ATTENTION DEFICIT DISORDER



by Mary Fowler



NICHCY Briefing Paper

#FS14, Update 1994

______________



National Information Center for Children and Youth with Disabilities

P.O. Box 1492

Washington, DC 20013

E-Mail: nichcy@aed.org

URL: http://www.nichcy.org

1-800-695-0285 (Voice/TT)



This document is copyright free. Readers are encouraged to copy and share

it with others. We only ask that you credit the material as a publication

of the National Information Center for Children and Youth with Disabilities

(NICHCY).

______________



Every year the National Information Center for Children and Youth with

Disabilities (NICHCY) receives hundreds of requests for information about

the education and special needs of children and youth with Attention

Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD).

Over the past several years, ADD and ADHD have become a subject of

increased attention from parents, professionals, and policy-makers across

the country.



In response to the increasing concern about and interest in this

disability, this NICHCY Briefing Paper was developed. It is designed to

answer some of the most commonly asked questions regarding ADD and ADHD and

to provide concerned individuals with other resources for information and

support.

_____________



A quote:



Maybe you know my kid. He's the one who says the first thing that comes to

mind. He's the youngster who can't remember a simple request. When he

scrapes his knee, he screams so loud and long that the neighbors think I am

beating him. He's the kid in school with ants in his pants who could do the

work if he really tried. Or so his parents have been told over and over

again."



Drawn from Mary Fowler's (1990) Maybe you know my kid: A parent's guide to

identifying, understanding, and helping your child with ADHD. Used with

permission.

______________



What is Attention Deficit

Disorder?



Attention Deficit Disorder (ADD), also called Attention Deficit

Hyperactivity Disorder (ADHD), is a developmental disability estimated to

affect between 3-5% of all children (Barkley, 1990). The disorder is

characterized by three predominant features: inattentiveness, impulsivity,

and in many but not all cases, restlessness or hyperactivity. The disorder

is most prevalent in children and is generally thought of as a childhood

disorder. Recent studies, however, show that ADD can and does continue

throughout the adult years. Current estimates suggest that approximately 50

to 65% of the children with ADD will have symptoms of the disorder as

adolescents and adults (Barkley, 1990, p. 124).



What Causes ADD?



Scientists and medical experts do not know precisely what causes ADD.

Scientific evidence suggests that the disorder is genetically transmitted

in many cases, and is caused by a chemical imbalance or deficiency in

certain neurotransmitters (chemicals that regulate the efficiency with

which the brain controls behavior). Results from a landmark study conducted

by Alan Zametkin, M.D., and his colleagues at the National Institute of

Mental Health showed that the rate at which the brain uses glucose, its

main energy source, is lower in subjects with ADD than in subjects without

ADD (Zametkin et al., 1990). Even though the exact cause of ADD remains

unknown, we do know that ADD is a neurologically-based medical problem and

is not caused by poor parenting or diet.



What Are The Signs of ADD?



Inattention. A child with ADD is usually described as having a short

attention span and as being distractible. The child will have difficulty

concentrating (particularly on tasks that are routine or boring),

listening, beginning or finishing tasks, and following directions

(especially when three or more steps are given at one time). The child may

appear to hear but not listen. Parents and teachers find that they often

have to repeat directions and redirect the child to tasks such as getting

ready for school, putting away toys or materials, completing worksheets, or

finishing meals. Some children with ADD wander about, while others appear

to daydream.



Attention is a skill that can be applied or directed in a variety of ways.

The inattentiveness of a child with ADD, then, can take several forms. The

child may have difficulty with selective attention (figuring out where his

or her attention needs to be), focusing attention (the child knows where

attention needs to be, but has difficulty zeroing in on the relevant task),

sustaining attention (difficulty in maintaining attention through

distractions), and/or dividing attention (difficulty doing two or more

tasks at the same time). The child can have difficulty with one or all of

these attention skills.



Impulsivity. A child with ADD often acts without thinking, and has great

difficulty waiting for his or her turn. The child may rush through

assignments, shift excessively from one task to another, or frequently call

out or ask irrelevant questions in class. This child will often interrupt

others and have outbursts of inappropriate responses such as silliness or

anger. When this child gets a case of "the giggles" or flies into a temper

tantrum, he or she has great difficulty regaining emotional control.



