Description and History

Asperger syndrome (AS)/ Disorder (AD),
-A neurodevelopmental disorder characterized by significant difficulties in social interaction and nonverbal communication, along with restricted and repetitive patterns of behavior and interests.
-Easily confused with giftedness

Childhood Disintegrative Disorder/Heller's Syndrome
-A condition in which children develop normally through age 3 or 4 then over a few months , they lose language, motor, social and other skills that they already acquired. Cause is unknown.

Pervasive Development Disorder-Not Otherwise Specified (PDD-NOS)
The diagnosis applied to children or adults who're on the autism spectrum but do not fully meet the criteria for another ASD such as autistic disorder or Asperger's Syndrome.

Autistic disorder/ Kanner's syndrome
-A condition related to brain development that impacts how a person perceives and socializes with others, causing problems in social interactions and communication.

"Conduct disorder" manifests to a group of persistent and repetitive behavioral and emotional problems in children and adolescents. Youngsters with this disorder have great difficulty following rules, respecting the rights of others, showing empathy, and having in a socially acceptable way. Their behavior may view by others as "bad" or delinquent rather than mentally ill. (American Academy of Child & Adolescent Psychiatry, 2018) CD has two subtypes: childhood-onset (before age 10) and adolescent-onset (after age 10). In about 40% of cases, childhood-onset CD prons to develop into adult antisocial personality disorder. (AAFP, 2001) Symptoms are divided into four main groups - aggression, destruction, deceitfulness, and violation of rules. (Johns Hopkins Medicine, 2021)

"In 1968, the term Conduct Disorder was first used in the DSM II drawn up under the auspices of American Psychiatric Association (APP). In 1977-1978, the term was taken up by the World Health Organization (WHO) in its updated International Classification of Diseases (ICD-9)." (Collective Expert Reports, 2005)

1.Talking to parents understand to their child’s strengths, challenges, interests and triggers.
2.Treating outbursts, and meltdowns as teachable moments rather than cause for punishment.
3.Use visual aids to communicate and teach in the classroom.
4.Minimizing stimuli in the classroom. This can include seating autistic students near windows for better light, avoiding clutter, teaching classmates about appropriate speaking volume, ensuring less wall posters around the student's desk and avoiding distracting computer screensavers.

1. Looking for Evidence-based programs for your school.
   An example is the ASD NEST and ASD Horizon programs in New York with great features in Class structure ( a special Ed and a general Ed teachers co-teaching) , Curriculum & Instruction (Teachers are trained to use the NYSS & specialized teaching strategies for children with autism as well specialized curriculum called Social Development Intervention - an evidence-based curriculum developed by NYU), and Social-Emotional Supports aimed at improving social functioning.
2. Providing the ASD students & famiilies different options for educational placement to choose the best mode of education for their child.
   Some example modes are specialized schools, traditional coursework, mainstreaming ,& specialized classrooms.
3. Putting in place support programs and initiative to help create awareness about autismamong teachers and neurotypical students and help them develop sincere nurturing relationships.
   
   

1. Following Individualized Educational Programs (IEPs) and Specially Designed Instructions(SDIs) with fidelity.
2. Using technology and visual aids both in and out of class to support these students. 3. Collaborate & communicate with other teachers so that they can equally understand the strengths and challenges of the student. This also helps with creating consistency with rules and routines hence minimising stress and confusion to the ASD student.
3. Offering clear and explicit instructions without shaming the student during lessons
4. Offering priming material so that student can get familiar with lesson content before class to avoid surprises.

1. Employing and collaborating with autism specialist.
2. Having a "home base" room for the students and train all teachers to understand and support them in accessing the room (when and how) to avoid disruptions and stress as well as student anxiety and overstimulation.
3. Enacting friendship groups like BESTBUDDIES, ASD awareness campaigns , anti-bullying campaigns and other community-building programs to help strengthen the whole school community.
   4.Inclusive environment is important for them to learn appropriate behavior.
   
   
   

1. Adapting work as needed without underestimating the student's ability.
   
   

2.Collaborating with the school psychologist to develop appropriate strategies and schedules.

3. Collaborating with other staff, students and their parents in creating goals both for class and transition out of school and working with the students to attain those goals.
4. Incorporating pair work and other helpful strategies in class to enable student achieve lesson objectives.
5. Paying attention to their strengths and interests and incorporate them in the lessons as well as using them to guide the students to choose electives and career paths that suit them.

1. Offering professional development to teachers to better equip them in working with students with ASD;
2. Planning transition programs early to allow these students enough time to work out their plans with their teachers.
3. Offering and employ programs that encourage social development and emotional skills.
   
   

1.Getting guidance , ideas and valuable insight on how to help ASD students form the Disability office.

2. Making sure assignment instructions are very clear.
3. Being available to answer questions, offer insight into projects, suggesting suitable pclasses and professors ans well as work study opprtunities.
4. Willingness to alter mode of lecture delivery for example giving written or recorded lectures.

1. Offering support programs to help new students acclimatize with the new mode of learning and environment as well as transition programs for after college life.

   
   

2. Offering students internships or work opportunities. School support.

   
   

3. Other than the general Disability office, provide a service office specific to ASD students to help them relax, build a close-knit community as well as get older mentors from the school.

It is interesting to note Kanner's perspective as he is frequently criticized for his ideas about the origin of autism. His claim was later supported by his student, Bettelheim. He viewed, albeit in part, that autism was a response to a parenting style devoid of emotional warmth. In this case, the child withdraws from the unpleasant reality into a private internal world. Asperger, on the other hand, focused on the language development. He observed that the speech of these children, while not delayed, was unusual and stereotyped.(Whitman,2004)

Kenya-Persons with Disability Act, 2003:
It states that " (1) No person or learning institution shall deny admission to a person with a disability to any course of study by reason only of such disability, if the person has the ability to acquire substantial learning in that course.
(2)Learning institutions shall take into account the special needs of persons with disabilities with respect to the entry requirements, pass marks, curriculum, examinations, auxiliary services, use of school facilities, class schedules, physical education requirements and other similar considerations.
(3) Special and non-formal education.
The Council shall work in consultation with the relevant agencies of Government to make provisions in all districts for an integrated system of special and non-formal education for persons with all forms of disabilities and the establishment where possible of Braille and recorded libraries for persons with visual disabilities" ( Kenyan Constitution, 2010)

Australia Disability Discrimination Act 1992
It state that a person should not be treated unfairly because of their past, present or future disability. This supports the education of all including students with autism, hence schools are held accountable by the Australian Human Rights Commision if they do so in any way.

