Ch.7 Attention Deficit Hyperactivity Disorder

ADHD
attention deficit hyperactivity disorder
ADHD: 3 diagnostic criteria types
1.predominantly inattentive type
2.predominantly hyperactive-impulsive
3.combined type
Criteria examples to determine subtypes
1.inattention:trouble paying attention to details, difficulty sustaining attention, problems with organization, distractible;
2.hyperactivity:fidgeting, leaving seat at inappropriate times, talking excessively;
3.impulsivity:problems awaiting one’s turn, interrupting others
ADHD prevalence
between 7%-9% of school-age pop. has ADHD.
much more frequent in boys, 2 to 1 ratio.
Identification techniques
medical examination, clinical interview, teacher and parent rating scales, behavioral observations
Medical examination
necessary to rule out medical conditions, such as brain tumors, thyroid problems, or seizure disorders as the cause of inattention &/or hyperactivity
Clinical interview of parents and child
provides info about the child’s physical and psychological characteristics, as well as family dynamics and interaction with peers.
Rating scales
used as an attempt to being some quantification to the identification process.
Observation
can be done in classroom or special observation rooms to observe child performing tasks that require sustained attention
ADHD causes
with learning disabilities ADHD most likely results from neurological dysfunction rather than actual brain damage.
Heredity plays a very strong role in causing the neurological dysfunction, with teratogenic and other medical factors also implicated to a lesser degree.
Brain abnormalities
researchers have found relatively consistent abnormalities in brain of people with ADHD- frontal lobes, basal ganglia and cerebellum
Frontal lobes function
executive function: involves ability to regulate one’s own behavior.
Basal ganglia function
responsible for coordination and control of motor behavior
Cerrubellum
responsible for coordination & control of motor behavior. Only about 10% of brain mass, it contains more than half of all the brain’s neurons.
Neurotransmitters
chemicals that help in sending of messages between neurons in the brain.
2 abnormal neurotransmitters involved in ADHD
dopamine & noradrenaline
Symptoms associated w/ major behavioral characteristics
inattention, hyperactivity, impulsivity
Psychological processes underlying ADHD
Executive functioning, behavioral inhibition
Executive functioning
describes a number of processes involved in controlling & regulating behavior: working memory, inhibitory control, behavioral inhibition & mental flexibility. Controlled by pre/frontal lobes. These characteristics are diminished with ADHD. -hard to stay focused, low academic achievement
Behavioral inhibition
involves the ability to delay a response; interrupt an ongoing response, if the response is deemed inappropriate because of sudden changes in the demands of the task; or protect a response from distracting or competing stimuli. in ADHD problems in ability to wait one’s turn, refrain from interrupting conversations
Adaptive behavior skills
stipulates that intellectual disabilities be defined as impairments in intelligence & adaptive behavior.
Social behavior problems
With ADHD students are more disliked by their peers than those without ADHD. Negative social status is common. End up socially ostracized
Educational considerations
1.classroom structure and teacher direction
2.functional behavioral assessment and contingency-based self-management
Classroom structure and teacher direction
1.reduce stimuli irrelevant to learning & enhancing materials important for learning
2.structuring a program with a strong emphasis on teacher direction
(Cruickshank program)
Functional behavioral assessment (FBA)
involves determining the consequences, antecedents, & setting events that maintain inappropriate behaviors.
Contingency-based self-management
usually involve having people keep track of their own behavior and then receive consequences, usually in the form of rewards, based on their behavior.
Combination of FBA & contingency-based self-management
proven successful in increasing appropriate behavior of elementary & secondary students with ADHD
Role of contingency in contingency-based self-management
reinforcement of some kind, such as social praise or points that can be traded for privileges, is especially important for self-management techniques to be effective.
ADHD medication
Psychostimulants, Strattera, Methylphenidate (Ritalin), Adderall and Vyvnse
Psychostimulants
stimulate or activate neurological functioning. the most frequent type of medication prescribed for ADHD
Strattera
an example of a nonstimulant that is also sometimes prescribed for ADHD
Methylphenidate (Ritalin)
most common stimulant prescribed for ADHD
Adderall and Vyvanse
other stimulants also prescribed.
Ritalin function
influences the release of the neurotransmitters dopamine & norepinephrine, enabling the brain’s executive functions to operate more normally.
Ritalin effectiveness
helps students have more normalized behavioral inhibition and executive functioning, leads to better results on parent & teacher rating scales, improved academic achievements, better classroom behavior and homework completion
Ritalin side effect possibilities
insomnia, reduction in appetite, abdominal pain, headaches and irritability.
ADHD medication cautions
should not be prescribed at first sign of medication problem, teachers shouldn’t assume medication will take care of all academic problems students face, dosage levels should be closely monitored, child should not be led that medication serves as substitute to self-responsibility and self-initiative, medication should not be viewed as a panacea by parents/teachers, psychostimulants are a controlled substance must be kept away from siblings/peers etc., communication is key for effective use of medication.