Social and Cultural Foundations of American Education/Special Needs/ADD

How can we learn to understand children with ADD?

Teaching children can be a difficult task because they all tend to be different. Some learn fairly quick while others may take longer. Some are quiet and attentive and some are not. Imagine trying to teach a child with a learning disorder. A disorder called Attention Deficit Disorder. To know how to teach a child with ADD, we must first educate ourselves on the subject.

Please note the style of the paragraph above, characterized by sentence fragments and statements that do not follow from preceding statements in a logical and orderly fashion. Such are the hallmarks of the prose generated by students suffering from ADD.

What is ADD?

Attention Deficit Disorder "is a neurological syndrome whose classic defining triad of symptoms including impulsivity, distractibility, and hyperactivity or excess energy" (Driven to Distraction, 6). It is not a learning disability, it is a learning disorder; it "affects 3 to 5 percent of all children, perhaps as many as 2 million American children" (Mathews ix). ADD affects more boys than girls. Children with ADD have a hard time focusing on things like school work, but they can concentrate on things they enjoy doing like playing games or watching their favorite cartoons or writing sentences without punctuation. These children tend to get into a lot of trouble, because they "engage in risky behaviors, get into fights, and challenge authority" in order to stimulate their brain, since their brain can not be stimulated by normal methods (Lawlis 7). ADD affects relationships with other peers because other children can not understand why they act the way that they do or why they spell they way they do or that their maturity level is different. ADD children like to play with younger children because they can relate to them better. Sadly, there are no cures for ADD but some people do grow out of it. The others usually learn how to deal with it. No one has been able to prove what causes this disorder, but there are some theories. These theories include environmental agents such as the use of cigarettes and alcohol while pregnant, a brain injury, food additives, sugar, and genetics(NIMH 7). Children with ADD have a hard time focusing and are easily distracted, but with teachers that are educated on the subject, and know to use "who" instead of "that" to refer to people, will know what kinds of strategies to use in order to teach children with the disorder. ADD and ADHD are believed by some researchers to be caused by various biochemical malfunctions of the brain. Specialists are finding that diet, exercise, nutritional supplements, and parenting strategies can either take the place of, or supplement prescription medications. Dr. Daniel Amen, Assistant Clinical Professor of Psychiatry and Human Behavior at the University of California, Irvine School of Medicine, has shown in his research that there are actually 6 distinct types of ADD, each with a different approach to treatment.

Types of ADD

There are two types of ADD; they are hyperactive-impulsive (ADHD) and inattention. The difference is the ADHD child can not stay still for even a minute and the inattentive child daydreams. One thing they do have in common is the inability to stay focused without help. They must be constantly reminded of a task to keep them from being distracted by something else.

ADHD

In 1845, Dr. Heinrich was the first to describe ADHD. He wrote a poem called "The Story of Fidgety Philip". "This was an accurate description of a little boy who had ADHD" (NIMH 2). Children with ADHD are in fact fidgety; they are constantly moving some part of their body, jumping and climbing, even in places where they should not. They wiggle around in their seats, tap their feet on the floor, talk a lot, etc... They do things without thinking first like blurting out an answer before the teacher calls on them or crossing the street before looking both ways. They have a hard time taking turns, for example, on the slide at the playground or waiting in line for the water fountain. These children are full of never ending energy. Dr. Grant Martin, author of "The Attention Deficit Child," did an interview with a family that had a child with this disorder and this is what they had to say: "Whenever we take Fred out in public, we spend all of our time reminding him to sit down or be quiet. He never stops. He's impossible to take to church, so we've about decided not to go anymore. He's always moving ninety miles an hour" (3). Parents who have to deal with this problem are usually left feeling embarrassed and wondering "where did we go wrong?"

