After reading this chapter, check to make sure you know:

WHAT ARE THE FOUNDATIONS OF ATTENTION DEFICIT/HYPERACTIVITY DISORDER (AD/HD)?

• AD/HD is not considered a separate disability under IDEA 04, but those with AD/HD sometimes qualify for services under another category. (p. 476)

History

• The history of AD/HD dates back only to the early 20^th century. (p. 477)
• Much of the research that is relevant to the field of learning disabilities is also relevant for AD/HD. (p. 477)
• The American Psychiatric Association (APA) has played an important role in defining AD/HD through various versions of the Diagnostic and Statistical Manual . (p. 477)
• Over the years, emphasis in the field has shifted from hyperactivity to inattention. (p. 477)

Definition

• The APA definition of AD/HD includes three types of AD/HD—predominantly inattentive, predominantly hyperactive-impulsive, and combined. (p. 478)
• The APA definition has been criticized by some professionals. (p. 478)

Prevalence

• Prevalence estimates of AD/HD in the school-age population are between 3%-5%. (p. 478)
• About three times as many boys as girls are identified with AD/HD with some estimates as high as 9 to 1. (p. 479)
• Prevalence decreases slightly with age. (p. 479-80)
• Contrary to popular belief, AD/HD does not go away in adolescence and adulthood for most people. (p. 480)
• AD/HD does not appear to be related to ethnicity. (p. 480)

WHAT ARE THE CAUSES AND CHARACTERISTICS OF ATTENTION DEFICIT/HYPERACTIVITY DEISORDER?

Causes

• There are many misconceptions regarding the causes of AD/HD. (p. 480-81)
• AD/HD is generally considered a neurologically based disorder. (p. 481)
• Areas of the brain that could be related to AD/HD are the prefrontal lobes, the basal ganglia, and the cerebellum. (p. 481)
• Recent evidence suggests that AD/HD is caused by a lag in brain development. (p. 481)
• There is some evidence for a genetic basis. (p. 481)
• Prenatal factors (e.g., premature birth, maternal smoking, and alcohol use) have been suggested as causes. (p. 481)

Characteristics

• Certain characteristics seem to be related to age. (p. 482)
• Cognitive characteristics include difficulty with executive functions such as self-regulation and working memory. (p. 482-83)
• Barkley's theory is that individuals with AD/HD have problems inhibiting their behaviors. (p. 482-83)
• School problems are most likely due to performance deficits, not ability deficits. (p. 483)
• Secondary-level students with AD/HD have particular difficulty in school. (p. 483)
• Social-emotional characteristics include problems with peer relations, lack of motivation, and poor-self concept. (p.483-84 )
• AD/HD is known to coexist with other disabilities including learning disabilities and emotional disturbance. (p. 485)

HOW IS ATTENTION DEFICIT/HYPERACTIVITY DISORDER IDENTIFIED?

• Identification should involve multiple sources of information from multiple settings. (p. 485-86)
• Some students with AD/HD qualify for services under the IDEA 04 categories of learning disabilities, emotional disturbance, or other health impairments. (p. 486)
• A medical evaluation is usually the first step in identification. (p. 486)
• Interviews can be conducted with parents, teachers, and the individual (particularly for adults). (p. 486)
• Questionnaires and checklists can provide important information including developmental milestones and early childhood behaviors. (p. 487)
• Behavior assessment systems and general behavior rating scales can provide test data. (p. 487-88)
• Academic achievement is usually evaluated. (p. 488)
• Rating scales developed specifically to identify AD/HD are available. (p. 487-88)
• Direct observation can provide objective data. (p. 488)

WHAT AND HOW DO I TEACH STUDENTS WITH ATTENTION DEFICIT/HYPERACTIVITY DISORDER?

Instructional Content

• Most students with AD/HD will be required to meet the standards of general education and thus will need direct instruction in academics. (p. 489)
• Self-regulation should be the goal of all programs and will likely need to be directly taught. (p. 489-90)
• Self-assessment and self-evaluation, incorporated into self-monitoring, help with attention and achievement. Self-reinforcement systems may also be used. (p. 489-90)
• Parent training in systematic behavior management is essential. (p. 490)
• Counseling services for adolescents may complement classroom strategies. (p. 490-91)

Instructional Procedures

• Explicit direct instruction is required in teaching students with AD/HD. (p. 491)
• Cognitive behavioral modification and precision teaching may be useful in teaching self-regulation. (p. 491-92)
• Behavioral intervention programs are a critical part of effective teaching of students with AD/HD. (p. 492-93)
• Consistent home and school communication is recommended to increase the educational success of students with AD/HD. (p. 493)
• Research clearly indicates that correct stimulant medication administration results in significant improvement in behavior and the ability to learn. (p. 493-95)
• Early intervention usually include stimulant medication, parent training, and classroom behavior management. (p. 495-96)

WHAT ARE OTHER INSTRUCTIONAL CONSIDERATIONS FOR STUDENTS WITH ATTENTION DEFICIT/HYPERACTIVITY DISORDER?

Instructional Environment

• Structure and routine are essential factors in the instructional environment of classrooms for students with AD/HD. (p. 496)
• Altering the classroom environment often results in a significant change in behavior. (p. 496-97)
• Instructional grouping can affect students with AD/HD, because other students may distract them or reinforce inappropriate behavior. (p. 498)
• Grouping options include large group and peer tutoring. (p. 498-99)

Instructional Technology

• The computer can be an effective learning tool for students with AD/HD. (p. 499-501)
• Several battery-operated devices can be successfully used to increase the attention of students with AD/HD. (p. 502)
• Drill-and-practice programs have been found to be effective learning tools for students with AD/HD. (p. 502)

WHAT ARE SOME CONSIDERATIONS FOR THE GENERAL EDUCATOR?

• Most students with AD/HD will spend some time in general education classes, and thus the role of the general education teacher is significant. (p. 503)
• There are many strategies and accommodations that can help teachers effectively manage students with AD/HD in their classrooms. (p. 503)
• Additional responsibilities for the general education teacher may include keeping observational data, completing checklists, and monitoring the effects of medication. (p. 503)
• General education teachers may also be involved in writing 504 plans. (p. 503-4)