Professional Documents
Culture Documents
1381 Westby Carol
1381 Westby Carol
Condition
(disorder/disease)
Environmental Personal
Factors Factors
DSM-IV Criteria for ADHD
I. Either A or B:
A. Six or more of the following symptoms of inattention have been
present for at least 6 months to a point that is disruptive and
inappropriate for developmental level:
Inattention
• Often does not give close attention to details or makes careless mistakes
in schoolwork, work, or other activities.
• Often has trouble keeping attention on tasks or play activities.
• Often does not seem to listen when spoken to directly.
• Often does not follow instructions and fails to finish schoolwork, chores, or
duties in the workplace (not due to oppositional behavior or failure to
understand instructions).
• Often has trouble organizing activities.
• Often avoids, dislikes, or doesn't want to do things that take a lot of
mental effort for a long period of time (such as schoolwork or homework).
• Often loses things needed for tasks and activities (e.g. toys, school
assignments, pencils, books, or tools).
• Is often easily distracted.
• Is often forgetful in daily activities.
B. Six or more of the following symptoms of hyperactivity-impulsivity
have been present for at least 6 months to a point that is disruptive
and inappropriate for developmental level:
Hyperactivity
• Often fidgets with hands or feet or squirms in seat.
• Often gets up from seat when remaining in seat is expected.
• Often runs about or climbs when and where it is not appropriate
(adolescents or adults may feel very restless).
• Often has trouble playing or enjoying leisure activities quietly.
• Is often "on the go" or often acts as if "driven by a motor".
• Often talks excessively.
• Impulsivity
• Often blurts out answers before questions have been finished.
• Often has trouble waiting one's turn.
• Often interrupts or intrudes on others (e.g., butts into conversations or
games).
C. Some symptoms that cause impairment were present before age 7 years.
D. Some impairment from the symptoms is present in two or more settings
(e.g. at school/work and at home).
E. There must be clear evidence of significant impairment in social, school,
or work functioning.
Based on these criteria, three
types of ADHD are identified:
Jason, 8, on medication
ADHD – predominantly hyperactive/
Impulsive (may be moving to
combined type)
Zach, age 15
ADHD – predominantly inattentive;
Sluggish cognitive tempo;
Comorbid language/learning disability
Parent Concerns
for Zach
Professional
Expertise
Clinical
Client Research
Decision
Evidence Evidence
Making
Barkley’s Definition of ADHD
• Reading problems
– Failure to monitor comprehension
– Failure to understand main ideas
– Difficulty with inferencing
• Failure to use language to regulate
behavior and plan
• Motor development and motor planning
Black
Blue
Red
Yellow
Green
Orange
Stroop Day-Night Test
Animal Stroop:
Name the body of the animal
Animal Stroop Task
Types of Cohesion
Category Type Examples
Conjunction Additive The boy saw the present and he read the tag.
Adversative The boy took his dog and baby frog on the raft,
but the big frog wasn’t allowed to come.
Causal The big frog bit the little frog because he didn’t
want another frog in his life.
Temporal When the baby frog saw the big frog on the raft,
he was worried.
Referential Pronominal The boy got a present. He opened it.
Demonstrative The big frog kicked the little frog. He shouldn’t
do that.
Comparative The boy had two frogs. The bigger one was
mean.
Lexical Max got a thistle for a shell. The thistle hurt the
Same word snail’s back.
Max was mad at the bird. He was furious.
Synonym Max tried a thistle, rose, and a mushroom. None
Superordinate of the plants worked.
Types of Cohesion
It is fun to see it. Becuase people are doing dangerous things like,
makking lions jump through hoops.
It is dangerous and scary to see it, but people are trained to do it. It looks
cool.
People have a lot of fun. People always cheer after ever trick. They are
so happy to come.
Dewitz, P., & Dewitz, P.K. (2003). They can read the words, but they can’t
understand: Refining comprehension assessment. The Reading Teacher,
56:5, 422-435.
The Octopus – 5th grade
Concept Questions
• What is an octopus?
– A big creature with 8 legs
• Why does an animal attack another animal?
