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An Overview of ADHD

An Overview of AD/HD

AD/HD stands for Attention Deficit Hyperactivity Disorder. It is considered to be a neurobiological disability that interferes with a person’s ability to sustain attention or focus on a task and to control impulsive behaviour. We may all have difficulty sitting still, paying attention or controlling impulses, but for some people the problem is so chronic and persistent that it gets in the way of daily life—at home, at school, at work and in social settings.

Current research has shown that AD/HD is caused by a deficiency of specific neurotransmitters in a specific set of brain circuits. Depending on which areas of these circuits are involved, the person may be distractive, impulsive or hyperactive.

We also know that genetics may play a part. AD/HD is likely to run in families and seems to be passed down through generations. According to one twin study, if one twin had AD/HD, the other identical twin had a 75% to 91% chance of also having AD/HD.

AD/HD is not a learning disability (LD). Each is a distinctive neurologically based disorder. Each is recognized and diagnosed differently. And each is treated in a different way. The treatment for AD/HD will not correct LD. The treatment for LD will not help AD/HD. About 30% to 40% of people with LD will also have AD/HD, so if one disorder is found it is important to look for the other.

Do Many Kids Have AD/HD?

Yes. AD/HD affects about 3% to 5% of the children in Canada, with boys being affected about two to four times more than girls.3,4 We also know that girls are often older than boys when they are diagnosed and that they are less likely to be referred for treatment. This may be because the behaviour of girls with AD/HD is not usually as disruptive or aggressive, and they are often less trouble to their parents and teachers.4 AD/HD can carry on into adulthood. Up to 67% of people who had AD/HD as a child may continue to have symptoms of AD/HD as an adult.

How Might a Child with AD/HD Behave?

Three behaviours are used to confirm a diagnosis of AD/HD—distractibility, impulsivity and high energy/activity (hyperactivity). It is important to note, though, that just as everyone has different fingerprints, everyone with AD/HD has a unique set of symptoms that occur more often and in different settings all the time.

Distractibility/Inattention is supersensitivity and limited ability to tune out both internal stimuli (e.g. thoughts, pain, hunger) and environmental stimuli (e.g. noise, movement).1

Children who are distracted often have poor short-term memory and may easily forget instructions, have trouble keeping track of belongings, and organizing or concentrating on one task or finishing a task.

Children who are inattentive may also be underactive (known as hypoactive). Hypoactivity is insufficient motor activity. They react and work slowly and seem to be unemotional, so that they appear “lazy” and “spacy” or daydreamers.

Impulsivity is a lack of restraint. Impulsive people may react immediately, without thinking ahead, so they tend to make judgment errors. They want to satisfy their needs immediately, often interrupting others and blurting out whatever is on their mind, which they may regret later. They may know the rules but can’t pause long enough to think before they act, and so they don’t learn from their experience. Children who are impulsive get into trouble at school, with friends and at home. They have difficulty working and playing in groups and rush through tasks, making careless mistakes. They exhibit aggressive behaviour as a reaction to stress.

Hyperactivity is persistent, heightened and sustained activity. Hyperactive children are constantly restless—tapping fingers or feet, swinging legs or squirming in the chair. They may be up and down from their desk during class activities or doing several things at once. They may start projects but are unable to complete them because of too much energy and boredom as they constantly need stimuli. Their motivation appears to be fading.

When AD/HD is left unidentified or untreated, a person is at great risk for impaired learning ability, decreased self-esteem, social problems, family difficulties and potential long-term effects.

Evaluation, Diagnosis and Treatment

There is no one test to diagnose AD/HD. A comprehensive evaluation is needed to rule out other causes and to diagnose the presence of other co-occurring conditions. Treatment plans should be tailored to meet the specific needs of each person. Treating AD/HD requires medical, educational, behavioural and psychological interventions.

Co-existing Conditions

AD/HD often co-occurs with other conditions, such as depression, anxiety or LD. When co-existing conditions are present, academic and behavioural problems may be more complex.

The Upside

With identification and treatment, children and adults with AD/HD can be successful. Many professionals who work with children and adults have reported many positive features of AD/HD when it is managed appropriately.

People with AD/HD are often highly creative, and can show strong leadership skills. They are compassionate and/or empathetic with others—good at relating to younger children, elderly people and marginalized groups. At times, they may be able to hyperfocus and show great “stick-to-it-ness.” They are intuitive/perceptive and have a powerful drive to move ahead.


*** AD/HD is not a learning disability. Each is a distinctive neurologically based disorder. Each is recognized and diagnosed differently. And each is treated in a different way. The treatment for AD/HD will not correct LD. The treatment for LD will not help AD/HD. About 30% to 40% of people with LD will also have AD/HD, so if one disorder is found it is important to look for the other.

These fact sheets have been funded with an unrestricted educational grant from Eli Lilly Canada Inc. LDAC is solely responsible for the content.

Learning Disabilities Association of Canada  
www.ldac-acta.ca
info@ldac-acta.ca

Symptoms of ADHD

Symptoms of AD/HD

AD/HD is considered to be a neurobiological disability that interferes with a person’s ability to sustain attention or focus on a task and to delay impulsive behaviour.

AD/HD usually shows up in early childhood, unless associated with some type of brain injury later in life. Formal diagnosis of AD/HD is based on the Diagnostic and Statistical Manual of Mental Disorders6 (DSM-IV) from the American Psychiatric Association. Although the official diagnostic criteria state that the onset of symptoms must occur before the age of 7, leading researchers in the field of AD/HD argue that this criterion should be broadened to include onset anytime during childhood.7

AD/HD in Children

AD/HD comes in many shapes and sizes,5 but most children with AD/HD have a hard time paying attention, keeping “at it” and finishing tasks.

The diagnosis of AD/HD is not based only on the presence of the following symptoms. It is also based on their severity and duration, and the extent to which they interfere with everyday life.

The symptom-related criteria for the three following primary subtypes are adapted from DSM-IV and summarized as follows:

  • Six (or more) of the following symptoms of inattention have persisted for at least 6 months to a degree that is chronic and inconsistent with development level:

Predominantly Inattentive Type

  • often fails to pay close attention to details or makes careless mistakes in schoolwork, work or other activities
  • often has difficulty keeping attention on tasks or play activities
  • often does not seem to listen when spoken to
  • struggles to follow through on instructions
  • has difficulty organizing tasks and activities
  • avoids or dislikes doing tasks that require sustained mental effort, like schoolwork or homework
  • often loses things needed for tasks or activities, such as school assignments, pencils, books or tools
  • is easily distracted
  • often forgetful in daily activities
  • Six or more of the following symptoms of hyperactivity-impulsivity have lasted for at least 6 months to a degree that is chronic and inconsistent with development level:

Predominantly Hyperactive-Impulsive Type

  • fidgets with hands or feet or squirms in seat
  • leaves seat in class or other places where staying seated is expected
  • runs about or climbs excessively when it is inappropriate (in teenagers or adults, may show up as restlessness)
  • has difficulty engaging in quiet activities
  • is often “on the go” or acts as if “driven by a motor”
  • talks excessively
  • blurts out answers before questions have been completed
  • has difficulty awaiting turn
  • interrupts or intrudes on others, such as butting into conversations or games

AD/HD Combined Type

  • Individual meets both sets of inattentive and hyperactive/impulsive criteria.

