Attention Deficit Disorder(ADD/ADHD)
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Throughout this post, the terms ADD and ADHD are used interchangeably. Add stand for attention deficit disorder. At this time the most widely used term is often not hyperactive. These children are generally not disruptive in the classroom and their behaviors are not necessarily annoying or noticeable to the teacher. However, add can be very problematic to the child, causing him or her to significantly underachieve in the classroom and experience low self-esteem.
- Easily distracted by extraneous stimuli
- Difficulty listening and following directions
- Difficulty focusing and sustaining attention
- Difficulty concentrating and attending to task
- Inconsistent performance in school work-one day the student may be able to do the task, the next day cannot; the student is “consistently inconsistent”.
- Tunes out-may appear ‘spacey’
- Disorganized-loses/can’t find belongings (papers, pencils, books); desks and rooms may be a total disaster area
- Poor study skills
- Difficulty working independently
The term ADHD is the current descriptive diagnostic term in the revised third edition of the American psychiatric association’s diagnostic and statistical manual (1987). It is the label used to describe the student who may have many of the above-mentioned characteristics in addition to many associated with a hyperactivity component.
Behavioural characteristics of attention deficit disorder with hyperactivity (ADHD)
- High activity level
- Appears to be in constant motion
- Often fidgets with hands or feet, squirms, falls from chair
- Finds nearby objects to play with/put in mouth
- Roams around classroom-great difficulty remaining in seat
- Impulsivity and lack of self control
- Blurts out verbally, often inappropriately
- Can’t wait for his/her turn
- Often interrupts or intrudes on others
- Often talks excessively
- Gets in trouble because he/she can’t stop and think before acting (responds first/thinks later)
- Often engages in physically dangerous activities without considering the consequences (for example: jumping from heights, riding bike into street without looking)l hence, a high frequency of injuries.
- Difficulty with transitions/changing activities
- Aggressive behaviour, easily over stimulated
- Socially immature
- Low self-esteem and high frustration
Note: not all symptoms apply to each child, and symptoms will vary in degree. Each child is unique and displays a different combination of behaviours, strengths, weaknesses, interests, talents and skills.
It is important to recognize that any one of these behaviour is normal in childhood to a certain degree at various developmental stages. For example, it is normal for a young child to have difficulty waiting for his/her turn, to have a short attention span, and to be unable to sit for very long. However, when a child exhibits a significantly high number of these behaviour when they are developmentally inappropriate (compared to other children their age), it is problematic. These children will need assistance and intervention.
What is the frequency of ADD/ADHD
The estimated incidence of ADHD varies widely, depending on the studies you read and the tools used. It is estimated by experts that 3 percent to 10 percent of school-age children are affected. The estimated figures most frequently cited in the literature are 3 percent to 5 percent. However, this is very likely an underestimation due to the fact that many ADD girls often go undiagnosed. ADHD is far more common in boys than girls. Hyperactivity affects at least 2 million children in the United State alone, girls more commonly have ADD without hyperactivity.
What are the possible causes of ADD/ADHD
The causes of ADHA are not known at this time, the scientific and medical communities are gaining more and more knowledge about how the brain works and what affects attention and learning. As with many disorders, it is not always possible to identify a cause. At this time, ADD/ADHA is usually attributed to heredity or other biological factors.
When parents have a child who has problems of any kind medical, physical, psychological, or social they feel guilty typically and blame themselves. Many parents believe that they did something that may have caused their child to have problems. This feeling of guilt and blame should be dispelled, if a child has ADD/ADHD, it is no one’s fault.
The following are possible causes of ADD/ADHD
- Genetic causes: We do know that ADHD tends to run in families, a child with ADD will frequently have a parent, sibling, grandparent, or other family member who has similar school histories and behaviour during their childhood.
- Biological/physiological causes: Many doctors describe ADHD as neurological inefficiency in the area of the brain which controls impulses and aid in screening sensory input and focusing attention. They say there may be an imbalance or lack of the chemical dopamine which transmits neuro sensory messages. The explanation is that apparently when we concentrate, our brain releases extra neurotransmitters, which enable us to focus on one thing and block out competing stimuli. People with ADD seem to have a shortage of these neurotransmitters.
- Complications or trauma in pregnancy or birth
- Lead poisoning
- Diet: ADHD symptoms linked to diet and food allergies continues to remain controversial in the medical community, current research has not given much support to a dietary connection. However, there are many strong proponents of this theory. Future research will perhaps shed more light on this topic.
