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Volume 3, Number 1: Assisting Learning and Success in ADHD Children

Assisting Learning and Success in ADHD Children

Katie Burns

Abstract

Attention-Deficit/Hyperactivity Disorder (ADHD) has become the center of controversy as Americans diagnosis children with ADHD at an ever increasing rate. Yet it seems at times that little is actually known about the disease beyond the accepted truth that a distinct disorder marked by inattention and hyperactivity does, in fact, exist. This disorder causes numerous problems within the classroom including classroom management and jeopardizing the education of all children in the class. One option to overcome these challenges is to place all ADHD children in a separate classroom, however this only serves to isolate the child and entirely exhaust the teacher. There are simple methods that can be learned by the teacher to help maintain order and facilitate learning in a classroom with one or more ADHD children.

In recent years Attention-Deficit/ Hyperactivity Disorder (ADHD) has become a buzz word both in and out of the education world; it has been the center of current controversies in the news, in education and even in private households. Researchers agree that there are grey areas attached with diagnosing ADHD, however, most contend that ADHD is a real, serious psychological problem affecting many youth today. It is important to understand exactly what ADHD is, the potential problems it may cause in the classroom, modifications to the classroom to ease difficulties of ADHD children, when individual learning plans (IEP) should be developed and appropriate adult, specifically teacher, response. Through the study and understanding of these few concepts much light can be shed on appropriate ways to approach teaching ADHD students.

Literature Review

Rief (2003) argued that ADHD is defined by approximately 15 different mini-definitions. ADHD is a chronic brain-based disorder that is a medical, developmental, physiological, neurological, behavioral and performance disorder that generally disrupts the overall function of a person with ADHD, specifically the executive functions. Executive functions are those functions which assist in; memory recall, planning, organizing, activation, alertness, self-regulation/self-control, prioritizing, flexibility, sequential thinking, setting goals, and developing and following a plan of action. Thus, because of an impaired executive function, children with ADHD often face academic challenges regardless of how intelligent or capable they may be.

Rief is supported by Mercugliano (1999) who asserted, more concisely, that ADHD “is characterized by an age-inappropriate level of inattention, with or without impulsivity and over activity, that occurs across settings, causes functional impairment, and cannot be attributed primarily to another disorder” (p. 831). Mercugliano further stated that “ADHD is currently defined by observable behavioral features that include a short attention span distractibility, impulsivity and over activity” (p. 831). Mercugliano’s definition is further simplified by Pennington (1991) who simply stated that “ADHD is defined in terms of problematic behaviors reflecting inattention, impulsivity, and hyperactivity” (p. 83). It is clear that ADHD is best defined by the marking characteristics of inattention, impulsivity and hyperactivity.

However, Pennington, like most ADHD researchers, believed that there is, at least a sub-type of ADHD that does exist and can seriously impede a child’s development process. Pennington claimed that the reason for these criticisms of the syndrome may simply be the result of a failure to accurately define symptoms. In other words, the symptoms hyperactivity and attention-deficit are simply not specific enough, thus people have called into question the validity of the syndrome. Pennington concluded that ADHD is a viable disorder but further research is required to develop a truly specific and encompassing definition of the syndrome and its symptoms.

Potential Classroom Obstacles

In a society that is infatuated with education, educators, parents and students alike must understand the effects that a syndrome, such as ADHD, can have on the education of a student. Rief (2003) asserted that ADHD “causes the most difficulty and impairment in school performance” (p. 70). Rief is supported by Power, Karustis and Habboushe (2001) who stated that “approximately 25% of children with ADHD have learning disabilities, including reading, math, and/or writing disorders. Regardless of whether they have learning disabilities, a strong majority underachieve academically” (p. 5). Furthermore, Dornbush and Pruitt (1995) cited that ADHD children exhibit 88% more difficulty assuming responsibility for work, require 77% more explanation from teachers, 58% display more anxiety and tension surrounding school and 78% display a genuine dislike for school. It is obvious from reports, such as these, that ADHD is the source of major crisis in the classroom for children living with ADHD.

