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.

Andrew Greenfield, Consultant Child and Educational Psychologist

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:

  1. Predominantly inattentive ADHD
  2. Predominantly hyperactive/impulsive ADHD and
  3. Combined ADHD.

Diagnosis

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.

Measurement

Psychologists use:

  • 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).

Treatments

  • Medication.
  • Training for parents, caregivers, teachers.
  • Strategies for children and adolescents.
  • Cognitive and/or Behaviour Management programs for the child.

Social/Academic Implications

  • 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

Strengths

  • Verbal Expression.
  • Visual gestalt – ability to see the ‘big picture’ quickly.
  • Long-term memory.
  • Intense emotions.
  • Enthusiastic, curious.
  • Active.
  • Generalisation of ideas.

Weaknesses

  • Listening.
  • Poor planning and organisation.
  • Visual detail.
  • Short-term /working memory.
  • Bored easily.
  • Impatient.
  • Written expression of ideas.

Three Principles of Instruction

  • Brevity.
  • Variety.
  • Structure/Routine.

Classroom Environment

  • Seat close to the teacher.
  • Seat among well-focused peers.
  • Use role model/buddy.
  • Keep work place uncluttered

Workload

  • 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.

Instructions

  • 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.

Teaching Methods

  • Use hands-on materials, computers and visual aids.
  • Use modelling, demonstration and guidance practice.
  • Accommodate writing, language and learning difficulties.

Summary

  • 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.

Useful Resources

Booklets

  • Learning Difficulties Coalition NSW (LDC) ADHD Hot Tips for Parents and Professionals – Tool Kit Series.

Websites

Books

  • 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.

Articles

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