Hi! If you are reading this, odds are that you are a conscious and seeking-to-be-informed special educator soon to be armed with all the necessary knowledge you'll need to totally rock some kid's (or several kids) academic world. Special Education is a tough field and as time goes on, our knowledge about the different challenges and strategies in our classrooms is only growing. As educators, it is our job to do everything we can to stay informed and dedicated to doing right by our students with different or more needs than their peers.
Here is a brief infographic on the state of special education provided by the University of Southern California's Rossier School of Education and retrieved from Upworthy.com.
Our blog in particular will focus on one of the most common disorders impacting our children and influencing our teaching styles today--ADD/ADHD, or Attention Deficit Hyperactive Disorder. We hope that you find it useful in growing your own knowledge of the many factors and challenges that come along with this disorder so that you can have the greatest possible impact in the classroom. Enjoy!
ADD/ADHD is one of
the most common neurodevelopmental disorders in the
country today. Usually diagnosed in childhood, ADD/ADHD often persists into
adulthood but those diagnosed can be taught to manage symptoms or associated
behaviors. Children with ADD/ADHD may have trouble paying attention,
controlling impulsive behavior, or be overly active. This can have a severe
impact on a student’s academic and social development, as well as effects on
mental health.
Contrary to popular
belief, ADD/ADHD is not a just behavioral disorder but an impairment in the
brain caused by a slower rate of development. Brain imaging studies have shown
that on average, the ADD/ADHD brain develops in a normal pattern but at a rate
that is approximately 3 years behind a normal child’s brain. These studies have
also indicated that the delayed brain development is in the regions primarily
responsible for thinking, paying attention, and planning/organizational skills.
ADHD used to be known
as ADD, or Attention Deficit Disorder,
however in 1994, it was renamed. ADD
might still be used today by some medical professionals, parents, and educators
in reference to one of the three subtypes of ADHD—predominantly inattentive
type. As its title suggests, ADHD, predominately inattentive type applies to
those who have trouble focusing on every day activities, specific tasks, etc
but otherwise do not display disruptive or hyperactive behavior. The remaining
subtypes are ADHD, hyperactive-impulsive type and ADHD, combined type. Additionally, ADHD is often diagnosed alongside other brain-related disorders, such as depression or anxiety.
This short animated video explains ADHD through the analogy of the process for creating a movie and may be helpful when explaining the impact of ADHD to children.
Who can diagnose
ADD/ADHD? What symptoms should I look for?
It is important to
recognize that diagnosis of ADD/ADHD can only be done by a licensed health
professional such as a pediatrician or mental health practitioner. Parents
typically notice that their child has difficulty remaining entertained by
certain activities for a lengthy period of time or that his or her behavior is
difficult to control. Diagnoses are typically made between ages three and six,
but can vary dependent on several factors, such as an individual’s personality
and temperament development. Often times, a classroom teacher will notice that
a child has difficulty paying attention or completing tasks and be asked to
record behaviors for a period of time so that the health professional working
with the child’s family can make an accurate assessment. Below is a brief
outline of some behaviors one might observe.
Hyperactive-impulsive
Predominately
inattentive
Combined type
•Fidgeting
•Squirming
•Getting up often
when seated
•Running or
climbing at inappropriate times
•Having trouble
playing quietly
•Talking
excessively or out of turn
•Interrupting
•Not paying
attention to detail
•Making careless
mistakes
•Failing to pay
attention or inability to remain on task
•Being unable to
follow or understand instructions
•Avoiding tasks
that involve effort or several important details
•Being distracted
or forgetful
•Losing things that
are needed to complete tasks
As the title
suggests, symptoms of the combined type can be any number of the symptoms
shown here, each to a varying degree. For this reason, most people with
ADD/ADHD are labeled as “combined type.”
This brief video features a college student, Stephen Tonti, discussing how his ADHD allowed him to explore his many interests rather than limiting his outlook.
ADD/ADHD is closely related to an
impairment of the executive functions—involuntary brain processes that allow us
to, quite literally, function in our environments. This can be especially
challenging to a school-aged child who is working on mastering several skills
and honing their intellectual abilities. Parents and teachers can and should
work closely together to ensure that a child diagnosed with ADD/ADHD is taught
the necessary coping mechanisms and given supporting tools to ensure greater
success in academic, social, and personal development.
ADD/ADHD are conditions that usually initially
manifest themselves during childhood, however, contrary to popular belief,
ADD/ADHD are not conditions that necessarily go away during one's lifetime.
Symptoms often persist and manifest themselves in different ways as one enters
adulthood.
Infancy
While some of the initial symptoms of ADD/ADHD may
begin to show themselves during infancy, physicians do give a diagnosis in
infancy. Despite this, infants who present hyperactivity, over-activity, and
irritability are more likely to be diagnosed with ADD/ADHD later in life.
Preschool Age (Toddlers)
Many toddlers are naturally very active and can
behave very impulsively, however, that does not mean that all toddlers who
exhibit these behaviors have ADD/ADHD. It can be difficult even for trained
healthcare professionals to diagnose these over the top behaviors that are
signs of ADD/ADHD. Toddlers who do have ADD/ADHD may not respond to discipline.
Additionally they may exhibit aggression and cause disruptions in their school.
If hyperactivity and behavior problems occur for over a year the likelihood
that the child has ADD/ADHD is increased greatly.
