Table Of Content

DOCUMENT RESUME EC 303 066 ED 370 334 Facts. Attention Deficit Disorder: Adding Up the TITLE Chesapeake Inst., Washington, DC. INSTITUTION Rehabilitative Office of Special Education and SPONS AGENCY Innovation and Services (ED), Washington, DC. Div. of Development. PUB DATE [94] HS92017001 CONTRACT 9p. NOTE Non-Classroom Use (055) Guides PUB TYPE MF01/PC01 Plus Postage. EDRS PRICE *Attention Deficit Disorders; Disability DESCRIPTORS Identification; Educational Diagnosis; Elementary *Intervention; Student Secondary Education; Etiology; Rights; Behavior; Student Characteristics; Student *Symptoms (Individual Disorders) ABSTRACT attention This paper presents an introduction to questions deficit disorder (ADD). Answers are provided to common Cause?" "How Can We including "What Is Add?" "What Behaviors Does ADD ADD?" "What Can We Do about Tell If A Child Has ADD?" "What Causes "What Are the Legal ADD?" "How Dopes ADD Affect School Performance?" to Children with Rights of Children with ADD?" and "What Happens of medication, ADD?" The booklet proposes that through supervised use of classroom counseling, behavior management, and modification academic success and lessons, children with ADD can experience fulfilling lives. (pB) *********************************************************************** Reproductions supplied by EDRS are the best that can be made from the original document. *********************************************************************** U.S. DEPARTMENT OF EDUCATION Office of Educational Research and Improvemen EDU ATIONAL RESOURCES INFORMATIO CENTER (ERICI , This document has been reproduced a received from the person or organizatro originating it :- Minor changes have been made :o improv reproduction quahty Points of view or opinions Stated in this dOc ment do not neceSsardy represent otttet OERI Position or policy ATTENTION DEFICIT DISORDER: ADDING UP THE FACTS Published By Division of Innovation and Development Office of Special Education Programs Office of Special Education and Rehabilitative Services U.S. Department of Education 2 BEST COPY AVAILABLE Washington, D.C., with The Widmeyer This document was developed by the Chesapeake Institute, from the Office of Special Education Croup, Washington, D.C., as part of contract #HS92017001 United States Department of Programs, Office of Special Education and Rehabilitative Services, of the authors and do not Education. The points of view expressed in this publication are those Education. We encourage the necessarily reflect the posit )n or policy of the U.S. Department of reproduction and distribution of this publication. Washington, D.C., with The Widmeyer the Chesapeake !nstitute, This document was developed by the Office of Special Education of contract #HS92017001 from Group, Washington, D.C., as part States Department of and Rehabilitative Services, United Programs, Office of Special Education those of the authors and do not expressed in this publication are Education. The points of view of Education. We encourage the policy of the U.S. Department necessarily reflect the position or publication. reproduction and distribution of this 4 ATTENTION DEFICIT DISORDER: Adding Up the Facts ADD also have learning disabilities. In any group of children, there is usually one child who never sits still. Frequently and Children with ADHD are often aggressive easily distracted, the child fidgets, glances about and rejected by their peers, while children with aimlessly, and seems to allow his mind to wander ADD (without hyperactivity) are more withdrawn This child attracts the predictable adult freely. and unpopular. Both types of children with ADD response: "Why can't you sit still and listen!" In commonly do not cooperate with others and are school, the often bright but disruptive "troublema- less willing to wait their turn or play by the rules. ker" may never learn to listen or do what others Their inability to control their own behavior may pay attention. seem so effortlessly to do alarm themselves and other children and cause them to become isolated. As a result, their self- What Is ADD? esteem suffers. There are an estimated 1.46 to 2.46 million Impulsive behavior, a tendency to be children with ADD in the United States (3-5 distracted, and hyperactive movement may not be percent of the student population). Most are boys the conscious choice of a "disruptive" child. (ADD is diagnosed four to nine times more often These behaviors are symptoms of a condition in boys than in girls); and because they are less called Attention Deficit Disorder (ADD). It is the disruptive than children with ADHD, many chil- which is the disorder, not the child's own will, dren who have ADD without hyperactivity go literally disrupts a child's true culprit, since it unrecognizea and unassisted. ability to concentrate. ADD, however, is not limited to children, In its most commonly diagnosed form, although for years it was assumed to be a child- ADD is accompanied by hyperactivity and is hood disorder, visible as early as age three, that sometimes called Attention Deficit Hyperactivity It is disappeared with the advent of adolescence. Disorder (ADHD). In addition to the inability