Managing ADHD in the classroom

November 2017

 

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JODY HOPKINSON talks to a clinical psychologist, a teacher and parents about what teachers can do to help Kiwi kids with ADHD in the classroom.

ADHD

While ADHD is well known, it is all too often not well understood. Misinformation and a lack of information means children with the condition, often co-occurring with dyslexia and oppositional defiance disorder (ODD), are regularly stigmatised, says clinical psychologist Dr Sarah Watson.

Dr Watson is a clinical child and adolescent psychologist. At her Auckland private practice, Totally Psyched, she works with children and families and provides teachers with professional development, strategies and ideas about what works best for their classrooms.

“As a result of ADHD, children have ways of behaving which can impede the child’s ability to learn in school and isolate them in relation to other students because of things like not waiting their turn, over talking and having a limited idea of what is personal space, for instance,” she explains.

ADHD is a neurological condition that affects the way the brain receives, processes and responds to information. It is divided into three sub-types: the inattentive type (formerly called ADD) which is characterised by inattention to detail, not listening when spoken to and being slow to process information; the hyperactive-impulsive type which is characterised by moving and fidgeting, talking nonstop, and acting without thinking through the consequences; and the combined type which features some or all of the inattentive and hyperactive-impulsive characteristics.

Students with ADHD can it find challenging to settle into class and stay on track, grasp and retain information, and they may find it difficult to regulate their emotions and to make friends and socialise, explains Watson.

“Research has shown that kids with ADHD don’t feel things more intensely than other kids – it’s that the frontal cortex of the brain takes longer to develop, so those kids’ ability to self-soothe is behind, their need for rewards and reminders greater and they tend to live in the ‘right now’.”

Children with ADHD can often display a number of strengths including persistence, creativity, enterprise and a willingness to take risks. They can also exhibit leadership abilities, empathy, sensitivity and a good sense of humour.

“Research has shown the ADHD brain is structurally different. It can be that the prefrontal cortex is more immature. It’s the last part of the brain to mature. With some, that can change over time and improve through adolescence so they would no longer meet criteria for ADHD; for others it matures more through adulthood; while for others it will improve but they still have symptoms in adulthood.”

Fortunately there are many tools and strategies which can help teachers bring out the beauty of their ADHD kids so they can get along better with their friends and be a proactive and happy member of the class.

“I tell teachers to find out what is a child’s BIGGEST impediment? If the teacher tries to solve everything, it can be really overwhelming, so focus on the top three things. So what is one of the biggest things that gets in the way of multiple areas? One frequent example is with the kids who are really wiggly and wriggly, especially for the younger ones, it causes a lot of aggravation like standing on people when they’re walking across the mat, or touching other people.”

Students with ADHD can miss that they are in someone else’s personal space and not being aware of others doing their work, for example,
says Watson.

“So use the personal hula hoop. Literally, give each child a hula hoop and walk around the room and as they bump into each other they begin to see how much space each person carries around them and to be more mindful of that. That way when you see one of the student’s impinging on another’s space you can say “hula hoop” and they’ll register.”

Apparatus support tools can be wobble cushions and wobble stools for those who need physiological feedback. These are inflated stools with a dimple in the bottom so it is convex so they can quite easily sit there and wobble but not be in anyone else’s space. The wobbling can help their memory to focus and allows them to wiggle without bothering anyone else. Constant reminders to “keep still” are unhelpful and tiring for both teachers and children. The wobble stools can lead to long-term behaviour modification.

Watson also suggests sitting children with ADHD at the front of the room so they are less likely to get distracted.

“Teachers can have the invisible string that links their eyes to yours so when you see them getting distracted say ‘I want to see the invisible string between you and me’ – like the Robert de Niro fingers to eyes ‘look at me, look at me’ concept. Just a reminder brings the kid back.”

Watson says that physiologically kids with ADHD are unable to sustain their attention for long spells so she suggests other strategies like ‘chunking’, ‘body breaks’ and ‘brain breaks’.

“Fatigue exacerbates loss of behaviour control, so doing little bits of work a little bit at a time, giving the child the chance to run outside, or a break by taking something to the office, helps.
For some kids with ADHD they find being still is
like torture.”

The ADHD brain needs to be rewarded straight away – the end of the week or even the day won’t work, says Watson.

