ADHD.doc

What is Attention Deficit Hyperactivity Disorder (ADHD)?

Attention Deficit Hyperactivity Disorder, or ADHD, is a common neurobehavioral problem that affects children as well as some adults.

Causes of ADHD

Some research suggests that the cause of ADHD is a genetic deficiency of certain neurotransmitters. The brain is composed of millions of interconnecting nerve cells called neurons.

In order for a person to think, move, or feel, these neurons must communicate with one another. They do so by sending and receiving chemical messengers called neurotransmitters.

When a neurotransmitter is released from a neuron, it crosses a gap called a synapse and binds to a receptor on another neuron, thus passing on a signal.

Symptoms of ADHD

The symptoms of the disorder include impulsiveness, hyperactivity, and an inability to maintain attention.

What Does Dopamine Do?

Neurotransmitters, such as dopamine, help regulate behavior. Without dopamine, neurons in the frontal cortex of the brain, which is responsible for attention, do not communicate properly. There is also evidence that the neuronal receptors that recognize dopamine are dysfunctional in people with ADHD.

How can I work with my child’s school?

If you think your child has ADHD, or a teacher raises concerns, you may be able to request that the school conduct an evaluation to determine whether he or she qualifies for special education services.

Start by speaking with your child's teacher, school counselor, or the school's student support team, to begin an evaluation. Also, each state has a Parent Training and Information Center and a Protection and Advocacy Agency that can help you get an evaluation. A team of professionals conducts the evaluation using a variety of tools and measures. It will look at all areas related to the child's disability.

Once your child has been evaluated, he or she has several options, depending on the specific needs. If special education services are needed and your child is eligible under the Individuals with Disabilities Education Act, the school district must develop an "individualized education program" specifically for your child within 30 days.

If your child is considered not eligible for special education services—and not all children with ADHD are eligible—he or she still can get "free appropriate public education," available to all public-school children with disabilities under Section 504 of the Rehabilitation Act of 1973, regardless of the nature or severity of the disability.

For more information on Section 504 visit the U.S. Department of Education's Office for Civil Rights which enforces Section 504 in programs and activities that receive Federal education funds.

Visit the Department of Education programs for more information about children with disabilities

Transitions can be difficult. Each school year brings a new teacher and new schoolwork, a change that can be especially hard for a child with ADHD who needs routine and structure. Consider telling the teachers that your child has ADHD when he or she starts school or moves to a new class. Additional support will help your child deal with the transition.

Do teens with ADHD have special needs?

Most children with ADHD continue to have symptoms as they enter adolescence. Some children, however, are not diagnosed with ADHD until they reach adolescence. This is more common among children with predominantly inattentive symptoms because they are not necessarily disruptive at home or in school. In these children, the disorder becomes more apparent as academic demands increase and responsibilities mount. For all teens, these years are challenging. But for teens with ADHD, these years may be especially difficult.

Although hyperactivity tends to decrease as a child ages, teens who continue to be hyperactive may feel restless and try to do too many things at once. They may choose tasks or activities that have a quick payoff, rather than those that take more effort, but provide bigger, delayed rewards. Teens with primarily attention deficits struggle with school and other activities in which they are expected to be more self-reliant.

Teens also become more responsible for their own health decisions. When a child with ADHD is young, parents are more likely to be responsible for ensuring that their child maintains treatment. But when the child reaches adolescence, parents have less control, and those with ADHD may have difficulty sticking with treatment.

To help them stay healthy and provide needed structure, teens with ADHD should be given rules that are clear and easy to understand. Helping them stay focused and organized—such as posting a chart listing household chores and responsibilities with spaces to check off completed items—also may help.

Teens with or without ADHD want to be independent and try new things, and sometimes they will break rules. If your teen breaks rules, your response should be as calm and matter-of-fact as possible. Punishment should be used only rarely. Teens with ADHD often have trouble controlling their impulsivity and tempers can flare. Sometimes, a short time-out can be calming.

If your teen asks for later curfews and use of the car, listen to the request, give reasons for your opinions, and listen to your child's opinion. Rules should be clear once they are set, but communication, negotiation, and compromise are helpful along the way. Maintaining treatments, such as medication and behavioral or family therapy, also can help with managing your teenager's ADHD.

