ADHD

                           Attention Deficit Hyperactivity Deficiency

                                                        (ADHD)

Introduction:

Definition: ADHD is a condition that develops within some children in their early childhood years where it is difficult for them to control their behavior, focus and pay attention. Students with ADHD have impairment of function such as concentration, memory, impulse control and inability to follow directions. This might sound familiar to many of you where you meet many of these students in class. You have struggled with them to have their homework done, or handed in time, or do certain tasks like clean the class room or the desk or put the instruments back…

ADHD impacts about two students in every school classroom, and educators need to be prepared for how to meet the unique challenges of teaching ADHD students and parents have the responsibility of working closely with their children’s teachers. We should know that ADHD is the #2 genetically inherited condition in the world, if one of the parents has ADHD and does not learn how to manage it properly, there will be worse outcomes for the child and that will make the teacher’s job harder.

A child with ADHD is easily distracted, talkative, interrupts others while explaining, and has difficulty waiting for his turn, and needs extra help with learning. A good relationship with parents is important to get the best of an ADHD student. As a teacher, you can have the responsibility of being able to recognize the sign of ADHD so as to inform parents of that possibility so that they seek medical treatment. Since parents are not with their child most of the time in school, so it is the teacher’s responsibility to identify those special needs of students. The teacher can identify but the diagnosis is kept for professionals. We should keep in mind that not every child who is hyperactive, inattentive or impulsive has an attention deficit hyper activity disorder. Many people bounce from one task to another or say things they didn’t mean to, so many questions should be considered when diagnosing like; are these behaviors excessive?  Long term? None of the symptoms are abnormal, everyone feels scattered or unfocused sometimes that does not necessarily mean ADHD.

Characteristics of ADHD students:

 ADHD begins in childhood. The symptoms are extreme restlessness, crying, poor sleep patterns, difficult to feed, constant thirst. However sometimes, it's not diagnosed until a person is a teen — and occasionally not even until someone reaches adulthood, because ADHD is a broad category covering different things — attention, activity, and impulsivity — it can show up in different ways in different people. Some of the signs of ADHD are when someone:
• has difficulty paying attention or staying focused on a task or activity
• has problems finishing assignments at school or home and jumps from one activity to another
• loses or forgets things such as homework
• is easily distracted, even when doing something fun
• has problems paying close attention to details or makes careless mistakes
• has trouble organizing tasks and activities
• has difficulty waiting friend's turns.
• interrupts or intrudes on other people
• fidgets with hands or feet or squirms about when seated
• feels restless
• talks excessively and has trouble engaging in activities quietly
• not listening to or following instructions
• responding to questions without fully formulating the best answers.
• Answering questions before they have been fully asked or completed
• Difficulty interacting with peers
• Unable to calm down or to play quietly
• Running or climbing when and where they shouldn’t.
Finally if child has ADHD, he or she may find it difficult to communicate and interact with other children and they will have problems with speech development.
Children with Attention Deficit Hyperactivity Disorder, also known as ADHD, are very energetic and can cause a great deal of frustration for parents that don't know how to deal with their sometimes outrageous behaviors. ADHD children sometimes seem as if they are driven by a motor, the Energizer Bunny that never stops! They also have a difficult time sitting still, often squirming in their seats or fidgeting with anything they can get their hands on. ADHD kids also seem to talk excessively that they don’t stop talking and moving

How Does ADHD Affect School Performance?

