Attention Deficit DisorderAttention Deficit DisorderLiceo Cultural Británico Liceo Cultural Británico

Lic. Gonzalo CampLic. Gonzalo Camp

Syndrome characterized by serious and Syndrome characterized by serious and persistent difficulties in three areaspersistent difficulties in three areas

1) distractibility (poor sustained attention to 1) distractibility (poor sustained attention to tasks) tasks)

2) impulsivity (impaired impulse control 2) impulsivity (impaired impulse control and delay of gratification) and delay of gratification)

3) hyperactivity (excessive activity and 3) hyperactivity (excessive activity and physical restlessness) physical restlessness)

DEFINITION OF ADD: DEFINITION OF ADD:

What are the Symptoms of ADD?What are the Symptoms of ADD?

Easily distracted by sounds and other Easily distracted by sounds and other things.things.

Difficulty focusing on assignments.Difficulty focusing on assignments. Very forgetful on appointments and other Very forgetful on appointments and other

due datesdue dates Having difficulty studying quietly.Having difficulty studying quietly.

WHO HAS ADD WHO HAS ADD

According to epidemiological data, According to epidemiological data, approximately 4% to 6% of the U.S. approximately 4% to 6% of the U.S. population has ADD population has ADD

In ArgentinaIn ArgentinaLos niños que recibieron el diagnóstico según el ambos sistemas fueron Los niños que recibieron el diagnóstico según el ambos sistemas fueron

del 4,99%. Los resultados según los criterios del DSM-IV fueron de del 4,99%. Los resultados según los criterios del DSM-IV fueron de 7,86 y la utilización de la escala más estricta, por su parte, arrojó una 7,86 y la utilización de la escala más estricta, por su parte, arrojó una prevalencia del 5,24% Los resultados se muestran dentro de lo prevalencia del 5,24% Los resultados se muestran dentro de lo esperable, aunque la prevalencia en niñas encontrada sobrepasan esperable, aunque la prevalencia en niñas encontrada sobrepasan aquellas que encontraron estudios similares en otros lugares.aquellas que encontraron estudios similares en otros lugares.

Ruben O. Scandar - La Fundación de Neuropsicología ClínicaRuben O. Scandar - La Fundación de Neuropsicología Clínica

TreatmentsTreatments

There is no cure for ADD. There is no cure for ADD.

There are treatments.There are treatments.

There are two main forms of treatmentsThere are two main forms of treatments

medicationsmedications

behavioral therapiesbehavioral therapies

Medical TreatmentsMedical Treatments

These are all the common medications These are all the common medications of Attention Deficit Disorderof Attention Deficit Disorder

There is: There is: Listol, Vaxa, ADDult.Listol, Vaxa, ADDult. Ritalin, Dexedrine, Cylert, Ritalin, Dexedrine, Cylert, ADDerallADDerall

Behavioral TreatmentsBehavioral Treatments

Behavioral treatments consist of Behavioral treatments consist of

Token economy is a way of Token economy is a way of

treating a problem by treating a problem by

punishing bad behavior punishing bad behavior

and rewarding goodand rewarding good

behaviorbehavior

Good Things About ADD.Good Things About ADD.

People with ADD may be very creative. People with ADD may be very creative. Like a painting in your home could come Like a painting in your home could come from someone who has Attention Deficit from someone who has Attention Deficit Disorder.Disorder.

Some of the Gifted are label as to having Some of the Gifted are label as to having Attention Deficit Disorder. It is very Attention Deficit Disorder. It is very misunderstood.misunderstood.

Bad things About ADDBad things About ADD

People with ADD can get really annoying.People with ADD can get really annoying. Have temper tantrumsHave temper tantrums They could one minute be mad and then the They could one minute be mad and then the

next be very happy. next be very happy. Then they could eventually get over what Then they could eventually get over what

ever they are doing.ever they are doing. They may have very bad anger problems.They may have very bad anger problems. He or she may have trouble remembering He or she may have trouble remembering

things and forget what they are doing.things and forget what they are doing.

What What happens in happens in

the the classroom?classroom?

