ADHD in the classroom

In fact, children who are unable to pay attention to one task are likely to avoid or develop a strong dislike to tasks that demand prolonged concentration. Academic success for sufferers can be inconsistent and infrequent. These difficulties are inherent components of Attention Deficit/Hyperactivity Disorder (ADHD).

It is a condition which includes persistent patterns of inattention, impulsivity and/or hyperactivity when compared with others of similar age and developmental levels. In terms of this definition, this pattern must adversely affect at least two settings, such as school, home and/or work and must present before the age of seven.

ADHD is the most common diagnosis for school-age children, with prevalence estimates ranging from 2% to 6%.

“For many parents, this diagnosis comes as a tremendous shock. Although they have long suspected that something was not quite right, they still find it difficult to adjust to the idea that their child may have a medical condition as the basis of a concentration problem,” says Educational Psychologist Moira Brown.

Getting into trouble
Children with ADHD often get into trouble for disrupting the class, or for not following instructions. They thus become frustrated as they find concentration for prolonged periods impossible. There is not enough time within the teachers schedule to really devote enough time to find out why the child is feeling so frustrated or behaving in a specific way.

With many children, the frustration as a result of the ADHD is not even recognised, the child is merely classified as a “difficult” child and this label may continue to follow him or her throughout school.

“These children are also labeled as ‘class clowns’ as they frequently joke and pull pranks in the classroom as a means of distracting attention from answering questions or from their poor or incomplete work. Others are known as ‘dreamy’ or ‘not quite with it'," comments Brown.

Challenge for teachers
Learning how to best deal with children with ADHD is also a challenge for the teacher. Since behaviour that accompanies ADHD can contrast sharply with what is expected in school, keeping control of a classroom that includes children with ADHD can be a difficult task.

It is vital for teachers to have some knowledge about the condition. They should motivate parents to have their children assessed should the presence of ADHD be suspected. They should also know how to best teach and treat these children in order to minimise the frustration they feel as a consequence of their condition.

It is vital for a teacher to maintain a close relationship with the parents of these children in order to discuss some of the problems as well as the achievements of the child. It is also a school’s responsibility to document behaviour and recommend an evaluation when a pattern of ADHD symptoms are present in an academic setting.

Diagnosis
ADHD cannot simply be diagnosed by a blood test or similar physical test. Instead a clinical diagnosis based on the patient’s history will need to be conducted by specially trained healthcare professionals. The patient would be evaluated based on the child’s overall patterns of behaviour and the symptoms of the disorder, using specific scientific diagnostic criteria.

Brown says that many other medically-based conditions such as various allergies and epilepsy need to be excluded before a diagnosis of ADHD can be made. “It is foolhardy and extremely unprofessional to diagnose a child without the results of these tests. Very often this is not done, resulting in heartache for parent and child alike. This creates suspicion in the minds of parents concerning ADHD,” she says.

First and foremost, teachers need to realise that ADHD children are often surprised by their own behaviour and do not deliberately intend to “act out” in the classroom. There is a damaging misconception that children with ADHD should be able to control attention and impulsive behaviour, should they choose to do so – that if a child puts more effort into paying attention and controlling impulsive behaviour, then he or she would be a much better student.

"I find that children are frightened and baffled by their inability to control their behaviour. Too often I hear a child say: “But I did not mean to do that!”. Continuing poor or disruptive behaviour leads to unwanted attention from the teacher to the child. If the cycle is not broken quickly and effectively, then the results can be far-reaching – the child may then begin to doubt himself with resultant low self-esteem” explains Brown.

Biological condition
ADHD is a biological, brain-based condition thought to be caused by an imbalance of some of the brain’s neurotransmitters, substances used to signal between nerve cells. In individuals with ADHD, there are lower than normal levels of certain neurotransmitters in the regions of the brain that are responsible for regulating behaviour and attention.

About half of children with ADHD can do well in a regular classroom and teachers who understand the needs of these children can greatly help by making certain adjustments within the classroom environment, without making the child feel punished or penalised.

These include:

• Seating the child in a quiet area with few distractions, preferably up front and close to the teacher.
• Scheduling difficult subjects that require more concentration in the morning and other school activities that require less attention in the afternoon.
• Mixing classroom lectures with brief periods of physical activity, such as washing the blackboard or going to the bathroom.
• Keeping assignments brief.
• Allowing the child to participate often.
• Giving the child extra time to answer questions or complete tests and other assignments.
• Preparing the student for transitions or changes in routines, such as field trips or changes from one activity to another.
• Giving immediate feedback and rewards for desired behaviour or for achievement.

Medication
Most experts agree than an appropriate treatment strategy for children with ADHD should include a combination of medical, educational and behavioural approaches. Historically, the most common medication to treat ADHD were psycho-stimulants which work by normalising the neurotransmitters in the brain. These medications do have some side effects and do not work for all patients. Furthermore, some patients with ADHD have gone untreated due to the stigma associated with stimulant treatment.

Brown believes that it is a very sad fact that many children have been denied the opportunity to achieve their potential due to misconceptions concerning medication. She says that these misconceptions are very difficult to deal with – people do not like being proved wrong.

(The Write Agency, updated March 2008)