Module 15 – Learning Difficulties: Attention Deficit Hyperactivity Disorder (ADHD)
Estimated Time: 25 minutes
Student Aims:
· To define ADHD
· To learn the causes and support available for ADHD
· To learn about the identification of pupils with ADHD
· To learn about ways to support pupils with ADHD in the classroom
/*! elementor – v3.23.0 – 05-08-2024 */
.elementor-heading-title{padding:0;margin:0;line-height:1}.elementor-widget-heading .elementor-heading-title[class*=elementor-size-]>a{color:inherit;font-size:inherit;line-height:inherit}.elementor-widget-heading .elementor-heading-title.elementor-size-small{font-size:15px}.elementor-widget-heading .elementor-heading-title.elementor-size-medium{font-size:19px}.elementor-widget-heading .elementor-heading-title.elementor-size-large{font-size:29px}.elementor-widget-heading .elementor-heading-title.elementor-size-xl{font-size:39px}.elementor-widget-heading .elementor-heading-title.elementor-size-xxl{font-size:59px}
15.1 Introduction
/*! elementor – v3.23.0 – 05-08-2024 */
.elementor-widget-image{text-align:center}.elementor-widget-image a{display:inline-block}.elementor-widget-image a img[src$=”.svg”]{width:48px}.elementor-widget-image img{vertical-align:middle;display:inline-block} 
ADHD is one of the most common cognitive disorders diagnosed in children in the UK.
According to the National Institute for Health and Care Excellence (NICE), the prevalence of ADHD in children is 5%, and in adults, it’s 3-4%.
In this module, you will learn more about what ADHD is, what causes it, and how it is supported both inside and outside the classroom.
15.2 ADHD: An Overview
Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder most commonly diagnosed during childhood; generally before the age of 12 years.
Children with ADHD typically exhibit symptoms such as hyperactivity, lack of impulse control and difficulty paying attention. These behaviours can interfere with the child’s school and home life.
ADHD is carried into adulthood. Adults with ADHD may struggle with time management, organisation, impulse control, goal setting and keeping a job. Some adults may also struggle with addiction, relationships and self-esteem.
The main traits of ADHD are inattention, hyperactivity, and impulsivity. These traits can manifest in different ways and to varying degrees in different individuals.
1. Inattention
A child with inattention symptoms may exhibit the following behaviours:
· Difficulty sustaining attention on tasks or activities, including play activities
· Difficulty following through on instructions and completing schoolwork or chores
· Frequently losing things necessary for tasks or activities
· Easily distracted by extraneous stimuli
· Forgetful in daily activities
2. Hyperactivity and Impulsivity
These two traits are combined to be known as hyperactive-impulsive behaviours, however, we have separated them below for clarity.
Hyperactivity
A child with hyperactivity symptoms may exhibit the following behaviours:
· Fidgeting, restlessness, or squirming in their seat
· Leaves their seat frequently or runs about excessively when it is inappropriate
· Difficulty engaging in activities quietly
· Always “on the go”
· Talking excessively
· Taps hands and feet
Impulsivity
A child with impulsivity symptoms may exhibit the following behaviours:
· Blurts out answers before a question has been asked
· Demonstrates a severe inability to wait in lines
· Interrupts others
· Intrudes on others
Some people may have combined ADHD, which includes symptoms of both inattention and hyperactive-impulsive behaviour.
The symptoms described above may range from mild to severe. Some children might be mildly disruptive or have mild inattentiveness when forced to perform tasks they don’t enjoy. However, more severe symptoms can cause major disruptions in learning for the child and their peers.
Fact
Over 1.5 million pupils in England have special educational needs (2022/23)
Source: adhd.co.uk
15.3 Causes of ADHD
The exact cause of ADHD is not fully understood, but it is believed to be the result of a combination of genetic, neurological, and environmental factors.
ADHD tends to run in families. If someone has a sibling or parent with ADHD, there is a strong likelihood that they will have it too.
