Adjustments to meet needs of students with ADhd
Approximately 5% of children suffer from AD(H)D(Barkley, 2000 cited in Kutscher, 2000; Green and Chee, 1997; Selikowitz, 2009.) However, prevalence is actually higher and Susan Ashley (2005) suggests there are 6 to 9 percent of children with AD(H)D. Jo Frost (2010) in the recent television programme "Extreme Parental Guidance", states that " 1 child in every classroom has AD(H)D." This figure is astonishing and this essay will aim to look at what AD(H)D is and how teachers and other professionals in a school setting can make reasonable adjustments for students with AD(H)D.
If there is a high incidence of AD(H)D within the classrooms , it is vital as a teacher that I and other professionals are aware of what AD(H)D actually is. AD(H)D is a mental disorder that is usually first diagnosed in childhood(Jarvis, Russell , Collis, 2009) and consists of the majority of the following characteristics being seen in either of the inattentive or hyperactive category. These hyperactive or inattentive traits are more developed than those of their peers at the same age. The symptoms are:
Inattention (six symptoms at least from this list)
Tends to make careless mistakes in their work
Cannot remain focussed on a task
Seems to look like they are drifting away when they are being spoken to directly and looks like they are not listening
Can be easily distracted by other children, objects and variables. E.g. and open window in the classroom.
Have difficulty organising tasks
Does not complete schoolwork or chores.
Avoids tasks that involve sustained attention for instance homework.
Loses equipment or notes required.
Forgetful. The individual cannot remember what happened this morning but can remember events from 6 years ago
Hyperactivity (six symptoms at least)
Leaves their seat without permission in class or at inappropriate times
Has trouble being quite during play
Runs or climbs excessively
Appears "on the go"
Cannot wait their turn
Can call out the answer to a question before the question is fully asked.
(adapted from the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, 2000 in Jarvis, Russell , Collis, 2009,pp57; Kutscher, 2000, Chadd, 2008; National Institute of Mental Health, 2008)
AD(H)D is in two main types as previously mentioned the inattentive type or the hyperactive and impulsive type. For the inattentive type this is normally diagnosed after the age of 7 in late primary or secondary school. Here the ratio of boys to girls are roughly equivalent, however it is diagnosed more in boys. The sole problem with this type of AD(H)D is that it affects academic performance where sufferers are described as academic underachievers. There is the other form of AD(H)D which is the hyperactive and impulsive type which mainly has boys who are diagnosed with this form. Individuals who suffer from this form of AD(H)D tend to be those who have ongoing behaviour issues and can fidget and be easily distracted(Selikowitz,2009.) Individuals can suffer from a combination of both forms of AD(H)D.
AD(H)D has been a controversial diagnosis for many years. Researchers are still debating over what the true cause is; heredity or hormone irregularities. The media seem quick to blame the parents and so do lay people who do not understand the concept of AD(H)D and state it is a "modern label for badly brought up kids"(Jo Frost, 2010; Ashley,2005;Green and Chee, 1997). In contrast the most dominant reason for AD(H)D is a chemical imbalance , this being serotonin. Serotonin affects how individuals behave and with this imbalance will cause individuals to be impulsive and display anti-social behaviours (Moir and Jessel, 1997 cited in Haralambos and Holborn, 2000). Haralambos and Holborn (2000) support Moir and Jessel (1997) in the idea that a consequence of hormonal imbalances is that these children will become delinquents in the near future and will result in exclusions or breaking the law and being subject to a custodial sentence.