Test taking is a further struggle for ADHD students. On the day of a test an ADHD student may be pushed over the edge of the arousal curve causing frustrations for the student, parents and teacher alike. Dendy (2000) argued that test failure was the result of two factors, the first being the failure of the student to complete homework or actually to sit down and study for the test. The second problem is that the student does not have enough time to finish the test. This can be compounded by the student becoming distracted during the testing period. Dendy continued to cite the third most common reason for school failure as the result of students “forgetting key assignments, tests and long-term projects” (p. 102).

In Dendy’s (2000) argument of the five most common reasons for school failure among ADHD students, he asserted that not doing homework/getting zeros is the number one problem. Power, Karustis, and Habboushe (2001) elaborated; declaring that “although surprisingly little research has investigated the homework difficulties of children with ADHD, it is clear that a majority of these children display more frequent and severe homework problems than their peers” (p. 7). These homework problems stem from the student’s “failure to write down homework assignments, failure to bring home assignments, unwillingness to begin work at the designated time, lack of persistence, distractibility, failure to complete work, conflict with parents, carelessness and failure to return assignments to the teacher” (p. 7-8). Additionally, Dendy (2000) asserted that ADHD students have difficulty with homework because they have an impaired sense of time that enables them to more easily procrastinate; waiting until the last minute to start homework and projects.

Modifications in the Classroom to aid learning

Having established that ADHD is a serious problem in the classroom, the debate over how to most effectively offer ADHD students an education begins. Some believe that ADHD students should be sent to separate special education classroom. Others believe that a pull-out system, in which students are included in normal classrooms for part of the day and then involved in special education classrooms for rest of the day, is the best option. Still others believe that ADHD students can be included in the regular classroom and should be expected to do the same work as normal children. While any or all of these methods may be employed at some point in an ADHD child’s education it is vital that the child first and foremost be given the opportunity to learn in a general education classroom, even if this requires accommodations from the teacher and school. Many adjustments can be easily made in the classroom; specifically in the areas of teacher training, classroom modifications, and communication with home; IEPs (Individual Education Plans) should be a last resort.

The most basic step in aiding ADHD students is to train teachers about the disorder and the resources that available to teachers and students. Pfiffner and Barkley (1998) asserted that “The educational success of children with ADHD involves…the presence of teachers actively and willingly engaged in the process of working with ADHD students…the teacher’s knowledge of and attitude about ADHD is critical” (p. 459). However, while it is apparent to Pfiffner and Barkley that teachers make the difference in an ADHD student’s education they also recognize that training regarding ADHD, and other behavioral problems, are rarely provided in education credentialing programs. Thus they call for information about ADHD to be imparted to teachers “through in-service presentations and by providing brief reading materials or videotapes” (p. 459). Likewise, Dendy (2000) promoted educators forming groups “who meet to brainstorm ideas to help struggling students” (p. 37). Dendy encouraged teachers to remember that they are not alone; they “don’t have to be the only teacher” (p. 37). Dendy also noted that teacher assignments are crucial because students “tend to do well in those classes where the teacher likes them and may fail the same subject with a teacher who doesn’t like them” (p. 38).

A recent study by Lauth, Heubeck, and Mackowaik (2006) reported that ADHD students have 20% more difficulty focusing and remaining on task than their normal counterparts. Thus it is obvious that if these students are to remain in the general education classroom adaptations must be made. Dornbush and Pruitt (1995) argued that “modifications will decrease anxiety and stress, maximize structure and predictability, enhance the student’s receptivity for learning and reduce undesired incidents between the impaired student, peers and teacher” (P. 33). Specifically, Dornbush and Pruitt advocated creating an emotionally safe environment within the classroom. This involves designing a classroom that attempts to build self-esteem, utilizes visual cues, allows for mistakes, establishes predictable rules and expectation, is flexible, and promotes respect. Specific ways of carrying out some of these modifications can vary from teacher to teacher and the effectiveness of each modification will vary with the student. However, Dornbush and Pruitt are clear that these are specific areas that teachers of ADHD students should look to modify.

