Docstoc

Understanding the needs of the

Document Sample
Understanding the needs of the Powered By Docstoc
					Understanding the Needs of the Child with Attention Deficit
Disorder (ADD, AD/HD)
At first, it was thought that attention deficit disorder only appeared in children, nowadays it
is accepted that the syndrome continues into adulthood. ADD is now recognised as one of
the possible conditions that can affect childhood development. It is also known by other
names - AD/HD (Attention Deficit / Hyperactivity Disorder) or HADD, (Hyperactivity and
Attention Deficit Disorder). For the purpose of simplicity and clarity, this article uses the term
ADD.

A conservative estimate is that 5 percent of school-age children have ADD, and yet it remains
poorly understood by the general public, often going unrecognised or undiagnosed. The
hallmark symptoms of ADD - distractibility, impulsivity and high activity - are so commonly
associated with children in general that the diagnosis is often not considered. A child with
undiagnosed ADD is thought to be "just being a child,"- only more so. Where does the "more
so" leave off and the neurological syndrome of ADD begin? How can we tell a spoiled child
from an ADD child? How can we tell a child with emotional problems from a child with ADD?
One must look carefully at the child's individual history as diagnosis of ADD rests primarily
upon the history.

This supplement contains a lot of useful information that may provide an insight into the
problem, for individual subject teachers who have students with ADD in their classes.
Guidance counsellors may therefore freely photocopy this article for teachers.

                                                        make a judgement based on a comparison of the
Testing and Diagnosis                                   individual child to his or her peer group.

Parents may often ask guidance counsellors if           If the student stands out as markedly more
there are any tests available to diagnose or            distractible, impulsive, and restless than other
detect ADD. Guidance counsellors should                 students, and if there is no other apparent cause
therefore be aware that the most reliable               for this behaviour, (such as disruption of the
diagnostic tool is the individual's history -           family, substance abuse, depression or other
as elicited from the child, from parents                medical condition,) then the diagnosis of ADD
and, very importantly, from teacher                     can be entertained. However, only a
reports.                                                professional who has experience in
                                                        working with ADD should make the
There are psychological tests that can provide          diagnosis.
additional evidence in making a diagnosis. For
example, certain subtests of the WISC (Wechsler         Types of ADD
Intelligence Scale for Children) - a standard
intelligence test for children may suggest ADD.         Children with ADD will tend to fall into one of
Typically, the subscores for digit span,                three subtypes:
arithmetic, and coding are low in ADD students.         (1)      ADD predominantly inattentive type:
Additionally, there is often a wide split between       those who are mainly distracted and inattentive.
what is called the verbal subscore and what is          (2)      ADD    predominantly     hyperactive-
called the performance subscore. There are              impulsive type.
other tests that attempt to assess attention and        (3)      ADD combined type: those who
impulsivity, but it should be stressed that there       combine hyperactivity with inattention and
is not one definitive "test" for ADD.                   distractibility

There is no clear line of demarcation between           These children are frustrating to teach because
ADD and normal behaviour. Rather, one must              of their unpredictability, their failure to conform



NCGE 04/08                                  Section 1                                      1.5.27
to expectations and their tendency to 'not learn         School Indicators that may point to ADD
from their mistakes'.
                                                         Some or all of the following often marks the
They are often on the receiving end of                   classroom behaviour of children with ADD:
complaints and questions from their teachers                   Being out of seat too frequently
and parents such as: “If I've told you once, I’ve              Deviating from what the rest of the class
told you a thousand times: DON'T DO THAT!                          is supposed to be doing
Why can't you do as your are told - like most                  Not following teacher's instructions or
other people? Why do you always have to be the                     orders
one to get it wrong?... Why is it that you are                 Talking out of turn or calling out
always one of the ones who doesn't hand in                     Being aggressive toward classmates
their homework?                                                Having a short attention span and being
                                                                   distractible
To make matters worse, the child's often honest                Bothering classmates by talking to them
answer to these questions is remarkably                            or intruding on their work efforts
consistent: “I don't know". The problem is that                Being oblivious and daydreaming
as the child gets older and moves into second                  Losing and forgetting equipment
level, the years of exasperation and blame can                 Handing in homework late or not at all
also lead to disaffection. The child with ADD                  Handing in incomplete or sloppy work
therefore, if not handled appropriately, may                       (Based on J. Taylor, 1994.)
continue to have difficulties in concentration and
impulse control that are basically biological in         Other Indicators
nature. Not only this, s/he may also develop an
antipathy to school and a lack of motivation to          It is often the case that children with ADD
even try to overcome his or her difficulties.            experience the world as a hostile place. In some
                                                         cases, they appear to find physical contact
                                                         distressing to the extent that they resist parents'
Recognising a Student with ADD                           attempts to cuddle them, or show strong
                                                         aversions to certain fabrics, tastes or textures.
Children with ADD are often of average to high           They may also be hypersensitive to other
ability, but disturb their parents and teachers          sensory stimuli. They sometimes react with
because their classroom achievement is erratic,          discomfort to levels of sound and light that
and often below their apparent level of ability.         others find tolerable.
The child with ADD will often be a source of
exasperation to the teacher. The child may               Research from the U.S.A shows that children
show, on some occasions high levels of                   with ADD also tend to have other emotional and
performance, a ready wit and an imagination of           behavioural difficulties. These may not in
a high order. The problem is that the child's            themselves be necessarily related directly to
performance is erratic. In one manifestation of          ADD, but may interact with the ADD to intensify
the disorder, s/he may often appear disengaged,          learning and adjustment problems. Studies
easily distracted and unmotivated. The child can         indicate an overlap between ADD and the
often appear to be lazy.                                 following problems:

