33-ADHD

a neurobiological disability characterised by chronic difficulties with inattention and/or impulsivity - hyperactivity . (Lay, 2007, p.248)
an individual who is inattentive and /or impulsive and hyperactive at a level that is unexpected or inappropriate for their age and development. (Lay, 2007, p.248)
These difficulties are manifested across various settings and affect the ADHD child's ability to function normally. (Lay, 2007, p.249).
These children have a geniune disability, for which there is little control and they require appropriate support and understanding (Lay, 2007, p.249).

Features of ADHD

The holy trinity as posited by Dr Russell Barkley (2006) states the 3 primary symptoms: (Lay, 2007).

Inattention

'Most obvious in situations where the child is required to sustain attention to mundane, dull and repetitive tasks (e.g., independent seatwork and homework)'. (pg.249)

'Has extreme difficulty giving sustained effort to tasks that have little intrinsic appeal (e.g., listening to a teacher talk endlessly) or tasks where there are minimal consequences for immediate completion (e.g. lack of instant feedback on how well one has done on a piece of class work)'. (pg.249)

Behavioral Disinhibition (Impulsiveness)

According to Barkley, apparently there is sufficient research to suggest that it is B.D. (impulsiveness) rather than inattention that is the quintessential trait of ADHD (pg. 249).

Impulsiveness - 'an inability to delay a response or to defer gratification; in short, it is poor self-regulation.' (pg.249) (Giving answers without waiting for instructions to be finished, etc ).

'Do not respond well when asked to work towards a longer-term goal and larger rewards, preferring to work for immediate, smaller rewards, on tasks that require less work' (pg. 249).

'These children have a hard time waiting their turn in a game, exercising restraint with peers and discreetly saying the right things.' (pg. 249) Thus they are unpopular.

Hyperactivity (pg. 250)

Restlessness, inattention, and impulsiveness - throughout life.

Hyperactivity declines with age.

Outward hyperactivity fades in adolescence.

Myths (Barkley, 2006 in Lay, 2007 p.250)

ADHD is not caused by:

The child not receiving enough attention
bad parenting
family problems
food additives, sugar and food allergies

Facts

Neurological and genetic factors are the greatest contributors to ADHD.

'Psychosocial factors (e.g., child caretaking ability, parental psychological problems) may exacerbate ADHD, contribute to its persistence and likely contribute to other associated emotional, behavioural and/or learning difficulties. (pg.250)

Associated Problems

Academic Performance (pg. 251)

They tend to under-perform relative to their intelligence tests.

This is attributed to 'their inattentive and restless classroom behaviour, as numerous studies have demonstrated significant improvement in academic performance when children are put on medication (pg.251).

>> 'The teacher would need to be alert to the child's specific academic difficulties with attention given to providing the appropriate instructional support (pg. 251)'

Motivational Difficulties

They lose motivation when working on repetitive tasks that have no immediate reward.

Their efforts vanish over time as compared to other children who can regulate motivation and carry on working towards a goal.

>>'Teachers are to keep in mind their need for immediate and external sources of reward to encourage persistance of effort' (pg.251)

Social Relationships (pg.251)

Main reason is the impairment of self-regulation - creates genuine difficulties in their social adjustment.

They disrupt the 'smooth stream of social interactions, the normal give-and-take and cooperation often taken for granted in social relationships (Whalen & Henker, 1992).

Consequences:

'Their disruptive and noncompliant social behaviour tends to elicit a pattern of negative, controlling and directive behaviour from both peers and adults alike...they have been shown to have less knowledge about social skills and appropriate behaviour with others (Grenell,Glass & Katzm 1987).

>> Therefore, social skills training and counselling are required to address these deficits.

