ADHD Pointers PDF

Attention Deficit/Hyperactivity Disorder Notes by Tai ♡ Currently, the definition provided in the Diagnostic and Statistical Manual, Fifth Edition (DSM-5; APA, 2013) is the one most widely used. APA states, “The essential feature of Attention-Deficit/Hyperactivity Disorder is a persistent pattern...

Attention Deficit/Hyperactivity Disorder Notes by Tai ♡ Currently, the definition provided in the Diagnostic and Statistical Manual, Fifth Edition (DSM-5; APA, 2013) is the one most widely used. APA states, “The essential feature of Attention-Deficit/Hyperactivity Disorder is a persistent pattern of inattention and/ or hyperactivity-impulsivity that interferes with functioning or development” (p. 61) Foundations and History: ADHD, ○ Predominantly although recognized more in Hyperactive-Impulsive recent years, was initially ○ Predominantly Inattentive described over 100 years ago by ○ Combined type British physician George F. Still in Prevalence: ADHD affects about 1902. Early research linked 3% to 5% of the school-aged symptoms like hyperactivity and population, with boys being impulsivity to brain injury or three times more likely to be "minimal brain dysfunction" diagnosed than girls. (MBD). In 1994, the term Causes and Characteristics: Attention Deficit/Hyperactivity ADHD is considered a Disorder (ADHD) was formally neurological disorder, with introduced. differences in brain regions like Definitions: ADHD is defined by the prefrontal lobes, basal the American Psychiatric ganglia, and cerebellum. There’s Association (APA) as a condition some evidence suggesting a marked by inattention and/or genetic basis, and hyperactivity-impulsivity. environmental factors like Symptoms must persist for at premature birth, maternal least six months, have appeared smoking, and exposure to lead before age seven, be present in may contribute. Children with multiple settings, and ADHD display hyperactivity and significantly affect the impulsivity when young but may individual's life. ADHD comes in shift to inattention or combined three types: symptoms as they grow older.  Identification of ADHD: Teachers grouped and the use of are key to identifying ADHD, supportive technology is crucial. often observing students' This includes: inattention, hyperactivity, or Classroom Environment: impulsivity. Diagnostic methods Designing a structured space include interviews, checklists, that minimizes distractions to rating scales, academic testing, help students focus. and direct observation. Instructional Approaches: Instructional Technology: Teaching students with ADHD Utilizing devices that enhance involves addressing both attention, software for academic challenges and drill-and-practice, and behavioral self-regulation. engaging programs to support Effective strategies include learning. structured environments, consistent routines, and using General Education technology like Considerations: Teachers may drill-and-practice software to be involved in writing and engage students and provide implementing Section 504 Plans immediate feedback. Grouping for accommodations. methods such as peer-assisted Collaboration between general learning also benefit students and special education teachers with ADHD. is crucial for the success of Instructional Considerations students with ADHD. Practical Considerations for the To effectively teach students Classroom with ADHD, it's essential to consider both the classroom Practical considerations for environment and instructional managing a classroom with technology. Students with ADHD students who have ADHD are particularly sensitive to include establishing clear rules distractions that can divert their and routines to create a attention from tasks. Therefore, structured environment. careful planning of how they are Teachers should ensure the  curriculum is engaging and incorporate technology to enhance learning. Glossary  Foundations and History 1950s: William Cruickshank researched the link between brain injury, hyperactivity, and distractibility. Terms "minimal brain dysfunction" (MBD) and "minimal brain injury" (MBI) were introduced to describe children with hyperactivity and distractibility, even without physical brain injury evidence. 1960s: The term learning disabilities was used to relabel many children with MBD/MBI. Cruickshank identified two types of hyperactivity: Sensory hyperactivity: Response to irrelevant stimuli, affecting school achievement. Motor hyperactivity: Leads to behavior management problems. 1968: APA introduced hyperkinetic reaction disorder of childhood in DSM-II. 1970s: Research shifted focus from hyperactivity to attention problems. 