Attention deficit hyperactivity disorder (ADHD) is an internationally validated medical condition of brain dysfunction in which individuals have difficulties in controlling impulses, inhibiting appropriate behaviour and sustaining attention. As a result of these difficulties, a child or young person can experience a range of educational, behavioural, social and related issues.
Specific learning difficulties, such as dyslexia, dyspraxia and dyscalculia, occur in approximately 40 per cent of children with ADHD, while disruptive behavioural disorders, such as oppositional defiant disorder and conduct disorder, occur in about 50 per cent of cases. Finally, anxiety disorders occur in about 30 per cent of all individuals with ADHD.
Many factors need to be taken into account when helping children with ADHD cope with the educational, behavioural and social aspects of school. It is important to note, though, that the full range of issues must be considered; for example, there is no point in planning one-to-one support for before the school day starts if it is unlikely that the child will be able to get to school on time because his/her mother cannot get him/her out of bed and onto the bus.
Though academic and behavioural issues within the school programme usually appear to be high on the agenda, a main area of concern for children with ADHD is interaction with other children. Initially, pupils with ADHD can appear quite amusing within a group of learners, but the “class clown” effect soon wears thin, to be replaced by impatience and intolerance of the constant interruptions that can take place. This can lead to the isolation of the individual from his/her peer group.
In addition, many problems for children with ADHD stem from their inability to handle the wide variety of environmental stimuli they can be exposed to. They tend to operate most effectively when they have a consistent structure to rely on which provides them with the safety and security to stay on task and out of trouble.
Consideration must therefore be given at school to all non-classroom time, such as break/lunch-time and sports/activities, where socialisation problems between learners can and will occur. It is recommended that break times are as structured as possible with appropriate staff scheduled in to provide effective supervision.
Though the term ADHD is not included within the SEN Code of Practice, the Disability and Discrimination act (2003), which complements the Revised Code of 2001, provides clear guidance that ADHD is a disability and thus must be managed within schools, the workplace and the community.
For day-to-day management of learners with ADHD in the classroom, specific tried and tested strategies and suggestions are listed below. In some cases, these will simply confirm good practice, but the key is to develop consistent routines for learning while retaining the flexibility to deal with some of the minor distractions and incidents that will occur.
Key Strategies that should be employed include:
Medication is one option that may be considered to help children manage their ADHD. However, as stated in the latest NICE guidelines, “Drug treatment for children with ADHD should always form part of a comprehensive treatment plan that includes psychological, behavioural and educational advice and interventions”.
For any child on medication, communication between the family, physician and school is crucial. Although the decision as to whether or not to prescribe medication lies with the physician, the roles of the family and the school are essential in monitoring progress and ensuring successful outcomes for the child. Schools must maintain positive communication with parents; frequent telephone/text contact, parent teacher conferences and, in some cases, daily report cards are all vehicles to be considered.
Educating these children can be difficult and demanding but also extremely fulfilling. The key is to develop a compromise between adapting the school environment to the needs of the child and helping the child to adapt to the demands of the school.
Fintan O’Regan is a regular speaker on issues relating to ADHD and the author of a number of books on the subject, including ADHD and How to Teach and Manage Children with ADHD: