There has been a large amount of information with varying conclusions and recommendations published about ad/hd



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CHAPTER I
THE PROBLEM

Introduction

There has been a large amount of information with varying conclusions and recommendations published about AD/HD (Attention Deficit / Hyperactivity Disorder). More and more research is being conducted in the medical and educational fields, but data among the various research groups is conflicting. The “Disorder” has become a topic of controversy among medical professionals and educators. There also has been a tremendous amount of media coverage on the medicated AD/HD child which includes one-sided accounts, hearsay, sensationalism, misconceptions, and unsubstantiated claims causing a whirlwind of rumor, speculation, and confusion about the disorder. Battle lines have been drawn, and caught in the middle of this controversial cyclone are the student with AD/HD, his parents, and the teacher (responsible for the education of the student with AD/HD and the other students of varying learning styles and differences in the classroom).

The first day of a new school year signals the beginning of the teacher’s quest to uncover and identify the different student learning styles and

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preferences represented in the classroom. No two students display identical

learning personalities. Individuals perceive and process information in many

different ways. The teacher crafts his/her lessons plans to enhance student

learrning perception, feeling, creativity, imagination, critical thinking, and problem solving skills. The classroom reflects the appropriate visual stimuli to engage student learning. A variety of course delivery modes and activities are included in the curriculum mix to stimulate the various learning styles of all the students. The classroom’s instructional climate is at the proper textbook settings for nurturing and cultivating a successful learning classroom learning environment.

During the first day assessment of the various learning differences and styles of the students, the teacher discovers the presence of a student diagnosed with Attention Deficits Disorder (AD/HD). Suddenly, it seems as if the bottom has fallen out of the painstakingly prepared lesson plans. The school year takes a detour down a more challenging road. There is no predicting how the student with AD/HD will react to the classroom, the course structure, and the other students in the room. There is no predicting how the other students will react to the student with AD/HD.

The teacher’s responsibility in the classroom, as defined by Randy Lee Comfort (1992), is to prepare the environment for children to learn through active exploration and interaction with adults, other children, and materials. “The caring classroom is one which affords an opportunity for a child to learn with an adult who

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provides security for every student at whatever level the child may be developmentally.” However, when faced with the reality of a classroom filled with



various learning personalities and learning differences, including one or more AD/HD student(s), Comfort’s textbook statement seems rather lofty and ideal.

The AD/HD student presents a unique set of challenges to the teacher. Children with attentions deficits learn best in very small, controlled settings in which there are few distractions. The ideal classroom structure and environment for the more traditional learner, with a variety of visual and auditory stimuli, is probably the worst for the AD/HD student. Colorful walls decorated with posters, maps, and charts may be stimulating to most students, but they are a distraction to the student with attention deficits.

The AD/HD student does not retain course instruction delivered in a straight lecture format. Even the traditional student will struggle with lecture-style instruction. Only 15 % of the student population tend to be auditory learners; and, according to statistics, students retain only 26% of what they hear (Rief 1993). The student with AD/HD will retain far less from lecture-style delivery. He may to fidget and make sounds that distract the other students in the class. He is not doing this on purpose. He is unaware of his actions.

Learning stations and centers with different activities, sounds and movements simultaneously taking place throughout the room become overwhelming for the student with AD/HD. AD/HD students tend to be concrete learners and succeed in a learning environment that is consistent and predictable. Providing a consistent learning


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environment for the AD/HD student, without detracting from the learning environment of the others in the classroom seems an insurmountable task.

Not only does the AD/HD student become overwhelmed in the classroom environment, the teacher equally becomes overwhelmed attempting to provide a stimulating learning atmosphere for all the students in the classroom.



The Definition of AD/HD

Since 1990, the total number of students diagnosed with AD/HD has

increased from 900,000 to approximately 7 million (Jensen 2000). Sandra Rief, M.A.

points out that many children with this disorder slip through the cracks.

