Training Manual ADHD 1

ADHD: A Comprehensive Training
Attention Deficit Hyperactivity Disorder
Group Members: James Breaden, Mackenzie

Morris, and Danielle Higgs
Table Of Contents
Table Of Contents..............................................................................................................2
Abstract...............................................................................................................................3
Outline of Training...........................................................................................................4
Description of Organization............................................................................................5
Facts.....................................................................................................................................6
Diagnoses/Treatments...................................................................................................13
Suggestions for Inclusion...............................................................................................18
Activities...........................................................................................................................20
Extracurricular suggestions...........................................................................................26
Summary..........................................................................................................................27
Reference Section............................................................................................................28
Appendices......................................................................................................................29
Abstract
The role of this training manual is to inform individuals in the recreation
profession of the disorder: Attention Deficit Hyperactive Disorder (ADHD). The
topics presented in the training manual provide a comprehensive overview
pertaining to ADHD. Techniques and policies used to provide a greater
understanding of the content will be discussed during a four-hour training
session. Each activity will have an expected outcome and a higher understanding
of individuals who have been diagnosed with ADHD. During the progression of
the training the trainee will gain a greater comprehension in regards to the
concepts of: inattention, hyperactivity and impulsivity. Furthermore an
understanding of the signs and symptoms in conjunction with treatment and
therapies will be gained, progressing through the manual. Moreover the
participants will gain the knowledge and ability to utilize the techniques needed
to work effectively with populations diagnosed with ADHD. This training
manual should be used in conjunction with an ongoing education regarding
populations diagnosed with ADHD.
1. Introduction
Outline of Training
10:00am-10: 30am
2. ADHD Pre-Test
10:30am-10: 45am
3. Facts/Overview of ADHD
10:45am-11: 45am
4. Video with questions and discussion
11:45am-12: 30pm
5. Lunch Break
12:30pm-1:00pm
6. Balloon Volleyball
1:00pm-1: 30pm
7. Closing Thoughts/Scenarios
1:30pm-2:00pm
If extra time permits:
Word search Activity

Scavenger Hunt Riddle Activity
Description of Organization
Mission
Camp for Courageous Kids is a non-profit organization with a mission to help
individuals and families affected by attention deficit hyperactivity disorders
(ADD/ADHD) in achieving their full potential and becoming a functional
member of society. Camp for Courageous Kids provides support, education and
resources for families living with ADHD to address the overview and barriers to
help find their strengths and self-worth and match them with a venue or avenue
that allows them to shine!
Facts
General Information:
Attention Deficit Hyperactivity Disorder (ADHD) is a disorder
characterized by a persistent pattern of inattention and/or
hyperactivity/impulsivity that occurs in academic, occupational, or
social settings. Problems with attention include making careless

mistakes, failing to complete tasks, problems staying organized and
keeping track of things, becoming easily distracted, etc. Problems
with hyperactivity can include excessive fidgetiness and
squirminess, running or climbing when it is not appropriate,
excessive talking, and being constantly on the go. Impulsivity can
show up as impatience, difficulty waiting one's turn, blurting out
answers, and frequent interrupting. Although many individuals
with ADHD display both inattentive and hyperactive/impulsive
symptoms, some individuals show symptoms from one group but
not the other.
People who suffer from attention deficit hyperactivity disorder
(ADHD) find life a little more challenging than those who dont.
Population:
Occurs mostly in children but not limited to. About 4 percent of
American adults over the age of 18 deal with ADHD.
6.4 million American children ages 4-17 have been diagnosed with
ADHD.
Males are almost three times more likely to be diagnosed with

ADHD than females.
*Interesting Fact: Kentucky has the highest rate of incidence of ADHD
being 14.8%
Myths/Misconceptions:
People with ADHD dont want to focus or complete tasks,
Sarkis said.
o Fact: It isnt a matter of desire, but a matter of ability. As Sarkis
explained, Its not that they dont want to follow through on
projects; they just cant. Its not that they dont want to stop by
the grocery store on the way home from work; they just
forget.
Only kids can have ADHD.
o Fact: While the disorder may be more common among
children and teens (the CDC states that 11 percent of
American kids aged 4-17 have ADHD), plenty of adults have
it, too. You may be more likely to be diagnosed as a child, but
plenty of adults are diagnosed at age 30 or even older.
10
There is only one type of ADHD.

