Attention deficit hyperactivity disorder
WHAT IS ADHD?
Attention Deficit Hyperactivity Disorder (ADHD) is a medical diagnosis given to children who have developmental, behavioural and cognitive difficulties compared to their peers. (Spohrer 2006). According to Barkley (1990) this is the most recent diagnostic label for children presenting with significant problems with attention, impulse control, and over activity. Children with ADHD are a heterogeneous population who display considerable variation in the degree of their symptoms.
Spohrer (2006) argues that ADHD has three components:
- Sustaining attention and concentration.
- Controlling impulses.
- Controlling motor activity.
The ADHD usually diagnosed during nursery, childhood or even adolescence. Children with ADHD face hardships in significant elevations of their lives, which have to do with their school, their family or their personal relationships. More specifically, they cannot control their behaviour and hyperactivity, plus, they cannot concentrate and pay attention (Stubbe, 2007). Barkley (1998) argues that ADHD is a disability of school-age children. According to Barkley (1998) the primary characteristics of this disorder are hyperactivity, inability to pay attention and inability to control their reactions.
ADHD is a behaviour disorder that influences children about 8% to 10% (Wender, 2002). The diagnosis normally becomes around the age of seven, but symptoms carry on throughout adolescence and adulthood (Barkley, 1998). "The evaluation and treatment of the common disturbances are often as important as the assessment and treatment of ADHD" (Cantwell, 1996). The ADHD can be caused by many factors - neurological, emotional, nutritional environmental and heredity - and may include many types of behaviour (Hartmann, 1993). The most common disorders are attendant disruptions language, communication, learning disabilities, conduct and anxiety disorders (Hartmann, 1993). Some students may experience mild and infrequent episodes while others may permanently disrupt the class. Methods used for these pupils include: medication, behaviour modification, training skills and specific family support (Cooper and Bilton 2002).
Many of the school-aged students with ADHD are above average in ability by their grades are low because they cannot focus on instruction, hate to write things down, and they lose their assignments and belongings (Reeve, 1996). Students with ADHD need interactive types of learning activities and alternate assessments to demonstrate mastery of learning objectives (Reeve, 1996). Teachers play a vital role in the determination of and interference with ADHD at all phases of education. Either way, the relationship between the teacher's and the child is of central significance. Teachers normally interpret the disorder symptoms according to their beliefs about children's behaviour, educational experience and their knowledge about ADHD (Ainscow, 1998; Nespor, 1987). Also, Poulou and Norwich (2000), based on the theories of pre-planned behaviour and motivation and emotions performance, have established a model explanation about the reactions and behaviours of teachers towards the academic behaviours of children.
Children with ADHD are usually characterized by Inattentiveness, Impulsivity and Hyperactivity. Inattention, impulsivity and hyperactivity are themain featuresof Attention Deficit Hyperactivity Disorder (ADHD). A child's academic success is often dependent on his capability to attend to tasks and teacher and classroom expectations with minimal distraction. Such skill enables a student to acquire necessary information, complete homework, and take part in classroom activities and discussions (Forness & Kavale, 2001). When a child exhibits behaviours associated with ADHD, results may include difficulties with academics and with forming relationships with his peers if appropriate instructional methodologies and interventions are not executed.
Children with ADHD can lose very easily their attention or distraction by an external factor (Cooper and O'Regan 2001). Children appear not to listen when talked to and may have difficulty paying attention to details. They might be easily distracted and may have difficulty focusing and finishing homework. They canget bored very easily especially whenchildren with ADHDdoing repetitive tasks (Southall, 2007). Parents and teachers often report that children have adherence difficulties in their attention to a particular job or do not give the necessary concentration in the rules of a game. However, according to Du Paul (1994), parents and teachers often describe the attention problems with the specific phrases: "not seem to hear", "daydreaming", "easily distracted" and "lose his stuff".
Impulsivity, the inability to control behaviour
Children with ADHD also have inability to control theirbehaviour, which is mainly known as impulsivity (Hinshaw, 1994). These children react incredibly quick to the situations, without being concentrated, or even waiting to hear the directions, that is why they make errors impetuous. A particular problem for children with ADHD is that they are not waiting for their turn in the game. In the school work, where their participation is requested, they select those that required less labor and where the rewards are immediate, ignoring those in which are required greater effort (Goldstein, 1992). Children with ADHD usually speak loudly, take part without asking for permission and interrupt the conversations of others or even their teachers' (for example, the teacher speaks and the child interrupts her during the lesson because he wants to ask the teacher "what time is it?") (Hinshaw, 1994).
Hyperactivity behaviour can include constant activity, being easily distracted and incapability to pay attention (Cooper and O'Regan 2001). Also, hyperactivity childoften talks excessively,frequently has difficulty playing in leisure activities quietly and usually fidgets with his hands or feet. Hyperactivity behaviour might make a student target for bullying and often interrupts or intrudes on others' conversations or games (Goldstein, 1992).