Impulsivity often leads the child into physical danger and disapproval. He

or she may engage in what looks like risk-taking behavior, such as running

across a street without looking, climbing on or jumping from roof tops or

tall trees, shooting a rubber band at a classmate, and so on. This child is

not really a risk-taker but, rather, a child who has great difficulty

controlling impulse. Often, the child is surprised to discover that he or

she has gotten into a dangerous situation and has no idea how the situation

developed or why.



Hyperactivity (Poor Motor Control). Many (but not all) children with ADD

are hyperactive. A hyperactive child is often described as always on the go

or motor driven. This child runs or climbs excessively, has difficulty

sitting still, fidgets, and engages in physical activity not related to the

task, such as frequent pencil sharpening, falling out of his or her chair,

finger tapping, or fiddling with objects. The child may also make excessive

vocalizations, noises, or talk in a loud voice. It is important to realize,

however, that some children are more hyperactive than others, and that a

hyperactive child may have periods of calm as well.



In contrast to children who have ADD with hyperactivity, some children with

ADD are underactive and often called lazy or spacey. Children with ADD,

those with hyperactivity and those without, are often accident prone.



Disorganization. Inattentiveness and impulsivity often cause the child with

ADD to be very disorganized. This child frequently forgets needed materials

or assignments, loses his or her place, and has difficulty following

sequences, such as directions with three or more steps. When given multiple

worksheets or directions, the child often does not know where to begin or

overlooks part of the assignment.



Social Skill Deficits. The child with ADD is often described as immature,

lacking in self-awareness and sensitivity, and demanding of attention. The

child may frustrate easily and be inconsiderate, overly sensitive, or

emotionally overreactive. He or she may have difficulty expressing

feelings, accepting responsibility for behavior, or get into frequent

fights or arguments. This child often reacts to a social situation without

first determining what behavior is desirable; for example, he or she may

interrupt a game in progress or crack a joke during a serious moment.

Though this child has social problems, it is important to understand that

the social skills deficits stem from the disorder. This child wants to be

liked and accepted, but usually goes about it with an inappropriate style.



Don't All Children Show These Signs Occasionally?



From time to time all children will be inattentive, impulsive, and exhibit

high energy levels. But, in the case of ADD, these behaviors are the rule,

not the exception. This child is often described as experiencing difficulty

"getting with the program" at home, in school, or with peers. Keep in mind,

however, that the degree of difficulty varies with each child.



Many parents spend years wondering why their child is difficult to manage.

They may blame themselves, thinking they are "bad" parents or feeling

guilty and ashamed of the way they respond to the child. As the child grows

older, the "out of step" behavior is often misunderstood as a deliberate

choice to be non-compliant, and the child is blamed. When the child enters

school and experiences difficulty in that environment, teachers with

knowledge of this disability may recognize the behaviors as possible

indicators of ADD. Teachers without knowledge of ADD may blame the child,

the parents, or both.



How Do I Know For Sure If My Child Has ADD?



There is a big difference between suspecting your child has ADD and knowing

for certain. Parents are cautioned against diagnosing this disorder by

themselves. ADD is a disability that, without proper identification and

treatment, can have serious and long-term complications.



Unfortunately, there is no simple test, such as a blood test or urinalysis,

which will determine if a child has this disorder. Diagnosing ADD is

complicated and much like putting together a puzzle. An accurate diagnosis

requires an assessment conducted by a well-trained professional, usually a

developmental pediatrician, child psychologist, child psychiatrist, or

pediatric neurologist.



What Does an ADD Assessment Involve?



The evaluation for diagnosing ADD usually includes the following elements:



1. A thorough medical and family history

2. A physical examination

3. Interviews with the parents, child, and child s teacher

4. Behavior rating scales

5. Observation of the child

6. Psychological tests which measure I.Q. and social and emotional

adjustment, as well as screen for learning disabilities.