Symptoms

According to Hedley & Uljarevic (2018), there has been a heightened risk of suicide in Autism Spectrum Disorders in the past 5years.Cross data studies between 1995 and 2014 reveals prevalence rates of suicide attempts in ASD to be at 7 to 47 % and suicide ideation at 72%.

Studies show that mobile technology is proving to be very helpful to ASD student ,their teachers and parents in terms of learning and communication.Even those who have serious difficulties with their speech are able to communicate their needs.

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There has been an increase in the number of students with ASD attending regular schools and higher educational institutions, though still with learning difficulties and low performance(Carmona-Serano et al., 2020).

OTHER ADVANCES AUTISMSPEAKS LIST
Advances in understanding the genetics and biology of autism .

Advances in addressing outcomes for autistic adults.

Advances in uncovering and addressing health disparities/

-Generally, educators and schools can learn about the leaner from the learner and ask them their prefered ways of learning , if they can communicate.
1They can also use the student's fascinations such as sports, GPS, boardgames, musicor any other interest to teach. For example building individualor rven whole class activity around music to support a child who loves music.The school can also create musical events to build on the child's strength. I once taught an ASD student who loved music and when we did an ensemble, he was the only one who could do bass. Since he was in my class and I was the one incharge of performing arts, I could use this to ensure he not only complete his work but also does it meticulously, albeit not so nice handwriting. ( At that point I just did that but didn't know about this fact).
Give them a choice as this helps them to learn and know themselves better?It also helps the teacher know them better? Choices can be in working alone or with a friend, writing or recording their work, reading loudly or silently e.t.c.
There are also several resources that school heads and teachers can get in touch with :
COMMUNITY & SCHOOL RESOURCES
Austism Speaks Resource Directory
Community Autism Resources
New York City Department of Education-Special Education
PROFESSSIONAL RESOURCES
Accommodations and Support for School-Age Students with ASD
Center on Secondary Education for Students with Autism (CSESA)
IRIS Center
NAESP Autism Resources
Organization for Autism Research
Among many others.
TOOLS
Autism Apps
Boardmarker Online
Digitability
Proloquo2Go

Brief History of Down Syndrome
Centuries ago, Down syndrome was present in many paintings and ancient pottery but without identification or a well-known name, until 1866 when the syndrome was named after the English doctor, John Langdon Down, who published the first clinical description of the syndrome. In his paper, Observation on the Ethnic Classification of Idiots, he claimed that it was possible to classify conditions by ethnic characteristics hence listing several classifications including the Ethiopian and Mongolian types of idiots. The Mongolian type, which later came to be known as Down Syndrome, was also called mongolism, and the patients ‘mongoloids’ .This name was however dropped because of its racist title.
In 1958, Jérôme Jean Louis Marie Lejeune (1926–1994), discovered that DS is caused by an extra chromosome on the 21st pair. His work was published on the 26th of January the following year and for the first time in history, a link between intellectual disability and chromosome abnormality was established. Until then, this was impossible. This led to the founding of cytogenetics and in the present age, DS can be detected in a baby at birth or by prenatal screening.
Controversially, the discovery by Jerome has been disputed and in 2014, Marthe Gautier was awarded the Grand Prize for this discovery, by the Scientific Council of the French Confederation of Human Genetics.

Recent research has majorly shifted focus from neurobiological changes associated with autism to genetic and epigenetic studies and exploration of parental and other environmental factors.
Undersdanding the causal aspect is vital in management and developmaent of therapeutic techniques targeting its core symptoms.

Ireland- Disability Act 2005
This act places a statutory obligation to service providers to suppport access to services and facilities for the disabled people.
According to the act's definition of disability, students with autism are entitled to have their health and educational needs assessed.
This means that schools are expected to take into account the special needs of the students with ASDlike having a school psychologist, aspecial needs teacher, ensuring educators prepare lesson plan with accomodations and modiffication that will enable the student to learn.

LEVEL 2
Requiring substantial

support

LEVEL 3
Requiring very substantial support

LEVEL 1

Requiring support

Many scholars believe that the impulsive behavior of students with conduct disorder has seven stages of symptom patterns: 1. Calm phase: when they are calmed, they can behave just like every other student to participate in all the activities and give positive feedback to teachers and peers. 2. Triggers: when the environmental pressure has not been relieved, their negative thoughts accumulate that if no intervention in this stage, they will turn into agitation stage. 3. Agitation: in this stage, they may not be able to participate in the class activity or on task and may show some anger. Teachers should intervene immediately to de-escalate the situation. 4. Acceleration: if failed to intervene in the early stage appropriately, at this stage the student with CD will try to dominate the situation and may lead to a power struggle with the teacher or any lead role character. The student with CD may begin to create troubles and rebel deliberately. Any intervention at this stage should not be drastic punishment or rant. Try to communicate with the student in a calm manner. 5. Peak: If the teacher was not intervened correctly in the acceleration phase, students with CD might enter the peak phase. They may not control impulsive behavior, violently attack peers or teachers, and even self-injury. 6. De-escalation: after the emotional catharsis of the period, they may become confused and confounded. Students with CD may regret what they had done. 7. Recovery: During this stage, they may be reluctant to join in a group or peer learning activities as they may be afraid of making mistakes again. The teacher needs to wait for the right time to discuss and communicate with the student about the ordeal and make an official referral. (Colvin, 1992)

School Support

• Create opportunities for them to meet with other students with similar conditions, if there are none in their schools, to help them know that the problem is not unique to them. These can be co-curricular or extra-curricular activities such as football, drama, swimming among others.
• Educate teachers on the disorder and how to help students.
• Create awareness among students using approaches like “circle of friends'' or “buddy” systems. These systems can also help with conflict resolution, and managing bullying within the school.
• Consider including sports for students with varying abilities such as down syndrome when organizing sports activities.
• Organize transition programs early enough for students transitioning to or from high school so that you get enough time to prepare them for the next level /life .
  

Applying the typical profile

• Strengths as visual learners.
• Work on speech and language skills.
• Develop memory skills with games.
• Limit verbal instructions.
• Use concrete materials.
• Try different activities to practice motor skills.
• Good awareness of social and emotional cues.
• Good social learners; learning from peers through observation.

School responsibilities

• Valuing and respecting diversity.
• Importance of positive attitudes and setting the framework for inclusion, understand the needs and the expectations of the DS student.
• Organize and divide the responsibilities of the supporting team.
• Involve parents, teachers and services.
• Find positive ways to solve problems.