1980: APA introduced Attention Deficit Disorder (ADD) with or without hyperactivity in DSM-III. 1987: DSM revision replaced hyperactivity with undifferentiated ADD. 1994: The term Attention Deficit/Hyperactivity Disorder (ADHD) was introduced in DSM-IV, which continues in later editions. Three groups of ADHD were defined: predominantly inattentive, predominantly hyperactive-impulsive, and combined type. Definitions ADHD is not considered a disability under IDEA, so no legal federal definition exists. The DSM-5 (2013) provides the most widely used definition of ADHD, describing it as a persistent pattern of inattention and/or hyperactivity-impulsivity that affects functioning or development.  Diagnosis requirements include displaying symptoms in more than one setting (e.g., home, school, or work). There are three types of ADHD according to the DSM-5: 1. Predominantly inattentive: Difficulty paying attention, organizing tasks, poor time management, and avoiding tasks requiring sustained attention. 2. Predominantly hyperactive/impulsive: Fidgeting, excessive talking, leaving seats inappropriately, and interrupting others. 3. Combined presentation: A mix of inattentive and hyperactive-impulsive symptoms. Severity levels (mild, moderate, or severe) specify the diagnosis based on symptom profile and functional impairment. Diagnostic criteria: Symptoms must be present for at least 6 months. Symptoms must appear before the age of 12. The disorder must impair performance in social, academic, or occupational areas. Behaviors should be inconsistent with the individual’s developmental level. Two additional categories introduced by DSM-5 Other specified ADHD Unspecified ADHD for individuals who display ADHD-like symptoms but don’t meet the full criteria for diagnosis. Prevalence of ADHD Approximately 5% of school-aged children have ADHD, making it one of the most common exceptionalities. In general education classes of 30-35 students, about two students per class may have ADHD, particularly in elementary years.  Gender ratio: ADHD is more prevalent in boys than girls, with a 2:1 ratio in children, although this ratio is smaller than previously thought and may be nearly equal in adults. Persistence into adulthood: Contrary to the belief that children will "outgrow" ADHD, research shows that over two-thirds of children with ADHD continue to exhibit symptoms into adulthood. ADHD often requires treatment throughout life, although the overall prevalence decreases with age. Cultural considerations: African American students with ADHD are often underdiagnosed due to factors such as lack of parental knowledge or reluctance to seek diagnosis. Cultural differences in how inattention is perceived may affect referral rates and, therefore, the recorded prevalence of ADHD. Increasing prevalence: ADHD diagnoses have been increasing rapidly in recent years, making it highly likely that teachers will work with students who have ADHD. Educational support: Since ADHD is not considered a separate disability under IDEA, it does not qualify for special education funding unless categorized under Other Health Impairment (OHI). Students with ADHD may receive support through a 504 Plan or informal interventions provided by general education teachers. Special education teachers may collaborate with general educators to provide instructional and behavioral strategies for students with ADHD, especially if they qualify under another disability category.  Causes and Characteristics Causes of ADHD: Common misconceptions suggest ADHD is caused by: ○ Poor diet, food additives, too much sugar, television viewing, or fluorescent lights. ○ Poor parenting or teaching, although inconsistent environments may increase symptoms, they do not cause ADHD. Research-based causes: ○ ADHD is generally accepted as a neurologically based disorder. ○ Prenatal and perinatal causes: Premature birth, maternal smoking, alcohol use, and exposure to lead have been linked to ADHD. Brain-based causes: ○ ADHD is associated with differences in brain anatomy and function, especially in the: Prefrontal and frontal lobes: Involved in problem-solving, self-regulation, and response inhibition. Basal ganglia and cerebellum: Related to motor behavior, contributing to hyperactivity. ○ There is evidence that some children with ADHD experience a lag in brain development, which may close by adolescence. Genetic causes: ○ ADHD has a strong genetic component, with 80% heritability. ○ Multiple interacting genes, particularly those regulating neurotransmitters like dopamine, may contribute to ADHD. ○ Studies show that 40-60% of children