ATTENTION DEFICIT
After completing this educational activity,
HYPERACTIVITY DISORDER
{Discuss the occurrence and distribution of ADHD from childhood through adulthood.
{Outline the current understanding of the causes of
{Discuss the impact of ADHD symptoms on function. {Discuss teaching-related practices that have been found to be useful with students with ADHD. A syndrome is a group of symptoms or traits that, when considered together, characterize a disease. Chicken Pox is a disease, while ADHD is a syndrome. A designation or diagnosis of ADHD can only
zThe child’s behaviour is causing significant
be made by a medical doctor or a psychiatrist. Diagnostic Statistical Manual of Mental Disorders
zApproximately 3 – 5 percent of the student
z According to the DSM-IV, children with ADHD
population are estimated to have ADHD. typically exhibit behaviour that is classified into two main categories: poor sustained attention and hyperactivity-impulsiveness.
ADHD – the condition is diagnosed four to
z Three subtypes of the disorder have been
nine times more often in boys than in girls. described in the DSM-IV: -predominantly inattentive -predominantly hyperactive-impulsive
children with ADHD do not grow out of it. -combined types
zCriteria for diagnosis are based on the
z Children with attention disorders have problems in a wide range of tasks that require attentional skills including:
outlined in the DSM-IV), that present early
a) Sustained Attention – often referred to as a “short attention span”
inconsistent with developmental level), occur frequently, persist over time (for at
Classroom Indicators: -difficulty beginning activities -difficulty remaining on task until activity is finished
-attention can shift “off task” when an alternative activity is present that is more gratifying
-difficulty focusing on two tasks at the same time (eg. Taking notes and listening to the teacher
d) Selective Attention:
z Children with hyperactive symptoms have -unable to focus selectively and difficulties with developmentally excessive overwhelmed by competing stimuli levels of motor and/or vocal activity
z May have difficulty appropriately regulating Classroom Indicators: activity level to a given situation or task. -difficulty filtering out internal and external
z 70% of children with ADHD have significant distractions (eg. Internal distractions such symptoms of hyperactivity/impulsivity as daydreaming, hunger, lack of sleep and external distractions such as noises in the
z Symptoms of hyperactivity typically environment.) decrease with development and age
z Excitability
z2 – 6% of adults manifest symptoms of
z Low frustration tolerance
z Poor planning ability
z Disorganization
z Jumping from one activity to another
z Difficulty in group activities z Difficulty delaying gratification
zHyperactivity usually decreases if ADHD
z Difficulty considering physical or social consequences of behaviour
zNo single cause has been identified for
zInterventions and treatment of ADHD may
treatment, family and individual therapy,
-The most frequent treatment for ADHD is the
-Although medications can be helpful, they
prescription of psychostimulant medications such
should not be the first and only treatment
as methylphenidate or Ritalin as it is commonly known. The decision to include medication as part of the treatment plan is made by parents of an ADHD child in consultation with their physician. -Other psychostimulant medications used are
-An integrative approach is necessary. Concerta, Dexedrine, Adderall and Strattera. -Mood stabilizers, such as Risperdal, may also be perscribed.
-are environmental modifications designed
-organized classroom -clear consistent rules or expectations -frequent reinforcement -supervised transitions
zBe consistent and sincere with praise.
zSelectively ignore inappropriate behaviour. zProvide calming manipulatives.
-Social Problem Solving Training-Self Instruction Training
z For many students with ADHD, a functional behavioural assessment can be useful.
z FBA is a systematic process for gathering details about the events that predict and maintain behaviour.
z The purpose of the FBA is to provide information that will be used to design effective behaviour support and intervention
-support the student’s participation in the
-help students correct their own mistakes
-computer games – for drill and practice
-partnering for math activities -mastery of math symbols -mnemonics (“Don’t Miss Susie’s Boat” –
zSelect appropriate instructional practices. divide, multiply, subtract and bring down for
zA successful program for the student with
basic steps in long division) -color code arthmetic symbols (+, -, =) -use a calculator to check computation
instruction, behavioural interventions and
-number lines, graph paper -manipulatives
1) Barkley, R. Attention Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment, 2nd Ed. New York, NY., Guilford Press, 1998.
2) U.S. Department of Education, Office of
Special Education and Rehabilitative Services, Office of Special Education Programs, Teaching Children With Attention Deficit Hyperactivity Disorder: Instructional Strategies and Practices,Washington, D.C., 2004.
DIGESTIVE ENZYMES PROMOTE OPTIMAL NUTRITION While healthy foods provide the foundation for optimal health and vitality, even the healthiest foods are of little use if they are not properly digested. Digestive enzymes break down ingested food into vital proteins, fats, and carbohydrates to provide However, as we age, normal digestion slows down, inhibiting our ability to process vital nutrient
7.27.2.14 APPENDIX A: SCOPES OF PRACTICE FOR FULLY LICENSED EMERGENCY MEDICALSERVICES PERSONNEL : Medical director means a physician functioning as the service EMS medical director as defined and described in 7.27.3 NMAC, Medical Direction for Emergency Medical Service. Medical control means supervision provided by or under the direction of a physician. Prior to accomplishing a new skill,