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Gallaudet Univeristy
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Attention Deficit Hyperactivity Disorder

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)

The Diagnostic and Statistical Manual (DSM-IV) divides the symptoms of ADHD into those of inattentiveness and those of hyperactivity and impulsivity. Some children with ADHD primarily have the Inattentive Type, some the Hyperactive-Impulsive Type, and some the Combined Type. Those with the Inattentive type are often less disruptive and are easier to miss being diagnosed with ADHD.

Identification
The following behaviors may be indicators of the Inattentive Type. The child:

  1. Does not pay close attention to school work , making carless mistakes and missing important details
  2. Shows a limited attention span in class and during social interactions
  3. Does not pay attention when spoken to, fails to make eye contact
  4. Does not complete  tasks at school, home or work
  5. Has difficulties in time management and organizational skills for tasks and activities
  6. Does not like and avoids tasks which require extended concentration
  7. Often misplaces or loses materials needed for an activity
  8. Is easily distracted
  9. Is often forgetful in daily activities

Hyperactivity symptoms:

  1. Fidgets, excessive movement of body
  2. Has difficulty staying seated
  3. Runs about and may climb objects at inappropriate times
  4. Has a hard time playing quietly
  5. Is in constant physical movement with excessive verbal responses

Impulsivity symptoms:

  1. Gives the answer before the question is completed
  2. Has difficulty waiting for their turn
  3. Interrupts or intrudes during games and conversations

Obtaining an interdisciplinary evaluation using feedback from teachers, parents and other important individuals in the student's life is mandatory for an appropriate assessment and diagnosis.

The two assessment tools frequently used for diagnosis are:

The T.O.V.A. (Test of Variables of Attention) uses geometric stimuli (to minimize the effects of cultural differences and learning problems), and contains two test conditions: target infrequent and target frequent.

The Attention-Deficit Scales for Adults (ADSA) is a tool in the assessment and diagnosis of AD/HD in adults. It has been shown to have a high degree of accuracy in correctly classifying adults with ADHD. Consisting of 54 items, the instrument addresses symptoms associated with ADHD by asking patients to select one of five choices with respect to each item. Included is a 2-part carbonized scoring sheet and an ADSA Profile Sheet for calculating internal consistency

Interventions
There is no single treatment for everyone. Options should be explored with a health care provider who is familiar with ADD/ADHD. Consideration needs to be given to the patient's needs, family, medical and personal history.

Behavioral therapy, or behavioral modification, is a psychological technique based on the premise that specific, observable, maladaptive, badly adjusted, or self-destructing behaviors can be modified by learning new, more appropriate behaviors to replace them. More about behavioral therapy.

Educational Recommendations
A child's academic success often depends on his or her ability to pay attention to tasks and the teacher, and meet classroom expectations without distractions.  These skills enable students to acquire necessary information, complete assignments, and participate in classroom activities and discussions (Forness & Kavale, 2001).

Kelly, Forney and others (1993) suggest using traditional environmental modifications such as those implemented in with hearing students with ADD.

The traditional ADHA classroom is closed style, where the student is placed close to the teacher, reducing visual distractions.

Teaching Children with Attention Deficit and Hyperactivity Disorder: Instructional Strategies and Practices (2004) is an excellent resource for classroom teachers

Deafness and ADHD

Parasnis and colleagues (2001) compared norms based on the hearing population from two diagnostic tests measuring inattentiveness and impulsivity: the Attention Deficit Scales for Adults, or ADSA (Triolo & Murphy, 1996), and the Test of variables of Attention, or TOVA (Greenberg & Waldman, 1993). Parasnis and colleagues found that deaf students given the TOVA tended to be over diagnosed with ADHD. The researchers suggested that a separate set of norms be developed for individuals with a hearing loss. However, deaf students who took the ADSA had means and variances comparable to those of the hearing population. Thus, the ADSA was a more reliable diagnostic tool for identifying ADHD in students with a hearing loss.

References

Forness, S. R., & Kavale, K. A. (2001). ADHD and a return to the medical model of special education. Education and Treatment of Children, 24(3), 224-247.

