Attention Deficit/Hyperactivity Disorder (ADHD)

DISABILITY CATEGORY: Other Health Impairment—Attention Deficit/Hyperactivity Disorder (ADHD)

TYPES:

• Inattentive type, where the person can’t seem to get focused or stay focused on a task or activity

• Hyperactive-impulsive type, where the person is very active and often acts without thinking

• Combined type, where the person is inattentive, impulsive, and too active

DEFINITION:

Many students with ADHD now may qualify for special education services under the “Other Health Impairment” category within the Individuals with Disabilities Education Act (IDEA). IDEA defines “other health impairment” as...

            “...having limited strength, vitality or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment, that is due to chronic or acute health problems such as asthma, attention deficit disorder or attention deficit hyperactivity disorder, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, and sickle cell anemia; and adversely affects a child's educational performance.” [34 Code of Federal Regulations §300.7(c)(9)]

Other definitions: Attention-Deficit/Hyperactivity Disorder (AD/HD) is a condition that can make it hard for a person to sit still, control behavior, and pay attention. These difficulties usually begin before the person is 7 years old. However, these behaviors may not be noticed until the child is older. (Source: NICHCY)

Attention-Deficit/Hyperactivity Disorder (ADHD) is the term used in the current Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) diagnostic criteria. ADD (Attention Deficit Disorder) with or without hyperactivity is the older term from the DSM-IIIR. (Source: ADHD.com)

FACTS AND STATS: 

• ADHD affects an estimated 4.1 percent of youths ages 9 to 17 in a 6-month period.

• About 2 to 3 times more boys than girls have ADHD.

• Children with untreated ADHD have higher than normal rates of injury.

• ADHD often co-occurs with other problems, such as depressive and anxiety disorders, conduct disorder, drug abuse, or antisocial behavior.

• Symptoms of ADHD usually become evident in preschool or early elementary years. The disorder frequently persists into adolescence and occasionally into adulthood. (Source: National Institute of Mental Health, 2001)

CAUSES: Doctors do not know just what causes AD/HD. However, researchers who study the brain are coming closer to understanding what may cause AD/HD. They believe that some people with AD/HD do not have enough of certain chemicals (called neurotransmitters) in their brain. These chemicals help the brain control behavior. (Source: NICHCY)

PREVENTION: While there is no proven way to prevent ADHD itself, early identification and treatment can prevent many of the problems associated with ADHD. (Source: AllRefer Health)

CHARACTERISTICS: Children with ADHD—one of the most common of the psychiatric disorders that appear in childhood—can't stay focused on a task, can't sit still, act without thinking, and rarely finish anything. If untreated, the disorder can have long-term effects on a child's ability to make friends or do well at school or work. Over time, children with ADHD may develop depression, poor self-esteem, and other emotional problems. (Source: NIMH)

The symptom-related criteria for the three primary subtypes are adapted from DSM-IV and summarized as follows:

AD/HD predominantly inattentive type: (AD/HD-I)

• Fails to give close attention to details or makes 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 easily distracted.

• Is forgetful in daily activities.

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 or taking turns.

• Interrupts or intrudes upon others.

AD/HD combined type: (AD/HD-C)

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

Youngsters with AD/HD often experience delays in independent functioning and may therefore behave in ways more like younger children. In addition, AD/HD frequently co-occurs with other conditions, such as depression, anxiety or learning disabilities. For example, in 1999, NIMH research indicated that two- thirds of children with AD/HD have a least one other co-existing condition. When co-existing conditions are present, academic and behavioral problems, as well as emotional issues, may be more complex.

Teens with AD/HD present a special challenge. During these years, academic and organizational demands increase. In addition, these impulsive youngsters are facing typical adolescent issues: discovering their identity, establishing independence, dealing with peer pressure, exposure to illegal drugs, emerging sexuality, and the challenges of teen driving.

