Basic Information on ADHD

71 Pages·2011·0.66 MB·English

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Contents
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Preface vii
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The Author R xi
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Section One: Basic Information on ADHDT 1
1.1 ADD, ADHD, AD/HD: What’s the DiAfference? 1
1.2 Defi nitions and Descriptions of AMDHD 2
1.3 Risk Factors Associated with A DHD 3
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1.4 Behavioral Characteristics of ADHD 5
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1.5 ADHD and the Executive Functions 11
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1.6 What We Do and DoH Not Yet Know About ADHD 13
1.7 ADHD and CoexGisting Conditions and Disorders 17
1.8 Possible CauseIs of ADHD 19
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1.9 ADHD Look-Alikes 22
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1.10 Girls wPith ADHD 24
1.11 MakOing the Diagnosis: A Comprehensive
Evaluation for ADHD 25
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1.12 Multimodal Treatment for ADHD 33
1.13 Medication Treatment for ADHD 39
1.14 Behavioral Treatment and Management of ADHD 44
1.15 What Teachers and Parents Need to Know
About Medication 52
1.16 The Impact of ADHD on the Family 55
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iv CONTENTS
1.17 The Impact of ADHD on School Success 57
1.18 Critical Elements for School Success 59
1.19 Positive Traits Common in Many Children and
Adults with ADHD 60
1.20 Educational Rights for Students with ADHD 60
Section Two: Checklists for Parents 67
2.1 What Children and Teens with ADHD Need
from Parents 67
2.2 Positive and Effective Discipline 69
2.3 Preventing Behavior Problems at Home 73
2.4 Preventing Behavior Problems Outside the Home 75
2.5 Coping and Dealing with Your Child’s Challenging
Behaviors 77
2.6 Rewards and Positive Reinforcers for Home 80
2.7 Following Directions and Increasing Compliance:
Tips for Parents 83
2.8 Environmental Modifi cations at Home 85
2.9 What Parents Can Do to Help with Organization 87
2.10 What Parents Can Do to Help with Time Management 91
2.11 Homework Tips for Parents 94
2.12 Parenting Your Child with ADHD: Recommended
Do’s and Don’ts 99
2.13 Supports and Training Parents Need 101
2.14 Building a Positive Relationship with the School 103
2.15 Advocacy Tips for Parents 105
2.16 Planning Ahead for the Next School Year 108
2.17 Pursuing an Evaluation for ADHD: Recommendations
for Parents 110
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Contents v
Section Three: Checklists for Teachers 113
3.1 Proactive Classroom Management 113
3.2 Preventing Behavior Problems During Transitions
and Challenging Times of the School Day 120
3.3 Tips for Giving Directions and Increasing
Student Compliance 124
3.4 Managing Challenging B ehavior 125
3.5 Rewards and Positive Reinforcers for School 130
3.6 Environmental Supports and Accommodations in
the Classroom 132
3.7 Getting and Focusing S tudents’ Attention 136
3.8 Maintaining Students’ Attention and Participation 139
3.9 Keeping Students on Task During Seat Work 144
3.10 Strategies for Inattentive, Distractible Students 146
3.11 Communicating with Parents: Tips for Teachers 149
3.12 Homework Tips for Teachers 151
3.13 What Teachers Can Do to Help with Organization 154
3.14 What Teachers Can Do to Help with Time Management 159
3.15 Adaptations and Modifi cations of Assignments 163
3.16 Adaptations and Modifi cations of Materials 165
3.17 Testing Adaptations and S upports 169
3.18 If You Suspect a Student Has ADHD 172
Section Four: Academic Strategies for Home and School 177
4.1 Common Reading Diffi culties 177
4.2 Reading Strategies and Interventions 179
4.3 Math Diffi culties Related to ADHD and
Learning Disabilities 189
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vi CONTENTS
4.4 Math Strategies and I nterventions 192
4.5 Why Writing Is a Struggle 196
4.6 Strategies to Help with P rewriting: Planning
and Organizing 199
4.7 Strategies for Composition and Written Expression 203
4.8 Strategies for Revising and Editing 207
4.9 Multisensory Spelling S trategies 210
4.10 Improving Handwriting and the Legibility of
Written Work 214
4.11 Strategies for Bypassing and Accommodating
Writing Diffi culties 217
Section Five: O ther Important C hecklists for
Parents and Teachers 221
5.1 The Team Approach 221
5.2 Memory Strategies and Accommodations 223
5.3 Relaxation Strategies, Visualization, Exercise,
and More 227
5.4 ADHD and Social Skills I nterventions 232
5.5 ADHD in Young Children 237
5.6 ADHD in Adolescents 242
5.7 Web Resources to Understand and Support Children
with ADHD and Related Disorders 246
5.8 Books and Other Resources by Sandra Rief 249
Index 251
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S E C T I O N O N E
Basic Information
on ADHD
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1.1 ADD , ADHD , AD/HD : WHAT ’ S THE
DIFFERENCE?