– Wants to eat it
• What are animal defenses?
– Pine needles, claws
• What is animal camouflage?
– So things can’t see it
• Prediction
– Octopus attacking humans
The Octopus – 5th grade
• Explicit questions
– What is the favorite food of the octopus?
(crabs)
– How does the octopus move forward very
rapidly when it is frightened? Pushes water
from its body
– What does the ink-like fluid do to the water?
Makes it dark (not specific enough)
– What is one color that an octopus can change
to? Pink and blue
The Octopus – 5th grade
• Implicit
– What is this passage mainly about? An
octopus and what it does when it’s scared or
excited (relational inference across text)
– Why doesn’t an octopus completely change
color when it sees a crab? Don’t know (causal
inference across text)
– What color does an octopus probably become
when it sees an enemy? Dark (relational
inference from text)
– Why might the shy octopus attack another
creature? If hurt (over reliance on prior
knowledge)
Theory of Mind & Emotion
Understanding
Davis, M., & Stone, T., (2003). Synthesis: Psycholgical understanding and social skills.
In B. Repacholi & V. Slaugher (Eds.), Individual differentes in theory of mind:
Implications for typical and atypical development (pp. 306-352). New York: Psychology
Press.
Theory of Mind Emotion Understanding
identifies emotions from faces and photos
judges that 2 persons can have different desires identifies causes of emotions
about the same object
recognizes that persons’ emotional reactions
depend on their desires
recognizes that 2 persons can have different
beliefs about the same object when the child
Pons,R. Harris, P., & M. de Rosnay (2004).
doesn’t know which is true Emotion comprehension between 3-11
judges another person’s false belief about what years : Developmental periods and
is in a distinctive container when the child hierarchical organization. European Journal
of Developmental, 1, 127-152
knows what is in the container
judges how someone will search given that
person’s false belief
recognizes that beliefs determine emotions even
if belief is false
understands words such as know, forget, realizes that intensity of emotion decreases with
remember, guess time
can use strategies to control one’s emotions
Wellman, H.M. & Liu, D. (2004). Scaling of can hide a felt emotion from others; knows
theory-of-mind tasks. Child Development, 75, social rules for hiding emotions
523-541.
understands that persons can have more than one
emotion at a time
Sad
1 2 3 4 5 6
Lonely Disappointed Discouraged Despairing Agonizing Maudlin
Lost tearful Gloomy Devastated Anguished
Sad Heartache Disillusioned Condemned
Tired homesick Dismayed Grave
Upset Hysterical Distraught Overwrought
Troubled Empty Pining
Weak Grieving Subdued
Withdrawn Resigned Tormented
Turmoil
Blank, M., Rose, S.A., Berlin, L.J. (1978). The language of learning:
The preschool years. New York: Grune & Stratton.
Early Childhood
(Alternative Thinking)
• Johnny has been playing with
this truck for a long time, all
morning, and now Jimmy
wants a chance to play with it.
What can Jimmy do or say so
he can have a chance to play
with the truck?
• Peter broke his mom’s favorite
flower pot and his mom might
be mad at him. What could
Peter say or do so that his
mom will not be mad?
Spivack, G., Platt, J.J., & Shure, M.. (1976). The problem-solving approach to
adjustment. San Francisco: Jossey-Bass.
Middle Childhood
(Means-End Thinking)
Child is told the beginning and end of a story and is
asked to fill in the middle, tell what happens in
between, or tell how the ending got to be that way.
Al (Joyce) moved into the neighborhood. He (she) didn’t
know anyone and felt very lonely. The story ends with Al
(Joyce) having many good friends and feeling at home
in the neighborhood. What happens in between Al’s
(Joyce’s) moving in and feeling lonely, and when he
(she) ends up with many good friends.
Spivack, G., Platt, J.J., & Shure, M.. (1976). The problem-solving
approach to adjustment. San Francisco: Jossey-Bass.
Adolescence
(Consequential Thinking)
George is in training. The football coach has a rule
that all members of the team get to bed early during
the week. George gets invited to a Tuesday night
social in the next town by a girl he likes a lot. If he
goes, he’ll end up getting to bed rather late. He would
really like to go.
