Transcript ADHD Presentation Slides - NCTM Birmingham, AL, 2005

The Effects of Attention Deficit
Hyperactivity Disorder
on Mathematics Learning
National Council of
Teachers of Mathematics
Southern Regional Conference
Birmingham, AL
October 22, 2005
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The Effects of Attention Deficit
Hyperactivity Disorder
on Mathematics Learning
Presenter Information:
Kay Haralson, Associate Professor of
Developmental Mathematics
[email protected] www.apsu.edu/haralsonk
Loretta Griffy, Associate Professor of Mathematics
Nancy Matthews, Adjunct Professor of Education
Austin Peay State University
Clarksville, TN 37044
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What is ADHD? (www.nichcy.org)
ADHD is a complex, neurobiochemical
disorder involving differences in brain
activity and structure in the prefrontal
cortex, the basal ganglia, and the
cerebellum. These areas are know to
help to inhibit behavior, sustain
attention, and control mood.
ADHD is considered a behavioral and
mental health disorder.
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Possible Causes of ADHD
(www.nichcy.org, www.ezinearticles.com)
PET (positron emission tomography) or brain
scans, indicate less activity and blood flow in
the part of the brain that inhibits impulsivity.
Studies have shown there to be an insufficient
availability of the neurotransmitters dopamine
and norepinephrine in the central nervous
systems of children with ADHD. These brain
chemicals are needed for paying attention and
controlling behavior.
Current investigations being done to identify
abnormalities in the dopamine-transporter
gene support the theory that ADHD can be
genetically inherited.
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Diagnostic Criteria for ADHD
(Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, 2000,
DMV-IV-TR, American Psychiatric Association, www.cdc.gov/ncbddd/adhd/symptoms.htm)
I. Either A or B:
A. Six or more of the following symptoms of
inattention have been present for at least 6
months to a point that is disruptive and
inappropriate for developmental level:
Inattention
1. Often does not give close attention to details
or makes careless mistakes in schoolwork,
work, or other activities.
2. Often has trouble keeping attention on tasks
or play activities.
3. Often does not seem to listen when spoken
to directly.
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Diagnostic Criteria for ADHD (DSM-IV-TR)
4. Often does not follow instructions and fails to
finish schoolwork, chores, or duties in the
workplace (not due to oppositional behavior or
failure to understand directions).
5. Often has trouble organizing activities.
6. Often avoids, dislikes, or doesn’t want to do
things that take a lot of mental effort for a long
period of time (such as schoolwork or
homework).
7. Often loses things needed for tasks and
activities.
8. Is often easily distracted.
9. Is often forgetful of daily activities.
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Diagnostic Criteria for ADHD (DSM-IV-TR)
B. Six or more of the following symptoms of
hyperactivity-impulsivity have been present
for at least 6 months to an extent that is
disruptive and inappropriate for
developmental level:
Hyperactivity
1. Often fidgets with hands or feet or squirms
in seat.
2. Often gets up from seat when remaining in
seat is expected.
3. Often runs about or climbs when and
where it is not appropriate (adolescents or
adults may feel very restless).
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Diagnostic Criteria for ADHD (DSM-IV-TR)
4. Is often “on the go” or often act as if
“driven by a motor”.
5. Often has trouble playing or enjoying
leisure activities quietly.
6. Often talks excessively.
Impulsivity
1. Often blurts out answers before
questions have been finished.
2. Often has trouble waiting one’s turn.
3. Often interrupts or intrudes on others.
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Diagnostic Criteria for ADHD (DSM-IV-TR)
II.
III.
Some symptoms that cause impairment were
present before age 7 years.
Some impairment from the symptoms is
present in two or more settings (e.g. at school/work
and at home).
IV.
V.
There must be clear evidence of significant
impairment in social, school, or work
functioning.
The symptoms do not happen only during the
course of a Pervasive Developmental
Disorder, Schizophrenia, or other Psychotic
Disorder. The symptoms are not better
accounted for by another mental disorder (e.g.
Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a
Personality Disorder).