AD/HD in Adults

Greater public awareness has led to more adults seeking evaluation and treatment for AD/HD and its associated symptoms. The current diagnostic criteria for AD/HD (reworded slightly to be more appropriate for adults) according to the most recent DSM-IV are:

  • fails to pay close attention to details or make careless mistakes at work
  • fidgets with hands or feet or squirms in seat
  • has difficulty sustaining attention in tasks or fun activities
  • leaves seat in situations where seating is expected
  • doesn’t listen when spoken to directly
  • feels restless
  • doesn’t follow through on instructions and fails to finish work
  • has difficulty engaging in leisure activities quietly
  • has difficulty organizing tasks and activities
  • feels “on the go” or “driven by a motor”
  • avoids, dislikes, or is reluctant to engage in work that requires sustained mental effort
  • talks excessively
  • loses things necessary for tasks and activities
  • blurts out answers before questions have been completed
  • is easily distracted
  • has difficulty awaiting turn (impatient)
  • is forgetful in daily duties
  • interrupts or intrudes on others

Although other rating skills and checklists are sometimes used in assessing adults for AD/HD, the above DSM-IV criteria are currently considered the most empirically valid. These core symptoms of AD/HD often lead to associated problems and consequences that often co-exist with adult AD/HD. These may include:

  • problems with regulating behaviour
  • poor working memory
  • poor persistence of efforts toward tasks
  • difficulties with regulation of emotions, motivation and arousal
  • greater than normal variability in task or work performance
  • chronic lateness and poor time management
  • easily bored
  • low self-esteem
  • anxiety
  • depression
  • mood swings
  • employment difficulties
  • relationship problems
  • substance abuse
  • risk-taking behaviours6

The impairment from both the core symptoms and associated features of AD/HD can range from mild to severe in their impact on academic, social and vocational settings, and in daily functioning. Since the symptoms of AD/HD are common to many other psychiatric and medical conditions and some situational/ environmental stressors, adults should never self-diagnose and should seek a comprehensive evaluation from a qualified professional.

Once a diagnosis is made, however, most people with AD/HD and their family and friends feel considerable relief—“at last there’s a name for it!” 5 The uncertainty over what was “wrong” is replaced with information and hope for the future.


*** AD/HD is not a learning disability. Each is a distinctive neurologically based disorder. Each is recognized and diagnosed differently. And each is treated in a different way. The treatment for AD/HD will not correct LD. The treatment for LD will not help AD/HD. About 30% to 40% of people with LD will also have AD/HD, so if one disorder is found it is important to look for the other.

These fact sheets have been funded with an unrestricted educational grant from Eli Lilly Canada Inc. LDAC is solely responsible for the content.

Learning Disabilities Association of Canada
www.ldac-acta.ca
info@ldac-acta.ca

ADHD and the Adult

Adults with AD/HD

For many years, professionals believed that children would outgrow AD/HD through puberty and adulthood. It is now recognized that AD/HD can carry on into adulthood—as many as 30% to 70% of children with AD/HD may continue to experience symptoms of AD/HD as an adult.

It can be difficult to spot AD/HD in adults because the symptoms are often mistaken for other things, like a stressful lifestyle, substance abuse or psychological problems. AD/HD is not often recognized in adults until they seek help with one of these conditions.

AD/HD in adulthood occurs as a continuation of childhood AD/HD. The person would have had the condition when younger, although it may not have been recognized at the time. Many adults realize they have AD/HD only when their own children or another family member are diagnosed with the condition.

Adults with AD/HD may experience problems in their relationships, work and education, but never really understand why. They may overreact to minor frustrations and find it difficult to organize things. Sometimes, they may have been treated for learning disabilities or depression. Others may have experimented with drugs, sex or gambling more than their peers.

Predominantly inattentive AD/HD is more common in women. It is associated with a higher incidence of learning disabilities, anxieties and sadness, and is often undiagnosed. Hyperactivity is more common in males and is sometimes associated with social rejection as a child.

Diagnosis of AD/HD in Adults

As it is for children, the criteria for diagnosis of AD/HD in adults were developed by the American Psychiatric Association. A detailed diagnosis procedure is needed to:

  • establish an accurate diagnosis and treatment plan
  • check for co-existing medical or educationally disabling conditions
  • rule out an alternative explanation for the person’s behaviour and difficulty

There is no single diagnostic test for AD/HD. Scales and checklists help clinicians obtain information from partners, family members, teachers and others about symptoms and functioning in various settings. This is necessary for an appropriate assessment for AD/HD and treatment monitoring. Symptoms must be present in more than one setting (for example, both at home and at work) to meet DSM-IV criteria for the condition. Such instruments are only one component of a comprehensive evaluation, which may include a medical examination, interviews and possible psychological assessment.

Treatment of AD/HD in Adults

In many cases, the diagnosis itself can be a major benefit for adults with AD/HD. Knowing that they have a medically recognized condition, and that they are not “lazy” or “stupid,” can be a big first step in dealing with their AD/HD. They may also feel saddened or angry that it was not recognized and treated sooner.

There is no cure for AD/HD. But being involved in the management and effective treatment strategies of your AD/HD will help you deal with the condition, along with support from doctors, family, friends, your local LDA chapter and employers. Treatment will normally involve several components, including:

  • education to help you and those close to you understand and manage your AD/HD
  • lifestyles changes, such as cutting back or giving up drugs, alcohol, taking up regular exercise, stress management and improved diet
  • developing strategies for dealing with behaviours that limit success
  • counselling to deal with self-esteem issues or co-existing conditions
  • marriage counselling to support your partner in understanding AD/HD
  • vocational counselling and workplace accommodations to help you achieve success at work
  • joining a support group or obtaining a coach
  • medication prescribed and taken appropriately to improve AD/HD symptoms and co-existing conditions

AD/HD and Relationships

AD/HD in adults can significantly affect their relationships with others, particularly a partner, family, friends and work colleagues. They may see the adult with AD/HD as unreliable, or become frustrated trying to understand or help. Research has found that the most common behaviours that have a negative impact on relations are:

  • doesn’t remember being told things
  • saying things without thinking
  • “zoning out” in conversations
  • problems dealing with frustration
  • trouble getting started on a task
  • underestimating time needed to complete a task
  • leaving a mess and being disorganized
  • forgetting special dates, meetings or always being late
  • not finishing a project.

For both members of a relationship, it is important to recognize these behaviours. That’s why any education about AD/HD needs to include the family and friends. Several interventions or strategies are available to deal with these difficulties. For example, if saying something without thinking is a problem, the adult with AD/HD should try to be aware of how his or her verbal impulsivity can make other people feel uncomfortable. People with AD/HD often enjoy vigorous conversation as a source of stimulation. But they should understand that others may not share this enjoyment and know how to tone down the argument and move onto another topic.19

Similar strategies are available for the other problems. Working with a counsellor or using self-help techniques can help adults with AD/HD improve their relationships.

AD/HD with Work or Studies

If you have AD/HD but didn’t know it for a long time, you may have been misunderstood at work, at university or college. Your behaviour—whether you are restless, impulsive, disorganized or easily distracted—can be seen as being purposefully disruptive and unreliable. People with AD/HD may be seen to be unmotivated, lazy, self-centred or even slow learners. AD/HD may lead to a lifetime of underachievement, falling short of goals at work and complicating relationships with co-workers. Since AD/HD symptoms are usually not visible, co-workers may also have difficulty understanding and accepting the limitations they create.

A poor person–job match may also exist. Sometimes, a person needs to choose a place of employment or type of work that makes the best use of particular strong points and minimizes weaknesses. At times, success may be achieved with the help of the employer by disclosing your AD/HD in order to receive job accommodations. These must be tailored to meet the person’s specific needs. Some examples of accommodations in the workplace include extra clerical support, access to audio and video equipment, job restructuring, reassignment to a different position that better matches strengths, modified work schedules, computer with reader and voice-activated software, and filing systems that meet your needs.