In addition to the classroom alterations and teacher training on ADHD, educators believe that one of the greatest reforms is needed in the area of homework. Dendy (2000) asserted if homework becomes too stressful “a vicious cycle may develop [where in] the student returns to school upset because she did not complete her homework, fails to complete class work, and is assigned even more homework. During this cycle, the student’s behavior usually deteriorates rapidly” (p. 105). It should be the goal of the teacher and homework to encourage students in their school work, not discourage them. Pennington (1991) suggested that homework, and teaching in general, should focus on teaching metacognitive skills. Because “metacognitive intervention has shown dramatic success in improving skills among poor comprehenders and could be very helpful with ADHD” (p. 102).

Dornbush and Pruitt (1995) asserted that another key to educational success is establishing “daily communication between teachers and parents” (p. 39) because “the most important element necessary for success of the student is positive communication between the home and school” (p. 39). Dornbush and Pruitt’s assertions are reiterated by Pfiffner and Barkley (1998) who stated that “when both teacher and parents are knowledgeable about ADHD, have realistic goals, and are motivated to work with ADHD, effective collaborations are easily developed” (p. 460). Moreover, they recognize the bitter effects that can result if teachers and parents engage in the blame game. Teachers become frustrated and develop negative attitudes towards future students with ADHD often they also come to believe that medication rather than modifications are the answer. Parents tend to place all blame on the “failing” school system for their child’s difficulty in the classroom. “Parents and teachers need to dispel notions of blame and to work toward improving the fit between the child’s characteristics and the environments at school and at home” (p. 460).

Individualized Education Plans/Educational Placement

Once all modifications seem to be rendered fruitless the final option is placing an ADHD student in special education; in many cases removing them from general classrooms. In this case an IEP (Individualized Education Plan) must be developed. According to Dornbush and Pruitt (1995) an IEP is an individualized education plan which must include a statement of the student’s present levels of educational performance, a statement of annual goals and short-term objectives for the student, a statement of the specific special education and related services to be provided, the extent to which the student will be able to participate in regular education programs and the projected dates for beginning the special education and how long it is expected to continue. They must also include an objective method of determining, at least annually, whether the student is achieving the short-term objectives that have been set (p. 155). Obviously the IEP is a fairly intensive step in the educational process of a student and requires the collaboration of parents, a school representative, the teacher and the student if and when appropriate. The IEP is developed only after tests have been taken by the student and they have been interpreted by professionals. An IEP will determine the placement of the student, which should include the student in general education as much as possible. Pfiffner and Barkley (1998) claimed that for “the mild to moderate case of ADHD, accommodations to the general education classroom sometimes coupled with pharmacological treatment are sufficient” (p. 484). In severe cases they argued that other alternative learning environments should be explored. When placing a child it is important for professionals, teachers, parents and sometimes the student to be involved in the decision making process. Pfiffner and Barkley emphasized that despite the fact that ADHD is recognized as a debilitating disorder it does not automatically qualify a student for special services. Rather “educational guidelines for ADHD state that significant impairment in school performance in conjunction with a diagnosis of ADHD is necessary to qualify for special services” (p. 484).

Adult/Teacher Response to ADHD

It is interesting to note how, as a nation, we are quick to abandon those that are in desperate need for our attention. These people come in all shapes and sizes; from those recovering from a natural disaster to those that are afflicted with a learning disorder, such as Attention-Deficit/Hyperactivity Disorder (ADHD). It is our responsibility and privilege to offer help to our neighbors that are in need, including children with ADHD. In the classroom it is easy for teachers to focus on those children who display high levels of learning and achievement, after all these are the students that are our hope for the future; success with these students is more obvious and often more glorified. Thus ADHD students are all too often made out casts because of the negative ideas and associations that surround ADHD in and out of the classroom. Yet classrooms have students who are begging for help, sometimes these are simple classroom alterations other times it is the teacher making the hard choice to develop an IEP for a student and moving the child into a special education classroom. Regardless of how help is delivered love and compassion for these students are a must; not an option.