Planning for the individual child

• Understand the student's profile, and recognize the effective interventions.
• Understand the students strengths and skills.
• Support and understand the difficult time during school day.
• Use the students strengths to support learning and development.
• Modify lesson plans.
• Be flexible but also cautious about interventions that do not have a clear evidence
• Share adaptations with partnership services and parents.
  

Promoting effective learning skills

• Meaningful activities based on student's experience.
• Visual resources to aid comprehension of abstract concepts and task demands.
• Practice new activities based on old skills.
• Allow extra practice opportunities.
• Applying skills in different contexts, situations.

Resources
Ataman, A. D., Vatanoğlu-Lutz, E. E., & Yıldırım, G. (2012, December 1). Medicine in stamps: History of down syndrome through philately. Journal of the Turkish German Gynecological Association. Retrieved October 27, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3881714/.
History of NADS. National Association for Down Syndrome. (n.d.). Retrieved October 27, 2021, from https://www.nads.org/about-us/history-of-nads/.
Hughes, J. (2021, August 19). Inclusive Education for individuals with down syndrome. Down Syndrome News and Update. Retrieved October 27, 2021, from https://library.down-syndrome.org/en-gb/news-update/06/1/inclusive-education-individuals-down-syndrome.
(n.d.).
Mandal, D. A. (2019, February 27). Down syndrome history. News. Retrieved October 27, 2021, from https://www.news-medical.net/health/Down-Syndrome-History.aspx.
Meeting the educational needs of pupils with down syndrome ... (n.d.). Retrieved October 27, 2021, from https://cdn.dseonline.app/pubs/a/practice-148.pdf.
2 Minute ReadMedically Reviewed by UPMCJanuary 26, 2021. (2021, September 23). Down syndrome: 10 facts you should know. UPMC HealthBeat. Retrieved October 27, 2021, from https://share.upmc.com/2021/01/10-facts-about-down-syndrome/.
Supporting children with Down Syndrome in primary school. (n.d.). Retrieved October 27, 2021, from https://downsyndrome.ie/wp-content/uploads/2018/03/Supporting-Children-with-Down-syndrome-in-Primary-School.pdf.
WebMD. (n.d.). Down syndrome: Causes, symptoms, diagnosis, & treatment. WebMD. Retrieved October 27, 2021, from https://www.webmd.com/children/understanding-down-syndrome-basics.
Featured resource. Center for Parent Information and Resources. (n.d.). Retrieved October 29, 2021, from https://www.parentcenterhub.org/.

Treatment
-Since the biological causes of autism haven't been determined, definitive or curative treatment is not yet possible. However, palliative treatment and programs can always be put in place to reduce the severity of the disorder. These enhance motor functioning, reduce sensory & eating problems.
Example
Early intervention, educational/behavioral interventions

Assessment
A child is evaluated whether he/she has ASD or some other type of developmental disorder. A few types of assessments that can be used are: Aptitude and achievement tests, adaptive behavior assessments, developmental evaluation, observational methodology that uses functional analysis

Diagnosis
According to DSM-V Link Titletheres are symptoms that can help determine the presence or absence of ASD in a child. A second assessment is done with an array of procedures conducted to establish the child's profile of stregths and limitations.Areview of other assessment procedures are finally used for treatment planning and evaluation.

National Institute of Neurological Disorders & Stroke( NINDS), a component of National Institute of Health ( NIH),the leading supporter of biomedical research in in the world, supports Autism Centers of Excellence (ACE) a trans-NIH initiative that supports largescale multidisciplinary studies on ASD; who are currently studying whether certain brain imaging & activity measures in infants diagnosed with Tuberous Sclerosis Complex (TSC) can predict the development of ASD.

"NINDS researchers areinvestigating the formation and funtion of neuronal synapses, the sites of communication between neurons, which may not properly operate in ASD neurodevelopmental disorders" ( Autism Spectrum Disorder Fact Sheet", n.d )

Writers, S. (2020, August 14). Resources and support for students with autism: Strategies and tips for schools success. Public Service Degrees. Retrieved October 26, 2021, from https://www.publicservicedegrees.org/resources/students-with-autism/.

Also included under neurodevelopmental disorders

Child-centered approach: individual and peer group counseling and cognitive-behavioral therapy; behavior management and treatment; problem-solving skills training; medicine.

Family-centered approach: for younger children - encourage the willingness of parents and children to change their behaviors; parental behavior management techniques training. For older children - use basic family communication skills to improve the interaction between parents and children; use clear communication methods and develop two-way dialogues.

Community-centered approach: establish a community network to combine all the resources in the community to help the children with CD for socialization opportunities and gain friendships.

School centered approach: acceptance - establish trust relationship and atmosphere; safe place and personnel - when students with CD need to vent their emotions, they have a safe place and the right person to go to in school; social skills learning - the teacher can use 1. demonstration and feedback 2. teaching, role-playing and practice 3. positive reinforcement, prompting and fading 4. appropriate consequences 5. self-management techniques to help students with CD to learn how to integrate into the social norm.

Psychotherapy-centered approach: cognitive-behavioral therapy - they learn how to solve the problem, communicate, and handle stress in a better way. They also learn how to control their impulses and anger. Family therapy - family members join in the therapy to improve communication skills and interactions. Medicine - if the student has other symptoms or disorders, such as ADHD, then medicine may help the student to go through daily life more productive way.

Since 2004, The American Education for People with Disabilities Act (IDEA) stated that the recommendations for referral for special education services could be assessed by Response to Instruction (RTI). According to The Special Education Act in Taiwan, professionals should evaluate and diagnose severe emotional disorders in children who require special education and related services. The most important part before the referral is the process of interventions. Children who suspect to have conduct disorders should go through about a semester of schooling period of the processes before requiring special education services. The processes are focused on 1. systematic observation; 2. using evidence-based practice program for learning; 3. screening the problematic students; 4. identifying their behavioral problems in the class; 5. the general class teacher collaborates with SpEd teacher and other specialists to provide consultation for the teacher and continue to follow up with the teacher about the student’s progression; 6. if the student has made progress, continue to monitor the student until the student has met the benchmark; 7. if the student has not made any significant progress, the general class teacher needs to collaborate with SpEd teacher and school social worker for differentiating learning; 8. all have been done and tried, and the student is still not making any significant progress; the teacher should refer the student to enter the special education system.

Aacap. (n.d.). Conduct disorder. Retrieved October 28, 2021, from https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Conduct-Disorder-033.aspx.

Conduct disorder. Johns Hopkins Medicine. (n.d.). Retrieved October 28, 2021, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/conduct-disorder.