With the proper diagnosis and treatment, knowledge about how AD/HD affects you, a willingness to make changes, and the support and encouragement of family members, friends, your local LDA chapter and employers, you can learn to work around your difficulties, increase productivity and enjoy a more rewarding life.


*** AD/HD is not a learning disability. Each is a distinctive neurologically based disorder. Each is recognized and diagnosed differently. And each is treated in a different way. The treatment for AD/HD will not correct LD. The treatment for LD will not help AD/HD. About 30% to 40% of people with LD will also have AD/HD, so if one disorder is found it is important to look for the other.

These fact sheets have been funded with an unrestricted educational grant from Eli Lilly Canada Inc. LDAC is solely responsible for the content.

Learning Disabilities Association of Canada  
www.ldac-acta.ca
info@ldac-acta.ca

Co Existing Condition of ADHD

Co-existing Conditions of AD/HD

People with AD/HD sometimes have other conditions at the same time. These are referred to as co-existing, co-occurring or co-morbid conditions. A staggering statistic from the United States suggests that nearly 70% of people with AD/HD have at least one additional or co-occurring major disorder.

Diagnostic precision is essential for any person suspected of having AD/HD. Identifying these co-existing conditions becomes critical, as the presence of another condition may require different approaches or medications. Just as untreated AD/HD can leave lasting scars, so can other untreated disorders cause unnecessary suffering in AD/HD individuals and their families.

When co-existing conditions are present, they can vary widely depending on the person’s age and gender. In children, learning and language disorders and oppositional defiant disorder are the most common, followed by conduct disorder, depression, anxiety and tic disorders.

In teens and adults, substance abuse and depressive disorders become more prominent. Often overlooked are the differences in the ways that men and women manifest mental disorders. Women and girls are less likely to have “acting-out” problems, such as oppositional defiant or conduct disorders, and more likely to have more internalized conditions such as depressive or anxiety disorders.

To successfully treat co-existing conditions, clinicians and patients need to recognize the symptoms and understand the benefits and risks of treatment for multiple conditions.

Learning disabilities

(LD) are a distinct disorder from AD/HD and affect as many as 25% of children with AD/HD. Many adults also have both LD and AD/HD. Since each disorder interacts with the other, the behavioural symptoms can be difficult to handle. LDs affect the acquisition, retention, understanding, organization or use of verbal and/or non verbal information. They interfere with a person’s ability to either interpret what is seen or heard, and to link information from different parts of the brain, which can result in auditory and visual perception problems; academic problems; motor, temporal, organizational and memory problems; and social skills problems.

Depression

AD/HD frequently co-exists with depression (about 10% to 30% of children with AD/HD and more than 45% of adults with AD/HD). Symptoms can include lack of concentration, hopelessness, helplessness, suicidal tendencies, excessive sleep, crying episodes and pervasive sadness, among others. All too often their symptoms are mistaken for anger, shyness, lack of direction, perceived laziness, obstinacy or chronic underachievement. The mood problem in AD/HD may be subtle—it may not always be severe enough to be diagnosed as depression, but it is more severe than the ordinary dips in mood of everyday life. Treating only the depression or just the AD/HD is insufficient. Many patients require specific medications for each condition.

Anxiety

Many people with AD/HD experience chronic anxiety (about 30% of children and 25% to 40% of adults with AD/HD). They worry excessively about things (school, work, friends) and from chronically forgetting obligations, daydreaming, speaking or acting impulsively, or being late. They may feel stressed out or tired, tense and have trouble getting restful sleep. Some may experience severe panic attacks. Again, specific medications may be needed for each condition.

Substance Abuse

Recent studies suggest that youth with AD/HD are at increased risk for very early cigarette use, followed by alcohol and then drug abuse. Cigarette smoking rates are almost double in adolescents with AD/HD. Many people who have undiagnosed AD/HD feel bad, and do not know why. To escape their emotional or physical pain, to fit in, to relax, they sometimes turn to using substances. But when the “use becomes abuse,” it can become an illness itself. So, during the evaluation, it is important to explore the possible underlying causes for the substance abuse, such as AD/HD.

Treating AD/HD as early as possible can reduce the risk of cigarette smoking and substance abuse. Clinical studies indicate that the use of stimulant medication also reduces the risk to start smoking cigarettes. Several international studies have found that stimulant pharmacotherapy did not increase the risk for later substance abuse.

People with AD/HD and current substance abuse require comprehensive multimodal intervention incorporating parallel addiction and mental health treatment.

High-Risk Behaviours

Searching for highly stimulating situations is often a central part of AD/HD. If a person is hyperactive, he or she usually seeks action (but not the dreamy, hypoactive people). The hyperactive child or teen with AD/HD seeks novelty and needs excitement. If there is “nothing to spice up the scene,” the person might create one, like creating a disturbance at school or car racing. Adults, too, may seek high stimulation, such as exercising heavily or creating tight deadlines to work under, or they may take up riskier activities like bungee jumping, and in some severe cases excessive gambling or sexual practices.

Aggressive and Defiant Behaviour

can also occur along with AD/HD. In children, this is called oppositional-defiant disorder (ODD) (about 40% of those with AD/HD) or conduct disorder (CD) (about 25% of those with AD/HD). ODD involves a pattern of arguing with multiple adults, losing one’s temper, refusing to follow rules, blaming others, deliberately annoying others and being angry, resentful, spiteful and vindictive. In the child with AD/HD only, you do not see the premeditation you see in ODD or CD.

CD is associated with efforts to break rules without getting caught, aggressiveness toward animals, destruction of property, lying or stealing things from others, running away, skipping school or breaking curfews. It is often described as delinquency, and children who have both AD/HD and CD may have lives that are more difficult than those with AD/HD only.

In adults, such symptoms may be called “antisocial personality.” Some of those who are diagnosed as antisocial personalities may also have AD/HD. They test the limits, may break the law, or lie or cheat. These individuals can respond favourably to treatments for both co-existing conditions.

Emotional Problems

After years of struggling and failing to perform in school, at home and in the community, feelings of inadequacy and low self-esteem often arise. Being labelled “lazy” or “stupid” time after time, some people with AD/HD may act out these feelings, become aggressive, get into fights or impulsively strike out. Others may internalize their feelings, becoming depressed, withdrawn or show a poor self-image. Still others may channel their feelings into their bodies, developing headaches or other physical symptoms. Some believe that they are less worthy, and come to expect failure.
The good news is that with proper diagnosis, most of the co-existing conditions can usually be treated by a combination of counselling, coping strategies, medication, family support, education and/or accommodations in school, home or work settings.
The impairment from both the core symptoms and associated features of AD/HD can range from mild to severe in their impact on academic, social and vocational settings, and in daily functioning. Since the symptoms of AD/HD are common to many other psychiatric and medical conditions and some situational/ environmental stressors, adults should never self-diagnose and should seek a comprehensive evaluation from a qualified professional.

Once a diagnosis is made, however, most people with AD/HD and their family and friends feel considerable relief—“at last there’s a name for it!” The uncertainty over what was “wrong” is replaced with information and hope for the future.


*** AD/HD is not a learning disability. Each is a distinctive neurologically based disorder. Each is recognized and diagnosed differently. And each is treated in a different way. The treatment for AD/HD will not correct LD. The treatment for LD will not help AD/HD. About 30% to 40% of people with LD will also have AD/HD, so if one disorder is found it is important to look for the other.

These fact sheets have been funded with an unrestricted educational grant from Eli Lilly Canada Inc. LDAC is solely responsible for the content.