Tell everything that goes on in George’s mind
and then tell what happens.
Spivack, G., Platt, J.J., & Shure, M.. (1976). The problem-solving
approach to adjustment. San Francisco: Jossey-Bass.
Conflict Resolution
John’s teacher assigned him to work with three other boys on a
project for the science fair. The boy’s decided to build a model
airplane that could actually fly. All of the boys, except one, a boy
named Bob, worked hard on the project. Bob refused to do
anything and just let the others do all the work. This bothered
John very much. Now I’d like you to tell the story back to me.
Now I’d like to ask you some questions about the story.
1. What is the main problem?
2. Why is that a problem?
3. What is a good way for John to deal with Bob?
4. Why is that a good way for John to deal with Bob?
5. What do you think will happen if John does that?
6. How do you think they both will feel if John does that?
Nippold, M.A., Mansfield, T.C., Billow, J.L. (2007). Peer conflict explanations in
children, adolescents, and adults: Examining the development of complex syntax.
American Journal of Speech-Language Pathology, 1, 1798-188.
Ways social skills
affect academics
• Teacher-student relationships
– Teacher may spend more time addressing child’s
behavioral issues then teaching child academic
concepts
• Peer relationships
– Child not selected for peer work groups
– Child does not fully participate in learning groups
• Ability to make inferences from texts
– If child does not understand emotionality and
temporal-cause/effect relationships in social
situations, cannot use this information to build
mental models for texts
Specific targets/outcomes
Emotional Understanding
Temporal Problem
Solving Non-verbal
sequence
& cause cues
and effect
Underlying Principles:
Explicit teaching
• Repeated exposures
• Variety of contexts
• Practice in safety
Developing episodic memory
McGuigan, F., & Salmon, K. (2004). The time to talk: The influence of the timing of
adult-child talk on children’s event memory. Child Development, 75, 669-686.
Tulving, E. (1993). What is episodic memory? Current Directions in Psychological
Science, 2, 67-70.
Outcomes focus on
participation
• Capacity goal
– Zach will identify when his clinician is
indicating boredom.
• Participation goal
– Zach will make and keep a friend
– Zach will invite a friend to a movie,
arranging time, place and
transportation
Emotional
understanding
Problem
Solving
Temporal,
cause/effect Noverbal
relationships cues
Scripts and role-plays
• Asperger’s
• Normal language scores
• Emotional understanding and script
examples
– “I want a snack and a friend”
– “Ms. Robinson embarrassed me”
• Parent concerns
– Play in peace with her siblings
– Listen and pay attention to others
Value of Scripts and
Role-plays
• Write out the script beforehand
• Props act as cues and supports
• Practice variations
• Focus on emotions
• Slow down the interaction
• Problem solve solutions when things go wrong
• Confederates both as role models and as
troublemakers
• Explicit teaching, debriefing is critical, more critical in
establishing the episodic memory than the prep
work
Ryan’s profile
• Classic SLI
• Highly motivated to participate
• Lacks sophisticated emotional understanding
• Takes over the conversation
• Parent concerns
– Let others talk about what they want to talk
about
– Let others talk!
Value of Videos
• Visual
• Slow things down
• Turn the sound off
• Focus on the non-verbal cues
• Watch it over and over again
• Too subtle=too hard to figure out/start with
the obvious and work towards subtle
• Target what the child is actually doing in a
non-threatening way
• Funny/OTT or more subtle, depending on
the needs of the client
Conversation game
• Classic SLI
• Highly motivated to participate
• Lacks sophisticated emotional understanding
• Takes over the conversation
• Parent concerns
– Let others talk about what they want to talk
about
– Let others talk!
