HELP FOR STUDENTS with ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD)


For the third time today, Sami shouted answers out of turn, insisted on standing at his desk on one leg with the other leg hooked through his chair, and frequently scribbled on his neighbors books or papers.  During math class, the teacher had to call Sami’s attention back to the task at hand several times in a row, but consistently found him looking out of the window; his mind in another dimension.  Suddenly, Sami blurted out, “Wow! Check out that red bird! I think its a cardinal?”  With his outburst, the other students lost concentration on the teacher and rushed to see the cardinal.  Frustrated, the teacher put Sami in time out and tried to regain focus from the other students.


Sami’s behavior is typical for children diagnosed with ADHD.  Three to five percent of children present this type of behavior both at school and at home.  For a true diagnosis, the child usually shows several symptoms before the age of 7.  These symptoms include :

. Either A or B: (1)
  1. Six or more of the following symptoms of inattention have been present for at least 6 months to a point that is disruptive and inappropriate for developmental level:
    
Inattention
  1. Often does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities.
    
  2. Often has trouble keeping attention on tasks or play activities.
    
  3. Often does not seem to listen when spoken to directly.
    
  4. Often does not follow instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions).
    
  5. Often has trouble organizing activities.
    
  6. Often avoids, dislikes, or doesn't want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework).
    
  7. Often loses things needed for tasks and activities (e.g. toys, school assignments, pencils, books, or tools).
    
  8. Is often easily distracted.
    
  9. Is often forgetful in daily activities.
    
  1. Six or more of the following symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for developmental level:
    
Hyperactivity
  1. Often fidgets with hands or feet or squirms in seat.
    
  2. Often gets up from seat when remaining in seat is expected.
    
  3. Often runs about or climbs when and where it is not appropriate (adolescents or adults may feel very restless).
    
  4. Often has trouble playing or enjoying leisure activities quietly.
    
  5. Is often "on the go" or often acts as if "driven by a motor".
    
  6. Often talks excessively.
    
Impulsivity
  1. Often blurts out answers before questions have been finished.
    
  2. Often has trouble waiting one's turn.
    
  3. Often interrupts or intrudes on others (e.g., butts into conversations or games).
    
  1. Some symptoms that cause impairment were present before age 7 years.
    
  2. Some impairment from the symptoms is present in two or more settings (e.g. at school/work and at home).
    
  3. There must be clear evidence of significant impairment in social, school, or work functioning.
    
  4. The symptoms do not happen only during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder. The symptoms are not better accounted for by another mental disorder (e.g. Mood Disorder, Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).
    
Based on these criteria, three types of ADHD are identified:
  1. ADHD, Combined Type: if both criteria 1A and 1B are met for the past 6 months
    
  2. ADHD, Predominantly Inattentive Type: if criterion 1A is met but criterion 1B is not met for the past six months 
    
  3. ADHD, Predominantly Hyperactive-Impulsive Type: if Criterion 1B is met but Criterion 1A is not met for the past six months.

     

    The year 2000 Diagnostic & Statistical Manual for Mental Disorders (DSM-IV-TR) provides criteria for diagnosing ADHD. The criteria are presented here in modified form in order to make them more accessible to the general public. They are listed here for information purposes and should be used only by trained health care providers to diagnose or treat ADHD.

    ADHD can vary from  mild to almost debilitating.  Support from teachers and parents is a necessary component to any success children will make.  It is vital that both work together and consolidate their efforts.  There are many methods that can be utilized to help students focus, decrease hyperactivity, and increase ability and self esteem.  One of the most important factors for all children is that rules and expectations be consistent and fair.  

    One of the most important things for parents to do is provide an appropriate location free of distractions for their child to do homework or study.  Busy rooms with noise from a TV or computer can really interfere with ability to focus. Also having a regular schedule that is predictable helps students organize their time and efforts.  One of the best tools that can help ADHD students is a simple timer.  By setting a limit of time that the child must sit and focus helps them to manage time better, as well as focusing on the task in front of them.  When the time is up allow the child to get up and move around and do something that they like to do.  The time limit that the parent sets should be appropriate for the child’s age, such as 10 minutes for an elementary child, and possibly a half hour for middle and highschool students.  

    Allowing children to get up and move around and do physical movements such as jump rope or trampoline are excellent to get their blood moving again.This increases their ability to think and focus, as well as releasing tension and excessive energy.  For those students who still need to fidget while sitting at a task, the hand sized squeeze balls found in the dollar store are helpful and not distractive for other students if used during school.  Another useful tool is having a tag board reading window. This is a piece of tag or brief card in which a narrow long rectangle has been cut out with a razor and is big enough to fit the size of most sentences in their books.  By blocking out other sentences on the page, students can focus only on the sentence they are reading and move down in order.

    If students are sitting on double desks or tables with other students, a study cubical can be made out of poster board in order to block out other stimuli which might distract attention and concentration.  Teachers must be aware that such students should not be seated near doors, windows or the back of the classroom.  Doing so only increases the chance that their ADHD students will become distracted by outside movements.

    Another important skill that teachers should utilize is walking around the classroom while teaching, unless specifically utilizing the boards.  In this way students can be touched on the shoulder, or the desk tapped to call their attention back to reality if found day dreaming.  Some teachers also find that using tokens for positive behaviors such as following directions, staying on task until its completed, raising hands instead of blurting out (impulsively) and staying in their seat, brings great results.  These tokens can then be turned in for small prizes or privileges, such as taking papers to the office, extra time at the library or computer center  etc.

    It is vital that teachers and parents work together, be consistent, place more emphasis on positive reinforcement and ignore negative behaviors as much as possible.  In this way students will feel more interested in continuing the postive behaviors and will notice that negative actions bring less attention or better yet….. no attention at all.  Patience with your child and with yourself is very important, and to set clear expectations, rules and ideals will help your child fulfill his or her ability.  If you feel that more help is needed , then you should seek professional help in dealing with your child.  Remember however, that if you do choose to medicate, behavior modification is a must- for as soon as the medications are stopped, most children return to their previous habits.   Therefore, long term goals need to include behavior modification and positive support. 


    sakina-and-sara


FOOTNOTES:

  1. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), Text Revision. Washington, DC, American Psychiatric Association, 2000. 
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4 Responses to HELP FOR STUDENTS with ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD)

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  3. Chelsea says:

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