Attention Deficit Hyperactivity Disorder (ADHD) and Other Health Impairments
Introduction to ADHD and Other Health Impairments
Attention deficit hyperactivity disorder (ADHD) and health and physical impairments are classified under Other Health Impaired (OHI) as per the Individuals with Disabilities Education Act (IDEA).
The Role of Attention
Prerequisite to Learning: Attention is essential for learning; without focus on relevant stimuli, learning cannot occur.
Components of Attention:
Alerting Network:
Represents readiness to receive information and suppresses irrelevant background stimuli.
Involves the ability to inhibit ongoing activities to focus on alerting signals.
Orienting Network:
Directs attention and aids in selecting relevant information while disregarding competing stimuli.
Executive Control Function:
Manages and sorts information akin to an airport control tower.
Involves self-regulation, planning, and rationalizing actions to guide future behavior.
ADHD in DSM-5
Definition: ADHD is defined as a persistent pattern of inattention or hyperactivity-impulsivity that interferes with functioning or development.
Symptoms must be more frequent or severe than observed in typically developing individuals.
Characteristics of ADHD:
One of the most prevalent neurodevelopmental mental health conditions diagnosed in childhood.
Involves impaired adaptive functioning at home, school, and social settings.
Importance of Chronological Age: Assessing attention levels based on developmental stages.
Adaptive Behavior and its Importance
Definition: Adaptive behavior encompasses conceptual, social, and practical skills that are necessary for daily functioning.
Conceptual Skills: Literacy, self-direction, numeracy, money management, and time concepts.
Social Skills: Interpersonal abilities, self-esteem, problem-solving, following rules, and obeying laws.
Practical Skills: Daily living activities, personal care, occupational skills, money management, and transportation use.
Impact of Impaired Adaptive Behavior: Difficulty adapting to everyday life due to insufficient skills to meet environmental demands.
Types and Presentation of ADHD
Persistency into Adulthood: Although presented in childhood, symptoms may vary into adolescence and adulthood.
No single medical or psychological test for diagnosing ADHD; it involves ruling in symptoms and ruling out other causes.
Subtypes of ADHD:
Combined Type: Symptoms of both inattention and hyperactivity/impulsivity.
Predominantly Inattentive Type (ADD): Symptoms focused mainly on inattention.
Predominantly Hyperactive-Impulsive Type: Exhibits hyperactivity and impulsiveness.
Symptom Requirements: Evidence of symptoms must appear prior to age 12 and persist for at least six months, with classification based on symptom presence in multiple environments.
Symptoms of Inattention (ADD)
Must meet six of the following twelve symptoms:
Fails to give close attention to details.
Makes careless errors.
Fails to sustain attention on tasks or play.
Fails to listen when spoken to directly.
Does not follow through on instructions or fails to finish tasks.
Has difficulty organizing tasks and activities.
Avoids tasks requiring sustained mental effort.
Loses necessary items for tasks.
Is easily distracted by extraneous stimuli.
Is forgetful in daily activities.
Symptoms of Hyperactivity-Impulsivity (ADHD)
Must meet six or more of the following symptoms:
Fidgets with hands or feet or squirms in seat.
Leaves seat in situations where remaining seated is expected.
Climbs or runs in inappropriate situations.
Unable to engage in leisure activities quietly.
Is always on the go or acts as if driven by a motor.
Talks excessively.
Blurting out answers before questions have been completed.
Has difficulty waiting for turn.
Prevalence of ADHD
Prevalence Rates:
Combined Type: 55%
Predominantly Inattentive Type: 27%
Predominantly Hyperactive-Impulsive Type: 18%
Comorbid Disorders: High prevalence of additional emotional, behavioral, or mental disorders among those diagnosed with ADHD. 64% report at least one other disorder.
Perspectives on ADHD
Child Perspective: Video insight from a child named Brad emphasizes difficulties with thought organization and excessive noise affecting focus.
Adult Perspective: Gender differences noted in diagnosis delays, particularly with girls who may internalize symptoms leading to underdiagnosis. Women often express feelings of not recognizing themselves due to untreated ADHD.
Importance of early intervention for effective support.
Eligibility for Special Education
Individuals with ADHD may be served under OHI or receive accommodations through a Section 504 plan.
Criteria for OHI:
Limited strength, vitality, or alertness due to chronic or acute problems.
Examples include ADHD, asthma, diabetes, epilepsy.
Impact on Educational Performance
Students with ADHD generally earn lower grades and perform poorly on achievement tests compared to typically developing peers.
Challenges in Sustained Attention: Difficulty tuning out distractions hinders their academic performance and skill acquisition.
Executive Functioning and Its Role
Executive Functioning: Involves working memory, mental flexibility, and self-control.
Working Memory: Retaining and processing information in the short term; essential for transferring knowledge to long-term storage.
Mental Flexibility: Ability to adapt behavior to different contexts and demands.
Self-Control: Inhibitory responses to prioritize actions and remain focused despite distractions.
Strategies for Supporting Children with ADHD
Developing Executive Functioning: Engaging relationships, structured environments, and opportunities for practice strengthen executive function development.
Physical Activity: Important for managing stress and improving brain function, particularly for children with ADHD.
Classroom Management: Establishing structured environments with clear rules and the use of organizational tools can greatly aid students with ADHD in staying on task and minimizing distractions.
Universal Design for Learning (UDL)
Definition and Principles: UDL is a framework that enhances access to learning for all students, removing barriers and promoting high achievement. Involves three main principles:
Multiple Means of Representation: Presenting information in varied formats for better understanding.
Multiple Means of Action and Expression: Allowing students to demonstrate their knowledge in diverse ways.
Multiple Means of Engagement: Ensuring learners are motivated and interested in learning.
Accommodations in Education
Provide various accommodations such as preferential seating, extended test-taking time, and organizational tools to support students with ADHD and learning disabilities.
Physical Disabilities Under OHI
Types: Includes orthopedic, neurological, and chronic health conditions. Examples are cerebral palsy, spina bifida, and muscular dystrophy.
Implication for Learning: Students may require adaptive tools, assistance from specialists, and thoughtful integration into a regular educational environment to support their learning and social-emotional needs.