Attention Deficit – Hyperactivity Disorder

Attention Deficit-Hyperactivity Disorder is a neurobiological condition that makes it difficult for a person to sit still, pay attention, and control their behavior. The exact cause of AD/HD is not known; however, research indicates that there may not be sufficient neurotransmitters in the brains of individuals diagnosed with this disorder. Just exhibiting inattentive, hyperactive, or impulsive behaviors is not sufficient for a diagnosis of AD/HD. These behaviors must also cause observable adverse effects on the child’s functioning at school and home. Treatment approaches include medication management, behavioral treatments, and a combination of both.

There are three subtypes of AD/HD:

ADHD/I Attention Deficit Inattentive Type

ADHD/HI Predominantly Hyperactive-Impulsive Type

ADHD/C Combined Type

Inattention: The child fails to give close attention to details, often has difficulty sustaining attention in tasks, and often does not appear to listen. The child may have difficulty organizing materials and activities, lose things, have difficulty following through with directions, and have difficulty completing school work and other tasks.
Hyperactivity: The child fidgets often with hands and feet, squirms in seat, leaves seat often, and runs and climbs about excessively. Have trouble playing quietly, and talk too much.

Impulsivity: The child blurts out often, has difficulty awaiting his turn, and interrupts and intrudes on others.

Children with AD/HD may have co-existing conditions that may require further assessment and treatment. The following disorders are:

  • Learning Disabilities
  • Anxiety Disorders
  • Mood Disorders
  • Tourette’s Syndrome
  • Disruptive Disorders
  • Often have fine motor delays and dysgraphia

The following strategies are helpful in working with children with AD/HD:

  • Behavioral Strategies
  • Provide for frequent breaks from seatwork or during time periods in which the child is required to sit for lengthy periods of time
  • Allow the child to move about as long as he is not disruptive to others
  • Provide the child with a “fidget” toy. A fidget toy is a small toy that the child can manipulate in his hands as he sits during a
    structured activity. (Ex: story time, movie, lectures)
  • Re-direct the child when he is distracted from an activity or task
  • Define appropriate behavior
  • Give praise immediately- vary your statements
  • Be consistent and sincere with the praise
  • Focus on praise not punishment
  • Selectively ignore some behaviors
  • Allow escape behavior outlets such as a quiet spot for the child to go to when he is feeling overwhelmed
  • Ask the child to perform less desirable tasks before favored tasks
  • Use visual cues, move closer to the child, and hand gestures to signal the child
  • Provide extra time to complete tasks
  • Possible Classroom Accommodations
  • Seat the child near the teacher
  • Seat the child near a student role model
  • Provide low-distraction work areas
  • Use pointers to help child track while reading
  • Use of egg timers for helping child remain on task
  • Music is often helpful for the student
  • Be aware of classroom lighting, outside noises, and furniture arrangement
  • Post rules, schedules, and assignments in classroom

Social Skill Development

  • Children with AD/HD may benefit from training in social skills
  • Utilize role playing and modeling to teach social skills
  • Help child use the newly learned social skills in other environments
  • Provide praise and positive reinforcement when child demonstrates social skills
  • Help the child improve social appropriateness by imagining how other people will react to her words and behavior.
  • Teach the child how to notice and interpret facial expressions and body language of others.
  • Create situations that allow the student to have successful social experiences.

Organizational Skills

  • Help child develop an organizational strategy for keeping himself organized in activities, schedule, and materials. This may include
    the use of agenda.
  • Pair child with a peer for play activities, homework, and other activities
  • Help child organize his bedroom, classroom desk, and backpack
  • Develop time management skills
  • Use of visual aids as reminders of subject material
  • Use of checklists
  • Teach note taking skills
  • Use of visual aids such as Venn diagrams
  • Provide a quiet, organized location in the home for homework
  • Ensure that the child completes homework at a specific time each day
  • Provide child with after school tutoring so that he can get help with homework
  • Check the child’s homework each evening to ensure completion and accuracy
  • Check to ensure that the child places his homework in a folder and turns it into the teacher the following day

Attention Deficit-Hyperactivity Disorder is most frequently diagnosed by a pediatrician, psychologist, neurologist, or other medical specialist. Diagnosis frequently involves ruling out other types of disorders before the child is diagnosed with AD/HD. For example, children with verbal memory problems present with many of the features of the Inattentive type of AD/HD. A comprehensive assessment is necessary to ensure that the proper interventions are selected to meet the needs of the child. A child with verbal memory deficits would not benefit from medical and behavioral intervention, but would benefit from interventions to enhance verbal memory.

There are several organizations that provide up to date information regarding Attention Deficit-Hyperactivity Disorder. It is also essential for families to work closely with a team of familiar with AD/HD to develop interventions and support for social, academic, and behavioral success of the child.

References:

http://nichcy.org/

http://www.ldonline.org/

Mather, N., & Jaffe, L. (2002). Woodcock-Johnson III: Reports, Recommendations, and Strategies. New York: John Wiley & Sons.