of adults with ADHD are also likely to have the disorder. ○ Twin studies confirm that identical twins have a higher likelihood of sharing ADHD compared to fraternal twins. Cognitive Characteristics: Average intelligence but with deficits in executive functioning. ○ Difficulty in activating, organizing, planning, and managing cognitive functions. ○ Problems with working memory and behavioral inhibition, leading to impulsivity and trouble monitoring behavior. ○ Neurological studies (e.g., fMRI) show reduced brain activity in areas controlling inhibition, contributing to impulsivity and motor control issues. Academic Characteristics: Executive functioning problems impact academic performance. Common academic issues: ○ Difficulty attending to and organizing tasks. ○ Not listening to directions or making careless mistakes. ○ Spending less time academically engaged compared to peers. Greater risk of grade retention and school dropout. School problems are often performance-related rather than ability-related, though many students with ADHD also have coexisting learning disabilities. Secondary-level students face additional challenges due to: ○ Coordinating schedules with multiple teachers. ○ Organizing long-term independent assignments. ○ Impulsivity that hinders future planning and postsecondary education. Social and Emotional Characteristics: Difficulty with peer relationships: fewer close friends and more peer rejection. Those with hyperactive-impulsive or combined types may exhibit more aggression and bullying behaviors. Those with inattentive type tend to be more withdrawn. Difficulty recognizing emotions in others, such as anger or fear, which can lead to impaired peer interactions. Motivational issues:  ○ Preference for easier tasks, lower persistence, and a reliance on external motivation rather than internal motivation. Coexistence with Other Exceptionalities ADHD and other exceptionalities: More than half of students with ADHD also have a coexisting disability. As many as 30-45% of students with ADHD also have a learning disability, complicating their academic challenges. Some professionals suggest that ADHD and learning disabilities may be different manifestations of the same condition. Common coexisting disabilities: Emotional disturbances (ED), including: ○ Conduct disorders ○ Oppositional defiant disorder (ODD) ○ Anxiety or mood disorders Up to 65% of students with ADHD may have both ADHD and an emotional disturbance. Students with both ADHD and conduct problems are at higher risk for social, behavioral, and legal issues. Implications for teachers: Teachers must recognize that many students with ADHD may benefit from treatments beyond those for ADHD, due to their coexisting conditions. Addressing the diverse characteristics of students with ADHD requires individualized approaches to meet their academic and social-emotional needs.  Identification of ADHD Comprehensive Identification Process: The identification of ADHD involves multiple people, procedures, and settings. No single source of information (e.g., parent or teacher) is sufficient to diagnose ADHD, as the diagnostic criteria require subjective interpretation. Common procedures include interviews, questionnaires, checklists, rating scales, academic testing, and direct observation. Students with ADHD may qualify for services under IDEA categories like: ○ Specific Learning Disabilities (SLD)  ○ Emotional Disturbance (ED) ○ Other Health Impairment (OHI) (for chronic impairments affecting school performance). Diagnostic Procedures: 1. Medical evaluation: ○ Conducted by a physician knowledgeable about ADHD to rule out other medical conditions (e.g., vision or hearing problems). 2. Interviews: ○ Conducted with parents, teachers, and the individual (if appropriate) to gather information about the individual’s developmental, medical, cognitive, and behavioral history. ○ Teachers provide critical input on school-related behaviors and compare the student’s behavior to their peers. 3. Questionnaires and Checklists: ○ Parents and teachers complete questionnaires about the child’s health, developmental milestones, and behavior in different settings. ○ Checklists help document behaviors like frustration, attention issues, following directions, and impulsivity. 