ADHD Past Paper Revision Notes PDF

**TA-LA EXAM REVISION 22/11** **UNIT 4: LEARNING DIFFICULTIES** **1- ADHD** Attention Deficit Hiperactivity Disorder.  INTRODUCTION                          -ADHD is one of the most common conditions that is diagnosed among children, and one of the most common conditions that is evaluated among...

**TA-LA EXAM REVISION 22/11** **UNIT 4: LEARNING DIFFICULTIES** **1- ADHD** Attention Deficit Hiperactivity Disorder.  INTRODUCTION                          -ADHD is one of the most common conditions that is diagnosed among children, and one of the most common conditions that is evaluated among teenagers and adults. If left untreated, it can cause significant impairment at work, school, and in an individual\'s social life.  -A common misconception is that ADHD only impacts children. It tends to continue into adulthood.  -An estimated 8.4% of children are diagnosed with ADHD. ⅔ of children with ADHD continue to have signs of it as adults. An estimated 2.4% of adults are diagnosed with ADHD.  -People with this condition can't focus, pay attention or sit still no matter how hard they try.  ADHD IN NUMBERS\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ -1 in 20 children -1 million adults  \- 3-6 years old, is the age when symptoms first appear -7 years old, the average age of ADHD diagnosis \- 5% of children \- 2,5% of adults \- 10% school age children are affected \- 5.6% girls and women -12.9% men and boys \- there's been an increase of 42% in diagnosis over the past 10 years.  \- 10-40% of teens with ADHD also have anxiety disorders.  HOW TO DIAGNOSE -A comprehensive clinical interview -Review of medical, psychological, and of school records.  -Administration of neuropsychological and psychological tests to evaluate attention, concentration, and focus:                      -A symptom report questionnaire, a general personality questionnaire                     -Neuropsychological tests                     -A comprehensive report that will summarize all of the information -A feedback session to go over the results of the testing and discuss recommendations for treatment.  THE BRAIN OF A PERSON WITH ADHD HOW ADHD AFFECTS THE BRAIN THE ADHD BRAIN IS AFFECTED IN THESE PARTS: 1- PREFRONTAL CORTEX: Functions as an intersection for attention, behavior and emotional responses. For people with ADHD, attention is switched easily. 2- LIMBIC SYSTEM: Regulates emotions. Deficiency of dopamine in the ADHD limbic system may result in restlessness, inattention or emotional volatility.  3- BASAL GANGLIA: Neural circuit system that regulates communication within the brain. In the ADHD brain, a 'short circuit' can cause inattention or impulsivity.  4-Reticular Activating System: The Major relay system between the brain's pathways. A dopamine deficiency may cause impulsivity and hyperactivity.  Within these regions of the brain, there are chemical messengers called neurotransmitters that help send signals to the various regions of the brain.  Individuals with ADHD tend to have low levels of a specific group of neurotransmitters called catecholamines, specifically dopamine and norepinephrine.  Decreased levels of dopamine and norepinephrine cause these regions of the brain to be underactive.  If those regions are underactive then they can't do their jobs as quickly or efficiently. That's why individuals will have difficulty with executive functions such as:                                     -Inhibitory control                                    -Working memory                                    -Cognitive flexibility.  WHAT ARE THE CAUSES? There isn't certainty.  There's evidence to suggest that ADHD has a genetic component to it.  Other factors are: Pre-mature birth Low birth weight Pediatric brain injury Exposure to lead during pregnancy Maternal drug or alcohol use during pregnancy FIRST SIGNS AND PARTICULARITIES ADHD is a neurodevelopmental disorder which means that individuals are born with it.  Males, specifically children, have more hyperactive symptoms whereas females tend to have more inattentive symptoms. Since females tend to have more inattentive symptoms, their ADHD can go undiagnosed for many years.  Teachers and parents will notice a boy who is hyperactive, but will not notice a girl who keeps to herself but has problems with focus and attention.  Parents first start to notice symptoms when their children are very young, but they tend to miss the signs because hyperactivity to a certain extent is normal in children.  As children get older, the symptoms of hyperactivity become less obvious but they still continue to have problems with restlessness, inattention, poor planning, and impulsivity.  