Of all the learning difficulties, ADHD or Attention Deficit / Hyperactivity Disorder is perhaps the one of the most difficult for teachers to manage in the classroom and for parents to manage at home.
Children with the symptoms of ADHD live daily under huge amounts of stress, as do the parents and siblings who live with and love these children on a daily basis. Their learning and their social functioning are both undermined by their excessive need to move, to act without thinking and to quickly lose attention for the tasks at hand.
For teachers in the classroom situation, the behaviour of the ADHD child can be very disruptive for the other children and needs to be carefully and effectively managed to maintain a calm learning environment for all of the children.
SIGNS & SYMPTOMS – WHAT DOES AN ADHD CHILD LOOK LIKE?
The child with ADHD looks like every other child in the classroom. However he shows a preponderance of three categories of behaviour and will stand out because of these: inattention, hyperactivity and impulsivity.
The truly ADHD child will display many symptoms very early in life, before the age of 6.
He is extremely active
As a baby he may have been a very poor sleeper. He may have learned to walk very early, been a climber and run his parents ragged trying to keep him safe. He will have been very active as a toddler but will have been slower than others to learn to share and take turns. As a school age child he may still not appear to need as much sleep as other children his age, and will often wake early and/ or have difficulty going to sleep at night.
The most evident symptom in the ADHD child at school is his difficulty sitting still for any length of time. He is restless, and constantly on the move. He will frequently get up out of his chair and move about the room. If he is able to stay in his chair he will be restless and fidgety, moving most of the time, swinging his legs, kicking against the chair legs or the seat in front or him or twisting around on his chair with his back to the teacher. This is aptly described as the “ants in his pants” phenomena! He will often run when he is supposed to be walking, such as inside the classroom.
At home he has difficulty sitting at the table for an entire meal, constantly moving, chattering, interrupting others, and maybe knocking things over in his haste to be finished with the torture of having to sit for so long. He has difficulty settling at any game or activity for long, loosing interest quickly and moving on to the next thing.
He is inattentive and very easily distracted
He has a very short attention span and is very easily distracted. He will quickly forget instructions even though he understood them when listening the first time. He will make careless mistakes in his work such as adding up too quickly and getting the wrong answer, or leaving the ending off a word when writing( he will most likely be able to correct his work himself when asked to take another look). He will seldom finish what he has started without extra reminders and extra help.
He is very impulsive
He is impulsive and often acts without thinking first. He will call out in class, answer questions before they are completed and talk excessively. He will often make noises (especially the boys) which disrupt the concentration of others in the class.
He will sometime lash out, especially at siblings but then feel full of remorse afterwards when he has had time to think about what he has done. Socially he will blurt out comments, interrupt other peoples’ conversations, charge into games already started and always try to be first in line. He has trouble taking turns in games and waiting for his turn with the teacher to check his work. He will run outside at playtime without remembering to put his things away.
As the child moves through the school his hyperactivity, impulsivity and inattention will result in difficulties starting tasks as well as with finishing them. He will struggle to organise himself, keep track of his belongings and remember to bring his sports gear on the right day. He will have difficulty learning and remembering new concepts. Parents and teachers will be frustrated with him as he appears bright but is constantly under achieving.
Often he is trying his very best, but to no avail. He may become frustrated and angry. He will begin to fall further and further behind academically.
THE ADHD CHILD WILL NOT BE LEARNING TO HIS FULL POTENTIAL
One thing is certain in this scenario: the ADHD child will not be learning to his full potential and he will tend to fall further and further behind as he gets older. Some of these children may then resort to attention seeking behaviours such as playing the class clown.
The untreated ADHD adolescent will have high frustration levels and very low self esteem from failure to learn in class and from constantly getting into trouble at home and at school. He may begin to engage in more negative and/or oppositional behaviour and possibly, because of his impulsivity, end up as a young person on the wrong side of the law.
TREATMENT – GETTING HELP AT SCHOOL
Because he is so visible ( and audible) in the classroom and his behaviour is disruptive to others, The ADHD child will often be one of the first children in the class to get additional support. After applying all of the strategies she knows, teacher will most likely refer the child to the SENCO (Special Needs Coordinator) who may then prioritise him for further assistance. The school may be able to supply a teacher aide for a few hours a week to shadow him in the classroom, reinforce correct behaviours and keep him on task.
The RTLB service (Resource Teachers for Learning and Behaviour) may be called in by the school SENCO to observe and assess him. They can offer further suggestions and strategies to the teacher for classroom management of the child’s behaviour. Further funding for a teacher aide may also be made available through this service but this is usually temporary and is usually withdrawn after a number of months.
If these strategies do not work and the child’s ADHD symptoms cannot be managed, further referrals will be made to access help in New Zealand through Group Special Education (GSE).
GETTING A DIAGNOSIS
The ADHD child is one who cannot be ignored in the school setting. Parents usually are informed of their child’s behavioural difficulties quite early on. Many however do not want to label their child for fear that the label will negatively affect how their child is treated in the education system.
Many others however do want to know and find it very helpful to be able to name their child’s learning disability. It is also very helpful for the child’s teacher if they know that this child is not just a “naughty boy” but has a disability underlying his behaviour.
One of the most compelling reasons for getting a full diagnosis is access to funding for support through the educational system. Also a NZ family may be eligible for the Child Disability Allowance, a non means tested allowance for children who need substantially more care than others their age, and /or the Disability Allowance (means tested) for children and adults who have increased expenses due to a disability. Both can be applied for through WINZ with a diagnosis from a specialist and an application form filled out and signed by your GP.
Parents can organise an assessment themselves by first making an appointment with the family GP. He will organise a referral to a paediatrician through the hospital.
Your RTLB case worker may also refer your child to a paediatrician or to an educational psychologist.
In NZ the Connors assessment is usually used to determine if a child or young person has ADHD. This assessment is based on a developmental picture of the range of behaviours in each area which are expected at each age. The child’s behaviours are rated via a questionnaire and then compared with age related norms.
The questionnaires are filled out by the child’s parents, their teacher and sometimes also another adult who knows the child well and sees them functioning outside of the home. As self report questionnaire is also used with children who are old enough where the child is asked to respond verbally to questions about their own behaviour.
CATEGORIES OF BEHAVIOUR IN ADHD
The three distinct categories of behaviour – inattention, hyperactivity and impulsivity – must be present most of the time for a diagnosis of ADHD to be made.
Behaviours within these categories must occur often, in many different environments and well over and above the normal range in frequency and intensity usually seen in children the same age.
Ref: Conners, 3rd Edition (2008). C Keith Connors, Ph.D: Multi – Health Systems, Toronto, Canada.