Greenberg, L. M., & Waldman, I. D. (1993).Developmental normative data on the Test of Variables of Attention. Journal of Child Psychology and Psychiatry, 34, 1019-1030.

Kelly, D. P., Jones, M., Moulton, N., Verhulst, S.,& Bell, S. (1993). Attention deficits in children and adolescents with hearing loss: A survey. American Annals of the Deaf,

147(4), 737-741.

Kelly, D., Forney, J., Parker-fisher, S. & Jones, M. (1993). The challenge of attention deficit disorder in children who are deaf or hard of hearing. American Annals of the Deaf, 138(4), 343-348.

Parasnis, I., Samar, J. V., & Berent, G. P. (2001).Evaluating ADHD in the deaf population:Challenges to validity. NTID Research Bulletin,6(1), 1-5.

Triolo, S. J, & Murphy, K. R. (1996). Attention deficit scales for adults. New York: Bruner/Mazel

U.S. Department of Education, Office of Special Education and Rehabilitation Services, Office of Special Education Programs, Teaching Children with Attention Deficit Hyperactivity Disorder: Instructional Strategies and Practices, Washington, D.C. 2004 

Resources

http://www.adhdnews.com/states.htm  is an extensive listing of services, resources and educational information for each state

CHADD National Office
8181 Professional Place - Suite 150
Landover, MD 20785
Tel: 301-306-7070
Fax: 301-306-7090

http://www.chadd.org/

Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), is a national non-profit, tax-exempt (Section 501 (c) (3) ) organization providing education, advocacy and support for individuals with AD/HD. In addition to our informative Web site, CHADD also publishes a variety of printed materials to keep members and professionals current on research advances, medications and treatments affecting individuals with AD/HD. These materials include Attention! magazine, the CHADD Information and Resource Guide to AD/HD, News From CHADD, a free electronically mailed current events newsletter, as well as other publications of specific interest to educators, professionals and parents.

ADHD Support
U.S. Headquarters
Shire US Inc.
725 Chesterbrook Blvd.
Wayne, PA 19087
http://www.adhdsupport.com/ 

ADDA:  The Attention Deficit Disorder Organization
15000 Commerce Parkway, Suite C
Mount Laurel, NJ 08054

856-439-9099   Phone
856-439-0525   Fax
adda@add.org   email

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.

Print Resources

Barkley, R.A. (1990). Attention deficit hyperactivity disorder: A handbook for diagnosis and treatment. New York: Guilford.

Bender, W. (1997). Understanding ADHD: A practical guide for teachers and parents. Upper Saddle River, NJ: Merrill/Prentice Hall.

DuPaul, G.  J., & Stoner, G. (1994). ADHD in the schools: Assessment and intervention strategies. New York: Guilford Press.

DuPaul, G. J., & Stoner, G. (2002). Interventions for attention problems. In M. R. Shinn, H. M. Walker, & G. Stoner (Eds.), Interventions for academic and behavior problems II: Preventive and remedial approaches (pp. 913-938). Bethesda, MD: National Association of School Psychologists.

Hallowell, E. (1994). Driven to distraction: Recognizing and coping with attention deficit disorder from childhood through adulthood. Tappan, NJ: Simon & Schuster.

Jensen, P. S., Martin, D., & Cantwell, D. P. (1997). Comorbidity in ADHD: Implications for research, practice, and DSM-IV.  Journal of the American Academy of Child and Adolescent Psychiatry, 36, 1065-1079.

Kelly, D., Forney, J., Parker-fisher, S. & Jones, M. (1993). The challenge of attention deficit disorder in children who are deaf or hard of hearing. American Annals of the Deaf, 138(4), 343-348.

Mitchell, T. & Quittner, A. (1996). Multimethod study of attention and behavior problems in hearing-impaired children. Journal of Clinical Child Psychology, 25(1), 83-96.

Rief, S. F. (1997). The ADD/ADHD checklist: An easy reference for parents and teachers. Reston, VA: Council for Exceptional Children.

Robelia, B. (1997). Tips for working with ADHD students of all ages.  Journal of Experimental Education, 20 (1), 51-53.

Schnittjer, C. & Hirshoren, A. (1981). The prevalence of behavior problems in deaf children. Psychology in the Schools, 18 (1), 67-72.