There is also a question of foetal development, with some researchers suggesting that infection, drinking, smoking, substance abuse, and poor nutrition during pregnancy can affect the way a baby’s brain develops; thus resulting in an ADHD diagnosis.
Differences in brain chemistry may also explain some cases of ADHD. Some children present a chemical imbalance in the brain that may cause these issues. In other cases, there may be issues with the parts of the brain that control the child’s ability to pay attention or focus. Some researchers think that this part of the brain may be less active in children with ADHD.
It is also possible that exposure to toxins may cause changes in the brain or affect the way a child’s brain develops. Brain injuries can also be a source of ADHD. A child who suffers damage to their frontal lobe may struggle with impulse or emotional control.
There are some factors doctors know do not cause ADHD. Children do not develop ADHD because they eat too much sugar or watch too much TV. Poor home or school life does not cause ADHD. Food allergies are not at the root of the problem. While these things may cause behavioural issues in children, these issues are not the result of ADHD.
It is also important to note that ADHD is not something that you can prevent or cure. The best thing to do is to identify it early and support positive interventions that help children manage their symptoms.
15.4 Treating ADHD
Treatment for ADHD includes medication and therapy to help control the symptoms.
Typically, a GP will prescribe medicine designed to increase attention span while helping the pupil control their impulses and hyperactivity. However, it is important to remember that ADHD is a complex disorder. The medicine may help the pupil in some ways but may not improve all the symptoms.
It is also important to remember that medicine has side effects that may be unpleasant for the child. These should be discussed with the GP so that an alternative can be found, if appropriate.
Along with taking medicine, it is beneficial for people with ADHD to participate in therapies such as psychotherapy, behavioural therapy, cognitive behavioural therapy, and social skills training, in addition to the SEN interventions used in the classroom.
15.5 Related Disorders
ADHD can be associated with other conditions or co-occurring disorders.
It is important to be aware of the following conditions when identifying and supporting pupils with ADHD
Oppositional Defiant Disorder (ODD)
ODD is a condition characterised by a persistent pattern of disobedient, hostile, and defiant behaviour towards authority figures, and it is commonly associated with ADHD.
Conduct Disorder (CD)
Conduct disorder is another condition that is commonly associated with ADHD. CD involves a persistent pattern of antisocial behaviour, such as aggression towards people and animals, vandalism, theft, and deceitfulness.
Children with conduct disorder may also display a lack of empathy and remorse for their actions.
Depression
Sometimes, the symptoms of ADHD cause children to feel isolated and get frustrated by what’s happening at school. Feelings of inadequacy, especially amongst peers, and other social problems can contribute to low self-esteem which can fuel depression.
Anxiety
Children with ADHD may also struggle with anxiety. This will often present through symptoms like excessive worrying, panicking or unnecessary fear. The child may also experience physical symptoms like sweating, stomach aches, heart racing, and diarrhoea.
Tourette’s syndrome
Tourette’s syndrome is a disorder that involves repetitive, involuntary movements and vocalisations, and it is more common in individuals with ADHD.
Children diagnosed with ADHD are also susceptible to secondary conditions such as autism, epilepsy, sleep problems, dyspraxia and dyslexia.
15.6 Identifying ADHD
Although it is challenging, the early identification of ADHD is important.
The symptoms the child exhibits will generally affect their home and school life and will be evident in other settings. These symptoms can have a profound effect not only on the child’s ability to function but also on those around them. Thus, educators who spot the potential of an ADHD diagnosis should discuss the situation with the child’s parents and advise them to organise an appointment with their GP as soon as possible.
It is important that parents receive advice from all of the relevant professionals, as required by the SEN Code of Conduct.
Some of the typical signs of ADHD in the classroom will present in one or more of the following ways.
Some children will struggle to focus, become easily distracted and appear to be daydreaming rather than listening.
Children who cannot sit still might present as hyperactive. These children may be careless, act without thinking or shout out in class. However, it is important to remember that all children present some symptoms of ADHD at some point in time.