o Fact: There are actually three main categories included in the
definition of ADHD: inattentive, hyperactive-impulsive, and
combined (when the person has symptoms of all
three: inattention, hyperactivity, and impulsivity). There are
also different levels of ADHD severity.
Only boys have ADHD.
o Fact: It may certainly seem like boys tend to be more
hyperactive and easily distracted than girls; one survey found that
82 percent of teachers believed ADHD is more prevalent in boys
than in girls, and that it was difficult to spot the symptoms in girls.
But both boys and girls can be diagnosed with ADHD, though the
prevalence is higher among boys (13.2 percent) compared to girls
(5.6 percent), according to the CDC.
Definition:
ADHD is a disorder defined by inattention, impulsivity and/or

hyperactivity that affects functioning and development.
Pathology/Etiology:
11
Heredity is the most common cause of ADHD.

Current research indicates the frontal lobe, basal ganglia, caudate nucleus,
cerebellum, as well as other areas of the brain, play a significant role in
ADHD because they are involved in complex processes that regulate
behavior (Teeter, 1998)

Exposure to Toxic Substances/Environmental Factors
o Researchers have found association between mothers who smoked
tobacco products or used alcohol during their pregnancy and the
development of behavior and learning problems in their children.
o Nicotine, alcohol, and lead can be toxic to developing brain tissue
and be have sustained effects n the behavior of the children exposed
to these substances at early stages.

Injury to the brain from trauma, brain tumors, strokes or disease
o These factors can cause problems with inattention and poor
regulation of motor activity and impulses.
Incidence and Prevalence:
6.4 Million American children ages 4-17 have been diagnosed with ADHD.
Average age of ADHD diagnosis is 7
6.1% of American children are being treated for ADHD with medication
42% increase in ADHD diagnoses over the past 8 years
12
Symptoms:
There are three groups of symptoms
Inattention
Hyperactivity
Impulsivity
Inattention:
Be disorganized
Lack focus
Have a hard time paying attention to details and a tendency to make
carless mistakes
Be easily distracted by things like noises or events that are usually ignored
by others
13
Hyperactivity:
Fidget when seated
Get up frequently to walk or run around
Have trouble playing quietly or doing quiet hobbies
Talk excessively
Impulsivity:
Impatience
Having a hard time waiting to talk or react
Different Symptoms:
New Developments in ADHD:

Although no immediate cure is in sight for ADHD, a new understanding may be
forthcoming
New techniques like brain imaging to observe how the brain actually
works is already providing new insights into the causes of ADHD.

Also other research is seeking to identify conditions of pregnancy and
early childhood that may cause differences in the brain.

Future ADHD medications
Animal studies are also adding to our knowledge of ADHD.
14
Diagnosis:
15
Diagnoses/Treatments
The American Academy of Pediatrics (AAP) recommends that healthcare

professionals ask parents, teachers, and other adults who care for the child
about the child's behavior in different settings, like at home, school, or
with peers.
Healthcare professionals use the guidelines in the American Psychiatric
Association's Diagnostic and Statistical Manual, Fifth edition (DSM-5)1, to
help diagnose ADHD. This diagnostic standard helps ensure that people
are appropriately diagnosed and treated for ADHD. Using the same
standard across communities can also help determine how many children
have ADHD, and how public health is impacted by this condition.

DSM-5 Criteria for ADHD
o People with ADHD show a persistent pattern of inattention and/or
hyperactivity-impulsivity that interferes with functioning or
development:
o Inattention: Six or more symptoms of inattention for children up to
age 16, or five or more for adolescents 17 and older and adults;
16
symptoms of inattention have been present for at least 6 months,

and they are inappropriate for developmental level:
Often fails to give close attention to details or makes careless
mistakes in schoolwork, at work, or with other activities.