In another major manifestation, the child will           60% of children with ADD display oppositional
appear to be wasting obvious ability in favour of        and defiant behaviour (e.g. often losing temper,
being oppositional and disruptive. S/he will often       arguing with adults, refusing to comply,
be found out of his / her seat, bothering                deliberately annoying others) to a degree that is
classmates and often off task.                           severely disruptive;
                                                         50%+ children with ADD show social skills
                                                         problems;

                                                         45% of children with ADD display conduct
                                                         disorder (chronic aggression towards others,



NCGE 04/08                                   Section 1                                      1.5.28
destructive behaviour, deceitfulness or theft,         Working with ADD Students – How
serious and chronic rule breaking) to a severe         Teachers and Guidance Counsellors Can
degree;                                                Help

33% of children with ADD experience major              There are many critical factors to consider when
clinical depression;                                   working with ADD students.

25% of children with ADD display antisocial or         1. Guidance counsellors’ / teachers’
delinquent (i.e. criminal) behaviour;                      flexibility, commitment, and
                                                           willingness to work with the student
30% of children with ADD display clinically                on a personal level.
defined anxiety disorders.                             This means putting in the time, energy, and
                                                       extra effort required to really listen to students,
Learning Problems                                      be supportive, and make changes and
                                                       accommodations as needed.
In addition, children with ADD tend to exhibit
significant learning problems. The following           2. Training and knowledge about ADD.
figures relate to the USA:                             It is essential that guidance counsellors and
                                                       teachers are aware that this problem is
90% of children with ADD are under productive          physiological and biological in nature. These
in schoolwork:                                         children are not "out to get us" deliberately.
                                                       Their behaviours are not calculated to make
90% of children with ADD underachieve in               teachers crazy. This awareness helps teachers
school;                                                maintain their patience, sense of humour, and
                                                       ability to deal with annoying behaviours in a
20% of children     with    ADD   have   reading       positive.
difficulties;
                                                       3.     Maintaining close communication
60% of children with        ADD   have   serious              between home and school.
handwriting difficulties;                              It is very important to increase the number of
                                                       contacts and establish a good working
30% of children with ADD drop out of school;           relationship with the parents of an ADD child. If
                                                       a teacher is to have any success with ADD
5% of people with ADD complete a 4-year                students, they need the support, co-operation
degree course in a college or university,              and open line of communication with their
compared with approximately 25 per cent of the         parents.
general population.
                                                       4.    Providing clarity and structure for the
                                                             student.
                                                       Students with attention problems need a
                                                       structured classroom. A structured classroom
                                                       need not be a traditional, no-nonsense, rigid
                                                       classroom with few auditory or visual stimuli.
                                                       The most creative, inviting, colourful, active, and
                                                       stimulating classroom can still be structured.

                                                       Students with ADD need to have structure
                                                       provided for them through clear communication,
                                                       expectations, rules, consequences, and follow-
                                                       up.




