Attention-deficit/hyperactivity disorder (ADHD) is an illness characterized by inattention,
hyperactivity, and impulsivity (Barkley, 1997,1998). ADHD, once called hyperkinesis or minimal brain dysfunction, is one of
the most commonly diagnosed behavior disorders in young persons; ADHD affects an estimated three percent to five percent of
school-age children. It is diagnosed
much more often in boys than in girls (Barkley, 1998).
Attention-Deficit/Hyperactivity
Disorder is usually first diagnosed in children and adolescents. It is characterized by inappropriate degrees of inattention,
impulsivity and/or hyperactivity. Children with Attention-Deficit/Hyperactivity Disorder are typically:
- impulsive
- forgetful
- restless
to the point of disruption
- prone
to fail
- unable
to follow through on tasks
- unpredictable
- moody
These characteristics
appear in early childhood, are relatively chronic in nature, and are not due to other physical, mental or emotional causes.
From time to time, all children will be inattentive, impulsive and/or exhibit high activity levels. However, for children
with ADHD, the persistence, pattern, and frequency of this behavior is much greater. These behaviors are the rule, not the
exception.
Although ADHD is usually diagnosed in childhood, it is not a disorder
limited to children - ADHD often persists into adolescence and adulthood and is frequently not diagnosed until later years.
When ADHD is left unidentified or
untreated a child is at great risk for:
- impaired
learning ability
- decreased
self-esteem
- social
problems
- family difficulties
- potential long-term effects
ADHD
is not new, though our understanding of the disorder is still developing.
Medical
science first noticed children exhibiting inattentiveness, impulsivity, and hyperactivity in 1902. Since that time, the disorder
has been given numerous names, including Minimal Brain Dysfunction or Minimal Brain Damage, and Hyperkinesis, The
Hyperkinetic Reaction of Childhood or Hyperactivity.
In 1980, the diagnosis of Attention
Deficit Disorder was formally recognized in the Diagnostic and Statistical Manual, 3rd edition (DSM III), the official diagnostic manual of the American Psychiatric Association (APA).
Scientific studies, using
advanced neuroimaging techniques of brain structure and function, show that the brains of children with ADHD are different from those of other children.
These children handle neurotransmitters (including dopamine, serotonin, and/or adrenalin) differently from their peers.
ADHD is often genetic. Whatever the specific cause may be it seems to be set in motion very early in life as the brain is developing. Other problems,
such as depression, sleep deprivation, specific learning disabilities, tic disorders, and oppositional/aggressive behavior problems, may be confused with or appear along with ADHD.
It is hard trying to reflect on my past students and examine if any of them exhibited behaviours associated with ADHD. As well as I am not one to make up a story just to impress so for the purpose of this
assignment I will focus on a current student, who has recently been diagnosed (on my suggestion to the parents) with ADHD
– Lishelle F.
Lishelle:
Lishelle, age 10, has more energy than most girls her age. But then, she's always been overly active. Starting at age
3, she was a human tornado, dashing around and disrupting everything in her path. At home, she darts from one activity to
the next, leaving a trail of toys behind her. At meals, she chatters nonstop.
Lishelle still struggles to pay attention and act appropriately.
But this has always been hard for her. She can be quiet and cooperative but often seems to be daydreaming. She is smart, yet
cannot seem to improve her grades no matter how hard she tries. Several times, she has failed exams. Even though she knew
most of the answers, she couldn't keep her mind on the test. Her parents responded to her low grades by taking away many privileges
and scolding, "You're just lazy. You could get better grades if you only tried."
Lishelle has been a pupil of my class during this school year. I had no
idea of the behaviours associated with ADHD, however when this child came into my class I immediately labeled her as having
ADHD.
The behaviours exhibited by Lishelle were:
v Inattention
ü Often
failed to give close attention to details or made careless mistakes in schoolwork and other activities
ü Has
difficulty sustaining attention in tasks and play
ü Has
difficulty organizing tasks and activities
ü Often
loses things necessary for tasks and activities
ü Is
easily distracted
ü Is
often forgetful
v Hyperactivity
ü Fidgets
and squirms in seat
ü Leaves
seat in classroom in situations when remaining seated is required and expected
ü Often
on the go – can’t keep still
ü Talks
excessively
v Impulsivity
ü Has
difficulty awaiting her turn
ü Constantly
interrupts and intrudes on others
For me this was totally unacceptable, so I held a parent conference
with her parents in September and asked them to tell me a bit about Lishelle and what her diet consisted. At that time I was informed that – sugar was not part of the diet so this could not be a cause for
her restless behaviour.
I then proceeded to
move Lishelle from her regular seat and placed her closer to me. Lishelle drove
me crazy, she was still restless and it would seem that my use of proximity control was not working. Instead of attempting to keep still, this gave Lishelle the license to become the boss of the class in
my absence. I also moved on to pleading with Lishelle to be still – “Keep
quiet Lishelle”, “Stop moving” “Get in your seat now!”
I was quickly approach the frustration level.
I am however pleased to note, that since completing the intensive
workshop on Special Ed. I have enlisted the aid of a few of the strategies in the manual.
Some have proven to be effective and others aren’t appropriate just yet.
Firstly, I like each and every one of my pupils and Lishelle knows
this. In this regard pupils are aware that they can come to me with any problems
they may be experiencing and together we will work it out.
I have modified the amount of work Lishelle is required to do –
immediately she started to experience success – success to Lishelle is getting everything right. I have also placed her in a buddy group with three other pupils and together they are working quite well.
Lishelle has also been shown how to organize her daily activities,
by using a Daily Planner Diary. So far she has written down all of her activities
thus far including her activities for over the weekend.
Her parents have been requested to give praise even for the smallest
of improvements, instead of the harsh verbal admonishments. I too have been singing
her praises and all the time all I am seeing is a child who is constantly smiling and adjusting to her “new” environment
and status.
Lishelle still has to work on keeping here workstation neat, this
is a sore point for her. I cannot allow her to move around a lot for at times
she distract the other pupils who are focusing on their work. I also cannot keep
her close to me at times, because depending on the subject that is being done; there are other pupils who need my attention.
Some strategies I would like to try in the future are: dividing the work into chunks and setting a time limit – this is important because next year March
she has an examination to write and it has time limits for each of the three sections.
I myself need to establish a routine, which is easy for the pupils to follow.
At times I am so taken up with the many teaching activities that the transition from one subject to another is not
done as smoothly as I would like it to be. Just like the millions of children
who have ADHD, Lishelle has to learn to live with it and try to constantly change to suit to her environment.
Because schools demand that children sit still, wait for a turn, pay attention, and stick with a task, it's no
surprise that many children with ADHD have problems in class. Their minds are fully capable of learning, but their hyperactivity
and inattention make learning difficult. As a result, many students with ADHD repeat a grade or drop out of school early.
Fortunately, with the right combination of appropriate educational practices, medication, and counseling, these outcomes can
be avoided.