Barriers to Learning
Most attention Deficit Hyperactivity Disorder children can be successful in the classroom with a little help. Lots of them also have Sensory Integration Dysfunctions (as many as 10% to 20% of all children might have some degree of Sensory Integration Dysfunction) (Du Paul and Stoner, 1994). " As a result, these learning disabilities, are not simply a failure to do one's work in school, but typically, defined as a significant discrepancy between one's intelligence or general mental abilities, on the one hand, and one's academic achievement, such as reading, math spelling, handwriting or language, on the other hand" (Parley, 1990).
Children with ADHD because of their excessive energy, isolation, passivity, disorganization impulsivity/ hyperactivity and distraction confront barriers at school (Kewley, 2001). For instance, a student with ADHD when he is trying to attract the attention may behave in these ways: he is talking all the time, shouting, whistling. As a result, children with ADHD are more likely to present low academic performance or even to abandon school Children with ADHD have barriers to learning. Disorganization, weak executive performance can be current in both ADHD and learning disabilities. Children with ADHD can also be confused with oral words, proposals or letters (sound memory), decode sounds (acoustic discrimination) and feeble optical memory (Du Paul and Stoner, 1994). However, according to Du Paul and Stoner (1994) with the appropriate educational practices and treatment, including medication and psychotherapy, these effects can be avoided. Children's with ADHD have difficulties with persistence toward a goal, working memory, impulsiveness and inhibition (Barkley, 1998).
Some children might create negative feelings such as insecurity, anxiety and low self-esteem when they confront possible failure at school (Goldstein and Goldstein, 1998). Also, according to Barkley (1998), concerning the affective disorder that the children might have, they cannot be concentrate in their work and might have some learning barriers due to the lack of sluggish, cognitive tempo, hesitant, shy, frustrated by school failures and social problems, have low self-esteem and socially anxious.
Children with ADHD when they have to systematize and generate their speech in reply to exact task requests, they are likely to talk less, use pauses, articulate certain sounds like "uh", "er", and "um" and even having misarticulations (Spohrer, 2006). Studies have indicated that 30-50% of children with ADHD present difficulties in the expression and perception of language (Mathers, 2006).
Intersection between ADHD children and Learning Problems
Children with ADHD might appear barriers in reading or spelling disabilities (Dyslexia), writing disorders (Dysgraphia) and arithmetic disorders (Dyscalculia) also might have specific learning difficulties like dyslexia (Barkley, 1990). Barkley (1997) argues that although ADHD is not categorized as a learning disability, its interference with concentration and attention can make it even more difficult for a child to perform well in school. The ADHD usually occurs in the elementary stage, and is a result of a specific learning disorder. Almost 50-70% of the children with ADHD have learning difficulties and adjustments problems (Kakouros and Manadiaki, 2000).
Their writing might be messy, with poorly formed letters or words. Moreover, they find difficulty in listening to their teacher and cannot organize their homework. They interrupt almost all the time their teacher in order to go to the toilet or to drink water, plus they forget their books and notebooks at school. If the teacher does not have the appropriate experience with ADHD these situations might lead to learning barriers to the children with ADHD and to the other students without ADHD.
"According to researches (Cantwell, 1996; Hill, 2000; Redmond, 2004), a child with ADHD has difficulties in language development" Moreover "he might confronts low performance in linguistic tests (vocabulary)" (Redmond, 2004) "and he might even has problems in the organization and monitoring the narrative language" (Zentall, 1998). Also, there are some researchers (Kewley, 2001) who comment that the symptoms both stammering and ADHD are included in a small group of children with disturbances in their speech. The school may be a problematic factor for a child because it is probably the first place that he ought to exercise his self-control and be adapted to a structured environment. The teacher has to try various methods of teaching and learning, resulting to an upper self-esteem and to a higher concentration.
Children with ADHD might face problems with their speech, plus they might have difficulties in distinguishing sounds. For instance, they face difficulties in analysing, organising and using information's that are involved during someone's speech. The types of language difficulties experienced bystudent with ADHD are varied and can caver all the modalities of language. They present barriers in the syntax concerning the structure of written and spoken language (oral and written grammar) (Cooper and O' Regan, 2001). These children find problems using or comprehending the structural components of sentences (Cooper and O' Regan, 2001). However, according to Cooper and O' Regan (2001) children with ADHD present Semantic difficulties in language involvebarriers with word meanings and organization. They have school problems include difficulties comprehending written and spoken language and poor vocabulary. Concerning their articulation: they cannot clearly say some consonants or consonant clusters (e.g. b, p, spl, ts). Furthermore, we can observe that the child can make editorial mistakes. All these, may affect their knowledge in general.