To determine whether it is a brief behavioural problem or ADHD, educators should look to see whether the symptoms persist for at least six months, are not explained by another issue or condition, or by stress or exhaustion, and which ultimately are severe enough to affect normal day-to-day life.
Conduct disorder is another condition that is commonly associated with ADHD. CD involves a persistent pattern of antisocial behaviour, such as aggression towards people and animals, vandalism, theft, and deceitfulness.
Children with conduct disorder may also display a lack of empathy and remorse for their actions.
Identifying ADHD in Early Years Pupils
Any identification in school-age children must take place via the SEN school policy and the SEN Code of Practice.
Educators play an important role in gathering and organising the relevant information required for initial assessments. Providing this information is imperative because the school must then work closely with the health team for strategic support and community intervention programmes.
Gifted Children vs. Children with ADHD
When identifying pupils with ADHD, it is important for educators to take the time to distinguish between gifted pupils and those who might have ADHD. This will prevent the misidentification and mislabelling of pupils who might be acting out because they are bored rather than because of an underlying issue, like ADHD.
When making the distinction between gifted children and children with ADHD, look at the way their behaviour changes when interventions are applied.
Children with ADHD will see little positive effect on their behaviour when they have increased contact with intellectual peers. Placing them in the correct classroom and modifying the curriculum will also often have little effect.
In pupils with ADHD, behaviour problems may continue to persist regardless of the teaching style, subject matter or attention paid to them.
Children with ADHD will often be unable to explain their inappropriate behaviour.
When asked why something is not completed, the child may be unable to explain why. When asked why they are talking excessively, they will generally not attribute their behaviour to a need to share information.
A child’s behaviours are often not influenced by their interest in the task at hand. They may struggle to complete tasks, even if the activity involves things that they enjoy. They may also move between tasks without a strategy or any reason.
Gifted pupils may present the same behaviours as pupils with ADHD; however, these behaviours are more likely to change in different contexts. Contact with intellectual peers, correct academic placement and appropriate modifications to the curriculum often curb inappropriate behaviours.
When asked, a gifted pupil is more likely to be able to explain why they are acting out, and learning social skills generally teaches them which impulsive behaviours are inappropriate.
If the child talks excessively, shifts from task to task, or has not completed a task, they can often explain why they chose to do so. The need to interrupt others may stem from a need to solve a problem, demonstrate that they know the answer, or share information they believe is relevant at the time.
Even when not paying attention, the child is generally able to work on multiple tasks and can also repeat instructions.
Finally, most inappropriate behaviour in gifted children comes from boredom with the topic, the teaching style, or a lack of attention. These behaviours are often curbed when the appropriate adjustments are made.
15.7 Supporting ADHD
There are several interventions that educators can apply when supporting ADHD in the classroom.
However, it is important to follow the SEN Code of Practice and ensure that these strategies meet the pupils’ needs.
Building Relationships
Having a positive relationship with the child is one of the best strategies available for supporting them in the classroom.
Living with ADHD means experiencing the world in a different way. Thus, it serves children well to have the support of an adult who is sensitive to the needs of someone with ADHD and has a better understanding of what it is like to live with the condition. Developing this supportive relationship often includes spending time with the pupil, getting to know their parents, reading up on ADHD research and asking for advice from other professionals.
Someone who is ADHD-sensitive is not just aware of the struggles encountered by pupils with ADHD but is also flexible when working with the child. They are warm, understanding, and have a good sense of humour to keep the conversation with the child positive. Working closely with parents is also important because it is a highly individual condition and parents can often provide a great deal of insight into certain behaviours.
Dealing with External Stimuli
Children with ADHD have trouble ignoring unwanted stimuli in order to stay on task. Educators can help them remove these stimuli in several ways.
One way to do this is to give the child headphones and music to listen to while they are working on tasks at their desk. The music will remove any auditory stimuli that may have otherwise distracted the pupil. The headphones are important because they will mask loud or sudden noises outside the classroom that might distract the pupil.
