ADD and ADHDADD and ADHDADD and ADHDADD and ADHD

Joyce A. Hill, Ph.D.Joyce A. Hill, Ph.D.New Mexico State University—AlamogordoNew Mexico State University—Alamogordo

Colleen M. Hill, B.A.Colleen M. Hill, B.A.

Definitions• ADHD—3 types

predominantly inattentive typepredominantly hyperactive-impulse typecombined type

• OHI—other health impaired: this is the category that children can be given special education services

Diagnostic Criteria: DSM—diagnostic and statistical manual of mental

disorders

• 6 or more symptoms of inattention OR hyperactivity-impulsivity that have persisted or at least 6 months to a degree that is maladaptive and inconsistent with developmental level

• Symptoms present before age 7• Impairment in 2 or more settings• Clear evidence of clinically significant

impairment in social, academic, occupational functioning

• Symptoms not part of another diagnosis

Myths• Careful research has shown that

sugar DOES NOT cause hyperactivity• Television and video games are NOT

linked to hyperactivity• A diet free of food colorings and

additives is not beneficial• ADHD disappears in adulthood—

2/3rds continue to have the condition• ADHD is a fad—reports of cases back

to mid 19th century

Current Research Evidence

• Some indication that ADHD results from neurological dysfunction rather than actual brain damage

• Abnormalities in frontal lobes, basal ganglia, cerebellum

• Neurotransmitter abnormalities (chemicals that help in the sending of messages between neurons)

Current Research Evidence

• Abnormal levels of dopamine • Some toxins related, exposure

to lead, abuse of alcohol

• Strong hereditary basis

Behavioral CharacteristicsRussell Barkley’s Model

• Limitations in behavioral inhibition withholding a response, protecting a

response from interruption• Limitations in executive functions self-directed behaviors such as

working memory, inner speech, emotional control, analyzing problems

• Limitations in goal-directed behaviorfocus on task, persistence, longer time

frames

Meeting needs…What research says.

• Allow time between asking a child to do or say something and expecting a response

• Avoid overloading working memory by limiting number of steps in directions, explains, etc.

• Create routines for transitions• Prepare children in advance for

changes

Meeting Need… More strategies

• Planning: Divide instructional sequence into meaningful chunks

• Clearly Introduce: Let children know the objectives for the day

• Modeling: Model steps of instructions, lessons

Behavior Helpers

• Frequent breaks• Behavior charts kept by child• Cue charts and reminders on desk• Posted charts of everyday routines• Prepare the child ahead of time for

changes in routines, or special events

• Visuals to cue working memory

The Medication The Medication ControversyControversy

The Medication The Medication ControversyControversy

Frequent Questions…• What are some common

stimulant medications available for children with ADHD?

• What are possible side effects of stimulant medication?

• Does stimulant medication help or harm a child?

• Alternative treatments for children with ADHD

Common Stimulant Medications…

• Ritalin• Adderall• Dexedrine• Concerta• Strattera

Potential Side Effects• Insomnia

• Dry mouth

• Nausea

• Loss of appetite

• Headaches

• Jitteriness

• Increased blood pressure

• Growth suppression

How Does Stimulant Medication Harm

Children?• Some children never fully

stop taking their medication

• Side effects for adults are worse

• Children become lethargic

• Medication alone does not do the trick

How Does Stimulant Medication Help

Children?• Enhanced response

inhibition• Enhanced item recall• Enhanced

performance of paired associate learning tasks

Alternative Treatments• Behavior modification• Parent education• Management training• Classroom

environment manipulations

• Motivational training

References• Chelonis, J. J., Edwards, M. C., Schulz, E. G., & Baldwin, R. B. (2002).

Stimulant medication improves recognition memory in children

diagnosed with attention deficit/hyperactivity disorder. Experimental

and Clinical Psychopharmacology, 10(4), 400-407.

• Diller, L. H. (1996). The run on Ritalin: Attention deficit disorder and

stimulant treatment in the 1990s. In M.A. Byrnes (Ed.), Taking sides:

Clashing Views on controversial issues in special education (pp. 305-

313). Boston, MA: McGraw/Dushkin.

• Hallahan, D.P., & Kauffman, J. M. (2003). Exceptional learners. Boston:

Allyn and Bacon.