Recently, deficits in executive function have emerged as key factors impacting academic and career success. Simply stated, executive function refers to the variety of functions within the brain that activate, organize, integrate and manage other functions. This permits individuals to appreciate the longer-term consequences of their actions and guide their behavior across time more effectively.Critical concerns include deficits in working memory and the ability to plan for the future, as well as maintaining and shifting strategies in the service of long-term goals. (Source: National Resource Center on AD/HD: A Program of CHADD)

MEDICAL TREATMENT: Like many medical conditions, AD/HD is managed, not cured. There's no "quick fix" that resolves the symptoms of the disorder. Yet a lot can be done to help. Through effective management, some of the secondary problems that often arise out of untreated AD/HD may be avoided. In the majority of cases, AD/HD management will be a life-long endeavor. It may be helpful to think of AD/HD as a challenge that can be met. Recently, the National Institute of Mental Health (NIMH), in combination with the U.S. Department of Education's Office of Special Education Programs (OSEP), completed a long-term, multi-site study to determine which treatments had the greatest positive effect on reducing AD/HD symptoms. This study is known as the MTA study (The MTA Cooperative Group, 1999). MTA stands for multi-modal treatment study of children with AD/HD.

The recommended multi-modal treatment approach consists of four core interventions:

• patient, parent, and teacher education about the disorder;

• medication (usually from the class of drugs called stimulants);

• behavioral therapy; and

• other environmental supports, including an appropriate school program. (Source: NICHCY)

PROGNOSIS: Children with AD/HD are at risk for potentially serious problems in adolescence: academic underachievement and school failure, problems in social relations, risk for antisocial behavior patterns, teen pregnancy, and adverse driving consequences.As noted above, AD/HD persists from childhood to adolescence in the vast majority of cases, although the symptom area of motor activity tends to diminish with time. Furthermore, up to two-thirds of children with AD/HD continue to experience significant symptoms in adulthood. Yet many adults with AD/HD learn coping strategies and compensate quite well. A key to good outcome is early identification and treatment. (Source: NRC on AD/HD: A Program of CHADD)

EDUCATIONAL IMPLICATIONS: School can be hard for children with AD/HD. Success in school often means being able to pay attention and control behavior and impulse. These are the areas where children with AD/HD have trouble.

Most students with AD/HD are helped by supports or changes in the classroom (called adaptations). The following tips for teachers describe some common changes that help students with AD/HD:

• Figure out what specific things are hard for the student. For example, one student with AD/HD may have trouble starting a task, while another may have trouble ending one task and starting the next. Each student needs different help.

• Post rules, schedules, and assignments. Clear rules and routines will help a student with AD/HD. Have set times for specific tasks. Call attention to changes in the schedule.

• Show the student how to use an assignment book and a daily schedule. Also teach study skills and learning strategies, and reinforce these regularly.

• Help the student channel his or her physical activity (e.g., let the student do some work standing up or at the board). Provide regularly scheduled breaks.

• Make sure directions are given step by step, and that the student is following the directions. Give directions both verbally and in writing. Many students with AD/HD also benefit from doing the steps as separate tasks.

• Let the student do work on a computer.

• Work together with the student’s parents to create and implement an educational plan tailored to meet the student’s needs. Regularly share information about how the student is doing at home and at school.

• Have high expectations for the student, but be willing to try new ways of doing things. Be patient. Maximize the student’s chances for success. (Source: NICHCY)

ORGANIZATIONS:

Attention Deficit Disorder Association (ADDA)
P.O. Box 543
Pottstown, PA 19464
484.945.2101
http://www.add.org

The Attention Deficit Disorder Association (ADDA) is designated as a 501 (c) 3 nonprofit organization by the Internal Revenue Service. This international organization has been in existence since 1989. The mission of ADDA is to provide information, resources and networking to adults with AD/HD and to the professionals who work with them. In doing so, ADDA generates hope, awareness, empowerment and connections worldwide in the field of AD/HD. Bringing together scientific perspectives and the human experience, the information and resources provided to individuals and families affected by AD/HD and professionals in the field focuses on diagnoses, treatments, strategies and techniques for helping adults with AD/HD lead better lives.

CH.A.D.D. (Children and Adults with Attention-Deficit/Hyperactivity Disorder)
8181 Professional Place, Suite 150
Landover, MD 20785
301-306-7070
800-233-4050
http://www.chadd.org

CHADD is the nation’s leading non-profit organization serving individuals with Attention-Deficit/Hyperactivity Disorder (AD/HD). Through collaborative leadership, advocacy, research, education and support, CHADD provides science-based, evidence-based information about AD/HD to parents, educators, professionals, the media and the general public.

