Do any of these apply to you?Do any of these apply to you? When reading textbooks, I find that within the first page, When reading textbooks, I find that within the first page,

without meaning to, my mind has drifted off the material without meaning to, my mind has drifted off the material and I must re-read the material?and I must re-read the material?

When creating something that I consider a challenge or When creating something that I consider a challenge or reading something of intense interest to me, I go into a reading something of intense interest to me, I go into a state of “hyper-focus” which is characterized by at least state of “hyper-focus” which is characterized by at least three of the following:three of the following:› Remaining at the task for lengthy periods of timeRemaining at the task for lengthy periods of time› Feeling very intense and irritable if disturbed by othersFeeling very intense and irritable if disturbed by others› Feeling extremely irritable if asked to do something elseFeeling extremely irritable if asked to do something else› Desiring complete quiet or just quiet music while workingDesiring complete quiet or just quiet music while working

Procrastination is a problem (something gets boring and Procrastination is a problem (something gets boring and pushed to the side). Also may be due to having to many pushed to the side). Also may be due to having to many important things on-the-go important things on-the-go

Always feel like should be doing (or accomplishing) moreAlways feel like should be doing (or accomplishing) more Drift off in social situations unintentionally and miss parts Drift off in social situations unintentionally and miss parts

of a conversationof a conversation

Attention Deficit DisorderAttention Deficit Disorder(ADD)(ADD)

Sarah Frostad, Kristin Singbeil Sarah Frostad, Kristin Singbeil and Kuldeep Basiand Kuldeep Basi

““There are no negatives just challenges”There are no negatives just challenges”

What is ADD?What is ADD? Attention Deficit Disorder (also known as Attention Deficit Disorder (also known as

ADD) used to describe patterns of behaviour ADD) used to describe patterns of behaviour that appear most often in school-aged that appear most often in school-aged children such as:children such as:› InattentiveInattentive› Overly impulsive Overly impulsive › Hyperactive (sometimes)Hyperactive (sometimes)› Have difficulty sitting still, attending to one Have difficulty sitting still, attending to one

thing for a long period of time, and may seem thing for a long period of time, and may seem overactiveoveractive

Commonality…Commonality… ADD is the most frequently diagnosed ADD is the most frequently diagnosed

behaviour disorder in North America (3% to behaviour disorder in North America (3% to 5% of school-aged children) but is not used 5% of school-aged children) but is not used as often in other countriesas often in other countries

Emotional effectsEmotional effects Aggressive or violent behaviourAggressive or violent behaviour

› Due to feelings of failureDue to feelings of failure Withdrawal, anxiety and depressionWithdrawal, anxiety and depression Low self-esteemLow self-esteem

› Due to lack of positive experiencesDue to lack of positive experiences Physical symptomsPhysical symptoms

› Burying feelings may result in the form of:Burying feelings may result in the form of: HeadachesHeadaches Stomach or back achesStomach or back aches Pain in the hands or legsPain in the hands or legs

Social EffectsSocial Effects Becoming the class clown or class bullyBecoming the class clown or class bully Avoiding or refusing to become involved in Avoiding or refusing to become involved in

activities where he/she is unsure of successactivities where he/she is unsure of success Those with ADD have difficulty with social skillsThose with ADD have difficulty with social skills

› Recognizing interpersonal boundariesRecognizing interpersonal boundaries Some indications of inattentiveness and Some indications of inattentiveness and

distractibility can include not paying attention distractibility can include not paying attention to details, making careless mistakes, not to details, making careless mistakes, not following instructions carefully or completely, following instructions carefully or completely, and losing or forgetting school work or toysand losing or forgetting school work or toys

Types of Attention Deficit Types of Attention Deficit Disorder:Disorder:

1.1. Attention Deficit Hyperactivity Attention Deficit Hyperactivity Disorder (ADHD)Disorder (ADHD)

2.2. Undifferentiated Attention Deficit Undifferentiated Attention Deficit DisorderDisorder

Attention Deficit Hyperactivity Attention Deficit Hyperactivity DisorderDisorder

Fidgets, squirms or seems restlessFidgets, squirms or seems restless Has difficulty remaining seatedHas difficulty remaining seated Is easily distractedIs easily distracted Has difficulty awaiting turnHas difficulty awaiting turn Blurts out answersBlurts out answers Has difficulty following instructionsHas difficulty following instructions Has difficulty sustaining attentionHas difficulty sustaining attention Shifts from one uncompleted task to anotherShifts from one uncompleted task to another Has difficulty playing quietlyHas difficulty playing quietly Talks excessivelyTalks excessively Interrupts or intrudes on othersInterrupts or intrudes on others Does not seem to listenDoes not seem to listen Often loses things necessary for tasksOften loses things necessary for tasks Frequently engages in dangerous actionsFrequently engages in dangerous actions