NCGE 04/08                                 Section 1                                      1.5.29
They need to have academic tasks structured.            6.     Access to teamwork is vital, some
This may be achieved by breaking assignments                   teachers        find      team-teaching
into manageable increments. Teachers should be                 extremely helpful.
aware that modelling, guided instruction, clear         Being able to "switch" or "share" students for
directions, standards and feedback are all              part of the school day often reduces behavioural
appropriate.                                            problems and preserves the teacher's sanity. It
                                                        also provides for a different perspective on each
These students require assistance in structuring        child.
their materials, their workspace, group
dynamics, handling choices, and transitional            7.     Modifying assignments and cutting
times. No matter what the teachers’ teaching                   the written workload!
style is or the physical environment of the             What takes an average child 20 minutes to do
classroom, the teacher can provide structure for        often takes the ADD student hours to
the student.                                            accomplish. This is particularly true of written
                                                        assignments. Teachers might consider accepting
One of the most critical factors for teachers in        alternative methods of sharing their knowledge,
preventing behavioural problems, (particularly          such as allowing a student to answer questions
for students with ADD and other special needs           orally or dictating answers to a parent could be
such as learning disabilities,) includes achieving      considered as alternatives. Teachers could
a clarity of expectations amongst the students,         consider easing up on handwriting requirements
(i.e. teaching them what is acceptable behaviour        and demands in the case of these students.
and what is not acceptable in the classroom).           Teachers should be encouraged to be sensitive
                                                        to the extreme physical effort it takes for
These children are in particular need of a              students with ADD to put down in writing, what
classroom that is structured, not chaotic. They         may appear simple. Typing/word processing
need to feel secure within the parameters of            skills are to be encouraged.
their classroom, knowing precisely what is
expected     of    them     academically    and         8.    Limiting the amount of homework.
behaviourally.                                          If the parent complains that an inordinate
                                                        amount of time is spent on homework, teachers
Teachers should make rules few, clear, and              should be flexible and cut it down to a
comprehensive. A teacher could for example,             manageable amount. Teachers should keep in
have the students discuss, decide on, and write         mind that if the student was unable to complete
out the classroom rules to give more ownership          the work during an entire school day, it is
to them in class.                                       unlikely that s/he will be able to complete it in
                                                        the evening.
5.    Using      creative,      engaging,    and
      interactive                                       9.    Providing       more      time    during
      teaching strategies, (i.e. keeping the                  assessments or tests.
      students involved and interacting                 These students (often very intelligent children)
      with their peers) is critical!                    frequently know the information, but cannot get
All students need and deserve an enriched,              it down, particularly on tests. Teachers should
motivational curriculum that employs a variety of       be encouraged to be flexible in permitting
approaches. To teach students with ADD                  students with these needs to have extra time to
effectively, a teacher needs training in multi-         take tests, and /or allow them to be assessed
sensory     teaching    strategies,   co-operative      verbally.
learning, reciprocal teaching, learning styles or
the theory of multiple intelligences.




NCGE 04/08                                  Section 1                                     1.5.30
                                                         school, psychologists paid for privately by
10. Providing              assistance     with           parents and/or the student’s GP. With many
      organisation and study skills.                     ADD students, medical treatment is critical to the
Students with ADD have major problems with               child's ability to function in school.
organisation and study skills. They need help
and additional intervention to make sure                 On an on-going basis, management of the
homework assignments are recorded correctly,             social/behavioural problems that these students
their work space and materials are organised,            often exhibit will probably require help from the
notebooks and desks are cleared of unnecessary           guidance counsellor. Counselling sessions with
collections of junk from time to time, and               the guidance counsellor can assist in many
specific study skill strategies are used.                ways, such as, behaviour modification (charts,
                                                         contracts,) time-out, conflict resolution, training
11. Modifying the learning environment.                  in social skills, relaxation techniques, controlling
The classroom environment is a very important            anger, and cooling down. Often, however, more
factor in how students function. Teachers should         intensive private counselling may be required.
be advised to organise the classroom in the
awareness that most ADD students need to be              Team Approach
able to make eye contact with the teacher. It
may also be a good idea to seat the student              A team approach should be used by a school
close by. It may also help the student with ADD          wherever possible when dealing with ADD
to be seated near well-focused students and/or           students. The guidance counsellor needs co-
be given a lot of space to work on his/her own.          operation and partnership with parents, teachers
                                                         and other professionals. In particular, the
12. Valuing students’ differences and                    student’s teachers should be involved in any
helping bring out their strengths.                       team approach. The teachers can provide
Schools should provide many opportunities for            invaluable help by:
children to demonstrate to their peers what they                providing samples of written work
do well. Teachers should recognise the diversity         (any piece or work that reflects the child's
of students’ learning styles and use individual          strengths and weaknesses);
approaches in the classroom.                                    documenting specific behaviours they
                                                         witness in the classroom (e.g. falling out of
13.    Believing in the student - not giving             chair; writing only one sentence in 20 minutes of
       up when plans A, B, and C do not                  independent work; blurting out inappropriately in
       work.                                             class, etc.)      It is important that teachers
There are always plans D, E, and F....... Success        document their observations and concerns, this
will require going back to the drawing board             documentation is crucial so that students get the
frequently. These children are worth the extra           help they need;
time.                                                           facilitating the necessary medical
                                                         /clinical evaluation and intervention that may be
Preventing Problems – Parents, Teachers                  needed for student success.
and Guidance Counsellors and other
Professionals Working Together                           Many times parents do not recognise that their
                                                         child is experiencing the problems that teachers
A teacher should not be expected to manage               and guidance counsellors may be seeing in
and educate these very challenging students              school.
without assistance. Neither should a guidance            Children with ADD present their pattern of
counsellor be expected to solve the difficulties of      behaviour year after year. It often takes parents
an ADD student on their own.                             a few years of hearing similar comments from
                                                         different teachers to become convinced that
A proper diagnosis should firstly be made with           they should pursue some sort of treatment for
the help of the appropriate professionals                their child.
(outside the school if necessary). This may
involve the NEPS psychologist appointed to the