The school experience can be challenging for students with ADHD. Students usually are identified only after demonstrating a failure to understand or follow rules or to complete required tasks. Other common reasons include frequent classroom disruptions and poor academic performance. Studies found that students with ADHD, compared to students without ADHD, had academic difficulties that resulted in the following: lower average marks, more failed grades, more expulsions, increased dropout rates, and a lower rate of college undergraduate completion . The disruptive behavior sometimes associated with the disorder may make students with ADHD more influenced by suspensions and expulsions.
ADHD's core symptoms—inattention, hyperactivity, and impulsivity—make meeting the daily rigors of school challenging.
Inability to Pay Attention
• Children with ADHD are often inattentive in the classroom. This may be manifested by not being able to follow rules or directions, not listening to the teacher and being distracted by external stimuli in the classroom. This affects children with ADHD in that they are often singled out by the teacher for problems with inattention. They may not be able to complete assignments in a timely fashion and may feel inferior to their classmates. These children may also suffer poor grades as a result.
Hyperactive Behavior
• Children with ADHD are hyperactive. They may not be able to sit still at their desks, frequently getting up and wandering about the classroom, asking to leave the classroom to go to the bathroom and/or acting out in various ways that distract other students. Teachers can become frustrated with this behavior, and consequently, students with ADHD are often in trouble. The hyperactive behavior can negatively affect school performance and learning.
Impulsive Behavior
• Children with ADHD are impulsive and, due to their condition, may act without forethought. They frequently blurt out in class, make noises, laugh at inappropriate times and interrupt others. Because of these actions that occur through no fault of their own, ADHD children may require separation from the group, which can negatively affect their socialization and friendships with peers.

Difficulty sustaining attention to a task may contribute to missing important details in assignments, daydreaming during lectures and other activities, and difficulty organizing assignments. Hyperactivity may be expressed in either verbal or physical disruptions in class. Impulsivity may lead to careless errors, responding to questions without fully formulating the best answers, and only attending to activities that are entertaining or novel. Overall, students with ADHD may experience more problems with school performance than their nondisabled peers.

How teachers can deal with ADHD students:

There are many different situations that teachers must work on:

        I.            Behavioral strategies

     II.            Group management

   III.            Motivating the behavior

  IV.            Modifying the curriculum

     V.            Test adaptation

  VI.            Teaching study skills

VII.            Organizational tactics

VIII.            Teaching the student to self-manage himself.

I.                   Behavioral strategies:

Behavior management strategies can be used to foster academic engagement and reduce overt behavioral symptoms of ADHD. In this section we discuss both antecedent-focused and consequence-oriented strategies that teachers may use to manage behavior.

A-    Antecedent-focused behavior support strategies:

In addition to making instructional choices that optimize student learning and engagement, children with ADHD also benefit from a pro-active approach to social skills and behavior management. Positive teacher practices are related to increases in task engagement and pro-social behavior in students. For example, it has been suggested that teachers can do several things in the classroom to develop a pro-active approach to develop students' social skills and positive behaviors. These include:

1-      Creating an environment in the classroom that is positive, encouraging, and supportive:

·         Provide students with more positive and encouraging feedback than negative feedback

·         Have positive and high expectations for each student.

2-      Teaching rules and reminding students of key rules and classroom expectations frequently:

·         Make sure that students understand what appropriate behavior looks and sounds like (for example, explain to students and model the behavior).

·         Provide students with visual cues (e.g., poster) to remind them of rules and state rules in a positive manner ("Please walk" vs. "Don't run").

·         Use preventative strategies such as positive reminders (that is, cues) of appropriate behaviors and/or expectations for a given situation.

3-      Provide students with positive and specific feedback regarding their ability to show appropriate behavior in the classroom:

·         Provide specific feedback about student actions and performance (for example, "Thank you for walking to the door quietly" vs. "Good job!")

4-      Setting up classroom routines for various classroom tasks or actions. Students with ADHD may need to review routines frequently and have picture cues illustrating key steps (younger students) or checklists guiding actions (older students):

B-     Consequence-oriented behavior management strategies

Students with ADHD also tend to respond positively to consequence-oriented behavior management techniques, but these should be accompanied by proactive strategies designed to increase academic success and prevent or reduce inappropriate behaviors.

