Attention Deficit Hyperactivity Disorder The Impact of ADHD on Learning Miranda Shields, PsyD mshields@murrieta.k12.ca.us
Definition DSM V Three types 1. Inattentive Type 2. Hyperactive Impulsive Type 3. Combined Type For diagnosis, child must show a persistent pattern of inattention and/or hyperactivity impulsivity that interferes with functioning or development, as characterized by six of the following symptoms for individuals under 17, five for individuals of 17 and older Characteristics must be demonstrated before age 12
Inattentive Type 1. Fails to attend to details 2. Difficulty sustaining attention 3. Often does not seem to listen when spoken to directly 4. Often does not follow through on instructions, fails to finish tasks 5. Often has difficulty organizing tasks and ideas 6. Often dislikes or avoids tasks requiring sustained mental effort 7. Often loses things required for tasks or activities 8. Easily distracted by extraneous stimuli (17+ may be internal) 9. Forgetful in daily activities
Hyperactive Impulsive Type 1. Fidgets 2. Often leaves seat or assigned area 3. Often runs or climbs where not appropriate (17+ restless) 4. Often unable to play quietly 5. Often on the go or acts as if driven by a motor 6. Talks excessively 7. Blurts out answer before appropriate 8. Difficulty waiting turn 9. Interrupts or intrudes on others
Exclusionary Factors Symptoms persist 6 months, are inconsistent with developmental level; negatively impact social/academic activities Not caused by oppositional behavior, defiance, hostility or lack of understanding Symptoms present before age 12 Present in two or more settings Clear evidence that symptoms interfere with functioning
Prevalence and Development 5% of children in most cultures; 2.5% adults Difficult to diagnose before age 4, usually identified in elementary school Motoric issues may decline in adolescence and adulthood. 2:1 ratio of boys to girls (1.6 to 1 adults) Girls more likely to present with inattentive type.
Education Code Title 5, section 3030 (b) (9) Other health impairment means having limited strength vitality or alertness, including a heightened alertness to environmental stimuli that results in limited alertness with respect to the educational environment that: (A) is due to chronic or acute health problems such as. attention deficit hyperactivity disorder (B) Adversely affects a child s education Also under SLD as a basic psychological process
Aspects of Attention Executive Skills Help us decide which activities/tasks we will pay attention to Allow us to organize behavior over time, inhibit impulses in favor of long term goals Allow us to persist at a task and sustain attention Enable us to manage emotions and monitor thoughts
Executive Skills Planning: Ability to choose goal and create a roadmap to reach it Organization: Ability to design and maintain systems for keeping track of materials and information Time management: Ability to estimate time needed; ability to keep to time limits and deadlines Working memory: Ability to hold information in mind while working on complex task
Executive Skills Metacognition: Observation of one s own problem solving; selfevaluation; self monitoring; use of strategies Response inhibition: Capacity to think before acting, evaluate situation Emotional control: Regulation of emotions in order to achieve goals Sustained attention: Ability to resist distractibility, boredom, fatigue
Executive Skills Task initiation: Ability to begin task in timely manner Flexibility: Ability to revise plans in face of new information or obstacles Goal directed persistence: Capacity to have a goal, follow through to completion, not be distracted by competing interests
Building Executive Skills Define skill Modify the environment Teach the skill: cue, coach, reinforce Fade support, transfer responsibility Encourage self advocacy