Understanding Language Impairments in Children with ADHD

70 Pages·2010·1.08 MB·English

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DSM-IV Criteria for ADHD
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
• Often does not give close attention to details or makes careless mistakes
in schoolwork, work, or other activities.
• Often has trouble keeping attention on tasks or play activities.
• Often does not seem to listen when spoken to directly.
• 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 instructions).
• Often has trouble organizing activities.
• 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).
• Often loses things needed for tasks and activities (e.g. toys, school
assignments, pencils, books, or tools).
• Is often easily distracted.
• Is often forgetful in daily activities.
B. Six or more of the following symptoms of hyperactivity-impulsivity
have been present for at least 6 months to a point that is disruptive
and inappropriate for developmental level:
Hyperactivity
• Often fidgets with hands or feet or squirms in seat.
• Often gets up from seat when remaining in seat is expected.
• Often runs about or climbs when and where it is not appropriate
(adolescents or adults may feel very restless).
• Often has trouble playing or enjoying leisure activities quietly.
• Is often "on the go" or often acts as if "driven by a motor".
• Often talks excessively.
• Impulsivity
• Often blurts out answers before questions have been finished.
• Often has trouble waiting one's turn.
• Often interrupts or intrudes on others (e.g., butts into conversations or
games).
C. Some symptoms that cause impairment were present before age 7 years.
D. Some impairment from the symptoms is present in two or more settings
(e.g. at school/work and at home).
E. There must be clear evidence of significant impairment in social, school,
or work functioning.
Based on these criteria, three
types of ADHD are identified:
ADHD, Predominantly Hyperactive-Impulsive Type: if
Criterion 1B is met but Criterion 1A is not met for the
past six months.
ADHD, Predominantly Inattentive Type: if criterion 1A is
met but criterion 1B is not met for the past six months
ADHD, Combined Type: if both criteria 1A and 1B are
met for the past 6 months
NOTE: Predominantly hyperactivity/impulsivity and combined types have
particularly be associated with deficits in executive functioning and
working memory.
American Psychiatric Association: Diagnostic and Statistical Manual of
Mental Disorders, Fourth Edition, Text Revision. Washington, DC,
American Psychiatric Association, 2000.
CChhiillddrreenn
Ryan, age 6, on medication
ADHD – predominantly hyperactive-impulsive
?comorbid Asperger’s
Jason, 8, on medication
ADHD – predominantly hyperactive/
Impulsive (may be moving to
combined type)
Zach, age 15
ADHD – predominantly inattentive;
Sluggish cognitive tempo;
Comorbid language/learning disability
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ffoorr ZZaacchh
Talks really loud a lot of time,
I think he is a little obnoxious.
Doesn’t really have hardly any friends at all.
He tries really hard.
Doesn’t understand doesn’t realize that he not
acting the same way as other kids at school.
Talks about Zach is cool.
Zach is always in the story.
It is getting better
It might be that he’s really consumed with
himself still cause that’s a younger child.
E: Is he aware of not having friends
Yeh, Said that he doesn’t have any friends.
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Biggest concern we have for him in school is
his social acceptance and his ability to
interact socially.
Anything that would give him skills in being
able to when a friend expresses a different
opionion than his, being able to say, “well,
that’s OK, but this is my opinion.”
When somebody has a toy he wants or isn’t
sharing a turn, being able to approach that
and in a socially acceptable manner, say,
“I’ve waited 5 minutes; can I have a turn
now.”
Give him tools that he can apply in situations
when usually the alternative would be to lash
out, or kinda spit, or take the toy.
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They might tame the wind,
They might calm the sea,
But they’re never harness my energy.
I’m the poster boy for hyperactivity!
It’s not my fault!
The world’s not keeping up with me.
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• Qualitatively different problems
with attention
– Spacey, daydreamy, easily
confused, stares a lot
• Under- rather than over-active
– Lethargic, sluggish, slow moving
• Slow information processing
• Social withdrawal
• Greater risk for anxiety
• Reduced response to stimulants