to now known that many children with ADD do not concentrate and the tendency to behave impulsive- grow out of it as they age. ly, children with ADHD have difficulty remaining While these still for even short periods of time. Although ADD is a serious and persistent children are inattentive, fidgety, spontaneous ta a disorder, research indicates children with ADD can fault, forgetful, and easily distracted, their "misbe- The first step is the recognition that be helped. havior" is not a choice but a result of the disorder. that it is real. The understanding ADD existz that follows recognition must then lead parents, School children with ADD often have teachers, school administrators, psychologists and multiple problems with schoolwork and social health care professionals to learn to work together They focus on their teacher only with activities. As a team, they can for the good of the child. They have trouble remaining great difficulty. guide the child in developing techniques that can seated, following instructions, concentrating on a turn repeated failure into continuous progress. single task, waiting for their turn in any activity, and simply finishing their assigned work. While these behaviors are not in themselves a learning disability, 10 to 33 percent of all children with not finish their academic work. What Behaviors Does ADD Cause? Not all of these behaviors appear in all While much of the behavior attributed to A child with ADD will be able to situations. ADD also is found in children without ADD, there focus when he or she is receiving frequent rein- are several important and distinguishing character- Ability forcement or is under very strict control. istics that reveal the presence of the disorder. to focus is also common in new settings, or while Children with ADD are impulsive, hyperactive, interacting one on one (including playing video and distractable beyond what is considered "nor- While other children may occasionally games). mal" for their age. They exhibit extreme behavior show some signs of these behaviors, in children in many different settings and situations over a with ADD the symptoms are more frequent and long period of time. While this behavior often is severe than in other children of the same age. As observed before children start school, it becomes children grow older, the behaviors affected by extremely visible in the more structured school ADD change. A preschool child may show gross environment. always running or climbing motor overactiviiy and frequently shifting from one activity to anoth- the American Psychiatric addition, In Older children may be restless and fidget in Association (APA) maintains ADD can be defined er. their seats or play with their chairs and desks. They include, for by the behaviors it causes. They frequently fail to finish schoolwork, or work example, the following: Adolescents with ADD tend to be carelessly. They more withdrawn and less communicative. Fidgeting with hands or feet or squirming are often impulsive, reacting on the spur of the in their seat (adolescents with ADD may moment without regard to previous plans or appear restless); necessary tasks and homework. Difficulty remaining seated when required to do so; How Can We Tell If A Child Has ADD? Difficulty sustaining attention and waiting Although very young children may show for a turn in tasks, games or group situa- characteristics of ADD, some of these behaviors tions; are in fact normal for their age. Even with older Blurting out answers to questions before children, other factors, including environmental the questions have been completed; influences, can produce behavior resembling ADD. Difficulty following through on instruc- Therefore, a diagnosis of ADD cannot be made by teachers or school administrators acting alone, but tions and in organizing tasks; rather by a team of professionals working with the Shifting from one unfmished activity to parents and the child believed to have ADD. This another; team follows a two-tier evaluation process to first Failing to give close attention to details determine if the child has ADD and then to decide and avoiding careless mistakes; the best treatment for the child's individual educational needs. Losing things necessary for tasks or activi- Any diagnoses of ADD must be done by ties; and examining the child's history through interviews Difficulty in listening to others without with parents, teachers, and health care profession- being distracted or interrupting. als in order to determine when the behavior began and whether the child displays the behavior charac- Children with ADD show different combi- teristics of ADD in many different settings. nations of these behaviors. For instance, children with ADD without hyperactivity do not show To help with this, parents and teachers excessive activity or fidgeting, but instead day- should complete a form asking them to measure and rate the frequency and severity of the child's dream, are lethargic or restless, and frequently do 2 6 disabilities, since many may also affect learning The behavior according to a fixed rating scale. children display signs of both. While some people and determine team will examine this