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Subtypes of ADHD (DSM-IV-TR)
Based on these criteria, three types of ADHD are
identified:
ADHD, Combined Type: if both criteria 1A and 1B
are met for the past 6 months
ADHD, Predominantly Inattentive Type: If
criterion 1A is met but criterion 1B is not met for the
past six months
ADHD, Predominantly Hyperactive-Impulsive
Type: if Criterion 1B is met but Criterion 1A is not
met for the past six months
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Prevalence
(DSM-IV-TR, www.adhdsupportcompany.com )
3%-7% of children suffer from ADHD.
ADHD is diagnosed approximately three
times more often in boys than in girls.
As many as half of those with ADHD also
have other mental disorders.
Over half of the children diagnosed with
ADHD carry the disorder into adulthood.
A large number of adults who were never
diagnosed as a child show clear symptoms
of ADHD.
AMA’s Special Council Report showed little
evidence of widespread over-diagnosis of
ADHD or over-prescription of medication for
ADHD. (www.nichcy.org)
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Identifying ADHD and Subtypes
( www.nimh.nih.gov, www.ets.org)
The diagnosis of ADHD and the subtypes of
ADHD should be made by a professional with
training in the evaluation of ADHD or in the
diagnosis of mental disorders. Such as:
Child psychiatrists and psychologists
Developmental/behavioral pediatricians
Behavioral neurologists
Neuropsychologists
Clinical teams with educational, medical, and
counseling professionals with training in the
evaluation of ADHD
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ADHD in Adults (www.addresources.org, www.akrongeneral.org)
Symptoms of ADHD in adults are similar to the
diagnostic criteria for children, but may be
displayed in different ways.
Inattention
Poor listening skills
Easily distracted, forgetful, daydreaming
Difficulty with making decisions
Trouble maintaining an organized work/living
area
Easily overwhelmed by tasks of daily living
Spends excessive time at work because of
inefficiency
Frequently losing or misplacing things
Need for others to organize you
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ADHD in Adults (www.addresources.org, www.akrongeneral.org)
Hyperactivity
Frequently late or rushed
Easily bored; intense need for excitement
Difficulty with falling asleep or waking up alert
Difficulty estimating how much time something
will take
Poor handwriting
Performs worse under pressure
Thoughts jump from one topic to the next
Strong need to control or have things your way
An internal sense of anxiety and restlessness
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ADHD in Adults (www.addresources.org, www.akrongeneral.org)
Impulsivity
Impulsive spending and money management
problems
Frequent, impulsive job changes
Very impatient, low frustration tolerance
Tactless, tendency to embarrass others
Frequent traffic violations
Trouble with authority
Mood swings
Prone to hysterical outbursts
Tendency to seek conflict, be argumentative
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ADHD in Adults (www.addresources.org, www.akrongeneral.org)
Symptoms that can develop after years of living
with ADHD
A sense of failure, not living up to one’s
potential
A sense of being different, unconventional
Very sensitive to being told to do something or
to being criticized
A tendency to worry needlessly and endlessly
Difficulty with personal or work relationships
A tendency toward addictions
Personal or family history of substance abuse,
depression, or anxiety
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Effects of ADHD on Math Achievement
In mathematics attention to details is critical.
Overlooking or misreading mathematical
symbols, key words, or instructions leads to
careless mistakes.
Poor organization skills hinder students from
getting paper, pencil, book, and assignment
together in one place.
If students are distracted while completing
math problems, they lose their focus, skipping
problems or steps in problems.
Constant movement of hands, feet, pencils, etc.
gets the student “off track”.
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Effects of ADHD on Math Achievement
Math homework takes a lot of mental effort for a
long period of time. Students with ADHD learn
to avoid these types of activities.
The excessive amount of time it takes for them
to complete assignments increases their
frustration level.
Underestimating the time needed to complete
assignments means that some go unfinished.
Students procrastinate and put off completing
assignments until it is too late.
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Effects of ADHD on Math Achievement
Students show inconsistent performance.
Information learned one day, seemingly
mastered, may be missing the next day.
Performance is worse under pressure.
Students have difficulty retrieving information
on demand, even when thoroughly studied.
Students become angry with themselves and
their teachers when they are criticized or when
they do not do well.
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Treatment Options
(www.hawaii.edu/medicine/pediatrics/pedtext/s01c10.html)
The American Academy of Pediatrics guidelines
for treatment of ADHD requires understanding
of four aspects:
ADHD is a chronic condition. Parental, medical,
and educational support should be provided into
adulthood.