- Prenatal alcohol and drug exposure: We are all aware of the impact of the high number of drug exposed infants who are now of school age. These children have often sustained neurological damage and exhibit many ADHD behaviour. Currently the statistics in the state where I teach are very alarming. Over one in every ten babies born in California today are exposed to drugs in the womb. Scientific research has not yet proven a causal relationship between prenatal drug exposure and ADD. However, drug exposed children clinically exhibit many neurological deficits and behaviour that we see in ADD children.
A Comprehensive Treatment Program For Add/Adhd
Once a child is identified and diagnosed with ADHD there are many ways to help the child and the family. The most effective approach is a multifaceted treatment approach which may include:
- Behavior modification and management at home and school
- Counselling family counselling is recommended because with an ADHD child in the house, the whole family is affected.
- Individual counselling to learn coping techniques, problem-solving strategies, and how to deal with stress and self-esteem.
- Cognitive therapy to give the child the skills to regulate his/her own behaviour as well as “stop-and-think” techniques.
- Social skills training (sometimes available in school counselling groups)
- Numerous school intervention (environmental, instructional, behavioural)
- Providing for physical outlet (e.g., swimming, martial arts, gymnastics, running-particularly non-competitive sports)
- Medical intervention (drug therapy)
- Parent education to help parents learn as much as they can about ADHD so they can help their child and be an effective advocate. Parent support groups are excellent sources of training, assistance, and networking. Most communities also have parenting classes and workshops dealing with a variety of helpful management strategies.
When pursuing any treatment, it is a good idea to ask the school nurse and other parents of ADHD children (perhaps through an ADD support group) for references. Seek out doctors and therapists who are knowledgeable and experienced specifically with treating children with ADHD. Medical treatment if often extremely helpful and cam make a major difference in treating children with ADHD. However, it is never to be used without the employment of behavioural, environmental and other interventions at home and school.
Physical activity is also very important, activities such as martial arts (particularly aikido) are commended because they increase the child’s ability to focus and concentrate.
If a child displays the symptoms of possible ADD/ADHD, school interventions should be implemented regardless of whether the child has been diagnosed with ADHD. School personnel may encourage the parents to pursue the evaluation for the purpose of determining how to best help and meet the needs of their child.
Preventing behavioral problems in the classroom through management techniques
The most critical factors for preventing behavioral problems, particularly for students with special needs (e.g ADD/ADHD, learning disabilities), include
- Clarity of expectation
- Teaching what is acceptable/unacceptable in your classroom
- Structure and routine
- Predictability, consistency
- Much practices, modelling and review of behavioral expectations and rules
- Clear, fair consequences
- Teacher understanding, flexibility, patience
- Heading off problems with preventive tactics
- Teacher assistance on a personal level.
These children are in particular need of a classroom that is structured, not chaotic, they need to feel secure within the parameters of their classroom, knowing precisely what is expected of them academically and behaviorally.
Teach your rules
- Make rules few, clear, and comprehensive. Many teachers have students discuss, decide on, and write the classroom rules to give more ownership in classroom.
- Come prepared to work
- Follow directions and stay on task
- Keep hands, feet and objects to yourselves.
- Be kind and courteous to others.
- Follow directions
- Pay attention
- Work silently during quiet time
- Do your best work
- Explain the rationale for your rules, any time spent on teaching your rules and modelling all behavioural expectations is time well spent.
- Post rules (written or pictorial) in at least on visible spot. Teach with examples. Role-play rules in action. This is appropriate at all grade levels. Review and practice frequently throughout the school year.
- With every behavioural expectation you communicate (1) explain, (2) write it down (3) demonstrate it in action and (4) let students practices. Example: practice 12-inch voices. What does it sound like? Is this a 12-inch voice.
- Communicate rules and expectations to parents in writing
How to teach students organization and study skills
Students with ADD/ADHD have major problems with organizational and study skills. This is, in fact, one of the key characteristics of the disorder. These students need direct assistance, structuring, and training in how to:
- Organize their material
- Organize their work place
- Record their assignments
- Make lists
- Prioritize activities
- Plan for short-term assignment
- Break down long-term assignment
- Know standards of acceptable work
- Read and use a calendar
- Read a clock and follow a schedule
- Know what to take home and leave home
- Know what to take home and return
- Know when and where to turn in assignments
- Know what to do specifically during seat work
- Known what to do when seat work is completed
- Know what materials are needed and expected
- Don’t assume the student is lazy in the classroom, a student with attention deficit disorder or a learning disability is typically not lazy. There are other reasons for their non-performance in the classroom.
- Don’t be fooled by inconsistency or assume the student is deliberately not performing because you have observe that at times he/she is able to do that kind of task/assignment. Students with attention of deficit disorder have inconsistency as a hallmark characteristic of their disorder. Some times they can do the work, sometime they cannot.