What about teens and driving?

Although many teens engage in risky behaviors, those with ADHD, especially untreated ADHD, are more likely to take more risks. In fact, in their first few years of driving, teens with ADHD are involved in nearly four times as many car accidents as those who do not have ADHD. They are also more likely to cause injury in accidents, and they get three times as many speeding tickets as their peers.13

Most states now use a graduated licensing system, in which young drivers, both with and without ADHD, learn about progressively more challenging driving situations.14 The licensing system consists of three stages—learner's permit, during which a licensed adult must always be in the car with the driving teen; intermediate (provisional) license; and full licensure. Parents should make sure that their teens, especially those with ADHD, understand and follow the rules of the road. Repeated driving practice under adult supervision is especially important for teens with ADHD.

Slajdy :

ADHD

              ATTENTION DEFICIT HYPERACTIVITY DISORDER

ADD (Attention Deficit Disorder)

‘zespół minimalnej dysfunkcji mózgu’

‘deficyt uwagi’ (ADD)

Zespół ZDUN – Zespół Deficytu Uwagi i Nadwrażliwości

Diagnosed 140 years ago

DSM IV

Hyperactivity, inattention and impulsiveness

It affects psychomotor, affective and cognitive domains (6 months)

ADHD - subtypes

Predominantly Inattentive Type:

The child with the symptoms of inattention:

- can make careless mistakes in schoolwork or other acitivites

- often fails to give close attention to details

- often does not seem to listen to what other people are talking about

- has difficulties with sustaining attention in exercises, tasks or play

ADHD - subtypes

- often does not follow the instructions or rules, which causes a failure with finishing homework or duties

- has difficulties with organizing tasks and acitvities

- often dislikes or avoids tasks which require sustained mental effort

- often loses things which are necessary for tasks

- may get bored with a task after only a few minutes    

ADHD - subtypes

- is forgetful

- is often distracted by other things going on in a room

ADHD - subtypes

Predominantly Hyperactive- Impulsive Type:

The child with hyperactive- impulsive problems:

- fidgets and squirms with hands or feet

- cannot stay seated in classroom or in other situations when that behaviour is expected

- climbs on things when it is inappropriate

- has difficulties with playing leisure activities quietly

- often talks excessively

ADHD - subtypes

- is often ‘on the go’

- often gives answers before questions have been completed

- has difficulty with waiting in lines

- often interrupts others

- may feel constantly restless

- seems unable to think before acting

Mixed type 

ADHD - problems

Academic achievement problems

ADHD children may have problems with:

- starting exercises

- staying on projects

- completing tasks

- making transitions

- interacting with other students

- following instructions

- producing work consistently

- organizing multi- step exercises 

ADHD - problems

Many students also have problems with:

- prioritizing work

- time management

- reading comprehension

- taking notes

- study skills

ADHD – how to help?

Design an appropriate educational plan and begin educational intervention:

1. Get pupil’s attention

- ask a speculative question, show a picture, tell a story, etc.

- use audio signals like a bell, timer or a musical instrument

- vary your tone of voice: loud, soft, whispering

- use clear signals, e.g. „Everybody..”, „Ready…”

ADHD – how to help?

2. Focus pupil’s attention

- employ mulitsensory strategies when presenting the lesson or giving directions

- maintain teacher’s visibility

- be aware of other sounds in the classroom environment

- incorporate demonstrations and presentations whenever possible; use visuals and handouts

- ask students to write down brief notes or illustrate key points of the instructions

ADHD – how to help?

3. Maintain pupils’ attention:

- move around the classroom

- ask questions which are open- ended, which require reasoning and stimulate thinking and discussion

- structure the lesson in a way that the material is done in pairs or small groups

- increase STT, decrease TTT

- give clearly defined structure and expectations

ADHD – how to help?

4. Keep pupils on- task during seat work:

- give a proper amount of work

- give positive reinforcement

- monitor independent work

- set time for specific exercises

- teach your students conflict solving and peer mediation skills

- prepare daily or weekly progress reports

ADHD – how to help?