To make the experience more inclusive, educators might allow other pupils to use headphones, too. If it seems more practical to play the music from an audio system, continue to provide the ADHD pupil with headphones because, otherwise, overhead music will simply be another distraction.
It is also important to minimise visual stimuli. Ensure that the classroom is uncluttered by removing any posters or decorations that may be a distraction.
It can sometimes be helpful to place a screen around the child’s desk to help them focus and minimise distractions from other pupils. However, this requires careful handling and is only suitable for some tasks like tests or quizzes. Using this method excessively or in an inappropriate context can stigmatise the child or prevent them from engaging in social development.
Regulating Behaviour
Children with ADHD can struggle to monitor their own behaviour and can’t explain why they are acting out. To support them, educators can explain to them which behaviour is appropriate or inappropriate. Then, when the children are told to stop, they will better understand which behaviour the teacher is referring to.
Using the traffic light system in class is useful for ADHD pupils and the class as a whole. Create a poster of a set of traffic lights and include an arrow. The red light stands for silence while the amber light allows children to whisper, and the green light encourages free conversation. This serves as a visual reminder of the classroom instruction which also helps the child regulate their own behaviour.
Building Concentration and Attention Skills
Pupils with ADHD tend to have a difficult time concentrating over extended periods. One way to help them concentrate is to break the time up into chunks and give them a visual timetable of when they should be working, how long they are expected to work and when they can relax. This helps make classroom time feel more manageable and provides predictability to the schedule. Thus, children can work knowing when they will finish rather than stopping to wonder if they’ve finished.
Building attention skills can be difficult, but many educators find that it is worth the effort. Create a chart for the pupil’s attention skills and mark their progressions. The first mark might be only 20 seconds of concentration. However, educators can turn it into a game and encourage the child to keep concentrating and beat their score. The key to success with the attention chart is to acknowledge the difficulty for the child and to create only realistic goals.
Supporting Social Skills
Some pupils with ADHD will struggle with social skills. These skills are important for classroom and personal development, and providing interventions to work on these skills is essential for ADHD pupils.
‘Circle time’ is a useful intervention for social skills. This is where the children sit in a circle – this works best in small groups – and discuss different issues, prompted by the teacher. Educators should choose topics that keep the needs of children with ADHD in mind.
Supporting social skills also means preventing the child from being stigmatised. One of the best ways to do this is to avoid disciplining the whole classroom based on the child’s behaviour, as this can lead to resentment and alienation in the classroom.
Playing to Their Strengths
Children with ADHD may experience difficulties, but they also exhibit many different strengths. Children with ADHD tend to be good at expressing themselves. They are often funny, artistic and enthusiastic. These children also tend to be ‘doers’ in that they are excited to put what they’ve learned into practice. Although they may struggle with details, they often do well with looking at the big picture. They are also often fun to be with and very curious. These are all positive things, and it is important to remember to praise their strengths when engaging with them.
Praising children provides positive reinforcement for acceptable behaviour and positive achievements. Praise their efforts specifically so that they know what they’ve done correctly. This will also help them to moderate their own behaviours.
Conclusion
ADHD is a complex and highly individual condition. While the exact causes of ADHD are still not fully understood, research has shown that a combination of genetic, environmental, and neurological factors contribute to the development of the disorder.
ADHD can have a significant impact on a person’s daily life, including their academic and social functioning, as well as their mental and physical health.
ADHD can be difficult to deal with in the classroom if it goes unidentified and unsupported. However, pupils with ADHD can become a real asset to the classroom when the right interventions are applied and strong relationships are built. Thus, educators are always encouraged to look at the situation from the child’s point of view so that they can help the child in a way that is meaningful.
In Module 16, we discuss the importance of SEN knowledge.
WELL DONE!
YOU HAVE MADE IT THROUGH MODULE 15! CLICK BELOW TO MOVE TO THE NEXT MODULE
Next