Transcript Attention

Attention-Deficit
Hyperactivity
Disorder
Catherine Jones-Hazledine
2/2/06
Symptoms
(Must have 6 of these, present for 6 months, before age 7)
Inattentive Type
 Fails to attend to details, makes
careless mistakes
 Difficulty sustaining attention in
play or work
 Does not listen when spoken to
 Does not follow through
 Difficulty organizing tasks
 Avoids tasks requiring sustained
mental effort
 Loses things needed
 Distracted by extraneous stimuli
 Often forgetful
Hyperactive-Impulsive Type
 Often fidgets hands/feet or
squirms
 Often leaves seat when sitting is
expected
 Runs about or climbs excessively
 Difficulty playing or engaging in
leisure activities quietly
 Often “on the go”
 Talks excessively
 Blurts out answers before
questions completed
 Difficulty awaiting turn
 Interrupts or intrudes on others
Things to Rule Out
Depression/Anxiety
 Drug/Alcohol Use
 Academic Problems
 Physical Illness
 Home problems

Assessment

Parent
 Parent
interview to obtain history
 Standardized rating scales
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School
 Academic
testing, if applicable
 School History
 Standardized rating scales

Clinic observations
Treatments
Drug Therapy
 Behavioral Interventions
 Combined Approach

Medication Pros/Cons
(thanks to Dr. Jodi Polaha)
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Can decrease disruption
Increased on-task behavior
Increased productivity
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Not effective for all kids
Compliance issues
Side-effects
Only works when taken
Does not impact some
problem areas
Some children should not
take
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Under 6
Anxious
Thought disorder
 Tics or Tourettes
What Causes ADHD?
(Russell Barkley, 2000)
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Bottom line: We don’t know yet…
Possibilities
 Deficiencies
in neurochemicals
 Lower electrical activity in the brain
 Less blood flow to areas of the brain
 Structural changes in the brain

What it is NOT:
 Bad
parenting
 Too much sugar
 Too much t.v.
What It Isn’t
What it Is
(Barkley, 2000)
What it isn’t
 Not a problem simply
filtering information
 May not be an issue
of simply being “more
distractible”
What it is
 Being easily bored
with activities
 Being drawn to most
rewarding parts
 Problem delaying
gratification
 Problem controlling
impulses
New Conceptualization
Russell Barkley, Ph.D
“ADHD is a delay in the development of
behavioral inhibition”
Impacts executive functioning, rather than
processing
 Results in problems with persistence and
motivation

Co-occurring Problems
ODD
 Learning Disabilities
 Poor social relationships
 Family conflict
 Depression
 School resistance

Rules for Schools
(Barkley, 2000)

Keep instructions brief and clear
 Visuals,
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charts, lists good
Make commands effective
Rewards and consequences delivered promptly
Frequent feedback
Rewards should be used first, more often
Rewards must be more powerful
Rewards should be changed frequently
Strategies for Learning
(Barkley,2000)
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Be sure tasks are matched to academic ability
Intersperse active with passive tasks
Keep assignments brief
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Keep time-limits short
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Timers can help
Feedback immediately
More academic am, more active pm
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Assignments for child 30% younger
Concentration and inhibition decrease over day
Classroom placement CAN make a difference
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Decreases attention from other students
 More opportunities to cue
Strategies for behavior
Positives
 Strategic use of
attention
Consequences
 Ignoring
 Must
sometimes teach
other students to do
this, too
 Cues
to remember can
be helpful (e.g. coins
in pocket)
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Tangible rewards
Token programs
 Can
be used with
entire class
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Time-outs
Partnering with Parents
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Home-school note program
 Provides
frequent feedback on behaviors
 Opportunities for teacher to reinforce
throughout the day
 Information can be easily conveyed to parents
 Rewards/consequences can be delivered at
home
References
Barkley, R.A. (2000). Taking charge of
ADHD. New York: Guilford Press.
 Polaha, J. (2004). An ADHD Primer:
Diagnosis and Treatment for Educators.
Presented at annual conference titled
Addressing Issues Related to Mild Brain
Injury and ADHD
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Resources
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CHADD
800-233-4050
www.chadd.org
Corman, C., & Trevion, E. (1995). Eulcee the
jumpy jumpy elephant. Plantation, FL: Specialty
Press.
Johnson, D. (1992). I can’t sit still: Educating
and affirming inattentive and hyperactive
chidren. Santa Cruz, CA: ETR Associates