Executive dysfunctionExecutive dysfunction

The frontal and pre-frontal lobes act The frontal and pre-frontal lobes act largely as our “chief executive officer”largely as our “chief executive officer”› Orchestrating language and memory Orchestrating language and memory

functions from other parts of the brainfunctions from other parts of the brain These frontal centres consider where we These frontal centres consider where we

came from, where we want to go, and how to came from, where we want to go, and how to flexibly control ourselves in order to actually flexibly control ourselves in order to actually execute the planexecute the plan These skills are called EXECUTIVE FUNCTIONSThese skills are called EXECUTIVE FUNCTIONS

Examples of what frontal lobes are Examples of what frontal lobes are responsible forresponsible for

InhibitionInhibition InitiationInitiation Self-TalkSelf-Talk Working memoryWorking memory ForesightForesight HindsightHindsight Sense of timeSense of time OrganizationOrganization FlexibilityFlexibility Shifting from Agenda A to Agenda BShifting from Agenda A to Agenda B Separating emotion from factSeparating emotion from fact Adding emotion to factAdding emotion to fact

Undifferentiated Attention Undifferentiated Attention Deficit DisorderDeficit Disorder

Lacks the hyperactivity impulsive symptomsLacks the hyperactivity impulsive symptoms The most significant characteristic is inattentivenessThe most significant characteristic is inattentiveness Cause: may reside primarily in parietal lobe; the Cause: may reside primarily in parietal lobe; the

front lobe processes seem intactfront lobe processes seem intact Primary Indicators:Primary Indicators:

› Low brain energy leads difficulty with attention, seems not Low brain energy leads difficulty with attention, seems not to listen, unorganized, forgetful (short-term), careless to listen, unorganized, forgetful (short-term), careless mistakes, instructional problemsmistakes, instructional problems

Attention Seeking: Attention Seeking: › Modest, shy, socially withdrawn, impatience, conversation Modest, shy, socially withdrawn, impatience, conversation

issuesissuesPositive Attributes: Positive Attributes:

willing to pursue areas others are afraid to try, does well if willing to pursue areas others are afraid to try, does well if self-employedself-employed

What does this mean for our What does this mean for our learners?learners?

Attention deficit disorders interfere with the Attention deficit disorders interfere with the learning process because they reduce the learning process because they reduce the child`s ability to pay attentionchild`s ability to pay attention

It is important to understand that ADD is not It is important to understand that ADD is not a disability in the learning processa disability in the learning process› A Learning Disability is a neurological A Learning Disability is a neurological

condition that affects the child`s ability to condition that affects the child`s ability to learn learn

Creating the proper learning Creating the proper learning environmentenvironment

Provide the student with a structured Provide the student with a structured predictable & welcoming environmentpredictable & welcoming environment› Display rules (check for understanding)Display rules (check for understanding)› Post daily schedules/assignments Post daily schedules/assignments › Seat near positive role modelsSeat near positive role models› Academic subjects in morningAcademic subjects in morning› Provide regular/frequent breaksProvide regular/frequent breaks› Contact parents to report good newsContact parents to report good news

Enhancing Self-EsteemEnhancing Self-Esteem Vary the way you call on studentsVary the way you call on students Reward more than you punishReward more than you punish Teach the child to reward themselves Teach the child to reward themselves

› Encourage positive self-talkEncourage positive self-talk Encourages the child to think positively Encourages the child to think positively

about themselves I.e. reflections!! about themselves I.e. reflections!!

Establishing the proper Establishing the proper learning environmentlearning environment

Seat students near the teacher’s deskSeat students near the teacher’s desk› So students will not focus on other students So students will not focus on other students

in front of themin front of them Surround students with good role modelsSurround students with good role models

› Encourage peer tutoring and Encourage peer tutoring and cooperative/collaborative learning cooperative/collaborative learning

Avoid transitionsAvoid transitions Provide a stimuli-reduced study areaProvide a stimuli-reduced study area

› Encourage parents to create this type of Encourage parents to create this type of environment at home also environment at home also

Ways of giving instructions:Ways of giving instructions: Use a variety of methods (oral, visual, written)Use a variety of methods (oral, visual, written)

› Use illustrationsUse illustrations Make instructions clear and concise Make instructions clear and concise

› Present work at a light pacePresent work at a light pace Make sure students understand instructions Make sure students understand instructions

before beginning the taskbefore beginning the task› Have student repeat back what you have saidHave student repeat back what you have said

Have a daily assignment notebook:Have a daily assignment notebook:1.1. Make sure each student correctly writes down all Make sure each student correctly writes down all

assignments each dayassignments each day2.2. Sign the notebook daily to signify completion of Sign the notebook daily to signify completion of

homework assignmentshomework assignments3.3. Use the notebook for communication with parentsUse the notebook for communication with parents

Giving AssignmentsGiving Assignments Use cooperative learning groups:Use cooperative learning groups:

› Need to have clear defined structures and Need to have clear defined structures and expectations that cooperative learning techniques expectations that cooperative learning techniques provideprovide

Monitor frequently (maintain a supportive attitude)Monitor frequently (maintain a supportive attitude) Modify assignments as neededModify assignments as needed

› Consult with special education to determine specific Consult with special education to determine specific strengths and weaknesses of the studentstrengths and weaknesses of the student

