Attention-Deficit / Hyperactivity Disorder

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A PowerPoint Presentation on ADHD

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Helpful Links

·  chadd.org offers scientifically reliable information in English and Spanish about ADD in children, adolescents, and adults. Sponsored by Children and Adults with ADHD (CHADD), the largest ADHD support and advocacy organization in the United States, it has downloadable fact sheets of science-based information for parents, educators, professionals, the media, and the general public. The site also includes contact information for two hundred local chapters of CHADD throughout the United States.

·  help4adhd.org presents evidence-based information in English and Spanish about ADHD in children, adolescents, and adults. This national clearing house of downloadable information and resources concerning many aspects of ADHD is funded by the U.S. government's Centers for Disease Control and Prevention and operated by CHADD. New material is added frequently, and questions directed to the site are responded to by knowledgeable health-information specialists.

·  add.org is a resource in English for adults with ADD. Sponsored by Attention Deficit Disorder Association (ADDA), the world's largest organization for adults with ADHD, it provides information, resources, and networking opportunities.

 

Books on Attention Deficit Hyperactivity Disorder

Taking Charge of ADHD: The Complete, Authoritative Guide for Parents (Revised Edition) by Russell A. Barkley PhD ABPP ABCN

ADHD and the Nature of Self-Control by Russell A. Barkley PhD ABPP ABCN

Attention Deficit Disorder: The Unfocused Mind in Children and Adults (Yale University Press Health & Wellness) by Thomas Brown

 

Recommendations for Assisting ADHD Children with:

Impulsivity

Inflexibility

Emotional Reactivity

Procrastination 

Memory Problems

Planning Deficits

Disorganization

Poor Self-Monitoring

Impulse Control

Home and Classroom interventions

• ADHD Children should be provided with explicit, extensive, and clear rules/expectations with frequent reviews.
• Teachers and parents must work to limit visual and auditory distractions including other students (siblings) or activities.
• ADHD Children benefit from classroom placement which is close to the center of learning activities.
• Parents and teachers should provide frequent eye contact
• ADHD Children should be placed with or near more well-controlled and focused peers who will role model positive behavior and extinguish efforts to obtain attention through negative behavior.
• ADHD Children benefit from a lower student-to-teacher ratio.
• Reduced homework requirements are necessary in order that ADHD Children can complete assignments with time left over for family activities.
• It is recommended that parents and teachers work with ADHD Children to help them plan their approach to a challenging situations.
• ADHD Children should be encouraged to verbalize plans before starting work. 
• ADHD Children benefit from having teachers or parents have them explain how they will approach a task.
• ADHD Children should be encouraged to develop and verbalize more than one approach to a task before starting.
• ADHD Children should be afforded frequent breaks, particularly with motor activity, which can be a reward for work completed (these only need to be one or two minutes in duration). 
• Behavioral programs geared toward controlling stimuli that precede or lead to impulsivity are likely to be more successful than those that focus on the consequences following an impulsive action. (Reward positive behavior and ignore negative behavior)
• It is beneficial for parents and teachers to limit ADHD Children’s exposure to stimuli or situations that pull for impulsivity.
• It is important to discuss behavioral expectations in high-risk situations as well as actions that ADHD Children might take to avoid problems.
• Parents and teachers must make every effort to reinforce appropriate behaviors (Catch them being good) and to a lesser extent provide consequences for inappropriate behaviors.
• ADHD Children's parents, teachers, and other involved individuals should be consistent in their use of behavioral techniques.
• Ongoing behavioral consultation is advised to recognize the need to modify reinforcers and consequences.