For teachers it is important to recognise when a student could have AD(H)D and understand how it can affect the student with their studies. During this essay I will use examples from my teaching experience at my current school to explain how the school and myself makes reasonable adjustments for students with AD(H)D. Schools are required to make "reasonable adjustments for disabled students with conditions that give rise to behaviour problems" stated a High Court ruling in 2009 under the direction of the Disability and discrimination Act. This case was in regards to a nine year old who had been excluded due to having AD(H)D and scratching a teacher who was physically removing him from the classroom(EHRC online, 2009). For anonymity purposes I will discuss students using the names student A and B
Student A is a year 7 student(11 years old) who was diagnosed with AD(H)D in year 4 of primary school. He was expelled in year 5 and sent to a pupil referral unit in the local area due to disengagement from his studies and being violent and disruptive in the classroom. He is seen to be defiant and stubborn with extreme impulsive tendencies. Student A display sever AD(H)D tendencies not normally seen at my current school with oppositional disorder. Biederman, Munir and Knee(1987) conducted a study on children displaying AD(H)D characteristics and noted that 64% of participants displayed oppositional disorder, this being student A is unwilling to conform and may try to annoy others on purpose(Kutscher, 2000).He is described as being similar to the 7 year old boy Regan in Jo Frost's recent documentary on AD(H)D children. Student A did not sit any key stage 2 examinations as he was out of mainstream education however he is gifted in Mathematics. He came to this school in September, a mainstream comprehensive with the aim of returning to normality. In order to make the transition from the pupil referral unit to secondary school smooth, student A was placed on a reduced timetable until the October half term. Student A was accustomed to 40 minute lessons and finishing at 2.30pm. Here he has 3 periods of 2 hour lessons with a 15 minute break in period 1 and a 30 minute lunch in period 2. The school adjusted its lesson length from 6 1 hour lessons to 3 2 hour lessons as research has supported the idea that longer lessons reduce stress and anxiety and also cause less disruption(for example , from the movement between lessons)(Kutscher, 2008). This school would be ideal for those suffering from AD(H)D who tend to suffer from anxiety disorder( 34% of AD(H)D sufferers; Kutscher, 2000), as lunches have fewer students due to being staggered during period 2 thus students are not faced with large groups of people who can distract or cause stressful situations.
When student A was on a reduced timetable he missed period 3 on a Thursday and both lessons on a Friday. This caused great implications for the student as he missed his only maths lesson and also the practical subjects of physical education and food technology. The pastoral support team thought it would be best to integrate the student slowly into the school which has a different structure(integrated curriculum with 14hours with the same teacher teaching English and humanities in the same lesson) and avoiding the physical subjects and maths until he had got accustomed to the environment and teachers. However, I feel that student A has not been able to build the essential relationships with students and teachers as well as his peers strting secondary school at the same time as obviously he has not been in my maths class and has not seen the interaction of the students with me or the interactions between groups of students within the class. Rob Plevin and Flinton O' Reegan(2009) and cooper and O'Reegan(2001) emphasise in their research that it is essential teachers build a relationship with students who have AD(H)D and try to make them feel at ease straight away. This will try to alleviate the tension and create less chance of outbursts occurring. Students need to feel safe within the environment and know they are able to make mistakes free from ridicule.
Student A and other diagnosed AD(H)D students receive social skills training once a week for 2 hours. This is to improve relationships with peers and authority figures. Ashley (2005) suggests that this is an effective way for the therapist or observer to observe the Childs interaction with his peers when in a group setting and it is ineffective in an individual setting. However, others such as Selikowitz(2009) and Green and Chee(1997) have posed arguments stating that social skills training can have a positive effect on the children at the time as they can learn how their words and behaviours affect others around them. However, once out of this group setting with the security of the therapist supporting the students gone, the students can find it hard to apply these skills to everyday situations. I have observed a social skills training session and it ended in one student physically assaulting another . Kutscher(2000) suggests that this training can be beneficial as well as having small groups of AD(H)D students together in a class to learn literacy skills, however , he suggests it can be detrimental to have all AD(H)D students in the same room as they can be easily distracted by others.
Student B is also a year 7 student who has recently began treatment for AD(H)D with medication being Ritalin. Student B has other learning difficulties( 70% of AD(H)D children have a learning disability, Kutscher 2000) These learning difficulties are similar to other AD(H)D students within the school, these are: dysgraphia, dyslexia, and poor sequencing skills. Larry Silver(1999) cited in Kutscher(2000) argues that AD(H)D can be exacerbated by these learning difficulties as students are struggling to follow and thus become stressed. This can be seen to be true with the majority of students diagnosed with AD(H)D within the school.
To reduce anxiety, it is important all teachers in the school make sure they reduce instructions into small chunks and step by step tell student what they should be doing to be successful at the task. As a school policy to help AD(H)D students as well as those students who do not have AD(H)D but have specific learning difficulties, instructions for tasks are given both verbally and written(for example in a PowerPoint on the board) in small step- by- step chunks(Terrell and Passenger, 2006).