4. Rating Scales: ○ General behavior rating scales and ADHD-specific scales help identify ADHD behaviors. ○ Common tools include: Achenbach System of Empirically Based Assessment Behavior Assessment System for Children (BASC-3) Conners 3rd edition (Conners-3) 5. Academic Testing: ○ Tests like the Kaufman Test of Educational Achievement or the Wechsler Individual Achievement Test may be used to assess the student’s academic performance. ○ Particularly relevant if the student may qualify for special education services under IDEA. ○  6. Direct Observation: ○ Observing the frequency and duration of behaviors in the classroom (e.g., how often the student leaves their seat) can help document ADHD symptoms. Role of Teachers: Teachers often play a key role in noticing ADHD behaviors and may provide input through interviews, rating scales, and classroom observations. Their insights help ensure that ADHD behaviors are documented across multiple settings. Instructional Approaches Instructional Content Instructional Content for Students with ADHD: 1. General Program Goals: ○ Improve attention, task completion, and academic achievement. ○ Include instruction in academics, self-regulation skills, and parent training. 2. Academic Instruction: ○ Students with ADHD must meet general education curriculum standards and pass state assessments. ○ Instruction should involve teaching specific strategies to enhance: Organizational skills Goal setting Listening and attending skills Following instructions ○ Use of mnemonic strategies (e.g., ROY G BIV for the colors of the rainbow) and self-instruction techniques. ○ Explicit strategy instruction combined with self-regulation has proven effective in enhancing skills in reading, writing, and other content areas. 3. Self-Regulation: ○ Self-regulation is seen as a key area where students with ADHD need support. ○ Strategies include: Teaching students self-instructions or problem-solving steps. Utilizing cue cards for independent work. Engaging in self-assessment and self-evaluation of behavior. Implementing self-monitoring checklists that prompt students to check their own behavior during tasks. Using self-reinforcement systems to encourage positive behaviors. 4. Parent Training: ○ Parents should be trained in systematic behavior management to interact positively with their children. ○ Training programs should be culturally relevant and include techniques like: Token reinforcement systems for appropriate behavior. Response cost (withdrawing rewards) and time-out for inappropriate behaviors. ○ Addressing parental stress is also crucial. 5. Counseling Services: ○ Counseling is essential for helping adolescents understand and accept their ADHD. ○ It can address emotional issues such as test anxiety or depression and assist in discussions about medication benefits. ○ Students need coping strategies for managing ADHD as they transition to adulthood. ○ Career counseling can help students explore suitable work environments and reinforce goal achievement. 6. Long-Term Considerations: ○ ADHD is a lifelong condition, with 70-80% of children continuing to exhibit symptoms into adolescence and adulthood. ○ Teaching coping strategies early can aid in managing symptoms over time. Instructional Procedures Classroom Management and Instructional Procedures: Effective classroom management can improve student behavior and academic outcomes (Myers et al., 2017). Strategies for ADHD are similar to those used for students with learning disabilities and emotional/behavioral disorders: ○ Task analysis ○ Clear and consistent rules ○ Repetitive verbal instructions ○ Advance organizers ○ Learning strategies Direct Instruction: Explicit direct instruction is essential for teaching students with ADHD. Components of direct instruction include: ○ Presentation: Use advance organizers, explain rationale, demonstrate. ○ Guided Practice: Ensure high accuracy (90%) before moving to independent work. ○ Independent Practice: Provide significantly more opportunities for practice. ○ Use of post organizers to summarize key points and remind students about assignments. Cognitive Behavior Modification (CBM): Developed to help students internalize effective learning strategies. Involves: 1. Teacher performs a task while verbalizing instructions. 2. Student performs the task with teacher guidance. 3. Student verbalizes instructions while working independently. 4. Progress from overt verbalization to whispering and then to covert verbalization. Precision Teaching: A system for evaluating and improving instruction through: 1. Pinpointing target behaviors. 2. Daily timed exercises to evaluate progress. 3. Graphing data to set instructional goals. 