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Adaptable/Flexible Thinking

• Parents and teachers should work to maintain a dependable and predictable environment as groundwork for adding flexibility. (Provide routines and schedules).
• Changes should be gradually and incrementally introduced one at a time.
• It is recommended that Parents and Teachers use visual organizers such as pictures, schedules, planners, and calendar boards to let ADHD Children know the order of activities for the day.
• It is important to alert ADHD Children to variations in the usual sequence of events before they occur.
• ADHD Children’s flexibility can be built by rotating two or three familiar tasks at regular intervals.
• ADHD Children benefit from external prompting to shift their attention, behavior, or cognitive set from one activity or focus to the next by using a “2-minute warning.” 
• ADHD Children should be allowed a few minutes of “down time” or leisure activity between the end of one activity and the beginning of the next.
• Use of a timer can facilitate an ADHD Child’s  adjustment to changes in activity.

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Emotional Control

Home and school interventions:

• Parents and teachers are encouraged to identify and manage situations that produce emotional changes or outbursts.
• Parents and teachers are encouraged to model appropriate emotional modulation. 
• Clear rules and expectations for emotional control and home and school must be maintained.
• ADHD Children should be provided with opportunities to discuss upcoming situations or events that may provoke emotional reactions. 
• ADHD Children will be assisted by increasing their awareness of the potential for emotional reactivity and the likely consequences to follow.
• ADHD Children benefit from spending time with peers who can model appropriate emotional control.
• Parents and teachers are encouraged to provide short breaks or a cooling off period to allow ADHD Children to consider how to respond to an event or situation. 
• Parents and teachers can assist ADHD Children by reinforcing them for:
  • identifying stress-inducing situations ahead of time
  • Using relaxation methods
  • verbalizing the feelings associated with a stress response
  • verbalizing the impact of the stressors

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Initiative

Home and School Interventions:

• Increased structure in the environment or in an activity can help ADHD Children initiate work.
• It is important for teachers and parents to reframe this problem as an initiation difficulty rather than lack of motivation.
• ADHD Children will benefit from having tasks broken into smaller; more structured steps to reduce the sense of being overwhelmed and increase initiation. 
• To increase initiative taking by ADHD Children, Parents and teachers are encouraged to provide physical activity, group interaction, frequent short breaks with motor activity, and variation of pace or stimulation.
• It is also recommended that ADHD Children be provided with guidance through the initial steps of a problem or task.
• ADHD Children benefit from examples or work samples of what is expected. 
• ADHD Children should be provided with realistic opportunities for initiating a task with an appropriate wait time that allows them to develop a plan and mobilize the skill needed for the particular activity or task.
• It is recommended that teachers and parents provide appropriate supportive signals or cues that remind the ADHD Child to initiate an activity (Use natural cues whenever possible).
• Tasks that are inherently motivating will require less internal initiation than tasks that are less motivating. 
• Parents and teachers are encouraged to avoid the natural tendency to do things for ADHD Children rather than help them get started.
• ADHD Children benefit from training in systematic idea generation (brainstorming). 
• Providing ADHD Children with “to do” lists will help them take initiative.
• Providing more interactive, hands on, or laboratory learning activities will make ADHD Children more likely to initiate.

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Working Memory

Home and School Interventions:

• Teachers are encouraged to “Preteach” the general framework of new information to be taught (preview the gist of what will be learned that day)
• ADHD Children benefit from having their attention guided to the important points when instructions are being presented.
• Teachers and parents should establish eye contact with ADHD Children prior to giving essential instructions or new material.
• ADHD Children benefit from additional processing time and/or time to rehearse new information.
• Teachers and parents are encouraged to break tasks or information into smaller steps or chunks.
• Changing tasks more frequently can alleviate some of the drain on sustained working memory (Tasks can be rotated, such that he might work for 10 minutes on math problems, 10 minutes on reading, and then return to another 10 minutes of math).
• Providing frequent short breaks (1 or 2 minutes in duration) that provide a motor activity or a relaxing activity assist in rejuvenating working memory. 
• Teachers are encouraged to provide “check-ins” to give breaks with motor activity and an opportunity for reinforcement. 
• Lengthy tasks, particularly those that ADHD Children experience as tedious or monotonous, should be avoided or interspersed with more frequent breaks or other, more engaging tasks (reward them with a more stimulating activity such as computer instruction time for completing the more tedious task).
• Given the negative impact of competing information on working memory, it is important to reduce distractions in the environment that can tax or disrupt a ADHD Child’s sustained working memory.
• Parents and teachers can pre-organize information to reduce demands for working memory and make encoding more efficient.
• ADHD Children benefit from being given additional time to retrieve details when answering a question.
• Teachers are encouraged to avoid open-ended questions and to rely more on recognition testing which does not require retrieval (multiple choice, fill in the blank etc.)
• ADHD Children benefit from having more demanding tasks scheduled to occur in the morning (memory is typically better in the morning than in the afternoon).
• Multimodal presentation of information will assist an ADHD Child’s memory (Accompany verbal instruction with visual cues, demonstration, and guidance).
• Parents and teachers are encouraged to keep the presentation of new information or instructions brief and to the point.
• Providing ADHD Children with a written checklist of steps required to complete a task will help compensate for working memory deficits.
• Parents and teachers are encouraged to repeat instructions or new information
• Parents and teachers are encouraged to have ADHD Children repeat or paraphrase what he has been taught/told in order to check for accuracy and to provide an opportunity for rehearsal. 

