The bestselling guide, fully revised and updated, offering practical information and tips to help every child with ADHD succeed
The ADD/ADHD Checklist helps parents and teachers to better understand children and teenagers with attention problems and provide the kind of support and intervention that is crucial to kids' success. Presented in a concise, easy-to-read checklist format, the book is packed with practical advice and information on a wide range of topics, including what we do and don't know about ADHD, probable causes, critical elements for school success, the most commonly prescribed medications, what children with ADHD need at home, effective behavioral strategies, how to help kids stay organized, and advocating for an ADHD child.
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Sandra F. Rief, M.A., is an internationally known speaker, teacher trainer, educational consultant, and author or coauthor of several bestselling books including How to Reach and Teach Children with ADD/ADHD and How to Reach and Teach All Children in the Inclusive Classroom. For more information, go to www.sandrarief.com.
The ADD/ADHD Checklist
The "go to" reference for parents and teachers―fully revised and updated! Whether you are a parent of a child with attention problems or a classroom teacher, this book will help you better understand children and teenagers with ADD/ADHD and give you tools to help them succeed. Sandra Rief, an internationally known expert on ADD/ADHD, offers you the most current information available on the disorder and practical advice on a wide range of topics:
The book follows a simple, concise, easy-to-read checklist format and is filled with valuable information and helpful advice. With the help of The ADD/ADHD Checklist, you can provide the interventions, appropriate strategies, encouragement, and support necessary to help children with attention problems succeed.
Praise for The ADD/ADHD Checklist
"One of the most comprehensive ADHD reference guides ever compiled . . . this book belongs in your ADHD resource library."
―Kathleen Nadeau, Ph.D., co-publisher, ADDvance magazine and coauthor of Learning to Slow Down and Pay Attention and Understanding Girls with AD/HD
"This exceptional book has so many lists brimming with helpful tips, valuable insights, and useful strategies that it deserves to be on everyone's short list of great ADHD books!"
―Dr. Andrew Adesman, chief, Developmental & Behavioral Pediatrics, Schneider Children's Hospital, New York
"An extremely valuable and user-friendly guide for parents, teachers, and professionals to understand, treat, parent, and educate children with ADHD."
―Sam Goldstein, Ph.D., co-author of Raising Resilient Children and Raising a Self-Disciplined Child
The ADD/ADHD Checklist
The go to reference for parents and teachers--fully revised and updated! Whether you are a parent of a child with attention problems or a classroom teacher, this book will help you better understand children and teenagers with ADD/ADHD and give you tools to help them succeed. Sandra Rief, an internationally known expert on ADD/ADHD, offers you the most current information available on the disorder and practical advice on a wide range of topics:
The book follows a simple, concise, easy-to-read checklist format and is filled with valuable information and helpful advice. With the help of The ADD/ADHD Checklist, you can provide the interventions, appropriate strategies, encouragement, and support necessary to help children with attention problems succeed.
Praise for The ADD/ADHD Checklist
One of the most comprehensive ADHD reference guides ever compiled . . . this book belongs in your ADHD resource library.
--Kathleen Nadeau, Ph.D., co-publisher, ADDvance magazine and coauthor of Learning to Slow Down and Pay Attention and Understanding Girls with AD/HD
This exceptional book has so many lists brimming with helpful tips, valuable insights, and useful strategies that it deserves to be on everyone's short list of great ADHD books!
--Dr. Andrew Adesman, chief, Developmental & Behavioral Pediatrics, Schneider Children's Hospital, New York
An extremely valuable and user-friendly guide for parents, teachers, and professionals to understand, treat, parent, and educate children with ADHD.