TWO TYPES OF ADHD INATTENTIVE ADHD HYPERACTIVE/IMPULSIVE ADHD ------------------------------------------------------------------------------------------------------------ --------------------------------------------------------------------------- EASILY DISTRACTED SQUIRMING AND FIDGETING STRUGGLES TO GET NEW INFO OFTEN DESCRIBED AS ''ON THE GO', DRIVEN BY A MOTOR, DIFFICULT TO KEEP UP' RESISTS, AVOIDS, OR DISLIKES TASKS THAT REQUIRE MENTAL ENERGY DIFFICULTY TAKING TURNS REGULARLY LOSES BELONGINGS AND FORGETS THINGS OR EVENTS LEAVES SEAT FROM ONE MOMENT TO THE OTHER DOES NOT SEEM TO LISTEN WHEN SPOKEN TO DIRECTLY EXCESSIVE TALKING DOESN'T FOLLOW THROUGH ON INSTRUCTIONS, AND FAILS TO FINISH SCHOOLWORK, CHORES, OR DUTIES IN THE WORKPLACE EXPLODES FROM TIME TO TIME DIFFICULTY ORGANISING TASKS, ACTIVITIES AND PERSONAL ITEMS. CONSTANT INTERRUPTION OF OTHER'S ACTIONS AND SPEECH 17% INATTENTIVE                                                         46% HYPERACTIVE/IMPULSIVE                                                        37% COMBINED  ADHD MASKING Keeping silent during conversations Stopping yourself from fidgeting Reducing the excitement and emotions Forcing eye contact Overcompensating Forcing oneself to keep still Try to not interrupt Scripting responses to questions Slowing down your speech TREATMENT Pharmacological therapy: The active ingredients in medications like Ritalin, Adderall, Concerta, or Strattera help increase the amount of dopamine and/or norepinephrine in the brain.  NON-pharmacological therapy: Behavioural and psychosocial treatments, behavioural parent training, coaching programmes, cognitive behavioural therapy, cognitive training, dietary modifications, neurofeedback \*ADHD can increase with the use of drugs, technology, or any other form of addiction.  ***[WHAT CAN TEACHERS DO?]*** 1- Build a strong relationship with the child's parents and with the children 2- Establish effective seating arrangements 3- Establish rules and routines, create an agenda 4- Be simple, clear and direct 5- Break things up, give them a step by step 6- Allow extensions, give them some more time 7- Reward good behaviour.  8- Give them something to have in their hands 9- If they like to draw, colour, or just scribble, try if it works, allowing them to do it.  **2- DYSLEXIA.** It is believed to be the result of the interaction between genetic and environmental factors.  Some cases run in families. Some develop due to a traumatic brain injury, stroke, or dementia, and it is called 'acquired dyslexia'.  Gene-Environment interaction: both factors appear to contribute to reading development. Parental education and teaching quality.  Reading helps a lot with fluency in children with the condition.  NEUROANATOMY -Some people with dyslexia show less electrical activation in parts of the left hemisphere of the brain involved with reading, such as the inferior frontal gyrus, inferior parietal lobule, and the middle and ventral temporal cortex.  -The cerebellar theory of dyslexia proposes that impairment of cerebellum controlled muscle movement affects the information of words by the tongue and facial muscles, resulting in the fluency problems that some people with dyslexia experience.  -The cerebellum is also involved in the automatization of some tasks, such as reading. The fact that some children with dyslexia have motor task and balance impairment could be consistent with a cerebellar rolle in their reading difficulties. However, the cerebellar theory has not been supported by controlled research studies.  Why do teachers spot SS that may have dyslexia first? Because the orthographic complexity of a language directly affects how difficult it is to learn it.  EPIDEMIOLOGY:  It is estimated to be as low as 5% and as high as 17% of the population. 2 or 3 out of 10 people. It often runs in families. Reading problems in both girls and boys show up in the same way.  SIGNS AND SYMPTOMS An early track of how children acquire a language makes a difference -Reading below the expected level for one's age -Difficulty in spelling words -Reading quickly without deep understanding -Writing words, ''sounding out'' words in the head -Skipping words or changing them while reading -Difficulties regarding Phonological and Phonemic Awareness. -Letter-sound correspondence -Spacial awareness.  -Confusion with letters, reads them in the wrong order -Recognises a word in one page but not in the other -Loses place on the page, skips lines, rereads lines -Inserts or deletes letters in a word when spelling -Has difficulty copying words from another paper or the board -Misspells many common words -Fossilised mistakes -Difficulty remembering the entire alphabet or remembering lists -Difficulty following spoken or written instructions.  -Writes slowly and laboriously -Confuses letters with similar shapes, like p and b or d. And could also happen with numbers   We often talk about levels of dyslexia in children: from mild dyslexia to moderate dyslexia and more severe dyslexia.  