Using Accommodations for Students with ADD/ADHD

Chapter 6

David Goh

The Value of Medical Information for Educators

• Learning occurs in the brain• Physicians are actively involved in treating

kids with LD• Advances in medical technology affect

children with LD• Awareness of current brain research• Teachers need to understand language

used in medicine

What is Neurosciences of the Study of the Brain

• Left-right brain differences in function– Left side- language– Right side- non verbal stimuli- spatial

perceptions, mathematics, music, directional orientation, time sequences, and body awareness

Recent Brain Research

• Magnetic Resonance Imaging (MRI)– Allows to study active brain waves- ex- left

frontal lobes of dyslexia are smaller

• Postmortem Anatomical Studies– Studies show fewer brain cells

• Genetics of Learning Disabilities– LD’s inherited

Importance of Neuropsychology and other Medical Personnel

• Neuropsychology is combination of Psychology and neurology- looks at relation of brain function and behavior

• Medical examination conducted by physician, neurologists, pediatrician, ophthalmologist, otology or psychiatrists– 2 part examine- neurological assessment and

neurological deviations (visual motor test, gross motor test, fine motor test)

ADHD and ADD• Attention Deficit Hyperactivity Disorder and

Attention Deficit Disorder– Refer to the same problems

• Prevalence- 1.6 to 2 million Americans have disorder; affecting 3% to 5 % of all kids in school; occurs 3 times more in boys than girls

• Subsumed under Other Health Impairments• Fastest growing diagnosis within Special Education• 30% that other siblings will have• Drastic impact on family• Can not be outgrown, but managed

Symptoms

• Inattention- no focus• Hyperactivity- can’t sit still• Impulsivity- unable to curb reactions• Making careless mistakes in schoolwork• Not listening to what is said• Difficulty organizing tasks and activities• Talking excessively• Interrupting• Psychological problems- anxiety, depression, learning

disabilities, oppositional defiance, conduct disorder

Causes

• We do not know the causes• ADD/ADHD not caused by home life, too much

TV, food allergies, excess sugar, and poor teaching

• Theories on causes- 1)kids with ADD/ADHD have less active brain function and use less sugar; 2) affect of fetal alcohol syndrome and smoking; 3) environmental toxins; 4) genetic link; 5) allergies

Assessment of ADD/ADHD and the Law

• IDEA added ADD/ADHD under other health impaired, specific learning disabilities, and mental illness

• Section 504 of Voc. Reb. Act 1973- provides reasonable accommodations

• To eligible symptoms must be present at least 6 months to a degree that is maladaptive and inconsistent with developmental levels

• Symptoms must be present prior to age 7 and in 2 or more settings (school, home, and work)

• Must be clear evidence of clinical impairment in social, academic, occupational functioning, and can not be caused by other mental disorders

Medical Treatment of ADD/ADHD

• Medication- psycho stimulants; antidepressants, antihypertensive– Should be combined with behavior management,

school modifications, and counseling– 3 to 5% can not take medication– ? School responsibility for monitoring medication

• Nutrition- relationship b/w brain activity and diet (i.e..calories and protein)

• Diet control- removal of food additives, coloring, blood sugar levels, treatment of allergies

Myths about Medication

• Lead to later drug addiction- fact may prevent drug addiction

• Medication should be stopped- fact 80% of people need to be on medication through teen and adult years

• Improvement on medication proves you have ADD/ADHD- fact medication helps people focus and pay attention regardless of the disorder

• Medication fixes the problem- fact side effects my include sleepiness/sleeplessness, loss of appetite, effects on height and weight

Getting Help and other Treatment

• LRE- finding appropriate classroom environment• Behavior management• Sit child in area away from distractions• Provide time to move• Clearly post rules and expectations• Visual reminders• Extra time• Reviewing instructions and expectation• Teach metacognition• Clear structure and advance notice• Break assignments into smaller tasks• To do lists• Provide organizational skills• Parenting skills training

Alternative and Controversial Treatments

• Biofeedback• Allergy treatments• Medicine to correct inner ear problems• Megavitamins• Chiropractic adjustments and bone realignment• Treatment of yeast infections• Eye training- visual tracking, fixation,• Special colored glasses

Need for Testing Accommodations

• Characterized by poor achievement• Exhibit low frustration• Low motivation• Poor test performance consistent with poor

classroom assignments and homework• Test typically underestimate true ability,

knowledge, or skill• Accommodation minimize inattention,

hyperactivity, and impulsivity• Hard to remain seated and sustain focus• Lack of self-monitoring and decision making

Methods of Accommodation

• Setting– Separate location, free of stimuli, short breaks, clutter free

• Timing and Scheduling– Short breaks with exercise or conversation, time extension

• Presentation– Rewording directions, underline key words in direction, provide

directions on top of each page, verbal reminders to check work, verbal praise, time management, task analysis, break down, tangibles

• Response– Write answer on test not blue book, prompt to check work, oral

exams, scribe, tape recorder

Empirical Research

• Most commonly used testing accommodation are separate room, small group assessments, and extended time

• Other accommodation offered have to considered individual's current functional level and nature of the disability

• Limited research studies have addressed effects of accommodations

• Recent and positive trend in public policy and increased federal funding to increase opportunity and access