Colson (2005) discussed a trip that he and his wife, Patty took to visit their grandson, Max, at a special needs school. Colson described his grandson as a loving kid who was “excited at the prospect of showing us where he studied and eager for us to meet his teachers” (p. 198). One of the first things Colson noted about the school was the extreme dedication of Max’s teachers; the student-teacher ratio at his school is four teachers for a class of seven. His teachers work for hours and hours, day after day, and when the students go home at three o’clock the real work is just beginning. The teachers meet together to discuss the behavior of each student and based on their observations the teachers painstakingly plan the activities for the next day. Often their job demands a great deal of physical work as sometimes special needs children need to be gently restrained. Despite all the work and toil, the teachers were “all remarkably cheerful. In fact, they radiated joy” (p. 198-199). In fact, he added “a survey of teacher satisfaction revealed that helping children was the teachers’ primary motivation” (p. 199).

Colson (2005) observed a classroom that was void of visual stimuli because it could potentially distract children from their learning. Each child had a unique set of learning standards that matched their disabilities; Max, for example, was learning to work independently for twenty minutes. Max loves school. However, as Colson stood their taking in the sights and sounds of Max’s school his mind drifted to the thoughts, Why do we as society take such trouble with these kids? Why does the school system spend as much as $65,000 per year to tend kids like Max? Max is never going to graduate and go to college and get a productive job … [In fact] there’s a serious question about whether he will ever be able to take care of himself (p. 200). Colson continued to point out that even if he was not in school and Max was institutionalized that would cost more than $50,000 per year.

Colson’s thought process is not all that unusual or uncommon. Colson (2005) noted that is was based on an idea by Peter Singer, who is an ethicist at Princeton. Singer is said to be the most influential philosopher alive. Singer argued that the governing philosophy for society should be concern with creating “the maximum happiness or pleasure for the greatest number of creatures, human and animal alike” (p. 200). This philosophy is a form of utilitarianism.

Sproul (1986) stated that utilitarianism is a sister ism of pragmatism, the difference is that utilitarianism is focused on the group as opposed to the individual. Sproul cited two major problems with utilitarianism; the first is defining good and the second is the problem of justice. How does one define the “good of the group;” what is good for one may not be good for another. And in “asking the question, ‘Good for whom?’ we have merely postponed or evaded the question, ‘What is good?” (p. 86). To illustrate the second dilemma of utilitarianism Sproul told a parable about a farmer and two bums. The farmer worked hard to earn $10,000, while the bums did nothing. The farmer and bums found themselves in the same room and the bums decided that the farmer should give them each $5,000, leaving the farmer with nothing. This would give the greatest good to the most people, but is this fair/just?

Colson (2005) asserted that this utilitarianism mindset has been employed, even as recently as the twentieth century, to rid society of disabled persons. For example, in the 1930’s in Germany, prior to Hitler, the “brightest and best-educated people in Europe were openly advocating eugenics – selective human reproduction and elimination of the disabled” (p. 201). Euthanasia was legalized in Germany for those people that were stricken with disabilities. Shortly, after the legalization of euthanasia Hitler appeared on the scene and started the systematic practice of killing children that he deemed unfit for society. The problem is not limited to Germany or to the World War II era. Today, here in the states, a pregnant woman and her husband are informed that their unborn child could have neurological defects, which could be exhibited in a variety of ways. They are asked, by their doctor, if they want to abort their child.

As Colson’s (2005) visit at Max’s school continued he noted that his thoughts turned to another extension of utilitarianism; “why keep people alive when they’re miserable?” (p. 205). This of course is at the center of euthanasia and stem cell research debates. However, if we start killing disabled people for the sake of science and the greater good, we will soon run out of people. Then who will be next? Colson believes that “without a view of God, or at the very least a transcendent natural order, there is no intrinsic significance to life” (p. 209).

