Learners with Other Disorders and Conditions Fall 2010 ED 226

Learners with Other Disorders and Conditions

Fall 2010ED 226

Children and Youth w/ Attention Problems

• Historical Development– 1902—morbid defects in moral control (Still)– Related to brain injury or infections of the central nervous

system (Goldstein and Bender)– Minimal brain dysfunction/various combinations of

impairments in control of attention, impulse, and motor control, (Clements)

– Hyperkinetic disorder (DSM-II, 1968)– Included attention in 1980– 1987, DSM-III developmentally inappropriate with marked

inattention– 1994, focus on dual nature, 3 subtypes: hyperactive-

impulsive, inattentive type, and combined type


• ADHD and IDEA– Despite advocacy group demands, ADHD was

noted added as a category to IDEA in 1990– Students were eligible for services under OHI– Children could receive services under Section 504

of ADA


• Current ADHD definition is the DSM-IV-TR– Six or more of the inattention symptoms for 6+

months:• Often fails to give close attention to detail or makes careless

mistakes in schoolwork, work, or other activities• Often has difficulty sustaining attention in tasks or play

activities• Often does not seem to listen when spoken to directly• Often does not follow through on instructions and fails to

finish schoolwork, chores, or duties in the workplace• Often has difficulty organizing tasks and activities


• Current ADHD definition is the DSM-IV-TR– Six or more of the inattention symptoms for 6+

months:• Often avoids, dislikes, or is reluctant to engage in tasks

that require sustained mental effort (school work or homework)• Often loses tings necessary for tasks or activities• Is often easily distracted by extraneous stimuli• Is often forgetful in daily activities


• Current ADHD definition is the DSM-IV-TR– Six or more of the hyperactive-impulsivity symptoms

for 6+ months:• Often fidgets with hands or feet or squirms in seat• Often leaves seat in classroom or in other situations in which

remaining seated is expected• Often runs about or climbs excessively in situations in which

it is inappropriate• Often has difficulty playing or engaging in leisure activities

quietly• Is often “on the go” or often acts as if “driven by a motor”• Often talks excessively


• Current ADHD definition is the DSM-IV-TR– Six or more of the hyperactive-impulsivity

symptoms for 6+ months:– Impulsivity

» Often blurts out answers before questions have been completed

» Often has difficulty waiting turns» Often interrupts or intrudes on others


• Current ADHD definition is the DSM-IV-TR– Some hyperactive-impulsive or inattentive

symptoms is present in two or more settings– There must be clear evidence of clinically

significant impairment in social, academic, or occupational functioning

– The symptoms do not occur exclusively during the course of a pervasive developmental disorder, schizophrenia, or other psychotic disorder and are not accounted for by another mental disorder


Percentage of Students with ADHD in Each Subtype

ADHD Subtypes

Inattentive Hyperactive/Impulsive

Combined No ADHD

% of children in each category

20% 13% 40% 27%

% of children with ADHD in each subtype

27% 18% 55% --


• Levels of Severity– Mild: few if any symptoms in excess of the 6

indictors required to make the diagnosis: minimal or no impairment in school or social settings

– Moderate: symptoms or functional impairment intermediate between “mild” and “severe”

– Severe: many symptoms in excess of those required to make the diagnosis; significant and pervasive impairment in functioning at home and in schools with like age peers


• Identification of Learners with ADHD– Structured clinical interviews with parents,

teachers, and the student– Direst observation of behaviors– Psychoeductional examination, including IQ and

achievement– Rating scales– Pediatric medical examination


• Prevalence of ADHD– Low-visibility, high-prevalence– 3-10%– More likely in males than females


• Conditions Associated with ADHD– Organic causes– Birth complications– Intellectual/developmental causes– Psychological issues– Environmental factors

Characteristics of Individuals with ADHD

• Low frustration tolerance• Resentment towards

family members• Mood lability• Poor self-esteem• Lack of effort• Perceived lack of self-

responsibility• Excess, insistent demands

that request be met

• Temper outbursts• Stubbornness• Rejection by peers• Oppositional behavior• Antagonism and

aggression• bossiness


• Should ADHD be a separate category in IDEA?Prevalence of ADHD in Various Disability Categories

Disability Category

Prevalence of Students with

ADHD in Category

Prevalence of students w/o ADHD

in Category

Overall Percentage of All Students in

Category

OHI 17.7% 2.3% 6.6%

ED 13.8% 2.5% 8.1%

MR 12.4% 11.9% 9.9%

LD 49.7% 48.7% 48.3%

Speech 6.5% 34.7% 18.7%


• ADHD as a Social Construct– Neither the category nor the service is needed or

justified– Diagnosis is a social invention rather than a

disability (Armstrong, 199%)• Children learn to control attention/behavior when

expected to do so• Schools have asked children to do more in the last

three decades• Lots of stimuli from a very early age

Autism Spectrum Disorders

• A developmental disability significantly affecting verbal and non-verbal communication and social interaction, usually evident before age 3, that adversely affects a child’s educational performance. Other characteristics often associated with autism are engagement in repetitive activities, resistance to environmental change or change in daily routines, and unusual sensory experience.

Autism Spectrum Disorders

• The term does not apply if a child’s educational performance is adversely affected because the child has a serious emotional disturbance.

ASD Issues

• Communication• Social• Routines

Physical and Sensory Disabilities• Physical and Health Disabilities– Small but diverse group of students– Orthopedic conditions– Health conditions (asthma, diabetes, cancer, heart

conditions, AIDS, epilepsy)– Cerebral Palsy– Spina bifida– Muscular dystrophy– Arthritis– Paralysis– Amputations

Physical and Sensory Disabilities

• Sensory Disabilities– Vision– Hearing– Most of these students are served in general

education classrooms

Physical and Sensory Disabilities

• Traumatic Brain Injury– Acquired injury due to external force– Results are varied and no injury is the same– Rehabilitation services

Communication Disorders

• Speech disorders– Articulation, fluency, voice

• Language disorders– Issues with receptive or expressive language

(understanding)

• 19% of all students receiving services

Medication: A Persistent Issue

• Responsibilities regarding students with medication needs– Being knowledgeable about any medications students

are taking– Sharing classroom observations with the parents so

that the effect of medication can be monitored– Alerting the school nurse and/or parent if there are

changes that may be related to the medication– Being prepared to respond to parents’ queries about

the child’s progress while on medicaiton

Documents

Learners with Other Disorders and Conditions Fall 2010 ED 226