Middle Childhood (Pre-Adolescence)
Large portions of ADD/ADHD diagnoses are made
before a child turns 10 years old. At this time the symptoms of hyperactivity,
inattentiveness, and possibly impulsivity will likely be present. These could
show themselves by a child leaving unfinished projects, scattering toys and
objects throughout their living space, frequent conflicts or arguments, and
relentless demands from the child. At this point a child may be having
difficulties both academically and socially in school due to some of the issues
that come along with ADD/ADHD. At this point it is very possible that a
physician will recommend medication or start trying different medications to
see how the child interacts with them. Adolescence
During adolescence roughly 80% of those diagnosed
with ADD/ADHD will still exhibit symptoms. There are several comorbid conditions
that may also begin to show symptoms such as anxiety and depression. This can
be a very difficult time for those with ADD/ADHD as there is more
responsibility at these ages. The difficulties with organization as well as
socialization and academics may be particularly problematic at this time. Some
even refuse to take medication, may not want to see a counselor or receive
academic help, and often will not accept responsibility for behaviors.
Adulthood
Adulthood ADD/ADHD has not received as much
attention or study as the condition at other ages. There is not a clear
consensus on whether ADD/ADHD can be outgrown; while some do appear to outgrow
the condition, perhaps those people never had ADD/ADHD in the first place. One
way or another, those who have ADD/ADHD in adulthood do not all act the same
way. Some appear to function perfectly normally and appear to have compensated
for some of the organizational and impulsive difficulties that come along with
the condition. Others have much more trouble and may demonstrate difficulties
with work, relationships with friends and family, and anxiety. A portion of
those with ADD/ADHD may also develop more severe mental issues and end up
highly dysfunctional. Since ADD/ADHD are conditions that have been getting
quite a bit of attention recently, it is likely that more and more information
about ADD/ADHD in adulthood will be released as the condition gets studied
more.
Before attempting to implement any strategy for a child with a learning disability, it's important to emphasize that each child is different. The nature of their learning disability differs, which is why I will try to avoid any "one size fits all" strategy recommendations. This variation is especially true in students with ADD/ADHD as discussed by my colleagues in the previous posts. I would recommend one reads these strategies as a collective tool box that lists strategies at a teacher's disposal, but doesn't require complete adherence to them. Three Factors for students with ADD/ADHD
According to an article written by Rick Lavoie (a special education expert), students with LD are affected by these three factors in the classroom: "the degree of interest in the activity, the difficulty of the activity, and the duration of the task." For this reason many traditional classroom activities such as worksheets or independent reading can prove to be difficult for students with ADD/ADHD, leading to disruptive behavior. Understanding that a student with ADD/ADHD is looking for stimulation and interested work is key to setting up your student with success. One strategy would be to tailor materials and tasks so that they match the interest of the child. Another strategy is to take ordinary tasks such as a worksheet and turn it into a competition. Of course if the task is difficult and the time frame long, no amount of gimmick or tailoring will keep a student with ADD/ADHD from becoming frustrated. To counteract such frustration a teacher can break up the assignments into smaller portions or "chunk." This allows students with ADHD to feel accomplished and prevents them from becoming overwhelmed by a huge task. Understanding that with the proper motivation and differentiation, students with ADD/ADHD can successfully complete work is the first step to making your students feel successful.
The power of engaging material
Organization and ADD/ADHD: the now and not now
Students with ADD/ADHD tend to have difficulty with planning and organization. This difficulty can result in forgetting to do homework, failing to study for exams and other seemingly careless behavior. What's important to acknowledge is that the student is not purposely trying to act in an irresponsible manner. Lavoie discusses in his article a concept developed by Dr. Edward Hallowell that explains the mindset of many students with ADD/ADHD. Dr. Hallowell suggests that people with ADD/ADHD see the world in two paradigms: the now and not now. When our students have that paradigm, then classwork given days in advance seem to be distant and unimportant tasks that will eventually be completed. This oversight isn't a result of irresponsibility or carelessness. Instead teachers need to create an environment that allows students with ADD/ADHD to easily become organized.
One strategy that can be used to encourage organization is by having a structured and predictable environment. The predictability makes it easy for students with ADD/ADHD to remember tasks that need to be completed as it becomes a routine. Another strategy is to break down long term projects or assignments into smaller much more immediate assignments. By breaking down assignments, the student gets a heightened sense of expediency since the task moves further from the "not now" into the "now." Other strategies outlined by the British Columbia school district are using check lists to help students monitor completion, explicitly teaching study strategies, and providing a class agenda for the student.
Engaging material, regardless the subject matter, can lead to great effort
Realistic implementations
While, many of the strategies outlined in this post are useful, it is difficult to change mid-year everything in your classroom. In recognition of the difficulty many teachers face, I wanted to leave some short and tangible changes one can make to help their students with ADD/ADHD. One strategy one can implement right now is giving your student a short checklist that allows them to monitor their progress for an assignment. Another strategy is to target specific behaviors you want a student to produce and express to that student (either with a constant reminder like a post it note or verbal cue) that they will be rewarded for completing these two behaviors. Finally, trying to develop a predictable environment will greatly help your students (regardless of them having ADD/ADHD or not).
Remember our kids may have issues with the traditional classroom, but in terms of effort and work ethic, students with ADD/ADHD can work just as hard (at times harder) than any other student. Beginning the conversation with your students about why their disability is not a hindrance, but a part of who they are is something we should all strive to do as special educators. Here is a video you can show your kids, so they can see positive representation of students with ADD/ADHD.