Student B can become quite anxious if certain routines are not upheld or there has been a problem in the morning(for instance, he has been told he cannot attend the computer club in the evening) and will remain thinking about this issue. This anxiety overflows to other students who become aware that he is anxious and will try to "wind up" the student, thus resulting in a fight. Due to his anxiety, he was removed from lessons after the first week of year 7 and only returned gradually to his normal timetable in November.
Routines are very important for AD(H)D students ,who do not respond well to change(Green and Chee,1997;ATL,2002; selikowitz 2009). Student B and A do not receive much structure or routines at home , school was the only place with routines for these boys. To help the boys have a set routine in every aspect of their life and reduce tensions Monday morning when they had to conform to rules and routines the school met with the parents to discuss strategies. In this meeting a schedule was created for both boys with times when they would wake up, times when they would get washed, have medication, play games, complete homework and then go to bed. These routines are now stuck in prominent places in their homes and the students are much calmer on a Monday morning.
Certain routines and expectations are essential in behaviour management. For example, in my lesson I have set routines(who gives out the maths books, seating plan, what I expect from rules), however in some lessons the whole school behaviour policy is not followed and the boys find it hard to cope and they are told they are doing something wrong but they are not receiving punishment. The school aims to use positive behaviour strategies as suggested by Terrell and passenger( 2006) and Selikowitz(2009) to encourage positive behaviour. The majority of AD(H)D students who display the hyperactive component are on reward cards which have 3 short term targets, 1 is always an organisation target(for instance, remembering all mathematical equipment) and the other 2 targets could be: remain seated unless asked to move by a teacher, follow instructions first time by a member of staff. Boardman et al(2006) supports this method of rewarding positive behaviour and from seeing these students in class I have seen the cards have a positive effect on their school life.
The school also tries to make reasonable adjustments for AD(H)D students by making sure all staff members are educated about AD(H)D and how we should deal with certain behaviours and what routines should be seen in the class. To make the learning experience uniform in expectations , the school completes learning walks to ensure all teachers have specific students for instance those with AD(H)D seated away from distractions. All teachers must chunk lessons as this helps maintain engagement helps to scaffold learning, both key elements that will help reduce behaviour issues from AD(H)D students(ATL, 2002; Green and Chee, 1997;), this will also help students who have a poor working memory(Kutscher, 2000). All lessons should make use of visual , auditory and kinaesthetic process and should involve problem solving tasks in the majority of lessons.
Alistair Smith (2010) at his recent Learn2Learn conference stated that it is essential for resilience and problem solving skills to be taught for learners to make progress. The way the education system is progressing it will help AD(H)D learners to internalise the processes needed to solve problems and they will not have a "meltdown...when the demands on the child" become too much from the task(Kutscher 2000, pp75)
In my maths lesson there is a student who has a doodle pad. This pad enables him to draw whilst I am explaining a concept at the board. It was suggested by The SENCO in order to reduce the distractions from others. I have found that concentration and workload has improved since he has had this doodle pad and he is making excellent progress in lesson. However, during an observation, this was deemed an unsatisfactory lesson as I allowed this student to doodle. even though he answered my questions correctly as soon as he was questioned. Even though the school does make reasonable adjustments for students with barriers to learning such as AD(H)D sometimes the students individual needs are not taken into account and it is what the lesson looks like from the outside that is important(for example, everyone with their heads up focussed on what I am saying).
This essay has highlighted the ways in which my workplace has tried to make reasonable adjustments for students with AD(H)D. In fact , the school has gone above the basic recommendations and made the school environment an inclusive and welcoming environment for all students. Longer lessons have reduced the anxiety and tensions. The uniform approach of all staff members in their teaching has set clear expectations in behaviour and a solid routine has been set with lessons having the same format (chunking to engage students).
If further research was to be conducted on the adjustments the school has made to accommodate AD(H)D students I would evaluate the anger management sessions and the social skills training to see how effective these can be.
In researching for this essay it has made me realise how fantastic the Additional needs department are and how much support they offer the students, parents and teachers. The observations of lessons has gave me an insight into the struggles AD(H)D students have to bear and it has helped me improve my teaching style by including the use of doodle pads and reward cards for students to emphasis desirable behaviours.
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