What are Attention Disorders? Attention Deficit Disorders are a

common childhood disorder, and they may affect children differently. It makes it hard for a child to focus and pay attention. Children of all backgrounds, teens, and adults can have attention disorders. Attention Disorders are most likely called either Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD).

What Causes ADD/ADHD? It is important to know that ADHD is a neurological

disability and people with this disorder have underdeveloped frontal lobes in the brain. This region of the brain that is underdeveloped is responsible for planning, impulse control, attention, reasoning, and working memory.

No one knows for sure what causes this frontal lobe abnormality but ADHD probably comes from a combination of things. Some possibilities are:

Genes, because the disorder sometimes runs in families Lead in old paint in and plumbing parts Smoking and drinking alcohol during pregnancy Certain brain injuries Food additives like artificial coloring, which might make

hyperactivity worse.

Is ADHD Medical? It is not a disorder of attention as

previously thought, it is a function of developmental failure in the brain circuitry that monitors inhibition and self-control

Children with ADHD display a range of symptoms and varying levels of severity

Most children with ADHD are of at least average intelligence

ADHD (cont.)

Almost one-third of children with ADHD will have some type of learning disability

3-5 % of the student population has ADHD with boys 4-9 times more likely to be diagnosed than girls.

Key Behaviors of ADD/ADHD Inattention, hyperactivity, and

impulsivity are the key behaviors of ADHD. It is normal for all children to be inattentive, hyperactive, or impulsive sometimes, but for children with ADHD, these behaviors are more severe and occur more often. To be diagnosed with the disorder, a child must have symptoms for 6 or more months and to a degree that is greater than other children of the same age.

Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) Criteria

Child must display several characteristics to be clinically diagnosed with ADHD

Severity. The behavior in question must occur more frequently in the child than in other children at the same developmental age.

Early Onset. At least some of the symptoms must have been present prior to age 7.

Duration. The symptoms must also have been present for at least 6 months prior to the evaluation.

Impact. The symptoms must have a negative impact on the child’s academic or social life.

Settings. The symptoms must be present in multiple settings.

Three subtypes of Attention Disorders according to DSM-IV

Predominately Inattentive The majority of symptoms (six or more) are in

the inattention category and fewer than six symptoms of hyperactivity-impulsivity are present, although hyperactivity-impulsivity may still be present to some degree.

Children with this subtype are less likely to act out or have difficulties getting along with other children. They may sit quietly, but they are not paying attention to what they are doing. Therefore, the child may be overlooked, and parents and teachers may not notice that he or she has ADHD.

Inattentive Behaviors Be easily distracted, miss details, forget things, and frequently

switch from one activity to another Have difficulty focusing on one thing Become bored with a task after only a few minutes, unless

they are doing something enjoyable Have difficulty focusing attention on organizing and

completing a task or learning something new Have trouble completing or turning in homework assignments,

often losing things (e.g., pencils, toys, assignments) needed to complete tasks or activities

Not seem to listen when spoken to Daydream, become easily confused, and move slowly Have difficulty processing information as quickly and

accurately as others Struggle to follow instructions

Three Subtypes of ADD/ADHD (cont.)

Predominately Hyperactive-Impulsive

Most symptoms (six or more) are in the hyperactivity-impulsivity categories.

Fewer than six symptoms of inattention are present, although inattention may still be present to some

degree.

Hyperactivity Behaviors

Fidget and squirm in their seats Talk nonstop Dash around, touching or playing

with anything and everything in sight Have trouble sitting still during

dinner, school, and story time Be constantly in motion Have difficulty doing quiet tasks or

activities.

Impulsivity Behaviors

Be very impatient Blurt out inappropriate comments,

show their emotions without restraint, and act without regard for consequences

Have difficulty waiting for things they want or waiting their turns in games

Often interrupt conversations or others' activities.

Three Subtypes of ADD/ADHD (cont.)

Combined hyperactive-impulsive and inattentive

Six or more symptoms of inattention and six or more symptoms of hyperactivity-impulsivity are present.

Most children have the combined type of ADHD.

How is ADD/ADHD diagnosed? No single test can diagnose a child as having

ADHD. Instead, a licensed health professional needs to gather information about the child, and his or her behavior and environment. A family may want to first talk with the child's pediatrician. Some pediatricians can assess the child themselves, but many will refer the family to a mental health specialist with experience in childhood mental disorders such as ADHD. The pediatrician or mental health specialist will first try to rule out other possibilities for the symptoms. For example, certain situations, events, or health conditions may cause temporary behaviors in a child that seem like ADHD.

Things to rule out before making a diagnosis of ADD: Is experiencing undetected seizures that could

be associated with other medical conditions Has a middle ear infection that is causing

hearing problems Has any undetected hearing or vision problems Has any medical problems that affect thinking

and behavior Has any learning disabilities Has anxiety or depression, or other psychiatric

problems that might cause ADHD-like symptoms

Has been affected by a significant and sudden change, such as the death of a family member, a divorce, or parent's job loss.

What Other Disorders Commonly Occur With ADHD?