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• AD/HD stands for A ttentEion Deficit/Hyperactivity Disorder.
Sometimes it is written with tThe slash mark ( AD/HD) and sometimes
without ( ADHD) . This is the current and offi cial term that is used
H
when referring to this disorder, and it is the umbrella term for the three
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types of AD/HD: the Predominantly Inattentive type (AD/HD - I),
the Predominantly Hyperactive and Impulsive type (AD/HD- H I),
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and the CombinedR type (AD/HD- C). Most people diagnosed with
ADHD have thYe combined type of the disorder with significant
symptoms in inattention, impulsivity, and hyperactivity.
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• ADD stands for A ttention Defi cit Disorder and has been a term asso-
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ciated with this disorder for many years. Many people use A DD inter-
changeably with A DHD when referring to all types of the disorder, and it
C
is also the term of choice by many when referring to the Predominantly
Inattentive type of ADHD, that is, individuals without hyperactivity.
• The federal special education law (Individuals with Disabilities Edu-
cation Act, IDEA) regulations that govern educational rights of children
with disabilities refer to both ADD and ADHD among the “ other health
impairments” that may qualify a student for special education and
related services (if they meet all of the other eligibility criteria).
• It is likely that there will be changes in the name and abbreviation
of this disorder (or among some types of the disorder) in the future.
1
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2 SECTION ONE
• Throughout the remainder of this book, I just use ADHD (with-
out the slash mark), which is inclusive of all three types.
1.2 DEFINITIONS AND DESCRIPTIONS
OF ADHD
There are several descriptions or defi nitions of ADHD based on the
research evidence and most widely held belief of the scientifi c com-
munity at this time, including the following from leading experts and
researchers in the fi eld:
• ADHD is a neurobiological behavioral disorder characterized by
chronic and developmentally inappropriate degrees of inattention,
impulsivity, and in some cases hyperactivity.
• ADHD is a chronic biochemical, neurodevelopmental disorder
that interferes with a person ’ s capacity to regulate and inhibit behavior
and sustain attention to tasks in developmentally appropriate ways.
• ADHD is a neurological ineffi ciency in the area of the brain that
controls impulses and is the center of executive functions — the self -
regulation and self - management functions of the brain.
• ADHD is a developmental delay or lag in inhibition, self - control,
and self - management.
• ADHD is a brain - based disorder that arises out of differences
in the central nervous system in both structural and neuroche mical
areas.
• ADHD is a pattern or constellation of behaviors that are so per-
vasive and persistent that they interfere with daily life.
• ADHD is a dimensional disorder of human behaviors that all
people exhibit at times to certain degrees. Those with ADHD display
the symptoms to a signifi cant degree that is maladaptive and devel-
opmentally inappropriate compared to others that age.
• ADHD is a developmental disorder of self - control. It consists
of problems with regulating attention, impulse control, and acti vity
level.
• ADHD represents a condition that leads individuals to fall to the
bottom of a normal distribution in their capacity to demonstrate and
develop self - control and self- regulatory skills.
• ADHD is a disorder of inhibition (being able to wait, stop
responding, and not respond to an event). Inhibition involves motor
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Basic Information on ADHD 3
inhibition, delaying gratifi cation, and turning off or resisting distrac-
tions in the environment while engaged in thinking.
• ADHD is a neurobiological behavioral disorder causing a high
degree of variability and inconsistency in performance, output, and
production.
• ADHD is a common although highly varied condition. One
element of this heterogeneity is the frequent co - occurrence of other
conditions.