4. Designing instructional programs based on data analysis. Promotes self-monitoring and awareness of progress. Behavioral Intervention: Involves the use of Functional Behavior Assessment (FBA) to define target behaviors and create effective intervention plans. Key elements include: ○ Ensuring positive consequences follow desirable behavior. ○ Providing immediate and consistent consequences for undesired behavior. ○ Emphasizing clear, brief, and frequent rules and instructions. Medication as Support: Psychostimulants (e.g., Ritalin, Adderall) can significantly improve behavior and learning in 70-80% of children with ADHD when combined with behavioral interventions. Important considerations for medication: 1. Requires effective communication among physicians, parents, and teachers. 2. Effects vary among individuals; not all children respond favorably. 3. Optimal dosage is critical; excessive dosages may hinder learning. 4. Medication should not replace responsibility for behavior changes; it should complement behavioral and academic training. Early Multicomponent Interventions: Effective approaches for preschoolers include stimulant medication, parent training, and classroom behavior management.  Components of successful interventions: ○ Positive reinforcement and response cost programs. ○ Effective directions and requests. ○ Teaching self-control and consistent discipline methods. Collaboration between parents and schools is essential for developing a cohesive intervention strategy that promotes effective management of ADHD symptoms. Instructional Considerations Instructional Environment: Structure and Routine: Essential for students with ADHD, as they rely on external structure to compensate for their internal challenges. Classroom Arrangement: ○ Minimize distractions by reducing clutter and auditory stimuli. ○ Arrange seating to ensure students are close to the teacher and away from distractions (e.g., windows, bulletin boards). ○ Use individual desks or study carrels to limit distractions. ○ Provide opportunities for movement within the classroom. Preschool Classroom: Structure is crucial; a highly structured environment with clear routines is beneficial. Use walls and doors to block distractions. Seat children away from potential visual or auditory distractions. Incorporate scheduled transitions and teacher-directed movement to maintain focus. Elementary and Secondary Classrooms: Clear routines and expectations help reduce anxiety and improve focus. Keep desks organized and materials accessible.  Students should be seated in a way that minimizes distractions and maximizes visibility to the teacher. Instructional Grouping: Large Group Instruction: ○ Individual seating in separated desks enhances focus. ○ Use engaging teaching styles and brief, active participation. ○ Incorporate technology (e.g., electronic response systems) and guided notes to keep students engaged. Peer Tutoring: ○ Provides immediate feedback and allows students to work at their own pace. ○ Pair students with similar strengths and interests for effective collaboration. ○ Peers can act as behavior modifiers by encouraging positive behavior. Classwide Peer Tutoring (CWPT): ○ Combines whole-class instruction with peer tutoring to enhance engagement and learning. ○ Allows students to practice and monitor skills with support from peers. ○ Can be used across various subjects and effective for diverse learners. Peer-Assisted Learning Strategies (PALS): ○ Engages students in strategic reading activities like partner reading, summarizing, and predicting. ○ Effective for improving reading fluency and comprehension across various grade levels. Instructional Technology Instructional Environment: Structure and Routine: Essential for students with ADHD, as they rely on external structure to compensate for their internal challenges. Classroom Arrangement: ○ Minimize distractions by reducing clutter and auditory stimuli.  ○ Arrange seating to ensure students are close to the teacher and away from distractions (e.g., windows, bulletin boards). ○ Use individual desks or study carrels to limit distractions. ○ Provide opportunities for movement within the classroom. Preschool Classroom: Structure is crucial; a highly structured environment with clear routines is beneficial. Use walls and doors to block distractions. Seat children away from potential visual or auditory distractions. Incorporate scheduled transitions and teacher-directed movement to maintain focus. Elementary and Secondary Classrooms: Clear routines and expectations help reduce anxiety and improve focus. Keep desks organized and materials accessible. Students should be seated in a way that minimizes distractions and maximizes visibility to the teacher. Instructional Grouping: Large Group Instruction: ○ Individual seating in separated desks enhances focus. ○ Use engaging teaching styles and brief, active participation. ○ Incorporate technology (e.g., electronic response systems) and guided notes to keep students engaged. Peer Tutoring: ○ Provides immediate feedback and allows students to work at their own pace. ○ Pair students with similar strengths and interests for effective collaboration. ○ Peers can act as behavior modifiers by encouraging positive behavior.  