ERIC Identifier: ED287261
Publication Date: 1987-00-00
Author: Scott, Mary E.
Source: ERIC Clearinghouse on
Handicapped and Gifted Children Reston VA.
Attention Deficit Disorder (ADD). Digest #445.
Many teachers and parents have received and will continue to receive the
diagnosis of ADD for children who have problems. The American Psychiatric
Association (APA) has identified and defined this disorder. According to the
American Psychiatric Association (1980), ADD is indicated when children display
inappropriate inattention, impulsivity, and sometimes hyperactivity for their
mental and chronological age. ADD may be diagnosed as with or without
hyperactivity. Approximately 20% of the population will be diagnosed as having
Teachers and parents are the ones who usually seek help for children who
exhibit the problems associated with ADD. Children from ages 8 to 10 years are
most likely to be referred and diagnosed as ADD. The younger the child is when
diagnosed as ADD, the more severe form of ADD they are likely to show.
Conversely, if preadolescent and/or adolescent children are diagnosed, they will
usually show a less severe form of ADD. ADD is most obvious in situations that
call for self-application or in group situations, and may be absent in a
one-to-one situation or in a situation that is novel to the child. These facts
should be kept in mind as the criteria used for diagnosis of ADD are considered.
WHAT ARE THE APA CHARACTERISTICS OF ADD?
The American Psychiatric Association (1980) uses the following criteria for
1. Inattention (will exhibit at least three of the following): --often fails
to finish things he or she starts --often seems not to listen --is easily
distracted --has difficulty concentrating on schoolwork or other tasks requiring
sustained attention --has difficulty sticking to a play activity
2. Impulsivity (will exhibit at least three of the following): --often acts
before thinking --shifts excessively from one activity to another --has
difficulty organizing work (this not being due to cognitive impairment) --needs
a lot of supervision --frequently calls out in class --has difficulty awaiting
turn in games or group situations
3. Hyperactivity--ADD may be diagnosed as with or without hyperactivity (if
hyperactive, will show at least two of the following): --runs about or climbs on
things excessively --has difficulty sitting still or fidgets excessively --has
difficulty staying seated --moves about excessively during sleep --is always "on
the go" or acts as if "driven by a motor"
4. Onset before age 7.
5. Duration of at least 6 months.
6. Not due to schizophrenia, affective disorder, or a severe or profound
When a child shows the appropriate criteria, the diagnosis of ADD will be
ASSOCIATED PROBLEMS OF CHILDREN WITH ADD ACCORDING TO THE APA CRITERIA
Teachers and parents who deal with children with ADD will need to deal with
and work on improving children's attention skills, impulsivity, and
hyperactivity, if present. Further research indicates that self-esteem and
social skills will also need to be remediated. Perceptual and conceptual skills
are also affected and need to be worked on. Finally, since ADD seems to affect
children's reinforcement responses and intrinsic motivation as well, effective
reinforcement systems need to be found. Many of these remediation needs in ADD
children are interconnected and approaches will impact one another.
WHAT ARE POSSIBLE CAUSES OF ADD?
Researchers still stress that no conclusive evidence on ADD is available but
indications are leaning toward some probability of ADD being genetic, prenatal,
or physical in nature. Because of the nature of possible causes, medication is
often tried as an answer to the problems seen in ADD children. However, no one
medication has been found to be successful with all ADD children. Dexedrine,
Ritalin, and Cylert are commonly prescribed. Active research into the causes is
WHAT ARE SOME DIRECTIONS FOR TEACHING STUDENTS WITH ADD?
ADD is often diagnosed as secondary to other learning difficulties which may
range from learning disabilities to emotional disturbance. The earlier the
diagnosis can be made and remediation begun, the better the chances of avoiding
these other complicating difficulties.
As indicated by the name of this disorder, attention skills will need
extensive work. Attention is an important prerequisite for all learning and
success in school. Students will need to learn to finish work once started. They
will need to learn to listen and be helped to have as few distractions as
possible. Additionally, they should be programmed to build up their length of
attention span. Some sources of ideas for this attention building are listed at
the end of this digest.
Impulsivity is also an area needing remediation. Students will need to stop
and think before they answer or begin work. This will require much supervised
remediation at first but this control must eventually become self-controlled on
the student's part. Activities and plans for working with impulsivity are
Hyperactivity or an inability to control movement, if present, can interfere
with attending and learning. Teaching students how to slow down and become aware
can include activities such as "The Turtle Imagery Procedure"; this activity
teaches children to say they will go slow, like a slow turtle, in a structured
program that includes more inclusive exercises. Other helpful methods include
modeling of appropriate behavior by adults, self-confrontation with videotape,
role playing, biofeedback, and relaxation.