Conduct disorder: Recent research and implications for ... (n.d.). Retrieved October 28, 2021, from https://faculty.lsu.edu/pfricklab/pdfs/policyandpractice-pdfs/scr-frick-conduct-disorder-in-jjs.pdf.

Searight, H. R., Rottnek, F., & Abby, S. (2001, April 15). Conduct disorder: Diagnosis and treatment in primary care. American Family Physician. Retrieved October 28, 2021, from https://www.aafp.org/afp/2001/0415/p1579.html.

The Special Education Act - Article Content - Laws & Regulations Database of the Republic of China. (n.d.). Retrieved October 28, 2021, from https://law.moj.gov.tw/ENG/LawClass/LawAll.aspx?pcode=H0080027.

Recent Advances

As for contemporary developments, the U.S. Department of Health and Human Services (n.d.) is currently conducting exhaustive research particular to the cardiovascular symptoms that may go along with the condition. This relates to an aortic condition being found in over twenty percent of females with TS. The Psychosocial impact of the ailment is also undergoing research as are the significant fertility concerns related to ovarian abnormalities.

Recent research is also being conducted on the potential for developmental delays along those with TS as we strive to learn more about the development and cognitive functions of those with the ailment. It is additionally worth noting that research into reproductive health in general has the potential for a very large impact on the standard of living for those with Turner’s.

DNA screening for potential abnormalities is conducted via either blood samples or ultrasound. Doctors look for three typical situations as early indicators which are: large fluid edema, heart conditions or abnormal kidney development.

During infancy, Turner’s can be caught early by a number of physical determinants which can include:

• A wide or malformed neck
• Stub-like toes or shortened fingers
• A noticeably shorter jaw
• Abnormal hairline
• The aforementioned potential heart defects
• Slow early growth
• Swollen limbs
• Palate malformation
• Ears set very low on the skull

In later growth stages ranging from childhood to the adult years, a number of additional signs may exist which are largely related to the lack of stature or ovarian concerns. These include:

• Aforementioned fertility complications
• Menstrual cycle abnormality treated by hormone therapy.
• Slower or incomplete teenage sexual development
• Noticeable height abnormalities related to short stature
• A lack of typical growth periods during childhood

Common Symptoms

We most commonly see extremely short stature (height) with those having this condition with heights rarely exceeding four feet eight inches tall. This again is cause alone for early diagnosis so that hormonal treatment can be initiated early to help these young ladies achieve more of a normal size. Those with this condition experience significantly slower growth rates as young women. They also typically experience puberty at a later stage than their peers.
An additional and extremely difficult set of symptoms for typical sufferers is related to sexual development. Many women with TS may not have developed breasts or regular menstruation. Due to the various stages of ovarian failure common to this ailment, pregnancy is nearly impossible without assistance in the manner of fertility treatment.

Related Medical Conditions

Women with Turner’s Syndrome can face a full spectrum of related disorders as TS can widely vary in impact. This can include:

• Aforementioned infertility and pregnancy complications. Hormone Replacement Therapy is common.
• A significant number of women with TS are insulin resistant with a smaller portion of those developing diabetes type II.
• Social mental health concerns
• Higher risk for ADHD
• Increased potential for learning disabilities related to spatial awareness (How your body is positioned near either objects or other individuals). This specifically commonly impacts math related subjects and working memory.
• Autoimmune concerns related to the thyroid.
• Kidney development problems
• Abnormal skeletal development
• Vision and hearing difficulties in a variety of conditions

ADHD Links

We would be remiss to discuss the educational implications of Turner’s without discussing the frequency of ADHD as a co-existing condition. Effective treatment options are absolutely available in many schools as well as a clinical process that dovetails nicely with educator efforts but this as with the host of other potential comorbidities can complicate life for TS patients beyond that typically seen in classrooms with students who only may suffer from ADHD.

Psychologists and Speech Language Therapists

School psychologists are frequently involved due to the high amount of social anxiety experienced by females with this condition which is often paired with depression. Referrals often also involve Speech Language Therapists due to the significant difficulties many with TS experience with normal consumption of food, articulation, receptive language and expressive language.

Non Verbal Learning Disabilities

Mooney & Newberry (2007) wrote an amazing guide to help many educators with Turner’s Syndrome as it is consistent with a NVLD or “Non-Verbal Learning Disability”. As TS is a spectrum disorder and may be expressed with any number of difficulties for students, intervention strategies must be tailored to the student and outstanding guides such as this are highly recommended. As awareness of Turner’s increases, educators are increasingly able to adapt accommodations and modifications to better assist these students.

Accommodations and Strategies

Accommodations and strategies useful for students with Turner Syndrome are often centered around the social anxiety, self-esteem and audio-visual difficulties faced. These commonly include relaxation exercises, advance warning/descriptions due to routine changes, organization skill training and counseling sessions. Classroom modifications for vision and hearing impaired students are frequent as are modifications to assist students of short stature.

State of Colorado Schools

Schools in the U.S. state of Colorado specifically focus upon the vision and hearing impacts of Turner Syndrome frequently encountered in schools. State projects among these schools offer sensory disability trained specialists to work with Colorado students on an IEP once a diagnosis is confirmed. These specialists work in conjunction with clinical staff to ensure proper treatment at home, school and medical facilities.

State of Minnesota Schools

The Minnesota Department of Education has implemented support services and awareness for Turner Syndrome in their schools statewide. The educational implications are spelled out in detail including the social difficulties, learning difficulties and associated conditions as well as developmental delays. The need for accommodations is also made very clear due to the short stature of the affected students. The IDEA (Individuals with Disabilities Education Act) eligibility and IEP standards are specified as a specific option for these students including any necessary modifications and accommodations. Students not qualifying for IDEA have the potential for other options under the Rehabilitation Act Section 504 but IDEA is specifically recommended by the State of Minnesota for their students.

New Jersey

New Jersey is one such exception to the rule however having introduced Turner Syndrome Awareness Month (February) in 2012 per the New Jersey Legislature (n.d.). This drive for awareness extends to families, clinicians and educational professionals to help the long-suffering students who have otherwise been either completely or partially overlooked with TS. As with other spectrum disorders, incomplete or incorrect diagnoses are common due to the veritable cornucopia of associated conditions and comorbidities.

Legislative Advocacy

As mentioned above, the Turner Syndrome Foundation takes the lead in legislative advocacy for this condition and due to the severe lack of laws specifically regarding Turner’s has multiple webinars available on their website (See references) to guide educators, clinicians and the general public to push for individual state recognition/awareness of TS.

Legal Relevance and Impact

In specifically discussing relevance and impact, the legislative awareness of Turner’s is shockingly poor. Grassroots organizations like these are taking the forefront in this fight due to an increasing public outcry while so many women are criminally overlooked. Many supports do exist under IDEA, Section 504 etc under federal educational guidelines in the United States but very few of these have specific language geared towards this particular condition. It is true that the treatment for many of the related conditions can help those with TS but educational institutions must be prepared to offer the specific accommodations and modifications necessary for those with TS.

Educational Institution Expectations

The expectations from education institutions are that legal awareness of this condition must continue to be highlighted as educators and clinicians are the primary professionals actively aware of TS and assisting those with the condition. Teachers are at the forefront of grassroots movements demanding TS awareness as the Turner Syndrome Foundation makes extremely clear in their many webinars I’ve watched while compiling this. This is an outstanding example of educational institutions using voice, choice and educator community status to raise awareness of women’s health issues.

Diagnosis

• Screening Tests: These tests which include blood tests and ultrasounds, can determine if there is lower or higher chance of having Down Syndrome baby.
• Diagnosis Tests: These tests which include CVS, amniocenteses, and PUBS, can detect Down Syndrome, bur are more risky for the mother and the baby.

Early Intervention
A system of services designed to help infants and toddlers with disabilities before their 3rd birthday.
Mandated by federal law in IDEA.
Staff work with the child's family to create and IFSP (Individualized Family Services Plan) that describes the unique needs of the child and how they will be addressed.
The IFSP will also detail the needs of the family and better help them understand how to best help their young child.

IEP
Parent and school staff work together to develop an IEP for the child.
Resources are available for parents to help them participate effectively in their child's education.
There is a lot of information available about effective teaching practices for children with Down Syndrome.
It is important for teachers to take everything into consideration before creating a plan.

Integration
Today, the majority of children with Down Syndrome are in general education classes, alongside their peers without disabilities.

IDEA
Requires special education and related services be made available free of charge to every eligible child with a disability.
These services are specially designed to address the child's individual needs associated with the disability.

Transition Services
While in secondary school, the school, parents, the IEP, and the student themselves will need to plan for the future and the student's life as an adult.
This means teaching independent living and self care skills, talking about higher education opportunities, and how to connect with adult service systems.
This transition should start not later than the student is at the age of 16. It is best for the students with Down Syndrome to start earlier than that.
Due to IDEA, opportunities to live and work independently have really grown for those with Down Syndrome. The public perception has changed and more opportunities are available than ever before.

Oral-motor/feeding and swallowing therapyHere exercises to help the jaw ,tongue, lip to strengthen the muscles of the mouth. The therapist will work with food textures and temperatures to work with oral awareness with eating and swallowing.

The goals should be specific, and who (child, child w/parent, what (specific goal), when (days/times week), where (at school, office,class), how (supplies needed)

Complete 2 worksheets, or 1 vocabulary game, or 1 sound game th sound

The goal should be achievable based on specific challenge. Be sure to have supplies available, help child navigate through obstacles to prevent goal attainment.

The steps taken should be logical and in line with the objective. "Child will have improved pacing of speech in class presentations" is specific and positive.

Mark a time for goals. Improve articulation when reading the /th/ sound in 4 weeks. Work on flashcards for 15 minutes 3 times a week.

Sharing information: here the therapist can share techniques and progress. Parents can discuss events that may be happening in students life. A sibling name may be difficult to say, crying when not understood are all important information that sharing can help the child's therapy.

REFERENCES

Colorado Schools fact sheet: Turner Syndrome. Colorado Department of Education. (n.d.). Retrieved October 28, 2021, from https://www.cde.state.co.us/cdesped/sd-db_factsheetwp_turner.

M., M. D. J., & Newberry, S. S. (2007). Nonverbal learning disabilities: A guide to school success: (the teacher's Manual). Maple Leaf Center.
New Jersey 2012 Resolution: Turner Syndrome Awareness Month. AJR65 AHE statement 1/14/13. (n.d.). Retrieved October 28, 2021, from https://www.njleg.state.nj.us/2012/Bills/AJR/65_S1.HTM.

Making Turner syndrome a national priority. Turner Syndrome Foundation. (2021, February 23). Retrieved October 28, 2021, from https://turnersyndromefoundation.org/volunteer_take_action/awareness/turner-syndrome-petition/.

Mayo Foundation for Medical Education and Research. (2017, November 18). Turner syndrome. Mayo Clinic. Retrieved October 28, 2021, from https://www.mayoclinic.org/diseases-conditions/turner-syndrome/symptoms-causes/syc-20360782.

Minnesota Department of Education Information Sheet for Turner Syndrome. Minnesota Department of Education. (2015, April). Retrieved October 28, 2021, from https://education.mn.gov/MDE/Search/index.htm?query=turner%27s&searchbutton=Search&v%3Asources=mn-mde-live&qp=mn-mde-live.

Turner syndrome: Causes, symptoms, diagnosis & treatment. Cleveland Clinic. (2017, November 18). Retrieved October 28, 2021, from https://my.clevelandclinic.org/health/diseases/15200-turner-syndrome.

U.S. Department of Health and Human Services. (n.d.). Turner Syndrome: Research activities and scientific advances. Eunice Kennedy Shriver National Institute of Child Health and Human Development. Retrieved October 28, 2021, from https://www.nichd.nih.gov/health/topics/turner/researchinfo/activities.

What is Turner Syndrome? Turner Syndrome Foundation. (2021, August 17). Retrieved October 28, 2021, from https://turnersyndromefoundation.org/what_is_turner_syndrome/.

PragmaticsThis reflects communication competency. Here we assess the rules of conversation such as turn taking, politeness, conversation repair.

Research on Genetic AspectsLanguage disorders cluster in families. Phonological disorders have been found in multiple studies over last 10 years (Gilger,1992). Pragmatic deficits are common among first relatives of autistic children.

Comorbidity of Language DisordersChildren seen in psychiatric setting have high rates of language disorders. One study found 53% of children in a psychiatric study also had undiagnosed language disorders. Most had problems with expressive syntax or putting together grammatical sentences.

These students appear detached. They lack confidence and assertiveness resulting from their ability to comprehend and express information. These students fail to follow instructions, ask or answer questions, and fail to interact normally with peers. For therapy to be effective, the sessions conducted in the most natural environments show the best improvement in language disorders. The student is able to maintain the skills in familiar settings. (ASL assoc 1993)

Toppelberg CO. Childhood second language acquistion and bilingualism. Presentation at Denny Cantwell Institue on Language and Child Psychiatry.