All dyslexics show signs of it early with phonics being the primary issue.  AN EARLY DIAGNOSIS IS KEY EARLY SIGNS OF DYSLEXIA\ -Difficulty with Rhymes, saying them and learning them. Also learning songs -Challenges in Letter Recognition, it is even more of a sign if the letter is in their own name -Mispronouncing words: 'beddy tear' -Struggling to name familiar objects, and referring to them as 'the thing or stuff', or just pointing -Trouble remembering sequences, like the order of the alphabet or numbers -Telling stories in a hard-to-follow manner, or out of order -Difficulty following multi-step directions.  SIGNS OF DYSLEXIA IN PRESCHOOLERS (5-6 yrs old) -Trouble learning letter names and remembering their sounds -Often confusing letters that look similar -Struggling to read familiar words, like cat, especially without pictures -Trouble organising space when writing or drawing -Difficulty separating individual sounds in words and blending sounds -Inconsistent word division -NO sings or just a few signs of learning how to read, even short familiar words SIGNS OF DYSLEXIA IN MIDDLE SCHOOLERS (12-14 yrs old) -Trouble expressing ideas clearly and logically -Difficulty learning foreign languages -Challenges understanding humour, sarcasm and nuanced language -Difficulty with spatial concepts, like reading charts and graphs -Repeatedly needing to read material to understand it -Extreme difficulty managing homework and tracking assignments -Unexpected trouble with higher maths, such as algebra. -Difficulties trying to finish activities that require reading in time.  TREATMENT: There's no specific medication to treat dyslexia, so human resources are in need.  An evaluation must be done to determine the child's specific area of difficulties. The report done by the specialist must be accurate, consistent, clear and as detailed as possible.\ This can be carried out by an educational psychologist or an appropriately qualified specialist dyslexia teacher.  Professionals who can provide help include psychologists, teachers, reading specialists, and speech-language pathologists (SLPs) who focus on learning challenges.  MSLE The formal name for this type of instruction is multisensory structured language education (MSLE). Multisensory teaching uses sight, sound, movement, and touch to help kids connect language to words. Experts often consider it the gold standard for teaching kids with dyslexia to read. These programs are intensive and are taught one-on-one or in small groups. Their goal is to improve spoken and written language skills. ***[What can TEACHERS do?]*** IT IS VERY IMPORTANT TO DO A CURRICULAR ADAPTATION, when adapting we are not making things easier, but making them more connected to their particular way of learning.\ Images help a lot, using bold but never italics. If one exercise depends on the previous one, correct number one first. **3- ASD** Autism Spectrum Disorder DIAGNOSIS: Diagnosing ASD can be difficult since there is no medical test, like a blood test, to diagnose the disorder. Doctors look at the child's behavior and development to make a diagnosis. ASD can sometimes be detected at 18 months of age or younger. By age 2, a diagnosis by an experienced professional can be considered reliable. PROFESSIONALS IN CHARGE:\ Developmental paediatricians\ Child neurologists\ Child psychologists or psychiatrists FACTORS:\ Having a sibling with ASD\ Having certain genetic or chromosomal conditions, such as fragile X syndrome or tuberous sclerosis.\ Experiencing complications at birth.\ Being born to older parents.\ \ SIGNS: Social communication and interaction skills can be challenging\ Avoids eye contact\ Doesn't respond to their name by 9 months of age\ Doesn't show facial expressions by 9 months of age\ Doesn't play simple interactive games by 12 months of age\ Uses few or no gestures by 12 months of age\ Doesn't share interests with others by 15 months of age\ Doesn't point to show something interesting by 18 months of age\ Doesn't notice when others are hurt or upset by 2 years of age\ Doesn't notice other children and join them in play by 3 years of age\ Doesn't pretend to be something else by 4 y.o\ Doesn't sing, dance, or act for you by 5 years old\ \ Other Characteristics: - Delayed language skills - Delayed movement skills - Delayed cognitive or learning skills - Hyperactive, impulsive, and/or inattentive behavior - Epilepsy or seizure disorder - Unusual eating and sleeping habits - Gastrointestinal issues (for example, constipation) - Unusual mood or emotional reactions - Anxiety, stress, or excessive worry - Lack of fear or more fear than expected - Restricted or Repetitive behaviors or interests Differences between GIRLS and BOYS with ASD It presents itself with similar symptoms for both boys and girls\ Girls are more likely to camouflage and hide certain characteristics of autism\ \ Levels of ASD: Level 1: Requires support\ Level 2: Requiring Substantial Support, needing help handling everyday challenges\ Level 3: Requiring VERY Substantial one-on-one support. Treatment and Intervention:\ As individuals with ASD grow into adulthood, additional services can help improve health and daily functioning and facilitate social and community engagement.