Learning Disabilities Association of Canada  
www.ldac-acta.ca
info@ldac-acta.ca

Diagnoses and Treatment of ADHD

Diagnoses and Treatment of AD/HD

Diagnosing AD/HD

Everyone shows signs of distractibility, impulsivity and hyperactivity at one time or another. Because of this, guidelines for determining whether a person has AD/HD are very specific.

There is no single test for AD/HD. Determining if a person has AD/HD is a multifaceted approach and involves a comprehensive evaluation for three reasons: to establish an accurate diagnosis; to evaluate for the presence of other co-existing medical conditions; and to rule out alternative explanations for behaviours and/or relationship, occupational or academic difficulties.

A physical examination, including hearing and vision tests, is usually the first step because it helps rule out any medical conditions that could cause AD/HD-type behaviour. Some medical conditions, such as hypothyroidism, can cause symptoms similar to AD/HD. A medical examination can also diagnose some of the conditions that may co-exist with AD/HD.

As part of the evaluation, a clinical assessment of the individual’s academic, social and emotional functioning and developmental level is done. This requires a clinical interview for a comprehensive history, observations, and information gathered from parents, teachers and partners. Diagnosing AD/HD in an adult requires an examination of childhood academic and behavioural history, as well as career difficulties.

Measures of attention span and impulsivity will be used, in addition to parent and teacher behavioural rating scales and checklists. The actual criteria for diagnosing AD/HD are set out by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition. To be diagnosed with AD/HD, a person must exhibit several of the listed characteristics. Some of them are:

Severity – The symptoms must be more frequent or severe than in other children the same age.

Early onset – Some of the symptoms must have been present before age 7.

Duration – The symptoms must have been present for at least 6 months.

Impact – The symptoms must have a negative impact on the individual’s academic, employment or social life.

Settings – The symptoms must be present in multiple settings, such as home, social settings, school or work.

To be diagnosed with AD/HD, individuals must exhibit six of the nine characteristics in either or both DSM-IV categories listed in Fact Sheet #2.

Treatment of AD/HD

A combination of education, behavioural, psychosocial and medication treatments is thought to be the most effective approach. This comprehensive approach to treatment is called “multimodal” and often includes:

  • parent training in behaviour management
  • behavioural intervention strategies
  • an appropriate educational plan
  • education regarding AD/HD
  • individual and family counselling
  • strategies for daily living
  • medication, when and if required
  • vocational counselling
  • lifestyle changes
  • appropriate academic and workplace accommodations
  • coaching, support groups

Behavioural interventions

Behavioural interventions try to change the physical and social environment to modify the behaviour of the person with AD/HD. This type of treatment requires the efforts of parents, teachers and other professionals. Some elements of this treatment include:

  • behavioural training for parents and teachers
  • clinical behaviour therapy (problem solving, social skills)
  • cognitive behavioural therapy (self-monitoring, verbal self-instruction, development of problem solving, self-reinforcement)

Some practical examples of behavioural interventions are being consistent and using positive reinforcement. Behaviour skill building, such as list making, day planners, filing systems and other routines, is also encouraged.

Pharmacological treatment

The most common medications are pyschostimulants that help in the production of neurotransmitters. A non-stimulant treatment for AD/HD has now been approved by Health Canada. Properly prescribed and taken according to instructions, medication can improve many of the symptoms of AD/HD, including inattention, distractibility and hyperactivity. Although medications do not cure AD/HD, while they are being taken they seem to correct for the lack of a certain chemical or neurotransmitter in the brain.

It is important to discuss with your doctor how the medication works and what its possible side effects are. Some possible side effects to these medications include insomnia, nervousness, headaches and weight loss. A comprehensive team approach with doctors, teachers and parents is required to monitor the medication and ensure that the correct dosage is being administered. Researchers have found that lower medication doses can be effective when a multimodal approach is used for treatment.

Prognosis

A multimodal treatment plan combining education, behavioural, psychosocial and medication is often used to treat AD/HD. Whatever approach is chosen, it needs to be recognized that the process must be maintained over a long period of time, and may need to be changed as the person develops. Constant monitoring and evaluation are required. Everyone must be included in this monitoring process, including the child with AD/HD if he or she has the capacity to understand. Armed with an understanding of the disability and its implications, and with appropriate treatment, strategies and support, individuals with AD/HD can succeed.


*** AD/HD is not a learning disability. Each is a distinctive neurologically based disorder. Each is recognized and diagnosed differently. And each is treated in a different way. The treatment for AD/HD will not correct LD. The treatment for LD will not help AD/HD. About 30% to 40% of people with LD will also have AD/HD, so if one disorder is found it is important to look for the other.

These fact sheets have been funded with an unrestricted educational grant from Eli Lilly Canada Inc. LDAC is solely responsible for the content.

Learning Disabilities Association of Canada
www.ldac-acta.ca
info@ldac-acta.ca

Adults and the Assessment Process

Reasons for An Adult Assessment for LD

How are learning disabilities identified (LD)? There is no one test for learning disabilities but a series of various psychological tests. It is important that the diagnosis is made by specialist licensed to diagnose LD. Some of these may include neuropsychologist, psychologist, clinical psychologist, school psychologist, educational psychologist and psychometrist who specialize in learning disabilities and are:

  • trained to administer the various tests;
  • trained and experienced in interpreting the results;
  • able to provide concrete recommendations for better learning and coping.

Why Go Through the Assessment?

If you decide to be evaluated for learning disabilities, you will learn a good deal about yourself. There are many compelling reasons to undergo an assessment. It will establish:

  • if there is, in fact, a learning disability or several different types of learning disabilities;
  • the extent and severity of the learning disability;
  • potential barriers to further academic studies or employment;
  • a program of remediation to improve problem areas or compensatory techniques and strategies to deal more effectively and efficiently with them;
  • a detailed account of your areas of weakness and strength;
  • recommendations for accommodations necessary to achieve success in school, home, and/or work;
  • recommendations for support services, such as counseling, vocational assessment, and job training and;
  • your civil rights protection. People with an LD diagnosis can request and have a right to accommodations in the work or educational setting.

Therefore, it is important to determine why you wish to be assessed. The reasons that lead the individual to seek an assessment as well as current problems and challenges should be discussed in addition to the expectations of what the assessment will accomplish. There are major differences between assessing for employment, educational needs or for self awareness.

The assessment should consist of:

  1. An initial interview
  2. A measure of intellectual functioning
  3. A measure of academic achievement levels
  4. Social and emotional evaluations
  5. Feedback interview

AN INITIAL INTERVIEW SHOULD COVER A THOROUGH REVIEW OF:

  • birth history and early development;
  • language and cultural background;
  • medical history including vision, hearing, neurological status, illnesses, allergies, medications and current health conditions;
  • family and social history to determine social, behavioral or emotional factors or any hereditary patterns;
  • academic and work history;
  • previous psychological evaluations and relevant medical tests.

A MEASURE OF INTELLECTUAL FUNCTIONING:

To assess learning aptitude: the individual’s actual ability to learn, measured through various different component of the learning process. The Wechsler Adult Intelligence Scale – Revised and the Woodcock-Johnson Psycho-educational Battery are widely used. In addition to determining levels of intellectual ability, specific measures should be included in the test battery to assess: short and long-term memory functions; language functions including receptive and expressive vocabulary; verbal and non-verbal abstract reasoning or logic; attention span, visual – perceptual abilities including various spatial tasks, sequencing, right-left orientation and fine motor dexterity and; organizational and planning skills.

