ADHD has been recognised since ancient times, and the core symptoms are hyper- activity, impulsivity and distractibility with difficulty maintaining concentration.
Approximately one in twenty children have ADHD. Males are diagnosed much more often than females.
ADHD is not a disorder that can be identified by one test. It depends on the frequency, severity and duration of the behaviour. Before this diagnosis can be made the symptoms have to have been present from a young age, and the children have to have had the problems in more than one setting. This is why it is important for both the parent and the doctor to make sure that there is a clear picture of how the child behaves at school, and at home. It is true that in different circumstances individuals will appear better or worse e.g. trying to keep quiet in church is different from watching a football game. It also depends what is expected of the individual. Children with ADHD can show variable patterns of behaviour.
Over 50% of individuals diagnosed with ADHD also meet the criteria for at least one other psychiatric or learning disorder. Children can present with behaviour that can be misdiagnosed as ADHD when it is just not the case e.g. dyspraxia( Developmental co-ordination disorder), hearing problems, Tourette syndrome, trauma including abuse, speech and language difficulties, dyslexia, Asperger’s syndrome. It can, however, occur with some of these problems.
ADHD is not about poor parenting or poor teaching.
How does the child present with problems in school?
Talking out of turn – these may be unsolicited words to the teacher or other class members, not always in line with the activities taking place in the classroom. This is called impulsivity.
Out of the seat – when the class has been told to be seated the child cannot remain seated and seems fidgety.
Attention problems – the child has difficulty working on his own or with groups in a classroom setting, and finds it difficult to follow the teacher’s commands at times.
Disruption – the child’s behaviour has an impact on his work and interrupts other children in the classroom. He may show this by making a noise or moving around.
Often runs/climbs excessively in situations where it is inappropriate.
Often has difficulty playing and engaging in leisure activities quietly.
Often intrudes, or interrupts others, or has difficulty awaiting his turn.
‘On the go’ all the time.
Doesn’t always seem to listen when spoken to.
May have difficulty organising activities or tasks.
Is easily distracted by external stimuli.
How to help
Understand the problem and consider how the child feels – this will allow you not to blame yourself or the child.
Provide boundaries for the child, so that you are consistent – your behaviour needs to be consistent even if theirs is not always.
Don’t delay feedback.
Reward the child for good behaviour, rather than reprimand him when he misbehaves – he will expect you to tell him off. Reward can be a treat, or praise.
Advice for school
Boundaries need to be clear, and the need to know where he is sitting, and who is looking after him, is so important for the child. Changes in classroom and teachers will cause anxiety for the child. He needs to know the plan for each day, and the need for repetition is important, so that, e.g, each Monday is the same.
When the child first comes in at the start of the day, he needs time to settle down, to allow him to feel in control. This is especially true after a busy time in the playground.
First of all place the child away from windows, and the main stream of child traffic, where he can be more easily distracted.
Make sure that he is in a good line of eye contact so that he can receive visual cues as well as auditory commands.
Break down instructions into small bits, and repeat each stage for the child if .
Help the child to be organised – different colour pens for different parts of his work and use, see-through pencil cases so that he can see if he has all the contents.
Give the child a reliable buddy to help him get from classroom to classroom and make sure that homework and books are packed away at the end of the day.
Encourage laptop use or photocopy sheets for the child with poor handwriting – success will encourage him to work harder.
Praise, praise and praise – he needs to know that he is praised for trying, not just for doing well.
Use a timer to show how long a task will take, or set the timer where the task should be completed before the buzzer goes off.
Always gain good eye contact before giving instructions. Ask the child to repeat them back to you. Don’t forget to keep the words you use to a minimum.
Offer a variety of tasks.
Provide activities appropriate to the child’s developmental level.
Be certain that the child can foresee an end to the task. When teaching new skills it is often hard for him to concentrate while the whole thing is being taught. Try ‘backward chaining’ i.e. start with the last component and work your way back. Thus the child sees an immediate end result and gets praise.
Reward the child for listening.
Try not to use negatives when correcting. Try “Now look at your book” instead of “Don’t look over there”.
Be consistent with your expectations and consequences for breaking rules.
There are different drugs available that can help the child to improve their concentration and attention if they have ADHD. These can be given once a day or be given several times a day depending on the type of drug used. Talk to your GP about the different types and discuss which is best for the child.
ADDIS, a UK parent support charity may also be able to give further information.