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When OTs Wore White Shoes

ADHD and Occupational Therapy

Published October 6, 2014 9:47 AM by Debra Karplus
 When I was in second grade in the 1950s, Timmy was a boy in class who received much attention for consistently being out of his seat in class.  Mrs. Goldberg frequently scolded him and demanded that he stay seated.  He often vomited in class so pupils laughed at; he seemed to have few friends.  Was Timmy simply a product of lax parenting and consequently bad behavior?  Or was this possibly my first exposure to ADHD?

In a 1904 issue of the British medical journal The Lancet, a humorous poem entitled "The Story of Fidgety Philip" was published, possibly the first known reference to what we now know as ADHD.

I was in occupational therapy school in the early 1970s and have no recollection of any mention of any sorts of attention deficits in children.  In the late 1960s, attention disorders began to be taken seriously by medical professionals as something much more and complex than just a child who would not behave, but was "hyperkinetic"

The term "Attention Deficit Hyperactivity Disorder" was created in 1987.  And in the 1990s, The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), that standard textbook and diagnostic guide used by virtually all psychiatric health care providers, ADHD first appeared.

Peek into any general education classroom at the elementary school level and you're likely to see behaviors such as a boy or girl talking incessantly, flipping a pencil into the air, making frequent trips to the pencil sharpener, making "towers" by connecting  markers to each other, or bouncing around in or around his seat.  He may be the kid with the really messy desk or school papers and books scattered beneath his seat.  But this child is typically easy to spot because he or she seems not to be doing what the other students are doing, that is, paying attention in class, copying from the chalk board or Smart board, or reading or completing assigned worksheets in class.

Statistics state that ADHD affects boys more than girls.  It is typically diagnosed at around age seven, in first or second grade.  The National Institute of Mental Health (NIMH) claims that about three to five percent of children have ADHD, but others insist that number many be closer to eight to ten percent.  Adults have ADHD, or more likely its cousin Attention Deficit Disorder (ADD), too.  And if you're like me, sitting here and writing, but staring out the window, getting up to prepare a cup of tea and being challenged by completing this article, you may wonder if you have ADD, too.

OTs employed in schools are likely to be working with a student with ADHD.  We can start by modifying the child's environment, such as making sure his desk and seat are the proper size and are located in the least distracting part of the room.  We can use sensory integration techniques and train the child in self-regulation skills.  And, OTs need to maintain clear lines of communication with parents and teachers regarding medication and behaviors.


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January 23, 2015 12:58 AM

I too went to school and graduated from EMU in 1974... we learned about A. Jean Ayres even back then.. apparently she coined the terms ADD and ADHD back in the 1960s.. and published in the 1960s... She was an OTR who ended up getting her Phd in this research..unfortunately.. themedical profession and psychologists were not aware of OT back in those days... but we had a teacher who was familiar with pediatrics.. which is likely why we learned about this.. I also recall a kid named Stanley inmy class... who likely would be ADHD now.. he had a tough life...glad we have more understanding nowadays.. I like sitting on the swiss balls at the desks ... and lots of recess and gym music and art.. a 7 yo not meant biologically to sit still for more than about an hourat best.. :)

margaret morrison, geriatrics - OTR/L, prn November 8, 2014 2:18 PM
central IL

Have a look at this great micro-course about attention deficit disorder:

Prcko October 10, 2014 2:23 PM

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