A MEASURE OF ACADEMIC ACHIEVEMENT LEVELS

To measure what a person has actually learned so far. Basic skill areas of reading, spelling, written expression and mathematics should be evaluated. The profile of reading sub-skills should be determined (e.g.: reading vocabulary, word recognition, comprehension of paragraphs and phonetic knowledge); math computation and problem-solving; mechanical and creative aspects of writing. Study skills, organizational and workplace skills, as well as time management are other areas that should be assessed along with the basic skills. Learning disabilities screening questionnaires may be used to assess the individual’s perception of areas of ability and difficulty, life skills, specific academic problems, and workplace issues.

SOCIAL AND EMOTIONAL EVALUATIONS

This part of the assessment consists of formal instruments to determine whether social/emotional problems occur concurrently with or are secondary to learning disabilities. Anxiety, depression, poor self-esteem and attention deficit disorder are important areas to examine. Additional testing may be required if one suspects ADHD.

FEEDBACK INTERVIEW

Once the testing is completed and interpreted, a one hour feedback interview is carried out to convey the results along with suggestions for remediation to improve weaknesses or compensatory strategies and accommodations to cope more effectively with the problem areas. A written report is provided either at the same time or following the session. Ensure that the assessment provides a clear statement about: whether or not there are learning disabilities and if so what types(s); about strengths and weaknesses; and about guidelines to remediate and/or compensate for the learning disability and appropriate accommodations needed.

LENGTH OF TIME

Assessment for a learning disability usually takes six to eight hours. Often testing is done over two or three testing sessions.

BENEFIT OF AN ASSESSMENT

The greatest benefit is usually peace of mind. Most feel a sense of emotional relief when they learn that their difficulties have a specific reason. Many adults have grown up feeling inadequate attributing their difficulties to a general lack of ability. Knowing why they have experienced definable weaknesses often has an immediate impact on how they perceive themselves. A better understanding of their problems and notably their strengths can be an important first step towards building self-esteem and developing more effective coping strategies.

COST OF ASSESSMENT

Psychologists are usually not covered under a provincial health plan. The cost typically ranges from $1800 to $3500. Many unemployed or underemployed adults cannot afford such services. It is possible to gain access to an assessment through an institution (college, university or hospital) or agency (social services, vocational rehabilitation, Employment Insurance) if you meet their requirements. Some people may be covered by the Extended Medical Coverage from their Employment Health Benefit Plan who cover a portion of the testing and most require a letter of referral from a physician to the psychologist. Check cost and coverage before starting the assessment and ask about a sliding scale fee structure and payment over time.

AFTER DIAGNOSIS, WHAT NEXT?

An assessment provides needed documentation and is a key that can open many doors. More importantly it helps people to match their career choices to their strengths. Ensure that the assessment provides a clear statement about: whether or not there are learning disabilities and if so what types(s); about strengths and weaknesses; and about guidelines to remediate and/or accommodations for the learning disability.

There can be advantages to both the employee and employer in monetary and personal cost-effectiveness. Many employers are willing to accommodate in a supportive yet confidential and professional manner. It is strongly recommended that post secondary students disclose since there are many excellent support programs for the student with learning disabilities in community colleges and universities. Finally, make certain you keep the original assessment. You may need these reports to request accommodations for work or education.

Learning Disabilities Association of Canada  
www.ldac-acta.ca
info@ldac-acta.ca

The Adult with Learning Disabilities and Employment

The Adult with Learning Disabilities and Employment

For many adults who have learning disabilities, the skills of searching and applying for a job, attending an interview, accepting a job offer and then keeping a job may be particularly difficult.

Many are unaware that the difficulties they encountered in school, and the problems in their jobs are due to learning disabilities.

The bright, alert demeanour of the person who has learning disabilities fosters behavioural expectations that may not be met. The disappointment that follows is equally frustrating to both employer and employee.

What are the major signs an employer should watch for?

PERFORMANCE INCONSISTENCY:

  • excellent spoken vocabulary with good sentence structure but unable to write thoughts;
  • able to develop a complicated set of arrangements over the telephone but becoming confused in group discussions;
  • capable of following printed information, but experiencing difficulty with verbal instructions;
  • understanding and identifying key elements in spoken information but unable to identify important points in print;

DIFFICULTY WITH TIME, SPACE AND NUMBERS:

  • confusing up with down; left with right; getting lost easily;
  • arriving late or unusually early for appointments;
  • capable of following printed information, but experiencing difficulty with verbal instructions;
  • difficulty doing accurate numerical or mathematical work, trouble with budgeting and money handling.

COMMUNICATIONS CONFUSION:

  • misinterpreting different meanings implied by tones of voice;
  • inaccurately responding to non-verbal cues such as facial expressions, eye contact, body and hand gestures;
  • interpreting language literally rather that understanding figures of speech.

CONCENTRATION PROBLEMS:

  • easily distracted by background noise and/or visual distractions;
  • difficulty paying attention to, and sometimes understanding and remembering, oral instructions;
  • a short attention span;
  • ongoing problems completing assignments or tasks.

POOR CO-ORDINATION:

  • appearing clumsy, awkward, and apparently accident-prone;
  • poor hand coordination;
  • difficulty in listening and taking notes at the same time;
  • copying inaccurately, with poor writing skills;
  • showing a lack of organization in written work.
  • It is felt by many people that the formal identification and disclosure of the presence of a learning disability assist both the employer and the employee.

THE BENEFITS FOR THE EMPLOYER INCLUDE:

  • a better understanding of the employee’s needs,
  • the ability to accommodate the learning disability without facing complaints from other employees and
  • the ability to meet the requirements of employment equity legislation.

THE BENEFITS FOR THE EMPLOYEE INCLUDE:

  • access to an appropriate job,
  • improved prospects for appropriate compensatory strategies and job accommodations and
  • the accompanying reduction in stress, related to covering up mistakes and hiding the presence of the learning disability.

WHAT ARE « JOB ACCOMMODATIONS » OR ASSISTIVE TECHNOLOGY?

  • These may include but are not limited to the following:
  • flexible work assignments
  • access to word processors, calculators, tape recorders, voice recognition phones to permit dialing by voice;
  • automatic dialers for persons with sequencing problems;
  • timers to help recognize the time spent on various tasks;
  • scanners that scan printed text and read it out loud.

Statistics tell us that many people with learning disabilities typically hold a job for three months. Many spend years on the merry-go-round of hiring and firing, until they give up altogether. Others settle for entry level jobs even if they have the potential and skills to progress well beyond that point.

WHAT ARE THE EMPLOYER’S RESPONSIBILITIES?

  • As a business person, it is in your best interest to recognize that staff turnover accounts for a great deal of lost productivity. It is more profitable to make « job accommodations » for an employee with learning disabilities than to hire a new person for a particular job.

WHAT ARE THE EMPLOYEE’S RESPONSIBILITIES?

  • To cooperate in the development of a « job accommodation » plan that is mutually agreeable and acceptable.
  • To work in a diligent and effective manner to meet job standards.

Adapted from:

  • Design for Success: An Employer’s Guide to Learning Disabilities, by E. Nichols, (1994) LDA-Ontario
  • Tools for Transitions: A Counsellor’s Guide to Learning Disabilities, by E. Nichols, (1994) LDA-Ontario.
  • Employing People with Learning Disabilities is Good Business, by LDAC, (1993)
  • Nobody’s Perfect: An Employer’s Introduction to Learning Disabilities by E. Nichols, (1994) LDA-Ontario.