--Sam Goldstein, Ph.D., co-author of Raising Resilient Children and Raising a Self-Disciplined Child
1.1 ADD, ADHD, AD/HD: WHAT'S THE DIFFERENCE?
AD/HD stands for Attention Deficit/Hyperactivity Disorder. Sometimes it is written with the slash mark (AD/HD) and sometimes without (ADHD). This is the current and official term that is used when referring to this disorder, and it is the umbrella term for the three types of AD/HD: the Predominantly Inattentive type (AD/HD-I), the Predominantly Hyperactive and Impulsive type (AD/HD-HI), and the Combined type (AD/HD-C). Most people diagnosed with ADHD have the combined type of the disorder with significant symptoms in inattention, impulsivity, and hyperactivity.
ADD stands for Attention Deficit Disorder and has been a term associated with this disorder for many years. Many people use ADD interchangeably with ADHD when referring to all types of the disorder, and it is also the term of choice by many when referring to the Predominantly Inattentive type of ADHD, that is, individuals without hyperactivity.
The federal special education law (Individuals with Disabilities Education Act, IDEA) regulations that govern educational rights of children with disabilities refer to both ADD and ADHD among the "other health impairments" that may qualify a student for special education and related services (if they meet all of the other eligibility criteria).
It is likely that there will be changes in the name and abbreviation of this disorder (or among some types of the disorder) in the future.
Throughout the remainder of this book, I just use ADHD (without the slash mark), which is inclusive of all three types.
1.2 DEFINITIONS AND DESCRIPTIONS OF ADHD
There are several descriptions or definitions of ADHD based on the research evidence and most widely held belief of the scientific community at this time, including the following from leading experts and researchers in the field:
ADHD is a neurobiological behavioral disorder characterized by chronic and developmentally inappropriate degrees of inattention, impulsivity, and in some cases hyperactivity.
ADHD is a chronic biochemical, neurodevelopmental disorder that interferes with a person's capacity to regulate and inhibit behavior and sustain attention to tasks in developmentally appropriate ways.
ADHD is a neurological inefficiency in the area of the brain that controls impulses and is the center of executive functions-the self-regulation and self-management functions of the brain.
ADHD is a developmental delay or lag in inhibition, self-control, and self-management.
ADHD is a brain-based disorder that arises out of differences in the central nervous system in both structural and neurochemical areas.
ADHD is a pattern or constellation of behaviors that are so pervasive and persistent that they interfere with daily life.
ADHD is a dimensional disorder of human behaviors that all people exhibit at times to certain degrees. Those with ADHD display the symptoms to a significant degree that is maladaptive and developmentally inappropriate compared to others that age.
ADHD is a developmental disorder of self-control. It consists of problems with regulating attention, impulse control, and activity level. ADHD represents a condition that leads individuals to fall to the bottom of a normal distribution in their capacity to demonstrate and develop self-control and self-regulatory skills.
ADHD is a disorder of inhibition (being able to wait, stop responding, and not respond to an event). Inhibition involves motor inhibition, delaying gratification, and turning off or resisting distractions in the environment while engaged in thinking.
ADHD is a neurobiological behavioral disorder causing a high degree of variability and inconsistency in performance, output, and production.
ADHD is a common although highly varied condition. One element of this heterogeneity is the frequent co-occurrence of other conditions.
1.3 RISK FACTORS ASSOCIATED WITH ADHD
ADHD places those who have this disorder at risk for a host of serious consequences. Numerous studies have shown the negative impact of this disorder without early identification, diagnosis, and proper treatment. Compared to their peers of the same age, youth with ADHD (those untreated for their disorder) experience:
More serious accidents, hospitalizations, and significantly higher medical costs
More school failure and dropout
More delinquency and altercations with the law
More engagement in antisocial activities
More teen pregnancy and sexually transmitted diseases
Earlier experimentation with and higher use of alcohol, tobacco, and illicit drugs
More trouble socially and emotionally
More rejection, ridicule, and punishment
More underachievement and underperformance at school or work
Prevalence of ADHD
Estimates of the prevalence in school-age children range from 3 percent to 12 percent. Most sources agree that somewhere between 5 and 9 percent of children are affected.
Approximately 2 to 4 percent of adults are believed to have ADHD.