Colson’s (2005) thoughts returned to Max and his mother, Emily, who after along day of struggling and fighting sit down together to “draw in tears, celebrating their discovery and the new freedom [the toil] has brought into Max’s life” (p. 210). Colson acknowledged that in a utilitarianistic mindset this experience of drawing together is meaningless because Max’s life is meaningless. However, Emily will walk away from this experience with her son, just like all the other experiences, filled with intense joy. In fact he claimed that Max’s disability is “not a good thing – it’s part of the world’s brokenness. Yet that brokenness has been used to enlarge my capacity to love. That’s a very great gift. Paradoxically, Max has introduced joy into the lives of his teachers, his mother, his grandparents, and many others because of these costs, these sacrifices” (p. 211).

Discussion

In America today it sometimes feels that every other child you meet has been diagnosed with ADHD to some degree. In some aspects it feels as if ADHD has been the catch all to explain away a child’s struggle in school, or a child’s struggle at home to focus. Often the argument is made that ADHD and its treatment is really a treatment for the parent who does not want to admit that they are struggling to control their child. ADHD has become a hot topic in America. However, the research presented here by a variety of scientists, researchers, clinicians, educators and doctors create a strong case for the valid existence of ADHD.

The struggles of ADHD student’s demands compassion from the educator as he/she attempts to identify and understand the struggles that are specific to his/her student with ADHD. For educators, or future educators, it is imperative to understand, that inattention is not always the choice of an ADHD student nor is the level of their struggles in school. Once these ideas are understood, believed and supported by the teacher it is simply not enough to verbally encourage them as they struggle; resources, provisions and adaptations must be made for these students. Teachers who have taken the time to study or research the common problems of ADHD students are more open and sympathetic to the needs of these students. In some ways it is a wonder that college students majoring in education/liberal studies are not required to take classes on learning disorders and common syndromes, so that a teacher will be better equipped to meet the needs of a student who is struggling. A compassionate teacher, who has taken the time to learn about and understand the difficulties of the ADHD student, will be more effective at helping the pupil succeed in school.

There are simple steps that a teacher in a general classroom can take if they desire to effectively help and teach an ADHD student. Teachers need be educated about ADHD and its effects on students; this is the first step in developing teachers that are sensitive and open to working with ADHD. Once an ADHD student is identified it is important that teachers work to make small changes in the classroom that will contribute to the learning of the student. Further the teacher must endeavor to build a working relationship with parents that is free of blame, so that together they can help the child attain success. Finally, when the student is still struggling despite the best efforts of the teacher, it is time for the teacher to call for an IEP and provide the student with help that is necessary.

Having worked with children that are in special education classrooms, one can see how a person’s compassion for disabled children may be tempered by the degree of their disability. Those that were deemed severely disabled appeared as a nuisance and a waste of time, these children could not talk, walk, read, write, eat or even go to the bathroom on their own. They could do very little for themselves. Why then would men and women spend their day devoted to helping these children? After volunteering in a classroom of severely disabled students for just one summer it was clear; these people have more joy and excitement for life than most fully functioning adults. However, special education children have taught people to love the little things in life, to value the bubbles that come out of the bubble machine, to stare at the petal of a flower and enjoy its beauty. These children never vocalize your name but they expressed love as you watched their face light up with excitement when you came to read them a book. One summer led to another and now ten years later I am confident that there is a reason for students like this to be in school.

Those children with moderate to mild disabilities are no different; they also want to love and to be loved, after all this is the human condition. Specifically, children with ADHD deserve the opportunity to experience love and to express love as they learn. Sure, it may mean longer hours for a teacher or even a more draining day; but think of the parents who toil constantly to make life work for this child. Like the severely disabled children, there are moments when the ADHD student simply can not accomplish all that he/she needs to without the help of another person, such as a teacher or an aid. In providing this support the teacher is displaying love and compassion for the student who is all too often outcasted.

