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FACT SHEET
A disorder characterized by inappropriate degrees of attention, impulsiveness, and/or
hyperactivity. Although these areas are considered to be core symptoms, all three
characteristics are not necessarily present in those affected. Symptoms are generally first
manifested early in childhood and may persist in varying degrees throughout adult life.
The difference between Attention Deficit Disorder and Attention Deficit Hyperactivity
Disorder (ADD/ADHD) is the absence or presence of hyperactivity.
CHARACTERISTICS
The causes of ADD/ADHD are found in the functioning of the brain. Attention
Deficit Disorder is a limiting metabolic dysfunction of the brain. When neural
building materials are lacking, neurological demands cannot be fulfilled easily.
This interferes with the efficient processing of information. Demands for new
learning, memory, and the management of information cannot be satisfied, which
overworks and stresses the brain.
Attention Deficit Disorder (ADD) and attention deficit hyperactivity disorder (ADHD)
are a limiting metabolic dysfunction of the Reticular Activating System, the center of
consciousness that coordinates learning and memory, and which normally supplies the
appropriate neural connections necessary for smooth information processing and clear,
non-stressful attention. When neural building materials are lacking, demand for further
connectivity cannot easily be fulfilled, interfering with the efficient processing of
information, and frustrating the ADD/ADHD individual. In other words, neural
"hardware" remains in limited production (there's not enough of it), and supply cannot
keep up with the demand (increasing stimulus or "traffic") for new neural connections
within the Central Nervous System (CNS). Demands for new learning, memory, and the
management of information processing cannot be satisfied, and the insufficient
"connections" result in existing neural pathways being repeatedly overworked and over
stressed, often resulting in complete gridlock or shutdown so that nothing gets processed
thereafter. This, most noticeably, generates frustration, bewilderment, and behavioral
problems in the individual.
ETIOLOGY
A single cause has not been conclusively proven (idiopathic). Some possibilities are:
1. Genetic/ Hereditary (strongest correlation)
2. Brain damage (head trauma) before, after or during birth (twice as likely to have
had labor> 13hrs)
3. Brain damage by toxins (internal: bacterial and viral, external: fetal alcohol
syndrome, metal intoxication, eg lead)
4. Strongly held belief by some people (including at least one book, Feingold's
"Cookbook for Hyperactive children") that food allergies cause ADD. This has
*not* been proven scientifically.
PROGNOSIS
ADD/ADHD is often life-long, though hyperactivity usually improves with age. Patients
with ADD/ADHD are more likely than average to use drugs, fail or drop out of school,
have financial or credit problems and get in trouble with the law; they also are rumored to
be more creative than average and many function very well. Early treatment allows for
better formation of study-habits and social skills. 20% outgrow it by puberty but other
problems can interfere. ADD that lasts into Adulthood is referred to as ADD-RT
(Residual Type).
IMPLICATIONS FOR PHYSICAL EDUCATION
Many children with ADD/ADHD experience great difficulty in school, where attention,
quick cognitive processing, and motor control are virtual requirements for success.
Children with ADD/ADHD tend to have difficulty and overreact to changes in their
environment. Whether at home or in school, children with ADD/ADHD tend to respond
best in structured/predictable environments. These environments often have clear and
consistent rules and expectations with defined consequences set forth ahead of time and
delivered immediately. By establishing structure and routines, parents and teachers can
cultivate an environment that encourages the child to independently control his or her
behavior and succeed at learning.
Adaptations which might be helpful (but will not cure ADD/ADHD) include:
1. Posting daily schedules and assignments
2. Calling attention to schedule changes
3. Setting specific times for specific tasks
4. Designing a quiet workspace for use upon request
5. Providing regularly scheduled and frequent breaks
6. Using computerized learning activities
7. Teaching organization and study skills
8. Supplementing verbal instructions with visual instructions
9. Modifying test delivery
While ADD/ADHD can be very inconsistent and unpredictable, research and science
have shown that, as with most children, the more we understand about a child the better
we can help them to learn. Dr. Edward M. Hallowell and Dr. John Ratey have written an
interesting brochure titled 50 Tips on the Classroom Management of Attention Deficit
Disorder. Below are some highlights for use in Physical education and classroom
management.
Be aware that ADD/ADHD may not be the root of all problems. Make sure that a child
is not impaired in another way. Oftentimes other impairments like vision, communication
or hearing can have similar symptoms. Addressing the right problem will ensure the most
effective results.
Structure an environment with reminders (visual and verbal), clear directions, and
determined limits. This will help to ensure a child's understanding and the ability to pay
attention to important factors of a lesson plan instead of an external environment.
Make simple, posted rules to reassure that children know their expectations. Make
frequent eye contact so that both the child and teacher are aware of any daydreaming or
lack of attention. This will bring a child back to an activity and give silent reassurance
that you are concerned about and interested in their attention.
Repeat directions and important information so that children have many
opportunities to absorb them. Writing down directions and verbally communicating them
will help to increase a child's understanding.
Give frequent feedback; this will help to keep them on track
Go for quality instead of quantity with an activity or work.
Break down large projects into small tasks; this will decrease an overwhelming
project and help to increase a child's self confidence and interest in the project.
ASSESSMENT SUGGESTIONS
Behavior Assessment- checklist of how the student behaved for the week with
activities and with the other students.
Persistence and Attention Assessment- How involved the student is and whether
the student accomplished the goals of class or not (persistence or attempt)
RECOMMENDED ACTIVITIES
Increase the novelty of lessons by using films, tapes, flash cards, or small group
work or by having a child call on others.
Incorporate the childrens interests into a lesson plan.
Structure in some guided daydreaming time.
Give simple, concrete instructions, once.
Investigate the use of simple mechanical devices that indicate attention versus
inattention.
Teach children self monitoring strategies.
Use a soft voice to give direction.
RESOURCES
http://www.addmtc.com/clinical.html
http://www.add-adhd-help-center.com/add_adhd_faq.htm
http://www.attentiondeficit-add-adhd.com/adhd_add_information.htm
http://www.childdevelopmentinfo.com/learning/teacher.shtml