Learning Disabilities Association of Canada
www.ldac-acta.ca
info@ldac-acta.ca

When Bright Employees Don’t Measure Up

When Bright Employees Don’t Measure Up

Ron has a BA from the University of Guelph. He sells microcomputers and software to small and medium-size companies that are computerizing office management, customer accounts, and payroll. He’s great at developing new customer prospects and making initial contacts.

Chatting with the clients and generating interest in the products always get the process off to a promising start. But then things seem to fall apart. He’s fuzzy on precise product specifications and sometimes misjudges customer requirements. His quotations are frequently incorrect and, too often, the customer slips away before he can straighten things out and close the sale. His manager is more and more on Ron’s case about his sloppy performance, yet the manager is confused about what to do. He knows Ron is bright enough and is really motivated to sell. So why doesn’t he get his act together?

Brenda’s a receptionist, outgoing and well-liked by everyone in her company. She is extra conscientious, always willing to go out of her way to make visitors welcome, handle personal messages for staff, and take on extra typing when things get hectic in the office. Because of this, people try to ignore the persistent mix-ups at the front desk. Messages are seldom right: the date is wrong or digits in a telephone number are reversed, or she thought they said ‘can’ instead of ‘can’t’ make the meeting. If one of these mistakes costs the company an important contract, though, people’s patience will run out.

Neither of these employees is stupid, nor are they purposely trying to lose their jobs. So why can’t they shape up? It’s likely both Ron and Brenda have learning disabilities (LD) unknown to them and undiscovered when they were in school. Research has confirmed that approximately 10 to 15% of the population has some type of learning disability that causes serious problems in school achievement or on the job.

In school, there is at least one child in every classroom, with Attention Deficit Disorders (ADD-H) often compounding those numbers. Even though this is not a new discovery to researchers in education and psychology, schools still struggle to cope with this reality. In business, it’s a relatively new concept.

Learning disabilities are not related to intelligence: in fact, many affected individuals have IQ’s well above average and often in the superior range. So they are frequently labeled lazy, stubborn, disorganized, or just uncaring. Highly intelligent people may have serious reading problems, may be atrocious at spelling, mathematics, or acquisition of a second language, or be unable to remember a name or a telephone number two seconds after hearing it. If they’re bright enough to compensate, to fake it somehow or scrape through at school, and often college, as well, the problem goes untreated and continues to affect their adult performance at work.

One of the hidden effects of learning disabilities is in the realm of social skills and communication. Similar-sounding words like ‘come’ or ‘crumb’ may be confused – or with more consequences for business, ‘contact’ and ‘contract’. Subtle social cues that most of us pick up from voice inflections, facial expressions, and body language can be missed by many of these individuals, as can dry humour and innuendo. Conversations that never quite connect lead to misunderstandings and frustrations on both sides, with a growing lack of confidence on the part of the affected person.

As workplace awareness increases, some managers may be wondering what magic tests their personnel departments could acquire to ensure that none of these unfortunate souls are inadvertently hired by their companies. But that’s not the point at all. There may be only one small area of weakness, and most of these difficulties can be corrected much more easily than can alcohol, health or family problems, lack of motivation, incompetence, or personality conflicts on the job.

Since 10 to 15% of the population is affected on some level, if such tests were administered to existing employees you might come up with some real surprises, from the president on down. For remember, many intelligent people compensate and learn to work around their problems area extremely effectively. Some of your best people might have to be fired if you used this criterion alone. (both Winston Churchill and Albert Einstein exhibited severe ‘learning problems’ in school) So there’s no easy out.

What to do about the Rons and Brendas, then? As a supervisor, assist the employee in pinpointing his or her specific strengths and weaknesses; carefully, with consideration and respect. If someone like Ron has trouble learning product specifications from a manual, arrange several days of hands-on training with one of the technicians. If he underlines relevant sections of the manual and makes brief refresher notes, he’ll have it down in no time. If math’s a problem, illustrate concepts graphically, break down problems into components and simple steps, and use the pocket or talking calculator. Encourage him to « partner » with someone for an accuracy check.

Train people who have communication difficulties like Brenda’s to check their information with the source every time. Have them write everything down and then read it back to check the details. In meetings, use handouts and charts as much as possible to accommodate people in the room who learn better visually than orally. Role-playing, creative use of videotapes, hands-on experience, and follow-up assignments ensure that everyone has got the point and can put new ideas into everyday practice.

Some managers may dismiss individual supervision as too time-consuming and costly. But companies that have learned effective supervision techniques quickly bring out the best in each worker. Motivation is increased and people’s energies and talents are directed efficiently and profitably to the business at hand. Truly unmotivated individuals can be directed to the hand of some other business.

So the next time you’re ready to jump on that employee who doesn’t follow instructions properly or can’t seem to write a decent order, remember that with a few minutes of careful instruction in the weak spot you may be unlocking an added source of energy and revenue for your company. You may also be helping your Ron or Brenda turn out that star performance you knew was just under the surface all along.

Here are some further suggestions for coping with LD or ADHD in the workplace:

  1. Use computer software that allows written material to be scanned into the computer and read aloud to the reader
  2. Use voice recognition software for dictating rather than writing or typing
  3. Obtain clerical or volunteer proofreading for spelling and grammar problems beyond what computer spell and grammar check software can do
  4. Ask supervisors to check work outlines or rough drafts before proceeding with a project
  5. Ask for instructions to be given slowly and clearly, in both verbal and written format.
  6. Repeat back instructions for confirmation – request a brief demonstration where relevant, reasonable, or possible
  7. Keep your work area tidy and organized – colour code items for easy location
  8. Have the supervisor ensure that common work stations, file and supply shelves are kept tidy and organized as well
  9. Arrange with your supervisor for a work location and schedule to minimize interruptions
  10. Do one task at a time, take short, frequent breaks (working longer total hours, if necessary)
  11. Use a daily calendar or daytimer and a signal watch that « beeps » for time management*

Learning Disabilities Association of Canada  
www.ldac-acta.ca
info@ldac-acta.ca

Transitional Steps to Successful Employment

Transitional Steps to Successful Employment

For an individual to have a good experience in the world of work, the amount and type of preparation that leads up to employment can make the difference between success and failure. Some students with learning disabilities decide to pursue employment immediately after high school however the changing nature of the job market is making employment more difficult to obtain without specific skills.

Steps to help a young person prepare for entering the workforce are:

  1. Consult as early as possible with a school counselor about interests, goals, training needs and reasons for choosing to go to work. It’s important to find a job that fits with your strengths.
  2. Develop self advocacy skills, knowledge of learning strengths and weaknesses and how the learning disability can affect job performance
  3. Understand type of accommodations needed
  4. Visit a number of job sites, and/ or arrange for job shadowing
  5. To help establish a work record and possible references, find summer volunteer or paid opportunities during the student’s senior years of high school or through a work co-op.

Other transition issues to be considered should involve independent living skills, managing money, transportation arrangements, interpersonal and communications skills and time management. Since inappropriate social skills and poor time management are often unmentioned causes for the loss of a job, it is important to address these issues with the student.

Transitioning from college to work is a process. Choosing a major or a career is a difficult task. A student can seek help with this process by:

  1. Meeting with the disability service provider and academic adviser to discuss how their learning disability might be an issue in the work setting of their chosen field.
  2. Investigating whether the student’s school has any job shadowing, co-op or mentoring programs.
  3. Looking for opportunities to gain work experience through campus leadership opportunities, student government, work study position on campus, internships, or summer jobs

Students can strengthen the likelihood of successful, satisfying employment by developing their basic skills and learning strategies. They must take advantage of reading and writing laboratories or any other academic resources to enhance their skills. One of the most important area to develop is an understanding of available technologies. Many facets of the employment world rely on technology. The new technologies also offer many advances that can be useful accommodations for some individuals.

