Teachers' Christian Fellowship of NSW

Notes from Andrew Greenfield’s presentation to 2013 Teacher’s Christian Fellowship Day Conference.

ADHD - Implications for students and Management Strategies for Teachers.

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

• www.everdaywithadhd.com.au
• www.additudemag.com/
• www.ldc.org.au
• www.cyh.com
• www.livingwithadhd.com.au
• www.chadd.org
• www.add.org
• www.addwarehouse.com

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

• Attention-deficit/hyperactivity disorder is characterised by a delay in cortical maturation; Shaw, P et al.; www.pnas.org/content/104/49/19649
• www.medscape.com/resources/adhd