Attention Deficit Hyperactivity Disorder

A. Definition

ADHD stands for Attention Deficit Hyperactivity Disorder. It is one of

the most common neurodevelopmental disorders of childhood. It is usually first
diagnosed in childhood and often lasts into adulthood. Children with ADHD may have
trouble paying attention, controlling impulsive behaviors (may act without thinking about
what the result will be), or be overly active (cdc.gov,2020). ADHD is identifiable via
behavioural, not physical characteristics, making it more likely to be misunderstood.

B. Criteria for Identification

DSM-5 Criteria for ADHD

As stated by (cdc.gov,2020), People with ADHD show a persistent pattern

of inattention and/or hyperactivity–impulsivity that interferes with functioning or
development:

1. Inattention: Six or more symptoms of inattention for children up to age 16

years, or five or more for adolescents age 17 years and older and adults;
symptoms of inattention have been present for at least 6 months, and they
are inappropriate for developmental level:
o Often fails to give close attention to details or makes careless mistakes in
schoolwork, at work, or with other activities.
o Often has trouble holding attention on tasks or play activities.
o Often does not seem to listen when spoken to directly.
o Often does not follow through on instructions and fails to finish
schoolwork, chores, or duties in the workplace (e.g., loses focus, side-
tracked).
o Often has trouble organizing tasks and activities.
o Often avoids, dislikes, or is reluctant to do tasks that require mental effort
over a long period of time (such as schoolwork or homework).
o Often loses things necessary for tasks and activities (e.g. school
materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses,
mobile telephones).
o Is often easily distracted
o Is often forgetful in daily activities.
 2. Hyperactivity and Impulsivity: Six or more symptoms of hyperactivity-
impulsivity for children up to age 16 years, or five or more for adolescents
age 17 years and older and adults; symptoms of hyperactivity-impulsivity
have been present for at least 6 months to an extent that is disruptive and
inappropriate for the person’s developmental level:
o Often fidgets with or taps hands or feet, or squirms in seat.
o Often leaves seat in situations when remaining seated is expected.
o Often runs about or climbs in situations where it is not appropriate
(adolescents or adults may be limited to feeling restless).
o Often unable to play or take part in leisure activities quietly.
o Is often ―on the go‖ acting as if ―driven by a motor‖.
o Often talks excessively.
o Often blurts out an answer before a question has been completed.
o Often has trouble waiting their turn.
o Often interrupts or intrudes on others (e.g., butts into conversations or
games)

In addition, the following conditions must be met:

 Several inattentive or hyperactive-impulsive symptoms were present before age

12 years.
 Several symptoms are present in two or more settings, (such as at home, school
or work; with friends or relatives; in other activities).
 There is clear evidence that the symptoms interfere with, or reduce the quality of,
social, school, or work functioning.
 The symptoms are not better explained by another mental disorder (such as a
mood disorder, anxiety disorder, dissociative disorder, or a personality disorder).
The symptoms do not happen only during the course of schizophrenia or another
psychotic disorder.

Diagnosing ADHD in Adults

ADHD often lasts into adulthood. To diagnose ADHD in adults and adolescents age 17
years or older, only 5 symptoms are needed instead of the 6 needed for younger
children. Symptoms might look different at older ages. For example, in adults,
hyperactivity may appear as extreme restlessness or wearing others out with their
activity.

C. Signs and Characteristics

According to (cdc.gov,2020) , all kids struggle at times to pay attention,

listen and follow directions, sit still, or wait their turn. But for kids with ADHD, the
struggles are harder and happen more often that can cause difficulty at school, at
home or with friends.
What are the Signs of ADHD?

A child with ADHD might:

 daydream a lot
 forget or lose things a lot
 squirm or fidget
 talk too much
 make careless mistakes or take unnecessary risks
 have a hard time resisting temptation
 have trouble taking turns
 have difficulty getting along with others

Based on the types of symptoms (presented in the criteria), three kinds (presentations)
of ADHD can occur (Nall, 2018):

1. Predominantly Inattentive Presentation: if enough symptoms of inattention,

but not hyperactivity-impulsivity, were present for the past six months. A person
with inattentive ADHD is more likely to demonstrate the following characteristics
in a way that disrupt:

 an apparent inability to pay close attention to a task or a tendency to make

careless mistakes

 difficulties with holding focus on activities or tasks

 giving the appearance of not listening while other people are talking

 experiencing difficulty with time management and task organization

 frequently losing items or accessories necessary for daily function

 becoming distracted easily

 forgetting to complete tasks and fulfill obligations

 an avoidance or intense dislike of tasks that require prolonged focus and thought

 difficulties with following instructions to complete tasks

2. Predominantly Hyperactive-Impulsive Presentation: if enough symptoms of

hyperactivity-impulsivity, but not inattention, were present for the past six months.

 seeming to be constantly ―on-the-go‖

  an inability to remain seated

 bouts of inappropriate running or climbing

 difficulties waiting for their turn in a conversation, often finishing other people’s
sentences or answering before the end of a question

 frequently intruding on others, including conversations, activities, or games

 persistent fidgeting, tapping of the hands and feet, or squirming

 excessive talking

 finding it difficult to play or engage in activities without creating excessive noise

 reluctance to wait for their turn, such as in a line or a turn-based game

3. Combined Presentation: if enough symptoms of both criteria inattention and

hyperactivity-impulsivity were present for the past 6 months.

