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Attention
Deficit and
Hyperactivity Disorder
(AD/HD)
There have always been difficult, impulsive, uncooperative children
whose behaviour has caused concern to parents and teachers. Recent
research has identified a particular group of symptoms which can now be
diagnosed as A.D/H.D. It is now suggested that A.D/H.D. is a
genetically based neurological disorder which is caused by a chemical
imbalance in the frontal lobe of the brain.
WHAT ARE THE SIGNS?
There are three key areas of difficulty and many children show problems
in all three areas and across different settings. If these
difficulties affect the child to such an extent that it interferes with
their ability to cope academically and socially,
then the possibility of A.D/H.D. may exist.
Here are some of the behavioural indicators:
1. INATTENTION
short concentration span
flits from one activity to another difficulty listening to instructions
difficulty blocking out distractions and focusing
attention rapid changes in activity
2. OVERACTIVITY
restless/fidgety/constantly on the move even in sleep difficulty
remaining in seat disruptive
3. IMPULSIVITY
cannot wait for instructions before starting an activity/ reacts
without thinking
cannot wait his /her turn reckless/accident prone
interrupts/ blurts out answers insensitive to consequences
poor self monitoring: fail to realise the impact of their behaviour on
others e.g. not aware that the teacher is losing her temper or the joke
is over.
WHAT TO DO ABOUT IT
AT HOME: Be consistent- don't say what you are not prepared to do
and always do what you say. Be positive - tell them what
you want, not what you don't want . Praise your child when
you catch them being good. Have clear routines for problem times
e.g. bedtime. Remove obvious distractions when he or she needs to
concentrate. Set aside some time to be on your own with your
child to play /do something they choose/have fun.
AT SCHOOL: AD/HD children respond best to clearly
defined rules/rewards and sanctions applied consistently to the
whole class. They need structure and routine and do not respond
well to open ended self directed tasks. Work assignments need to
be broken down into small, clear attainable tasks. Praise needs to
be frequent, immediate and explicit: "Well done you did X well."
Children need to be seated away from distractions.
AD/HD children need a high level of physical activity so find
legitimate reasons for the child to move e.g. giving out books,
collecting equipment, taking messages. Tasks need to be varied
frequently e.g. a sitting activity to a a practical task to use of I.
T. to delivering a message to discussion time. Gain eye contact before
giving instructions and be concise. Use educational software
whenever possible as this is highly appropriate for this type of
child: there is no delay, it is interactive not passive, and the
activities change rapidly.
Referral to Psychiatrist/Paediatrician
A multi-disciplinary approach is important in diagnosing and treating
children with A.D/H.D. Drug treatment, usually Ritalin, can be used in
severe cases. It is not a cure but can slow down the child's reaction
time and give them time to reflect on the consequences of their
actions. It also can enable to them to have more control rather
than be driven by their overwhelming urge to react immediately.
This allows other behavioural techniques to be more effective.
SOME POSSIBLE TARGETS FOR AN I.E.P.
1. Gradually increase the amount of time spent on
task.
2. Complete task within a specified time, through
use of a timer or watch e.g. set a clear task to be achieved in
5 minutes and give immediate reward on completion and then allow
the child to change activity or move about. 3. Complete one task before
starting another.
4. Remain seated for a specified time, but do not
expect A.D/H.D. children to sit still for very long. These children
actually need to move in order to boost their ability to concentrate
and remain focused.
5. Listen to instructions and follow without need
for repetition.
6. Adopt an appropriate way of asking for help, answering in class or
contributing to discussions.
7. Develop a routine for checking that he/she has
the correct items for a task.
8. Learn how to wait his/her turn.
9. Learn to set own realistic targets.
10. Learn to make logical plan before starting a piece of work.
HOW CAN A NON TEACHING ASSISTANT HELP?
1. Ensuring that the child recognises the signals
to listen and pay attention.
2. Enabling the child to organise their ideas and
equipment before starting a task.
3. Spotting and removing obvious distractions.
4. Helping the child to gain greater self control
by providing a commentary on what is happening e.g." You need
to wait until your name is called. Remember to finish that before
you ask. Wait until the queue is shorter. What would happen if you
did that? This is not a good time to ask." Evidence suggests that
these children find great difficulty doing this themselves and need to
be shown how to monitor what is going on. They can then begin to see
the consequences of their behaviour.
5. Providing instant reward or feedback on completion of a task.
6. Developing social skills: turn taking, sharing, listening,
considering others' feelings etc.
7. Providing repetitions and reminders to compensate for
inattentiveness.
Ged Balmer
Chartered Educational
Psychologist
Cert. Ed., BSc.(Hons), MSc.,
C. Psychol., AFBPsS.
British Psychological
Society No: 34097
in collaboration with
colleagues
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Chartered Educational
Psychologist
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and an independent opinion"