Often has trouble holding attention on tasks or play
activities.
Often does not seem to listen when spoken to directly.
Often does not follow through on instructions and fails to
finish schoolwork, chores, or duties in the workplace (e.g.,
loses focus, side-tracked).

Often has trouble organizing tasks and activities.
Often avoids, dislikes, or is reluctant to do tasks that require
mental effort over a long period of time (such as schoolwork
or homework).
Often loses things necessary for tasks and activities (e.g.
school materials, pencils, books, tools, wallets, keys,
paperwork, eyeglasses, mobile telephones).

Is often easily distracted
Is often forgetful in daily activities.
o Hyperactivity and Impulsivity: Six or more symptoms of
hyperactivity-impulsivity for children up to age 16, or five or more
for adolescents 17 and older and adults; symptoms of hyperactivityimpulsivity have been present for at least 6 months to an extent that
17
is disruptive and inappropriate for the persons developmental

level:
Often fidgets with or taps hands or feet, or squirms in seat.
Often leaves seat in situations when remaining seated is
expected.
Often runs about or climbs in situations where it is not
appropriate (adolescents or adults may be limited to feeling
restless).
Often unable to play or take part in leisure activities quietly.
Is often "on the go" acting as if "driven by a motor".
Often talks excessively.
Often blurts out an answer before a question has been
completed.
Often has trouble waiting his/her turn.
Often interrupts or intrudes on others (e.g., butts into
conversations or games)
o In addition, the following conditions must be met:
Several inattentive or hyperactive-impulsive symptoms were
present before age 12 years.

Several symptoms are present in two or more setting, (such
as at home, school or work; with friends or relatives; in other
activities).
There is clear evidence that the symptoms interfere with, or
reduce the quality of, social, school, or work functioning.

The symptoms are not better explained by another mental
disorder (such as a mood disorder, anxiety disorder,
18
dissociative disorder, or a personality disorder). The

symptoms do not happen only during the course of
schizophrenia or another psychotic disorder.
Treatment:
Behavior therapy
o Children with ADHD can possibly show behaviors that can be
extremely disruptive to others. Behavior therapy can help reduce
these behaviors and should begin as soon as the child is properly
diagnosed.
o The goal of behavioral therapy is to instill or reinforce positive
behaviors while also limiting negative or problematic behaviors.
o Behavior therapy with parents
Parents will learn strategies and techniques to manage the
behavior of their children easier and to strengthen the
relationship between the parent and child.
o Behavior therapy with children
A therapist will work directly with a child and teach new
behaviors to replace ones that cause problems, the therapist
assist the child in expressing his/her feelings in more
positive ways.
Medications
19
o Medications can help children with ADHD manage their symptoms

and behavioral problems that lead to trouble with family, friends
and school.
o Stimulants
Between 70-80 percent of children with ADHD have fewer
ADHD symptoms when they take these fast-acting
medications.
o Medications that work for one child may not work for the next,
different medications and doses vary widely.

Leading children with ADHD
o Make assignments/activities clear- make sure they understand the
directions
o Positive reinforcement
o Allow time to get up and move when stationary for long periods
o Be sensitive to self-esteem
When working closely with/parenting a child with ADHD
o Create a daily routine
o Stay organized
o Be clear and specific when talking
o Use goals and praise
20
Suggestions for Inclusion
Providing structure and consistency

o Structure is critical to success in any program, although this does
not mean inflexibility. Setting expectations and establishing exactly
what behaviors are acceptable and inacceptable, along with
consequences of not being able to follow those expectations. Good
structure requires communication between staff and ADHD youth,
constant clear directions, and establishing rules and maintaining
standards.
Planning
o Typically, staff will react to negative behavior with punishment or
exclusionary tactics. Alternately, examine the environment,
determine what is causing the behavior and discuss different ways
to modify the situation.
o Limit transition time and have a plan when activities stall.
Short, equipment-less activities to keep the children
occupied and attentive

Designing positive environments
o Build an environment that is welcoming, safe and supportive.
o Encouragement, motivation, and incentive that will improve
performance.
Increasing motivation to participate
21
o Making tasks meaningful and relevant to their interests, providing

frequent opportunities to work with peers, and highlighting
personal and group strengths whenever they come up.
o Variety of lights, sounds, pitches of voice, different types of music,
and some humor or silliness can aid in keeping the attention of the
children and making sure they are focused.