One major problem students with ADD will encounter is in the area of
effective socialization with peers. It is part of a cycle that when students
fail to make friends and get along with others, the students then also have
negative feelings about themselves.
Other specific skill deficits in perceptual and conceptual areas will also
need attention. Much of the work in this area focuses on the task to be taught
and uses a strong behavioral approach emphasizing incremental learning steps.
ADD seems to affect reinforcement response. But for any remediation program
to succeed, parents and teachers will need to find out what would be potentially
reinforcing for a student, and then a reinforcement schedule can begin to be
planned. Success for those students is crucial.
FOR MORE INFORMATION
American Psychiatric Association. DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL
DISORDERS (3rd ed.). Washington, DC: 1980.
ATTENTION DEFICIT DISORDER AND HYPERACTIVITY, A Computer Search Reprint.
Stock No. 552. The Council for Exceptional Children, 1920 Association Drive,
Reston, VA 22091, l987.
Bloomingdale, L.M. ATTENTION DEFICIT DISORDER: DIAGNOSTIC, COGNITIVE AND
THERAPEUTIC UNDERSTANDING. New York: S.P. Medical and Scientific Books, 1984.
Bohlene, D.S. "Intellectual and Affective Characteristics of Attention
Deficit Disordered Children." JOURNAL OF LEARNING DISABILITIES 18 (1985):
SPECIFIC REMEDIATION REFERENCES
Attention Kinsbourne, M., and P. Caplan. CHILDREN'S LEARNING AND ATTENTION
PROBLEMS. Boston: Little, Brown and Co., 1979.
Impulsivity Horowitz, J. "Controlling Impulsiveness: Self-awareness
Exercises." ACADEMIC THERAPY 21 (l986): 275-282.
Hyperactivity Carter, E.N., and J.N. Reynolds. "Imitation in the Treatment of
a Hyperactive Child." PSYCHOTHERAPY: THEORY, RESEARCH AND PRACTICES 13 (1976):
Lupin, M. PEACE, HARMONY, AWARENESS--A RELAXATION PROGRAM FOR CHILDREN.
Allen, TX: Developmental Learning Materials, 1970.
Ross, D.M., and S. Ross. HYPERACTIVITY: CURRENT ISSUES IN RESEARCH AND
THEORY. New York: John Wiley and Sons, 1982.
Schnieder, M. "Turtle Technique in the Classroom." In M. Herbert, CONDUCT
DISORDERS OF CHILDHOOD AND ADOLESCENCE (p. 119). New York: John Wiley and Sons,
Socialization and Self-Esteem Canfield, J., and H. Wells. 100 WAYS TO ENHANCE
SELF-CONCEPT IN THE CLASSROOM. Englewood Cliffs, NJ: Prentice-Hall, 1976.
Elarado, P., and M. Cooper. AWARE. Menlo Park, CA: Addison-Wesley Publishing
Jackson, N.F., D.A. Jackson, and C. Monroe. GETTING ALONG WITH
OTHERS--TEACHING SOCIAL EFFECTIVENESS TO CHILDREN. Champaign, IL: Research
Schilling, D.E. "Self-esteem: Concerns, Strategies, Resources." ACADEMIC
THERAPY 21 (1986): 301-307.
Perceptual and Conceptual Ebersole, M.L., N.C. Kephart, and J.B. Ebersole.
STEPS TO ACHIEVEMENT FOR THE SLOW LEARNER. Columbus, OH: Charles E. Merrill,
1968. (Additional books in the Kephart series may also be helpful).
Reinforcement Glazzard, Peggy. LEARNING ACTIVITIES AND TEACHING IDEAS FOR THE
SPECIAL CHILD IN THE REGULAR CLASSROOM. Englewood Cliffs, NJ: Prentice-Hall,
Purkey, W.W. INVITING SCHOOL SUCCESS--A SELF CONCEPT APPROACH TO TEACHING AND
LEARNING. Belmont, CA: Wadsworth Publishing Co., Inc., 1978.
Resources Contact your local school psychologist or examiner, or personnel in
charge of assessment and diagnosis in your school district, for further
information on ADD.