information claim that ADD is caused by food additives, sugar, by the parents. Physi- a course of action agreed to evi- yeast, or the actions of parents, there is no for cians should perform a medical exam to check dence to support these beliefs. problems with hearing or vision, and perhaps may administer neurological exarninatior.s. Parents are frequently requested to provide detailed family and what can we Do About ADD? developmental history as well as information about While there is no known cure for ADD, the child's abilities, interests, and behavior. A the effects of ADD can be reduced through an specialist should visit the classroom to observe the approach that combines medicine, psychology, and student's behavior and examine the amount of education. Medication produces a clear and imme- work accomplished over a set period of time. The diate short-term effect in behavior, but should not specialist, frequently a psychologist, will assess the be used as the only treatment, because the long- child, his or her ability to control his or her ac- term effectiveness Af drugs is unclear. tions, and check for other emotional and learning disabilities. Stimulants such as Ritalin, Dexedrine, and C lett allow the brain and nervous system to While there is no single test for ADD, an communicate with the rest of the body more combining accurate diagnosis can be made by effectively, which improves attention span, concen- observations, tests, and other measurements gath- tration, motor control, and on-task behavior, while ered from parents, teachers, psychologists, physi- reducing hyperactivity. cians, and the child. From 60 to 90 percent of school-aged chil- Once the observation and testing is com- dren with ADD are treated with stimulant medica- plete, the team will review the results and decide However, tion for a prolonged period of time. whether or not the child has ADD, and if the child While studies medication is not a total solution. needs special services. From this information, the of show that stimulants effectively calm 70 percent specialists involved can develop a treatment and an children with ADD, this effect decreases over education plan which directly address the child's time, and most studies show that medication learning problems and characteristic behavior. results in few long-term benefits on academic achievement and social adjustment. what causes ADD? In addition, medication may have side- Studies on brain modeling and brain Some children lose weight, 1.ose their effects. imaging show differences in the brains of children Less appetite, or have problems falling asleep. with ADD. However, the causes of these differ- slowed growth, a tic common side effects include scientists suspect ences are not yet known. Most disorder, and problems with thinking or with social the cause of ADD is genetic or biological, al- interaction. These effects usually can be eliminat- though they acknowledge that environment helps ed by reducing the dosage or changing to a differ- determine the specific behaviors of an individual ent medication. child. An effective non-medical treatment is to Some believe ADD may be caused by an help children learn how to control their behavior. imbalance of neurotransmitters (chemicals used by Many teachers and parents use a form of positive abnormal the brain to control behavior) or by reinforcement in which the child is rewarded for glucose metabolism in the central nervous system. with good behavior. This sometimes is combinefl negative reinforcement, in which the inward (or In addition, a child may develop ADD for the points used to reach the reward) is removed because of problems in the child's development Children with ADD perform best bad behavior. before birth or neurological damage. Frequently, consis- when they have an organized structure with ADD the same biological factors that influence Other students frequently of cause and effect. tent rules so that they can clearly understand what cannot manage several different tasks at once, are they are doing and what they should do next. poorly organized, or lose objects needed to per- Psychologists and social workers can work form tasks. with children with ADD on their self-esteem, On average, children identified as hyperac- anxiety, and social skills. They can help children tive are at least three times more likely to vay understand their problem and develop coping back a grade and be suspended from school than mechanisms to succeed. children without ADHD. Teachers, parents, doctors and other health care professionals can work together to devise a What Are The Legal Rights Of plan to improve behavior and to develop alternate Children With ADD? General teachers should methods of education. work with special education teachers to establish The Federal government has established methods for adapting their regular curriculum and several legal provisions that affect the education of teaching techniques to the needs and abilities of children with ADD the Individuals with Disabil- students with ADD. Parents and teachers should ities Education Act and Section 504 of the Reha- communicate regularly to avoid confusing children bilitation Act of 1973. Students with