Make sure you test knowledge and not attention Make sure you test knowledge and not attention spanspan

Make sure to include movement within the classMake sure to include movement within the class› Break up instruction at least every 20 minutes to Break up instruction at least every 20 minutes to

provide stimulation to the learner (brain-based provide stimulation to the learner (brain-based learning technique)learning technique)

Diagnosed according to behavioural Diagnosed according to behavioural features in 4 core areas:features in 4 core areas:

Physicians base their diagnosis on the Physicians base their diagnosis on the individual’s behavioural features in four individual’s behavioural features in four core areas: core areas:

1.1. InattentivenessInattentiveness2.2. Distractibility Distractibility 3.3. ImpulsivityImpulsivity4.4. HyperactivityHyperactivity

Treatment of ADDTreatment of ADD Therapy for the management of ADD consists Therapy for the management of ADD consists

of:of:› Training and education, for the parents and Training and education, for the parents and

teachers of the child, that optimize teachers of the child, that optimize expectations and environment to the child’s expectations and environment to the child’s conditioncondition

› Psychological therapy for the child to teach Psychological therapy for the child to teach him/her self-control and self-monitoring skillshim/her self-control and self-monitoring skills

› Medications to reduce the problematic Medications to reduce the problematic behavioursbehaviours Medication is frequently the only treatment pursuedMedication is frequently the only treatment pursued

Training and Education of Parents and Training and Education of Parents and TeachersTeachers

Private tutoring which has fewer distractionsPrivate tutoring which has fewer distractions› Giving the child a better chance of learning how to Giving the child a better chance of learning how to

focusfocus Parents and teachers can also be taught Parents and teachers can also be taught

reward/discipline approaches that provide reward/discipline approaches that provide incentivesincentives

Marriage/parental counselling and family therapy Marriage/parental counselling and family therapy Some claim that these therapy methods help to Some claim that these therapy methods help to

create a more constructive and nurturing create a more constructive and nurturing environment that can help to reduce the environment that can help to reduce the behaviour problems of children diagnosed with behaviour problems of children diagnosed with ADDADD

Physiological TherapyPhysiological Therapy This approach is helpful first to allow the patient This approach is helpful first to allow the patient

to accept the diagnosis and then to accept to accept the diagnosis and then to accept themselves despite their disorderthemselves despite their disorder

In this type of therapy, the ADD sufferers In this type of therapy, the ADD sufferers discover their destructive or self-defeating discover their destructive or self-defeating patterns of behaviour and are able to learn patterns of behaviour and are able to learn alternative ways to handle their emotions and alternative ways to handle their emotions and cope better in day-to-day activitiescope better in day-to-day activities

Social skills therapy – another frequently used Social skills therapy – another frequently used approach – helps children to learn appropriate approach – helps children to learn appropriate behaviours such as sharing a toy, waiting in line, behaviours such as sharing a toy, waiting in line, asking for help, and acting or speaking asking for help, and acting or speaking appropriatelyappropriately

MedicationsMedications The most common medication prescribed is The most common medication prescribed is

methylphenidate (Ritalin)methylphenidate (Ritalin)› Between 80% and 90% of those children diagnosed with Between 80% and 90% of those children diagnosed with

ADD have been prescribed ADD have been prescribed Stimulant drugs act in the brain by increasing levels of Stimulant drugs act in the brain by increasing levels of

catecholamines, one of which is dopamine, the substance catecholamines, one of which is dopamine, the substance currently believed by some to be deficient in sufferers of currently believed by some to be deficient in sufferers of ADDADD› Stimulants are known to be addictive and frequently abusedStimulants are known to be addictive and frequently abused› Stimulants – drugs that excite or speed up the central Stimulants – drugs that excite or speed up the central

nervous system – are generally used for their ability to:nervous system – are generally used for their ability to: Increase alertness and endurance; Increase alertness and endurance; Keep users awake for a long period of timeKeep users awake for a long period of time Decrease appetite Decrease appetite Produce feelings of well-being and euphoriaProduce feelings of well-being and euphoria

Use of medication in treating Use of medication in treating ADDADD

Invisible AdaptationsInvisible Adaptations Auditory SignalsAuditory Signals

› Use a timer or play a bar of music in classUse a timer or play a bar of music in class Visual SignalsVisual Signals

› Raising your handRaising your hand› Have students cover their paper when Have students cover their paper when

reading or working on problems.reading or working on problems.

ReferencesReferences1.1. Canadian Mental Health Association Canadian Mental Health Association

http://www.cmba.ca/BINS/content_page.asp?cid=3-99

2. FASLink Fetal Alcohol Disorders Society: 2. FASLink Fetal Alcohol Disorders Society: Research, Information, Support & Research, Information, Support & Communications Communications http://www.faslink.org/ADHDLIKE.htm

3. Government of Canada: Attention Deficit 3. Government of Canada: Attention Deficit Disorder Disorder http://dsp-psd.tpsgc.gc.ca/Collection-R/LoPBdP/BP/prb0017-e.htm#A.%20The%20Evolutiontxt