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Although any disability can coexist with ADHD, certain disabilities seem to be more common than others. These include disruptive behavior disorders, mood disorders, anxiety disorders, tics and Tourettes Syndrome, and learning disabilities Jensen, et al. In addition, ADHD affects children differently at different ages. In some cases, children initially identified as having hyperactive-impulsive subtype are subsequently identified as having the combined subtype as their attention problems surface.

These characteristics affect not only the academic lives of students with ADHD, they may affect their social lives as well.

Conduct Disorder (CD) Information | Child Mind Institute

Children with ADHD of the predominantly hyperactive-impulsive type may show aggressive behaviors, while children of the predominantly inattentive type may be more withdrawn. Also, because they are less disruptive than children with ADHD who are hyperactive or impulsive, many children who have the inattentive type of ADHD go unrecognized and unassisted. Their inability to control their own behavior may lead to social isolation.

Consequently, the childrens self-esteem may suffer Barkley, a. In the United States, an estimated 1. ADHD has traditionally been viewed as a problem related to attention, stemming from an inability of the brain to filter competing sensory inputs such as sight and sound. Recent research, however, has shown that children with ADHD do not have difficulty in that area.

Instead, researchers now believe that children with ADHD are unable to inhibit their impulsive motor responses to such input Barkley, ; a. It is still unclear what the direct and immediate causes of ADHD are, although scientific and technological advances in the field of neurological imaging techniques and genetics promise to clarify this issue in the near future. Most researchers suspect that the cause of ADHD is genetic or biological, although they acknowledge that the childs environment helps determine specific behaviors.


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Imaging studies conducted during the past decade have indicated which brain regions may malfunction in patients with ADHD, and thus account for symptoms of the condition Barkley, a. A study conducted at the National Institutes for Mental Health NIMH found that the right prefrontal cortex part of the cerebellum and at least two of the clusters of nerve cells known collectively as the basal ganglia are significantly smaller in children with ADHD as cited in Barkley, a.

It appears that these areas of the brain relate to the regulation of attention.

Research roundup: Conduct disorder

Why these areas of the brain are smaller for some children is yet unknown, but researchers have suggested mutations in several genes that are active in the prefrontal cortex and basal ganglia may play a significant role Barkley, a. In addition, some nongenetic factors have been linked to ADHD including premature birth, maternal alcohol and tobacco use, high levels of exposure to lead, and prenatal neurological damage. Although some people claim that food additives, sugar, yeast, or poor child rearing methods lead to ADHD, there is no conclusive evidence to support these beliefs Barkley, a; Neuwirth, ; NIMH, Although toddlers and preschoolers, on occasion, may show characteristics of ADHD, some of these behaviors may be normal for their age or developmental stage.

These behaviors must be exhibited to an abnormal degree to warrant identification as ADHD. Even with older children, other factors including environmental influences can produce behaviors resembling ADHD. A person must exhibit several characteristics to be clinically diagnosed as having ADHD:. Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 years. Some impairment from the symptoms is present in two or more settings e. There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning.


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The symptoms do not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder and are not better accounted for by another mental disorder e. The regulations implementing these laws are 34 CFR sections and , respectively, which require school districts to provide a "free appropriate public education" to students who meet their eligibility criteria. IDEA provides funds to state education agencies for the purpose of providing special education and related services to children evaluated in accordance with IDEA and found to have at least one of the 13 specific categories of disabilities, and who thus need special education and related services.

Attention Deficit Hyperactivity Disorder may be considered under the specific category of "Other Health Impairment" OHI , if the disability results in limited strength, vitality, or alertness, including a heightened alertness to environmental stimuli that results in limited alertness with respect to the educational environment and that is due to chronic or acute health problems. Under IDEA, each public agency —that is, each school district —shall ensure that a full and individual evaluation is conducted for each child being considered for special education and related services.

The childs individualized education program IEP team uses the results of the evaluation to determine the educational needs of the child. The results of a medical doctors, psychologists, or other qualified professionals assessment indicating a diagnosis of ADHD may be an important evaluation result, but the diagnosis does not automatically mean that a child is eligible for special education and related services.

A group of qualified professionals and the parent of the child determine whether the child is an eligible child with a disability according to IDEA. After it has been determined that a child is eligible for special education and related services under IDEA, an IEP is developed that includes a statement of measurable annual goals, including benchmarks or short-term objectives that reflect the students needs. The IEP goals are determined with input from the parents and cannot be changed without the parents knowledge.

