ADHD is a complex neurobiological disorder. Researchers believe that people with ADHD have a few structures within the brain that are smaller and that their neurotransmitters – chemical messengers of the brain – do not work properly. This gives rise to very poor concentration, impulsive and/or hyperactive behaviour that significantly interferes with and impairs everyday life.
The purpose of classifying behaviour enables specialists to understand/help child and suggest strategies for those who live and work with them. Children with ADHD often test the limits of teachers and parents. In order to help the child you need to remain in control and respond positively, not allowing yourself to get drawn into a negative behavioural style.
- It is easy to make the mistake of treating children with ADHD like “little adults.”
- Use less talk and less emotion when disciplining children with ADHD
Focus on planning for child with special needs:
School can be a hostile place for a child with ADHD
- Be aware of problem situations
- Accommodate skills difficulties
- Acknowledge and note vulnerabilities
- Find out about potential problems before child enters the class so you can plan ahead and avoid possibility of a poor start
- Assess situations with the ADHD child in mind. School trips or a school play are likely to make the child very excited. Establish one or two essential rules before the event and make sure the child knows what the rules are and what will happen if she/he does or does not comply. May be necessary to plan for a parent or classroom assistant to be present at the event.
- Try to control the level of stimulation the ADHD child is exposed to. Child with ADHD is easily aroused.
- Give short, clear instructions: try not to “flood” the child with information as s/he will “switch off.”
- Tell the child what to do, rather than what not to do, eg “please put your feet on the floor” rather than “take your feet off the table.” Giving positive rather than negative instructions better for morale of teacher and child.
Rules, Rewards and Punishments:
Have only few rules in classroom; make sure they are visible and child knows rules and consequences of compliance or non-compliance. Rules should be phrased positively, eg “be kind to others, listen when the teacher is speaking.” Praise and reward appropriate behaviour and achievements – try and ignore minor behaviour.
Enforce rules consistently and quickly: ADHD children cannot await rewards and forget why they are punished if there is a delay.
- Child may need help in appreciating rules, procedures of classroom and find them hard to remember
- Reinforcement and meaningful rewards help is more effective than punishment, as is a positive attitude, comment or smile
- Set boundaries and limits for child in classroom and playground
- Make it clear it is the behaviour not the child that is unacceptable
- Remember the threat of punishment has little effect on child with ADHD because of poor appreciation of cause and effect and consequences of actions
- Use reward systems, giving child opportunities to be rewarded frequently. Change reinforcers as ADHD children become bored very quickly. Use positive reinforcers but remember ADHD children also need mild negative consequences. If punishments are too extreme, the child will give up trying to behave.
- Punish carefully – avoid lecturing, criticising, ridiculing, sarcasm, etc
- Work on one difficult behaviour at a time – remember you are teaching the child to behave just as you teacher him to read.
- Remember the child has a disability and try to be kind to him/her and to yourself.
- Make sure the child knows it is his/her choice to be rewarded or punished.
- Remember the difficult child is not evil and that sanctions are put in place to help him
- Don’t presume that child will behave well because of getting a treat/reward
- Try to provide opportunities for the child with ADHD to retreat, like giving small jobs that are not used as a punishment
- Whenever possible, try to give the child with ADHD opportunities to be responsible – don’t resent doing so because he doesn’t deserve it – think of him as being disabled
- Make sure that the child is given a second chance to succeed as soon as s/he has failed, ie “as soon as you say you are ready to be quiet you can leave the naughty chair/return to the room” etc.
- Teach the child problem solving skills so that s/he feels in control. Remember that feelings of helplessness are close to feelings of depression.