Things We Things We CanCan See (aka, See (aka, Common Complaints)Common Complaints)

Difficulties sustaining attentionDifficulties sustaining attention DaydreamingDaydreaming Child doesn’t listenChild doesn’t listen Always losing thingsAlways losing things ForgetfulForgetful Easily distractedEasily distracted Needs constant supervisionNeeds constant supervision Child doesn’t finish anything he/she startsChild doesn’t finish anything he/she starts

Common Complaints (cont’d)Common Complaints (cont’d)

Problems with impulse controlProblems with impulse control Impatient/Difficulties waiting for thingsImpatient/Difficulties waiting for things Always interrupting othersAlways interrupting others Blurts out answersBlurts out answers Doesn’t take turnsDoesn’t take turns Tries to take shortcuts on many tasks Tries to take shortcuts on many tasks

(including chores, homework, etc.)(including chores, homework, etc.)

Common Complaints (cont’d)Common Complaints (cont’d)

HyperactivityHyperactivity Always on the goAlways on the go Squirmy…can’t sit stillSquirmy…can’t sit still Talks too muchTalks too much Frequently hums or makes odd noisesFrequently hums or makes odd noises Unable to “put the brakes on” motor activityUnable to “put the brakes on” motor activity Child has two speeds; asleep and awakeChild has two speeds; asleep and awake

What Do These Behaviors Have What Do These Behaviors Have in Common?in Common?

Problem isn’t as much sustaining attention Problem isn’t as much sustaining attention as it is sustaining as it is sustaining inhibitioninhibition…this is the …this is the hallmark of ADHDhallmark of ADHD

InhibitionInhibition: a mental process that restrains : a mental process that restrains an action (behavior) or emotionan action (behavior) or emotion

Problems of inhibition are not a matter of Problems of inhibition are not a matter of choice, but are instead a result of what is choice, but are instead a result of what is (or is not) going on in the child’s brain(or is not) going on in the child’s brain

ADHD and the Human BrainADHD and the Human Brain

Portions of brain’s frontal lobe are Portions of brain’s frontal lobe are responsible for “Executive” functions:responsible for “Executive” functions: Consolidating information from other areas of Consolidating information from other areas of

the brainthe brain ““Considers” potential consequences and Considers” potential consequences and

implications of behaviorsimplications of behaviors Puts “brakes” on (Puts “brakes” on (inhibitsinhibits) impulsive ) impulsive

reactionsreactions Initiates appropriate response to environmentInitiates appropriate response to environment

ADHD and the Brain (cont’d)ADHD and the Brain (cont’d)

Research suggests that in in children with Research suggests that in in children with ADHD, these “executive” areas of the ADHD, these “executive” areas of the brain are brain are under-activeunder-active

Increasing the activity level in these areas Increasing the activity level in these areas of the ADHD brain have been shown to of the ADHD brain have been shown to decrease behavioral symptoms. This is decrease behavioral symptoms. This is the logic behind using Stimulant the logic behind using Stimulant medications as a first line treatment for the medications as a first line treatment for the disorder.disorder.

Things That Look Like ADHDThings That Look Like ADHD

DepressionDepression AnxietyAnxiety Hearing problemsHearing problems Visual problemsVisual problems Seizure disorderSeizure disorder Oppositional defiant Oppositional defiant

disorderdisorder AutismAutism

Learning disabilitiesLearning disabilities Parenting problemsParenting problems Substance useSubstance use Medication side-Medication side-

effectseffects Lead poisoningLead poisoning

Establish the Proper Learning Establish the Proper Learning EnvironmentEnvironment

Establish the Proper Learning Establish the Proper Learning EnvironmentEnvironment

Place students with ADD near you, but in Place students with ADD near you, but in regular seating orientationregular seating orientation

Place students with backs to rest of classPlace students with backs to rest of class

Surround students with ADD with good Surround students with ADD with good role models (encourage peer tutoring)role models (encourage peer tutoring)

Establish the Proper Establish the Proper Environment (cont.)Environment (cont.)

Pay attention to change in child’s Pay attention to change in child’s schooling (avoid physical relocation, schooling (avoid physical relocation, change in schedule, and disruptions) change in schedule, and disruptions) watch them on field tripswatch them on field trips

Have a reduced-distraction study area, Have a reduced-distraction study area, encourage parents to do the same. encourage parents to do the same.