AD/HD is diagnosed between 3 to 9 times more frequently in boys than girls.
It is believed that many more girls actually have AD/HD and aren’t diagnosed
because of then they exhibit fewer of the disruptive behaviors associated with
hyperactivity and impulsivity. Many girls have the predominantly inattentive
type of the disorder and are likely not being identified and diagnosed. (Rief 1998)

AD/HD affects approximately 3% to 5% of the school-aged population. These estimates rise to 6.8% - 10% when comorbid symptoms (the presence of more than one mental disorders), along with learning and behavioral differences are added to diagnosis. Other estimates put the percentage of school-aged children affected with AD/HD as high as 23% (Bender 1997). It is estimated that at least one student with AD/HD is present in today’s classroom.

Through his work and research on AD/HD, Dr. Sam Goldstein, University of Utah and the University Neuropsychiatry Institute, contends, “AD/HD is a very common condition, affecting at least one out of twenty kids to
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a significantly impairing degree.” No two students diagnosed with attention deficits interact and learn the same. Dr. Goldstein (2001) points

out, “in school settings, children with AD/HD demonstrate a normal range of intellectual ability. Thus 2 % of the population of children receiving a diagnosis of AD/HD suffers from sub-borderline intellectual ability with 2 % demonstrating gifted intellect.” Many times the gifted AD/HD masks learning disabilities and other disorders such as anxiety, oppositional behavior, and depression. A student often is labeled inconsistent and lazy by the classroom teacher. One day the child performs brilliantly, the next day she is dull and unresponsive. This labeling adds to the AD/HD student’s low self-esteem and self-doubt.

AD/HD is not a learning disability. It is classified as a neurological or mental disorder. To be tagged with a mental disorder further contributes to low self-esteem and self-doubt, particularly in older children and adults. Dr. Larry Silver, a Child and Adolescent Psychiatrist and Clinical Professor of Psychiatry at Georgetown University Medical Center, defines AD/HD as a neurologically-based disorder caused by a deficiency of a specific neurotransmitter in a specific set of brain circuits:

AD/HD is categorized in two types, Attention Deficit Hyperactivity
Disorder (AD/HD) and Undifferentiated Attention Deficit Disorder
(AD/HD/WHO – Attention Deficit Disorder Without Hyperactivity).
The diagnosis is determined by three behavior categories, Attention Span, Hyperactivity, and Impulse Control. Specific behavior characteristics are

listed under each category. An AD/HD student might fall into one category,

but it is possible for the student to display characteristics from all three.

The AD/HD student might talk excessively and be disruptive, or quiet and shy.

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It might be hard to draw the student into a class discussion or the student may
be impatient, unable to wait his or her turn, and blurt out answers. (2001)
Thus, it becomes more of a challenge for the teacher to define the typical AD/HD student’s learning personality. There is no such thing as a typical, textbook AD/HD student.

There are some commonalities that seem to prevail among AD/HD students in general. Unimportant sights and sounds tend to be distractions, and drive the student’s mind to jump from one thought or activity to the next. How the student reacts to this tendency is different from individual to individual. Some students become restless and disruptive; other students drift off and daydream. Whatever the reaction, attention and the ability to focus and organize are requirements for success in school. Here lies the challenge for the classroom teacher. When faced with a classroom of 30 students with multiple learning differences and personalities, some difficult to identify, as is the case with the student diagnosed as AD/HD; how can learning activities and exercises be worked into lesson plans that meet the needs of each individual student? The time factor alone makes it impossible. Many educators are discovering that meeting the learning needs of the students isn’t in varying the lesson plans, but in the tools

available to assist each individual student to receive, organize, process, and retain information. In the same manner many that coaches of youth sports, through the use of various motivational methods and assistive skill building devices, strive to create an equal and level playing field for the young participants of varying

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physical abilities; classroom teachers must strive to create an equal and level learning field for their students of varying learning styles and abilities. More and more teachers and school administrators are turning to multisensory instructional methods and assistive technology devices to establish an equal and level field of learning for all the students in the classroom, including the student with AD/HD.