Classwide Peer Tutoring (CWPT): ○ Combines whole-class instruction with peer tutoring to enhance engagement and learning. ○ Allows students to practice and monitor skills with support from peers. ○ Can be used across various subjects and effective for diverse learners. Peer-Assisted Learning Strategies (PALS): ○ Engages students in strategic reading activities like partner reading, summarizing, and predicting. ○ Effective for improving reading fluency and comprehension across various grade levels. Instructional Technology Benefits of Technology for Students with ADHD: Increased Attention and Motivation: Many students with ADHD demonstrate improved focus when working on computers or engaging with video games (Marino et al., 2014). Immediate Feedback: Computers provide instant feedback, which can enhance motivation and help students track their progress. Key Features of Technology: Instructional Software: ○ Engaging graphics, sounds, and game formats make learning more interactive and interesting. ○ Software can break content into smaller chunks and offer step-by-step instructions. ○ Provides opportunities for repeated trials, allowing students to learn at their own pace. Computer-Assisted Instruction (CAI): Positive Outcomes: CAI has been shown to improve academic performance in math and reduce off-task behavior (DuPaul & Stoner, 2014).  Enhanced Writing: Using computers for written assignments allows students to focus on content rather than the mechanics of writing, which can improve productivity (DuPaul & Eckert, 1998). Personal Digital Assistants (PDAs): Help students with organization, memory, and task management. Attention Maintenance Technology: Attention Training System (ATS): A device that helps reduce off-task behavior by tracking points and providing visual feedback without negative social stigma. Tone-Prompt System: Uses soft tones to remind students to self-monitor their attention, promoting self-regulation. Drill-and-Practice Programs: Effective Learning: Drill programs that emphasize rapid responses and include progress monitoring can significantly benefit students with ADHD. Engaging Formats: Software that includes game elements and animations can further enhance engagement and learning outcomes. Examples of Effective Programs: Headsprout Early Reading Program: A CAI program designed to improve reading fluency and task engagement for students with ADHD through individualized, interactive teaching. General Education Considerations Role of General Education Teachers: Significant Impact: General education teachers play a crucial role in managing ADHD, focusing on effectively facilitating learning rather than trying to eliminate the condition.  Key Considerations for Classroom Management: 1. The Three Cs (Guetzloe, 2004): ○ Conditions: Ensure rules and routines are clear and positively stated. ○ Curriculum: Make learning interesting and engaging; utilize technology when possible. ○ Consequences: Implement positive reinforcements rather than solely using punitive measures. 2. Strategies for Supporting Students with ADHD: ○ Visual Aids: Use color coding, highlighting, and larger fonts to emphasize important information. ○ Structured Outlines: Provide lesson outlines to assist with note-taking and studying. ○ Study Buddy: Pair students with a peer to help repeat and explain directions. ○ Clear Expectations: Post and regularly review classroom rules and consequences to maintain clarity and consistency. 3. Managing Workload: ○ Shorten Assignments: Break larger tasks into smaller, manageable segments. ○ Variety in Activities: Intermix different activities within assignments to maintain engagement. ○ Minimize Homework: Assign only independent practice of previously learned skills to reduce stress for students and parents. 4. Self-Monitoring Tools: Encourage the use of timers and checklists to help students manage their tasks and time effectively. 504 Plan: Accommodations: Students with ADHD not eligible for special education can receive accommodations under Section 504 of the Vocational Rehabilitation Act. Collaboration: The general education teacher participates in creating a 504 Plan, outlining necessary accommodations in consultation with parents, students, and other educators.  