What every teacher should know about Attention Deficit Hyperactivity Disorder (ADHD) - Part 2: Learning environment, teaching techniques, and classroom ethos

The Learning Assessment and Neurocare Centre 

Children with Attention Deficit Hyperactivity Disorder (ADHD) have developmentally inappropriate attention, hyperactivity and/or impulsive behaviour that can be disruptive in the classroom. In the second article of a two-part series for teachers, the Learning Assessment & Neurocare Centre point out the realities of the condition, and provide suggestions and strategies for working with children with ADHD.

Learning environments for children with Attention Deficit Hyperactivity Disorder

Create an organised educational environment:

• Have a quiet area that is available for all children.
  
• Make sure the classroom is well-organised, tidy and calm. 
  
• Teach children how to organise their desk, time, and so on. 
  
• Establish and display a daily routine. 
  
• Develop a clear system for keeping track of completed and uncompleted work; provide due dates for all assignments and make sure the child has copied them into their homework book.
  

Teaching techniques and the ADHD child

• Children with ADHD particularly need structure, routine, and predictability.
  
• Classroom setting is important with the child near the front, with minimised distractions, close to teacher with a good role model, ideally in small classes and with 1:1 attention.
  
• Be conscious of the hypersensitivity of the ADHD child to words, actions, situation, and so on as they often over-react to apparently minor - to the observer – triggers.
  
• Teach the child listening skills (stop work, put down your pen, look at the speaker).
  
• Repeat instructions and directions frequently.
  
• Break up the lesson into segments.
  
• Involve several different activities. 
  
• Try and involve the student in demonstrations. 
  
• Use visual aids whenever possible and agreed cues to maintain attention.
  
• Modify curricula: abbreviate assignments; increase work time, reduce the number of problems per page:  worksheets are better than books:  computers are excellent for ADHD children as they provide immediate feedback and a multisensory approach that prevents the child becoming bored.
  
• Use mistakes to demonstrate more positive ways for future learning rather than failure - remember that children with ADHD experience failure in many aspects of their lives.
  

The classroom and children with Attention Deficit Hyperactivity Disorder

• Be sensitively open about ADHD: hiding a problem makes it something to be ashamed of.  Every child in your class will have some area of weakness.
  
• Remember ADHD children have a medical problem that is difficult for them and difficult for you.
  
• It is also important to be aware that ADHD affects both boys and girls and that no two children with ADHD will appear the same or require exactly the same management.
  
• ADHD affects all IQ levels. 
  
• Remember, that those (often, but not only, girls) who have significant problems only with concentration (inattentive ADHD,) need help as much as those who are also hyperactive, impulsive or disruptive.
  
• Try and avoid regarding the child as a nuisance.
  
• Remember even with the best laid plans, there are always instances when a child cannot conform.
  
• A great deal of unease and embarrassment can be avoided when everyone working with the child is aware of and understands the condition.
  
• The key to success is for parents and teachers to work together with a common purpose.
  
• There needs to be an effective blend of warmth and firmness as a listening “coach”, encouraging and supporting the child with ADHD.
  
• Think of the child with ADHD as emotionally fragile and vulnerable.
  
• Try to promote and enhance the child’s self esteem - see your role as observing the behaviour and linking it to learning by reading the subtext of this behaviour.
  

Classroom ethos and the ADHD child

• Try to cultivate understanding and support between class members.
  
• Try to cultivate a relationship with parents. Don’t condemn or preach, and keep them regularly informed.
  
• There needs to be understanding, support and respect for each member of the team.
  
• The overall school ethos is crucial to the success of managing a child with ADHD. Often only slight changes of approach can make a huge difference both to the child and the teacher.
  
• The teacher’s attitude to a child in front of peers is very important.
  
• Have realistic expectations by having a good understanding of facts and the realities of ADHD.
  
• Remember, a teacher’s unprejudiced comments are vital for evaluation and monitoring of progress, especially before and after medical assessment.
  

Medication for Attention Deficit Hyperactivity Disorder

• Medication should be seen as an adjunct to teaching to allow the child to be “available” for good teaching and parenting strategies, which are still essential as part of overall management of child’s needs.
  
• It is important for teachers and the medical profession to work together without boundaries in the best interests of the child
  

The situation of the ADHD child

• Symptoms of ADHD may be mild, moderate or severe or combined with other conditions. Adults will, therefore, see variability in skills and maturity levels in these students.
  
• A child with ADHD is usually about a third less mature than his chronological age with a
  
• two to four year lag in age-appropriate developmental skills. They know what to do but don’t always do what they know.
  
• 40-50% of children with ADHD have at least one parent with the condition, and 30% have a sibling with the condition.
  
• Do not expect the child to become an angel overnight. Even when on medication, there will still be problems in some situations. This doesn’t mean all is lost, but does require a philosophical approach and understanding of the reality of ADHD. It helps one to get things into perspective. Remember, children with ADHD are not “problem children” but “children with a problem.” Symptoms of ADHD present lifelong challenges. ADHD is a life sentence. Untreated and misunderstood, it blights a childhood and prevents a future.  Understanding and support is the key to its freedom.
  
• Don’t forget that the child with ADHD usually has many positive qualities and skills that can be buried underneath the struggles of suffering from ADHD. The challenge is to discover and develop these to allow the child to achieve to their potential and enjoy a better quality of life.
  
• Most of all ensure that you have an up-to-and date informed understanding of the facts and reality of suffering from and living with ADHD and its appropriate management, so that you and your colleagues can provide essential support to the child and each other.