ADHD Treatment Home Management and School Accommodations Robin K. Blitz, MD. ADHD DIAGNOSTIC CLINIC Week 3

Transcription

1 ADHD Treatment Home Management and School Accommodations Robin K. Blitz, MD ADHD DIAGNOSTIC CLINIC Week 3

2 ADHD Target symptoms Behavioral / Emotional Improvements in: Self-esteem Behavior in public places Compliance with rules Success with reward schedules Social / Family Improvements in: Family relationships Sibling interactions Peer relations Waits turn ADL independence Good sportsmanship Compliance with requests

3 ADHD Target symptoms Academic improvements in: Grades / Academic productivity Attention to details Fewer careless mistakes Following directions with less reminders Organization Brings homework home Turns in homework Brings supplies to class Uses planner Safety improvements in: Less climbing / running in inappropriate situations Wearing helmet / riding safety Wearing seatbelt Driving Less injuries

4 Home Management Structure, Consistency, Routine Firm, consistent, predictable limits, rules, and consequences Consistent bedtime, scheduled mealtimes, structured quiet time for homework Teach organization set example Positive Behavior Management Chronic Care Model introduced to Parents

5 Home Management Positive Behavior Management Effective for targeted behaviors, not helpful in reducing basic ADHD symptoms Appropriate expectations Point system Concrete rewards for targeted positive behaviors Time out - Time In / Contingent Attention Respond to child with positive attention when desired behaviors occur Withhold attention when undesired behaviors occur

6 Home Management Chronic Care Model Establish Treatment program with family / specify target outcomes to guide treatment Systematic follow-up If child does not meet target outcomes, then re-evaluate original diagnosis, use of appropriate treatments, adherence to treatment plan, and presence of comorbidities

7 Parent Support Parent-to-Parent Support Groups See resource list in Emily Packet PCH Psychology Parent Training Group 10-week curriculum Weekly, 1 ½ - 2 hours per session

8 School Services Evaluation Psychoeducational Assessment Speech / Language Evaluation Occupational Therapy Evaluation Hearing and Vision Screen 504 Plan Accommodations in the classroom IEP If ADHD or other issues impair ability to function in regular classroom environment

9 School Services Evaluation To rule out other contributing factors to child s difficulties with learning: LD Communication Disorder ID To evaluate level of ADHD impairment OHI

10 School Services 504 Plan 1973 Rehabilitation Act Modification of regular curriculum because of a diagnosed impairment which substantially limits learning or school performance Under regular education Interventions Physical: Preferential seating, Quiet areas for test-taking Instructional: Shorter assignments, repeat and simplify directions Behavioral: Frequent breaks, communicate with parents and teachers, Positive reinforcement

11 School Services Behavioral Contingency Management Goal Improve the clarity and specificity of expectations and increase the frequency of feedback and the power of reinforcers Daily Report Card Teachers provide daily feedback about identified target behaviors Student brings report card home daily Parents provide daily rewards for good performance

12 School Services IEP Under IDEA ADHD leads to heightened awareness to environmental stimuli which results in limited awareness of educational environment, thus adversely affects educational performance For ADHD, under OHI Impairment of academic performance and productivity Make sure to include other supports if necessary: Speech / Language Social Skills OT Organizational Skills

13 ADHD Management