Building self esteem
o Children with ADHD must have frequent feedback on their
strengths as well as areas that need improvement in order for them
to cognitively track their progress and success. Reinforcing social
behaviors, self-respect, and responsibility can aid a child with
ADHD to conduct problem-solving strategies when they come
across difficulties and distractions.
22
Activities
Goal: To better understand what ADHD is, how its diagnosed, and how to better
teach children who are diagnosed with ADHD
I. Introduction
The organization will be introduced as well as the purpose for the

training. Employees will be asked to stand and introduce him or her and
tell one interesting fact about themselves.
I.
ADHD quiz
First we will test the groups knowledge of ADHD with a quiz to start off
the activities.
II.
Video with questions and Discussion

The ABCs of ADHD worksheet
1.) Every classroom has at least __ or __ students who have been diagnosed with
Attention Deficient Hyperactivity Disorder. (1,2)
2.) ADHD has been clinically diagnosed as a __________ (behavioral disorder)
3.) ADHD is associated with ________ weaknesses that hinder learning.
(Cognitive)
23
4.) When does ADHD generally first appear? (Early childhood)

5.) What are the three main characteristics of ADHD? (Symptoms of inattention,
hyperactivity and impulsivity)
6.) What are the three subtypes of ADHD? (Hyperactive-impulsive, combined
and inattentive)
7.) What is the most common type of ADHD? (Combined)
8.) Why are girls with ADHD overlooked? (Their symptoms are less extreme than
boys and therefore they are under diagnosed and given little treatment.)
9.) What is the criteria that needs to be met for ADHD diagnosis? (At least 6 of 9
symptoms of inattention, and/or at least 6 of 9 symptoms
hyperactivity/impulsivity, appears before age 7, persists for at least 6 months,
their pervasive (occur in different contexts) and the symptoms must be
impairing)
10.) For every __ boys that have ADHD, __ girl has ADHD (3,1)
11.) What was the first medical description of ADHD in 1902? (A problem of
moral control)
12.) True or False? Too much sugar in your diet can cause ADHD. (False)
13.) True or False? Children with ADHD are twice as likely to have mothers who
were smoking during their pregnancy (True)
14.) ADHD continues in __ to ___% of children into adulthood. (60, 80)
15.) The _______ and ________ of a persons brain is altered when living with
ADHD. (Cerebellum, prefrontal cortex)
16.) _________ networks interact differently in people with ADHD. (Neural)
17.) How can you as a teacher and leader make sure you don't make a student go
into cognitive overload? (The teachers can make different instructional choices to
balance out the load)
III.
24
Hands-on activity: Balloon Volleyball
This is an easy game but it takes focus and a lot of movement. The concept of
the game is just like volleyball but of course with a balloon(s). Blow up a
balloon(s) and use a piece of painters tape to mark a centerline for a net on
the ground. Depending on how many people are playing you can use more
than one balloon. The point of the game is to keep the balloon from touching
the ground. More balloons can be thrown into the game to increase difficulty
and challenge the individuals.
IV.
Scavenger Hunt Riddle
The purpose of this game is to get the group minds working. In most cases,
when children have ADHD their minds are all over the place. This activity
would help their minds slow down and focus on completing the riddles.
Q: The more I dry, the wetter I become?

