ADHD in Children

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Hey, the brakes don’t work!

Imagine a child on a bicycle speeding downhill. The world is whizzing by. The road takes a sudden curve. The wind whips his face and his eyes blur with tears. Suddenly, he spots a ditch up ahead. He tries to brake—but the brakes don’t work! As the bike’s momentum increases, it is all he can do to keep from flying off. Obstacles in his path cry out for his attention. Everything seems out of control. What are the chances he will avert a collision with the tractor trailer heading right toward him?

You now have some idea of the life of someone with Attention Deficit Hyperactivity Disorder (ADHD). It all comes from the difficulty of “Putting on the Brakes,” to borrow the title of a new book on the disorder by Patricia Quinn.

Another expert in the field, Dr. Russell Barkley, explains that for ADHD people, the front part of their brains where the controls are found doesn’t do a good job of putting on the brakes. This means that these people may:

  • Have trouble putting brakes on distractions. Their minds are pulled off the main topic by any competing action. This accounts for the “Attention Deficit” of ADHD.
  • Have trouble sitting still rather than methodically going about a task. This accounts for the “Hyperactivity” of ADHD.
  • Have trouble putting brakes on any thought that comes into their minds. There is trouble putting brakes on frustrations and over-reactions. This accounts for the “impulsivity,” an integral part of the condition.

Now imagine your world as a flashing kaleidoscope, where rapidly-shifting sounds, images, and thoughts are constantly derailing your attention and drawing you away from your work.

Imagine feeling bored to distraction yet helpless to focus on important tasks, and at other times driven impulsively from one activity to the next.

Picture yourself as a child, feeling unable to wait your turn or restrain yourself from blurting out comments as your teacher or parent is speaking. Even though you know full well the negative consequences you will suffer from your behavior, you easily become oppositional and answer back to authority.

Visualize being so disorganized you are constantly losing things, losing track of time and forgetting important obligations. You are so distracted you don't notice when someone speaks to you, when the phone rings or someone is honking at you to get your attention.

For children with ADHD, the above scenarios are all too familiar. Individuals with this neurological disorder may be unable to sit still, wait on line, plan ahead, finish tasks, concentrate or be fully aware of what is going on around them.

They often have problems with delaying gratification or taking “no” for an answer. They may exhibit social problems due to their tendency to engage in provoking behavior, and to lash out and overreact to small annoyances.

Yehuda

Yehuda, age 9, has more energy than most boys his age. But then, he's always been overly active, his parents testify. Starting at age 3, he was a human tornado, hurling himself from one activity to the next, triggering chaos wherever he paused on his hi-speed trajectory through the house.

He was reckless and impulsive, running into the street and several times almost colliding with oncoming cars.

On the playground, his tendency to overreact created friction with other children. He would push or punch playmates simply for bumping into him—behavior that continued even as he got older. He lost friends and complained about being picked on.

ADHD can only be identified by looking for certain characteristic behaviors, which vary from person to person.

In the classroom, Yehuda was constantly getting out of his seat, calling out of turn, and blurting out wisecracks. He was incapable of quietly waiting his turn.

His parents were at their wits’ end. What was wrong with their child? It was if he were two people, charming and affectionate at times, but more often excitable, uncontrollable and exasperating beyond endurance.

Children and teens with ADHD—studies show the neurological deficit affects as many as 2 million American school children—may seem to be rebellious, socially maladjusted or so “spaced-out” that they appear abnormal. The condition often continues into adulthood, undermining relationships and job performance, and causing untold emotional pain.

Unlike a broken foot or an ear infection, ADHD does not have clear physical signs that can be seen in an x-ray or a lab test. ADHD can only be identified by looking for certain characteristic behaviors, which vary from person to person.

ADHD or a Look-Alike?

Not everyone who is hyperactive, inattentive, or impulsive has an attention disorder. Since most people sometimes blurt out things they didn't mean to say, dash from one activity to another, or become disorganized and forgetful, how can specialists tell if the problem is ADHD?

To make a correct diagnosis, specialists consider several critical questions: Are these behaviors long-term? Are they continuous, not just a response to a temporary situation? Do they occur in different settings or only in one specific place like the playground or in the classroom?