1.3 RISK FACTORS ASSOCIATED
WITH A DHD
ADHD places those who have this disorder at risk for a host of seri-
ous consequences. Numerous studies have shown the negative impact
of this disorder without early identifi cation, diagnosis, and proper
treatment. Compared to their peers of the same age, youth with
ADHD (those untreated for their disorder) experience:
• More serious accidents, hospitalizations, and signifi cantly higher
medical costs
• More school failure and dropout
• More delinquency and altercations with the law
• More engagement in antisocial activities
• More teen pregnancy and sexually transmitted diseases
• Earlier experimentation with and higher use of alcohol, tobacco,
and illicit drugs
• More trouble socially and emotionally
• More rejection, ridicule, and punishment
• More underachievement and underperformance at school
or work
Prevalence of ADHD
• Estimates of the prevalence in school -a ge children range from
3 percent to 12 percent. Most sources agree that somewhere between
5 and 9 percent of children are affected.
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4 SECTION ONE
• Approximately 2 to 4 percent of adults are believed to have
ADHD.
• The worldwide prevalence of ADHD in children is estimated at
approximately 5 percent. The U.S. prevalence rate falls somewhere in
the middle range of other reporting countries.
• Although this disorder can have serious negative outcomes affect-
ing millions of people when untreated, it is estimated that at least half
of the children with ADHD are not receiving treatment, and far more
adults remain unidentifi ed and untreated.
More Statistics Associated with ADHD
• Between 50 and 75 percent of individuals with ADHD have at
least one other disorder or coexisting condition such as anxiety,
depression, oppositional defiant disorder, learning disabilities, or
speech and language impairments. See checklist 1.7.
• Barkley (2000), a leading researcher in the field, cites these
statistics:
• Almost 35 percent of children with ADHD quit school before
completion.
• Up to 58 percent have failed at least one grade in school.
• At least three times as many teens with ADHD as those
without ADHD have failed a grade, been suspended, or been
expelled from school.
• For at least half of the children with ADHD, social relation-
ships are seriously impaired.
• Within their fi rst two years of independent driving,
adolescents with a diagnosis of ADHD have nearly four times
as many auto accidents and three times as many citations
for speeding as young drivers without ADHD (Barkley &
Murphy, 1996).
• For more information, go to the Web sites of CHADD (Children
and Adults with Attention Defi cit/Hyperactivity; www.chadd.org ),
the National Resource Center on ADHD ( www.help4adhd.org) ,
and the National Institute of Mental Health (w ww.nimh.nih.gov/
health/ ).
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Basic Information on ADHD 5
References
Barkley, R. A. (2000). Taking charge of ADHD (Rev. ed.). New York:
Guilford Press.
Barkley, R. A., Murphy, K. R., & Kwasni, D. (1996). Motor vehicle driv-
ing competencies and risks in teens and young adults with ADHD.
Pediatrics, 98 (6 Pt. 1), 1089 – 1095.
1.4 BEHAVIORAL CHARACTERISTICS
OF ADHD
The fourth edition of the Diagnostic and Statistical Manual of Men-
tal Disorders (DSM - IV) and the text revised edition (DSM- IV - TR),
published by the American Psychiatric Association, is the source of
the offi cial criteria for diagnosing ADHD. The DSM lists nine spe-
cifi c symptoms under the category of inattention and nine s pecifi c
symptoms under the hyperactive/impulsive category. Part of the
diagnostic criteria for ADHD is that the child or teen often d isplays
at least six of the nine symptoms of either the inattentive o r the
hyperactive - impulsive categories or six of the nine symptoms in both
categories.
The checklists that follow contain symptoms and characteristics
common in children and teens with ADHD. The specifi c behaviors
listed in the DSM- I V (1994) and DSM- I V- T R (2000) are italicized.
Additional symptoms and characteristics associated with ADHD are
also included; they are not italicized.
Predominantly Inattentive Type of ADHD
• This type of ADHD is what many prefer to call ADD because
those diagnosed with it do not have the hyperactive symptoms. They
may show some, but not a signifi cant amount of symptoms in the
hyperactive - impulsivity category.
• These children and teens often slip through the cracks and are
not as easily identifi ed or understood. Since they do not exhibit the
disruptive behaviors that command attention, it is easy to overlook
these students and misinterpret their behaviors and symptoms as “ not
trying” or “ being lazy. ”
• Most people display any of the following behaviors at times and
in different situations to a certain degree. Those who truly have an
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