\ 1. Current treatments for autism seek to reduce symptoms that interfere with daily functioning and quality of life\ 2. ASD affects each person differently, meaning that people with ASD have unique strengths and challenges and different treatment needs.\ 3. Therefore, treatment plans usually involve multiple professionals and are catered toward the individual TYPES of TREATMENT Behavioral\ Developmental\ Educational\ Social-relational\ Pharmacological\ Psychological\ Complementary and Alternative AUTISM TREATMENT Medication treatments: 50% of children with ASD are prescribed medication to help manage the symptoms\ Educational and Behavioral Treatments: There are many programs available that help educate and improve social behavior for children with ASD\ Diet Treatments: Many parents turn to dietary supplements and elimination diets to help alleviate the symptoms of ASD **4. Bullying.** Bullying in NUMBERS Nearly 1 in 3 students report being bullyied.\ 1 in 10 students change or drop out of school due to bullying.\ Reports of Bullying are more frequent in middle school that in any other level.\ \ DEFINITION: Bullying is an **[ongoing]** and deliberate misuse of power in relationships through repeated verbal, physical and/or social behaviour that intends to cause physical, social and/or psychological harm.\ It can involve and individual or a group misusing their power, or perceived power, over one or more persons who feel unable to stop it from happening.\ Single episodes of social rejection or dislike, mutual arguments and fights ARE NOT bullying.\ Bullying can happen in person or online.\ Bullying behavior is repeated, or has the potential to be repeated over time\ Bullying of any form can have immediate, medium and long-term effects on those involved including bystanders. TYPES of BEHAVIOUR INVOLVED Physical: pushing, poking, kicking, hitting, biting, pinching, slapping, etc\ Verbal: name calling, sarcasm, spreading rumours, threats, teasing, belittling...\ Emotional: isolating, tormenting, ridicule, manipulation...\ Sexual: unwanted physical contact, inappropriate touching...\ Cyberbullying: using the internet to send nasty messages, spread rumours... ROLES involved The victim\ The Bully\ The Upstander\ The Bystander\ \ CAUSES of someone being a bully Feeling powerless in their own lives\ Someone else is bullying them\ Jealousy or frustration\ Lack of understanding or empathy\ Looking for attention\ Mimicking behaviors of family\ Bullying behavior gets rewarded\ Inability to regulate emotions IMPACTS of BULLYING can go from negative emotions, to behavioral problems.\ \ ***[What can TEACHERS DO?]*** 1. Educate yourself 2. Encourage respect for all students 3. Practice active listening 4. Learn to identify early signs of bullying 5. Identify where a student can go for extra support 6. Use inclusive language in the classroom 7. Use correct pronouns 8. Empower students to break the cycle of bullying 9. Create opportunities for connection 10. Keep going **DCD- Developmental Coordination Disorder** It is not the same as 'dyspraxia', but dyspraxia is one of the symptoms of DCD. These are children who demonstrate substantial difficulty in coordinating movements.\ As a result, these movement difficulties interfere with a child's ability to perform everyday tasks and have an impact on academic achievement. DCD is highly interlinked with the rest of the disorders, like adhd, asd and dyslexia. POSSIBLE CAUSES: It is not clear why coordination doesn't develop as well as other abilities in children with DCD. However, a number of risk factors can increase a child's likehood of developing DCD. Factors that could INCREASE THE CHANCES of DEVELOPING DCD: - Being born prematurely - Being born with a low birth weight - Having a family history of DCD, although is not clear which genes may be involved. - Use of alcohol or drugs while pregnant - Early low stimulation. Such as not promoting certain moves and coordination skills when the child can do it. MAIN CHARACTERISTICS: - Marked impairment of the development of motor co-ordination - Impairment significantly interferes with academic achievement of activities in daily living - Problem not due to a recognised medical condition - Not a pervasive developmental delay - They have problems with movement and coordination - DCD does not affect intelligence, but it can affect some cognitive skills - DCD can also affect the immune