The Attention Deficit Information Network, Inc.
475 Hillside Ave
Needham, MA 02194
781-455-9895
http://www.addinfonetwork.com

The Attention Deficit Information Network, Inc. is a non profit volunteer organization. We offer support and information to families of children with ADD, adults with ADD and professionals through a network of AD-IN chapters. AD-IN was founded in 1988 by several parent support group leaders on the premise of parents helping parents deal with their children with ADD. Our network has parent and adult support group chapters throughout the country.

RESOURCES:

General Web Sites:

http://www.help4adhd.org/index.cfm  The National Resource Center on AD/HD: A Program of CHADD is funded through a cooperative agreement with the Centers for Disease Control and Prevention. Attention-deficit/hyperactivity disorder (AD/HD) affects how millions of children and adults function on a daily basis. The NRC was created to meet the information needs of both professionals and the general public.

http://www.aap.org/healthtopics/adhd.cfm  Children's Health Topics: ADHD. An extensive series of pages and publications devoted to ADHD, from the American Academy of Pediatrics.

http://www.attentiondeficitdisorder.ws  An internet community resource provided by
TheNewIdeas.Net family of ADD/ADHD information Web sites.

http://www.abcteach.com  This site includes free printable material and activities for kids, parents, student teachers, and teachers.

http://www.myadhd.com  MyADHD.com was developed to make it easy for stakeholders such as healthcare professionals, families, adults with ADHD, and educators to exchange information electronically to optimize assessment and treatment of ADHD and related disorders. The site provides forms that can be electronically transmitted.

http://www.ldonline.org LD Online is a national educational service of public television station WETA in Washington, D.C. It is operated in association with the Coordinated Campaign for Learning Disabilities and is made possible by generous support from Lindamood-Bell Learning Processes®. LD Online offers online services and produces video programs dedicated to improving the lives of children and adults with learning disabilities and ADHD. LD Online features thousands of helpful articles on learning disabilities and ADHD, monthly columns by noted experts in the field, a free and confidential question and answer service, active bulletin boards, and a Yellow Pages referral directory of professionals, schools, and products.

http://www.education-world.com/a_issues/archives/special_ed.shtml  Education World, Educator's Best Friend, is a resource that includes a search engine for educational Web sites only, a place where educators can find information without searching the entire Internet; original content, including lesson plans, practical information for educators, information on how to integrate technology in the classroom, and articles written by education experts; site reviews; daily features and columns; teacher and principal profiles; Wire Side Chats with the important names in education; and employment listings. In this site of School Issues Archives, you will find more than 200 original articles written by Education World editors.

Web Sites for Parents:

http://www.adhd.com  This Web site provides tips, links, and resources for parents and caregivers of children with ADHD.

http://www.adhdnews.com  ADHDNews.com is a community started by Brandi Valentine in 1995. It provides help to families looking for help on ADHD.

Web Sites for Children:

http://www.ncpamd.com/Kids_Pages.htm  Articles, games and book reviews for children and adolescents interested in understanding mental health issues.

http://www.kidshealth.org/kid/health_problems/learning_problem/adhdkid.html  Created by The Nemours Foundation's Center for Children's Health Media,KidsHealth is the largest and most visited site on the Web providing doctor-approved health information about children from before birth through adolescence. KidsHealth has separate areas for kids, teens, and parents - each with its own design, age-appropriate content, and tone.

http://www.cyh.com/SubDefault.aspx?p=255  Created by Child and Youth Health, this web site allows children ages 6 to 12 years old to research health topics such as ADHD.

Publications:

Teaching Children with Attention Deficit Hyperactivity Disorder: Instructional Strategies and Practices (2004).  Produced under the U.S. Department of Education, this report recommends appropriate stategies in academic instruction, behavior intervention, and classroom accommodations for children with ADHD.

Attention Deficit Hyperactivity Disorder (2001).  A publication of the National Institute of Mental Health, this four-page PDF file gives a brief overview of the symptoms, treatments, and research findings. [http://www.nimh.nih.gov/publicat/NIMHhelpchild.pdf]

Attention Deficit Hyperactivity Disorder (2003).  A publication of the National Institute of Mental Health, this forty-nine page detailed booklet describes the symptoms, causes, and treatments, with information on getting help and coping. [http://www.nimh.nih.gov/publicat/adhd.cfm]

The Disorder Named AD/HD - CHADD Fact Sheet #1.  This fact sheet provides a basic overview of AD/HD symptoms, diagnosis, and treatment modalities.

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