Because there isn’t a clear line between the normal behaviour of all children and those children suffering from ADHD it is important that the final diagnosis should always be made by professionals specially trained in the disorder
“In addition to making sure that no other medical condition is causing the symptoms, one must recognize that ADHD is a comparative diagnosis. It depends not just upon the presence of symptoms but upon the intensity and duration of those symptoms. Most children are distractible, impulsive, and restless some of the time. The vast majority of children do not have ADHD, and one must be very careful not to make the diagnosis so easily that it loses meaning or becomes a fad.” (p43)
According to the DSM-III-R there is a diagnostic criteria of fourteen behaviours that could point towards ADHD in children, however they do point out that for this criteria to be met the behaviours must be significantly more frequent than that of most people of the same mental age (ADHD Kids, March 2001) Listed here are the top five significant behaviors that parents and teachers should look for if they suspect that a child may have ADHD
- Often fidgets with hands or feet or squirms in seat (in adolescents or adults may be limited to subjective feelings of restlessness)
- Has difficulty in remaining in seat when required to do so.
- Is easily distracted by extraneous stimuli.
- Has difficulty in waiting turn in games or group situations.
- Often blurts out answers to questions before they have been completed.
NOTE: The above items are only five of the fourteen and are listed in order of the most frequent behaviours caused by ADHD.This information is based on data collected on a national field trial of the DSM-III-R criteria for disruptive behaviour disorders. (p200)
How It Feels To suffer From ADHD
I felt a cleaving in my mind-
As if my brain had split-
I tried to match it seam by seam-
But could not make them fit
The thought behind, I strove to join
Unto the thought before-But sequence raveled out of sound
Like balls upon a floor
-Emily Dickinson (1864)
Although Emily Dickinson was writing of her frustration at being a woman poet in the nineteenth century this poem is a first-class example of how one feels when ones thoughts simply won’t come together. The majority of people have at some point in their lives understood the frustration of losing their train of thought or forgetting exactly what it was that one wanted to say in an important or exciting situation. These are feelings that most of us experience occasionally but for someone that suffers from ADHD it is a normative experience, which can occur frequently, if not always, the frustrations of which can be devastating.
In his book ‘Driven to Distraction’ Edward Hallowell explains how it feels to suffer from ADHD by equating it to driving in the rain with broken windshield wipers so having to constantly strain to see where you are going or, listening to a radio that is full of static which makes it extremely difficult to hear the music over the crackle. The frustration of these feelings can become so overwhelming that it is understandable that constantly living under such conditions can often cause angry and violent outbursts and while like the rest of society the ADHD sufferer will experience many different problems during their life time their frustrations make them more prone to impulsive and seemingly rude behavior which is nearly impossible for them to control, or even understand as wrong. Certain individuals may believe that firm discipline is the only answer to the problem, unfortunately however this is completely missing the point. (What is ADHD March 2001)?
Drugs and medications that can be used to treat ADHD
Stimulant drugs such as Ritalin, Dexedrine and Aderall have been used for many years to treat the symptoms of ADHD.For many people, these medications can radically reduce their hyperactivity and improve their ability to focus, work and learn. ( Some Basic facts About ADD Medications, April 2001) It is important to remember however that these medications do not cure the disorder but they can temporarily control the symptoms. Unfortunately ther is no such thing as a quick cure however, many experts believe that the most significant gains appear when medication is combined with medication, behavioural therapy and practical support. (Basic Meds, April 2001)
If Stimulant drugs such as the ones mentioned above are used correctly and under medical supervision, they are considered quite safe, however they can become addictive in teenagers and adults if they are misused. These medications can and often are used in slightly different ways for different children. Ritalin and Dexedrine come in short term tablet that last about three hours, as well as longer preparations that can last the full duration of the school day. The short term dose can be more practical for those that only need the drug during the school day while the sustained release dosage can free the child from the embarrassment of going to the teacher or school nurse to get their tablets. (Basic Meds, April 2001)
Nine out of ten children do improve significantly when taking one of these stimulant drugs, therefore if one does not work it is always advisable to try another. Although these particular medications are highly acclaimed in helping those with ADHD, Ritalin and other stimulant drugs used for this purpose in children have sparked a great deal of controversy. While on a medications some children may lose weight, have a reduced appetite, and temporarily grow at a much slower rate, nevertheless many doctors say that if the child’s overall development is monitored carefully the benefits of such drugs will far outweigh the potential side effects. These doctors also suggest that any side effects that do occur can often be handled by simply reducing the dosage. (Basic Meds, 2001)
School Discipline
A position paper produced by CHADD (Children and Adults with Attention Deficit/Hyperactivity Disorder) concludes that school discipline is of concern to educators, parents and the general public right across the board. Although it is important that all children should enjoy the knowledge that they are being taught in a safe and nurturing environment it is only fair that those children with ADHD and other children with special education needs should bask in the same secure environment. CHADD is a national membership organization of over 35,000 professional and parent members who endorse this concept fully, and suggest that there are two primary elements to achieving this goal:
1.The provision of a predictable, rational, and equitable disciplinary structure in the school setting, and;
2. The provision of behavioural skill programmes for those students who display behaviours that are inconsistent with the discipline codes applied in the school setting.
