Often we hear friends comment on their ADHD, hyperactivity or focusing problems, but ADHD  is not as prevalent as we might believe as it effects less than 9% of children and approximately 3.4% of adults. We all experience difficulties with attention and focusing at some point in our lives, but a diagnosis is only warranted when the symptoms are pervasive and troubling in more than one area of our life.

Definition

ADHD is a neurodevelopmental disorder that causes difficulties with attention, organization, excessive physical movement, and executive functioning skills (organizing, decision making, short term memory). Most scientists believe it to be primarily hereditary, meaning it runs in families.  In Individuals with Disabilities Education Act (2004), attention deficits are included under the category of Other health Impairment and defined 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 https://sites.ed.gov/idea/regs/b/a/300.8. 

It is not a behavior disorder nor is it the result of bad parenting. However, the sooner you address the issues, the more likelihood of preventing underachievement and low self-esteem that can lead to other emotional and behavioral problems. https://www.understood.org

Symptoms of ADHD include inattention (not being able to keep focus), hyperactivity (excess movement that is inappropriate for the setting), and impulsivity (hasty acts that occur in the moment without thought of the consequences). In a broad estimate of prevalence, approximately  7-9% of children ages 2-19 have ADHD, which is often first identified in school-aged children when it leads to disruption in the classroom or problems with schoolwork. It is more common among boys than girls. Half of the children with ADHD also have a behavior or conduct disorder and about a third experience anxiety.

Children and Adults with Attention Deficit/Hyperactivity Disorder, https://chadd.org/about-adhd/general-prevalence/

Center for Diseases Control, Data and Statistics About ADHD

Types

Attention Deficit/Hyperactivity Disorder is defined by three types:

    1. Inattentive
    2. Hyperactive/Impulsive
    3. Combined
  • Children younger than 17 require 6/9 symptoms; 17 & above require 5/9 symptoms.
  • Symptoms must have occurred over the past 6 months.

Diagnostic Statistical Manual, 5th version (DSM-5), 2013

There is not a single test that can diagnose ADHD, but rather a battery of tests are usually given to rule out learning disorders, health concerns, and cognitive impairments.  Many health issues can be masked as ADHD: unchecked hypoglycemia or diabetes, rare blood disorders, traumatic brain injury, auditory processing disorder and a variety of other illnesses. It’s a good idea to schedule a medical check up with a doctor before jumping to a conclusion that your child has ADHD.

 

Characteristics Checklist

Inattentive

  • Does not pay close attention to details or makes careless mistakes on tasks.
  • Has problems staying focused on tasks or activities, such as during lectures, conversations, or long reading.
  • Does not seem to listen when spoken to (i.e., seems to be elsewhere).
  • Does not follow through on instructions and doesn’t complete schoolwork, chores or job duties (may start tasks but quickly loses focus).
  • Has problems organizing tasks and work (for instance, does not manage time well; is messy & disorganized).
  • Avoids or dislikes tasks that require sustained mental effort such as completing math lessons, writing an essay, or taking tests.
  • Often loses things needed for tasks or daily life, such as school papers, books, keys, wallet, cell phone, and eyeglasses.
  • Is easily distracted.
  • Forgets daily tasks, such as doing chores and running errands. Older teens and adults may forget to return phone calls, pay bills, and keep appointments.
  • Hyperactive/ Impulsive
    • Fidgets with or taps hands or feet, or squirms when seated.
    • Not able to stay seated (in classroom, church, workplace).
    • Runs about or climbs where it is inappropriate.
    • Unable to play or do leisure activities quietly.
    • Always on the go, as if driven by a motor.
    • Talks too much, often loudly.
    • Blurts out an answer before a question has been finished (for instance may finish people’s sentences, can’t wait to speak in conversations).
    • Has difficulty waiting his or her turn, such as while waiting in line or while playing games.
    • Interrupts or intrudes on others (for instance, cuts into conversations, games or activities, or starts using other people’s things without permission). Older teens and adults may take over what others are doing.   What Is ADHD?, American Psychiatric Association

    Everyone has difficulty with some of these symptoms some of the time, but true ADHD is when these symptoms affect daily life functioning at school, work, and play leading to persistent frustration and failure. 

    ADD Resource Center  offers a free screening online at https://www.addrc.org/child-adolescent-screening-tests/

    TIP: Many Misdiagnosed

    Intellectually gifted people, whose needs are neglected or misunderstood, may exhibit traits and behaviors that resemble conditions like Attention Deficit/Hyperactivity Disorder (ADHD).  Thus, misdiagnosis can result in unnecessary medication and unintended harm.

  • Misdiagnosis Initiative , SENG Social Emotional Needs of Gifted offers a guide to use when trying to distinguish if a child has ADHD, giftedness or both. 