A: Towel
Q: I'm a bird but I can't fly?
A: Penguin
Q: I don't go out and play, I just stay home all day, I'm nice - you might agree, but
mostly your feet just rub me?
A: Doormat
Q: Stiff is my spine and my body is pale, but I'm always ready to tell a tale?
25
A: Book
Q: What has a ring, but no finger?
A: Telephone
Q: I have a neck, but no head, but I still wear a cap?
A: Bottle
Q: Some take me in the morning, others take me in the evening, but one thing
you should know - that when I'm 'taken', I don't really go anywhere?
A: Shower
Q: My words number quite many (like pen, pent, and penny); my title you will
discover is explained under my cover?
A: Dictionary
Q: Fluttering, flying and flitting so free, from flower to flower is where you'll find
me?
A: Butterfly
Q: I start with an "e", I end with an "e", but I usually contain only one letter?
A: Envelope
Q: I'm so simple that I only point; yet I guide people all over the world?
A: Compass
Q: Although I may have eyes, I can't see. At one time there was a dearth of me in
Ireland and people went hungry?
A: Potato
Q: What's black and white and read all over?
A: Newspaper
Q: If you were 'able', you'd add a 'T'?
A: Table
Q: Look for a rainbow in a box?
A: Box of Crayons/Markers
26
Q: Keys open my door, but mine only make a sound?

A: Piano
Q: I'm an insect, and the first half of my name reveals another insect; also some
famous group of musicians had a similar name?
A: Beetle
Q: I may be black, and may be white, or any color in between. I'm small and
made of plastic, not round but very light; when I'm moved up and down, I'm
used to create sound?
A: Guitar Pick
Q: I get bigger when I eat, but die weaker when I drink?
A: Fire
Q: What invention lets you look right through a wall?
A: Window
Q: People climb me, cut me and burn me. They show me no respect! My rings are
not of gold, but they do tell my age?
A: Tree
Q: What is higher without the head, than with it?
A: Pillow
Q: I have a heart, and my last five letters mean the same as "strangle"?
A: Artichoke
Q: I grow shorter, as I grow older?
A: Candle
Q: I have a face that doesn't frown, I have hands that do not wave, I have no
mouth, just a familiar sound, I don't walk - but I move around?
A: Clock
Q: When you buy me I'm black, when you use me I'm red, and when you throw
me away I'm gray?
A: Burning Charcoal
27
V. Word Search
To finish our activity session, we will hand out a word search full of ADHD
terms. Along with finding those terms we will play loud music and go
around trying to distract them to give the group a sense of what its like living
with ADHD.
VI. Closing Thoughts
28
29
To conclude our training session, we will discuss as a group various

activities and information learned during the four hours. Also we will give
the group of employees 3 various scenarios to respond to as a group.
Scenarios:
1. John is an 8 year old boy who was diagnosed with ADHD last year. Everyday
he comes to school bouncing off the walls and has trouble paying attention in
class. If you were Johns teacher, how would you accommodate your teaching
plan to meet his needs? Give at least 3 ways you could help John focus better
in class and cope with his constant jitters.
2. Mrs. Dunrud realized that Nigel was very bright. This was obvious. All one
had to do was be alone with him for five minutes and hear about the latest
books he was reading or his opinions on current events. The problem was
that he was such a wealth of information and had so many opinions that he
was seemingly never quiet. He dominated the class discussions, blurted out
his answers and was considered obnoxious by almost every one of his
classmates. How could Mrs. Dunrud appropriately tell Nigel what he was
doing wrong without hurting his feelings or embarrassing him in front of his
peers?
3. 3. Youve had Claire in class for almost a month now and start to notice that
she is avoiding her homework, making poor grades on her tests and seems to

be very unorganized. Assuming she's inattentive and has ADHD. How
would you approach this situation and make her more attentive?
Extracurricular suggestions
Great Video: https://www.youtube.com/watch?v=uU6o2_UFSEY
30
31
Summary
In summary, individuals in the recreation profession will have a greater
understanding about the disorder: Attention Deficit Hyperactive Disorder. Each
activity presented during the training will provide a higher understanding of
individuals who have been diagnosed with ADHD.
32
Reference Section
(2012). The ABCs of ADHD. Retrieved April 21, 2016, from
https://www.youtube.com/watch?
v=YkKZHdfCvZI
Coolest Scavenger Hunt Riddles. (n.d.). Retrieved April 21, 2016, from
http://www.coolest-kid-birthday-parties.com/scavenger-hunt-riddles.htm
Glossary of ADHD Terms. (n.d.). Retrieved April 21, 2016, from
http://www.webmd.com/add-adhd/guide/adhd-glossary
Glossary of Terms. (n.d.). Retrieved April 21, 2016, from
http://www.chadd.org/Understanding-ADHD/About-ADHD/Glossary-ofTerms.aspx
Morin, A. (2014). Cabin Fever: 9 Indoor Activities for Hyperactive Kids. Retrieved April
21, 2016, from https://www.understood.org/en/school-learning/learning-athome/games-skillbuilders/cabin-fever-indoor-activities-for-hyperactive-kids#slide3.
Symptoms and Diagnosis. (2016). Retrieved April 17, 2016, from