Sophisticated medical tests such as EEGs (to measure the brain s electrical

activity) or MRIs (an X-ray that gives a picture of the brain's anatomy)

are NOT part of the routine assessment. Such tests are usually given only

when the diagnostician suspects another problem, and those cases are rare.

Positron emission tomography (PET Scan) has recently been used for research

purposes but is not part of the diagnostic evaluation.



The professional evaluating your child will look at all the information

collected and decide whether or not your child has ADD. This professional

will base this decision in part upon whether your child's behaviors

correlate with the criteria listed in the American Psychiatric

Association's (APA) Diagnostic and Statistical Manual (DSM).



Periodically, new editions of the DSM are released as DSM criteria undergo

revisions to incorporate up-to-date information gathered by researchers.

Since ADD was first included in the DSM as a distinct syndrome 25 years

ago, the criteria for the disorder have been significantly refined. It is

important to know that, although criteria change, the basic disorder does

not. Changes reflect advances in the understanding of the components of the

syndrome now commonly referred to as ADD.



Recently the American Psychiatric Association has released the newest

edition of the manual, the DSM-IV (1994, May). Criteria for ADD (which is

officially named Attention Deficit/Hyperactivity Disorder) have undergone

significant restructuring. The box below lists some of the diagnostic

features of ADD, as set forth in this most recent DSM edition. In general,

for a child to be diagnosed as having ADD, the behavioral signs of

inattention adn/or hyperactivity-impulsivity must be evident in early

childhood (prior to age 7), inappropriate for the child's age, present for

at least six months, and result in clinically significant impairment in two

or more settings (e.g., at home, in school). All children with ADD do not

have the disorder to the same degree. Some children may be mildly affected,

while others may experience moderate to severe difficulties in all areas of

their lives.

____________



Definining Attention Deficit/Hyperactivity Disorder*



Instead of a single list of 14 possible symptoms as listed in the prior

edition of the DSM (the DSM-III-R), the DSM-IV categorically sorts the

symptoms into three subtypes of the disorder:



-- Combined Type: multiple symptoms of inattention, impulsivity, and

hyperactivity;



-- Predominantly Inattentive Type: multiple symptoms of inattention with

few, if any, of hyperactivity-impulsivity;



-- Predominantly Hyperactive-Impulsive Type: multiple symptoms of

hyperactivity-impulsivity with few, if any, of inattention.



Other essential diagnostic features of AD/HD include:



-- Symptoms of inattention, hyperactivity, or impulsivity must persist for

at least six months and be maladaptive and inconsistent with developmental

levels;



-- Some of the symptoms causing impairment must be present before age 7

years;



-- Some impairment from the symptoms is present in two or more settings

(e.g., at school/work, and at home);



-- Evidence of clinically significant impairment is present in social,

academic, or occupational functioning;



-- Symptoms do not occur exclusively during the course of Pervasive

Developmental Disorder, Schizophrenia, or other Psychotic Disorder, and are

not better accounted for by another mental disorder (e.g., Mood Disorder,

Anxiety Disorder, Dissociative Disorder, or Personality Disorder).



* Drawn from the American Psychiatric Association's (1994), Diagnostic and

Statistical Manual of Mental Disorder (4th ed.), pp. 83-85.

___________



How Do I Get My Child

Evaluated For ADD?



If your child is an infant or toddler, and you suspect an attention or

hyperactivity problem, you may want to investigate what early intervention

services are available in your state through the Part H program of the

Individuals with Disabilities Education Act (IDEA). You can find out about

the availability of these services in your state by contacting the

StateDepartment of Education, contacting your local education agency,

asking your pediatrician, or contacting the nursery or child care

department in your local hospital.



While your state may not specifically list ADD as a disability to be

addressed through the Part H program, most states have a category such as

"atypical children" or "other" under which an ADD assessment might be made.



Preschoolers (children aged 3-5) may be eligible for services under Part B

of the Individuals with Disabilities Education Act. If your child is a

preschooler, you may wish to contact the State Department of Education,

local education agency, ask your pediatrician, or talk with local day care

providers about how to access services under Part B in order to have your

child assessed.