Definition of Assistive Technology (AT)

The Technology-Related Assistance for Individuals with Disabilities Act of 1988 defines an assistive technology device or tool as any item, piece of equipment, or product that is used to increase, maintain, or improve the abilities of people with disabilities. AD/HD affects the student’s ability to focus, organize, listen, process information and communicate. Assistive technology tools have been proven to greatly improve the student’s reading, writing, spelling, and math skills, and the ability to achieve success in school. Functioning as a bypass, AT helps the student work around or compensate for learning or attention deficits. From highlighting markers to mind mapping and outlining software, AT devices help the student with AD/HD rely less on others and more on themselves to

successfully complete their work. Electronic devices such as computers, word processing software with spell checkers, pocket organizers, and calculators have made it possible for many AD/HD students to focus, organize, complete assignments and effectively accomplish tasks and assignments in a variety of classroom settings. Affordable and available, assistive technology tools help

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students of all ages and learning styles to learn, practice, and use skills essential to becoming a successful learner.



Assistive technology tools also serve as tremendous aides in helping the classroom teacher provide a variety of learning activities and exercises specific to the various learning personalities and differences of the student population. Not only can AT tools help the students learn, but various tools and devices help the teacher plan and organize lesson plans, delivery the course information, construct and administer assessment, calculate and organize student grades, and display course materials and resources. The use of assistive technology devices in the classroom can benefit both teacher and students; but, the use of the devices depends on how willing the teacher is to accept, learn, and include the various AT methods, formats, and tools into the general classroom curriculum.
Purpose
The purpose of the study is to identify relationships between the unique educational challenges presented a teacher by the presence of an

AD/HD student in a traditional classroom setting, the perception/attitude the classroom teacher has toward the student with AD/HD, and the use of readily available assistive technology devices by all students in the classroom.

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Assistive technology devices are not cures for learning problems, such as AD/HD, they are tools. The Merriam-Webster’s Collegiate Dictionary defines a tool as a “device that aids in accomplishing a task”.( 2001) Research studies have documented the effectiveness of AT devices as aids for empowering the student with learning problems.



Devices and software such as electronic spell checkers and calculators, speech recognition software, word processing software, audible electronic dictionaries, book scanners, and screen readers can be used by students as a byway to accomplishing tasks in reading, writing, spelling, and math. Studies involving the use of assistive technology in the classroom generally have centered on the learner. It would be of compelling interest to look at the benefits assistive technology devices lend the classroom from the standpoint of the person responsible for creating and maintaining a successful learning environment, the teacher. The investigation into the effects of the integration of assistive technology devices with the curriculum on the teacher confronted with the challenge of meeting the unique learning needs of the AD/HD student, along with the learning needs of the other students in the classroom, would be of powerful significance in promoting the use of AT for the empowerment of both teachers and students. Studying the ways the use of assistive technology devices can enhance the ability of the teacher to create an equal and level learning venue for all students, lessens the possibility of inadvertently allowing a student with the
10 unique learning differences associated with AD/HD, to slip through the educational system’s cracks.
Statement of the Problem
The problem of this study is to determine the relationship between the

use of assistive technology devices included in the general course curriculum and lesson plans with the unique challenges the teacher encounters when attempting to meet the learning needs of all students, including the special needs of the student with AD/HD included in the traditional classroom setting. Further, the study attempts to investigate the impact the teaching challenges created by the unique learning differences of the AD/HD student in the classroom has on the teacher’s perception of AD/HD and the teacher’s attitude towards accommodating the special learning needs of the AD/HD student. The study will determine the relationship between the use of assistive technology devices in the classroom and the teacher’s attitude towards accommodating the student with AD/HD.



General Hypotheses

The objective of this study is to demonstrate the correlation between the challenges the AD/HD student brings to the traditional classroom settings, teacher

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attitudes towards the provision of special accommodations, and the inclusion of assistive technology in lesson plans. The following hypotheses were developed:

1.) There is a significant relationship between the unique teaching challenges the classroom teacher must meet due to the inclusion of

the AD/HD student in the traditional classroom setting, and the use of assistive technology devices in course activities.

2.) There is a significant relationship between the attitude of the teacher forced to adjust the classroom environment and make special


accommodations for the AD/HD student, and the availability and use of assistive technology devices in the classroom.