Struwwelpeter by Heinrich Hoffmann The Story of Fidgety Philip "Let me see if Philip can Be a little gentleman; Let me see if he is able To sit still for once at table." Thus spoke, in earnest tone, The father to his son; And the mother looked very grave To see Philip so misbehave. But Philip he did not mind His father who was so kind. He wriggled And giggled, And then, I declare, Swung backward and forward And tilted his chair, Just like any rocking horse;- "Philip! I am getting cross!" See the naughty, restless child, Growing still more rude and wild , Till his chair falls over quite. Philip screams with all his might, Catches at the cloth, but then That makes matters worse again. Down upon the ground they fall, Glasses, bread, knives forks and all. How Mamma did fret and frown, When she saw them tumbling down! And Papa made such a face! Philip is in sad disgrace. Where is Philip? Where is he? He's fallen on the ground, you see. Blood is spurting up and from him- He has pulled a knife down on him! What a terrible to-do! Philip has been cut in two! Here a knife, and there a fork... Philip, this is naughty work. Table all so bare, and ah! Poor Papa and poor Mama Look down upon their child's corpse And begin to cook a second course. http://www.fln.vcu.edu/struwwel/philipp_e.html

Inattention

Unlike ADHD, inattention children can sit still but often drift off into space and daydream. Anything can catch their attention and distract them. Some distracting things can be air conditioners, a fan blowing a piece of paper around that is taped to the wall, a bird outside a window, or some one walking down the hallway. "Children who are inattentive have a hard time keeping their minds on any one thing and may get bored with the task after only a few minutes" (NIMH 3). They are forgetful and unorganized. They will forget to write down directions for homework, misplace their homework, forget to bring their books home so that they can do their homework, and make a lot of careless mistakes. Dr. Grant Martin, author of "The Attention Deficit Child," did an interview with a family who had a child with this type of ADD and this is what they had to say: "Sally daydreams constantly. We know she's bright, yet she's flunking several of her classes. The other day her dad and I struggled with her for several hours to get her homework done. At first she said she didn't have any. We checked her notebook and found the assignment sheet. She was tearful, but we finally completed the two pages of math. And would you believe it, the next day we got a call from her teacher telling us Sally hadn't turned in her work" (3). This situation can leave the child's family and teachers racking their brains trying to figure out how a child can struggle through all of that hard work and forget about it so soon after.

The Ritalin Controversy

Of all the issues that surround AD/HD, the use of psychostimulainte drugs like methylphenidate (Ritalin®), dextroamphetamine (Dexedrine®), and amphetamine (Adderall®) is probably the biggest and most controversial. Many American adults and teens have been exposed to Ritalin as the wonder drug that most effectively treats AD/HD, but unless they have taken it or they have a child that is taking it, few are fully aware of its negative physical and social side effects. Since children spend so much time in school, teachers end up playing a large role in assessing behavior and identifying symptoms associated with AD/HD which could lead to Ritalin being prescribed. Therefore, the more informed teachers are about Ritalin, the better they can join together with parents and doctors to make the best decisions for the child. Ritalin was first patented in 1954 by the CIBA pharmaceutical company. It was not used in the treatment of AD/HD until the 60's, and is currently the most prescribed drug for AD/HD in the world. (Wiki) Although many studies have shown that Ritalin decreases the three main symptoms of AD/HD (inattention, hyperactivity/impulsiveness, and aggression) there are also many negative side effects. Ritalin is known to create: loss of appetite, difficulty sleeping, headaches, stomachaches, and even contribute to the development of a tic. Beyond the negitive physical aspects of Ritalin use, there are many social problems that have arisen as Ritalin has become more widely used. The DEA reports Methylphenidate, a Schedule II substance, has a high potential for abuse and produces many of the same effects as cocaine or the amphetamines. The abuse of this substance has been documented among narcotic addicts who dissolve the tablets in water and inject the mixture. and the increased use of this substance for the treatment of ADHD has paralleled an increase in its abuse among adolescents and young adults who crush these tablets and snort the powder to get high. Youngsters have little difficulty obtaining methylphenidate from classmates or friends who have been prescribed it. Greater efforts to safeguard this medication at home and school are needed.(usdoj.gov) Perhaps the least studied but equally important side effect Ritalin can cause is behavioral. A child could learn to associate taking a pill with "being normal" or acting responsibly. It isn't hard imagine a parent or teacher who is tired of struggling with a difficult child and turns to Ritalin for their own relief instead of exhausting other solutions that don't use drugs.

