ADHD and Mental Retardation

ADHD and Mental Retardation
By:Daniel M. Bagner, M.S.

Mental Retardation
* Sub average intelligence (IQ < 70: DSM-IV; <75: AAMR)
* Associated adaptive deficits in at least two areas:
o Communication, self-care, home living, social skills, community use, self-direction, health and safety, functional academics, leisure, and work
* Occurrence of deficits before age 18
Classification of MR
Pervasive Profound/custodial
Extensive
Severe/trainable
Intermittent
Educable
Mild
IQ range
Support required
Educational Classification
Level of MR
Etiology of MR
ADHD in MR
ADHD in Genetic Etiologies of MR

* Down Syndrome
* Fragile X syndrome

Underdiagnosis of ADHD in MR
* Symptoms less obvious than other disorders such as psychosis (Fisher, Burd, Kuna, & Berg, 1985)
* “Diagnostic overshadowing” (Reiss, Levitan, & Szyszko, 1982)

Developmental Appropriateness of ADHD in Children With MR
* DSM-IV suggests taking child’s mental age (MA) into account for assessing hyperactivity
* For rating scales
* Interdiagnoser reliability difficult when accounting for a child’s cognitive development

Developmental Appropriateness of ADHD in Children with MR
* If DSM-IV guidelines are correct
* Pearson and Aman (1994)
* Not necessary to adjust for IQ or MA but may be appropriate to control for CA
* Parents and teachers may make implicit corrections

Prevalence of ADHD in MR
Sustained Attention in MR
Selective Attention in MR
Attention in MR and ADHD in the Classroom
Similarities of ADHD: With or Without MR
“Breadth of Attention” in MR
Impulsivity in MR
Hyperactivity in MR
Hyperactivity in ADHD and MR in the Classroom
Aggression in MR and ADHD
Behavioral Adjustment in Children with MR and ADHD
Risk Factors in Children with ADHD and MR
Long-term Prognosis
Characteristic of and often observed in children with MR
Medication for ADHD in Children with MR
Behavioral Treatments for ADHD in Children with MR
Future Directions

ADHD and Mental Retardation.ppt