http://www.cdc.gov/ncbddd/adhd/diagnosis.html
Treatment. (2016). Retrieved April 15, 2016, from
http://www.cdc.gov/ncbddd/adhd/treatment.html
Quiz: How Well Do You Know ADHD? (n.d.). Retrieved April 21, 2016, from http://
www.additudemag.com/quiz/4/results.html
Meeting Minutes
33
Appendices
April 1, 2016: at 11:15am James Breaden, Mackenzie Morris and Danielle
Higgs met until 12:15 pm to discuss Training Manual

April 8, 2016: James Breaden, Mackenzie Morris and Danielle Higgs met
from 11:30 am-12: 30pm

April 13, 2016: James Breaden, Mackenzie Morris and Danielle Higgs had
a meeting from 11:15am-12: 30pm.

April 21, 2016: Danielle Higgs and Mackenzie Morris met from 12:30pm-1:
30pm to finalize project.

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ADHD: A Comprehensive Training

Attention Deficit Hyperactivity Disorder

Group Members: James Breaden, Mackenzie

ADHD: A Comprehensive Training

ADHD: A Comprehensive Training

ADHD: A Comprehensive Training

If extra time permits:

Word search Activity

ADHD: A Comprehensive Training

ADHD: A Comprehensive Training

ADHD: A Comprehensive Training

ADHD: A Comprehensive Training

social settings. Problems with attention include making careless

ADHD: A Comprehensive Training

Males are almost three times more likely to be diagnosed with

ADHD: A Comprehensive Training

There is only one type of ADHD.

ADHD is a disorder defined by inattention, impulsivity and/or

ADHD: A Comprehensive Training

Heredity is the most common cause of ADHD.

behavior (Teeter, 1998)

to these substances at early stages.

Incidence and Prevalence:

ADHD: A Comprehensive Training

ADHD: A Comprehensive Training

New Developments in ADHD:

ADHD: A Comprehensive Training

works is already providing new insights into the causes of ADHD.

early childhood that may cause differences in the brain.

ADHD: A Comprehensive Training

The American Academy of Pediatrics (AAP) recommends that healthcare

have ADHD, and how public health is impacted by this condition.

ADHD: A Comprehensive Training

symptoms of inattention have been present for at least 6 months,

mistakes in schoolwork, at work, or with other activities.

loses focus, side-tracked).

paperwork, eyeglasses, mobile telephones).

ADHD: A Comprehensive Training

is disruptive and inappropriate for the persons developmental

present before age 12 years.

reduce the quality of, social, school, or work functioning.

ADHD: A Comprehensive Training

dissociative disorder, or a personality disorder). The

ADHD: A Comprehensive Training

o Medications can help children with ADHD manage their symptoms

different medications and doses vary widely.

ADHD: A Comprehensive Training

Suggestions for Inclusion

Providing structure and consistency

occupied and attentive

ADHD: A Comprehensive Training

o Making tasks meaningful and relevant to their interests, providing

children and making sure they are focused.

ADHD: A Comprehensive Training

The organization will be introduced as well as the purpose for the

Video with questions and Discussion

ADHD: A Comprehensive Training

4.) When does ADHD generally first appear? (Early childhood)

ADHD: A Comprehensive Training

Hands-on activity: Balloon Volleyball

Scavenger Hunt Riddle

Q: The more I dry, the wetter I become?

ADHD: A Comprehensive Training

ADHD: A Comprehensive Training