If your child is school-aged, and you suspect that ADD may be adversely

affecting his or her educational performance, you can ask your local school

district to conduct a evaluation. With the exception of the physical

examination, the assessment can be conducted by the child study team,

provided they have been trained in the assessment of Attention Deficit

Disorder. If not, the district may need to utilize an outside professional

consultant trained in the assessment of ADD. This person must know what to

look for during child observation, be competent to conduct structured

interviews with the parent, teacher, and child, be able to interpret the

interview results, and know how to administer and interpret behavior rating

scales.



Parents may also choose to have their child assessed privately. In

selecting a professional to perform an assessment for ADD, parents should

consider the clinician's training and experience with the disorder, and his

or her availability to coordinate the various treatment approaches. Parents

can consult their child's pediatrician, community mental health center,

university mental health clinics, or hospital child evaluation units. Most

ADD parent support groups have a list of clinicians trained to evaluate and

treat children with ADD.



How is ADD Treated?



There is no cure or "quick fix" when treating ADD. Widely publicized

"cures" such as special diets have, for the most part, proven ineffective.



Effective treatment of ADD generally requires these basic components:

education about the disorder, training in the use of behavior management,

medication when indicated, and an appropriate educational program.



(1) Education about the Disorder. Parents and teachers need to be aware of

the symptoms of ADD and how those symptoms impact the child's ability to

function at home, in school, and in social situations. Once the adults in

the child's life understand that the child cannot help many of his or her

problematic behaviors, they will be able to structure situations to enable

the child to behave appropriately and achieve success. Remember, the child

who has difficulty with attention, impulse control, and in regulating

physical activity needs help and encouragement to overcome these problems.



(2) Behavior Management. Children with ADD respond well to rewards and

structure. The child does best in an organized environment where rules and

expectations are clear and consistent, and when consequences for meeting

the demands of a given situation are set forth ahead of time and delivered

immediately. Thus, the child's environment needs to be ordered and

predictable. Frequent and consistent praise and rewards for appropriate

behavior such as completing tasks on time or being polite and courteous

encourage the child to repeat such desirable behavior.



The main principle behind all behavior management strategies is to increase

the child s appropriate behavior and decrease inappropriate behavior

through the use of consequences. The best way to influence any behavior is

to pay attention to it. The best way to increase a desirable behavior is to

reward it. Ignoring an undesirable behavior will decrease its frequency.



There are many books on behavior management written for the lay person.

Below are some guidelines for behavior management.



Guideline 1, Behavior Modification Charts: Children with ADD usually

require a formal program for managing their behavior. Most often, such a

program centers around behavior modification charts. Parents, teachers, and

other important adults in the child s life will need training in how to

implement and use these charts effectively.



Charts are designed to provide the child with a clear picture of what

behaviors are expected. The child then has the choice to meet those

expectations. Parents or teachers provide feedback to the child about his

or her choices by delivering consequences. Charts provide high motivation

and enable the child to develop an internal sense of self-control --

specifically, that he or she can behave appropriately.



There are two basic types of chart programs. (1) Token Economy - Here, the

child earns tokens (chips, stickers, stars) for appropriate behavior.

Tokens can be exchanged for various rewards. (2) Response Cost - In this

chart program, the child is given tokens for free. Tokens are withdrawn for

inappropriate behavior (e.g., out of seat, off-task, etc.).



The most effective programs use both types of chart systems and work on a

give and take basis. In this combination system, the child is given a token

for behaving appropriately and loses a token when misbehaving.



When creating and implementing a behavior modification chart, you may wish

to follow these suggestions:



-- Make a list of problematic behaviors or ones that need improving.



-- Select the behaviors to be modified. The parents (or teachers), with

input from the child, review the list of problematic behaviors and select

three, four, or five to work on at a given time. The behaviors charted

should be ones that occur daily, such as going to bed on time, doing

homework, or getting ready for school on time.



-- Design a reward system (Token Economy, Response Cost, or a combination).

The parents (or teachers) need to pay attention to the child's behavior

throughout the course of a day and provide frequent rewards when the child

behaves appropriately. At the end of the day, tokens can be exchanged for

rewards, such as extended bed time, playing a game with Mom or Dad, or a

favorite snack. Remember, a reward is only effective when it has value to

the child. Rewards might have to be changed frequently.