Target symptoms need to be addressed. Set
realistic goals for improvement in specific areas.
Medication and behavior strategies are
important. A combined approach has been shown
to be more effective than either strategy alone.
Close follow-up of target symptoms and
medication use. Reevaluations and monitoring
should be done periodically and consistently.
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Treatment Options
(www.nichcy.org)
A joint study by the NIMH (National Institute of Mental Health)
and the (OSEP) U.S. Department of Education’s Office of
Special Education Programs indicated that a multimodal treatment approach had the greatest
positive effect on reducing ADHD symptoms.
The recommended multi-modal treatment approach
consists of four core interventions:
1. patient, parent, and teacher education about
the disorder;
2. medication (usually from the class of drugs
called stimulants);
3. behavioral therapy; and
4. other environmental supports, including an
appropriate school program.
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Multi-modal Treatment (www.nichcy.org)
1. Patient, parent, and teacher education
about the disorder:
Learn about ADHD and the nature of the
challenges it presents.
Understand that the child has troubles and is
not the cause of the troubles.
Children with ADHD should learn to be selfadvocates but parents and teachers can also
be strong advocates for the child
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Multi-modal Treatment
(www.nichcy.org)
2. Medication (usually stimulants)
Since ADHD is neuro-biochemically-based it
stands to reason that medication that gets to
the core of the problem would be effective.
These medications work to make the brain’s
systems work more efficiently, improving
attention, memory, executive functions, and
inhibition.
The result is better concentration, increased
working memory capacity, greater recall, less
hyperactivity, and more impulse control.
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Multi-modal Treatment
(www.nichcy.org)
3. Behavioral Therapy
Parents and teachers need to be the
executives in the child’s life, providing
structure, routines, assistive devices, external
supports and guides.
Develop behavior management strategies. Use
positive attention, rules, consequences, and
formal systems such as contracts and charts.
The main goal is to increase the child’s
appropriate behavior and decrease
inappropriate behavior.
Teach problem solving. Develop skills in the
art of negotiation, give and take, and conflict
resolution through peaceful means.
Use good communication skills. Say what you
mean in a firm, loving way.
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Multi-modal Treatment
(www.nichcy.org; Quinn, 1994;
Nadeau, 1994; Murphy, 1995; Amen, 1997)
4. Education Intervention
Provide a structured environment
preferential classroom seating
pair student with good role models
create a classroom with limited distractions
give a detailed plan of the course activities
and requirements, avoid changes in routine
design tasks of low to moderate frustration
level, challenge but don’t overwhelm
provide frequent reminders of due dates of
assignments and tests dates
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Multi-modal Treatment
(www.nichcy.org; Quinn, 1994;
Nadeau, 1994; Murphy, 1995; Amen, 1997))
4. Education Intervention
Enhance organization skills
encourage the use of a daily/weekly planners
use a tape recorder for class lectures
make directions clear and concise, provide
direct one-on-one instruction
give out only one task at a time
monitor work frequently, provide feedback
use handouts to minimize the need for note
taking
provide an outline of material on the overhead
maintain frequent communication between
home and school with daily/weekly progress
reports
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Multi-modal Treatment (www.nichcy.org; Quinn, 1994;
Nadeau, 1994; Murphy, 1995; Amen, 1997)
4. Education Intervention
Allow accommodations in assessment
extend time to complete tests
provide a distraction free environment for
taking tests
alter the response format of tests
allow tests to be taken over a period of time in
short intervals
expect no less from students with ADHD, but
give them alternative ways to demonstrate
their competencies
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Multi-modal Treatment (www.nichcy.org; Quinn, 1994;
Nadeau, 1994; Murphy, 1995; Amen, 1997)
4. Education Intervention
Be sensitive to the students’ emotional needs
be aware of their low frustration tolerance and
stress tolerance
be aware that if they have outbursts of anger,
it is generally toward themselves and not
toward you
recognize secondary problems such as
depression, anxiety, and other emotional
problems
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Mathematics Individualized Instructional
Practices (Teaching Children with Attention Deficit Hyperactivity Disorder:
Instructional Strategies and Practices, 2004)
teach students to recognize patterns when
performing operations on whole numbers
use mnemonics for basic computation
color code arithmetic symbols to provide visual
cues
use calculators to check basic computation
provide real-life examples of money skills
teach mastery of math symbols, e.g. – or minus
means to take away
use computer tutorial games for basic
computation
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Mathematics Individualized Instructional
Practices (Teaching Children with Attention Deficit Hyperactivity Disorder:
Instructional Strategies and Practices, 2004)
use number lines for computing whole number
operations
use manipulatives in basic computation skills
use graph paper to help organize columns
when performing basic computations
teach students to look for clue words that
indicate specific operations
use guiding questions to talk students through
the steps of problems
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References
ADHD Support Company, (2005) Adult ADHD. Available
Internet: www.adhd.supportcompany.com
Akron General Medical Center. (2004). Attention deficit
disorder in adults (ADD). Available Internet:
www.akrongeneral.org/psychiatry/psychiatry_add.asp
Allen, T. (2005). Attention deficit hyperactive disorder . . . A
teacher’s perspective. Available Internet:
http://ezinearticles.com
Amen, D. G. (2001). Attention, Doctors. Newsweek. February
26, 2001.
