Attention Deficit and Hyperactivity Disorder
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:
short concentration span
flits from one activity to another difficulty listening to instructions
difficulty blocking out distractions and focusing attention rapid changes in activity
restless/fidgety/constantly on the move even in sleep difficulty remaining in seat disruptive
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.
Chartered Educational Psychologist
Cert. Ed., BSc.(Hons), MSc.,
C. Psychol., AFBPsS.
British Psychological Society No: 34097
in collaboration with several colleagues.
Chartered Educational Psychologist
"advice, assessment and an independent opinion"