Behavioural management systems that provide consistent and immediate rewards to children with ADHD have been found to be effective in reducing the severity of symptoms of ADHD and increasing productivity. These techniques can be used with the instructional adaptations to further support the child's goals. Before implementing one or more of these programs, however, it is necessary to ensure that students have the skills and the instructional supports they need to accomplish their goals.

Here are brief descriptions of two types of behavior management programs.

a)      Token economy

Token economy management systems provide students with "tokens" or secondary reinforces when students demonstrate specific target behaviour.⁵ The steps for setting up a token economy reinforcement system are:

1. Decide on goals to be met (for example, completion of independent seat-work).
2. Decide on the type of secondary re-enforcer (token) to be used (for example, poker chips, and check marks).
3. Decide how many tokens are to be earned by demonstrating target behaviors (teachers can break more complex tasks down into component parts and give tokens for each part).
4. Student and teacher work out the types of activities that the tokens could be exchanged for (for example, five tokens equal five minutes’ free time at the computer).
5. Students are taught the value of the tokens (model what has to happen to earn a token).
6. Students can exchange tokens for activities on a daily basis.
7. The intervention should be monitored to assess its effectiveness — are there increases in appropriate target behaviors?

b)       Behavioral contract

In a behavioral contract, the specific or target behaviors are outlined. Of course, it is important that the target behavior, outlined is achievable. The student should be receiving work in reasonable quantities (remember the slow processing speed of many students with ADHD), the work should be well within the child's instructional level, and the student should have a clear understanding of how to do the assignments (for example, double-checking that the student understands the directions or providing the student with a worked example).

The steps for setting up a behavioral contract are:

1. The teacher and the student identify the target behavior(s) on the contract.
2. Begin the program with a focus on a limited (for example, two or less) number of target behaviors. The behaviors should be specific, observable, and positively stated.
3. The goal each day is to have the student reach a specified criterion regarding the target. The criterion that is initially set should be attainable by the student. For example, at the beginning of using a behavioral contract for math, the student may select an activity reward if the student completes 50% of the assigned problems.
4. Give the reinforcement either at the end of the class or at the end of the day.
5. The criterion to meet is then increased steadily as the student is able to meet each new goal level.

II.                Group management:

We have to pay attention, when deciding to work on groups to 3 main aspects:

1- Classroom rules

2- Time management

3- Effective grouping

III.             Motivating the behavior:

Students with ADHD need excitement in their learning environment since they are hardly stimulated, and they have problems with non-stimulation & repetitive Activities. Therefore, teachers should vary activities, give frequent breaks and encourage movement that is purposeful and not disruptive.

IV.             Modifying the Curriculum:

Students with ADHD need a curriculum that adopts “FOCUSING ON DOING” and a one that avoid long periods of sitting and listening.

V.                Test adaptation:

In order to have a successful exam, the teacher must focus on different important ideas, such as:

1- Extra time

2- Frequent breaks

3- Good exam environment.

VI.             Teaching study skills:

Teachers may need to teach students study skills such as listening, outlining and note-taking, in addition to teach them how to break a complex task into a simpler one and how to manage time.

VII.          Organizational tactics:

Students with ADHD have difficulty in organizing their work, so organizational strategies include:

1- Designating space for material.

2- Establishing a routine for writing down assignments for example a note-book.

3- Having notebooks with different colors for different subjects

VIII.       Teaching self-management

                  Primary goal of teachers is to help children:

                 - Be aware of their thinking process.

                 - Take responsibility for their reinforcement.

Finally it’s important to work with this child by the cooperation with the parents, so that it will be a dual effect.

Conclusion

We should not give up hope because ADHD is treatable. Many of us think that there is no solution for that and give up, but medically speaking neuroscientist discovered the presence of something called neuro- plasticity which enables the brain to grow additional cells or modify the function of existing cells.

                                                                               Done by: Mouniba Faraj
                                                                                             Jamileh Abdulbalki
                                                                                             Maya Yassin
                                                                                             Zeina Al-masri.