Educational Strategies For Children With ADD

Mark

In third grade, Mark's teacher threw up her hands and said, "Enough!" In one morning, Mark had jumped out of his seat to sharpen his pencil six times, each time accidentally charging into other children's desks and toppling books and papers. He was finally sent to the principal's office when he began kicking a desk he had overturned. In sheer frustration, his teacher called a meeting with his parents and the school psychologist. But even after they developed a plan for managing Mark's behavior in class, Mark showed little improvement. Finally, after an extensive assessment, they found that Mark had an attention deficit that included hyperactivity. He was put on a medication called Ritalin to control the hyperactivity during school hours. Although Ritalin failed to help, another drug called Dexedrine did. With a psychologist's help, his parents learned to reward desirable behaviors, and to have Mark take "time out" when he became too disruptive. Soon Mark was able to sit still and focus on learning.

Lisa

Because Lisa wasn't disruptive in class, it took a long time for teachers to notice her problem. Lisa was first referred to the school evaluation team when her teacher realized that she was a bright girl with failing grades. The team ruled out a learning disability but determined that she had an attention deficit, ADHD without hyperactivity. The school psychologist recognized that Lisa was also dealing with depression. Lisa's teachers and the school psychologist developed a treatment plan that included participation in a program to increase her attention span and develop her social skills. They also recommended that Lisa receive counseling to help her recognize her strengths and overcome her depression.

Henry

When Henry's son entered kindergarten, it was clear that he was going to have problems sitting quietly and concentrating. After several disruptive incidents, the school called and suggested that his son be evaluated for ADHD. As the boy was assessed, Henry realized that he had grown up with the same symptoms that specialists were now finding in his son. Fortunately, the psychologist knew that ADHD can persist in adults. She suggested that Henry be evaluated by a professional who worked with adults. For the first time, Henry was correctly diagnosed and given Ritalin to aid his concentration. What a relief! All the years that he had been unable to concentrate were due to a disorder that could be identified, and above all, treated.

What Are the Educational Options?

Children with ADHD have a variety of needs. Some children are too hyperactive or inattentive to function in a regular classroom, even with medication and a behavior management plan. Such children may be placed in a special education class for all or part of the day. In some schools, the special education teacher teams with the classroom teacher to meet each child's unique needs. However, most children are able to stay in the regular classroom.

Whenever possible, educators prefer to not to segregate children, but to let them learn along with their peers. Children with ADHD often need some special accommodations to help them learn.

For example, the teacher may seat the child in an area with few distractions, provide an area where the child can move around and release excess energy, or establish a clearly posted system of rules and reward appropriate behavior. Sometimes just keeping a card or a picture on the desk can serve as a visual reminder to use the right school behavior, like raising a hand instead of shouting out, or staying in a seat instead of wandering around the room. Giving a child like Lisa extra time on tests can make the difference between passing and failing,and gives her a fairer chance to show what she's learned. Reviewing instructions or writing assignments on the board, and even listing the books and materials they will need for the task, may make it possible for disorganized, inattentive children to complete the work.

Many of the strategies of special education are simply good teaching methods. Telling students in advance what they will learn, providing visual aids, and giving written as well as oral instructions are all ways to help students focus and remember the key parts of the lesson. Students with ADHD often need to learn techniques for monitoring and controlling their own attention and behavior. For example, Mark's teacher taught him several alternatives for when he loses track of what he's supposed to do. He can look for instructions on the blackboard, raise his hand, wait to see if he remembers, or quietly ask another child. The process of finding alternatives to interrupting the teacher has made him more self-sufficient and cooperative. And because he now interrupts less, he is beginning to get more praise than reprimands.

In Lisa's class, the teacher frequently stops to ask students to notice whether they are paying attention to the lesson or if they are thinking about something else. The students record their answer on a chart. As students become more consciously aware of their attention, they begin to see progress and feel good about staying better focused. The process helped make Lisa aware of when she was drifting off, so she could return her attention to the lesson faster. As a result, she became more productive and the quality of her work improved.

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 dropout of school early. Fortunately, with the right combination of appropriate educational practices, medication, and counseling, these outcomes can be avoided.