Delimitations

The scope of the present study is to determine the degree of teaching challenges presented by the AD/HD student as it relates to the availability and use of assistive technology in the classroom. The focus of this study is to examine the differential relationships between specific teacher attitudes when faced with the challenge of meeting the unique learning needs of the AD/HD student in the classroom and the effects the incorporation of assistive technology devices in with the course curriculum has on empowering the teacher to successfully meet the challenges and establish an equal and level learning field for all the students in the classroom.

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1.) Data will be collected from a survey distributed randomly to teachers


(Grades Pre-K – Postsecondary Grade 16) in Northeastern Ohio, Central
Ohio, and Southern Ohio.

2.) The survey will be distributed in three formats: 1.) personal interview;


2.) hard copy; and, 3.) online. Participants will be encouraged to comment
on each question and the survey topic in general

Definitions and Operational Terms

A number of frequently used terms are defined below to provide a better understanding of the study.



AD/HD - Term used for Attention Deficit/Hyperactivity Disorder, can be used to describe the disorder with or without hyperactivity.

Assistive Technology (AT) – any item, piece of equipment, or product that is used to increase, maintain or improve the abilities of individuals with disabilities:  tools to promote independence across all areas of daily living. AT devices may be categorized as high technology and low technology. Many low-tech devices can be purchased at a hardware store, selected from a catalog, or fabricated using tools and materials found in home workshops (Franklin,
1991). Examples might be note-taking cassette recorders, pencil grips, NCR paper/copy machine, simple switches, head pointers, picture boards, taped instructions, or workbooks. High-tech devices frequently incorporate some type
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of computer chip, such as a hand-held calculator or a "talking clock." Examples might be optical character recognition (OCR) calculators, word processors with spelling and grammar checking, word prediction, voice recognition, speech synthesizers, augmentative communication devices, alternative keyboards, or instructional software.

Attention Deficit Disorder - a specific neurological difference for which there is no cure.   Individuals with the disorder have decreased activity in the regions of the brain responsible for regulating their impulses, memory, and planning ability. AD/HD is not a learning disability.

Comorbid - The presence of more than one disorder. Example would be an individual having both AD/HD and depression.

Learning Disability (Difference) - Could be any number of disabilities that affect an individual's ability to learn.

Learning Preference - A particular way or method in which an individual prefers to learn or study.  

Learning Style - A particular way in which an individual learns. Examples include: Physical, Mathematical, Visual, Linguistic.

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Multimedia -
The use of computers to present text, graphics, video, animation, and sound in an integrated way.  Long touted as the future revolution in computing, multimedia applications were, until the mid-90s, uncommon due to the expensive hardware required. With increases in performance and decreases in price, however, multimedia is now commonplace. Nearly all PCs are capable of displaying video, though the resolution available depends on the power of the computer's video adapter and CPU.  Because of the storage demands of multimedia applications, the most effective media are CD-ROMs.


Summary

Chapter 1 introduced a recent analysis of the goal for the classroom teacher to prepare the classroom environment for students to learn and the challenges in meeting that responsibility with the inclusion of an AD/HD student in the mix; and the impact assistive technology devices can make on successfully achieving that goal. The textbook role of the teacher is compared to the reality and challenge of creating a stimulating and productive classroom that “affords an opportunity for a child to learn with an adult who provides security for every student at whatever level the child may be developmentally.” (Comfort)

Chapter 1 established the fact that Attention Deficits Disorder (AD/HD) is not a learning disability. It is classified as a mental disorder, and to be labeled

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as having a mental disorder often time causes low self-esteem and self-doubt in

older children and adults. The challenge for the teacher to define

the typical AD/HD student’s learning personality is impossible in that there is no such thing as a typical AD/HD student. AD/HD falls into three behavioral categories and many times the symptoms overlap in individual cases. When comorbid symptoms or learning and behavioral problems exist along with the AD/HD, any advance curriculum planning designed to compensate for AD/HD students becomes a challenge.