Appropriate Learning Environments
Create an organised educational environment:
- Have a quiet area that is available for all children
- Make sure the classroom is well-organised, tidy and calm
- Teach children how to organise their desk, time etc
- Establish and display a daily routine
- Develop a clear system for keeping track of completed/uncompleted work; provide due dates for all assignments and make sure child has copied them into his/her homework book
For Instructional Teaching
- Children with ADHD particularly need structure, routine, predictability
- Classroom setting is important with child near the front, with minimised distractions, close to teacher with good role model, ideally in small classes and with 1:1 attention
- Be conscious of the hypersensitivity of ADHD to words, actions, situations etc – they often over-react to apparently minor – to the observer – triggers
- Teach the child listening skills (stop work, put down your pen, look at the speaker)
- Repeat instructions and directions frequently
- Break up lesson into segments
- Involve several different activities
- Try and involve student in demonstrations etc
- Use visual aids whenever possible and agreed cues to maintain attention
- Modify curricula: abbreviate assignments; increase work time, reduce number of problems per page: worksheets are better than books: computers are excellent for ADHD children as they provide immediate feedback and a multisensory approach that prevents child becoming bored
- Use mistakes to demonstrate more positive ways for future learning rather than failure – remember children with ADHD experience failure in many aspects of their lives
- The vulnerable child may manage on his own – it is often in group situations and when unstructured that things go wrong for the child with ADHD and that this does not necessarily mean that diagnosis or medication is incorrect but may suggest reference to the specialist centre for further advice
Understanding, Ethos and Medication
- Admitting your inability to cope is the first step towards achieving a positive resolution
- Be sensitively open about ADHD: hiding a problem makes it something to be ashamed of. Every child in your class will have some area of weakness.
- Remember ADHD children have a medical problem that is difficult for them and difficult for you.
- It is also important to be aware that ADHD affects both boys and girls and that no two children with ADHD will appear the same or require exactly the same management.
- ADHD affects all IQ levels.
- Remember, too, that those (often – but not only – girls) who have significant problems mostly with concentration only (inattentive ADHD) need help as much as those who are also hyperactive/impulsive/disruptive.
- Try and avoid regarding the child as a nuisance
- Remember even with best laid plans, there are always instances when child cannot conform
- A great deal of unease and embarrassment can be avoided when everyone working with child is aware and understands the condition
- Key to success is for parents and teachers to work together with common purpose
- There needs to be an effective bend of warmth/firmness as a listening “coach”, encouraging and supporting the child with ADHD
- Think of the child with ADHD as emotionally fragile and vulnerable
- Try to promote and enhance child’s self esteem – see your role as observing the behaviour and linking it to learning by reading the subtext of this behaviour
- Don’t adopt dangerous approach that you don’t want to pre-judge a child
Ethos
- Eradicate the notion that all children be treated the same
- Try to cultivate understanding and support between class members
- Try to cultivate a relationship with parents – don’t condemn or preach and keep them regularly informed
- There needs to be understanding, support and respect of each member of the team
- The overall school ethos is crucial to success of managing a child with ADHD – often only slight changes of approach make a huge difference both to child and teacher alike
- The teacher’s attitude to child in front of peers is very important
- Have realistic expectations because of a good understanding of facts and reality of ADHD
- Remember a child’s confidentiality should always be respected – special arrangements for medication should not be common knowledge to the class
- Remember a teacher’s unprejudiced comments are vital for evaluation and monitoring of progress, especially before and after medical assessment
- Medication should be seen as an adjunct to teaching to allow the child to be “available” for good teaching and parenting strategies, which are still essential as part of overall management of child’s needs
- It is important for teachers and the medical profession to work together without boundaries in the best interests of the child
And Finally ….
- Symptoms of ADHD may be mild, moderate or severe or combined with other conditions – adults will, therefore, see variability in skills and maturity levels in these students
- A child with ADHD is usually about a third less mature than his chronological age with a 2-4 year lag in age appropriate developmental skills – he knows what to do but doesn’t always do what he knows
- 40-50% children with ADHD have at least one parent with condition and 30% have a sibling with the condition
- Adults with ADHD often find careers compatible with their personality so symptoms are not a problem in the workplace, can become less severe with age or the adult learns to compensate – some, however, will still need medication
- Do not expect the child to become an angel overnight – even when on medication there will still be problems in some situations – this doesn’t mean all is lost but does require a philosophical approach and understanding of the reality of ADHD and helps one to get things into perspective – remember, children with ADHD are not “problem children” but “children with a problem.” Symptoms of ADHD present lifelong challenges. ADHD is a life sentence. Untreated and misunderstood, it blights a childhood and prevents a future. Understanding and support is the key to its freedom.
Don’t forget that the child with ADHD usually has many positive qualities and skills that can be buried underneath the struggles of suffering from ADHD – the challenge is to discover and develop these to allow the child to achieve to their potential and enjoy a better quality of life
Most of all ensure that you have an up to date informed understanding of the facts and reality of suffering from and living with ADHD and its appropriate management so that you and your colleagues can provide essential support to the child and each other
