ADHD in the Elementary Age Student

1
ADHD in the Elementary Age Student

• Cyndi McCrea
• University of Virginia

2
Table of Contents

• Characteristics
• Treatment
• Current Trends
• Classroom Strategies
• Resources
• References

3
Sound Familiar?

• She seems like shes daydreaming.
• He just cant sit still.
• He cant seem to remember a simple direction.
• She interrupts constantly.
• He acts without thinking.

4
Characteristics

• Description
• Inattentive, impulsive or hyperactive behavior
  that is not age-appropriate and the behavior
  leads to chronic problems in daily functioning
  and the behavior is innate to the child.
• (Reiff, 2004)

5
What You Might See

• Difficulty focusing
• Disorganized
• Low motivation
• Difficulty controlling emotions
• Poor memory
• Talkative
• (Brown, 2005)
• Friendship problems
• Unfinished work
• Messiness
• (Adams, 2005)
• Deficiency in inhibition
• (Kutscher, 2005)

6
Identification

• There is no single test to diagnose ADHD.
• A comprehensive evaluation is used to rule out
  other causes or the presence of co-existing
  conditions.
• The evaluation includes
• a developmental and social history
• medical exam
• clinical assessment
• symptoms checklists

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Identification

• DSM-IV Criteria for ADHD
• Symptoms present before age 7.
• Symptoms present in two or more settings (e.g. at
  school/work and at home).
• Significant impairment in social, school, or work
  functioning.
• The symptoms are not better accounted for by
  another mental disorder.
• (CHADD, 2004)

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Inattention

• Six or more symptoms present for at least 6
  months to a point that is disruptive and
  inappropriate for developmental level
• 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.
• (CHADD, 2004)

9
Hyperactivity and Impulsivity

• Six or more of the following symptoms
  present for at least 6 months to an extent that
  is disruptive and inappropriate for developmental
  level
• 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.
• 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).
• (CHADD, 2004)

10
Combination Type

• Individual meets both sets of inattention and
  hyperactive/impulsive criteria.

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Risks

• School failure
• Family stress
• Depression
• Substance abuse
• Delinquency
• Risk for accidental injuries
• Job failure
• Driving risks
• Problems socializing with peers
• (Hallahan Kauffman, 2006)

12
Treatment

• Multimodal approach which may include
• parent and child education about the diagnosis
  and treatment
• behavior management techniques
• self-regulation training
• medication
• special education services

13
Research Issues

• Girls with ADHD are typically diagnosed at age
  12, five years later than boys (Adams, 2007).
  Girls are more likely to be unfocused or
  inattentive.
• Children with both autism and ADHD are four times
  more likely to bully. These children may have
  pent up energy that needs to be properly
  channeled or they may have other underlying
  behavioral or medical issues that have not been
  addressed (University of Rochester Medical
  Center, 2007).

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Research Issues

• Public opinions about ADHD
• 85 of those interviewed believed that doctors
  overmedicate children with ADHD and those drugs
  have long-term harm on a child's development
• 31 believed children with ADHD would pose a
  danger and
• 45 said rejection at school is likely if a child
  goes for treatment.
• Marcus (2007)

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Legal Considerations

• 504
• Faster and easier procedure (than an IEP) for
  obtaining accommodations and supports.
• Appropriate for students with significant
  impairments.
• General Curriculum and Classroom
• Adjustments
• Modifications
• Accommodations
• Typical of best teaching practices.

• Individualized Education Program (IEP)
• Specific legal procedures and policies.
• More appropriate if a student has very
  significant school difficulties.
• Requires medical diagnosis
• Listed as Other Health Impairment (OHI) .
• More extensive evaluation.
• Specific goals and objectives
• Monitoring and compliance required.
• (Reiff, 2005)

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Aargh!

• Working with students with ADHD can be
• Demoralizing,
• Demanding,
• Frustrating
• Exhausting
• It can challenge a teachers sense of competence.
  
• Students with ADHD are often unaware of their
  most disturbing behaviors and
• when they are aware, they often cant seem to
  help themselves (Pfiffner, 1996).

17
However

• Teacher can focus on strategies for handling
  behaviors so they can enjoy the unique strengths
  of their ADHD students.

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Focus!

• Secure the childs attention before giving
  direction by using direct eye contact (Wodrich,
  2000)
• Give one direction at a time
• Check to ensure understanding of directions.
• Monitor frequently while the student is working
  for both effort and success.
• Provide one on one assistance as needed.
• Post rules, daily schedules and assignments
• Call attention to schedule changes (Jensen,
  2004).
• Assign preferential seating,
• Use headphones to block noise,
• Seat the child near a positive peer model

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Organization and Study Skills

• Teach how to
• create a homework area free of distractions.
• organize materials.
• create and prioritize schedules and calendars.
• take effect notes.
• complete, check, and turn in work on time.
• Provide tools and strategies such as charts,
  tables, graphic organizers, and calendars
• Organize notebooks using color coded dividers,
  complete a weekly clean out, and keep a homework
  folder.
• Keep desk clear (use baskets, folders)

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Assignments

• Create assignments that relate to the childs
  interest.
• Focus on their strengths and learning styles.
• Use computerized learning materials.
• Use visual cues.
• Teach mnemonic devices.
• Provide shortened assignments
• Highlight sections or alter fonts (Wodrich,
  2000).
• Provide written outlines or notes,
• Provide printed instructions
• Give fewer assignments,
• Adjust evaluation standards
• Use a timing device.