and nervous systems IT can be harder to diagnose DCD in children under 5 because movement skills vary a lot during that time. SOME SIGNS to keep in mind: - Appears clumsy or awkward, like running awkwardly or holding scissors awkwardly - Difficulties organising their school desk, school bag, homework or even the space on a page - Poor body awareness - Delayed gross and fine motor skills - Movement planning and learning difficulties - Difficulty with activities that require the coordinated use of both sides of the body - Reduced strength and endurance - Rushing through tasks as completing them slowly is difficult due to reduced control or balance DIAGNOSIS AND PROFESSIONALS INVOLVED: The diagnosis is usually made by a paediatrician, often in collaboration with an occupational therapist and a psychotherapist. Children with suspected DCD are usually assessed using a method called the Movement ABC, which involves tests of:\ -Gross motor skills, their ability to use large muscles that co-ordinate significant body movements, such as moving around, jumping and balancing.\ -Fine motor skills, their ability to use small muscles for accurate co-ordinated movements, such as drawing and placing small pegs in holes. They will also take into account:\ -The child's medical history. This includes any problems that may have happened during their birth and any delays reaching developmental milestones\ -The family medical history, such as whether any family members have been diagnosed with DCD, will also be considered.\ \ CRITERIA:\ The child will usually need to meet all of the following criteria:\ -Their motor skills are significantly below the level expected for their age and opportunities they have had to learn and use these skills.\ -Their lack of motor skill significantly and persistently affects their day-to-day activities and achievements at school\ -Their symptoms first developed during an early stage of their development\ -Their lack of motor skills isn't better explained by long-term delay in all areas (general learning disability) or rare medical conditions, such as cerebral palsy or muscular dystrophy\ \ SYMPTOMS:\ Problems in infants:\ Delays in reaching developmental milestones can be an early sign of DCD in young children, take may take longer to, for example:\ -roll over\ -Sit\ -crawl\ -walk\ -shows unusual body positions, postures, during their 1^st^ year\ -Has difficulty playing with toys that involve good co-ordination, such as stacking bricks\ -Has some difficulty learning to eat with cutlery\ \ As they grow older they may have difficulty with:\ -Playground activities such as hopping, jumping, running, and catching or kicking a ball\ -Walking up and down stairs\ -Writing, drawing and using scissors\ -Getting dressed, doing up buttons and tying shoelaces\ -Keeping still, they may move and swing their legs and arms a lot.\ -Staying fit as their poor performance in sports ADDITIONAL PROBLEMS:\ -Difficulty concentrating\ -Difficulty following instructions and copying information\ -Being poor at organising themselves and getting things done\ -Being slow to pick up new skills\ -Difficulty making friends, they may avoid taking part in team games are being 'bullied' for being different or clumsy\ -Behaviour problems (low tolerance to constant frustration)\ -Low self-esteem\ \ TREATMENT:\ There is no cure for it. However, several treatments can help and many professionals have tools and ways to help these kids.\ \ TYPES OF THERAPIES:\ -Occupational therapists focus on coordination\ -Physical therapists may work on muscle strength\ -Psychologists, specialized teachers, doctors, paediatrician, physiotherapist, etc.\ \ **WHAT can TEACHERS do?** -Dictation (text-to-speech) software\ -Touchscreens\ -Keyboards\ -Paper with wide, coloured or raised lines\ -Worksheets that have the problems already written on them\ -Verbal and visual demonstrations to help with directions\ -Encourage practice of functional tasks required in the daily routine\ -Practice multiple, short sessions versus one long session. i.e. practice a skill 5 min per day, versus 35 min per week\ -Vary the practice sessions\ -Facilitate the use of cognitive strategies. Ask the child to set goals, to self check skills, and problem solve\ -Break down large tasks into smaller chunks\ -Use movement activities in different social settings in order for child to practice skills in a group setting\ -Change the rules of games in order for the child to participate if necessary, like changing the size of a basketball hoop\ -Differentiate the levels of activities if necessary\ -Little by little, increase the difficulty of the skills being taught. Change one aspect of the skill at a time.\ -When the child begins to show progress offer praise and encouragement. Slowly reduce the amount of support you provide, like less verbal cuese