Shapiro T. Language and the psychiatric diagnosis of preschool children: Psychiatr Clin North AM. 1982, 309-319. PubMed.

Means, Jennifer. (2006). The impact of IDEA and NCLB on speech and language related services: How to meet the challenges. Forum on Public Policy

American Speech-Language Assoc. (1993). Definitions of communication disorders and variations. http://www.asha.org/policy/RP1993-00208/

Blosser, J and Neidecker, E. (2002). School programs in speech-language pathology: Organization service delivery. Boston: Allyn and Bacon.

GilgerJW. Genetic in disorders of language. Clin Commun Dis. 1992;2:235-47.

Speech buddies. (2021). Speech Therapy in Schools: A parents Guide. https://www.speechbuddy.com/

Theravive, (2021). Language Disorder. www.theravive.com/therapedia/language-disorder-dsm-V/

To aid communication use repetition, modeling, gestures, and rephrasing of sentences.

Learing Techniques include, use clear directions, develop concentration and attention, visualization and listening skills. Minimize distractions within and outside the classroom.

Learning Techniques includes allowing child to develop progression of concrete to abstract, focus on what is tangible and important to the child. Teach focus on prepositions, adjectives and use of synonyms and homonyms. Role play helps alternate speaking and listening skills.

Diagnosis

There are a variety of ADHD symptoms and depending on which symptoms are present people are identified as having one of 3 possible presentations of ADHD. According to the DSM-5 criteria for diagnosing ADHD in a child or adult requires that the behaviors and/or symptoms must have continued for at least 6 months in two or more settings (such as school, home, places of worship, etc.). Academic, occupational, and/or social functioning must have been negatively affected as a result of the patients symptoms. Finally, in children (patients under 17 years old) at least 6 symptoms must be present and for adults (patients 17 years or older) at least 5 symptoms are necessary. Please see the following link for a full table of diagnostic symptoms from the DSM-5: https://www.aafp.org/dam/AAFP/documents/patient_care/adhd_toolkit/adhd19-assessment-table1.pdf

Combined

This is when a person meets enough of the symptom requirements for both inattentive and hyperactive types (Symptoms and Diagnosis of ADHD | CDC, 2020).

Hyperactive

• 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 their turn.

  
  

• Often interrupts or intrudes on others (e.g., butts into conversations or games)

  
  
  

(Symptoms and Diagnosis of ADHD | CDC, 2020)

Inattentive

• 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.

  
  
  
  

(Symptoms and Diagnosis of ADHD | CDC, 2020)

This shows how thinking changed as research developed. We see the balance of emphasis between the inattentive and hyperactive symptomology teetering this way and that as the scientific and medical communities debated what criteria were most relevant and whether the subtypes should be categorized as separate disorders entirely. We also see the wider use of ADHD-specific stimulant medications and the introduction of nonstimulant medications. Today there is a much wider variety of medication and treatment options than ever before.

Ignorance still exists and some people refuse to recognize ADHD for what it is and stigmatize those who have it as "lazy", or insist that difficulties are due to diet and nutrition, society has come a long way as has the medical community.

Further reading on the ADHD brain and function:

https://www.understood.org/articles/en/adhd-and-the-brain

Comorbidities

It is well known that there is a high instance of comorbidity with other disorders. According to CHADD (2019b) over two-thirds of children diagnosed "[...]with ADHD have at least one other co-existing condition". CHADD (2019a) sites the most common comorbidities in children with ADHD as follows: Learning Disability 45%, Conduct Disorder 27%, Anxiety 18%, Depression 15%, speech problems 12%.

This is important as it can affect a student's access to services and how/where they fall in terms of legal protections and definitions. For example, ADHD is not a Specific Learning Disability (SLD), but its symptoms can greatly interfere with learning. There is also a high instance of children with ADHD having a coexisting SLD (Learning Disabilities Association of America, n.d.)(CHADD, 2019a). The symptoms of ADHD may have some overlap with the SLD, but depending on the severity of each disorder the student may qualify for services under different provisions of current federal statutes (see Major Laws and Protections section)(CHADD, 2018b).

For more information and statistics on children and adult ADHD comorbidities please see https://chadd.org/about-adhd/co-occuring-conditions/

Individuals with Disabilities Education Act (IDEA)

IDEA provides for students who have a qualifying disability and need SPED and/or special services due to that disability.

It allows for early intervention screenings and services for children and their families.

A full evaluation from a team of professionals is required for students looking to qualify for services under IDEA. Parents must consent to the evaluation for their child to receive services. If they disagree with the findings they can dispute it through the procedures of due process (CHADD, 2018b).

IDEA requires that parents be fully informed of any evaluations, changes, or decisions made regarding their child's education, services, and status.

It guarantees students with disabilities access to FAPE and placement in the least restrictive environment (LRE). IDEA is intended to ensure that all students with disabilities receive and education that is beneficial to them. It requires that students that qualify and require services be provided with a written Individualized Education Program (IEP) that is tailored to their needs and abilities. An IEP includes goals for the student, details of their educational placement, which services are to be provided, and their frequency, duration, and means by which the school district will measure progress(CHADD, 2018b).

IDEA also outlines procedures, protections, and due process practices for students with disabilities, their families, and school districts.

IDEA has a stricter definition of 'disability' than Section 504 so some students with ADHD will qualify, but others who are less impaired may not (CHADD, 2018b). According to CHADD (2018b) students with ADHD usually "qualify under Other Health Impairment (OHI) category. They may also qualify under Specific Learning Disabilities (SLD) or Severe Emotional Disturbance (SED)." Students who have special services through an IEP have more rights than students who have protections under a 504 plan alone (Wright & Wright, 2017). Additionally, students who "[receive] special education services under the IDEA [are] automatically protected under Section 504." (Wright & Wright, 2017).

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The Americans with Disabilities Act (ADA

The ADA is very similar to Section 504 of the Vocational Rehabilitation Act of 1973 they provide the same rights, remedies, and procedures (Wright & Wright, 2017). Wright & Wright (2017) explain that "Except for accessibility of buildings, and modifications and accommodations in testing, Section 504 and ADA provide few protections and limited benefits to children with disabilities." The ADA built upon the Vocational Rehabilitation act of 1973 and widened its scope in regards to the businesses and organizations required to comply with the accessibility and non-discrimination terms (Wright & Wright, 2017).

The ADA protects more than just students with disabilities, and in this case ADHD, it also protects adults.