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 Planning

Home and School Interventions:

• Parents and teachers can build an ADHD Child’s awareness of options and alternatives by providing examples of how they might approach a situation.
• Teachers are encouraged to provide a “manual” with steps for common routines or assignments. 
• ADHD Children should always be involved in setting goals for an activity or task. 
• Parents and teachers are encouraged to have them predict how well they expect to do in completing a task or activity. 
• Encourage ADHD Children to verbalize a plan of approach at the outset of any given task
• Having ADHD Child develop more than one plan for a task or activity will increase their awareness of alternative approaches. 
• Having ADHD Children develop plans for meaningful, complex activities (e.g., their birthday party, baking a favorite treat) will provide inherent motivation.

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 Organization

Home and School Interventions:

• Parents and teachers are encouraged to present information in a well-organized manner.
• It is important that communication between home and school be maintained in order to help ADHD Children stay on track with their assignments. 
• Where possible, keep an extra set of text books at home (alleviates a need to remember what books to bring back and forth).
• Encourage ADHD Children to work on only one task, or one step of a larger task, at a time. 
• Parents and teachers can model breaking down longer tasks into smaller, sequential steps, and by developing a time line for completion of each step. 
• Teachers and parents are encouraged to separate worksheets into smaller problem sets, or divide them on the page with a marker
• ADHD Children benefit from being allowed extra organization time at the outset or the end of the school day. 
• ADHD Children should be encouraged to make use of a supervised study hall
• ADHD Children also benefit from working in a small groups with more organized peers who can serve as models.
• Cross-age tutoring can be helpful as a means of having better organizational strategies modeled for ADHD Children. 
• Teachers are encouraged to preview the organizational framework of new material to be learned in a bulleted or outline format
• Having ADHD Children restate the overall concept and structure of the information or task that was presented in a lecture will assist them with organization.   
• It is good practice to maintain a list of students in each subject with phone numbers so that an ADHD Child can call a peer if they forget an assignment.

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Self-Evaluation

Home and School Interventions:

• Teachers and parents should build in editing or reviewing as an integral part of every task in order to increase error recognition and correction.
• Setting goals for accuracy rather than speed can help increase attention to errors. 
• Parents and teachers are encouraged to reward ADHD Children for accuracy to support continued focus on monitoring his work.
• Have ADHD Children predict how well they will do on a particular task, and then compare this prediction with the actual outcome in order to increase their awareness of their strengths and weaknesses. 
• Encourage ADHD Children to chart their performance and/or behavior in order to have a tangible record of their activity for ongoing monitoring.
• ADHD Children should be encouraged to talk through a task in order to increase their attention to the task and increase error recognition. 
• Encourage ADHD Children to identify strengths and weaknesses for specific tasks or activities. 
• Provide guided constructive feedback (teacher, parent, and peer) to increase self-awareness of strengths and needs for similar future activities.