Teaching Teens with ADD and ADHD

What Every Teacher Must Know about ADD and ADHD

1. ADD/ADHD occurs in approximately 5 percent of all children worldwide. However, rates of attention deficit disorder vary around the globe and in the united States. Within the U.S., reported rates vary from 3 percent in Salt Lake City to above 10 percent in several states, including parts of Arizona and upstate New York. Internationally, rates of 8.9 percent were reported in China, 9.5 percent in Puerto Rico, and 29 percent in India. Boys diagnosed with ADD or ADHD outnumber girls approximately three or four to one. The primary difference between girls and boys with attention deficits is that the boys are usually more aggressive and oppositional.

2. ADD/ADHD is a complex neurobiological disorder. Reseachers believe that people with ADD/ADHD have a few structures within the brain that are smaller and that their neurotransmitters, the chemical messengers of the brain, do not work properly. The neurotransmitters norepinephrine, dopamine, serotonin are thought to work inefficiently. See Summary 2.

3. There are two distinctly different types of attention deficit disorders. Federal education law refers to those with hyperactivity and impulsivity as having ADHD (attention deficit hyperactivity disorder) and those who are predominately inattentive as having ADD (attention deficit disorder). However , AD/HD (attention-deficit/hyperactivity disorder) is the technically correct diagnostic label established by the American Psychiatric Association. See Summary 5.

4. All children with ADD/ADHD are not alike. Symptoms of attention deficits may be mild, moderate, or severe, or combined with other conditions. This means adults will see variability in skills and maturity levels in these students.

5. ADD/ADHD often occurs with other conditions. According to information from a major study at the National institute of Mental Health (NIMH), two-thirds of children with ADHD have at least one other coexisting condition. See Figure 1. Most research has been done on children with ADHD. However, when information is gathered on teenagers, the occurrence of these conditions tends to be higher. When symptons are severe and co-occurring conditions are present, both ADD and ADHD are much more challenging to the child, family, and school to diagnose the treat effectively.

6. A two to four year lag in age-appropriate developmental skills (adaptive functioning ) may be present. Developmental delays are often observed in motor skills, self-help abilities, personal responsibility, independence, and peer relationships. Consequently, these students may seem less mature and responsible than their peers. typically, a sixteen-year-old with ADD or ADHD acts more like a twelve-year-old.

7. Several behaviors linked to deficits in neurotransmitters often accompany ADD/ADHD, causing problems at home and school. Students with ADD or ADHD may experience problems with some, but usually not all, of these behaviors:

Executive functioning difficulties: These skills are critical for success in school, yet are often lacking in students with attention deficits. (See Summary 28.) Deficits in key executive function skills that interfere with the ability to do well academically may include:

Working memory and recall: briefly holding facts in your head and manipulating them;

Activation, arousal, and effort: getting started, staying alert, and finishing work;

Impulsivity: saying or doing things impulsively before thinking;

Control of emotions: low frustration tolerance, emotional blow-ups;

Internalizing language: using "self-talk" to guide behavior;

Complex problem solving: taking the whole apart, analyzing it, and putting it back together.

Forgetfulness and disorganization: These problems interfere with completion of school work (forgetting to do or turn in homework and tests, forgetting due dates for projects, forgetting to stay after school or for detention). See Summaries 29 and 30.

Variability in school work from day to day and class to class: This is often baffling to teachers and parents. Some days a student can do the work completely and accurately but most days he can't. Without medication, the student's ability to force himself to continually refocus on school work is impaired.

Not learning from punishment and rewards as easily as other children: This characteristic makes teaching and disciplining them more difficult. Misbehavior may be repeated. They "don't seem to learn from their mistakes," prompting observations that they "know what to do but don't always do what they know."

An impaired sense of time: Students with attention deficits may be tardy, not allow adequate time for homework and school projects, and have difficulty planning ahead, especially for assignments and long-term projects. See Summaries 31-35.

Sleep disturbances: Approximately 50 percent of these students may have trouble falling asleep and waking up. Furthermore, half are not getting restful sleep and are still tired even after eight hours of sleep. Consequently, students may be sleep deprived and sleep in class.

Levels of alertness. These students not only have trouble regulating levels of waking and sleeping, but also levels of alertness. They may have difficulty staying alert enough to listen and take class notes. They may sleep in class.

Difficulties with transitions and change in routine: Changing classes, lunch, recess, having a substitute teacher, or riding the bus home after school are often high-risk times for misbehavior.

8. ADD/ADHD runs in families. Forty to fifty percent of all children with attention deficits have at least one parent and thirty percent have a sibling with the condition.

9. Medication works effectively for most children (75-90percent). When medication works properly, schoolwork and behavior will improve significantly. Unfortunately, stimulant medication often wears off during two key transition times: lunchtime and the bus ride home after school. Plus, medication doesn?t seem to significantly correct problems related to disorganization, forgetfulness, and impaired sense of time. See Summaries 51-55.

10. Teenagers don't outgrow ADD/ADHD. Symptoms of attention deficits often present lifelong challenges The primary observable difference in teenagers is that they may become less hyperactive than they were as children. However, the hyperactivity is often replaced by restlessness. For 50 percent, the symptoms of attention deficits do not cause major problems in adulthood. Adults often find a career that is compatible with their personality so symptoms don't present in the workplace, symptoms become less severe with age, or the adult learns to compensate. For some adults, continuing to take medication will be a necessity.