Attention Deficit/Hyperactivity Disorders - ADD/ADHD

 

Understanding Attention Deficit Hyperactivity Disorder (ADHD)

Children with Attention Deficit Hyperactivity Disorder represent 3-5% of America's school-age population. They frequently display disability-related behaviors that arise from impulsivity, hyperactivity or inattention. It is critically important that adults recognize that positive interventions can help them change these behaviors.

The following curriculum was developed to help educate parents, teachers and others about ADHD.

  1. What is ADHD? - This section explains how the diagnosis of ADHD is made - who can make the diagnosis, who can prescribe medicine and who can counsel or provide therapy.

  2. ADHD & Education - This section explains several of the various disability categories under which a child with ADHD may receive services in public schools.

  3. ADHD - What Parents Can Do - This section provides suggestions for parents to help their children learn to manage their own behaviors.

  4. Tips for Teachers - This section provides specific instructional strategies for teachers, although many parents will find them useful in understanding how to advocate for appropriate interventions for their child.

Begin the Understanding Attention Deficit Hyperactivity Disorder (ADHD) curriculum>>

Frequently Asked Questions about ADHD

1. What is ADHD?

Attention-Deficit/Hyperactivity Disorder (AD/HD) is a condition that can make it hard for a person to sit still, control behavior, and pay attention. These difficulties usually begin before the person is 7 years old. However, these behaviors may not be noticed until the child is older.

Doctors do not know just what causes AD/HD. However, researchers who study the brain are coming closer to understanding what may cause AD/HD. They believe that some people with AD/HD do not have enough of certain chemicals (called neurotransmitters) in their brain. These chemicals help the brain control behavior.

Parents and teachers do not cause AD/HD. Still, there are many things that both parents and teachers can do to help a child with AD/HD.

To learn more about Attention Deficit/Hyperactivity Disorders (ADHD/ADD), see our fact sheet: HTML or PDF*

2. Is there a simple test to diagnose ADHD?

No; unfortunately, there is no simple test (like a blood test or a short written test) to determine whether someone has AD/HD. This is true of many medical conditions (for example, there is no "test" for a simple headache, yet anyone who has had a headache knows it's real!).

Accurate diagnosis is made only by a trained clinician after an extensive evaluation. This evaluation should include ruling out other possible causes for the symptoms involved, a thorough physical examination, and a series of interviews with the individual (child or adult) and other key persons in the individual's life (for example, parents, spouse, teachers, and others).

3. My child is very bright. He can't have ADHD, too, can he?

Yes. Intelligence and AD/HD are separate. It is possible to be intellectually gifted and have AD/HD, too. However, AD/HD may impact academic performance. When a child is identified as both gifted and as a child with AD/HD, this is often called twice exceptional. School accommodations may be appropriate.

4. What Are Some Related Problems?

One of the difficulties in diagnosing ADHD is that it's often found in conjunction with other problems. These are called coexisting conditions, and about two thirds of all children with ADHD have one. The most common coexisting conditions are:

  • Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD): At least 35% of all children with ADHD also have oppositional defiant disorder, which is characterized by stubbornness, outbursts of temper, and acts of defiance and rule breaking. Conduct disorder is similar but features more severe hostility and aggression. Children who have conduct disorder are more likely get in trouble with authority figures and, later, possibly with the law. Oppositional defiant disorder and conduct disorder are seen most commonly with the hyperactive and combined subtypes of ADHD.

  • Mood Disorders (such as depression): About 18% of children with ADHD, particularly the inattentive subtype, also experience depression. They may feel inadequate, isolated, frustrated by school failures and social problems, and have low self-esteem.

  • Anxiety Disorders: Anxiety disorders affect about 25% of children with ADHD. Symptoms include excessive worry, fear, or panic, which can also lead to physical symptoms such as a racing heart, sweating, stomach pains, and diarrhea. Other forms of anxiety that can accompany ADHD are obsessive-compulsive disorder and Tourette syndrome, as well as motor or vocal tics (movements or sounds that are repeated over and over). A child who has symptoms of these other conditions should be evaluated by a specialist.