Value of the
Conversation Game
• Practice
• Cause and effect
– Pre-teaching
• Conversational responsiveness
– Checking in with the other person
– Adjusting to the partner, changing
• Balanced turn taking
• Not static but dynamic, changing, flexible
Measuring progress:
• 1-5 scale
– Emotions
– Content
– Appropriate turn taking/responsiveness
– Non-verbal cues
– Amount of support needed from the clinician
• Parent report
Zach profile
• Narratives
• Content
• On IEP for LD but no speech services
• Parent concerns
– Doesn’t have friends
– Doesn’t understand that he isn’t acting like
others
– Loud and obnoxious
– Acts like a younger child
Jason profile
• ADHD only
• Academics
• Social
– Nice kid
– No clue how long he talks
• Parent concerns
– Starting to run into academic
problems
– Behavior!
Bibliography
•American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th
ed., text rev.). Washington, DC: Author.
•Baker, L., & Cantwell, D.P. (1992). Attention deficit disorder and speech/language disorders.
Comprehensive Mental Health Care, 2, 3-16.
•Barkley, R.A. (2006). A theory of ADHD. In R.A. Barkley (Ed.), Attention-deficit hyperactivity disorder
(pp.297-334). New York: Guilford.
•Barkley, R.A. (2005). ADHD and the nature of self-control. New York: Guilford.
•Beitchman, J.H., Brownlie, E.B., & Wilson, B. (1996). Linguistic impairment and psychiatric disorder:
Pathways to outcomes. In J.H. Beitchman, N.J. Cohen, M. Konstantareas, & R. Tannock (Eds.),
Language, learning and behavior disorders (pp. 493-514). Cambridge: Cambridge University Press.
•Berk, L.E., Potts, M.K. (1991). Development and functional significance of private speech among
attention-deficit hyperactivity disorder and normal boys. Journal of Abnormal Child Psychology, 19,
357-377.
•Beitchman, J., Tuckett, M., & Bath, S. (1987). Language delay and hyperactivity in preschoolers:
evidence for a distinct group of hyperactives. Canadian Journal of Psychiatry, 32, 683-687.
•Brock, S.W., & Knapp, P.K. (1996). Reading comprehension abilities of children with attention-
deficit/hyperactivity disorder. Journal of Attention Disorders, 1, 173-186.
•Brown, T.E. (2006). Executive functions and attention deficit hyperactivity disorder: Implications of
two conflicting views. International Journal of Disability, Development and Education, 53(1), 35-46.
•Bruce, B., Thernlund, G., & Nettelbladt (2006). ADHD and language impairment. European Child and
Adolescent Psychiatry, 15, 52-60.
•Cadesky, E.B., Mota, V.L., & Schachar, R., (2000). Beyond words: How do children with ADHD
and/or conduct disorder process nonverbal information about affect? Journal of the American
Academy of Child & Adolescent Psychiatry, 39(9), 1160-1167.
•Camarata, S.M., & Gibson, T. (1999). Pragmatic language deficits in attention-deficit hyperactivity
disorder (ADHD). Mental Retardation and Developmental Disabilities Research Reviews, 5, 202-
214.
•Cantwell, D., & Baker, L. (1991). Psychiatric and developmental disorders in children with
communication disorder. Washington, DC: American Psychiatric Press.
•Cherkes-Julkowski, M. & Stolzenberg, J. (1991). Reading comprehension, extended processing
and attention dysfunction. ERIC EJ427050.
•Cohen, N., Menna, R., Vallance, D. (1998). Language, social cognitive processing, and behavioral
characteristics of psychiatrically disturbed children with previously identified and unsuspected
language impairments. Journal of Child Psychology and Psychiatry, 39, 853-864.
•Denkla, M.B. (1994). Measurement of executive function. In G.R. Lyon (Ed.), Frames of reference
for the assessment of learning disabilities: New views on measure issues (pp. 117-142). Baltimore:
Brookes.
•Flory, K., Milich, R., Lorch, E.P., Hayden, A.N., Strange, C., & Welsh, R. (2006). Online story
comprehension among children with ADHD: Which core deficits are involved? Journal of Abnormal
Child Psychology, 34, 850-862.
•Gillam, R.B., & Pearson, N.A. (2004). Test of narrative language. Austin, TX: Pro-Ed.
•Grodzinsky, G.M., & Diamond, E. (1992). Frontal lobe functioning in boys with attention-deficit
hyperactivity disorder. Developmental Neuropsychology, 8, 427-445.
