ADHD: The Child/teacher Struggle

Introduction

Try to imagine this situation: at a parent-teacher conference, a child’s teacher informs two parents that their son or daughter is easily distracted while doing homework or other tasks. Perhaps they are also constantly fidgeting in their seats and cannot seem to focus on just one thing. As a parent, along with the teacher, this arises the question, does my child have ADHD? Before jumping to any conclusions or self-diagnosis, parents ought to consider what ADHD is and the different ways it presents itself, the causes, the proper means to diagnosis, and finally possible treatment methods. Teachers are not exempt from this process. Following diagnosis, teachers are entitled to make accommodations to attend to the newfound needs of students who have ADHD.

Attention Deficit Hyperactivity Disorder (ADHD) in children

Attention Deficit Hyperactivity Disorder, or ADHD is a disorder that affects 6.1 million children across the United States. ADHD is the current overarching name of the condition. In 1950, the words to describe the behavior included minimal brain damage and hyperkinesis. It wasn’t until 1980 that the American Psychiatric Association, or APA for short, replaced these words with attention deficit disorder. Then in 1987, the APA linked this to ADD (attention-deficit-disorder) with hyperactivity. Therefore, a new syndrome was named: Attention deficit hyperactivity disorder (Staff, 2019). This name first became official in May of 2013 when the APA released the Diagnostic and Statistical Manual of Mental Disorders. This manual is what doctors refer to when they are making a diagnosis for mental health conditions.

As previously stated, ADHD is a brain-based disorder. It can cause problems with a child’s normal everyday activities both in the home and at school. Although closely related to ADD, ADHD includes being hyperactive with impulsive behaviors. People with ADHD have trouble focusing on one single task or sitting still for long periods of time.

ADHD can present itself in many different ways. Therefore, no two cases of ADHD are exactly the same. Symptoms can look similar to that of other disorders and can also look like “normal” childhood behaviors. Common symptoms include, but are not limited to, three overarching categories including inattention, impulsivity, and hyperactivity. Normally, a child will fall into only one of these three categories. That being said, it is not uncommon for a child to have a combination of such symptoms. These three categories although distinct can also be hard to distinguish from the others.

Types

The first type of ADHD is inattention. People with inattention ADHD have an extremely hard time staying focused, finishing tasks, and following instructions. This inattention can also include such things as not being organized, constant daydreaming, a lack of persistence, and simply not paying attention when the teacher calls on them in class. It is important to note that these problems are not due to any lack of comprehension on the child’s behalf. Children with inattentive ADHD may not receive a proper diagnosis because such children typically do not interrupt the classroom. According to Dr. Stephen Hinshaw, a chair member at the psychology department at UC Berkeley, inattentive ADHD is most commonly found in young girls. This is due to the fact that symptoms are less obvious than those in boys, and therefore, they often go unnoticed or simply unacknowledged.

The second type of ADHD is hyperactive-impulsivity. Hyperactivity means that a person seems to move constantly, as though in a state of extreme restlessness, and may excessively fidget, tap or talk. Impulsivity includes rash decision making, or without fully thinking things through. Children typically don’t think about the long-term effects, but rather try to find the quickest way to get the reward that they want. In the home, this may look like disrespect towards parents, siblings, and other peers on the communication platform. In the school setting, children with hyperactive-impulsivity may be proven to interrupt the teacher during class, are not able to wait their turn to talk, and may struggle greatly with standing in line. Added to the excessive amount of energy, kids with hyperactive-impulsivity ADHD also find it very difficult to focus on the task at hand.

The most common type of ADHD is a combination of hyperactive-impulsivity and inattention. This type of ADHD includes symptoms from both inattention and hyperactive symptoms. Hyperactivity involves such things as fidgeting, tapping, talking, and overall constant movement. This movement is typically during situations that are not appropriate. Kids display an above-average level of activity and energy as a whole. Therefore, a combination of symptoms may include excessive fidgeting, all the while giving the resemblance of being spaced-out.

Symptoms

According to the U.S. Centers for Disease Control and Prevention Data, one in ten children who are between the ages of five and seventeen have received a ADHD diagnosis. This statistic makes ADHD the most common childhood neurodevelopmental disorder to be found within the United States as a whole (Angel, 2021). Children with ADHD struggle in school; specifically, in a general controlled classroom area. The Centers for Disease Control and Preventions has proven that boys are three times more likely to be diagnosed than girls. This is thought to be because boys tend to exhibit more of the hyperactive symptoms to begin with. Although many have ADHD, many girls will often daydream and will be hyper-talkative rather than hyperactive. Seeing that girls are stereotyped to be talkative, many will overlook this particular symptom. Furthermore, many of the symptoms can be the typical childhood behaviors, and therefore it can be hard to know whether is it ADHD related or not.

Causes

Understanding the symptoms is the first step towards diagnosis. This prompts the question: what causes ADHD? Despite ADHD being generally common, doctors are still unsure as to what causes the condition in the first place. Although they believe it may have neurological origins, they also believe that genetics may play a role as well. That being said, there is a lack of evidence to prove causation. The National Institutes of Health have highly suggested that an overall reduction in dopamine is a factor in ADHD. Dopamine is the chemical in the brain that helps move signals from one nerve to another. “It plays a role in triggering emotional responses and movements.” (Britannica, 2020) Other researchers suggests a structural difference in the brain. People with ADHD have less grey matter volume. This grey area helps with speech, self-control, decision-making and overall muscle control. Scientists are studying possible other factors including brain injury, exposure to the environment, alcohol and tobacco use during pregnancy, premature birth, as well as low birth weight. That being said, the above factors have yet to be proven. ADHD is thought, at least partially, to have hereditary contributions. About 40% of children who have been diagnosed with ADHD have a parent who were diagnosed with ADHD as well. Although research has not determined for sure what does cause ADHD, they have ruled out several factors. Against popular opinion, it has been shown that eating sugar, watching excessive amounts of television, and environmental factors do not inherently cause ADHD. Although such factors may increase symptoms, they are not proven to be causational.