The purpose of this study was to identify the unique challenges a classroom teacher encounters when attempting to create a stimulating and productive learning environment for the entire classroom, and the effect assistive technology can have on easing the burden and helping the teacher achieve successful learning outcomes for all students, including the AD/HD student. The study focused on the effectiveness of incorporating assistive technology methods and devices into the course curriculum to include the entire student population, rather than specific individuals with

learning differences; and the teacher’s attitude and willingness to enhance the curriculum with AT methods and devices. These factors will be investigated to conclude the use of assistive technology in the course instruction and activities can empower the teacher in the cultivation and maintenance of an equal and level learning field designed to empower all students with the means to achieve academic success. Finally, a list of operational terms and definitions has been included to aid in the understanding of the research.

CHAPTER II
REVIEW OF THE LITERATURE
Volumes of documented research exist on how the brain work and

what factors affect learning. The volumes of literature on AD/HD demonstrate and state the unresolved controversies that feed on the issue. Once called hyperkinesias or minimal brain dysfunction, AD/HD is one of the most common mental disorders among children and adults. Opinions on AD/HD/AD/HD range from complete denial to as many as 23% of all children having the disorder (Bender 1997). Eric Jensen (2000) cites estimates ranging from 2 to 10 percent of American children and 15 to 20 million Americans of all ages as being affected by the disorder. Jenson cites the following statistics:

It impacts five times as many boys and girls and twice as many Caucasians as
African Americans. Prescription medications are three times more likely to
be used in the treatment of boys than girls, and, as children with AD/HD age,
the use of medication increases. By the fifth grade, 19 to 20 percent of
Caucasian boys were taking a medication for AD/HD, and some middle schools
report as many as 50 percent. ( Jensen 2000)
Much of the controversy surrounding the disorder centers on the methods and the validity of diagnosis, and the medications prescribed as treatment for the disorder; however, there is a large amount of educational material and available support systems for the promotion of a healthy, supportive relationship between the student with

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AD/HD, her parents, and the teacher. Also, literature reveals the use of certain assistive technology devices and techniques help level the field of learning for the student with AD/HD; and enable the student to become a participating and contributing member of the traditional classroom and learning environment. Literature also indicates that when both low end and high end AT devices are incorporated in with the curriculum and made available to all students, the classroom learning environment noticeably is enhanced.

The chapter is divided into five categories. The first category defines the symptoms of Attention Deficit Disorder and provides an overview of the diagnosis process. The second category examines the various challenges the student with AD/HD, the parents, and the teacher face on a daily basis. Guidelines and practical advice for teaching the student with AD/HD is included in this section. The third category looks at various assistive technology devices known to aid and empower the student with AD/HD in various subjects and learning disciplines. The fourth category examines Gardner’s Multiple Intelligence theory, multisensory instructional methods, and the AD/HD learning style. Vygotsky’s Zone of Proximal Development (ZPD) theory as applied to the use of the computer as a “more capable peer” or assistive coach for the AD/HD student is considered in the fifth category.


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The Characteristics and Symptoms of AD/HD and the Diagnosis


Today, more and more students in the United States are diagnosed with Attention Deficit Disorder as an answer to poor performance in school and classroom social and behavioral problems. As the rate of diagnosed students

steadily increases, so does the controversy over the cause, diagnostic procedure, treatment, and existence of the disorder.

AD/HD is not a new phenomenon. On the Suite101.com Web site, when asked by a reader where AD/HD came from, Valerie de Armas pointed out that “AD/HD symptoms were recorded in the mid 1800s in children with nervous system injuries and diseases. In 1848, a German physician wrote a children’s’ story, “Fidgety Phil”, describing hyperactive behavior.” She went on to answer:

British pediatrician, George Frederic Still was probably the first to do


any comprehensive observations of AD/HD children. He reported his observations
in a series of lectures at the Royal College of Physicians in 1902. He described the
children he observed as aggressive, defiant, lawless, overactive, attention
impaired, dishonest and accident-prone. He also described them as having a
“defect in moral control”. He didn’t paint a very pretty picture of the disorder for
sure! His observations went on to note that the behavior was biological rather than

a result of poor parenting. He theorized that the behavior was either inherited or

the result of an injury at birth. (Armas 2001)
The widely accepted psychiatric definition of AD/HD is from the Diagnostic and Statistical Manual of Mental disorders, DSM-IV:



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