Social Acceptance

Anthony Kane, a MD physician, stresses the importance of healthy peer relationships for the normal development of a child. Statistics show that 60% of children who have ADHD suffer from peer rejection. “ADHD children are more frequently disliked or neglected by their peers. It is difficult to determine the factors that make a child unpopular, but children who frequently display aggressive or negative behavior are more likely to be rejected by their peers” (Kane). Many of the symptoms of that a child experiences with ADHD for example, being out of their seats or yelling at inappropriate times, causes them to behave differently than their peers who do not have this disorder. In result, children with ADHD are often rejected because they appear to be different.

It is important to try to help children with ADHD who lack the appropriate social skills early on because as they get older their social skills seem to get worse. If their inappropriate behavior continues it could lead to further social rejection and the inability for them to relate to others. (Kane).

Good Teaching Strategies

Teachers can do several things to help an ADD child stay better focused in the class room. They can place the child away from any distractions. For example, sitting them close to the teacher's desk turned where they can not see the other children or siting them closer to children who are well behaved and remember to raise their hand and wait to be called on can be a good influence. Writing directions and assignments on the board are good ideas since ADD children often have problems focusing long enough to hear them. The teacher can use a folder or a notebook to put homework assignments in to send home everyday and have the parents sign it to be sure their children brought it home. The teacher also needs to make known what classroom rules are and what the consequences will be if a rule is broken. According to Sandra Reif, author of "How to Reach and Teach ADD/ADHD Children", "Time outs or time aways for ADHD students are necessary...these children often can't handle all of the stimulation in a classroom and become worked up and sometimes out of control" (20). Positive reinforcement is "the best behavioral management strategy and the one that builds self-esteem an respect" (Reif 20). Teachers should always look for positive actions from the children and praise them for it; by doing this, the child might feel better about themselves and will want to do more good things in order to receive more praises. If the child only hears negative things about themselves, they tend to give up and act out. They already feel like outsiders because they do not relate to children their own age that well due to their maturity level. Teachers can say something like, "I am very proud of you for waiting your turn" or "Thank you for being so polite." Rewards can also be given for good behavior at the end of the week; this gives children a reason to want to do well in school. Rewards work well, since ADD children can focus on things they like. Depending on the child, in some cases, the ADD child may need to go to a special education class for part of the day or see a tutor for one-on-one time. And in extreme cases the child may need to go to a school that specializes in ADD children.

Most teachers are aware that every child is different and that each child learns better under certain circumstances. There are several tips that teachers can use in their classroom to meet the needs of the children in their class who have ADHD. Chris Dendy suggest these following accommodations: un-timed tests, use of calculator or computer, modification of assignments (ex: few math problems but still masters concepts), reduced demands on limited working memory capacity, written homework assignments given by teachers, and utilization of note takers or guided lecture notes. He also suggest that accommodations should be individualized to best meet the needs of each individual who may have ADHD.

Another study gives more vital information on how teachers can provide a proper learning environment and how to give instructions to students with ADHD. This study published by ERIC lists several tips on how to establish a better learning environment:

• Seat students with ADHD near teacher’s desk but still include them as a part of the regular class seating.
• Place them up front.
• Surround them with good role models.
• Encourage peer tutoring.
• Avoid distracting stimuli such as, as air conditioners, high traffic area, or doors and windows.
• Avoid change.

There are also helpful tips for teachers while giving instructions to children with ADHD. These tips include:

• Maintain eye contact during verbal instruction.
• Make direction clear and concise. Be consistent with daily instructions.
• Simplify complex directions.
• Make sure students comprehend the instructions before beginning the task.
• Repeat instructions in calm, positive manner, if needed.

