Prevention (CDC) featured a prevalence rate of 8.7% 
prevalence rate for children 8-15 years of age. If a teacher has a class of 20 
children, will have one or two students with ADHD. 
1 
EFTA01222886

AD/HD predominantly hyperactive-
impulsive type: (AD/HD-HI) 
■ Fidgets with hands or feet or squirms in chair. 
■ Has difficulty remaining seated. 
■ Runs about or climbs excessively. 
■ Difficulty engaging in activities quietly. 
■ Acts as if driven by a motor. 
■ Talks excessively. 
■ Blurts out answers before questions have been 
completed. 
■ Difficulty waiting for turn. 
■ Interrupts or intrudes upon others. 
Sometimes hyperactivity goes away in adolescence-typically not the inattentive 
piece 
Some people feel that students with hyperactivity don't have as many learning 
difficulties as AD/HD-I 
2 
EFTA01222887

AD/HD predominantly inattentive 
type: (AD/HD-I) 
W 
• 
or • 
. 
. 
. 
.. 
. 
• 
careless mistakes. 
■ Has difficulty sustaining attention. 
■ Does not appear to listen. 
■ Struggles to follow through on instructions. 
■ Has difficulty with organization. 
■ Avoids or dislikes tasks requiring sustained 
mental effort. 
■ Loses things. 
■ Is forgetful in daily activities. 
Young children go unnoticed in the early years-inform preschool teachers to 
watch for children who are off on their own not 
causing any trouble, but losing out on information. Some researchers believe 
that by Kindergarten, children with undiagnosed and untreated AD/HD 
demonstrate a 30% lower IQ score due to loss of information. 
3 
EFTA01222888

AD/HD combined type: (AD/HD-C) 
■ Individual meets both sets of inattention 
and hyperactivity/impulsive criteria. 
4 
EFTA01222889

Critical Questions to Ask 
■ Ara theca hohawinrc ovrocciwo Inns -term and 
pervasive? 
■ Do they occur more often than in other children 
the same age? 
■ Are they a continuous problem. not just a 
response to a temporary situation? 
■ Do the behaviors occur in several settings or 
only in one specific place like the playground or 
in the schoolroom? 
■ Did these symptoms occur before the age of 7? 
5 
EFTA01222890

Diagnosis 
■ There is no single test to diagnose AD/HD. 
Therefore, a comprehensive evaluation is 
necessary to establish a diagnosis, rule 
out other causes and determine the 
presence or absence of co-existing 
conditions. 
6 
EFTA01222891

An evaluation requires time 
and effort and should include: 
■ A careful history from parents and 
teachers, as well as the child, when 
appropriate. 
■ Clinical assessment of the individual's 
academic, social, and emotional 
functioning and developmental level. 
■ Checklists for rating AD/HD symptoms and 
ruling out other disabilities. 
Value of the historical interview; other family members with depression, 
underachievement, substance abuse 
7 
EFTA01222892

Professionals who can 
diagnose AD/HD are: 
• Clinical psychologists 
• Clinical social workers 
• Nurse practitioners 
• Neurologists 
• Psychiatrists 
• Pediatricians 
8 
EFTA01222893

AD/HD is a medical 
• ". • • osis-
■ NOT an educational diagnosis. 
Teachers can be very helpful by providing 
information for the family to share with the 
diagnosing professional - checklists, 
anecdotal information, medication 
monitoring, etc. 
States differ in their protocols for determining who qualifies for assistance. 
Students qualifying for extended time on SAT's 
9 
EFTA01222894

Students should receive a 
thorouah nhysical exam first to 
rule out other possible causes 
such as: 
Assessment of hearing and vision 
Thyroid dysfunction, other disorders 
Head injury 
Sleep Apnea 
A doctor asks about head injuries-then broken arms-"When I fell out of that 
tree!" 
10 
EFTA01222895

Possible causes of AD/HD-
like behavior: 
■ A sudden change in the child's life-the death of a 
parent or grandparent; parent's job loss. 
■ Undetected seizures, such as in petit mal or 
temporal lobe seizures 
■ A middle ear infection that cause intermittent 
hearing problems 
■ Medical disorders that may affect brain 
functioning 
■ Underachievement caused by learning disability 
■ Anxiety or depression 
11 
EFTA01222896

IL Took 
'
A
T
I 
■ -aren an• c I • e•uca ion a•ou 
diagnosis and treatment. 
■ Behavior management techniques. 
■ Medication. 
■ School programming and supports. 
■ Tailored to the unique needs of each child 
and family. 
The most widely referred to study among professionals is the MTA study 
which concluded that the one most effective treatment is medication alone; but 
multimodal treatment is the best 
12 
EFTA01222897