While this project is more specifically directed toward education and students with disabilities it is important to note what protections exist outside of that environment and beyond school-age years. Most notably for adults with ADHD, the ADA offers a measure of workplace protections and accommodations. As with Section 504 an individual must have more than just a diagnosis of ADHD to be protected and provided for under the ADA. An individual must demonstrate that their disability "significantly impact[s] [their] ability to perform major life activities or functions and the individual must be regarded as having a disability and have a record of having been viewed as disabled." (Noor, n.d.).

The individual with ADHD must also be able to carry out essential job functions with or without accommodations (Hoyer Law Group, PLLC, 2021) and have the prerequisite skills, education, certifications, and/or knowledge necessary for the job (ADHD At Work, 2018). For Example, a person with ADHD working as a software engineer would still have to have the required skills and certifications, be able to write code, run software diagnostics, and understand the technologies they are working with - the core functions of the job. However, they could request accommodations to help with less essential aspects of their job, such as meeting reminders, a flexible schedule, or a quiet workspace. These accommodations must be reasonable and appropriate and not an undue hardship on the employer. The ADA prohibits companies and organizations with over 15 employees from discriminating against disabled employees and requires them to make accommodations for such workers (Sherman, 2021). For workers with ADHD, these cases can be difficult and many times getting accommodations is up to the discretion of the employer. Accommodating a physical disability - someone who relies on crutches or a wheelchair for mobility for example - might require rearranging furniture, installing a ramp, or automatic doors. Such changes are often fairly straightforward and the purpose/reason for them fairly apparent and barriers might be structural building requirements or the cost of installation, especially to small businesses. People with less outwardly apparent disabilities can face more difficulties getting accommodations especially if employers lack the understanding or willingness to learn about the disability in question and be supportive.

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Causes

Scientists are not sure what specifically causes ADHD, however, it is clear from multiple studies and the way ADHD often runs in families that there is a strong genetic factor. Studies also suggest that disruptions of development (such as a brain injury or preterm birth), environmental factors, and neurological factors also may be key elements that cause ADHD (Rodden & Dodson, 2021)(Franke et al., 2021).

Adult ADHD:

One of the main problems with much of the research on ADHD is that most studies tended to focus on ADHD in children rather than in adults and it was mostly viewed as a childhood disorder. In recent decades this is starting to change as more studies expand to include how the disorder affects adults and the rates of adult diagnosis continue to grow at an alarming rate (Constance, 2020)(Chung et al., 2019). While diagnoses of ADHD in both adults and children have increased since the 1990s, currently the increase of ADHD diagnoses among adults is quadruple the increase of diagnoses among children (Chung et al., 2019)(Constance, 2020).

Women and ADHD:

Another trend and avenue of recent research has been identifying the gender gap in diagnosis. It is common knowledge in the community that girls are far less likely to be diagnosed with ADHD than boys (CHADD, 2018a)ADDitude Editors & Dodson, 2021)(Data and Statistics About ADHD | CDC, 2020). Women and girls are starting to receive diagnosis and treatment, but lack of clinical research is still a problem (CHADD, 2018a).

Race and Ethnicity and ADHD:

In the United States people of color (POC) and/or ethnic minorities are less likely to be diagnosed with ADHD than white people even though ADHD symptoms occur at the same rate or higher in these groups as in white populations (Frye, 2021). Frye (2021) reports that by 8th grade "African American children were 69 percent less likely — and Latino children 50 percent less likely — to receive an ADHD diagnosis than their white counterparts." and that "Before they even entered kindergarten, African American children were 70 percent less likely to be diagnosed with ADHD than white children". These numbers were similarly reflected in communities where children's primary language was not English. It was also found that POC are less likely to receive treatment after diagnosis than white people. Frye (2021) states that in a 2016 study 65% of white children diagnosed with ADHD took medication compared to only 30% of Latino children and 35% of African American children. Studies on ADHD in regards to race and ethnicity are confounded by many factors and it is clear that "Identifying risks attributable to these confounding factors should also inform efforts to target ADHD screening, diagnostic, and treatment practices, as well as to clarify potential causes of reported racial/ethnic disparities." (Morgan et al., 2013). Sadly, the underdiagnosis and undertreatment of ADHD in minority populations and POC is reflective of the norm of inequality across every aspect of healthcare in the US. This has run-on consequences for children and adults if undiagnosed and untreated: being labeled as defiant or lazy, issues with social functioning, self-esteem, and career stability/progress, higher risk of suspension, expulsion, incarceration, and substance abuse (Morgan et al., 2013)(Frye, 2021)(ADDitude Editors & Dodson, 2021). As awareness grows and people speak out there is hope that the medical community will be held accountable for such oversights and the systemic racism that has pervaded the practice for centuries. With such accountability, systemic change will hopefully follow.

ADHD and Emotional Dysregulation:

It is well known that ADHD affects a person's ability to regulate their emotions(Barkley, 2021)(Shaw et al., 2014). However, emotional dysregulation is not included in the current DSM identifying factors for diagnosis or symptomology. There has been more focus on this aspect of ADHD in recent years as providers search for different approaches to help patients and as our understanding of brain functioning grows through advances in neuroimaging.

ADHD and Neuroimaging:

Neuroimaging has advanced by leaps and bounds in the past couple decades and with these advancements, scientists are looking at how the ADHD brain is structured and functions. This includes identifying predictive features and biomarkers including:

• Diagnostic biomarkers, which link a brain structural measure, activity pattern, or conductivity to a particular diagnostic category.

  
  

• Pharmacodynamic/response biomarkers, which reveal if treatment strategies are impacting the intended brain mechanisms, with a potential impact on symptoms and disease severity.

• Prognostic biomarkers, which predict the development of a phenotype or a comorbid disorder in the future.
  
  

(Franke et al., 2021)

Already researchers have uncovered structural differences in the brains of children with ADHD and uncovered interesting possibilities for how ADHD brains develop. Further research is needed and issues relating to small sample sizes, lack of longitudinal and adult-focused studies, and region-by-region brain mapping rather than aggregate function need to be addressed (Franke et al., 2021).