NCGE 04/08                                   Section 1                                       1.5.31
A List of Don’ts                                         fears. It is very painful and stressful for them to
                                                         have a child with a special problems and needs.
Guidance counsellors and teachers say and do
hundreds of things during the course of the              Preventing Problems.
school day. Every word, gesture, and action can
have an affect on the students s/he works with.          Behavioural problems in class often occur when
The following list may be a useful reminder of           students are undirected. Planning well and
inappropriate behaviour for all educational              beginning instruction promptly are generally
professionals to consider when working with              good deterrents to behaviour problems.
ADD students.                                            Transitions and non-instructional time are
                                                         typically the most disastrous times of the day for
Don't:                                                   ADD students. Hyperactive children have major
                                                         problems during break times, travelling on the
- assume the student is lazy in the                      bus, waiting in line, on the way to the toilet, etc.
classroom.      A student with attention deficit         Schools should be aware that there may need to
disorder or a learning disability is typically not       be more structuring of breaktime activities.
lazy. There are other reasons for their non-
performance in the classroom.                            One should avoid catching students with ADD
                                                         off-guard. They should be prepared for any
- be fooled by inconsistency or assume                   change in routine (e.g. assemblies, field trips,
that the student is deliberately not                     substitute teachers, visitors, etc.). With ADD
performing because you have observed                     students, there is a need to explain what take
that at times s/he is able to do a particular            place and teach the appropriate and required
task/assignment.         Students with attention         behaviours.
deficit disorder have inconsistency as a hallmark
characteristic of their disorder. Sometimes the          Communication with Parents
can do the work and sometimes they cannot.
                                                         A child with ADD or learning disabilities often
- give up on any student. These challenging              experiences behavioural, emotional, and social
students often try the patience and could                problems that are evident in a number of
discourage any teacher or guidance counsellor.           situations, not only in the classroom. Many of
These children need persistence and belief in            these children have problems on the sports field,
their ability to succeed no matter how difficult         in church, and in social situations of all kinds.
and frustrating it is.                                   Families often need help learning how to cope
                                                         and deal with a "difficult" or "challenging" child.
- give up on behaviour modification                      Parents need to hear that they are not alone.
techniques. Students with ADD often do not
respond well to behaviour modification and               Medication and School
positive reinforcements in the initial stages.
Guidance counsellors (and teachers) may need             Medication can make a significant difference in
to revamp revise, and modify any behaviour               the lives of individuals with ADD. However,
management programme frequently.                         parents do not easily make the decision to try
-    forget    to    network     with   other            their child on medication for ADD. They often
professionals. A teamwork approach should                are fearful and feel guilty. When dealing with
support you in making observations, helping              parents of ADD students, guidance counsellors
with behavioural management and classroom                should avoid being judgmental and sharing any
strategies, providing information and making             personal philosophy about the rights and/or
necessary referrals.                                     wrongs of medication with parents.

