ATTENTION-DEFICIT/HYPERACTIVITY DISORDER Fact Sheet Number 19 (FS19), 1997 _______________________ A fact sheet from... NICHCY 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) ________________________ DEFINITION Attention-Deficit/Hyperactivity Disorder (AD/HD) is a neurobiological disorder. Typically children with AD/HD have developmentally inappropriate behavior, including poor attention skills, impulsivity, and hyperactivity. These characteristics arise in early childhood, typically before age 7, are chronic, and last at least 6 months. Children with AD/HD may also experience problems in the areas of social skills and self esteem. INCIDENCE AD/HD is estimated to affect between 3-5 % of the school-aged population. Even though the exact cause of AD/HD remains unknown, it is known that AD/HD is a neurobiologically based disorder. Scientific evidence suggests that AD/HD is genetically transmitted and in many cases results from a chemical imbalance or deficiency in certain neurotransmitters, which are chemicals that help the brain regulate behavior. CHARACTERISTICS AD/HD is diagnosed according to certain characteristics described in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994), known as DSM-IV. A child with AD/HD is often described as having a short attention span and as being distractible. The child will have difficulty with one or all parts of the attention process: focusing (picking something on which to pay attention), sustaining focus (paying attention for as long as is needed), and shifting focus (moving attention from one thing to another). According to DSM-IV (pp. 83-84), some symptoms of inattention include: -- often fails to give close attention to details, making careless mistakes in schoolwork or other activities -- often has difficulty sustaining attention in tasks or play activities -- often appears to not be listening when spoken to directly -- often has difficulty following through on instructions; may fail to finish schoolwork, chores, or duties (not due to oppositional behavior or failure to understand instructions) -- often has difficulty organizing tasks and activities -- often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (schoolwork and homework) -- often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools) -- is often easily distracted by extraneous stimuli -- is often forgetful in daily activities. According to DSM-IV (p. 84), some symptoms of hyperactivity include: -- often fidgets with hands or feet or squirms in seat -- often leaves seat in classroom or in other situations in which remaining seated is expected -- often runs about or climbs excessively in situations in which this is inappropriate -- often has difficulty playing or engaging in leisure activities quietly -- often is "on the go" or acts as if "driven by a motor" -- often talks excessively. Impulsiveness with AD/HD appears when children act before thinking. According to DSM-IV (p. 84), some symptoms of impulsivity include: -- often blurts out answers before questions have been completed -- often has difficulty awaiting turn -- often interrupts or intrudes on others (during conversations or games). From time to time all children will be inattentive, impulsive, and overly active. In the case of AD/HD, these behaviors are the rule, not the exception. EDUCATIONAL IMPLICATIONS Planning for educational needs begins with an accurate diagnosis. Children suspected of having AD/HD must be appropriately diagnosed by a knowledgeable, well-trained clinician (usually a developmental pediatrician, child psychologist, or pediatric neurologist). Treatment plans may include behavioral and educational interventions and sometimes medication. Parents suspecting a problem may seek the services of the local school district or an outside private professional to conduct an evaluation. For children under age five, families may want to contact early childhood programs specialized in serving the needs of youngsters with disabilities. Call the local public school system and ask about services for children with disabilities. Many children with AD/HD experience great difficulty in school, where attention and impulse and motor control are virtual requirements for success. Children with AD/HD tend to overreact to changes in their environment. Whether at home or in school, children with AD/HD respond best in a structured, predictable environment. Here, rules and expectations are clear and consistent, and consequences are set forth ahead of time and delivered immediately. By establishing structure and routines, parents and teachers can cultivate an environment that encourages the child to control his or her behavior and succeed at learning. Adaptations which might be helpful (but will not cure AD/HD) include: -- posting daily schedules and assignments -- calling attention to schedule changes -- setting specific times for specific tasks -- designing a quiet work space for use upon request -- providing regularly scheduled and frequent breaks -- using computerized learning activities -- teaching organization and study skills -- supplementing verbal instructions with visual instructions -- modifying test delivery. Further information regarding helpful strategies can be found in the NICHCY's Briefing Paper Attention-Deficit/Hyperactivity Disorder. RESOURCES Alexander-Roberts, C. (1994). ADHD parenting handbook: Practical advice for parents from parents: Proven techniques for raising a hyperactive children without losing your temper. Dallas, TX: Taylor Publishing. (Telephone: 1-800-677-2800.) Barkley, R. (1995). Taking charge of AD/HD. New York: Guilford Press. (Telephone: 1-800-365-7006.) Catalog# 2099 Fowler, M. (1994). Attention-Deficit/Hyperactivity Disorder. NICHCY Briefing Paper, 1-16. (Available from NICHCY. Telephone: 1-800-695-0285.) Fowler, M. (1996). Maybe you know my kid: A parent's guide to identifying, understanding, and helping your child with ADHD (3rd ed.). New York: Birch Lane Press. (Telephone: 1-800-447-2665.) Fowler, M. (1992). CH.A.D.D. educators manual: An in-depth look at attention deficit disorders from an educational perspective. Plantation, FL: CH.A.D.D. (Available from Caset Associates. Telephone: 1-800-545-5583.) Goldstein, S., & Goldstein, M. (1992). 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.) ISBN# 0471533076 Wodrich, D.L. (1994). Attention deficit hyperactivity disorder: What every parent wants to know. Baltimore, MD: Paul H. Brookes. (Telephone: 1-800-638-3775.) Stock# 1413 ORGANIZATIONS Attention Deficit Disorder Association (ADDA) P.O. Box 972 Mentor, OH 44601 (216) 350-9595 (800) 487-2282 (voice mail to request information packet) E-Mail: NATLADDA@aol.com http://www.add.org CH.A.D.D. (Children and Adults with Attention Deficit Disorders) 499 NW 70th Avenue Suite 101 Plantation, FL 33317 (954) 587-3700 (800) 233-4050 (voice mail to request information packet) Web Address: http://www.chadd.org _____________ Update, June 1997 This fact sheet is made possible through Cooperative Agreement #H030A30003 between the Academy for Educational Development and the Office of Special Education Programs. The contents of this publication do not necessarily reflect the views or policies of the Department of Education, nor does mention of 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 (NICHCY). Back To Special Education Articles Page