"Co-morbid Disorders" 
■ 
earning sisaci ies - I o '•o 
■ Tourette Syndrome - tics and repetitive 
mannerisms 
■ Oppositional Defiant Disorder - as many as 1/3 
to 1/2 (mostly boys) have another condition -
often defiant. stubborn, noncompliant, temper, 
belligerent 
■ Conduct Disorder - 20 to 40% of AD/HD children 
may eventually develop CD 
■ Anxiety and Depression 
■ Bipolar Disorder 
In pre-k - understanding certain sounds or words 
School-age - reading, spelling, writing, arithmetic disorders may appear 
Very few children have this syndrome, many of the cases of Tourette syndrome 
have associated AD/HD 
13 
EFTA01222898

What does an AD/HD 
diagnosis mean for a child? 
■Kids with AD/HD may be 
delayed as much as 30% 
of their actual age in their 
ability to pay attention 
and remember. 
This means that a 9 year old may act more like a 6 year old. 
Sending an undiagnosed, untreated eighteen-year-old off to college would be 
like sending a 12-year-old off to college-what structures would need to be in 
place in order for that student to be successful?! 
14 
EFTA01222899

The treatment of AD/HD: 
WHAT WORKS BEST! 
Accurate diagnosis - which should always 
include identification of talents and strengths. 
2. 
Implementation of a 5-step plan that promotes 
talents and strengths. 
3. 
Education about ADHD 
4 
Structure, strategies 
5. 
Counseling, depending on needs 
6. 
Complimentary and/or alternative treatments 
sleep, diet, exercise, 
Some doctors have said that as many as 70% of children diagnosed with 
ADHD are diagnosed in a 15 minute office visit with a pediatrician and a 
hysterical mother-urge families to get a full evaluation; medication should not 
be used to determine a diagnosis 
15 
EFTA01222900

MEDICATION 
■ For most children medication is an integral part 
of treatment. 
■ It is not used to control behavior. 
■ Medication is used to help important networks of 
nerve cells in the brain to communicate more 
effectively with each other. 
■ Between 70 and 80% of children with AD/HD 
respond positively to these medications. 
■ Medication does not cure AD/HD: when 
effective, it alleviates AD/HD symptoms during 
the time it is active (e.g.. an antibiotic) 
■ Eyeglasses or hearing aids example 
16 
EFTA01222901

Role of the Teacher 
■ Teacher does not make diagnosis. It is a 
medical diagnosis. 
■ Teacher is critical in providing observations and 
follow-up information. 
■ Know what AD/HD is and what it is not. 
■ Communicate with families. (80% have 1 parent 
with AD/HD) 
■ Identify child's strengths. 
■ Employ behavior interventions and education 
strategies and techniques to best meet student's 
needs. 
■ Structure and Routine - Brevity and Variety. 
17 
EFTA01222902

Areas of Concern 
■ Activating & getting started 
■ Irritability, depressed mood, sensitive to criticism 
■ Memory, recall 
■ Motor activity 
■ Compliance 
■ Academic skills 
■ Sustaining attention & concentration 
■ Sustaining effort 
■ Impulsiveness 
■ Organization & planning 
■ Socialization 
Every child with AD/HD is very different and needs a personalized plan 
18 
EFTA01222903

ACCOMMADATION BY 
TEACHER: 
■ Physical arrangement of room 
■ Lesson presentation 
■ Assignments/Worksheets 
■ Test taking 
■ Organization 
■ Behaviors 
■ Mood 
Seating arrangement-eye contact, next to teacher, next to good role models, 
study carrels for all 
Explanations, color-coding, 3-part directions, math-switch from adding to 
subtracting- error analysis 
Fewer problems 
Extended time-not unlimited time 
Using a computer for essays, KIDSPIRATION, note-takers, technology-tape-
recorders 
Books for home, positive feed-back, ignoring bad behavior, have students keep 
track of behaviors to make them more aware 
Most accommodations are just good teaching strategies-helpful for all kids, 
critical for kids with AD/HD 
Don't miss recess to stay in and complete work-more difficult in the next class 
19 
EFTA01222904

ACADEMIC SKILL: 
If reading is weak: 
If oral expression is weak: 
If written language is weak: 
If math is weak: 
Provide extra time; use "previewing" strategies; select text with less on a page; 
shorten amount of reading required; avoid oral reading 
Accept all oral responses, substitute display for oral report, give questions 
ahead of time, tell student when you are going to call on them-clue 
Alternative testing situations, extended time, use of technology 
Use of calculator 
"FAIR" DOES NOT ALWAYS MEAN EXQUAL - example of student who 
needed CPR 
20 
EFTA01222905