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Slide 1 - Attention Deficit Hyperactivity Disorder A Window into Disability as Variability -- Harvard University
Slide 2 - ADHD in the Classroom My daily “emotional rollercoaster” with Sean We both had the same goal: academic success for Sean, but we couldn’t reach it…
Slide 3 - ADHD in the Classroom Sean was a very tactile child Velcro under the desk helped him focus, but why?
Slide 4 - My Research Questions Why did the Velcro trick work? What is ADHD? What are the major theories surrounding ADHD? What is the neuroscience behind ADHD? How will this information help me avoid the “emotional rollercoaster” in my classroom?
Slide 5 - What is ADHD? 3-7% of children in the US are diagnosed DSM-IV diagnostic tool Inattention Impulsivity Hyperactivity Variability!!! For our purposes, we will think about children like Sean…
Slide 6 - What do we traditionally think of when we think of a good student?
Slide 7 - Key Points in the Presentation ADHD Theory Barkley’s Behavior Inhibition Theory (1997) Neuroscience and ADHD: structure/function differences that have been studied in children with ADHD Sikstrom and Soderlund’s Moderate Brain Arousal Theory Why the Velcro trick worked!
Slide 8 - Key Points in the Presentation What does this mean for the classroom? Examples of interventions that do not work for most kids Examples of interventions that might work when considering MBA theory Discussion on changing our ideas of what a good student is to account for variability
Slide 9 - Barkley’s Behavior Inhibition Theory (1997) Behavior inhibition deficits cause executive function deficits. Children with ADHD will have deficits in the following executive functions: working memory, self-regulation, and motor control. What do all of these terms mean?
Slide 10 - Barkley’s Theory Behavior inhibition is the ability to stop an initial or ongoing response and the ability to redirect yourself to a goal-oriented behavior Sean during independent reading as an example
Slide 11 - Barkley’s Theory Executive Functions Self-regulation Sequencing behaviors Planning and organization Working memory Internal speech Defined differently even by leaders in the field
Slide 12 - Executive Functions Self-regulation The ability to regulate your affect, motivation, or arousal in service of a goal directed action (Barkley 1997). An inability to self-regulate will also cause a deficit in the ability to self-direct motor functioning Sean was unable to self-regulate motivation during independent reading
Slide 13 - Executive Functions Working Memory The ability to store and manipulate information in your mind Sean often couldn’t hold the academic goal in his WM
Slide 14 - Executive Functions Working Memory Task Count the number of times the team in white passes the basketball Basketball Video
Slide 15 - Gaps in Barkley’s Theory Barkley’s theory puts the onus of change on the child Barkley leaves out neuroscience His theory tells us a lot about behaviors, but it does not tell us why they occur.
Slide 16 - Brain 101 Neurons - receive and transmit info Neurotransmitters Chemicals that help neurons “talk” Example: Dopamine Cerebral Cortex 4 lobes Occipital, Parietal, Temporal, Frontal Prefrontal Cortex Houses EF’s
Slide 17 - Structural Differences Tannock (1998) reviewed structural imaging studies. Children with ADHD show differences in: prefrontal cortex basal ganglia corpus callosum
Slide 18 - Functional Differences Tannock (1998) reported that ERP studies show children with ADHD perform poorly in sustained and selective attention tasks compared to controls
Slide 19 - Individual Variability andCareful Interpretation Important to remember that all individuals have structural and functional differences We must interpret findings with care
Slide 20 - Why? We still want to know why children with ADHD exhibit the behaviors they do Moderate Brain Arousal will help us understand behaviors so we don’t confuse them with the child’s intentions.
Slide 21 - Sikstrom and Soderlund (2007)Moderate Brain Arousal Theory Children with ADHD have a dysfunctional dopamine system What is dopamine? Dopamine Video
Slide 22 - Dopamine LevelsADHD v. “Normal” A. Tonic (ever present) dopamine is lower in children with ADHD B. Their phasic response (response to stimuli) is higher Sikstrom & Soderlund(2007)
Slide 23 - Sikstrom and Soderlund (2007)Moderate Brain Arousal Theory Low dopamine levels cause a higher dopamine release in response to external stimuli This large boost in dopamine levels causes hypersensitivity to the environment Secondary effects The body becomes conditioned to seek out external stimuli because it’s highly rewarding
Slide 24 - MBA Theory: Stochastic Resonance “Noise” imported through the perceptual system can compensate for low levels of dopamine Too much or too little noise can be detrimental!
Slide 25 - External Stimuli The Velcro and the gorilla are instances of children with ADHD seeking out external, novel stimuli to bring themselves to a normal arousal level
Slide 26 - Listen to the Noise Sikstrom, Soderlund, and Smart (2007) Kids with ADHD performed better on a memory recall task with white noise White noise was detrimental for controls doing the same task Soderlund, Sikstrom, & Smart (2007)
Slide 27 - More Noise! MBA can explain a 1996 study of auditory stimulation and arithmetic performance Kids with ADHD did better listening to their favorite music! Speech had no effect
Slide 28 - What strategies do not work? Keeping MBA theory in mind… Minimizing distractions? Behavior contracts?
Slide 29 - What does work? Appealing stimuli Color differentiation Salient visuals Novel ways of starting lessons…any ideas?
Slide 30 - Counterintuitive Strategies Strategic seating chart for lessons and independent work Sitting Sean at the front of the rug never worked! Music (as “white noise”) “Blurting out answers” - stop to think about the context of the “blurting out”
Slide 31 - Classroom Reality Make goals available in the environment Break down independent work into clear steps Teach strategies for self-help Sketching out steps Asking questions
Slide 32 - Variability As teachers we are keen observers. Notice what modality your student might be most attracted to. Sean liked tactile things Notice their energy level and help them find strategies that work to keep them at a moderate arousal level Make lessons the most “salient” thing in the environment! Notice what works.
Slide 33 - What is a good student? How does MBA theory change our concept of “good” students? Is ADHD a deficit or an example of variablity? What role does the environment play?