Have parents set up regular homework Have parents set up regular homework routinesroutines

Instructing Students With ADDInstructing Students With ADD

Maintain eye contact when possible (i.e. Maintain eye contact when possible (i.e. giving verbal instructions)giving verbal instructions)

Make directions clear and concise. Be Make directions clear and concise. Be consistent with daily instructions.consistent with daily instructions.

Simplify complex directions. Avoid multiple Simplify complex directions. Avoid multiple commands.commands.

Instructing Student with ADD Instructing Student with ADD (cont.)(cont.)

Make sure students comprehend the Make sure students comprehend the instructions before beginning the task instructions before beginning the task

Repeat instructions in a calm, positive Repeat instructions in a calm, positive manner, if needed manner, if needed

Help the students feel comfortable with Help the students feel comfortable with seeking assistance seeking assistance

Instructing Student with ADD Instructing Student with ADD (cont.)(cont.)

provide opportunity for students to apply provide opportunity for students to apply concepts they have studied to the reality concepts they have studied to the reality of their daily lives of their daily lives

bridge from previously taught concepts bridge from previously taught concepts to new concepts to new concepts

Giving Assignments Giving Assignments

Give out only one task at a time. Give out only one task at a time. Monitor frequently. Maintain a supportive Monitor frequently. Maintain a supportive

attitude attitude Give extra time for certain tasks. Students Give extra time for certain tasks. Students

with ADD may work slowly. Do not with ADD may work slowly. Do not penalize them for needed extra time.penalize them for needed extra time.

Modifying Behavior And Modifying Behavior And Enhancing Self-Esteem Enhancing Self-Esteem

Providing Supervision and Discipline:Providing Supervision and Discipline:

Remain calm, state the infraction of the rule, Remain calm, state the infraction of the rule, and avoid debating or arguing with the student.and avoid debating or arguing with the student.

Have pre-established consequences for Have pre-established consequences for misbehavior.misbehavior.

Administer consequences immediately, and Administer consequences immediately, and monitor proper behavior frequently.monitor proper behavior frequently.

Enforce classroom rules consistently.Enforce classroom rules consistently.

Modifying Behavior And Enhancing Modifying Behavior And Enhancing Self-Esteem (cont.)Self-Esteem (cont.)

ProvidingProviding EncouragementEncouragement:: Reward more than you punish, in order to Reward more than you punish, in order to

build self-esteem.build self-esteem.

Praise immediately any and all good Praise immediately any and all good behavior and performance.behavior and performance.

Change rewards if they are not effective Change rewards if they are not effective in motivating behavioral change.in motivating behavioral change.

Find ways to encourage the child.Find ways to encourage the child.

Modifying Behavior And Enhancing Modifying Behavior And Enhancing Self-Esteem (cont.)Self-Esteem (cont.)

use contingency-based self-management use contingency-based self-management techniques techniques

have individuals keep track of their own have individuals keep track of their own

behavior and then receive consequencesbehavior and then receive consequences use self-monitoring of attention to use self-monitoring of attention to

increase on-task behavior increase on-task behavior Helps students become more aware of what trigger Helps students become more aware of what trigger

off-task behavioroff-task behavior

Other Educational Other Educational Recommendations Recommendations

Check for other learning disabilities Check for other learning disabilities (present in ~30% of kids with add)(present in ~30% of kids with add)

Try a private tutorTry a private tutor Individualized mildly or non-competitive Individualized mildly or non-competitive

activities (bowling, walking, swimming)activities (bowling, walking, swimming) Involvement in Social Activities (scouting, Involvement in Social Activities (scouting,

church group)church group)

KEY Tips for Managing ADHDKEY Tips for Managing ADHD

Be patientBe patient Be persistent Be persistent Be understandingBe understanding *Most importantly, remember to *Most importantly, remember to

differentiate the behaviors from the childdifferentiate the behaviors from the child Bad behaviors Bad behaviors are not are not synonymous with a synonymous with a

bad childbad child

Thank you very much!!!!Thank you very much!!!!