  • Learning Disabilities: About half of all children with ADHD also have a specific learning disability. The most common learning problems are with reading (dyslexia) and handwriting. Although ADHD isn't categorized as a learning disability, its interference with concentration and attention can make it even more difficult for a child to perform well in school.

If your child has ADHD and a coexisting condition, the doctor will carefully consider that when developing a treatment plan. Some treatments are better than others at addressing specific combinations of symptoms.

For more information on ADHD and Coexisting Disorders, try these resources:

  • ADHD and Coexisting Disorders: Depression - HTML or PDF*

  • ADHD and Coexisting Disorders: Disruptive Behavior Disorders - HTML or PDF*

  • ADHD and Coexisting Disorders - HTML or PDF*

  • ADHD and Coexisting Disorders: Tics and Tourette Syndrome - HTML or PDF*

5. How is ADHD treated?

ADHD can't be cured, but it can be successfully managed. Your child's doctor will work with you to develop an individualized, long-term plan. The goal is to help your child learn to control his or her own behavior and to help families create an atmosphere in which this is most likely to happen.

In most cases, ADHD is best treated with a combination of medication and behavior therapy. Any good treatment plan will require close follow-up and monitoring, and your child's doctor may make adjustments along the way. Because it's important for parents to actively participate in their child's treatment plan, parent education is also considered an important part of ADHD management.

6. What are some behavioral strategies that might help my child with ADHD?

1. Create a routine. Try to follow the same schedule every day, from wake-up time to bedtime. Post the chedule in a prominent place, so your child can see where he or she is expected to be throughout the day and when it's time for homework, play, and chores.

2. Help your child organize. Put schoolbags, clothing, and toys in the same place every day so your child will be less likely to lose them.

3. Avoid distractions. Turn off the TV, radio, and computer games, especially when your child is doing homework.

4. Limit choices. Offer your child a choice between two things (this outfit, meal, toy, etc., or that one) so that he or she isn't overwhelmed and overstimulated.

5. Change your interactions with your child. Instead of long-winded explanations and cajoling, use clear, brief directions to remind your child of his or her responsibilities.

6. Use goals and rewards. Use a chart to list goals and track positive behaviors, then reward your child's efforts. Be sure the goals are realistic (think baby steps rather than overnight success).

7. Discipline effectively. Instead of yelling or spanking, use timeouts or removal of privileges as consequences for inappropriate behavior. Younger children may simply need to be distracted or ignored until they display better behavior.

8. Help your child discover a talent. All kids need to experience success to feel good about themselves. Finding out what your child does well - whether it's sports, art, or music - can boost social skills and self-esteem.

For more information about ADHD/ADD, try these resources:

FAQ's about ADHD and Education

1. Will Special Education Help My Child?

Special education is instruction that is specially designed (at no cost to parents) to meet the unique needs of a child with a disability. "Specially designed" means adapting the content, methodology, or delivery of instruction (as appropriate) to the needs of the child, in order to:

  • address the unique needs of the child that result from his or her disability, and

  • ensure the child's access to the general curriculum (the same curriculum as for students without disabilities) so that he or she can meet the educational standards that apply to all children within the school district or jurisdiction.

Because special education is specially designed instruction, it may be very helpful to your child. However, not all children with AD/HD need, or are eligible for, special education services. Conversely, many would not be able to receive an appropriate education without special education services.

2. What is the difference between Section 504 and IDEA?

There are significant differences between Section 504 and IDEA. Perhaps the most significant is that Section 504 is is a civil rights law, and IDEA is an educational benefit law. Section 504 is designed to level the playing field for individuals with disabilities. Its purpose is to ensure that individuals with disabilities have the same access to education that individuals without disabilities have. It does this by eliminating barriers that exclude individuals with disabilities from participating in protected activities, including a free and appropriate public education. As an educational benefit law, IDEA offers additional services and protections for those with disabilities that are not offered to those without disabilities.

These laws are also distinguished by the their different eligibility requirements and the benefits they provide. The definition of a disability is much broader under Section 504 than it is under IDEA. All IDEA students are covered by Section 504, where as not all Section 504 students are protected under IDEA. An IEP, which is provided to students covered by IDEA, must be tailored to the child's unique needs and must result in educational benefit. However, a Section 504 Plan provides accommodations based on the child's disability and resulting weaknesses, but does not require academic improvement.