Managing ADHD

'The best treatment for ADHD is multimodal. That is, it typically includes the use of medication prescribed by a doctor, restructuring of the learning environment, effective behaviour management of the child both at home and in school, and individualized instruction for the child on strategies for organisation and self-regulation' ( Lay 2007, pg.252)

Structuring the learning environment for students with ADHD

Preferential Seating:

Avoid seating the student near windows and open doors
Seat the child with ADHD around positive peer models.
Seat the child in front of the classroom within an arm's length of the teacher's reach; this allows you to re-direct the child's attention quickly when necessary
Use a quiet carrel or corner for seatwork. (But be sure to help the child understand that this is not a punitive, but rather a supportive gesture)

(Lay 2007, pg. 252)

Communicating With the ADHD child

Before you give instructions, insist on body readiness (e.g., eye contact)
Keep instructions short (i.e., give two-step or at most three-step instructions)
First, tell the child what you are about to tell him/her; second, tell him/her; third, ask him/her to repeat what you have just told him/her.

For example, "Roger, i am going to tell you two things. First, bring your Math worksheet and a pencil to your quiet work corner. Second, do the first two questions. What are the two things you need to do?"

(Lay 2007, pg. 252)

Adjusting Assignments

Break a lengthy assignment into smaller chunks and give deadlines for sub-tasks. This helps to make a long assignment more manageable and allows the child to focus attention on small portions, a bit at a time.
Explain what is meant by a completed task. For example, your English homework is completed when you have answered all the questions and checked for spelling errors.
Consider using a 10-minute timer for seatwork. Give praise for work completed with accuracy within the time limit.
On long assignments, it is preferable to have the child check in with the teacher at 10- to 15- minute intervals. This allows the child an energy break and provides the teacher an opportunity to give immediate feedback and praise for good work and/ or effort.

(Lay, 2007, pg. 253)

Structuring Instruction

Vary instructional media, materials and presentation formats when you teach.
Use computer programmes for short drills and practices.
Use graphic organisers (e.g., story maps, Venn diagrams, plot profiles, character webs) to enable the child to visually organise learning.
Give opportunities to learn in small groups or one-to-one settings.
Set expectations a little lower and increase praise and encouragement for effort.
Have the child keep a journal of his/her thinking, reasoning, questions and understanding of concepts.
Provide opportunity for the ADHD child to stretch, stand up and walk around briefly (e.g., ask the child to clean the whiteboard, hand out worksheets or get a drink of water at the cooler).
Teach the child to make a schedule or a daily 'things-to-do' list and reward good organisation.

(Lay, 2007, pg.253)

Seeking Help For A Student Suspected to Have ADHD

1) Discuss with Learning Support Coordinator in the school.

2) Share concerns with the child's parents or caregivers and whether the difficulties observed in school occur at home.

3) If no.2 rings true, encourage the parent to have the child evaluated by an educational or school psychologist.

4) Be careful not to discuss ADHD at this time, as it is important that the diagnosis should be made by a qualified professional.

5) Additionally, you can consult an educational psychologist for advice on making classroom accommodations for a child with ADHD.

6) Finally you could direct parents of ADHD children to the school's educational psychologist for consultation on managing their child's ADHD symptoms in the home.

D. RESOURCES

In your groups, you could explore:

The ‘Centre for Enabling Living’ website http://www.cel.sg for information of your selected area of disabilities according to the relevant age groups. You can also review their ‘Useful Links’ for more information
‘Hoagies’ Gifted Education Page’ http://www.hoagiesgifted.org for information on giftedness
‘SPARK’ http://www.spark.org.sg for information on ADHD
‘Dyslexia Association of Singapore’ http://www.das.org.sg/ for information on Dyslexia
Family and Community Development site on juvenile delinquents http://fcd.ecitizen.gov.sg/TeenageNYouth/ParentingTeenagers/JuvenileDelinquency/
Council for Exceptional Children: Bahviour Disorders/Emotional Disturbances http://www.cec.sped.org/AM/Template.cfm?Section=Behavior_Disorders_Emotional_Disturbance&Template=/TaggedPage/TaggedPageDisplay.cfm&TPLID=37&ContentID=5624

In addition to this, you can register and access Teachers TV at: http://www.teachers.tv/ and explore the resources and videos on this website.

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