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 ADD.
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 diagnosing ADD.
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 mental retardation.
When a child shows the appropriate criteria, the diagnosis of ADD will be given.
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 ongoing.
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 available.
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): 604-608.
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): L60-161.
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, 1978.
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 Co., 1977.
Jackson, N.F., D.A. Jackson, and C. Monroe. GETTING ALONG WITH OTHERS--TEACHING SOCIAL EFFECTIVENESS TO CHILDREN. Champaign, IL: Research Press, 1983.
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, 1982.
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.
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