Collaboration with Special Educators: Communication: Effective collaboration between general and special education teachers is essential for providing high-quality instruction. Individualization: Decisions about classroom management and curriculum adjustments should be based on individual student needs, with input from all involved educators. Monitoring Progress: Sharing observations about students’ performance helps ensure appropriate educational strategies are applied. Conclusion: General education teachers are pivotal in creating an effective learning environment for students with ADHD. By employing specific strategies, collaborating with special educators, and implementing structured approaches, teachers can help these students achieve academic success and improve their overall classroom experience. Practical Considerations for the Classroom Glossary 1. ADHD (Attention Deficit/Hyperactivity Disorder): A neurodevelopmental disorder characterized by patterns of inattention, hyperactivity, and impulsivity that interfere with functioning or development. 2. General Education Teacher: An educator responsible for teaching a diverse group of students in a regular classroom setting, including those with ADHD. 3. Classroom Management: Strategies used by teachers to maintain a productive learning environment, including establishing rules, routines, and consequences. 4. Three Cs: ○ Conditions: Classroom rules and routines that are clear and positively stated. ○ Curriculum: The content taught, which should be engaging and interesting to maintain student attention. ○ Consequences: Positive interventions and reinforcements used to encourage desired behaviors rather than punitive measures. 5. Visual Aids: Tools such as color coding, highlighting, and increased font size used to emphasize important information for students with ADHD. 6. Structured Outlines: Pre-prepared lesson outlines provided to students to assist with note-taking, homework, and studying. 7. Study Buddy: A peer assigned to assist a student with ADHD by repeating and explaining directions or helping with academic tasks. 8. Self-Monitoring Tools: Devices or strategies, such as timers and checklists, used to help students track their tasks and manage their time effectively. 9. 504 Plan: An accommodation plan developed under Section 504 of the Vocational Rehabilitation Act for students with ADHD who do not qualify for special education services. 10. Collaboration: The partnership between general and special education teachers to provide appropriate instruction and support for students with ADHD. 11. Individualization: Tailoring instruction and strategies to meet the unique needs of each student based on their specific challenges and strengths. 12. Instructional Strategies: Techniques employed by teachers to enhance learning for students with ADHD, such as direct instruction, cognitive behavior modification, and drill-and-practice programs. 13. Cognitive Behavior Modification (CBM): An educational approach that helps students internalize efficient learning strategies through verbalization and reflective goal setting. 14. Computer-Assisted Instruction (CAI): Educational software that provides immediate feedback, reinforcement, and interactive learning opportunities for students with ADHD. 15. Peer Tutoring: A collaborative learning approach where students help each other with academic tasks, providing immediate feedback and support. 16. Classwide Peer Tutoring (CWPT): A structured method that combines whole-class instruction with peer tutoring, enabling students to teach each other under teacher supervision. 17. Peer-Assisted Learning Strategies (PALS): A program that involves students in strategic reading activities through peer collaboration to improve fluency and comprehension. 18. Behavioral Intervention: Strategies designed to modify student behavior through positive reinforcement and clear consequences for both desirable and undesirable behaviors. 19. Attention Maintenance Technology: Tools such as the Attention Training System (ATS) that help students with ADHD stay focused and manage their attention. 20. Drill-and-Practice Programs: Computer-assisted instructional programs that provide repetitive practice of skills to reinforce learning. 21. Self-Reinforcement: A technique in which students reward themselves for demonstrating desired behaviors or completing tasks. 22. Functional Behavior Assessment (FBA): An evaluation method used to identify target behaviors and develop effective intervention plans based on the functions of those behaviors. 23. Positive Reinforcement: A strategy that involves providing rewards or incentives to encourage desirable behavior. 