D. Research Findings about the Cause

Scientists are studying cause(s) and risk factors in an effort to find better
ways to manage and reduce the chances of a person having ADHD. The cause(s) and
risk factors for ADHD are unknown, but current research shows that genetics plays an
important role. Recent studies of twins link genes with ADHD (cdc.gov,2020).

In addition to genetics, scientists are studying other possible causes and risk factors
including:

 Brain injury
 Exposure to environmental (e.g., lead) during pregnancy or at a young age
 Alcohol and tobacco use during pregnancy
 Premature delivery
 Low birth weight

Research does not support the popularly held views that ADHD is caused by
eating too much sugar, watching too much television, parenting, or social and
environmental factors such as poverty or family chaos. Of course, many things,
including these, might make symptoms worse, especially in certain people. But the
evidence is not strong enough to conclude that they are the main causes of ADHD.

E. Accommodation Strategies in Teaching

Students with ADHD have difficulty with attention and self-control. And at
school, that can look like inattention, distractibility, hyperactivity, impulsivity, and
disorganization—all of which can get in the way of learning. What classroom
accommodations can help students with ADHD? Here are some strategies teachers can
try (Morin, n.d.)
Setting Up the Classroom Environment
 Use flexible seating, like wiggle chairs, standing desks, foot rests, seat cushions,
or resistance bands on chair legs.
 Increase the space between desks or work tables.
 Designate a quiet work space in the classroom.
 Set up preferential seating close to the teacher and/or away from high-traffic
areas.
 Post a written schedule for daily routines and rules. When possible, let the
student know ahead of time about schedule changes.

Building Organization Skills

 Use an assignment notebook or an electronic calendar.

 Provide an extra set of books to keep at home.
 Provide folders and baskets of supplies to keep desk organized.
 Color-code materials for each subject.
 Provide typed notes or an outline of the lesson to help with taking notes.
 Teach note-taking strategies, like using graphic organizers and mind-mapping
software.
 Have a buddy take notes for the student.

Giving Instructions

 Give directions out loud and in writing, and have the student repeat them.
 Provide a lesson outline that details instructions and assignments.
  Keep instructions simple, clear, and concrete.
 Use pictures and graphs to help create visual interest.
 Provide a rubric that describes the elements of a successfully completed
assignment.
 Help the student break long assignments into smaller chunks.

Completing Tests and Assignments

 Allow understanding to be demonstrated in different ways, like oral reports,

posters, and video presentations.
 Provide different ways to respond to test questions, like saying the answers or
circling them.
 Minimize the number of questions and problems per worksheet.
 Schedule frequent short quizzes, rather than one long test at the end of each
unit.
 Give credit for work done instead of taking away points for late or partial
assignments (with a plan for moving toward completing assignments).
 Grade for content, not for neatness.
 Give extra time and quieter space for work and tests.

Managing Behavior

 Use a behavior plan with a reward system.

 Use a nonverbal signal (like a sticky note on the desk or a hand on a shoulder)
to get the student’s attention and indicate the need for things like taking a brain
break.
 Talk through behavior problems one-on-one.
 Check in frequently to monitor the student’s ―emotional temperature‖ or
frustration level.

F. Materials/Assistive Technology for Accommodation

In order to improve student’s certain school deficits and excel in School,

assistive technologies can help students to achieve success by working independently.
If the students are struggling with reading:

Audio books and Reading Software. It allows users to listen to text (recorded book)

Optical Character Recognition (OCR). It scans printed materials into a computer and
the scanned text is then read aloud by the Screen Synthesizers/ Screen Reading
System (reads aloud text, it may be scanned text, typed by the students or material
from the internet).

Other Assistive Technologies that may help students:

Portable Word Processors. It helps children with ADHD who have trouble in
handwriting. It is a lightweight device designed for note-taking and writing assignments
(looks like a computer keyboard with a screen).

Speech-recognition Programs. This software is helpful for those students whose oral
language skills are superior to their writing skills. If they read aloud into a microphone,
his/her words will automatically appear on a computer screen.

Word-prediction Software. This can assist students with ADHD in producing

grammatically correct and topic-specific sentences and paragraphs. It also predicts the
word the user intends to type that will help to improve his/her vocabulary and writing
expressions.

References

Centers for Disease Control and Prevention. (2020). Attention-Deficit Hyperactivity

Disorder (What is ADHD?). https://www.cdc.gov/ncbddd/adhd/facts.html

What is Attention Deficit Hyperactivity Disorder? (n.d.). https://www.webmd.com/add-

adhd/childhood-adhd/attention-deficit-hyperactivity-disorder-adhd#1