Disruptive, impulse control, and conduct disorders

Although children who are eligible under IDEA must have an IEP, students eligible under Section are not required to have an IEP but must be provided regular or special education and related aids or services that are designed to meet their individual educational needs as adequately as the needs of nondisabled students are met. Section was established to ensure a free appropriate education for all children who have an impairment — physical or mental — that substantially limits one or more major life activities.

If it can be demonstrated that a childs ADHD adversely affects his or her learning — a major life activity in the life of a child — the student may qualify for services under Section To be considered eligible for Section , a student must be evaluated to ensure that the disability requires special education or related services or supplementary aids and services. Therefore, a child whose ADHD does not interfere with his or her learning process may not be eligible for special education and related services under IDEA or supplementary aids and services under Section IDEA and Section require schools to provide special education or to make modifications or adaptations for students whose ADHD adversely affects their educational performance.

Eligible children with ADHD must be placed in regular education classrooms, to the maximum extent appropriate to their educational needs, with the use of supplementary aids and services if necessary. Of course, the needs of some children with ADHD cannot be met solely within the confines of a regular education classroom, and they may need special education or related aids or services provided in other settings. A diagnosis of ADHD is multifaceted and includes behavioral, medical, and educational data gathering. One component of the diagnosis includes an examination of the childs history through comprehensive interviews with parents, teachers, and health care professionals.

What Causes ADHD?

Interviewing these individuals determines the childs specific behavior characteristics, when the behavior began, duration of symptoms, whether the child displays the behavior in various settings, and coexisting conditions. The American Academy of Pediatrics AAP stresses that since a variety of psychological and developmental disorders frequently coexist in children who are being evaluated for ADHD, a thorough examination for any such coexisting condition should be an integral part of any evaluation AAP, Specific questionnaires and rating scales are used to review and quantify the behavioral characteristics of ADHD.

hoedeathjurol.ga Taken from Green, Wong, Atkins, et al. Technical Review 3. Rockville, MD: U. As with all psychological tests, child-rating scales have a range of measurement error. Appropriate scales have satisfactory norms for the childs chronological age and ability levels. Collecting information about the childs ADHD symptoms from several different sources helps ensure that the information is accurate.

Appropriate sources of information include the childs parents, teachers, other diagnosticians such as psychologists, occupational therapists, speech therapists, social workers, and physicians. It is also important to review both the childs previous medical history as well as his or her school records. An educational evaluation assesses the extent to which a childs symptoms of ADHD impair his or her academic performance at school.

The evaluation involves direct observations of the child in the classroom as well as a review of his or her academic productivity. It is best to collect this information during two or three different observations across several days. Each observation typically lasts about 20 to 30 minutes. In order to receive special education and related services under Part B of IDEA, a child must be evaluated to determine 1 whether he or she has a disability and 2 whether he or she, because of the disability, needs special education and related services.

The initial evaluation must be a full and individual evaluation that assesses the child in all areas related to the suspected disability and uses a variety of assessment tools and strategies. As discussed in the section on Legal Requirements above , a child who has ADHD may be eligible for special education and related services because he or she also meets the criteria for at least one of the disability categories, such as specific learning disability or emotional disturbance. It is important to note that the assessment instruments and procedures used by educational personnel to evaluate other disabilities —such as learning disabilities —may not be appropriate for the evaluation of ADHD.

A variety of assessment tools and strategies must be used to gather relevant functional and developmental information about the child. An educational evaluation also includes an assessment of the childs productivity in completing classwork and other academic assignments. The productivity of the child with ADHD can be compared to the productivity of other children in the class.

Once the observations and testing are complete, a group of qualified professionals and the parents of the child will review the results and determine if the child has a disability and whether the child needs special education and related services. Using this information, the childs IEP team, which includes the childs parents, will develop an individualized educational program that directly addresses the childs learning and behavior. If the child is recommended for evaluation and determined by the childs IEP team not to meet the eligibility requirements under IDEA, the child may be appropriate for evaluation under Section A medical evaluation assesses whether the child is manifesting symptoms of ADHD, based on the following three objectives:.

The guideline, developed by a committee comprised of pediatricians and experts in the fields of neurology, psychology, child psychiatry, child development, and education, as well as experts in epidemiology and pediatrics, is intended for use by primary care clinicians who are involved in the identification and evaluation process.