Guideline 2, Punishment: Children with ADD respond best to motivation and

positive reinforcement. It is best to avoid punishment. When punishment is

necessary, use it sparingly and with sensitivity. It is important for

parents and teachers to respond to this child's inappropriate behavior

without anger and in a matter-of-fact way. These children need to be taught

to replace inappropriate behavior with appropriate behavior.



Guideline 3, Time-out: When the child is misbehaving or out of control,

time-out is an effective way to manage the problem. Time-out means the

child is sent to a predetermined location for a short period of time. A

place out of the mainstream of activity is best; for example, one

particular chair may be specified as the "time-out chair." The time-out

location should not be a traumatic place, such as a closet or dark

basement. The purpose of time-out is to provide the child with a

cooling-off period wherein he or she can regain control.



An important aspect to time-out is that the child no longer has the

privilege to choose where he or she would like to be and how time is spent.

In general, the child stays in time-out and must be quiet for five minutes.

Preschool-aged children are usually given two or three minutes in time-out.

For toddlers, 30 seconds to a minute is appropriate.



(3) Medication. Medication has proven effective for many children with ADD.

Most experts agree, however, that medication should never be the only

treatment used. Stimulants are the medication most widely prescribed for

ADD. These drugs (e.g. Ritalin, Dexedrine, Cylert) are believed to

stimulate the action of the brain s neurotransmitters, which enables the

brain to better regulate attention, impulse, and motor behavior. Ritalin is

the most widely used stimulant medication. In most cases, Ritalin has few

and mild side-effects. Anti-depressant medications are also used in

children who cannot take stimulant drugs.



The parents' decision to place a child on medication is a personal one and

should be made after a thorough evaluation of the child has taken place and

after careful consideration by both the parents and the physician. The

prescribing physician should explain the benefits and drawbacks of this

form of treatment to the parents. Doses are generally administered

gradually, so that the child receives the lowest dose needed to achieve the

best therapeutic benefit. Parents should monitor closely how their child

responds to the medication. Such monitoring generally includes feedback

from the child's teacher(s). Parents should communicate with the physician

as often as is necessary to determine when medication has reached the

proper level for the child, and to discuss any problems or questions.



(4) Appropriate Educational Program. Many children with ADD experience the

greatest difficulty in school where demands for attention and impulse or

motor control are virtual requirements for success. Though most children

with ADD do not have a learning disability that interferes with the

psychological process of learning, these children often are unable to

perform to their level of ability in school. Their poor performance and

academic failure usually result from uncompleted tasks, assignments

completed but not handed in on time, disorganization, and not following

directions. Behavioral difficulties such as hyperactivity, low frustration

tolerance, and outbursts of temper also prevent many of these children from

adapting to the classroom regimen. With help, these children can and do

succeed in school. (Note: Some children with ADD, however, do have learning

disabilities. Any evaluation should screen for the co-existence of learning

disabilities or other disabilities and ADD.)



Children with ADD do best with a teacher who is knowledgeable about the

disorder and willing to problem-solve to help the child overcome his or her

difficulties. A classroom where activities are highly structured and where

the teacher uses lots of motivation and hands-on instruction are similarly

helpful to children with ADD. Teachers and parents need to communicate

frequently.



There are numerous interventions which can be used effectively with the ADD

child. Here are a few guidelines:



-- The classroom environment needs to be structured and predictable, with

rules, schedules, and assignments posted and clearly spelled out.



-- It is best to seat the child close to the teacher, away from

distractors.



-- Directions should be clear, simple, and given a few at a time.



-- The curriculum will need to be modified in accordance with the child's

organizational skills and his or her ability to pay attention and

concentrate. How tasks are approached may be modified in a number of ways.

For example, tasks can be structured into easily completed parts; the

length of assignments can also be shortened or the child can be given extra

time to complete tasks. The child's progress during tasks can be monitored.

Including organizational and study skills in the daily curriculum is

another helpful modification, as is coordinating the amount of work between

subject areas.