The worldwide prevalence of ADHD in children is estimated at approximately 5 percent. The U.S. prevalence rate falls somewhere in the middle range of other reporting countries.
Although this disorder can have serious negative outcomes affecting millions of people when untreated, it is estimated that at least half of the children with ADHD are not receiving treatment, and far more adults remain unidentified and untreated.
More Statistics Associated with ADHD
Between 50 and 75 percent of individuals with ADHD have at least one other disorder or coexisting condition such as anxiety, depression, oppositional defiant disorder, learning disabilities, or speech and language impairments. See checklist 1.7.
Barkley (2000), a leading researcher in the field, cites these statistics:
Almost 35 percent of children with ADHD quit school before completion.
Up to 58 percent have failed at least one grade in school.
At least three times as many teens with ADHD as those without ADHD have failed a grade, been suspended, or been expelled from school.
For at least half of the children with ADHD, social relationships are seriously impaired.
Within their first two years of independent driving, adolescents with a diagnosis of ADHD have nearly four times as many auto accidents and three times as many citations for speeding as young drivers without ADHD (Barkley & Murphy, 1996).
For more information, go to the Web sites of CHADD (Children and Adults with Attention Deficit/Hyperactivity; www.chadd.org), the National Resource Center on ADHD (www.help4adhd.org), and the National Institute of Mental Health (www.nimh.nih.gov/ health/).
1.4 BEHAVIORAL CHARACTERISTICS OF ADHD
The fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and the text revised edition (DSM-IV-TR), published by the American Psychiatric Association, is the source of the official criteria for diagnosing ADHD. The DSM lists nine specific symptoms under the category of inattention and nine specific symptoms under the hyperactive/impulsive category. Part of the diagnostic criteria for ADHD is that the child or teen often displays at least six of the nine symptoms of either the inattentive or the hyperactive-impulsive categories or six of the nine symptoms in both categories.
The checklists that follow contain symptoms and characteristics common in children and teens with ADHD. The specific behaviors listed in the DSM-IV (1994) and DSM-IV-TR (2000) are italicized. Additional symptoms and characteristics associated with ADHD are also included; they are not italicized.
Predominantly Inattentive Type of ADHD
This type of ADHD is what many prefer to call ADD because those diagnosed with it do not have the hyperactive symptoms. They may show some, but not a significant amount of symptoms in the hyperactive-impulsivity category.
These children and teens often slip through the cracks and are not as easily identified or understood. Since they do not exhibit the disruptive behaviors that command attention, it is easy to overlook these students and misinterpret their behaviors and symptoms as "not trying" or "being lazy."
Most people display any of the following behaviors at times and in different situations to a certain degree. Those who truly have an attention deficit disorder have a history of frequently exhibiting many of these behaviors-far above the normal range developmentally. They are pervasive symptoms, exhibited in different settings and environments, and they cause impairment in functioning at school, at home, and in other settings.
Many children with ADHD and significant difficulties with inattention are often able to be focused and sustain attention for long periods of time when they play video games or are engaged in other high-interest, stimulating, and rapidly changing activities.