Research has shown that an important variable in relation to job satisfaction and career choices is a clear understanding of one’s learning disability and how it impacts on day to day work performance and activities. Whether the student is a high school graduate or postsecondary education graduate, the student must begin this process early and transfer their knowledge of their learning disability into the world of employment.

Students should consider the following:

  1. What is the impact of my learning disability(ies) on job performance?
  2. Does the job ‘match’ or ‘fit’ with my abilities?
  3. How, to whom or when does one disclose a learning disability?
  4. What are possible accommodations that will enhance job performance?
  5. What kinds of social demands and interactions are needed?

Every company or organization has its own unique culture. The culture consists of company rules, values and politics, which are widely held but often unspoken.

  1. Observe your co-workers
  2. Know what is expected of you
  3. Observe how others dress, communicate and interact.

It is important to match job tasks with individual strengths and weaknesses to identify specific accommodations that will enhance job performance.

Getting ready for the world of work also means becoming familiar with the laws that govern employment and to have a clear understanding of employers’ obligations to provide reasonable accommodations. It also means that accommodation is a shared process.

Employees have a responsibility to ensure that they are part of the solution. Once the employee discloses the learning disability to the employer/supervisor and provides details of what would be an appropriate accommodation in the particular task/job, then the employee must continue to cooperate with the employer to ensure appropriate change. Clear communication with the employer is one of the basic steps needed in successfully implementing accommodations. Remember, there is no set formula for accommodation – each person has unique needs.

To have a successful employment transition, it is important to identify and tap into your own support system by seeking the support of family, loved ones, a mentor, friends and/or co-workers.

Whether it’s a high school student or a postsecondary student going into the world of work after graduation, or an individual making a career move, fear of the unknown is a natural emotion.

For many, who are unprepared for this transition, extreme anxieties can interfere with employment satisfaction and success. Being well prepared is key to allaying fears and preparing to enter the workplace with self-confidence, anticipation and enthusiasm.


Adapted with permission from Learning Disabilities of America – Fact Sheet ‘Transitioning from College to Work’

Roadmap On Learning Disabilities for Employers, (2003) Learning Disabilities Association of Canada


Learning Disabilities Association of Canada  
www.ldac-acta.ca
info@ldac-acta.ca

Workplace Accommodations and Best Practices

Workplace Accommodations and Best Practices

Best Practices and Accommodations for Various Learning Disabilities

As an employer, you may be vaguely aware of what a learning disability is, and the obligation to provide appropriate accommodations, but you may not know how to match an accommodation with a candidate’s specific need. The following list provides a description of the major types of learning disabilities, along with workplace examples, and solutions in modifying the interviewing process. Solutions offered may in fact be helpful to all employees or candidates, regardless of ability.

Employers must:

  • be willing to enter into a mutual agreement in offering accommodations;
  • be willing to explore all the options in the types of accommodation needed; and
  • make sure that the accommodation and/or solution is mutually satisfactory.

Persons with learning disabilities must:

  • tell employers what their specific needs are;
  • suggest the kinds of accommodations that will meet their specific needs; and
  • enter into a partnership with the employer, whatever the agreed-upon accommodation.

Information Processing Problems

1) Auditory Perception Problems:

The individual has difficulties in receiving and/or processing accurate information from their sense of hearing. This may be characterized by an inability to hear one sound over background noises or hearing the difference between similar sounds and/or sounds in order. There may be difficulty in remembering a series of commands or instructions or in retrieving stored information.
Examples:

  • difficulties hearing verbal instructions or questions if there are other noises in the room;
  • slowness in responding to verbal questions or instructions;
  • poor information sequencing; and
  • poor listening skills.

Solutions:

  • reduce background noises (telephones ringing, noisy machinery or background conversations);
  • allow sufficient time for instructions or questions to be repeated;
  • let candidates sit near interviewer(s), speak slowly and deliberately, allow time for the candidate to process information;
  • provide written copy of instructions;
  • whenever possible provide a copy of the questions;
  • demonstrate exactly what needs to be done, rather than describing the task; and
  • encourage note taking.

2) Visual Perception Problems:

The individual has difficulties taking in and/or processing information from the sense of sight which may be characterized by difficulties in seeing specific images or picking out an object and/or in seeing things in the correct order and/or in seeing the difference between two similar objects such as « v » and « u ». There may also be difficulties perceiving how far or near objects may be.

Examples:

  • incapacity to find key information provided in written form;
  • inability to pick out one line of print from another;
  • interferes with the ability to read, compute, or complete an inventory or a budget;
  • interferes with a person’s ability to read as quickly as others;
  • difficulties filling out an application form; and
  • may be clumsy, trip or bump into things.

Solutions:

  • provide a room with minimal physical distractions;
  • provide a written exam in an alternative format such as on tape;
  • provide voice-activated computers for written material;
  • give verbal instructions;
  • provide a talking calculator;
  • provide information on tape; and
  • give time to complete the task.

3) Academic problems

The individual has difficulties in the ability to use language and to express oneself in reading, writing, spelling, and/or mathematics. There may also be difficulties sounding out letters, confusing words that sound similar, and expressing thoughts on paper.

Examples:

  • not able to write exams;
  • frequent spelling and grammar mistakes;
  • unreadable penmanship, poor spelling; and
  • unable to do simple calculations.

Solutions:

  • provide information on tape;
  • provide a computer and/or spell checker;
  • allow extra time for written tests;
  • allow a reader to read test questions aloud;
  • provide verbal instructions that are clear and simple ;
  • demonstrate exactly what needs to be done;
  • put the information on tape;
  • use a colour pen to highlight key information or instructions;
  • allow assistive technology (such as audio and visual aids, word processors, spell checkers, proofreading computer programmes, voice-activated computers, calculators, tape recorders) to enhance performance;
  • allow more time for reading and writing; and
  • preview information in order to prepare for interview.

4) Motor, temporal and organizational problems

The individual has difficulties in moving one’s body to achieve its goals, perception of time and space, and the sequencing of information.

Examples:

  • difficulty in using the hands while writing;
  • showing a lack of organization in written work;
  • arriving late or unusually early;
  • inaccurate movement such as clumsiness, awkwardness or stiffness;
  • confusion between left and right;
  • difficulty telling time; and
  • tendency to reverse letters and numbers.

Solutions:

  • use timers or verbal response as reminders;
  • map information;
  • allow extra time for travel between interviews;
  • use alarms or bells, etc. to signal changes;
  • use visual cue to indicate change;
  • allow candidate to work at their own pace; and
  • allow extra time to process information.

5) Attention Problems

The individual has difficulty sustaining attention during a long period of time characterized by distractibility,inconsistent performance and/or problems focusing on details.

Examples:

  • easily distracted by background noises during an interview;
  • difficulty paying attention to verbal instructions or questions, sometimes not remembering or understanding verbal information; and
  • fidgeting, need to be on the move (feet/pencil tapping).

Solutions:

  • give clear directions in small single units, rather than one long installment;
  • repeat all information several times until understood;
  • allow person to get up and move around at intervals; and
  • allow extra time.

6) Social Skills Problems

The individual has difficulties in assessing one’s impact on others, acting impulsively and not having the ability to judge non-verbal body language.

Examples:

  • standing too close;
  • inappropriate body language and/or talking too loudly or too softly; and
  • inability to read facial expressions, body gestures and/or tone of voice.

Solutions:

  • avoid sarcasm, say what you mean;
  • don’t expect hints, body gestures to convey information;
  • allow extra time;
  • maintain eye contact; and
  • paraphrase information to convey the message.