There are many other strategies that teachers can use to not only help keep order in the classroom but to help the child as well. Some strategies to manage the behavior of a child with AD/HD involve using progress charts to reward good behavior and to give the student opportunities to release energy and stay involved with the classroom by having them run errands, erase chalkboards, or pass out materials. Teachers can also help these students stay on task by repeating a short, simple version of the directions throughout the assignment, having students highlight important information on worksheets, and by breaking the assignment down in parts. Other things teachers can do that benefit an AD/HD student in the classroom is giving them lots of examples when teaching a new idea, using a game or manipulative format for lessons, and allowing the student more time to complete difficult assignments or tests. Something important that teachers should keep in mind is that being patient, consistent, having high positive expectations and using positive reinforcement instead of punishment are all influential characteristics when dealing with AD/HD children. (McIntyre)

Conclusion

Children with ADD have a learning disorder that causes them to have a hard time concentrating on things, especially in school. There are two different types of ADD; they are hyperactive-impulsive (ADHD) and inattention. Both types have different symptoms but share the inability to focus. Teachers are usually the first to recognize if a child has ADD and are a reliable source in making the diagnosis since they are around other children in the same age range. Teachers can work with ADD children and used certain teaching strategies to manipulate the minds of ADD children to help them focus better. The diet changes recommended are to: Increase protein intake, especially at breakfast. Examples would be bacon and eggs, or even a protein bar or shake (for those who are rushed in the mornings); Increase complex carbohydrates, such as vegetables, fruit, whole grains and beans; Decrease simple carbohydrates, such as white bread, white rice, white potatoes, sugar, and other sweets. Supplements can be as simple as "Attentive Child" TM, which has many of the individual ingredients found to increase dopamine levels and blood flow to the brain. DHA from purified fish oil has also been shown to help with mood, memory, and neurological function. The exercise recommendations are for 30-45 minutes of aerobic exercise 5 times a week. Parenting strategies are to ask the questions and check the answers. "Let me see your homework assignments for this evening", would be a good example. Check the homework once it is finished, even better is to sit with your child as they do the homework to make sure they understand the concepts. Passive parenting does not work with a child with ADD. Speaking from experience, I have Combined ADD and my daughter has Inattentive ADD (she could be the poster child!). Diet, supplements, and exercise have made a positive difference in my daughter, both at school and at home.

Multiple Choice Questions

Click to reveal the answer.

What is ADD?

A. A disability.

B. A handicap.

C. A disorder.

D. Laziness.

C. A disorder.

What are the two types of ADD?

A. Hyperactive-impulsive and inattention.

B. Excitability and laziness.

C. Disabled and enabled.

D. Very active learner and very slow learner.

A. Hyperactive-impulsive and inattention.

What do children with ADD have a hard time with?

A. Playing

B. Sleeping

C. Focusing

D. Talking

C. Focusing

Caitlyn can not sit still for any amount of time. She is fidgety and talkative. If Caitly has ADD, what type would it be?

A. Excitability

B. Hyperactive-impulsive

C. Inattentive

D. Enabled learner

B. Hyperactive-impulsive

Nathan's teacher complains that he daydreams most of the day, and he never finishes his class work. If Nathan has ADD, what type would it be?

A. Laziness

B. ADHD

C. Slow learner

D. Inattention

D. Inattention

The first doctor described ADHD in 1845 in a poem titled, "____________________".

A. The Story of Fidgety Francis

B. The Story of Fidgety Philip

C. The Story of Fidgety Paul

D. The Child that Couldn't Stop Moving

B. The Story of Fidgety Philip

___________ are usually the first to see signs of ADD.

A. Parents

B. Relatives

C. Teachers

D. Counselors

C. Teachers

Ritalin can produce the same effects as ___________.

A. Heroin

B. Morphine

C. Cocaine

D. Vicodin

C. Cocaine

What amount and frequency of exercise should an Inattentive ADD child receive?

A. 30-45 minutes, 5 times a week.

B. 10-15 minutes, during recess.

C. None, it makes them hyper.

D. 60 minutes, twice a week.

A. 30-45 minutes, 5 times a week.

What is a good strategy to help a child release hyperactive energy during class time?

A. Allow them to roam the school.

B. Let them pass out materials.

C. Instead of teaching, let the children play games.

D. Make them sit still with their head down.

B. Let them pass out materials.

What characteristics should a teacher try to use, especially while instructing ADHD children?

A. Have patience.

B. Have reachable but high expectations.

C. Use positive reinforcement.

D. All of the above.

D. All of the above.

What could a teacher do to make sure an ADHD child finishes their assignment?

A. Repeat simple instructions

B. Collect their work if they misbehave

C. Break assignments down into smaller parts

D. Both A & C

D. Both A & C

Essay Question

Click to reveal the answer.