Causation is not the only thing researchers are trying to determine. As of right now, there is no single test to determine whether a patient has ADHD or not. This is partially because anxiety, depression, sleep problems, and various learning disabilities have symptoms that are similar to that of ADHD. In order to make a diagnosis, doctors will assess symptoms that a child has had within the past six months, then, they will gather information from teachers, family members, and caregivers in order to assess such symptoms. This includes current medical issues, personal family medical history, and school records. Proper examination will also be performed through means of a physical exam in order to check for other health problems or conditions. This includes such things as performing a medical test as well as a vision and hearing test.

Treatments

Following a diagnosis, people with ADHD are then entitled to treatments. Treatments typically include behavioral therapies, medication, or in some cases, both. One common form of therapy is called psychotherapy. Psychotherapy is the technical terminology for talk therapy. In talk theory, a medical doctor will talk to diagnosed children or adults about ADHD and how it affects one’s life, as well as possible ways to manage it. Another type of therapy is behavioral therapy. This type of therapy helps a child learn more about monitoring and managing the behaviors that come along with their ADHD (Segal, 2020). If a child or adult decides not to use therapy, then medications are also an option. Medications can be helpful for those living with ADHD. These medications are designed to affect brain chemicals with the purpose of better control over both impulses and actions. Medications typically take on one of two forms, as approved by the Food and Drug Administration. The first is a stimulant, while the second is a non-stimulant. Stimulants are the most common medication prescribed to children with ADHD. Stimulants’ purpose is to increase the dopamine that children with ADHD are otherwise lacking. If stimulants don’t work, then a non-stimulant medication might be a better option. Such medications work on increasing norepinephrine in the brain. Norepinephrine works to increase heart rate, blood flow, and blood pressure. Doctors will prescribe medication based on what type of ADHD a child exhibits. Just as a child continues to grow and develop, their ADHD type can also develop over time. This means that treatments may vary with time as well. While looking at medication options, patients ought to be aware that medications can produce various side effects. Such side-affects include decreased appetite, repetitive movements, headaches, irritability and insomnia. It can also result in mood swings or fatigue.

A study in the journal of Nutrition Research and Practice suggests that staying healthy will significantly help to manage symptoms. Doctors suggest developing healthy eating habits that include eating fruits, vegetables and whole grains. They also highly recommend participation in physical activities of some kind. Other recommendations include limiting screen time from computers, phones, TVs, and other electronics, as well as getting the right amount of sleep each night.

Teching Children with ADHD

Understanding ADHD, causation, diagnosis, and treatment options are all important. As a teacher, one can take that a step further. How do teachers ensure learning for students who have ADHD? Or in other words, what does an inclusive classroom look like for them? In the classroom, students may seem rather distracted, perhaps simply by staring out the widow, or are bouncy up and down and cannot keep still on their seats. Such behaviors can take away from instruction and disrupt the entire class. Students may demand attention, have trouble following simple instructions, and also may be prone to struggle when no direct supervision is present. The American school system requires students to sit still, listen quietly, pay attention, follow instructions, and concentrate. Children with ADHD struggle in this regard not because their brains simply won’t let them, not that they aren’t willing.

Teachers need to have the right mindset when teaching students with ADHD. A teacher must help integrate students in the three areas of accommodation, instruction and intervention. Accommodations include what a teacher can do to make learning easier. Instruction includes the methods a teaching is using in their instruction. Finally, intervention includes how a teacher intends to end the disruptive behaviors that present themselves in the classroom. That being said, the most effective tool is helping students with ADHD maintain a positive attitude. Finding ways to motivate a student will benefit greatly as well.

There are several things that a teacher can do to help make accommodations for students. Changing the seating or creating quiet space may help to diminish distractions. Seating students away from any windows and doors and towards the front of the classroom – when able – may also prove to be beneficial. Students with ADHD greatly benefit from repetition of instruction and the use of charts and pictures that they are able to refer to when needed. Furthermore, teachers can help organizations by providing specific homework folders and notebooks that record their intended purpose. For example, one folder might say “mail” while another might say, “completed homework.” Simply labels such as these will students ADHD maintain focus and a sense of control over the task presented to them.

Teaching students with ADHD goes beyond helping with the simple classroom makeup. During class time, teachers ought to make a specific point to establish eye contact, list activities on the board, and clearly state expectations. Students with ADHD need frequent breaks and therefore allowing that child a facet to release pent-up energy is really important. Finally, a simple accommodation may be that students diagnosed with ADHD are allowed a fidget toy or rubber ball to squeeze as a means to release some energy in a quiet manner. Such an outlet needs to be quiet as not to disrupt the rest of the class.

Conclusion

ADHD, or attention deficit hyperactive disorder is the most common neurodevelopmental disorder among children in the United States. Children with ADHD have trouble paying attention, have impulsive attitudes and may be overly active. While ADHD can be hard to diagnose, it is important that catch symptoms early on. Following proper diagnosis, treatments are important to begin and to stay on top of. Children with ADHD can go on to lead fulfilling lives. Teachers too need to be aware of accommodations and teaching strategies as they teach students with ADHD. Children who have ADHD are none the less children of God and therefore need to be treated as such.