Learning Objectives
I'm so glad to be here to discuss ADHD and the ways in which it might impact you as a speech and language community. Before we get started, let's go over the learning objectives. After this course, you should be able to:
- Identify symptoms of the various types of ADHD presentations
- Identify academic, developmental and social weaknesses that may results from an ADHD diagnosis
- Identify some non-medical interventions for children with ADHD
Overview
During the presentation, I'm going to go through the definition of ADHD symptoms and presentation across individuals. There are a lot of myths associated with this disorder that I hope to “bust” throughout the presentation. Additionally, I will discuss how speech and language as a community becomes involved in this disorder and address the treatment objectives. Finally, I will review a brief case study of a child that I've been working with that is also seeing an SLP.
What is ADHD?
Myth #1: ADHD is not a real disorder
This is the first myth that I would like to bust immediately. Within my practice, I hear a lot of concerns from parents, educators, sometimes even individuals that are coming to see me for a diagnosis about whether or not ADHD is a real diagnosis. It is. It's a disorder comprised of deficits in executive function skills.
Executive function skills is a term or concept that people are becoming familiar with, especially within clinical settings. I think this is happening because of our better understanding of how executive functions provide the ability to plan and organize ourselves in order to accomplish goals. Deficits in executive functions is a primary symptom of ADHD.
Executive functions include behavioral inhibition, sustained attention, resistance to distraction, regulating your activity level to the demands of a situation.
Behavior inhibition. Behavior inhibition is the primary executive function that allows all of the other executive functions to function appropriately. Behavior inhibition is the ability to stop what you're doing to allow the other executive functions to take over and guide, plan or organize your behavior.
Behavioral inhibition involves skills such as working memory, internalizing your speech, self-regulating physical behavior and analyzing/synthesizing information in order to accomplish goals. It's probably best exemplified by those videos that show the child sitting at a table with a big bowl of candy on it and they are told, "If you can sit here while I leave and not touch these doughnuts, then you can have two when I walk back in." Honestly, most often the videos are showing children who struggle with behavioral inhibition. They can't internalize their speech. They are talking out loud about what they should do. They're really debating whether or not they should take the candy. They struggle with holding on to the demands of what that person asked them to do, that working memory piece. Often, they can't self-regulate that behavior. They take the treat before the person walks in. That analysis and synthesis of their decision is a tough one.
With that example in mind, that is how I want you to think of what behavioral inhibition is. It's really deficient in kids, individuals and adults with ADHD.
The executive functions are housed in the prefrontal lobe of the brain. The brain develops in a back to front fashion with the pre-frontal lobe being the last part of our brain to actually develop. It's not fully developed when we are born. The research suggests that the prefrontal lobe of the brain isn't fully developed until around the ages of 13 to 17; and that's in typically developing individuals. The prefrontal lobe develops slightly earlier in girls than boys. It develops later in individuals with ADHD compared to typically developing individuals. A male with ADHD may not develop the prefrontal lobe fully until their early college years. You can imagine some of the deficits you're going to see during the adolescent years because of that slow or delayed development.