Additionally, fewer procedural safeguards are offered to children and parents under Section 504 than under IDEA.

3. If my child has an IEP or gets special education, does she have to be in a different classroom?

No. If your child has an Individualized Education Plan (IEP) or is receiving special education services, it does NOT automatically mean she will be placed in a special education classroom. IDEA has a Least Restrictive Environment (LRE) clause, which states that children should be educated in the least restrictive environment that is still sufficient to meet their academic needs. Therefore if your child can learn in a regular education classroom then that is where the law says she should be placed.

For more information about ADHD and IDEA, try these resources:

4. My child has ADHD but doesn't qualify for an IDEA; can he still qualify under Section 504?

Maybe. A child who was denied coverage under IDEA may qualify for coverage under Section 504. The key is whether or not the student’s AD/HD substantially impacts a major life activity.

5. What is Section 504?

"Section 504" refers to the section of the Rehabilitation Act of 1973 which guarantees certain rights to individuals with disabilities, including AD/HD. This federal law states that no person "... shall, solely by reason of her or his disability, be excluded from the participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving Federal financial assistance" (Sec. 504.(a)).

6. My child has been diagnosed with ADHD; isn't he automatically qualified for Section 504 services?

No. Although a formal diagnosis is a good first step, it does not automatically mean your child will qualify for accommodations under Section 504. Eligibility for Section 504 is based on the existence of an identified physical or mental impairment that substantially limits a major life activity. The diagnosis of AD/HD is not enough; his AD/HD must significantly impact his learning or behavior.

For more information about Section 504, try these resources:

7. What is LRE?

LRE, or Least Restrictive Environment, is a term used to mandate that students with disabilities are placed in special classes, separate schools or positions other than regular education classrooms only when the nature or severity of the disability is such that even with aids and services education can not be achieved. The placement must also allow the disabled student to be with non-disabled peers to the greatest extent possible.

To learn more about Least Restrictive environment (LRE), try these resources:

8. My child gets all As and Bs, can she still get accommodations?

Yes. Academic performance in and of itself is not enough to determine eligibility for services one way or another. According to the U.S. Dept. of Education's Office of Civil Rights, "If the protections of §504 . . . are to have any meaning for a qualified handicapped person of superior intelligence, then the student must be entitled to implementation of a Section 504 Accommodation Plan which allows him to achieve educational success reasonably commensurate with his ability," (cf. 27 IDELR 858).

Thus, even if a child is receiving A or B grades in classes, but is having difficulty paying attention in class, with behavior at school, or at home with homework, the child may still be eligible for accommodations. The deciding factor will be to what extent AD/HD impacts the student's ability to learn or behave in class.

For more information about accommodations, try this resource:

9. What are some tips I can share with my child's teacher?

  • Reduce seating distractions. Lessening distractions might be as simple as seating your child near the teacher instead of near the window.

  • Use a homework folder for parent-teacher communications. The teacher can include assignments and progress notes, and you can check to make sure all work is completed on time.

  • Break down assignments. Keep instructions clear and brief, breaking down larger tasks into smaller, more manageable pieces.

  • Give positive reinforcement. Always be on the lookout for positive behaviors. Ask the teacher to offer praise when your child stays seated, doesn't call out, or waits his or her turn, instead of criticizing when he or she doesn't.

  • Teach good study skills. Underlining, note taking, and reading out loud can help your child stay focused and retain information.

  • Supervise. Check that your child goes and comes from school with the correct books and materials. Ask that your child be paired with a buddy who can help him or her stay on task.

  • Be sensitive to self-esteem issues. Ask the teacher to provide feedback to your child in private, and avoid asking your child to perform a task in public that might be too difficult.

  • Involve the school counselor or psychologist. He or she can help design behavioral programs to address specific problems in the classroom.