-- Behavior management (e.g. positive reinforcement) is also necessary.

Behavior charts, used in combination with other educational interventions,

often produce positive results.



How Can I Help My Child Improve Self-Esteem?



Most undiagnosed and untreated children with ADD suffer from low

self-esteem. Many will also show signs of being mildly depressed. These

feelings stem from the child's sense of personal failure. For the child

with ADD, the world is often an unkind place. Negative feedback in the form

of punishment or blame tends to be a constant in this child's life. Early

diagnosis and treatment help to stem the feelings of poor self-esteem.



To encourage a good sense of self, this child must be helped to recognize

personal strengths and to develop them. Using many of the behavior

management techniques described in this document will help. The child's

self-esteem will improve when he or she feels competent. These are not

children who can't, or won't. They can, and do. It's just that "can" and

"do" come harder for them.

_____________



WAYS TO IMPROVE SELF-ESTEEN IN CHILDREN WHO HAVE ADD



Become Proactive. Knowledge is power. Gain enough knowledge about the

disability so you understand why and how ADD affects the child at home, in

school, in social situations, and the entire family system.



Change Your Belief System. Before the child can change his or her

self-concept, the adults in the child's life have to change the way they

view the child. Separate the child from the behavior, and then separate the

child from the disability. These are not ADD children. They are children

with ADD.



Act, Don't React. Emotional responses such as blame and anger will diminish

when you stop, look, listen, and then respond. In other words, count to

ten.



Nurture Yourself. Take time alone with your spouse, develop an interest or

hobby, establish a regular exercise program be good to yourself.



Catch The Child Being Good. Give your child lots of praise, encouragement,

recognition, and positive attention. Reward the child for meeting

expectations. Use punishment sparingly, and never ridicule the child.



Develop The Child's Sense of Competence and Responsibility.



-- Identify the child's strengths and weaknesses.

-- Develop realistic expectations of the child.

-- Play to the child's strengths by building opportunities for success in

the environment. Remember, you may have to structure situations carefully

to make success achievable.



* Assign special jobs (feeding the family pet, mowing the lawn, decorating

the house for holidays).

* Cultivate the child's special interests (help start a card or doll

collection, take trips to museums).

* Enroll the child in extra-curricular activities (sports, performing

arts). Finding an activity best suited to your child may require trial and

error. Encourage the child by attending practices and performances.

* Play with your child. Let the child choose and direct the game or

activity and, if not too obvious, let the child win.



"I think I can. I think I can," said the little red engine. And he could.

_______________



Does My Child Need Special Education?



Approximately one half of the children with ADD are able to learn

satisfactorily and perform to their ability levels within a regular

education classroom when the disorder is recognized, understood, and when

curriculum adjustments to the regular program of instruction are made.



The other half of the children with ADD will require special education

services, most of which can be provided within the regular education

classroom or the resource room. Such services might include teaching of

organization techniques, behavior modification programs, daily or weekly

report cards, training in self-monitoring, self-evaluation, and

self-instruction methods, and the coordination of efforts among the

different teachers working with the child.



Some children -- approximately 15% -- will need a more intensive program,

particularly those children who have other disabilities in addition to ADD.

A series of steps is typically necessary in order for a child to be placed

into a special education program. First, the child is referred to the local

school district's evaluation team. An evaluation is then made to determine

what effect the child s disability is having on his or her ability to

perform educationally. Once a child is determined to be eligible for

special education and related services, the parents collaborate with the

school in developing an individualized educational plan (IEP). The IEP is

designed to address the child s specific problems and unique learning

needs. Strategies to improve social and behavioral problems are also

addressed in the IEP.



What Are My Child's Legal Rights For Special Education?



Numerous sources are available to provide information about your child's

right to receive special education and related services. For an in-depth

explanation of the laws governing the rights of children, contact the

National Information Center for Children and Youth With Disabilities

(NICHCY) at P.O. Box 1492, Washington, DC 20013. Request a copy of: (a)

NICHCY's NEWS DIGEST entitled The Education of Children and Youth with

Special Needs: What Do the Laws Say? (Volume I, Number 1, 1991); and (b)

NICHCY's NEWS DIGEST entitled Questions and Answers about the IDEA (Volume

III, Number 2, 1993).