Children and adolescents with ADHD are more likely than children without the disorder to suffer from other mental disorders. About one-half of all young people with ADHD have oppositional defiant disorder; about one-quarter have an anxiety disorder; as many as one-third have depression; and one-fifth have bipolar disorder.

(Mental Health America 2009)

Other disorders (cont.)

Adolescents with untreated ADHD are at risk for substance abuse disorders. Research shows that young people treated for ADHD have lower rates of substance abuse than children who go untreated.

(Mental Health America 2009.)

Expectations when cognitively testing students with attention disorders

Lower processing speeds Difficulties with memory Difficulties with long-term retrieval Inability to sustain attention while

testing- need frequent redirection

How do attention disorders affect learning? Students with attention disorders have a

much harder time concentrating and paying attention in class. They do not remember material accurately or in entirety, due to not being able to sustain attention.

They lose “chunks” of material due to the above and oftentimes fall behind their peers.

Academics are based on a foundational process- if chunks of material are missed then future material is affected- Student achievement spirals downwards.

How Does ADHD Affect School and Social Life?

On a social level, children with ADHD often have trouble developing meaningful relationships with peers and family members. Other children may find it frustrating to play with a child who has ADHD, because classic symptoms include difficulty following rules, waiting one’s turn or excessive talking.

(Mental Health America 2009)

Treatment Treatment for ADHD is effective for most

children. Early identification, diagnosis and treatment help children reach their full potential. The most effective treatments for ADHD include a combination of medication, behavioral therapy, and parental support and education. Although the value of medication has been well-documented, parents should feel free to discuss any concerns about medication use with their child’s doctor.

(Mental Health America 2009)

Tips to Help Kids Stay Schedule. Keep the same routine every day, from wake-

up time to bedtime. Include time for homework, outdoor play, and indoor activities. Keep the schedule on the refrigerator or on a bulletin board in the kitchen. Write changes on the schedule as far in advance as possible.

Organize everyday items. Have a place for everything, and keep everything in its place. This includes clothing, backpacks, and toys.

Use homework and notebook organizers. Use organizers for school material and supplies. Stress to your child the importance of writing down assignments and bringing home the necessary books.

Be clear and consistent. Children with ADHD need consistent rules they can understand and follow.

Give praise or rewards when rules are followed. Children with ADHD often receive and expect criticism. Look for good behavior, and praise it.

Last Thoughts… If your child or a child you know is

diagnosed with ADHD, be patient. Even with treatment, symptoms may take time to improve. Instill a sense of competence in the child or adolescent. Promote his or her strengths, talents and feelings of self-worth. Remember that the side effects of untreated ADHD (such as failure, frustration, discouragement, social isolation, low self-esteem and depression) may cause more problems than the disorder itself.

Practical Tips for Managing ADHD Behaviors Difficulty Starting an Activity: Give your child a cue that it is time to

begin working. Break down tasks into smaller pieces. Explain the purpose of the assignment. Give your child immediate feedback. Praise them for good effort. Set a reasonable time limit for

completing the task.

Practical Tips (cont.) Talking Too Much: Be direct about when it is ok to interrupt and

when it is not. Do not accidentally reinforce interrupting by

stopping your conversation to attend to your childs interruption.

Develop a signal to indicate that you are going to continue talking and use it.

Create opportunities to practice turn taking by playing games.

Praise successful waiting.

Practical Tips (cont.) Remembering: Have your child repeat

directions/or information out loud. Write important information down. Break multi-step tasks into smaller

steps. Make up songs for improving recall

(think of Schoolhouse Rock).

Practical Tips (cont.)

Staying on Task: Clear work area of distractions. Make sure that your child

understands the task. Break the task into smaller pieces. Be available to help when needed.

What are some tips for parents of kids with ADHD? Try to focus on your child's good qualities. "Catch" your

child behaving well at least three times a day and tell them you noticed. Work up to more than three times a day.

When you catch your child, simply describe to them the behavior you saw that you'd like to see more of.  For example, “You really stayed with me at the mall today.”

Tell your kid what you want them to do, instead of what you don't want them to do. (Say "Walk." instead of "Don't run.")

Help your child develop good social and communication skills, which will help them form fulfilling friendships with other kids.

How can I help my child improve their behavior? Don't try to change lots of behaviors at

once.  Target one to three behaviors at a time to work on. 

Reward your child with privileges and special activities like a trip to the park or a family picnic for successfully meeting behavioral goals.

Keep a few rules and enforce them consistently. (Choose your "battles" carefully.)

Offer choices, but keep them simple.

How should I set up the house and our routine to help my child?

Keep a regular routine and provide lots of structure, so your child knows what to expect.

Post lists and reminders for the routines in key places around the house.  For example, you might keep a list of things to bring to school by the front door or in your child's backpack.

Keep your home organized.  Store things as close as possible to where they are used, and have “a place for everything, and everything in its place.”

Resources http://www.4-adhd.com/

http://www.familyeducation.com/learning-disabilities

http://www.childrensdisabilities.info/adhd/groups-ADHD-child.html

http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder/complete-index.shtml

http://www.nmha.org/

http://www.med.umich.edu/yourchild/topics/adhd.htm