For more information about ADHD and education issues, see these resources:

  • 3 Accommodations That Can Help Students with Attention Deficit Disorders Perform Better in School - Children and youth with attention deficit disorder (ADD) often have serious problems in school. Through the implementation of relatively simple and straightforward accommodations to the classroom environment or teaching style, teachers can adapt to the strengths and weaknesses of students with ADD. Full article>

  • NEW Accommodating Students with Attention Deficit Hyperactivity Disorder*

  • ADHD: Building Academic Success

  • ADHD and Children Who are Gifted

  • Dual Exceptionalities

  • Giftedness in Children with ADHD

  • Helping Your Adolescent with ADHD Get Homework Done

  • Homework Routines*

  • Mastering the Hidden Curriculum of School: from It’s So Much Work To Be Your Friend - Every school has unspoken rules that impact everything from navigating the campus and classroom layout to the schedule and the social scene.  In his new book, It’s So Much Work to Be Your Friend: Helping the Child with Learning Disabilities Find Social Success, Rick Lavoie offers insight that can help kids with learning difficulties uncover — and master — the unwritten rules of school. Full article>

  • Organizational Problems and the Beginning of the School Year - Get ready for a great year at school. Rick Lavoie tells parents how the family can solve organizational problems at the beginning of the school year. Don't let their backpacks become black holes. Full article>

  • Raising a Teacher’s Awareness about LD and AD/HD — Parents as Educators - Every August parents and kids alike eagerly await the start of a new school year. But, for parents who have a child with a learning disability (LD), Attention-Deficit/Hyperactivity Disorder (AD/HD), or any other disability, the anticipation usually creates feelings of anxiety, worry, and even dread. One of the biggest worries for parents is whether this year’s teacher will have any awareness or knowledge about their child’s disability — how the child learns best, what she struggles with, and what she needs to be successful in the classroom. Full article>

  • Smoothing Your Child’s Transition to Middle School - Ah, middle school. Though your child may barely be entering puberty and may still be a pre-teen, the transition to middle school is a big step on the road to maturity. A big, scary step. Regardless of what specific grade marks the beginning of junior high or middle school in your community, your child will be both excited and afraid. Researchers have found that students anticipating the move to middle school worry about three aspects of the change: logistical, social, and academic. Full article>
  • Teaching Children with Attention Deficit Hyperactivity Disorder: Instructional Strategies and Practices - MS Word**or PDF*

  • Using a Home-School Report Card with Your ADHD Child - Now that school has started up again, one of the most important things parents can do to help make it a successful year for their child is to carefully monitor how their child is doing each day at school. Full article>

FAQ's about Postsecondary Education

1. As a student with a disability leaving high school and entering postsecondary education, will I see differences in my rights and how they are addressed?

Yes. Section 504 and Title II protect elementary, secondary and postsecondary students from discrimination. Nevertheless, several of the requirements that apply through high school are different from the requirements that apply beyond high school. For instance, Section 504 requires a school district to provide a free appropriate public education (FAPE) to each child with a disability in the district’s jurisdiction. Whatever the disability, a school district must identify an individual’s education needs and provide any regular or special education and related aids and services necessary to meet those needs as well as it is meeting the needs of students without disabilities.

Unlike your high school, your postsecondary school is not required to provide FAPE. Rather, your postsecondary school is required to provide appropriate academic adjustments as necessary to ensure that it does not discriminate on the basis of disability. In addition, if your postsecondary school provides housing to nondisabled students, it must provide comparable, convenient and accessible housing to students with disabilities at the same cost.

2. Do I have to inform a postsecondary school that I have a disability?

No. However, if you want the school to provide an academic adjustment, you must identify yourself as having a disability. Likewise, you should let the school know about your disability if you want to ensure that you are assigned to accessible facilities. In any event, your disclosure of a disability is always voluntary.

3. What academic adjustments must a postsecondary school provide?

The appropriate academic adjustment must be determined based on your disability and individual needs. Academic adjustments may include auxiliary aids and modifications to academic requirements as are necessary to ensure equal educational opportunity. Examples of such adjustments are arranging for priority registration; reducing a course load; substituting one course for another; providing note takers, recording devices, sign language interpreters, extended time for testing and, if telephones are provided in dorm rooms, a TTY in your dorm room; and equipping school computers with screen-reading, voice recognition or other adaptive software or hardware.