_______________



ADD Policy Clarifications Issued by the U.S. Department of Education...



In 1991, a Policy Clarification Memorandum on Attention Deficit Disorder

was issued jointly by three offices within the Department of Education. It

has been jointly signed by Robert R. Davila, then Assistant Secretary for

the Office of Special Education and Rehabilitative Services, Michael L.

Williams, Assistant Secretary for the Office for Civil Rights, and John T.

MacDonald, Assistant Secretary for the Office of Elementary and Secondary

Education. In 1993, the Office of Civil Rights (OCR) issued a memorandum

which further clarified the responsibility of schools to evaluate children

with ADD.



These Memoranda did three things. They clarified the circumstances under

which children with ADD are eligible for special education services under

Part B of the Individuals with Disabilities Education Act (IDEA), as well

as the Part B requirements for evaluation of such children's unique

educational needs. They also clarified the responsibility of State and

local educational agencies to provide special education and related

services to eligible children with ADD under Part B. Finally, the memoranda

clarified the responsibility of Local Education Agencies (LEAs) to provide

regular or special education and related aids and services to those

children with ADD who are not eligible under Part B, but who fall within

the definition of "handicapped persons" under Section 504 of the

Rehabilitation Act of 1973.



Copies of these Policy Memoranda are available by writing or calling

NICHCY.

______________



Where Can I Find a Parent Support Group?



There are numerous ADD parent support groups located throughout the

country. For information about a group in your location, contact CH.A.D.D.

(Children with Attention Deficit Disorders) at 499 NW 70th Avenue, Suite

308, Plantation, FL 33317. You can also call CH.A.D.D. at (305) 587-3700.

If there is no parent support group in your area, the CH.A.D.D. staff can

give you guidance in how to start a group in your area.



References



Barkley, R. (1990). Attention Deficit Hyperactivity Disorder, a handbook

for diagnosis and treatment. New York: Guilford Press.



American Psychiatric Association. (1994). Diagnostic and statistical manual

of mental disorders (4th ed.). Washington, DC: Author.



Fowler, M.C. (1990). Maybe you know my kid: A parent's guide to

identifying, understanding, and helping your child with ADHD. New York:

Birch Lane Press.



Zametkin, A., Mordahl, T.E., Gross, M., King, A.C., Semple, W.E., Rumsey,

J., Hamburger, S., & Cohen, R.M. (1990). Cerebral glucose metabolism in

adults with hyperactivity of childhood onset. New England Journal of

Medicine, 323(2), 1361-1366.



________________________________________________________



FYI: Information Resources from NICHCY's Database



Bibliographic Note:



The following information was selected from numerous resources abstracted

in NICHCY s database. If you know of a group which provides information

about ADD or ADHD to families, professionals, or the general public, or

develops materials in this area, please send this information to NICHCY for

our resource collection and database. We will appreciate this information

and will share it with others who request it.



You can obtain many of the documents listed below through your local

library. Whenever possible, we have included the publisher's address or

some other source in case the publication is not available in your area.

The organizations listed provide various services and information about ADD

and ADHD.



BIBLIOGRAPHY



Print Materials



Barkley, R. (1990). Attention deficit hyperactivity disorder, a handbook

for diagnosis and treatment. New York: Guilford Press. (Telephone:

1-800-365-7006.)



DuPaul, G.J., & Stoner, G. (1994). ADHD in the schools: Assessment and

intervention strategies. New York: Guilford. (Telephone: 1-800-365-7006.)



Fowler, M. (1993). CH.A.D.D. educators manual: An indepth look at attention

deficit disorders from an educational perspective. Plantation, FL:

CH.A.D.D. (Telephone: 1-800-545-5583.)



Fowler, M. (1993). Maybe you know my kid: A parent's guide to identifying,

understanding, and helping your child with ADHD (2nd ed.). New York: Birch

Lane Press. (Telephone: 1-800-447-BOOK.)



Goldstein, M., & Goldstein, S. (1990). Managing attention disorders in

children: A guide for practitioners. New York: Wiley Interscience Press.

