Analysis of Diverse Learners
Attention Deficit Hyperactivity Disorder (ADHD)
ABSTRACT
Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most common mental disorders affecting children and adults. Though the main symptoms of ADHD include inattention, hyperactivity and impulsivity, these can manifest themselves in surprising ways that can make day-to-day life extemely challenging not only for those who have it, but for those close to them.
This analysis of the characteristics and treatment options for ADHD is largely centered around diagnoses in children, and the implications for the educational environment, specifically, but much of the same information applies to adult ADHD, and some adult-specific links are included in the resources section.
Although pharmacological intervention can play a big role in addressing the disruptive effects of ADHD, it is seldom sufficient on its own, and there are many strategies that students, teachers, and families can put in place for academic success.
compiled by Bobby Bartlett
University of Maryland, Baltimore County
NOTICE: This project was constructed as a part of a course assignment. The information provided in the materials is accurate to the best of our ability but was not constructed by experts in the field.
What is ADHD?
Attention-Deficit/Hyperactivity Disorder (ADHD) is an extremely common neurodevelopmental disorder affecting children and adults.
Symptoms include inattentiveness (struggling to focus), hyperactivity (movement levels and energy that are not context-appropriate), and impulsivity (seemingly reflexive actions that occur without thought).
It is estimated that 3-7% of school-aged children may have ADHD - some sources put this as high as 11%. (American Psychiatric Association, n.d., CHADD, n.d.)
Students with ADHD can be some of the top performers in their class, and adults with ADHD can be very successful in life, but without proper identification and treatment, those students are more likely to have poorer grades, lower test scores, and are more likely to be absent from school, referred to the office for discipline, and drop out of high school (DuPaul, Weyandt & Janusis, 2011).
Characteristics
The DSM-5 has defined three presentations of ADHD — their characteristics are...
ADHD Predominantly Inattentive Presentation
ADHD Predominantly Hyperactive-Impulsive Presentation
ADHD Combined Presentation
Six or more symptoms (for children; for adults, five or more symptoms) must persist for at least 6 months to a degree that is inconsistent with developmental level and that negatively impacts day-to-day life to confirm a diagnosis.
(Reynolds & Kamphaus, n.d.; CDC, n.d.)
What causes ADHD?
The leading theory of ADHD's cause is a chemical imbalance in the brain. The Dynamic Developmental Theory proposes that ADHD is caused by deficient regulation of the neurotransmitter GABA, due to low levels of dopamine.
Another leading theory suggests that those with ADHD have abnormal function from the parts of the brain which affect executive functioning. This operational disparity leads to deficits in attentiveness, behavioral appropirateness, rationality, forethought and short-term memory processing.
It is believed that there is also a genetic component to predisposition toward ADHD, and it can be hereditary. Studies have concluded that the most likely genetic basis involves a gene which regulates dopamine synthesis within the brain.
Some evidence suggests that environmental factors can play a role in the development of ADHD symptom-behaviors; recent research has found that there is a statistically significant (albeit small) relationship between screen-based media and ADHD-related behaviors.
(Stephens & Byrd, 2017; Beyens, Valkenburg, Piotrowski, 2018)
Treatment
The most common interventions for students and adults with ADHD include psychotropic medication (most typically in the form of stimulants) and behavioral strategies implemented at home and in school/work settings. A clinical diagnosis is necessary to be prescribed such medication.
Medication alone is rarely sufficient to solve the challenges posed. Many students and adults have found success implementing the following strategies on their own, or through their support network at home, in the classroom and the workplace.
Behavioral Interventions
- Reinforcement of desired behaviors or avoidance of problem behaviors
- Can be implemented proactively, or after behavior has taken place
- Examples
- Teachers post simple, positively phrased, classroom rules in plain view of all students, and strategically reviews them. Students who follow classroom rules should be frequently praised; students with ADHD may need a closer reference, such as having a laminated card with the class rules on their desk.
- Reduce task demands by modifying the length or content of assignments to match a student's attention span, gradually increasing in length as students demonstrate success.
- Provide students with a choice of tasks they can perform to demonstrate the same academic skill or understanding.
- Give praise or token reinforcement (e.g. poker chips, or some sort of classroom currency) when desired behaviors are observed. Tokens can be exchanged at some designated point in the day or week for rewards like a snack or preferred activities.
- Tokens also can be taken away for disruptive or off-task behavior. This "response cost" strategy should be limited to situations where positive reinforcement (rewards) alone have not achieved the desired result.
Self-Regulation Interventions
- Encourages students and adults with ADHD to track, evaluate and reinforce their own behaviors.
- Teach students to regularly evaluate their classroom behavior and work quality on a 1-5 scale. The teacher makes the same evaluation concurrently, and students can receive reinforcement based on how closely the teacher concurs with their self-evaluation.
- Self-monitoring - Have students keep a log of their behavior and activities, such as when doing homework or preparing for class. The act of tracking these behaviors can lead to quick and lasting improvements in organizational skills.
All forms of intervention are made more effective with open and frequent communication between home and school, with ongoing feedback, follow-up, and reinforcement.
The most successful interventions will involve collaboration between the classroom teacher and a behavioral specialist (e.g. the school psychologist), with the teachers taking the lead to identify the problem behaviors, and the consultants using their expertise to develop possible strategies for intervention.
(DuPaul, Weyandt & Janusis, 2011)
Resources
CHADD - Children & Adults with ADHD - Detailed resources for understanding ADHD and strategies for taking on its challenges. Tailored for adults, parents & caregivers, teachers and professionals.
VIDEO Attention Deficit Hyperactivity Disorder - Causes, Symptoms & Pathology - A good "whiteboard" overview of ADHD and the science behind it.
Online Guide: ADHD - A Guide for Families - A "book" by the American Academy of Child & Adolescent Psychiatry, with information about ADHD, getting treatment, supporting school success through the teenage years, and other resources.
Bibliography
American Psychiatric Association. (n.d.). What Is ADHD? American Psychiatric Association. https://www.psychiatry.org/patients-families/adhd/what-is-adhd.
Beyens, I., Valkenburg, P., & Piotrowski, J. (2018). Screen media use and ADHD-related behaviors: Four decades of research. Proceedings of the National Academy of Sciences of the United States of America, 115(40), 9875-9881. Retrieved June 24, 2021, from https://www.jstor.org/stable/26531357
Centers for Disease Control and Prevention. (2020, September 21). Symptoms and Diagnosis of ADHD. Centers for Disease Control and Prevention. https://www.cdc.gov/ncbddd/adhd/diagnosis.html.
CHADD. (2019, June 13). About ADHD - Symptoms, Causes and Treatment. CHADD. https://chadd.org/about-adhd/overview/.
DuPaul, G., Weyandt, L., & Janusis, G. (2011). ADHD in the Classroom: Effective Intervention Strategies. Theory into Practice, 50(1), 35-42. Retrieved June 24, 2021, from http://www.jstor.org/stable/23020735
Reynolds, C. R., & Kamphaus, R. W. (n.d.). Attention Deficit/Hyperactivity Disorder DSM-5 Diagnostic Criteria. Pearson Clinical. https://images.pearsonclinical.com/images/assets/basc-3/basc3resources/DSM5_DiagnosticCriteria_ADHD.pdf.
Stephens, J., & Byrd, D. (2017). Attention-Deficit/Hyperactivity Disorder (ADHD): Reviewing the Neurocognitive Characteristics of an American Epidemic. Journal of the Washington Academy of Sciences, 103(1), 37-56. Retrieved June 24, 2021, from https://www.jstor.org/stable/90013591