ADD, like with ADD with different strategies and expecta- students with any other disability, do not automati- tions. cally qualify for special education and related services under the IDEA without meeting certain How Does ADD Affect School conditions. Performance? If a child with ADD is found not to be eligible for services under Part B of the IDEA, the Children with ADD are usually identified requirements of Section 504 of the Rehabilitation in school only after they consistently demonstrate Act of 1973 may be applicable if he or she meets their failure to understand or follow rules or the Section 504 definition of disability, which is The most common complete required tasks. any person who has a physical or mental impair- referrals to special education are those for children ment which substantially limits a major life activi- who frequently disrupt the class, show a lack of Thus, depending on the ty such as learning. attention, and exhibit poor academic performance. severity of their condition, children with ADD While ADD is not a learning disability, the mai or may not fit the definition of either or both difficulties students with ADD have in focusing laws; not all children with ADD are covered. their attention reduces the amount of work they Although ADD is not a separate disability can accomplish, even when they show strong category under the IDEA, children with ADD who Studies demonstrate that the academic ability. require special education and related services can ability to concentrate and focus is a better predic- be eligible for services under the "other health tor of academic success than other measures of impaired" category 'of Part B of the IDEA when For example, if a student is academic ability. "the ADD is a chronic or acute health problem that distracted and does not finish a test, most teachers results in limited alertness, which adversely affects do not give credit for blank responses, even if the Children with ADD educational performance." student knows the answers. may also be eligible for services under the "specif- Other factors also interfere with the ability ic learning disability" or "seriously emotionally These children of children with ADD to learn. disturbed" categories of the IDEA when they have make careless errors and respond without thinking. those conditions in addition to their ADD. They frequently have trouble judging the impor- These laws require schools to make modifi- tance of different information, losing main ideas in cations or adaptations for students whose ADD a flood of trivia. Some children with ADD have impairment. educational significant results in difficulty with abstract ideas, including the concept 4 13- 11111. Once parents and teachers understand this, Children with ADD must be placed in a regular and once they recognize that children with ADD classroom, to the maximum extent appropriate to are not lazy or "bad," but have a biological disor- their educational needs, with the use of supplemen- der, they can stop blaming themselves or their tary aids and services if necessary. While children children and take appropriate steps to prevent a covered under the IDEA must have an Individual pattern of failure that leads to low self-esteem and Education Plan (IEP), students covered under Through the supervised use of hopelessness. Section 504 need a less formal individualized medication, counseling, be :avior management, and assessment. modification of classroom lessons, children with However, when important changes are ADD can most certainly learn what they need to made in the regular education classroom, about succeed as attentive and productive members of half the children with ADD succeed in that setting society. With adult patience, understanding, and without special education. Such changes may assistance, children with ADD can indeed sit still elude: curriculum adjustments, alternative class- and listen and learn. specialized room organization and management, teaching techniques and study skills, use of behavior management, and increased parent/teacher Of course, the needs of some collaboration. children with ADD cannot be met solely within the confines of a regular classroom and they may need related aids or services provided in other settings. What Happens To Children With ADD? One-third to one-half of children with ADD continue to show signs of ADD as adults. While they may gain greater ability to focus tiv-ir attention, their level of impulsive behavior remains inappropriate for their age. They frequently are unorganized, forgetful, and unproductive. ADD thus can affect its victim's college education, employment, and relationships with others. In fact, some adults with ADD were not diagnosed as children and recognize the disorder only when their children's similar problems are diagnosed as ADD. Children With ADD Can Succeed While children with ADD have greater difficulties than most other children, their problems can be reduced through early identification Parents and teachers can and careful treatment. help by remembering the child does not choose to behave disruptively. Children with ADD do want to control their behavior and do try to obey their parents and teachers.