ADHD

ADHD is defined as :

• ADHD - Attention Deficit Hyperactivity Disorder
•  Internationally validated medical condition
•  Involving brain dysfunction
•  Individuals have difficulties in controlling impulses, inhibiting their behaviour and sustaining  their attention span
•   Leads to a variety of educational, behavioral, social and related difficulties
  

Core features :

-          Poor attention span

-          Excessive impulsivity

-          Hyperactivity

The major symptoms of ADHD :
 

Symptoms of poor attention span may include :

-          Disorganization

-          Forgetfulness

-          Being easily distracted

-          Difficulty in sustaining attention in tasks or play activities

Symptoms of hyperactive or impulsive behaviors may include :

-          Fidgeting

-          Having trouble playing quietly

-          Interupting others

-          Always being on the go

The attention span of children with ADHD can be improved by :

·         No doubt, the issue of poor attention span is the most damaging feature for children with ADHD

·         First step, we cannot assume a child understands what paying attention really is

·         A series of role-play activities between you and the child may need to take place. For ex.:

-      Exhibit a series of incidents or examples when you did not get to hear or understand the   taped story that was being played

-        The child would be asked to clarify examples why you didn’t hear the story or to rate your listening skills

-        Attempt to show how daydreaming works

-        Once again the child rates your performance in a detective-type way

·      Once you feel the child understands what is meant by paying attention, it is possible to start to teach attention span by timing their performance against a chart or similar visual tool.

·        Attention cards can be devised and put on students desks.

·        Sometimes using a beeper inside the pant’s pocket might be effective.

Teacher/parent can manage impulse control for children with ADHD :

§       First step is to explain the concept of impulsivity to a child

§   The best place to start is to consider recent examples of incidents and to determine through the student’s own words how these incidents could have been handled differently

§   Getting the child to consider a number of separate situations and listing an impulsive act vs a thought-out act would be a starting point.

Impulsive Act	Thought-out Act
Running into the street	Pausing at kerb, checking for traffic
Interrupting conversations	Saying ‘Excuse me’ and waiting your turn

§    Next stage is to construct a chart with a specific situation and ask the child to clarify what they think the negative consequence would be vs what would be listed as ‘Alternative Thought’, for example not doing homework.

§    Consistent and remain flexible

§    Some tried and trusted strategies :

-          Seat the student next to the teacher

-          Place the student up front with his/her back to the rest of the class

-          Surround the ADHD student with good role models

-          Avoid distracting stimuli

-    ADHD children do not hande change well, so avoid transitions, changes in schedule,  physical relocation, disruptions

-          Be creative! Produce a ‘stimuli-reduced area’ for all students to access

-          Maintain eye contact with ADHD student during verbal instruction

-          Make directions clear. Be consistent with daily instructions

-         Simplify complex directions

-         Make sure the ADHD student comprehends what they are doing before beginning the task

-          Repeat in a calm, positive manner

-          Help the ADHD child to feel comfortable with seeking assistance (most won’t ask)

-          These children need more help for a longer period of time that the average child

-          Keep a daily assignment notebook

-          Give one task at a time but monitor frequently

-          Modify assignments as necessary. Develop an individualized program

-          Give extra time for certain tasks

-          Keep in mind the ADHD child can easily get frustated

Some of the rewards list that would be beneficial  for students with ADHD :

• Positive comments
• Stamps, stickers, merits, points, certificates
• Additional responsibilities in the class
• Free time
• Informing parents of positive issued
• Options involving special areas of interset (music, art, sports)
• Freedom of movement
• Choice of work/class options
• Field trips, outings
• Lunch with headteacher
• Reduce homework
• Phone tokens, food, money (for older students)

The negative experiences children with ADHD face in school :

• Lack of understanding by teacher
• Confusing and lengthy processes to obtain support through action plans, statementing, etc
• Lack of understanding by health care professionals
• A feeling of being in the dark and having to cope without support of information

Some of the main effects that have significant impact on the lives of individuals with ADHD and their families :

• Lack of foresight/hindsight, i.e. always living for the moment
• Poor organizational skills, complete lack of time management
• Lack of social skills and inability to read social cues
• Poor frustation tolerance, being inflexible
• Risk-taking/thrill-seeking behaviors
• Problems with transitions, problems in paying attention to others
• Lying, swearing, stealing and blaming others

There are also the results of three studies on general behavior patterns, exclusions from school and sexual activity that compares ADHD and typical children. The results are that ADHD children scores much worse in these behavior patterns ;

·         Argues with adults

·         Blames others for own mistakes

·         Acts touchy or is easily annoyed

·         Swears

·         Lies

·         Stealing (not involving threats)

·         Temporarily excluded from school

·         Permanently excluded from school

·         Not completing school

·         Numbers of sexual partners

·         Birth control used

·         Sexually transmitted disease

·         Pregnancies

·         Children sired

·         Children not in parental care

Medication should be used for children diagnosed with ADHD when :

·         Only after comprehensive evaluation

·         When a child is at significant risk of harming him/herself or others

·         When serious attempts at non-medical interventions have proved insufficient

·         When the child is at risk of emotional and/or academic failure