Persons with learning disabilities will not require all of the above accommodations but employers can assist employees by identifying and mutually agreeing upon appropriate accommodation based on their strengths and weaknesses.

Source: Barriers Free Interviews and Competitions, published by Learning Disabilities Association of Canada (1998)

Learning Disabilities Association of Canada  
www.ldac-acta.ca
info@ldac-acta.ca

Strategies for Adults Living with LDs

Strategies for Adults Living with LDs

Build your own success story. Learn to help manage your learning disability in different areas of your life. Find out about strategies, techniques and tricks for dyslexia and other learning disabilities to help you tackle daily challenges in the areas of education, employment, and social interaction.

Attention

  • When possible, locate in an environment free of distractions such as people or noise. Position your desk so that your back is facing a door or widow. Ask that your work space is not near an office gathering place such as a photocopier, water fountain or coffee machine.
  • Create your own distractions that help you to focus. Listen to the music, on a radio or bring a portable radio with headphones. Listen to relaxing music not a talk show. Use tactile toys such as a soft or textured hand ball to keep your hands busy.
  • When possible, get up and move around at intervals. Limit your movement to 10 or 15 minutes.

Auditory Processing

  • If a boss or co-worker has a habit of giving you verbal instructions in a hallway, or in noisy areas, ask to move into quiet room. Carry a note book all the time. Or ask if the information can be emailed or written down for to you to remember.
  • Let co-workers know that you prefer to communicate important information or instructions in writing.
  • Make eye contact with the speaker as you face the person.  Ask to have information or directions repeated or clarified when you feel confused. Repeat information quietly to yourself in steps, to remember it.

Coordination

  • If writing is a challenge, consider using alternative methods of presenting information. For example, tape or digitally record your notes, provide oral reports and up dates, use a computer or laptop with voice activate software, send emails. Provide information in point form rather then in lengthy sentences.
  • Allow extra time for travel, car pool to work or to activities.
  • Be aware that undeveloped body, facial, or hand coordination may appear awkward, aggressive or confrontational. Practice walking towards someone and notice the grip when shaking hands. Make sure that it’s not too hard or too weak. In front of a mirror, rehearse different facial expressions, noticing the positions of your eyes, mouth, lips, etc.

Math

  • Use budgeting software or spread sheets to enhance your performance at home or work. These programs or software help in household budgeting such as incoming / outgoing income, fixed and variable expenses, or saving money for a large purchase.
  • Think about job sharing with someone at work. A co-worker can do your math or financial responsibilities as you take over your co-workers tasks or duties such as answering the phone, greeting people or doing paper work.
  • Use a regular or talking calculator for simple and complex math problems.

Organization

  • Challenge yourself to use a visual planner, an agenda book, etc., so that you can see at a glance the tasks or activities you are supposed to do and when to do them. Set a timer, an alarm digital watch, etc., throughout the day to remind you to look at the planner.
  • Instead of writing down a reminder, record a voice message on a tape or digital recorder or call your home or office answering machine and leave a message to yourself.
  • Breaking down tasks or jobs into smaller parts greatly reduces the feelings of being overwhelmed and/or frustrated. Attach deadlines to each part. Then, “presto”, the large task gets done leaving your relaxed and satisfied.

Procrastination

  • Prioritize your daily and weekly tasks.  Order them by deadlines or due dates. Once organized, arrange them in order of importance to get them done. For example, paying your bills on time should be more important than cleaning your desk.
  • In your minds eye, see a picture of the completed task and how you will feel at that time. Maintain focus and remind yourself how good you will feel when you’re done.
  • Learn to set deadlines and let other people know about your deadlines and encourage them to check up on you.

Reading

  • Allow assistive technology (such as audio and visual aids, word processors, spell checkers, proofreading computer programs, voice-activated computers, calculators, tape recorders) to enhance performance.
  • Use assistive technology such as voice-activated software if the mechanical aspects of writing remain a major hurdle.
  • Use your finger when reading. Move your finger beneath the line as you read. This way you focus on the words, it helps your from skipping words or dropping sentences.
  • Comic books, newspapers, magazines are good examples of reading materials

Self-esteem

  • Understand the specifics of your learning disability. Identifying your strengths allows you to use and develop them to there potential. Knowing what your areas of need are allows you to find and ask for accommodations.
  • Avoid getting overwhelmed and burdened by large tasks or problems. Divide large tasks into smaller, manageable ones. Or brake down the problem into chunks, and pick one or two to deal with at a time. This will help ensure success that things were accomplished, rather then avoided due to its complexity.
  • Understand why you had trouble in school. Yes, it’s too bad that others ridiculed you. Yes, lack of understanding and proper help denied you an education. Yes, you tried to hide your problems and couldn’t cope. But that’s life. Get on with it and work towards your new goals.

Social Skills

  • People’s actions speak louder than their words. If a co-worker or friend’s words say one thing but their actions say another, “stop”, “think” and consider that their actions might mean their true feelings.
  • Be alert at every opportunity to what others are doing around you. Look around for clues about how people greet each other, dress for work, home or evening, take turns talking, seating, etc. Be observant.
  • Find yourself a mentor such as a co-worker or friend who is willing to provide you with tips. Your mentor might advise on different stages of braking into a conversation, introduce you to other people, or suggest alternative ways of doing things. Listen to their feedback on your actions.  Thank your mentor often. In return, offer your help when you can.

Spelling

  • Consider doing your written work on a desktop or laptop computer and use the spell and grammar checkers. If hand written use an electronic pocket spell checker. Beware that electronic speller, Thesaurus, etc., make errors especially when you have used the wrong word but spelled it correctly. For example, “After I maid my bed, eye drove to work”
  • Make it a habit to work with a dictionary. You can even make or adapt a dictionary by adding words, or highlighting existing words that you find are difficult to remember.
  • Before handing in written work, have someone edit and proofread it. Or use voice output software that reads the written text for you.

Time

  • Make use of external structure to save time. Make frequent use of colour code lists, reminder post-it notes, coloured files, and to-do list.
  • Avoid getting overwhelmed and burdened by large tasks or problems. Divide large tasks into smaller, manageable ones. Or brake down the problem into chunks, and pick one or two to deal with at a time.  Write down what needs to be done. Attach deadlines to the small parts. Inform people when you anticipate a task to be ready.
  • Write everything down in your calendar or agenda book. Share your agenda with family, friends, employer or co-worker. Use alarms or timers to frequently check you agenda.

Visual Processing

  • Use your finger or a ruler as a reading guide to help you keep focus on one line or word at a time.
  • Before writing letters, reports or essays, create an outline to simplify and organize ideas. Have a friend or co-worker proof-read all written materials.
  • Use technology like voice-activated computer software or tape /digital recorder or talking calculator for written material.

Writing

  • Use assistive technology such as a desk top or laptop computer. Software such as voice-activated, voice output, grammar, editing/proofreading or word prediction help in writing, spelling, and organizing information. Using this type of technology in writing, helps you overcome a major hurdle.
  • When organizing and writing a report, memo or filling in document such as a job application, create a list of important example keywords that are repeated. The works should be in large print, bold in colour, and well formed. This list of example keywords is helpful when filling in information.
  • Have a friend edit your written works by providing clear, constructive feedback on its quality, explaining both the strengths and weaknesses, commenting on the structure as well as the information that is included.
  • Ask for extra time to prepare written work (and) allow yourself extra time to get it done.

Learning Disabilities Association of Canada
www.ldac-acta.ca
info@ldac-acta.ca

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