•Hamlett, K.W., Pelligrini, D.S., & Conners, C.K. (1987). An investigation of executive processes in
the problem-solving of attention deficit disorder-hyperactivity children. Journal of Pediatric
Psychology, 12, 227-240.
•Humphries, T., Koltun, H., Malone, M., & Roberts, W. (1994). Teacher-identified oral language
difficulties among boys with attention problems. Journal of Developmental and Behavioral
Pediatrics, 15, 92-98.
•Kim, O.H., & Kaiser, A.P. (2000). Language characteristics of children with ADHD. Communication
Disorders Quarterly, 21(3), 154-16.
•Leslie, L., & Caldwell, J. (2005). Qualitative reading inventory—4. Boston: Allyn & Bacon.
•Lorch, E.P., Milich, R., Sanchez, R.P., van den Broek, P., Baer, S. Hooks, K., Hartung, C., &
Welsh, R. (2000). Comprehension of televised stories in attention deficit hyperactivity disordered
and nonreferred boys. Journal of Abnormal Psychology, 109, 321-330.
•Lorch, E.P., Berthiaume, K.S., Milich, R., van den Broek, P. (2007). Story comprehension
impairments in children with attention-deficit/hyperactivity disorder. In K. Cain & J. Oakhill (Eds.),
Children’s comprehension problems in oral and written language (pp. 128-156). New York: Guilford.
•Lorch, E., Milich, R. Astrin, C., & Berthiaume, K. (2006). Cognitive engagement and story
comprehension in typically developing children and children with ADHD from preschool through
elementary school. Developmental Psychology, 42, 1206-1219.
•McBuernett, K., Pfiffner, L.J., & Frick, P.J. (2001). Symptom properties as a function of ADHD type:
An argument for continued study of sluggish cognitive temp. Journal of Abnormal Child Psychology,
29, 207-213.
•McInnes, A., Humphries, T., Hogg-Johnson, S., & Tannock, R. (2003). Listening comprehension
and working memory are impaired in attention-deficit hyperactivity disorder. Journal of Abnormal
Child Psychology, 31:4, 427-443.
•Milich, R., Balentine, A.C., & Lyman, D.R. (2001). ADHD/combined type and ADHD/predominantly
inattentive type are distinct and unrelated disorders. Clinical Psychology: Science and Practice, 8 ,
463-488.
Multimodal Cooperative Group (1999). A 14-month randomized clinical trial of treatment
strategies for attention-deficit/hyperactivity disorders. Archives of General Psychiatry, 56, 1073-
1086.
Multimodal Cooperative Group (2004). National Institute of Mental Health Multimodal Treatment
Study of ADHD follow-up: changes in effectiveness and growth after the end of treatment.
Pediatrics, 113, 762-769.
Oram, J., Fine, J., Okamoto, C., & Tannock, R. (1999). Assessing the language of children with
attention deficit hyperactivity disorder. American Journal of Speech-Language Pathology, 8, 72-
80.
Pelc, K., Kornreich, C., Foisy, M., Y Dan, B. (2006). Recognition of emotional facial expressions
in attention-deficit hyperactivity disorder. Pediatric Neurology, 35(2), 93-97.
Pennington, B.F., Bennetto, L., McAleer, O., & Roberts, R.J. (1996). Executive functions and
working memory: Theoretical and measurement issues. In G.R. Lyon & N.A. Krasnegor (Eds.),
Attention, memory and executive function. Baltimore: Brookes.
Pennington, B.F., & Ozonoff, S. (1996). Executive functions and developmental
psychopathology. Journal of Child Psychology and Psychiatry, 37, 51-87.
Purvis, K.L., & Tannock, R. (1997). Language abilities in children with attention deficit
hyperactivity disorder, reading disabilities, and normal controls. Journal of Abnormal Child
Psychology, 25, 133-144.
Rapport, L.J., Friedman, S.L., Tzelepis, A., & Van Voorhis, A. (2002). Experienced emotion and
affect recognition in adult attention-deficit hyperactivity disorder. Neuropsychology, 16, 102-110.