SUSTAINING HOPE

Mark

Today, at age 14, Mark is doing much better in school. He channels his energy into sports and is a star player on the intramural football team. Although he still gets into fights now and then, a child psychologist is helping him learn to control his tantrums and frustration, and he is able to make and keep friends. His grandparents point to him with pride and say, "We knew he'd turn out just fine!"

Lisa

Lisa is about to graduate from high school. She's better able to focus her attention and concentrate on her work, so that now her grades are quite good. Overcoming her depression and learning to like herself have also given her more confidence to develop friendships and try new things.Lately, she has been working with the school guidance counselor to identify the right kind of job to look for after graduation. She hopes to find a career that will bypass her attention problems and make the best use of her assets and skills. She is more alert and focused and is considering trying college in a year or two. Her counselor reminds her that she's certainly smart enough.

Henry

These days, Henry is successful and happy in his job as a shoe salesman. The work allows him to move around throughout the day, and the appearance of new customers provides the variety he needs to help him stay focused. He recently completed a course in time management, and now keeps lists, organizes his work, and schedules his day. Now that he has harnessed his energy, his ability to think about several things at once allows him to be creative and productive. He is proud that he and his wife have developed important parenting skills for working with their son, so that he, too, is doing better at home and at school. Henry is also pleased with his new ability to follow through on projects. In fact, he just finished making his son a beautiful wooden toy chest for his birthday.

Can ADHD Be Outgrown or Cured?

Even though most people don't outgrow ADHD, people do learn to adapt and live fulfilling lives. Mark, Lisa, and Henry are making good lives for themselves--not by being cured, but by developing their personal strengths. With effective combinations of medicine, new skills, and emotional support, people with ADHD can develop ways to control their attention and minimize their disruptive behaviors. Like Henry, they may find that by structuring tasks and controlling their environment, they can achieve personal goals. Like Mark, they may learn to channel their excess energy into sports and other high energy activities. And like Lisa, they can identify career options that build on their strengths and abilities.As they grow up, with appropriate help from parents and clinicians, children with ADHD become better able to suppress their hyperactivity and to channel it into more socially acceptable behaviors, like physical exercise or fidgeting. And although we know that half of all children with ADHD will still show signs of the problem into adulthood, we also know that the medications and therapy that help children also work for adults.

All people with ADHD have natural talents and abilities that they can draw on to create fine lives and careers for themselves. In fact, many people with ADHD even feel that their patterns of behavior give them unique, often unrecognized, advantages. People with ADHD tend to be outgoing and ready for action. Because of their drive for excitement and stimulation, many become successful in business, sports, construction, and public speaking. Because of their ability to think about many things at once, many have won acclaim as artists and inventors. Many choose work that gives them freedom to move around and release excess energy.

But some find ways to be effective in quieter,more sedentary careers. Sally, a computer programmer, found that she thinks best when she wears headphones to reduce distracting noises. Like Henry, some people strive to increase their organizational skills. Others who own their own business find it useful to hire support staff to provide day-to-day management.

Credits:
This booklet was written by Sharyn Neuwirth, M.Ed., an education writer and instructional designer in Silver Spring, MD. Scientific information and review was provided by NIMH staff members L. Eugene Arnold, M.D.; F.Xavier Castellanos, M.D.; and Alan J. Zametkin, M.D. Also providing review and assistance were Russell A. Barkley, Ph.D., University of Massachusetts Medical School; Eileen Weiner-Dwyer, Ph.D., and Kevin Dwyer, M.A., N.C.S.P., of the Montgomery County (Maryland) Schools; JoAnne Evans, R.N., Children and Adults with Attention Deficit Disorders; Jane Hauser, U.S. Department of Education; Reid Lyon, Ph.D.,National Institute of Child Health and Human Development; Harvey C.Parker, Ph.D., A.D.D. Warehouse; Larry B. Silver, M.D., Georgetown University. Editorial direction was provided by Lynn J. Cave, NIMH.

Source:

U.S. Department of Health and Human Services

Public Health Service

National Institutes of Health

National Institute of Mental Health