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THE MARSHALL MEMO
What Research Tells Us About Attention Deficit Hyperactivity Disorder
By Kim Marshall, TIE columnist 13-Oct-15
This piece is reprinted from The Marshall Memo, Kim Marshall’s weekly summary of current research and best practices in the field of education. Drawing on his experience as a teacher, principal, central office administrator, consultant, and writer, Kim Marshall lightens the load of busy educators by serving as their “designated reader.” ________________________________________________________________________ The article: “ADHD: From Stereotype to Science” by Thomas Brown in Educational Leadership, October 2015 (Vol. 73, #2, p. 52-56). In this Educational Leadership article, Thomas Brown (Yale Clinic for Attention and Related Disorders) summarizes recent findings on ADHD: • ADHD is “a developmental impairment of the brain’s self-management system,” says Brown, and it involves challenges in these six areas: - Activation – Getting motivated, organized, and started on necessary tasks, prioritizing; - Focus – Attending to what needs to be done, sustaining attention, and shifting focus when needed; - Effort – Regulating alertness, sustaining effort to complete tasks, having enough processing speed, and managing sleep; - Emotion – Handling frustration and modulating emotions; - Memory – Using short-term working memory and accessing recall; - Action – Processing and presenting information efficiently, monitoring actions to fit the setting, and avoiding excessive impulsivity. • All of us experience some ADHD characteristics from time to time, says Brown; those with ADHD have more chronic and impairing challenges. • Not all people with ADHD have problems with hyperactivity and excessive impulsivity; the majority of those who do outgrow it in early adolescence. • A quarter of children with ADHD have a parent who has ADHD and 30 percent have siblings who do, with higher incidence between identical twins; • Areas of the brain that are important to self-management tend to mature 3-5 years later in children with ADHD than in the general population; • For many but not all children with ADHD, some impairments continue throughout their lives. • ADHD symptoms most often emerge in the elementary and middle-school grades, but for some, onset occurs in high school or when they move away from home. • There is no correlation between ADHD and intelligence; it occurs across the IQ spectrum. • Emotions (conscious and unconscious) play a crucial role in motivation and self-regulation among children with ADHD; many also have chronic difficulty recognizing and managing the expression of emotion. • There are many differences in how the various symptoms manifest themselves among children with ADHD, even those of exactly the same age. • Children with ADHD are more likely than the general population to have difficulty with learning disabilities, anxiety and mood disorders, sleep, obsessive-compulsive behavior, substance use, and autism spectrum disorders. • Eight out of 10 people with ADHD can benefit from carefully managed medication, but meds aren’t a cure; the best analogy is eyeglasses improving vision while they’re worn. • One mystery is why children with ADHD can have great difficulty maintaining focus with some activities (school tasks, for example) and yet have no difficulty focusing on a video game or art project for extended periods of time. Motivation and interest appear to be the key factors. • Short-term working memory is often a challenge for people with ADHD – keeping one bit of information in mind while thinking about or doing something else – but long-term memory is often excellent. “When I’m reading something that’s not really interesting to me, it’s like I’m licking the words and not chewing them,” said one student with ADHD. “I know what all the words mean as I’m reading them, but they just don’t stick inside my head. I don’t really digest them.” • Open-ended writing is the biggest challenge for most children with ADHD because of executive-function challenges with organizing, prioritizing, sequencing, and elaborating free-floating ideas into organized sentences and paragraphs. “Educators who are aware of our new understandings about ADHD are better equipped to identify students who may be struggling with this disorder,” says Brown. They can then describe the symptoms to parents who may then work with a physician, psychologist, or other medical specialist who is trained in making a full diagnosis and treatment plan.
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