ADHD and learning problems is a challenge that many young people must attempt to balance. The combination of ADHD and learning is a volatile one because the disorder causes unruly behaviour since school is a place where young people are expected to behave in a mature and responsible manner, the symptoms of this disorder can lead to problems in the classroom. An ADHD-friendly environment is pleasant for all students. According to Davison and Neale (1998), ADHDstudents will be probable need more individual attention in and out of the classroom. Kewley (2005) argues that, students with ADHD are capable of higher level thinking and can outshine theirpeers with imagination and problem-solving skills. The key to helpchildren with ADHD so as to focus at school and to do homework is to pose a challenge to them. The position of the child should be assessed by evaluating the educational, social and psychological needs of the child. The child needs an additional support and attention from the teacher, and also the definition of learning objectives may be enough to keep the child attends to school. The social activities should also be monitored, respectively.
Some experts argue that in order to help a child with ADHD must manage two positive factors: a) The organization of the class and b) the behaviour of the teacher (). a) The organization of the class: For instance, the class should be comfortable, spacious and secure. The child should be sitting close to the teacher also, away from windows and sockets and in a small class. b) The behaviour of the teacher: First, the school teacher should not label the child, or to have a critical and negative attitude towards the child. The teachers have to find out some priorities of what a child can do or not, for example ' deal of these leaflets'. Also, must reward the efforts of the child so as not to have poor self-esteem and self-confidence. The teacher should use simple, clear and direct instructions and only one directive at a time. The schoolteacher should avoid long and complex commands, like to ask the child to do many things at the same time so as the child not to be confused. Furthermore, parents and teachers should understand the nature of the problems and then to create a consistent approach at home and at school. Otherwise the child may be "confused" even more. Meetings should be made between the family, teachers / professors and doctors. These can help to monitor progress, to clear up questions to help the child understand, solve problems before they grow and ensure that everyone works with a common goal. Prevention should be aimed at preventing the development problems in children with ADHD, such asbeing disappointed and display,aggressive reactions, feel unsuccessful, lose their hope, find difficulty to make friends and blown into trouble.
However, according to Kewley (2005), the first major component of the most effective instruction forstudents with ADHD is effective academic instruction. Teachers can help prepare their students with ADHD to achieve by applying the principles of efficient teaching when they introduce, conduct, and conclude each lesson. Children with ADHD learn best with a carefully structured lesson-one where the teacher illustrates what she wants children to learn in thespecific lesson and places these skills and knowledge in the context of previous lessons. Effective teachers preview their hopes about whatchildren with ADHDwill learn and how they should react during the lesson. Also, the encouraging and supporting attitude of teachers whilst keeping teaching activities, on the one hand creates a suitable frame that gives the occasion in the child to experience success. On the other hand, it creates a positive attitude towards the children's educational process to encourage their additional efforts.
Children with ADHD often cannot maintain their friendships and their relationships.They usually suffer from low self-esteem. These children need steadily special educational approaches. The experts in ADHD report that it is impossible all the symptoms to be disappeared, although Ritalin and similar drugs may reduce some of them (Doggett, 2004).
Usually, the children with ADHD have repeated involuntary contraction of their muscles, their face, their scalp, and they might repeat some sound voices (Barnes, 1992). The ADHD is a disorder that cannot exceed suddenly as the child grows up. On the contrary, if ADHD is not going to be diagnosed promptly, and without thehelp of the experts, then the symptoms which appeared in childhood, may not only remain, but, they are going to be even more complicated and intensified during adolescence and adulthood (Kakouros, 2002). Teenagers, who were diagnosed with ADHD in their childhood, often have an increased anxiety and nervousness, low academic performance, social problems and emotional adjustments.
Furthermore, "a noise is enough(e.g.a pencil ora sharpener thatfells down,a page from the notebook, the cough of a child, the air outside, a honk from a car in the street)to defuse the child's nervousness, stress, and concern. Thus, this mightlead to crises and violent outbreaks of anger and behaviour disorders"(Mark, 1993).
I would like also to mention a short story about hyperactivity girl:
In elementary and junior high school, she was shy and cooperative however frequently seemed to be daydreaming. She was clever, nevertheless, couldn't enhance her grades no matter how hard she tried. Many times, she failed exams. Even though sheknew the majority of the answers, she couldn't be concentrated on the test. Her parents responded to her low grades by taking away privileges and scolding, "You're just lazy. You could get better grades if you only tried." One day, after she had failed yet another exam, the teacher found her crying, "What's wrong with me?"
Children with ADHD might have learning difficulties, but, they do not have cognitive delay or low intelligence (Kate, 2006). These children are gifted, creative and their intelligence is average or even higher. They all have individual talents, which can and should be appreciated from the society. They need special encouragement and support, especially on academic matters. A properly collaboration between teachers and parents concerning the child's goodis necessary.
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