CHARACTERISTICS AND SYMPTOMS OF INATTENTION
Easily distracted by extraneous stimuli (for example, sights, sounds, movement in the environment)
Does not seem to listen when spoken to directly Difficulty remembering and following directions
Difficulty sustaining attention in tasks and play activities
Difficulty sustaining level of alertness to tasks that are tedious, perceived as boring, or not of one's choosing
Forgetful in daily activities
Does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)
Tunes out; may appear "spacey"
Daydreams (thoughts are elsewhere)
Appears confused
Easily overwhelmed
Difficulty initiating or getting started on tasks
Does not complete work, resulting in many incomplete assignments
Avoids, dislikes, or is reluctant to engage in tasks requiring sustained mental effort such as schoolwork or homework
Difficulty working independently; needs a high degree of refocusing attention to task
Gets bored easily
Sluggish or lethargic (may fall asleep easily in class)
Fails to pay attention to details and makes many careless mistakes (for example, with math computation, spelling, and written mechanics such as capitalization and punctuation)
Poor study skills
Inconsistent performance; one day is able to perform a task and the next day cannot; the student is "consistently inconsistent"
Loses things necessary for tasks or activities (for example, toys, school assignments, pencils, books, or tools)
Difficulty organizing tasks and activities (for example, planning, scheduling, preparing)
ACADEMIC DIFFICULTIES RELATED TO INATTENTION
Reading
Loses his or her place when reading
Cannot stay focused on what he or she is reading (especially if the text is difficult, lengthy, boring, or not of his or her choice reading material), resulting in missing words, details, and spotty comprehension
Writing
Off topic as a result of losing train of thought
Poor spelling, use of capitalization and punctuation, and other mechanics and a poor ability to edit written work as a result of inattention to these details
Math
Numerous computational errors because of inattention to operational signs (plus, minus, multiplication, division), decimal points, and so forth
Poor problem solving due to inability to sustain the focus to complete all steps of the problem with accuracy
Predominantly Hyperactive-Impulsive Type of ADHD
Individuals with this type of ADHD have a significant number of hyperactive-impulsive symptoms; they may have some but not a significant number of inattentive symptoms considered developmentally inappropriate. This type of ADHD is most commonly diagnosed in early childhood, and many of those receiving this diagnosis will be reclassified as having the combined type of ADHD when they get older and the inattentive symptoms become developmentally significant.
Children and teens with ADHD may exhibit many of the characteristics in the lists that follow. Although each of these behaviors is normal in children at different ages to a certain degree, for those with ADHD, the behaviors far exceed that which is normal developmentally (in frequency, level, and intensity). Again, the behaviors written in italics are those listed in the DSM-IV and DSM-IV-TR.
Most children, teens, and adults with ADHD have the combined type of the disorder. That means they have a significant number of inattention, impulsive, and hyperactive symptoms that are chronic and developmentally inappropriate, evident from an early age, and are impairing evident from an early age and are impairing their functioning in at least two environments (such as home and school).
CHARACTERISTICS AND SYMPTOMS OF HYPERACTIVITY
"On the go" or acts as if "driven by a motor"
Leaves seat in classroom or in other situations in which remaining seated is expected Cannot sit still (instead, jumps up and out of chair, falls out of chair, sits on knees, or stands by desk)
Talks excessively
Highly energetic; almost nonstop motion
Runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)
A high degree of unnecessary movement (pacing, tapping feet, drumming fingers)
Restlessness
Seems to need something in hands; finds or reaches for nearby objects to play with or put in mouth
Fidgets with hands or feet or squirms in seat
Is not where he or she is supposed to be (for example, roams around)
Difficulty playing or engaging in leisure activities quietly
Intrudes in other people's space; difficulty staying within own boundaries
Difficulty settling down or calming self
Overall difficulty regulating motor activity
CHARACTERISTICS AND SYMPTOMS OF IMPULSIVITY
Much difficulty in situations requiring waiting patiently
Difficulty with raising hand and waiting to be called on
Interrupts or intrudes on others (for example, butts into conversations or games)
Blurts out answers before questions have been completed
Has difficulty waiting for his or her turn in games and activities
Cannot keep hands and feet to self
Cannot wait or delay gratification; wants things immediately
Knows the rules and consequences but repeatedly makes the same errors or infractions of rules
Gets in trouble because he or she cannot stop and think before acting (responds first, thinks later)
Difficulty standing in lines
Makes inappropriate noises
Does not think or worry about consequences, so tends to be fearless or gravitate to high-risk behavior
Engages in physically dangerous activities without considering the consequences (for example, jumping from heights, riding bike into the street without looking); hence, a high frequency of injuries
Accident prone and breaks things
Difficulty inhibiting what he or she says, making tactless comments; says whatever pops into his or her head and talks back to authority figures
Begins tasks without waiting for directions (before listening to the full direction or taking the time to read written directions)
(Continues...)
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