What Are the Foundations of Attention Deficit/ Hyperactivity Disorder?

• The formal history of AD/HD dates back only to the beginning of the 20th century with the identification of the characteristics of attention problems and hyperactivity in children. Much of the research that would later lead to the description of AD/HD was conducted in the 1950s and 1960s. In 1994, the current term of attention deficit/hyperactivity disorder was introduced.
• The American Psychiatric Association's definition of AD/HD is the most widely used. It states that attention deficit/hyperactivity disorder is marked by inattention and/or hyperactivity-impulsivity that appears as a pattern of behavior and is more severe than behaviors in peers. AD/HD characteristics must be persistent, frequent, and severe. They must include inattention and/or hyperactivity impulsivity. They must be present for at least six months and have appeared before the age of 7. The characteristics must be present in multiple settings. Finally, the disorder must be shown to have a significant effect on the individual's life.
• The APA has identified three types of AD/HD: predominantly hyperactive-impulsive, predominantly inattentive, and combined.
• Prevalence estimates of AD/HD range from 3% to 5% of the school-aged population.
• About three times more boys than girls are identified, and the prevalence decreases slightly with age.

What Are the Causes and Characteristics of Attention Deficit/Hyperactivity Disorder?

• It is generally accepted that AD/HD is a neurological disorder. Research has focused on differences in the prefrontal lobes, the basal ganglia, and the cerebellum. There is some evidence that AD/HD is caused by a lag in brain development.
• There is evidence that AD/HD may have a genetic basis, though some nongenetic factors, including premature birth, maternal smoking and alcohol use, and exposure to lead, have also been suggested.
• Younger children with AD/HD tend to display characteristics associated with the hyperactive/impulsive type of AD/HD. Older students most often show characteristics of the inattentive or combined type of AD/HD.
• Cognitive characteristics of AD/HD include deficits in executive functioning that lead to a deficit in behavioral inhibition, decreased ability to spend time on task, and slower visual processing speed. One theory that has received considerable attention is that the primary characteristics of AD/HD result from deficits in behavioral (response) inhibition and self-regulation that, in turn, lead to behavior such as impulsivity.
• Academic characteristics of AD/HD include difficulty attending to academic tasks, difficulty organizing academic tasks, not listening to directions, and making careless mistakes. Academic problems are most likely to be performance related rather than ability related.
• Social-emotional characteristics of AD/HD include difficulty with peer relationships and problems in motivation.
• AD/HD often coexists with other disabilities, most frequently a learning disability. Other disabilities that often coexist with AD/HD are emotional disturbance, oppositional defiant disorder, and anxiety or mood disorders.

How Are Students with Attention Deficit/ Hyperactivity Disorder Identified?

• Identification should involve multiple sources of information from multiple settings.
• A student being assessed for AD/HD may also be assessed for specific learning disabilities or emotional disturbance to determine whether he or she is eligible for services through these IDEA 04 categories.
• Individuals involved in the identification process may include physicians, psychologists, nurses, social workers, teachers, and parents.
• Identification procedures that may be used include teacher, parent, and student interviews, the use of questionnaires and checklists, the use of rating scales, academic testing, and direct observation.

What and How Do I Teach Students with Attention Deficit/Hyperactivity Disorder?

• Most programs for students with AD/HD include instruction in academics and self-regulation skills, parent training, and counseling services components.
• Effective instructional procedures for students with AD/HD include direct instruction, cognitive behavior modification, precision teaching, and behavioral intervention. Behavioral intervention may include home based contingency programs.
• The use of medication may support the learning of students with AD/HD. The use of medication is controversial but supported by research. Medication is most effective when used in combination with behavioral and academic training programs.
• Primary approaches to early intervention programs with students with AD/HD include stimulant medication, parent training, and classroom behavior management. Most preschoolers with AD/HD will benefit from a combination of these approaches.

What Are Other Instructional Considerations for Teaching Students with Attention Deficit/ Hyperactivity Disorder?

• Structure and routine and designing the classroom environment specifically for students with AD/HD are extremely important.
• How students with AD/HD are grouped can have a significant effect on their success.
• Both attention systems and drill-and-practice software can help students with AD/HD learn.

What Are Some Considerations for the General Education Teacher?

• Many accommodations can be helpful in effectively teaching and supporting students with AD/HD in the general education classroom.
• Many general education teachers will be involved in writing and implementing Section 504 Plans to accommodate students with AD/HD.
• Positive communication and collaboration between the general educator and the special educator are significantly related to success in the classroom for students with AD/HD.