Attention Defecit Hyperactivity Disorder
Notes from Andrew Greenfield’s presentation to 2013 Teacher’s Christian Fellowship Day Conference.
ADHD - Implications for students and Management Strategies for Teachers.
What is ADHD?
Attention Deficit Hyperactivity Disorder (ADHD) is a medical condition characterised by a persistent pattern of inattention, hyperactivity and/or impulsivity that is more frequent and severe than is typically observed in people of the same age group.
There are 3 main types of ADHD:
- Predominantly inattentive ADHD
- Predominantly hyperactive/impulsive ADHD and
- Combined ADHD.
There can be varying degrees within each subtype – mild, moderate, severe and profound.
Symptoms must have persisted for at least 6 months and exhibited across various settings e.g. home and school.
- ADHD frequently overlaps with other conditions as Conduct Disorder, Anxiety, ODD which can make diagnosis difficult.
- ADHD can be diagnosed by Paediatricians, Psychiatrists, Child/Educational Psychologists.
- Reports from the child’s home and school should be undertaken.
- ADHD is more common in boys than girls.
- ADHD is hereditary.
- Rating scales (behaviour/concentration) by parents and teachers.
- Observation of the child’s behaviour.
- Cognitive tests (IQ test) investigating strengths and weaknesses.
- Assessment of possible Learning Difficulties.
- Neuropsychological test: Evoked Potential, EEG, qEEG.
- Information regarding family history, birth, developmental milestones.
- Continuous Performance Tasks (CPT).
- Training for parents, caregivers, teachers.
- Strategies for children and adolescents.
- Cognitive and/or Behaviour Management programs for the child.
- Poor Working Memory – forgetful, poor sustained attention, easily distracted, misinterprets information.
- Poor use of Hindsight – repeats same mistakes, does not learn from past experiences.
- Poor use of Forethought – cannot anticipate future events, poor planning and organisation, problems in initiating, persisting with and completing tasks aimed at the future.
- Poor use of Inner Voice – keeps breaking the rules, poor self-control, lack of responsibility, difficulty making choices, problems checking, regulating and modifying behaviour.
- Poor problem solving.
- Can’t separate emotions from fact – over emotional, overacts, not objective.
- Impulsive Behaviour – speech, decisions, cannot delay gratification.
Strengths & Weakness of Children with ADHD
- Verbal Expression.
- Visual gestalt – ability to see the ‘big picture’ quickly.
- Long-term memory.
- Intense emotions.
- Enthusiastic, curious.
- Generalisation of ideas.
- Poor planning and organisation.
- Visual detail.
- Short-term /working memory.
- Bored easily.
- Written expression of ideas.
Three Principles of Instruction
- Seat close to the teacher.
- Seat among well-focused peers.
- Use role model/buddy.
- Keep work place uncluttered
- Divide tasks into manageable parts.
- Give short assignments.
- Allow extra time.
- Give assignments one at a time.
- Reduce homework.
- Provide breaks, allow students to move around.
- Be clear and concise.
- Specify consistent expectations and consequences.
- Use private cues/signals.
- Give multisensory instructions.
- Have direct eye contact.
Skills & Strategies
- Set short-term goals.
- Use contracts.
- Teach self-monitoring.
- Teach problem solving.
- Teach think before you respond and act.
- Use extra class assistance.
Incentives & Consequences
- Increase immediacy.
- Reward effort and accept fewer correct responses.
- Provide regular feedback.
- Give positive reinforcement.
- Use a variety of rewards that students’ value.
- Ignore minor negative behaviour.
- Use hands-on materials, computers and visual aids.
- Use modelling, demonstration and guidance practice.
- Accommodate writing, language and learning difficulties.
- ADD/ADHD is a complex condition that affects different people in different ways.
- A student’s strengths/weaknesses and learning style should be the main focus.
- A full comprehensive assessment should be ascertained before making a diagnosis i.e. by a Child/Educational Psychologist and specialist Developmental Paediatrician.
- Don’t believe everything you read and hear about ADD/ADHD.
- Support students with ADHD at home and at school.
- Learn simple behaviour management techniques.
- Learning Difficulties Coalition NSW (LDC) ADHD Hot Tips for Parents and Professionals – Tool Kit Series.
- You and Your ADHD Child by Ian Wallace: Practical strategies for coping with everyday problems, 1996.
- ADHD the Facts, Dr Mark Selikowitz, 2004.
- Taking Charge of Adult ADHD: Russell A Barkley PhD, 2010.
- ADHD, 3rd Edition, A Clinical Workbook, Russell A Barkley & Kevin R Murphy, 2006.
- Attention-deficit/hyperactivity disorder is characterised by a delay in cortical maturation; Shaw, P et al.; www.pnas.org/content/104/49/19649