Classroom Set-up/Environment

• Flexible seating - wiggle seats, resistance bands on chair legs, floor cushions, sit/stand desks

  
  

• Increased distance between workspaces

  
  

• Classroom zones including a quiet zone

  
  

• Preferential seating where the student will be least distracted or next to a good role model or instructor

  
  

• Posting daily schedule and rules

  
  
  
  

(Seay & Saline, 2021)(Morin, 2021)

For a helpful list (with links) of current studies and topics in ADHD research see https://www.additudemag.com/adhd-research-studies-2020/

Assignment Accommodations

• Extra time on assignments and tests

  
  

• Breaking down assignments and large projects into smaller parts or shortening assignments

  
  

• Give both written and verbal instructions

  
  

• Allow knowledge to be demonstrated in different ways/mediums (oral presentations, video presentations, diagrams)

  
  

• Reduce the number of questions on assignments/worksheets

  
  

• Utilize more frequent smaller quizzes rather than large unit exams

  
  

• Award points for work completed instead of deductions for incompleteness

  
  

• Grade for content over neatness

  
  

• Allow for student to do tests and assignments in a quiet space

  
  
  
  
  

(Seay & Saline, 2021)(Morin, 2021)

Managing Behavior

• Use of unobtrusive nonverbal signals to communicate appropriate behavior cues (volume control, break time)

  
  

• Check-ins to monitor students emotional state and frustration level

  
  

• Establish behavior goals and set up a reward system for good behavior. Do not take away earned points or deductions for bad behavior

  
  

• Discuss behavior issues one-on-one

  
  

• Make rewards and consequences more immediate to help make connections apparent/Give feedback immediately

  
  

• Recognize correct answers only when hand is raised or asked directly

  
  

• Positive reinforcement and acknowledging good work

  
  

• Progress reports sent home

  
  

• Use conscientious/prudent reprimands - do not criticize, lecture, or yell, use calm non-threatening tone

  
  
  
  

(Seay & Saline, 2021)(Morin, 2021)

Organization/Planning Accommodations

• Agenda book and supervise the writing down of daily assignments and deadlines

  
  

• Binders with dividers and folders for notes and work

  
  

• Planning short breaks between assignments possibly use this time to have student review work or tests for mistakes

  
  

• Provide an extra set of books for the student to keep at home

  
  

• Provide an outline of the lesson plan or typed notes

  
  

• Teach note-taking strategies and utilize graphic organizers and worksheets

  
  

• Assign note-taking buddies

  
  

• labeled/color coded baskets and containers to help keep desk organized

  
  

• Set a timer for tasks and reminders of time remaining

  
  

• Check desk and space and encourage neatness. Do not penalize for messiness

  
  

• Provide organization rules/guidelines

  
  
  
  

(Seay & Saline, 2021)(Morin, 2021)

Social Accommodations

• Assign special assignments in front of peer group to help peers foster respect

  
  

• Give student compliments and praise good work and behavior frequently to boost confidence and esteem and ease frustration

  
  

• Give student leadership role to help with esteem

  
  

• Talk to the student and encourage them to step away from angering situations, practice calming techniques, have them tell an adult when they feel anger or strong emotions

  
  

• Encourage cooperative tasks and activities to help them learn how to work with others

  
  

• Teacher-directed small group activities to encourage social interaction

  
  
  
  

(Seay & Saline, 2021)(Morin, 2021)

Instructions

• Keep instructions clear, concrete, and simple. should include time frame

  
  

• Give directions in writing and verbally and have the student repeat them back

  
  

• Give student lesson outline with directions and assignment details

  
  

• Use visual aids (pictures, charts, graphs) to create interested

  
  

• Provide a rubric that clearly describes necessary elements for a properly completed assignment

  
  
  
  

(Seay & Saline, 2021)(Morin, 2021)

Distractability Accommodations

• Ask students questions to keep them engaged and encourage participation and discussion

  
  

• Involve the student in lesson presentation to help keep them engaged

  
  

• Cue student to stay on task with private signal

  
  
  

(Seay & Saline, 2021)(Morin, 2021)

Masters, T. (2021, October 3). A Brief History of ADHD. Edge Foundation. Retrieved October 29, 2021, from https://edgefoundation.org/a-brief-history-of-adhd/

Morgan, P. L., Staff, J., Hillemeier, M. M., Farkas, G., & Maczuga, S. (2013). Racial and Ethnic Disparities in ADHD Diagnosis From Kindergarten to Eighth Grade. PEDIATRICS, 132(1), 85–93. https://doi.org/10.1542/peds.2012-2390

Morin, A. (2021, March 30). Classroom accommodations for ADHD. Understood. Retrieved November 2, 2021, from https://www.understood.org/articles/en/classroom-accommodations-for-adhd

National Resource Center on ADHD. (n.d.). ADHD Across the Life Span [Infographic]. ADHD Across the Life Span. https://chadd.org/wp-content/uploads/2018/11/ADHD_Across_Life_Span_infographic.pdf

Noor, A. (n.d.). ADHD and the Protection Under the ADA. Disability Resource Community. Retrieved October 27, 2021, from http://www.disabilityresource.org/47-adhd-and-the-protection-under-the-ada

Rawe, J. (2021, January 28). ADHD and the brain. Understood. Retrieved October 28, 2021, from https://www.understood.org/articles/en/adhd-and-the-brain

Rodden, J., & Dodson, W., MD. (2021, June 2). The History of ADHD and Its Treatments. ADDitude. https://www.additudemag.com/history-of-adhd/

Seay, B., & Saline, S. P. (2021, August 26). 20 Classroom Accommodations That Target Common ADHD Challenges. ADDitude. Retrieved November 2, 2021, from https://www.additudemag.com/20-adhd-accommodations-that-work/

Shaw, P., Stringaris, A., Nigg, J., & Leibenluft, E. (2014). Emotional Dysregulation in Attention Deficit Hyperactivity Disorder. American Journal of Psychiatry, 171(3), 276–293. https://doi.org/10.1176/appi.ajp.2013.13070966

Sherman, C., PhD. (2021, February 8). Is ADHD a Disability? Your Legal Rights at Work. ADDitude. Retrieved October 27, 2021, from https://www.additudemag.com/workplace-legal-protection/

Symptoms and Diagnosis of ADHD | CDC. (2020, September 21). Centers for Disease Control and Prevention. Retrieved October 27, 2021, from https://www.cdc.gov/ncbddd/adhd/diagnosis.html

United States Department of Education. (n.d.). Know Your Rights: Students with ADHD. Retrieved October 30, 2021, from https://www2.ed.gov/about/offices/list/ocr/docs/dcl-know-rights-201607-504.pdf

Wright, P., & Wright, P. (2017, January 31). Key Differences Between Section 504, the ADA and the Individuals with Disabilities Education Act (IDEA). Wrights Law. Retrieved October 30, 2021, from https://www.wrightslaw.com/info/sec504.summ.rights.htm