(Telephone: 1-800-225-5945.)



Goldstein, S., & Goldstein, M. (1993). Hyperactivity -- Why won't my child

pay attention? A complete guide to ADD for parents, teachers, and community

agencies. New York: Wiley. (Telephone: 1-800-225-5945.)



Goldstein, S., & Ingersoll, B. (n.d.). Controversial treatments for

children with ADD. Plantation, F: Children and Adults with Attention

Deficit Disorders. (Telephone: (305) 587-3700.)



Gordon, M. (1990). ADHD/Hyperactivity: A consumer's guide. DeWitt, NY: GSI

Publications. (Telephone: (315) 446-4849.)



Hallowell, E.M., & Ratey, J. (1994). Driven to distraction. New York:

Pantheon Books. (Telephone: 1-800-733-3000.)



Latham, P.S., & Latham, P.H. (1992). Attention deficit disorder and the

law: A guide for advocates. Washington, DC: JKL Communications. (Telephone:

(202) 223-5097.)



Moss, D. (1989). Shelly the hyperactive turtle. Rockville, MD: Woodbine

House. (Telephone: 1-800-843-7323, outside of DC area; (301) 468-8800, in

DC area.)



Parker, H.C. (1992). The ADD hyperactivity handbook for schools: Effective

strategies for identifying and treating ADD students in elementary and

secondary schools. Plantation, FL: Impact Publications. (Telephone:

1-800-233-9273.)



Silver, L.B. (1992). Attention deficit hyperactivity disorder: A clinical

guide to diagnosis and treatment. Washington, DC: American Psychiatric

Press. (Telephone: 1-800-368-5777.)



Wodrich, D.L. (1994). Attention deficit hyperactivity disorder: What every

parent wants to know. Baltimore, MD: Paul H. Brookes. (Telephone:

1-800-638-3775.)



Organizations



Attention Deficit Information Network (AD-IN) - 457 Hillside Avenue,

Needham, MA 02194. Telephone: (617) 455-9895.



Children with Attention Deficit Disorders (CH.A.D.D.) - 499 NW 70th Avenue,

Suite 308, Plantation, FL 33317. Telephone: (305) 587-3700.



Challenge, Inc. -- P.O. Box 488, W. Newbury, MA 01985. Telephone: (508)

462-0495.

_______________



NICHCY Briefing Papers are produced in response to requests from parents,

professionals, and other concerned individuals. Individual copies of these

and other NICHCY products are provided free of charge. In addition, NICHCY

disseminates other materials and can respond to individual inquiries. For

further information and assistance, or to receive a NICHCY Publications

List contact NICHCY, P.O. Box 1492, Washington, DC 20013, or call

1-800-695-0285 (Voice/TT).



NICHCY thanks our Project Officer, Dr. Sara Conlon, at the Office of

Special Education Programs, U.S. Department of Education, for her time in

reading and reviewing this document. We also thank the following

individuals for their thoughtful review and comments on this briefing

paper: Sandy Thomas, President, CH.A.D.D.; Dr. Russell Barkley, Department

of Psychiatry, University of Massachusetts Medical Center; Dr. George

Storm, behavioral and developmental pediatrician, Exeter, New Hampshire;

Bonnie Fell, Vice President, CH.A.D.D.; and Fran Rice, Advocacy Associates,

Mount Pelier, Vermont.



Project Staff



Project Director: Suzanne Ripley

Deputy Director: Richard L. Horne

Editor: Lisa Kupper

Author: Mary Fowler



This document is made possible through Cooperative Agreement #H030A30003

between the Academy for Educational Development and the Office of Special

Education Programs of the U.S. Department of Education. The contents of

this document do not necessarily reflect the views or policies of the

Department of Education, nor does mention or trade names, commercial

products, or organizations imply endorsement by the U.S. Government.



This information is in the public domain unless otherwise indicated.

Readers are encouraged to copy and share it, but please credit the National

Information Center for Children and Youth with Disabilities. Your comments

and suggestions for briefing papers are welcomed. Please share your ideas

and feedback by writing the Editor.





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