In providing an academic adjustment, your postsecondary school is not required to lower or effect substantial modifications to essential requirements. For example, although your school may be required to provide extended testing time, it is not required to change the substantive content of the test. In addition, your postsecondary school does not have to make modifications that would fundamentally alter the nature of a service, program or activity or would result in undue financial or administrative burdens. Finally, your postsecondary school does not have to provide personal attendants, individually prescribed devices, readers for personal use or study, or other devices or services of a personal nature, such as tutoring and typing.

4. If I want an academic adjustment, what must I do?

You must inform the school that you have a disability and need an academic adjustment. Unlike your school district, your postsecondary school is not required to identify you as having a disability or assess your needs.

Your postsecondary school may require you to follow reasonable procedures to request an academic adjustment. You are responsible for knowing and following these procedures. Postsecondary schools usually include, in their publications providing general information, information on the procedures and contacts for requesting an academic adjustment. Such publications include recruitment materials, catalogs and student handbooks, and are often available on school Web sites. Many schools also have staff whose purpose is to assist students with disabilities. If you are unable to locate the procedures, ask a school official, such as an admissions officer or counselor.

5. When should I request an academic adjustment?

Although you may request an academic adjustment from your postsecondary school at any time, you should request it as early as possible. Some academic adjustments may take more time to provide than others. You should follow your school’s procedures to ensure that your school has enough time to review your request and provide an appropriate academic adjustment.

6. Do I have to prove that I have a disability to obtain an academic adjustment?

Generally, yes. Your school will probably require you to provide documentation that shows you have a current disability and need an academic adjustment.

7. May a postsecondary school charge me for providing an academic adjustment?

No. Furthermore, it may not charge students with disabilities more for participating in its programs or activities than it charges students who do not have disabilities.

For more information about postsecondary education, see these resources:

ADD/ADHD News

Girls and ADHD

A 5-year study complete by the University of California, Berkeley provides new insight into the experiences of girls who have Attention Deficit/Hyperactivity Disorder (ADHD). The researchers were particularly interested in how ADHD symptoms change as girls enter adolescence. The study found that although hyperactivity tended to decrease, other less visible symptoms such as depression, eating disorders, and peer interaction problems became more prominent. Read the study's press release at:
http://www.berkeley.edu/news/media/releases/2006/06/29_adhd.shtml.

Support Resources

Attention Deficit/Hyperactivity Disorder ADD/ADHD Support Groups

Web Sites

ADD/ADHD About.com
http://add.about.com/
A site with a chat area, lots of ADHD info, and links to other sites. Keeps up-to-date with the latest news in the ADHD world. Sends out a weekly email.

ADHD News
www.adhdnews.com
A web site with lots of information. Much of it is geared towards the needs of children with ADHD, but there is also much here useful to adults.

Attention Deficit Disorder Association - Southern Region (ADDA-SR)
www.adda-sr.org/
This web site provides information to assist parents, teachers, professionals, adults with ADHD or anyone wanting to learn more about ADHD.

Attention Deficit Disorder Resources
www.addresources.org
The web site of Attention Deficit Disorder Resources has over 100 articles written by national ADHD authorities as well as adults with ADHD. Plenty of information for parents too. 100 plus links to ADHD-related web sites. Includes the National ADHD Directory with over 1000 ADHD Service Providers listed as well as a National ADHD Events Calendar. Free monthly eNews available.

CHADD - Children and Adults With Attention-Deficit/Hyperactivity Disorder
www.chadd.org/
This national non-profit, tax-exempt organization provides education, advocacy and support for individuals with ADHD.

National Resource Center on AD/HD
www.help4adhd.org
The National Resource Center on AD/HD (NRC): A Program of CHADD (Children and Adults with Attention-Deficit/Hyperactivity Disorder), was established in 2002 to be the national clearinghouse for the latest evidence-based information on AD/HD. The NRC provides comprehensive information and support to individuals with AD/HD, their families and friends, and the professionals involved in their lives.

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