It would seem that because of the reported growth in violent and criminal misconduct among students in the USA and the UK that both countries are adopting a ‘hard line’ approach on school disciplinary policies within schools and education establishments. However, as is often the case when faced with new problems and dilemmas the education system seeks out a minority group on which to place the blame, and in this case, that group seems to be those children with special education needs. The blame is being placed at the feet of these children as in many circumstances they are not subjected to the same discipline procedures as the other students.
This in itself is extremely concerning however what is of even greater concern is that many professionals believe that a solution to the problem is to either move special education students to other placements (which totally invalidates the need for inclusion) or to exclude them entirely from the school. (CHADD, School Discipline, April 1998) CHADD would disagree with any such ideas as it claims that
- There is little evidence to support the belief that children with disabilities are disproportionately responsible for school discipline problems, and;
- There is no validity to the claim that special educational procedural safeguards excessively interfere with the ability of school administrators to exercise appropriate discipline and control in the schools. (April 1998)
These issues are of great concern, therefore CHADD collected data from its 35,000 members, which concluded that the following circumstances are being frequently tolerated by ADHD and other special education needs students.
Many students with ADHD are not being formally recognized by their schools so are therefore regularly subjected to educational disciplinary actions when special education procedures should have applied. Because of this, many of these students are often being repeatedly excluded and expelled which quite often means that the children receive little or no form of education let alone special education. Many ADHD children, when not expelled are transferred to ‘alternative’ education settings that are specific for the’ troublesome’ child where there is little or no real educational value. It would seem then that all this could be avoided if only ADHD was diagnosed properly and recognized as a disability under the special education laws.
Children with ADHD are disproportionately affected by these circumstances for two main reasons. Firstly, the neurological symptoms of ADHD often manifest themselves as behaviour that is inconsistent with school rules and secondly many children with ADHD live in areas that do not fully recognize ADHD as a disability that warrants special services. (School discipline, 1998)
It would seem obvious then that schools have a responsibility to make sure that before any sort of disciplinary action is taken that the child in question has been given adequate skill training to eliminate such behaviours before they occur. Perhaps if this was the case the child could concentrate solely on his or her education in harmony with others.
Suggested classroom accommodations and teaching tips
The organization Chadd has set up an extremely useful website with information for teachers that think they may have pupils with learning disabilities or behavioural problems. Although this is an extensive list for the purpose of this essay, I shall include five suggested classroom accommodations that appear to be compatible with all students of all abilities.
1.if a child seems to have, confusion over written material (difficulty finding main idea from a paragraph, attributes greater importance to minor details) the teacher is then advised to provide the student with the reading material with the significant areas underlined or, provide outlines of the important material so the child is clear as to what is expected.
2.If the child has difficulty sustaining attention or is easily distracted by extraneous stimuli the teacher is advised to break activities into small units and reward attention.
3.If the child has poor handwriting allow for a scribe and grade for content, not handwriting. Allow for computer or typewriter.
4.If the child has difficulty remaining seated then give them the opportunity to frequently move around and make sure that there is ample room for movement at all times.
5.If the child has a problem with excessive talking, then make sure that the student is called when it is appropriate and always reinforce positive listening (Classroom interventions for children with ADHD,1999)
These are only five of the suggested classroom accommodations that can be used (there are thirty four altogether) for children with learning disabilities. All of the above seem to be more than compatible with the running of a ‘mainstream’ school, infact it seems that these accommodations should be exercised with all students as matter of course, after all nobody likes to sit in a cramped area and everyone deserves to be listened to (at the appropriate times)
There is no question that ADHD is ‘out there’, in our schools and among all of our children and if the inclusion of these children into ‘mainstream’ schools is to be effective then all teachers (and parents) should be made aware of it and given adequate traing to help them to deal with it. However, it is worth remembering that in a country where many of our children share a classroom with up to thirty others it may be difficult for those in the teaching profession to cope with the extra workload, this however must remain to be seen.