“The behavior must appear early in life, generally before age 7, and continue for at least 6 months,” National Institute of Mental Health specialists say. In children, they must be more frequent or severe than in others the same age.

Above all, the behaviors must impair functioning in at least two areas of a person's life, such as school, home, work, or social situations, explains the National Institute of Mental Health. So someone whose work or friendships are not impaired by these behaviors would not be diagnosed with ADHD. Nor would a child who seems overly active at school but functions well elsewhere.

Getting a Handle On It

Life can be hard for children with ADHD. They're the ones who are so often in trouble at school, can't finish a project, and lose friends. They may spend torturous hours each night struggling to study for a test or complete homework assignments, then forget to bring the work to school.

It's not easy coping with these frustrations day after day. Some children vent their frustration by acting oppositional, starting fights, or damaging property. Some channel the frustration into physical ailments, like frequent stomachaches or headaches.

It's especially challenging being the teacher of such a child. Pushed to the limits of their patience, teachers sometimes find themselves ridiculing, or screaming at the child, even though they know it's not appropriate

Although medication is often recommended to help control the ADHD child’s behavior problems, the subject of medication—whether to administer, what kind, how much, and for how long—is beyond the scope of this article.

Our aim is to present some helpful tips to teachers in managing an ADHD child in the mainstream classroom and in helping the child to build self-esteem and achieve success.

Tailoring the Curriculum

How do we ensure that a child will remain motivated and succeed at a given task?

  • Modify the assignment, but privately, to avoid embarrassing her.
  • Give shorter lessons and more of them, which makes it easier for children to stay focused.
  • Acknowledge even partial success and extend approval generously.
  • Compliment even in mid-assignment to encourage continued focused performance
  • Make corrections with a light hand. Instead of “try harder next time,” try – I see how hard you tried. Keep up the effort. It’s really paying off.

 

Keeping the Inattentive Child Focused.

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  • Smile, make eye contact with child, pat her on the back or otherwise make contact, where appropriate.
  • Use his name in the lesson or example that is being taught to the entire class.
  • Tap on the desk (or use other code) to bring the child back into focus.
  • Alert child’s attention with phrases such as “This is important.”
  • Break down longer directions into simpler chunks.
  • Check for comprehension.
  • Encourage child to underline the key words of directions.
  • Encourage him to mark incorrect multiple-choice answers with an “x” first. This allows them to “get started” quickly, while forcing them to read all of the choices before making a final selection.
  • Allow physically hyperactive children out of their seats to hand out and pick up papers, etc.
  • Compliment a child, publicly, at least once daily, on some organizational or attentional task or effort.
  • Take a moment or two once or twice daily to speak privately to the student; give a two-second pep talk, mention something positive you happened to notice regarding student’s work, behavior, self-control, focusing, etc.

 

Organizational Help

First, recognize that disorganization is a major disability for almost everyone with ADHD. In fact, when organizational problems are not in evidence, a diagnosis of ADHD is unlikely.

Ensure that parents and child all know the correct assignment. The following options can be used. This part will take work, especially to keep the system going:

  • Inform about typical routines (such as vocabulary quizzes on Fridays).
  • Hand out written assignments for the week.
  • Initial student’s homework assignment pads after each period.
  • Notify family immediately of any late assignments.
  • A phone call takes the child out of the loop, and works best.
  • Modify lesson/ homework assignments so child can at least attempt completion and feel successful.
  • Give additional time for tests/assignment
  • Return tests to redo parts that were done impulsively.
  • Provide oral supplementary questions to tests.
  • Buddy system for cooperative learning, whether for tests and reg. assignments
  • Alternatives to tests: research, project, report, etc

Above all—and this applies to all children not only those with ADHD—when you have to discipline, make sure to do so without anger and without vindictiveness. It may help to imagine that you are caught going through a “stop” sign. The policeman stops you and gives you your well deserved ticket. How would you like it if he handed you the ticket and yelled at you at the same time—ridiculing and insulting you because of your misdemeanor?

When you hand out punishment, do it with respect. Leave the child’s self-image intact. Invest in kindness, no matter how provoking the situation. You may not see results right away but that investment will one day yield a huge return.

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