Amen D. G. (1997). Windows in the A.D.D. mind:
Understanding and treating attention deficit disorders in the
everyday lives of children, adolescents, and adults.
Fairfield CA: MindWorks Press.
American Psychiatric Association (2000). Diagnostic and
statistical manual of mental disorders (4th ed., text
revision). Washington DC: American Psychiatric
Association.
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References
Attention Deficit Disorder Resources. (2005). Available Internet:
www.addresources.org
Baker, K. B. (2001). Attention deficit hyperactivity disorder and
reading achievement. Queensland Journal of Educational
Research. 17. Available Internet:
education.curtin.edu.au/iier/qjer/qjer17/baker.html
Barabasz, A,, Barabasz, M. (1995). Attention deficit
hyperactivity disorder: Neurological basis and treatment
alternatives. Journal of Neurotherapy. 1(1). Available
Internet: www.snr-jnt.org/journalnt/jnt(1-1)1.html.
Fowler, M. (2004). Attention-deficit/hyperactivity disorder,
Washington, DC: National Dissemination Center for Children
with Disabilities. Available Internet: www.nichcy.org
Kid Source Online. (2000). Teaching children with attention
deficit disorder. Available Internet:
www.kidsource.com/kidsource/content2.add.html
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References
Murphy, K. R., LeVert, S. (1995). Out of the fog: Treatment
options and coping strategies for adult attention deficit
disorder. New York, NY: Skylight Press.
Nadeau, K. G. (1994). Survival guide for college students with
ADD or LD, New York, NY: Magination Press.
National Center on Birth Defects and Developmental Disabilities.
(2005). Attention-deficit/hyperactivity disorder. Available
Internet: www.cdc.gov/ncbddd/adhd
National Institute of Mental Health. (2003). Attention deficit
hyperactivity disorder. Available Internet:
www.nimh.nih.gov/Publicat/ADHD.cfm
Okamoto, J. K. (2002). Chapter I.10.Attention
deficit/hyperactivity disorder. Department of Pediatrics,
University of Hawaii. Available Internet:
www.hawaii.edu/medicine/pediatrics/pedtext/s01c10.html
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References
Quinn, P. O. (Ed.). (1994). ADD and the college student: A
guide for high school and college students with attention
deficit disorder. New York, NY: Magination Press.
The Office of Disability Policy Educational Testing Service.
(1999). Policy statement for documentation of attentiondeficit/hyperactivity disorder in adolescents and adults.
Available Internet: www.ets.org/disability/adhdplcy.html
U.S. Department of Education, Office of Special Education and
Rehabilitative Services, Office of Special Education
Programs. (2004). Teaching children with attention deficit
hyperactivity disorder: Instructional strategies and practices.
Washington, D.C
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The Effects of Attention Deficit
Hyperactivity Disorder
on Mathematics Learning
To obtain a copy of this power point presentation go
to:
www.apsu.edu/haralsonk
and click on ADHD
or e-mail
Kay at [email protected]
Thank you for your attention!
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