EFTA01222886.pdf

AD/HD is a neurobiological disorder- . " 0 • . • e • - VII school-age children. consequences including: School failure ■ It nearly always Family stress persists from Depression childhood through Problems with adolescence. relationships ■ Many symptoms Substance abuse continue into Delinquency adulthood. Job failure 9% is a new statistic just out - researchers at the Mayo Clinic and Centers for Disease Control and Prevention (CDC) featured a prevalence rate of 8.7% prevalence rate for children 8-15 years of age. If a teacher has a class of 20 children, will have one or two students with ADHD. 1 EFTA01222886  AD/HD predominantly hyperactive- impulsive type: (AD/HD-HI) ■ Fidgets with hands or feet or squirms in chair. ■ Has difficulty remaining seated. ■ Runs about or climbs excessively. ■ Difficulty engaging in activities quietly. ■ Acts as if driven by a motor. ■ Talks excessively. ■ Blurts out answers before questions have been completed. ■ Difficulty waiting for turn. ■ Interrupts or intrudes upon others. Sometimes hyperactivity goes away in adolescence-typically not the inattentive piece Some people feel that students with hyperactivity don't have as many learning difficulties as AD/HD-I 2 EFTA01222887  AD/HD predominantly inattentive type: (AD/HD-I) .. W • or • . . . . • careless mistakes. ■ Has difficulty sustaining attention. ■ Does not appear to listen. ■ Struggles to follow through on instructions. ■ Has difficulty with organization. ■ Avoids or dislikes tasks requiring sustained mental effort. ■ Loses things. ■ Is forgetful in daily activities. Young children go unnoticed in the early years-inform preschool teachers to watch for children who are off on their own not causing any trouble, but losing out on information. Some researchers believe that by Kindergarten, children with undiagnosed and untreated AD/HD demonstrate a 30% lower IQ score due to loss of information. 3 EFTA01222888  AD/HD combined type: (AD/HD-C) ■ Individual meets both sets of inattention and hyperactivity/impulsive criteria. 4 EFTA01222889  Critical Questions to Ask ■ Ara theca hohawinrc ovrocciwo Inns -term and pervasive? ■ Do they occur more often than in other children the same age? ■ Are they a continuous problem. not just a response to a temporary situation? ■ Do the behaviors occur in several settings or only in one specific place like the playground or in the schoolroom? ■ Did these symptoms occur before the age of 7? 5 EFTA01222890  Diagnosis ■ There is no single test to diagnose AD/HD. Therefore, a comprehensive evaluation is necessary to establish a diagnosis, rule out other causes and determine the presence or absence of co-existing conditions. 6 EFTA01222891  An evaluation requires time and effort and should include: ■ A careful history from parents and teachers, as well as the child, when appropriate. ■ Clinical assessment of the individual's academic, social, and emotional functioning and developmental level. ■ Checklists for rating AD/HD symptoms and ruling out other disabilities. Value of the historical interview; other family members with depression, underachievement, substance abuse 7 EFTA01222892  Professionals who can diagnose AD/HD are: • Clinical psychologists • Clinical social workers • Nurse practitioners • Neurologists • Psychiatrists • Pediatricians 8 EFTA01222893  AD/HD is a medical • ". • • osis- ■ NOT an educational diagnosis. Teachers can be very helpful by providing information for the family to share with the diagnosing professional - checklists, anecdotal information, medication monitoring, etc. States differ in their protocols for determining who qualifies for assistance. Students qualifying for extended time on SAT's 9 EFTA01222894  Students should receive a thorouah nhysical exam first to rule out other possible causes such as: Assessment of hearing and vision Thyroid dysfunction, other disorders Head injury Sleep Apnea A doctor asks about head injuries-then broken arms-"When I fell out of that tree!" 10 EFTA01222895  Possible causes of AD/HD- like behavior: ■ A sudden change in the child's life-the death of a parent or grandparent; parent's job loss. ■ Undetected seizures, such as in petit mal or temporal lobe seizures ■ A middle ear infection that cause intermittent hearing problems ■ Medical disorders that may affect brain functioning ■ Underachievement caused by learning disability ■ Anxiety or depression 11 EFTA01222896  IL Took ' A T I ■ -aren an• c I • e•uca ion a•ou diagnosis and treatment. ■ Behavior management techniques. ■ Medication. ■ School programming and supports. ■ Tailored to the unique needs of each child and family. The most widely referred to study among professionals is the MTA study which concluded that the one most effective treatment is medication alone; but multimodal treatment is the best 12 EFTA01222897  "Co-morbid Disorders" ■ earning sisaci ies - I o '•o ■ Tourette Syndrome - tics and repetitive mannerisms ■ Oppositional Defiant Disorder - as many as 