THE OVERLAP BETWEEN ADHD AND LEARNING DISABILITIES

(1)

T

^HE

O

VERLAP BETWEEN

ADHD

AND

L

^EARNING

D

ISABILITIES

Stephanie Moulton Sarkis PhD NCC LMHC

(2)

www.stephaniesarkis.com 2

Stephanie Moulton Sarkis PhD NCC LMHC

• Ph.D. from University of Florida

• Author of 4 books on ADHD

• Private practice in Boca Raton, Florida

– Counseling and Coaching

• Adjunct Assistant Professor at Florida Atlantic University

• Sub‐Investigator at FAU Clinical Trials

• Blogger –Huffington Post and Psychology Today

• www.stephaniesarkis.com

(3)

DSM‐5 Criteria for ADHD

• Inattentive type

– Meets at least 6/9 criteria if 16 or younger – Meets at least 5/9 criteria if 17 or older

• Hyperactive/Impulsive type

– Meets at least 6/9 criteria if 16 or younger – Meets at least 5/9 criteria if 17 or older

• Combined type

– Meets criteria for both the Inattentive type and Hyperactive/Impulsive type

• American Psychological Association (2013)

(4)

• Diagnostic criteria

– Difficulties learning and using academic skills as indicated by the presence of at least one of the following symptoms that have persisted for at least 6 months, despite

interventions

• Inaccurate or slow and effortful word reading

• Difficulty understanding the meaning of what is read

• Difficulties with spelling

• Difficulties with written expression

• Difficulties mastering number sense, number facts, or calculation

• Difficulties with mathematical reasoning

Specific Learning Disorder

(5)

– Affected academic skills are substantially and quantifiably below those expected for

individual’s chronological age, and cause significant interference

– Learning difficulties behind during school‐age years but may not become fully manifest until demands for those affected academic skills exceed the individual’s limited capacities

• Timed tests, heavy academic loads

Specific Learning Disorder

(6)

Executive Functions

• Executive Functions (EFs) are housed in the prefrontal cortex (frontal lobes) of the brain

• EFs help inhibit and self‐regulate behavior

• Similar to the tasks of an executive

– Direct – Process – Manage

– Disseminate information

6

(7)

ADHD and LDs Overlap

• Comorbidity rate of 45.1%

– Includes

• Math learning disabilities

• Reading learning disabilities

• Writing disorders

• DuPaul, Gormley, & Laracy, 2013

ADHD LDs

(8)

Frontal Lobe & Pre‐Frontal Cortex

(9)

Executive Functions

• Working Memory

• Time Management

• Behavioral Inhibition

• Regulation of Emotions

• Planning

• Forethought

• Learning from Consequences

• Organization

• Reconstitution of Information

• Brown 2009; Barkley 2005

(10)

Available Assistance

• Medication

• Counseling

• Tutoring

• Coaching

• Working Memory Training

(11)

Coaching for ADHD and LDs

• Study of 54 undergraduates with ADHD and/or LD, 7 in‐depth interviews

• They felt that coaching

– Provided a self‐determined approach to goal attainment

– Was supportive of their autonomy

– Helped develop and manage executive function skills – Promoted self‐efficacy and confidence regarding

future success

• Parker & Boutelle 2009

(12)

Working Memory Training for ADHD and LDs

• Study participants had greater improvement on

– Working memory scores

– Number of ADHD symptoms – Cognitive failures

• Improvements in working memory and

cognitive failures were maintained at the 2‐

month follow‐up

• Gropper, et al. 2014

(13)

Recommendations for

Scholarly Success in College

• Seek accommodations

• Always attend the “real” class in college

– Use the online/televised class as a supplement

• Use study groups

– Limit the number of participants to four or five

• Meet with professors regularly

– Review tests and class notes

• Get tutoring on a regular basis

(14)

Recommendations for Personal Success

• Seek help from a counselor and/or coach

• Receive regular health care

• Get as much sleep as possible

• Have a structured schedule

– Study for 30 minutes, take a 15 minute break – Schedule in relaxation time, but not too much!

• Seek healthy stress‐reducing outlets

(15)

Seeking Accommodations

• Accommodations “even the playing field” so the ADHD/LD student is working at par with his or her peers.

• Receiving accommodations in high school does not automatically qualify a student for accommodations in college

• Private colleges are not required to provide accommodations unless they receive federal funding

(16)

Applying for Accommodations

• Apply through college’s Office of Student Disability Services (OSDS)

• Apply as early as possible

• Most OSDS require

– An ADHD evaluation

• Must list recommended accommodations

– Copy of accommodations from high

school

(17)

Recommended Accommodations

• Assistance with writing class notes

• Extended time on tests

• Testing in a separate and quiet location

• Permission to record lectures

• Instructions given in writing

• Priority in class registration

• Reduced course load

(18)

Students’ Records & Privacy Rights

• Family Educational Rights & Privacy Act (FERPA)

– College students 17 years old and older have exclusive access to their records

– Must sign a release to allow parental access to records

• It is recommended that students allow parents to have access to their records

(19)

Summary

• ADHD and LDs are commonly cooccuring

• Many accommodations apply to both disorders

• Coaching was found to be an effective strategy

• Start seeking accommodations as soon as child is accepted to a college

(20)

Resources

• CHADD

www.chadd.org

• Learning Disabilities Association of America www.ldaamerica.org

• National Center for Learning Disabilities www.ncld.org

(21)

References

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: Author.

• Barkley, R. A. (2005). Attention‐Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment. 3rd ed. New York: The Guilford Press.

• Brown, T.E. (2009). ADD/ADD and impaired executive function in clinical practice.

Current Attention Disorders Reports 1(1):37–41.

• DuPaul, G.J., M.J. Gormley, & Laracy, S.D. (2013). Comorbidity of LD and ADHD:

Implications for DSM‐5 for assessment and treatment. Journal of Learning Disabilities, 46(1):43‐51.

• Gropper, R.J., Gotlieb, H., Kronitz, R., & Tannock, R. (2014). Working memory training in college students with ADHD or LD. Journal of Attention Disorders, 1/13/14, doi: 10.1177/1087054713516490

• Parker, D.R., and Boutelle, K. (2009). Executive Function Coaching for College Students with Learning Disabilities and ADHD: A New Approach for Fostering Self‐Determination. Learning Disabilities Research & Practice 24(4):204‐215.

(22)

Q

^UESTIONS

THE OVERLAP BETWEEN ADHD AND LEARNING DISABILITIES

T

O

ADHD

L

D

Stephanie Moulton Sarkis PhD NCC LMHC

DSM‐5 Criteria for ADHD

Specific Learning Disorder

Specific Learning Disorder

Executive Functions

ADHD and LDs Overlap

ADHD LDs

Frontal Lobe & Pre‐Frontal Cortex

Executive Functions

Available Assistance

Coaching for ADHD and LDs

Working Memory Training for ADHD and LDs

Recommendations for

Scholarly Success in College

Recommendations for Personal Success

Seeking Accommodations

Applying for Accommodations

• Apply through college’s Office of Student Disability Services (OSDS)

• Apply as early as possible

• Most OSDS require

– Copy of accommodations from high

school

Recommended Accommodations

Students’ Records & Privacy Rights

Summary

Resources

References

Q

?