The fact of the matter is that it all comes down to love. Our greatest example of love is Jesus Christ. He laid down his life for all of us who struggle everyday. During the course of his ministry, time and time again he devoted his day to ministering to the needs of disabled and outcasted. There is no problem too big or too small to bring to Christ; He simply loved everyone around him. When summarizing the commandments Jesus stated that “You shall love your neighbor as yourself” (Matthew 22: 39, English Standard Version) is the greatest commandment second only to loving God with everything you have.

If, as Christians, we are to live this out then we must learn to love our neighbors, even our neighbors that are young children struggling with ADHD who may exhaust and overwhelm us. It is time to lay aside the negative ideas and beliefs we may have surrounding ADHD. Christ blesses those who follow Him. Perhaps a compassionate teacher working with an ADHD student will learn how to more fully love, enjoy life and to radiate joy, just as Max’s teachers had learned.

Perhaps it is unfair that school systems spend thousands of dollars investing in the lives of disabled children, but Jesus has called us to love the “least of these” (Matthew 25:40, ESV). ADHD, children are the least of these, and their teachers have a unique opportunity to love, teach and care for these students. They are a part of the flock that the Heavenly Father has blessed them with. The teacher can display love for these children by meeting their needs, whether that is developing an IEP or implementing classroom modifications, the little efforts of the teacher will be greatly rewarded. The teacher and student can embark on learning journey together in which both teach and both learn. After all according to Colson (2005) “a survey of teacher satisfaction revealed that helping children was the teachers’ primary motivation” (p. 199). Helping students, including those with ADHD, is why people enter the teaching profession.

Conclusion

ADHD is a plausible psychological disorder that is best defined by its characteristic behaviors of inattention, impulsivity and hyperactivity. The combination of these behaviors can prevent children from flourishing in the classroom. Teachers can counteract some of the effects of ADHD in the classroom by learning to recognize the syndrome and its symptoms. Additionally, teachers can make minor modifications in the classroom to help encourage learning in the ADHD student. However, the success of an ADHD child ultimately hinders on the love and care that teachers offer their students. Thus it is important that teachers and adults in general, determine how to best respond to these students; by embracing the outcast.

References

Colson, C. (2005). The Good Life. Wheaton, Illinois: Tyndale House Publishers, Inc.

Conners, C. (1999). Clinical use of Rating Scales in Diagnosis and Treatment of Attention-Deficit/Hyperactivity Disorder. The Pediatric Clinics of North America, 46(5), 857- 870

Dendy, C. (2000). Teaching Teens with ADD and ADHD: A Quick Reference Guide for Teachers and Parents. Bethesda, MD: Woodbine House Inc.

Dornbush, M. & Pruitt, S. (1995). Teaching the Tiger. Duarte, CA: Hope Press.

Lauth, G., Heubeck, B. & Mackowiak, K. (2006). Observation of Children with Attention- Deficit Hyperactivity (ADHD) Problems in Three Natural Classroom Contexts. British Journal of Educational Psychology, 76, 385-404.

Mercugliano, M. (1999). What is Attention-Deficit/Hyperactivity Disorder?. The Pediatric Clinics of North America, 46(5), 831-843.

Pennington, B. (1991). Diagnosing Learning Disorders: A Neuropsychological Framework. New York: The Guilford Press.

Pfiffner, L. & Barkley, R. (1998). The Treatment of ADHD in School Settings. In Barkley, R. (Ed.), Attention-Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment (p. 458- 490). New York: The Guilford Press.

Power, T., Karustis, J., & Habboushe, D. (2001). Homework Success for Children with ADHD: A Family-School Intervention Program. New York: Guilford Press.

Rief, S. (2003). The ADHD Book of Lists. San Francisco, CA: Jossey-Bass.

Sproul, R.C. (1986). Lifeviews: Make a Christian Impact on Culture and Society. Grand Rapids, Michigan: Fleming H. Revell.

Katie Burns is a senior at Azusa Pacific University. This article was adapted from a senior thesis, submitted in a senior capstone course. Professor Paul Flores was the supervising instructor.

 

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