What are some teaching strategies that a teacher can use to help keep an ADD child's attention? There are no right or wrong answers.

There are a variety of teaching strategies, for students diagnosed with attention deficit disorder (ADD). These methods may vary depending on the needs of the child. Here are some ideas that are typically successful when working with students diagnosed ADD. A teacher should placing a child with ADD close to a child who is self-disciplined, so the other child can set a good example of what the child with ADD should be doing. Also, avoid placing a child with ADD in an area with many distractions, for instance around the door, window, or another child with a disability. Following directions is hard for students with ADD, so writing directions on the board can compensate for problems listening and remembering instruction. Another tool for following directions is using a notebook or planner, so the student can have permanent reminders of what they should be doing for homework or an in-class activity. The problem maybe remembering the planner everyday! Another factor with students with ADD is that they might have problems calming down. Sometimes these children need a break from the stimuli to prevent behavior problems and to quickly correct them. Praise is beneficial tool for all students, including those with special needs. Every child, even the most misbehaved child, does something right in a day, and they should be aware that they can do something well. Many strategies will be needed when working with students diagnosed with ADD, but taking the time to make accommodations can lead to a highly functioning child and classroom. —Jamie Kaufman

References

• American Psychological Association. (2006). APA cites critical gaps in evidence for current treatment of children’s behavioral and mental health problems. Retrieved November 9, 2007 from http://www.apa.org/releases/children_meds.html.
• "Attention Deficit Hyperactivity Disorder (ADHD)." Medline Plus. 2005. A.D.A.M., Inc. 18 Jul 2006 <http://www.nlm.nih.gov/medlineplus/ency/article/001550.htm>.
• "Attention Deficit Hyperactivity Disorder." NIMH. 1996. National Institute of Mental Health. 18 Jul 2006 <http://www.nimh.nih.gov/publicat/adhd.cfm>.
• Dendy, Chris A. Zeigler. (2000). Teaching Teenagers with ADD and ADHD (The ABC’s of ADD and ADHD! – Impact on School Performance). Revised from Appendix C, Teenagers With ADD (1995). Retrieved 15 June 2007 from adders.org. http://www.adders.org/info135.htm
• Hallowell, M.D., Edward M., and John J. Ratey, M.D. Driven to Distraction. New York, NY: Touchstone, 1994.
• Hoffmann , Heinrich Fidgety Philip. Retrieved February 25, 2007, Web site: http://www.fln.vcu.edu/struwwel/philipp_e.html
• Kane, Anthony. (n.d.). Why Other Children are Rejecting Your Child. Retrieved 19 June 2007 from Edu.org. http://edu.org/why_other_childre_are_rejecting_your_child.php
• Lawlis, Dr. Frank. The ADD Answer. New York: Viking, 2004.
• Mathews, Dawn D. Attention Deficit Disorder Sourcebook. First ed. Detroit, MI: Omnigraphics, 2002.
• Martin, Dr. Grant. The Attention Deficit Child. Colorado Springs: Chariot Victor Publishing, 1998.
• McIntyre, Ph.D., T. March 4, 2004. Strategies for Teaching Youth with ADD and ADHD. <”http://www.ldonline.org/article/13701”>.
• Methylphenidate (n.d.) Retrieved March 9, 2007 from http://www.usdoj.gov/dea/concern/methylphenidate.html
• Rief, Sandra F. How to Reach and Teach ADD/ADHD Children. West Nyack, NY: The Center for Applied Research in Education, 1993.
• Rief, Sandra F. The ADHD Book of List. San Francisco, CA: Jossey-Bass, 2003.
• Ritalin. (n.d.) Retrieved March 9, 2007 from http://en.wikipedia.org/wiki/Ritalin
• "Teaching Children with Attention Deficit/Hyperactivity Disorder." (1998). The ERIC Clearinghouse on Disabilities and Gifted Education. The Council for Exceptional Children. Retrieved 15 June 2007 from http://ericec.org/digests/e569.html
• "What is ADHD? Reviewed by W. Douglas Tynan." (2005). Retrieved 16 June 2007 from KidsHealth. http://www.kidshealth.org/parent/medical/learning/adhd.html