24. Response Cost: A behavioral intervention technique where a student loses privileges or tokens as a consequence of undesirable behavior. 25. Time-Out: A disciplinary technique used to remove a student from a situation where they are misbehaving to help them regain self-control. 26. Task Analysis: A method of breaking down complex tasks into smaller, manageable steps to make learning easier for students with ADHD. 27. Advance Organizer: A tool or strategy used to provide an overview of the material to be learned, helping students to understand the context and structure before they begin studying. 28. Engaged Learning: An instructional approach that encourages active participation and investment in the learning process, often through interactive and hands-on activities. 29. Executive Functioning: A set of cognitive processes that include working memory, flexible thinking, and self-control, which are often impaired in individuals with ADHD. 30. Mnemonics: Memory aids or techniques used to help students remember information more effectively, such as acronyms or visualization strategies. 31. Behavioral Modeling: A technique in which a teacher demonstrates a desired behavior for students to observe and replicate. 32. Instructional Technology: Tools and software designed to enhance learning and teaching, including computers, tablets, and specialized educational software. 33. Self-Instruction: A strategy that involves students guiding themselves through a task using verbal cues or prompts. 34. Motivational Strategies: Techniques used to enhance student engagement and commitment to learning, such as setting achievable goals or providing choices in learning activities. 35. Scaffolding: An instructional approach that provides temporary support to students as they develop new skills, gradually removing assistance as students become more competent. Key Points: History of ADHD: ADHD was first recognized in the early 20th century, described by British physician George F. Still. Over the decades, professionals recognized hyperactivity, impulsivity, and attention difficulties as part of this disorder. In 1994, the term "attention deficit/hyperactivity disorder" was introduced and continues to be used today​(Ronald Taylor, Lydia Sm…). Definition and Diagnosis: ADHD is defined by the American Psychiatric Association (APA) in the DSM-5 as a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. It has three presentations: predominantly hyperactive-impulsive, predominantly inattentive, and combined type​(Ronald Taylor, Lydia Sm…). The symptoms must be present for at least six months and in multiple settings to qualify for diagnosis​(Ronald Taylor, Lydia Sm…)​(Ronald Taylor, Lydia Sm…). Causes and Characteristics: ADHD is largely accepted as a neurological disorder, with differences observed in the prefrontal lobes, basal ganglia, and cerebellum of affected individuals. There is also evidence suggesting genetic and non-genetic causes (e.g., premature birth, maternal smoking)​(Ronald Taylor, Lydia Sm…). Symptoms can vary with age: younger children often exhibit hyperactivity and impulsivity, while older students tend to show more inattention​(Ronald Taylor, Lydia Sm…). Coexisting Conditions (Comorbidity): ADHD often coexists with other exceptionalities, such as learning disabilities (30-45%) and emotional disturbances (up to 65%). These comorbidities can complicate the management of ADHD in students​(Ronald Taylor, Lydia Sm…)​(Ronald Taylor, Lydia Sm…). Identification and Assessment: Identifying ADHD requires a comprehensive approach involving multiple people and sources, including parents, teachers, interviews, rating scales, and direct observation. Many students with ADHD qualify for services under Section 504 plans or IDEA under specific categories like Other Health Impairment (OHI)​(Ronald Taylor, Lydia Sm…)​(Ronald Taylor, Lydia Sm…). Treatment and Intervention: The use of psychostimulant medications like Ritalin and Adderall is common. Medications combined with behavioral interventions can lead to significant improvements in behavior and academic performance in about 70-80% of children with ADHD​(Ronald Taylor, Lydia Sm…). Behavioral interventions and structured instructional environments are crucial in managing ADHD, particularly in younger children​(Ronald Taylor, Lydia Sm…). Long-Term Outlook: ADHD is a lifelong condition; up to 80% of children with ADHD continue to show symptoms into adolescence, and many adults continue to experience attention and behavioral difficulties. Career counseling and coping strategies are essential for adolescents and adults with ADHD​(Ronald Taylor, Lydia Sm…).