1/3 to 1/2 (mostly boys) have another condition - often defiant. stubborn, noncompliant, temper, belligerent ■ Conduct Disorder - 20 to 40% of AD/HD children may eventually develop CD ■ Anxiety and Depression ■ Bipolar Disorder In pre-k - understanding certain sounds or words School-age - reading, spelling, writing, arithmetic disorders may appear Very few children have this syndrome, many of the cases of Tourette syndrome have associated AD/HD 13 EFTA01222898  What does an AD/HD diagnosis mean for a child? ■Kids with AD/HD may be delayed as much as 30% of their actual age in their ability to pay attention and remember. This means that a 9 year old may act more like a 6 year old. Sending an undiagnosed, untreated eighteen-year-old off to college would be like sending a 12-year-old off to college-what structures would need to be in place in order for that student to be successful?! 14 EFTA01222899  The treatment of AD/HD: WHAT WORKS BEST! Accurate diagnosis - which should always include identification of talents and strengths. 2. Implementation of a 5-step plan that promotes talents and strengths. 3. Education about ADHD 4 Structure, strategies 5. Counseling, depending on needs 6. Complimentary and/or alternative treatments sleep, diet, exercise, Some doctors have said that as many as 70% of children diagnosed with ADHD are diagnosed in a 15 minute office visit with a pediatrician and a hysterical mother-urge families to get a full evaluation; medication should not be used to determine a diagnosis 15 EFTA01222900  MEDICATION ■ For most children medication is an integral part of treatment. ■ It is not used to control behavior. ■ Medication is used to help important networks of nerve cells in the brain to communicate more effectively with each other. ■ Between 70 and 80% of children with AD/HD respond positively to these medications. ■ Medication does not cure AD/HD: when effective, it alleviates AD/HD symptoms during the time it is active (e.g.. an antibiotic) ■ Eyeglasses or hearing aids example 16 EFTA01222901  Role of the Teacher ■ Teacher does not make diagnosis. It is a medical diagnosis. ■ Teacher is critical in providing observations and follow-up information. ■ Know what AD/HD is and what it is not. ■ Communicate with families. (80% have 1 parent with AD/HD) ■ Identify child's strengths. ■ Employ behavior interventions and education strategies and techniques to best meet student's needs. ■ Structure and Routine - Brevity and Variety. 17 EFTA01222902  Areas of Concern ■ Activating & getting started ■ Irritability, depressed mood, sensitive to criticism ■ Memory, recall ■ Motor activity ■ Compliance ■ Academic skills ■ Sustaining attention & concentration ■ Sustaining effort ■ Impulsiveness ■ Organization & planning ■ Socialization Every child with AD/HD is very different and needs a personalized plan 18 EFTA01222903  ACCOMMADATION BY TEACHER: ■ Physical arrangement of room ■ Lesson presentation ■ Assignments/Worksheets ■ Test taking ■ Organization ■ Behaviors ■ Mood Seating arrangement-eye contact, next to teacher, next to good role models, study carrels for all Explanations, color-coding, 3-part directions, math-switch from adding to subtracting- error analysis Fewer problems Extended time-not unlimited time Using a computer for essays, KIDSPIRATION, note-takers, technology-tape- recorders Books for home, positive feed-back, ignoring bad behavior, have students keep track of behaviors to make them more aware Most accommodations are just good teaching strategies-helpful for all kids, critical for kids with AD/HD Don't miss recess to stay in and complete work-more difficult in the next class 19 EFTA01222904  ACADEMIC SKILL: If reading is weak: If oral expression is weak: If written language is weak: If math is weak: Provide extra time; use "previewing" strategies; select text with less on a page; shorten amount of reading required; avoid oral reading Accept all oral responses, substitute display for oral report, give questions ahead of time, tell student when you are going to call on them-clue Alternative testing situations, extended time, use of technology Use of calculator "FAIR" DOES NOT ALWAYS MEAN EXQUAL - example of student who needed CPR 20 EFTA01222905  Parental Involvement ■ Initial assignment notebook daily/weekly ■ Provide daily rewards for bringing completed assignment notebook/progress note home ■ Call teacher every for feedback ■ Supply school with medication & necessary medical forms ■ Parent support group ■ Parent education ■ Provide positive reinforcement for points earned in behavior program at school For younger kids, coaching parents-giving them strategies to use at home For older kids, the use of a coach can be helpful-takes pressure off of parent, keep parental relationship intact Discourage parents from making threats that they won't keep Kids with AD/HD don't always learn from experience-keep repeating the same mistakes-use preventative strategies-put structures in place 21 EFTA01222906