Behaviors Associated with ADHD 

  • Poorly sustained attention in almost all situations
  • Diminished persistence on tasks not having immediate consequences
  • Impulsivity, poor delay of gratification
  • Impaired adherence to commands to regulate or inhibit behavior in social context

       versus                                      

Behaviors Associated with Giftedness 

  • Poor attention, boredom, daydreaming in specific situations
  • Low tolerance for persistence on tasks that seem irrelevant
  • Judgment lags behind development of intellect
  • Intensity may lead to power struggles with authorities
  • High activity level; may need less sleep
  • Questions rules, customs and traditions

Dr. James Webb and Diane Latimer (1993), ADHD and Children Who Are Gifted


Example

Children that have ADHD may also be gifted, have a specific learning disability or a combination of any other exceptionality. Jay is intellectually gifted, artistically creative, but also has great difficulty with attention and focus. He is capable of hearing new information once and remembering it, but can’t get organized enough to remember his baseball gear, find his most valuable possessions or meet school assignment deadlines.

Strategies

  1. Maintain eye contact with your child while giving directions and require that she “look at my eyes” while listening unless this is awkward and culturally inappropriate for her.
  2. Limit the number of directions presented at one time (two at a time is good, then build up as you see progress). Have him repeat the directions you give him.
  3. Give written directions as well as oral directions (on paper, poster, or slides).
  4. Let your child observe you or a peer performing a new task before she attempts it.
  5. Use plenty of visuals and hands-on experiences to teach/reinforce each concept; see Multisensory Instruction
  6. Use gentle touch to get the child’s attention when he does not hear you. For example, place your hand gently on their shoulder as a prompt.
  7. Place the student away from distracting noises and visuals (hallway door, noisy children, windows, or other visually distracting items).
  8. Build a study carrel/booth or find a nook for privacy, if possible.
  9. Divide independent work (paces, workbooks, written assignments) into smaller segments. For example, if they are assigned a two page essay, let them take a small stretch/snack break in between each paragraph. Movement is critical to increase attention.
  10. Teach your child self-regulation strategies using the following:
  •  >      use of a silent timer for completion of independent work;
  •  >      check-off lists for different task (laminate for reuse);
  •  >      use headphones to block excess noise;
  •  >      monitor speed of work and on-task behavior; and
  •  >      use of calendar on a device to alarm before due dates.
  1. Provide outlines, study guides and guided notes to use when reading.
  2. Provide students with graph paper to help line up math problems.
  3. Alert student’s attention to key points with phrases such as, ‘This is important’; use highlighters.
  4. Teach typing and allow him to do written assignments on the computer.
  5. Use high interest material (the student’s interests).
  6. Use humor frequently during instruction.
  7. Develop non-verbal signals for off-task behavior, essential points and upcoming directions to help diminish negative verbalizations.
  8. Establish a daily routine and maintain it.
  9. Color-code folders and make a simple one-binder system for all work to be kept.
  10. Streamline paperwork by having your child submit work online.
  11. When teaching handwriting, begin with large, whole body writing for muscle memory, then miniaturize to regular paper and pencil.
  12. Concentrate on the child’s strengths to help her discover something in which she excels.
  13. For vocabulary, use homemade flashcards, pictures paired with words. Use terms in personalized sentences as much as possible; label objects with note cards.
  14. Allow test questions or other assignments to be answered orally, especially if the rate of writing tends to be slow.
  15. Practice role-play for social situations if necessary (i.e. preparing for good behavior during field trips and other outings).

TIP: Calming  the Hyperactive Child

Children with ADHD are often overstimulated by their environment and have a very difficult time ignoring extraneous noises and sights. Even if the environment is perfectly calm, the child’s brain is jumping around in all different directions. Therefore, the following may help to soothe, calm and focus:

  • fidget toys: purchased or handmade such as a deflated balloon with sand in it or a sock with beans sewn into it to fiddle with while working
  • noise cancelling headsets or calming music played through a headset
  • low lighting, possibly lamps rather than overhead lighting
  • flexible seating using bean bags, rubber balls or even standing and pacing when appropriate; free mobility helps to refocus
  • snacks, gum, something to chew on to release energy

Resources

Children & Adults with Attention Deficit Hyperactivity Disorder (CHADD) was founded by parents and children with ADHD in 1987 as they experienced frustration in trying to find help, resources, and general information about ADHD. www.chadd.org  About ADHD Fact Sheets & Infographics

Attention Deficit Disorder Association (ADDA)is the world’s leading adult ADHD organization founded over twenty-five years ago to help adults with Attention Deficit Hyperactivity Disorder (ADHD) lead better lives. ADHD is believed to be hereditary, so it’s highly likely that one or more parents have it. Lots of resources here, particularly helpful for students preparing for college. www.add.org Attention Deficit Disorder Association: Home | ADDA

CDC Center for Disease Control, https://www.cdc.gov/ncbddd/adhd/index.htm

The Parent’s Guide to Attention Deficit Disorder provides logical and useful suggestions for parents searching for solutions to their child’s problems and has hundreds of suggestions for parents to help their child who has an Attention-Deficit/Hyperactivity Disorder be more successful. Parent’s Guide to Attention Deficit Disorder<br> (PGADD) , www.Hawthorne-ed.com

The A.D.D. Resource Center,  https://www.addrc.org/

OT Toolbox provides strategies for teaching executive functioning skills, Tool Box