Instruction and curriculum

Provide more direct instructions

Simplify complex directions

Maintain eye contact during verbal instructions

Provide a written outline of the material

Eliminate repetitive tasks

Teach specific study skills, like: note taking, organization, etc.

Use peer tutoring

Require a daily assignment notebook

Encourage ADHD students to ask for help  

ADHD - techniques

Behavioural techniques

Meichenbaum’s techniques – self- regulation

Shernbourne’s techniques

Drama techniques

Storytelling

Relaxation techniques

Art therapy (e.g. music)

SEN students

Able and gifted students

Students with linguistic diversity

Students with ethnic and cultural diversity

Students with specific (special) learning needs. Specific learning needs may be related to:

- academic attainment

- learning difficulties

- specific learning difficulties (e.g. dyslexia)

- speech and language difficulties (e.g. lisping, stammering, stuttering)

Students’ additional needs

1. Physical needs (physical disabilites) and sensory impairments (e.g. impaired sight or hearing difficulties)

2. Psychological needs (e.g. emotional or behaviour problems)

3. Health needs (e.g. asthma or other health problems that might affect Ss’ attendance)

4. Care needs (e.g. a student on a drugs rehabilitation scheme)

6. Other needs (e.g. family commitments) 

Differentation strategies

1. Differentation by task, by outcome and by time allowed

Building ladders of tasks

Differentiating resources

Using a mix of mastery and developmental tasks

Allowing students to present work on a given topic in different ways, e.g. as a written piece of work, as a presetnation, mind map or web page

Using higher- order questioning on Bloom’s taxonomy

Bloom’s taxonomy

Higher order thinking skills - Lower order thinking skills

Evaluation, Synthesis, Analysis, Application, Comprehension, Knowledge

Differentation strategies

2. Differentation by accommodating different learning styles and support needs

Using methods that suit a wide range of learning style and individual preferences

Peer assessment and peer support

Using gourp work, collaboration and cooperation

Differentation strategies

3. Differentation by setting individual tasks and targets

Using self- assessment

Setting individualised challenging goals

A teraz uwaga – myslalam ze umre jak to przeczytalam How is ADHD treated?   TABELKA!!!!

Currently available treatments focus on reducing the symptoms of ADHD and improving functioning. Treatments include medication, various types of psychotherapy, education or training, or a combination of treatments.

Medications

The most common type of medication used for treating ADHD is called a "stimulant." Although it may seem unusual to treat ADHD with a medication considered a stimulant, it actually has a calming effect on children with ADHD. Many types of stimulant medications are available. A few other ADHD medications are non-stimulants and work differently than stimulants. For many children, ADHD medications reduce hyperactivity and impulsivity and improve their ability to focus, work, and learn. Medication also may improve physical coordination.

However, a one-size-fits-all approach does not apply for all children with ADHD. What works for one child might not work for another. One child might have side effects with a certain medication, while another child may not. Sometimes several different medications or dosages must be tried before finding one that works for a particular child. Any child taking medications must be monitored closely and carefully by caregivers and doctors.

Stimulant medications come in different forms, such as a pill, capsule, liquid, or skin patch. Some medications also come in short-acting, long-acting, or extended release varieties. In each of these varieties, the active ingredient is the same, but it is released differently in the body. Long-acting or extended release forms often allow a child to take the medication just once a day before school, so they don't have to make a daily trip to the school nurse for another dose. Parents and doctors should decide together which medication is best for the child and whether the child needs medication only for school hours or for evenings and weekends, too.

A list of medications and the approved age for use follows. ADHD can be diagnosed and medications prescribed by M.D.s (usually a psychiatrist) and in some states also by clinical psychologists, psychiatric nurse practitioners, and advanced psychiatric nurse specialists. Check with your state's licensing agency for specifics.

*Not all ADHD medications are approved for use in adults.
NOTE: "extended release" means the medication is released gradually so that a controlled amount enters the body
over a period of time. "Long acting" means the medication stays in the body for a long time.

Over time, this list will grow, as researchers continue to develop new medications for ADHD. Medication guides for each of these medications are available from the U.S. Food and Drug Administration (FDA).