THE OVERLAP BETWEEN ADHD AND LEARNING DISABILITIES

Transcription

1 THE OVERLAP BETWEEN ADHD AND LEARNING DISABILITIES Stephanie Moulton Sarkis PhD NCC LMHC

2 Stephanie Moulton Sarkis PhD NCC LMHC Ph.D. from University of Florida Author of 4 books on ADHD Private practice in Boca Raton, Florida Counseling and Coaching Adjunct Assistant Professor at Florida Atlantic University Sub Investigator at FAU Clinical Trials Blogger Huffington Post and Psychology Today 2

3 DSM 5 Criteria for ADHD Inattentive type Meets at least 6/9 criteria if 16 or younger Meets at least 5/9 criteria if 17 or older Hyperactive/Impulsive type Meets at least 6/9 criteria if 16 or younger Meets at least 5/9 criteria if 17 or older Combined type Meets criteria for both the Inattentive type and Hyperactive/Impulsive type American Psychological Association (2013) 3

4 Specific Learning Disorder Diagnostic criteria Difficulties learning and using academic skills as indicated by the presence of at least one of the following symptoms that have persisted for at least 6 months, despite interventions Inaccurate or slow and effortful word reading Difficulty understanding the meaning of what is read Difficulties with spelling Difficulties with written expression Difficulties mastering number sense, number facts, or calculation Difficulties with mathematical reasoning 4

5 Specific Learning Disorder Affected academic skills are substantially and quantifiably below those expected for individual s chronological age, and cause significant interference Learning difficulties behind during school age years but may not become fully manifest until demands for those affected academic skills exceed the individual s limited capacities Timed tests, heavy academic loads 5

6 Executive Functions Executive Functions (EFs) are housed in the prefrontal cortex (frontal lobes) of the brain EFs help inhibit and self regulate behavior Similar to the tasks of an executive Direct Process Manage Disseminate information 6

7 ADHD and LDs Overlap ADHD LDs Comorbidity rate of 45.1% Includes Math learning disabilities Reading learning disabilities Writing disorders DuPaul, Gormley, & Laracy,

8 Frontal Lobe & Pre Frontal Cortex 8

9 Executive Functions Working Memory Time Management Behavioral Inhibition Regulation of Emotions Planning Forethought Learning from Consequences Organization Reconstitution of Information Brown 2009; Barkley

10 Available Assistance Medication Counseling Tutoring Coaching Working Memory Training 10

11 Coaching for ADHD and LDs Study of 54 undergraduates with ADHD and/or LD, 7 in depth interviews They felt that coaching Provided a self determined approach to goal attainment Was supportive of their autonomy Helped develop and manage executive function skills Promoted self efficacy and confidence regarding future success Parker & Boutelle

12 Working Memory Training for ADHD and LDs Study participants had greater improvement on Working memory scores Number of ADHD symptoms Cognitive failures Improvements in working memory and cognitive failures were maintained at the 2 month follow up Gropper, et al

13 Recommendations for Scholarly Success in College Seek accommodations Always attend the real class in college Use the online/televised class as a supplement Use study groups Limit the number of participants to four or five Meet with professors regularly Review tests and class notes Get tutoring on a regular basis 13

14 Recommendations for Personal Success Seek help from a counselor and/or coach Receive regular health care Get as much sleep as possible Have a structured schedule Study for 30 minutes, take a 15 minute break Schedule in relaxation time, but not too much! Seek healthy stress reducing outlets 14

15 Seeking Accommodations Accommodations even the playing field so the ADHD/LD student is working at par with his or her peers. Receiving accommodations in high school does not automatically qualify a student for accommodations in college Private colleges are not required to provide accommodations unless they receive federal funding 15

16 Applying for Accommodations Apply through college s Office of Student Disability Services (OSDS) Apply as early as possible Most OSDS require An ADHD evaluation Must list recommended accommodations Copy of accommodations from high school 16

17 Recommended Accommodations Assistance with writing class notes Extended time on tests Testing in a separate and quiet location Permission to record lectures Instructions given in writing Priority in class registration Reduced course load 17

18 Students Records & Privacy Rights Family Educational Rights & Privacy Act (FERPA) College students 17 years old and older have exclusive access to their records Must sign a release to allow parental access to records It is recommended that students allow parents to have access to their records 18

19 Summary ADHD and LDs are commonly cooccuring Many accommodations apply to both disorders Coaching was found to be an effective strategy Start seeking accommodations as soon as child is accepted to a college 19

20 Resources CHADD Learning Disabilities Association of America National Center for Learning Disabilities 20

21 References American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: Author. Barkley, R. A. (2005). Attention Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment. 3rd ed. New York: The Guilford Press. Brown, T.E. (2009). ADD/ADD and impaired executive function in clinical practice. Current Attention Disorders Reports 1(1): DuPaul, G.J., M.J. Gormley, & Laracy, S.D. (2013). Comorbidity of LD and ADHD: Implications for DSM 5 for assessment and treatment. Journal of Learning Disabilities, 46(1): Gropper, R.J., Gotlieb, H., Kronitz, R., & Tannock, R. (2014). Working memory training in college students with ADHD or LD. Journal of Attention Disorders, 1/13/14, doi: / Parker, D.R., and Boutelle, K. (2009). Executive Function Coaching for College Students with Learning Disabilities and ADHD: A New Approach for Fostering Self Determination. Learning Disabilities Research & Practice 24(4):

22 QUESTIONS? 22