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Hyperactive or Impulsive

• Students can be assigned helper activities such
  as running errands to the office, the counselor,
  the janitor, the library or another class.
• Frequent and scheduled breaks.
• Buddy to a student in a lower grade.
• Get a drink of water.
• Do seatwork standing up
• Clean the board,
• Work at the board activities
• Moving and organizing materials (Jensen, 2004).
• Prepare for transitions.
• Teach them self talk (I will calm down.) that
  they can use as they come in from outside or have
  them walk a lap or two before lining up.
• Use positive command like please walk instead
  of dont run. (Students who are impulsive often
  only hear what you dont want them to do when
  they are given a negative command and not the
  dont part of the statement.)

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Either or Both!

• Enforce rules consistently using rewards and
  consequences.
• Catch them being good.
• Teach self advocating skills such as how and when
  to ask for help.
• Communicate regularly with the parents.
• Use technology such email and answering machines,
  
• Use student assignment books,
• Provide suggestions for parents.
• Use written communication such as notes or
  progress reports.
• Provide an extra set of textbooks for the parents
  to use at home.
• Teachers also can collaborate with other
  professional staff about the students strengths
  and needs.
• (Council for Exceptional Children, 2007)

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Resources for Parents Websites

• www.chadd.org -A national non-profit organization
  working to improve the lives of affected people
  through education, advocacy and support.
• www.adhdnews.com - a support community for ADHD
  with message boards, blogs, free newsletters and
  articles to help your child.
• www.Advance.com- answers to your questions about
  ADHD, has an easy to use Young Adult section
• http//kidshealth.org/index.html - health
  information for parents, kids, and teens

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Resources for Parents Childrens Books

• Bright, Shiny Skylar by Valerie Tripp and Joy
  Allen
• David Goes to School by David Shannon
• Eagle Eyes by Jeanne Gehret
• Joey Pigza (series) by Jack Gantos
• Learning to Slow Down and Pay Attention by
  Kathleen G. Nadeau and Ellen B. Dixon
• Otto Learns About His Medicine by Matthew Galvin
• Shelly the Hyperactive Turtle by Deborah Moss
• Sometimes I Drive My Mother Crazy, But I Know
  Shes Crazy About Me by Lawrence Shapiro
• Waiting for Mr. Goose by Laurie Lears
• Zipper The Kid with ADHD by Caroline Janover and
  Rick Powell

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Resources for Parents Books for Parents

• ADHD A Complete and Authoritative Guide from
  the American Academy of Pediatrics
• Making the System Work for Your Child with ADHD
  by Peter Jensen
• ADHD What Every Parent Wants to Know by David
  Wodrich
• Kids in the Syndrome Mix of ADHD, LD,
  Aspergers, Tourettes, and More! By Martin
  Kutscher
• Great resource for teachers too!

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Resources for Teachers

• All About ADHD The Complete Practical Guide for
  Classroom Teachers by Linda Pfiffner, Ph.D.
• Help for the Struggling Student by Mimi Gold
• Innovative Strategies for Unlocking Difficult
  Children by R. Bowman, T. Carr, K. Cooper, R.
  Miles and T. Toner.
• Understanding Special Education A Helpful
  Handbook for Classroom Teachers by Cynthia Stowe

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References

• Adams, Carley (2007). Girls and ADHD Are you
  missing the signs. Retrieved September 5, 2007
  from http//content.scholastic.com/browse/article.
  jsp?id11532
• Brown, T. (2005). Attention deficit disorder
  The unfocused mind in children and adults. New
  Haven Yale University Press.
• Children and Adults with Attention-Deficit/Hyperac
  tivity Disorder (CHADD) (2004). The disorder
  named AD/HD (WWK!). Retrieved September 5, 2007,
  from http//www.help4adhd.org/en/about/what/WWK1
• Council for Exception Children (2007). Homework
  practices that support students with
  disabilities What we have learned about
  homework and students with disabilities.
  Retrieved September 5, 2007 from
  http//www.cec.sped.org/AM/Template.cfm?Section
  HomeCONTENTID1811 TEMPLATE/CM/ContentDisplay.c
  fm
• Hallahan, D. Kauffman, J. (2006). Exceptional
  learners An introduction to special education
  (10th ed.). New York Pearson Education, Inc.
• Jensen, P. (2004). Making the system work for
  your child with ADHD. New York The Guilford
  Press.

• Kutscher, M. (2005). Kids in the syndrome mix of
  ADHD, LD, Aspergers, Tourettes, Bipolar, and
  more! The one stop guide for parents, teachers,
  and other professionals. Philadelphia Jessica
  Kinsley Publishers.
• Lehigh University (2007). Nonmedicinal treatment
  touted for preschoolers with ADHD. Retrieved
  September 5, 2007 from http//www.sciencedaily.com
  /releases/ 2007/08/070821143557.htm
• Marcus, M. (2007). Public perceptions harsh of
  kids, mental health. Retrieved September 5, 2007
  from http//www.usatoday.com/news/health/2007-04-2
  9-public-perceptions_N.htm
• Pfiffner, L. (1996). All about ADHD The
  complete practical guide for classroom teachers.
  New York Scholastic Professional Books.
• Reiff, M. Tippins, S. (2004). ADHD A complete
  authoritative guide. United States of America
  American Academy of Pediatrics.
• University of Rochester Medical Center (2007).
  Children with both autism and ADHD often bully,
  parents say Researchers caution against
  labeling. Retrieved September 5, 2007 from
  http//www.sciencedaily.com/releases/2007/05/07051
  7100417.htm
• Wodrich, D. (2000). Attention-deficit/hyperactivi
  ty disorder What every parent wants to know.
• Baltimore Paul H. Brookes Publishing Co.

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This project was constructed as a part of a
course assignment. The information provided in
the materials is accurate to the best of our
ability but was not constructed by experts in the
field. On my honor as a student, I have
neither given nor received aid or assistance on
this assignment.