- neglect to involve parents. Invite parents             Many children improve dramatically once the
to visit the school and meet with you to plan            proper medication and dosage has been
strategies for working together on behalf of their       prescribed and regulated. The role of the school
child. Be sensitive to parents’ frustrations and         should be a supportive one for any ADD student



NCGE 04/08                                   Section 1                                       1.5.32
taking medication. School personnel need to be
aware of and sensitive to the issues involved           Help and Support
with students on medication.
                                                        Hyperactivity       and    Attention      Deficit
Medication should be continued as long as it is         Disorder (H.A.D.D.)
helping significantly. Its use therefore needs          Formerly known as Hyperactive Children's
regular review every 6 - 12 months. The length          Support Group Ireland (H.C.S.G.I.), H.A.D.D.
of time a child will need to be on medication           was established in 1980. In 1997, the group
depends on the individual. It is not necessarily        changed its name to include Attention Deficit
stopped at puberty. Experience seems to show            Disorder with or without Hyperactivity. The
that by treating children before complications          objectives of the group are as follows:
arise, they benefit greatly, but there is no firm       1.      To help and support children and their
data on this. Some children outgrow the need                    families.
for medication during school years and many             2.      To create a better understanding of the
more discontinue medication when they leave                     developmental difficulties children face
school. Although for many, ADD symptoms may                     as a result of hyperactivity and
continue, provided students can get through                     ADD/ADHD.
school with their self-esteem intact and with           3.      To ensure adequate resources are
reasonable      academic      and     behavioural               available to support the needs of
achievements behind them, they should be able                   children who are hyperactive or have
to focus and maximise their strengths. Indeed                   ADD/ADHD.
some students may over-focus in later life on           4.      To provide an information sharing and
things which they are really interested in,                     support network for families.
without necessarily needing to continue                 5.      To improve diagnostic services.
medication.                                             6.      To organise
                                                                meetings/conferences/workshops.
Where To From Here                                      7.      To provide a parent/professional link.
                                                        8.      To encourage research into hyperactivity
ADD/ADHD has been a much-maligned                               and ADD/ADHD
condition, but is more common than is generally
recognised. It has generated a great deal of            For further information, please contact:
myth and misinformation. It is important to view
it through the eyes of the sufferer and those           H.A.D.D.,
involved with them.                                     The Hyperactivity and Attention Deficit
Children with ADD are not 'problem children' but        Disorder Family Support Group
children who have a problem. Unrecognised and           Carmichael House
untreated ADD prevents a happy childhood and            North Brunswick Street
blights a future. Sufferers have a biological           Dublin 7.
vulnerability to life's stresses and other              Tel: (01) 874 8349
environmental difficulties, as well as to social,       Email: hadd@eircom.net
educational and psychiatric problems. However,
it is a very treatable condition and early
identification and appropriate management are
essential for a more positive future. The families
of children with ADD deserve support and
understanding and not blame.




NCGE 04/08                                  Section 1                                     1.5.33
References
                                                        How to Teach the ADHD / ADD Child
Rief, Sandra F. (1993), How to Reach and Teach          http://www.childrensdisabilities.info/adhd/teachi
ADD/ADHD Children, The Centre for Applied               ng-adhd.html
Research in Education, U.S.A.
                                                        ADHD Library
Hallowell, Edward M, M.D. & Ratey, John J.,             Over 80 pages of information on ADHD / ADD
M.D. (1995), Driven to Distraction, Simon &             http://www.newideas.net/p0000374.htm
Schuster, U.S.A.
                                                        Internet Sites (UK)
Kewley, G. D., Dr. (1999), Attention Deficit
Hperactivity Disorder, LAC Press, Sussex, UK.           Adders.Org
                                                        The objective of the website is to promote
Cooper, P, and Ideus, K. (1995), Attention              awareness of ADD, and to provide information
Deficit Disorder - A Practical Guide for Teachers,      and free practical help to sufferers, both adults
David Fulton Publishers, London.                        and children, their families in the UK and around
                                                        the world.
Internet Sites (USA)                                    www.adders.org/

CHADD                                                   Attention Deficit Disorder in Europe
Children and Adults with Attention-Deficit              www.pavilion.co.uk/add/
/Hyperactivity Disorder
This is a national non-profit organisation
representing children and adults with attention-
deficit / hyperactivity disorder (AD/HD). CHADD         NCGE wishes to thank Geraldine Graydon
works to improve the lives of people with               of H.A.D.D. for her assistance in compiling
attention-deficit / hyperactivity disorder through      this supplement.
education, advocacy and support.
www.chadd.org/

The National Attention Deficit Disorder
Association
www.add.org/

ADD / ADHD Links Pages
Hundreds of ADD / ADHD categorised links
checked monthly and updated weekly
http://user.cybrzn.com/~kenyonck/add/Links/

ADD/ADHD, Vision & Learning
www.add-adhd.org/

ADHD News
www.adhdnews.com/

ADHD/ ADD Parents Page
http://members.tripod.com/~kimjudge/adhd.ht
ml


Internet Resources for Special Children
www.irsc.org/add.htm




NCGE 04/08                                  Section 1                                     1.5.34

				
DOCUMENT INFO