“If you think about a toddler they have to have everything right now. The ADHD brain is in ‘the now’. The reward part of the brain takes longer to develop and mature. I don’t know how many times a parent has told me sticker charts don’t work but if used the right way – you want this then provide it straight away - it’s an immediate reinforce.

“Giving ADHD kids a large piece of work will make them feel overwhelmed and they’re not going to be able to do all that. So I suggest giving them worksheets for homework and literally cut the worksheets up physically so you have got it in many bits. And then get the parents to do it over three nights with the child and say, ‘do this, and THEN we’re going to the park’.

“The ADHD child needs reminders. Constant reprimands are demoralising and demotivating. Reminders encourage and are supportive. If they’ve been told off a lot it is very natural to become defensive – they either internalise it and become anxious or externalise it and become
really angry. Often for those who are either inattentive hyperactive or emotionally under controlled just being believed and validated is the most important thing.”

One couple with first-hand experience in this area are Rachel and Andy Fowler of Pongakawa in the Bay of Plenty. The eldest of their three sons, Tom, was diagnosed at age six with dyslexia with an “indication of ADHD”.

“He never ended up doing really naughty things but he was always just doing things! We had some wonderful support from Dr Leila Masson. We thought we had a relatively healthy household with me making home-cooked meals but she gave us an insight into how eliminating food with numbers in them could really help Tom’s behaviour. Even now, if he has a chip with barbecue flavouring on it, we notice how quickly his pupils dilate and he goes up the wall.”

While extremely helpful, the change in diet was not enough and it was after an RTLB told the couple that Tom was a child “literally climbing the walls” that they went for an assessment. This came out as ADHD combined hyperactive and inattentive. The couple, while on the required 18-week parenting course, decided to try Tom on Ritalin. The results were automatic.

“He’s not the naughty kid anymore and now he can learn. He can focus. Tom had always been reasonably self-assured and confident, but he had begun to lose faith in himself and think he was a bit of a doongy at school.

“On Ritalin, he was able to learn and focus, and very quickly he went up two reading years. He notices the difference. He likes how he feels on it and he says he’s ‘clear’ and there’s not a ‘fog’. School is not set up for boys and not set up for boys with ADHD, and to assist, the teachers need strategies. With Whaea Sherree it was her patience and her belief in him and us as a family. We needed some help to back him and she did that 110 per cent.”

If Dr Watson was looking for an example of how best to help kids with ADHD achieve in the classroom she need look no further than Tom’s former teacher at Pongakawa School, Whaea Sherree Clarke who now teaches Years 5 and 6 at Arataki Primary School in Mount Maunganui.

“I have three principles. I create self-belief, I use creative licence – I interpret the curriculum in creative ways – and I have patience – it’s important to remember that all the students will get there in the end.

“I do believe in my students. I have high expectations of them. I tell them ‘I believe in you’. Some of the kids I teach have high trials and tribulations and that is huge in their learning. Creativity helps them to manage that.

“I have cush balls in the class which help my kinaesthetic learners who self-regulate through their hands. It’s not that they WANT to play with the balls – it’s that they NEED to. With the kids who need help with self-regulation I use gentle touch; I use their first name and touch their shoulder. I say, ‘I can see what you’re doing. I can see that you’re focused’.

“I’ll say, ‘It’s great to see that you are using paragraphs in your writing’ when the child isn’t and then he starts using them straight away! I learnt a lot from Incredible Years for Teaching. I use colour coding a lot, in their books, everything. Their timetable is all visual.

“With maths assessment, I have to remember it’s not about them reading about maths, it’s about them doing well at the actual maths. They get overwhelmed and I need to be mindful of that. I give frequent brain breaks and I make the
learning fun.”

Clarke says a part of teaching is keeping the parents upbeat so they feel successful too.

“For me teaching is a three way partnership between the student, me and the parents. I regularly touch base with my students’ families and have frequent phone calls home about positive things. Then if I do have to make a call that’s tricky I’m doing so after 10 good conversations.”

Does she remember her pupil Tom from Pongakawa School?

“Oh Tom, he is such a beautiful boy, so lovely. I just saw him blossom. It’s something I’ll never forget as a teacher. I loved the phone calls home about him. I’d get off the phone and have a moment as a teacher and as a person to celebrate, to watch him transform his life… it transformed my life and learning.

“One day is never the same as the other. It’s good to change it up or it gets boring. And nobody likes boring!” she laughs.


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