Transcript ADHD - Web.NMSU.Edu Web Publishing Services

ADD and ADHD
Joyce A. Hill, Ph.D.
New Mexico State University—Alamogordo
Colleen M. Hill, B.A.
Definitions
• ADHD—3 types
predominantly inattentive type
predominantly hyperactive-impulse type
combined type
• OHI—other health impaired: this is the
category that children can be given special
education services
Diagnostic Criteria: DSM—diagnostic and
statistical manual of mental disorders
• 6 or more symptoms of inattention OR
hyperactivity-impulsivity that have persisted or
at least 6 months to a degree that is
maladaptive and inconsistent with developmental
level
• Symptoms present before age 7
• Impairment in 2 or more settings
• Clear evidence of clinically significant
impairment in social, academic, occupational
functioning
• Symptoms not part of another diagnosis
Myths
• Careful research has shown that sugar
DOES NOT cause hyperactivity
• Television and video games are NOT
linked to hyperactivity
• A diet free of food colorings and
additives is not beneficial
• ADHD disappears in adulthood—2/3rds
continue to have the condition
• ADHD is a fad—reports of cases back
to mid 19th century
Current Research Evidence
• Some indication that ADHD results from
neurological dysfunction rather than
actual brain damage
• Abnormalities in frontal lobes, basal
ganglia, cerebellum
• Neurotransmitter abnormalities
(chemicals that help in the sending of
messages between neurons)
Current Research Evidence
• Abnormal levels of dopamine
• Some toxins related, exposure to
lead, abuse of alcohol
• Strong hereditary basis
Behavioral Characteristics
Russell Barkley’s Model
• Limitations in behavioral inhibition
withholding a response, protecting a response
from interruption
• Limitations in executive functions
self-directed behaviors such as
working memory, inner speech, emotional
control, analyzing problems
• Limitations in goal-directed behavior
focus on task, persistence, longer time frames
Meeting needs…What research
says.
• Allow time between asking a child to do
or say something and expecting a
response
• Avoid overloading working memory by
limiting number of steps in directions,
explains, etc.
• Create routines for transitions
• Prepare children in advance for changes
Meeting Need… More strategies
• Planning: Divide instructional sequence
into meaningful chunks
• Clearly Introduce: Let children know the
objectives for the day
• Modeling: Model steps of instructions,
lessons
Behavior Helpers
•
•
•
•
•
Frequent breaks
Behavior charts kept by child
Cue charts and reminders on desk
Posted charts of everyday routines
Prepare the child ahead of time for
changes in routines, or special events
• Visuals to cue working memory
The Medication
Controversy
Frequent Questions…
• What are some common
stimulant medications
available for children with
ADHD?
• What are possible side
effects of stimulant
medication?
• Does stimulant
medication help or harm a
child?
• Alternative treatments for
children with ADHD
Common Stimulant
Medications…
•
•
•
•
•
Ritalin
Adderall
Dexedrine
Concerta
Strattera
Potential Side Effects
•
•
•
•
•
•
•
•
Insomnia
Dry mouth
Nausea
Loss of appetite
Headaches
Jitteriness
Increased blood pressure
Growth suppression
How Does Stimulant
Medication Harm Children?
• Some children never fully
stop taking their
medication
• Side effects for adults are
worse
• Children become lethargic
• Medication alone does not
do the trick
How Does Stimulant
Medication Help Children?
• Enhanced response
inhibition
• Enhanced item recall
• Enhanced
performance of paired
associate learning
tasks
Alternative Treatments
•
•
•
•
Behavior modification
Parent education
Management training
Classroom
environment
manipulations
• Motivational training
References
•
Chelonis, J. J., Edwards, M. C., Schulz, E. G., & Baldwin, R. B. (2002).
Stimulant medication improves recognition memory in children
diagnosed with attention deficit/hyperactivity disorder. Experimental
and Clinical Psychopharmacology, 10(4), 400-407.
•
Diller, L. H. (1996). The run on Ritalin: Attention deficit disorder and
stimulant treatment in the 1990s. In M.A. Byrnes (Ed.), Taking sides:
Clashing Views on controversial issues in special education (pp. 305313). Boston, MA: McGraw/Dushkin.
•
Hallahan, D.P., & Kauffman, J. M. (2003). Exceptional learners. Boston:
Allyn and Bacon.