Rapport, M.D., Tucker, S.B., DuPaul, G.J., Merlo, M., & Stone, G. (1986). Hyperactivity and
frustration: The influence of control over and size of rewards in delaying gratification. Journal of
Abnormal Child Psychology, 14, 192-204.
Reader, M.J., Harris, E.L., Schuerholz, L.J., & Denkla, M.B. (1994). Attention deficit
hyperactivity disorder and executive dysfunction. Developmental Neuropsychology, 10, 493-
512.
Redman, S.M. (2005). Differentiating SLI from ADHD using children’s sentence recall and
production of past tense morphology. Clinical Linguistics & Phonetics, 19(2), 109-127.
Renz, K., Lorch, E.P., Milich, R., Lemberger, C., Bodner, A., & Welsh, R. (2003). Online story
representation in boys with attention deficit hyperactivity disorder. Journal of Abnormal Child
Psychology, 31, 93-104.
Routh, D.K. & Schroeder, C.S. (1976). Standardized playroom measures as indices of
hyperactivity. Journal of Abnormal Child Psychology, 4, 199-207.
Shure, M.B. (1997). Interpersonal cognitive problem solving: Primary prevention of early high-risk
behaviors in the preschool and primary years. In G.W. Albee & T.P. Gullotta (Eds.), Primary
prevention works (pp. 167-188). Thousand Oaks, CA: Sage.
Snowling, M.J., Bishop, D.V.M., Stohard, S.E., Chipchase, B., & Kaplan, C. (2006). Psychosocial
outcomes at 15 years of children with a preschool history of speech-language impairment.
Journal of Child Psychology and Psychiatry, 47(8), 759-765.
Tannock, R., & Schachar, R. (1996). Executive dysfunction as an underlying mechanism of
behaviour and language problems in attention deficit hyperactivity disorders. In J.H. Beitchman,
N.J. Cohen, M.M. Konstantareas, R. R. Tannock (Eds.), Language learning and behavior
disorders: Developmental, biological, and clinical perspective (pp. 128-155). New York:
Cambridge University Press.
Tannock, R., & Schachar, R. (1996). Executive dysfunction as an underlying mechanism of
behaviour and language problems in attention deficit hyperactivity disorders. In J.H. Beitchman,
N.J. Cohen, M.M. Konstantareas, R. R. Tannock (Eds.), Language learning and behavior
disorders: Developmental, biological, and clinical perspective (pp. 128-155). New York:
Cambridge University Press.
Tannock, R., Purvis, K.L., & Schachar, R.J. (1992). Narrative abilities in children with attention
deficit hyperactivity disorder and normal peers. Journal of Abnormal Child Psychology, 21, 103-
117.
Tirosh, E., & Cohen, A. (1998). Language deficit with attention-deficit disorder: A prevalent
comorbidity. Journal of Child Neurology, 13, 493-497.
Westby, C.E. & Cutler, S. (1994). Language and ADHD: Understanding the bases and treatment of
self-regulatory behaviors. Topics in Language Disorders, 14(4), 58-76.
Walcott, C.M., & Landau, S. (2004). The relation between disinhibition and emotion regulation in boys
with attention deficit hyperactivity disorder. Journal of Clinical Child and Adolescent Psychology, 33,
772-782.
Whalen, C.K., Henker, B., Collins, B.E., McAuliffe, S, & Vaux, A. (1979). Peer interaction in structured
communication task: Comparison of normal and hyperactive boys and of methylphenidate and
placebo. Child Development, 50, 388-401.
Willcutt, E.G., Doyle, A.E., Nigg, J.T., Faraone, S.V., & Pennington, B. (2005). Validity of the executive
function theory of attention-Deficit/hyperactivity disorder: A meta-analytic review. Biological Psychiatry,
57(11), 1336-1346.
World Health Organization (2005). International classification of diseases and health related problems:
ICD-10 (2nd ed.). Geneva: Author.
Zentall, S.S. (1988). Production deficiencies in elicited language but not in spontaneous verbalization
of hyperactive children. Journal of Abnormal Child Psychology, 16, 657-673.