Attention-Deficit/Hyperactivity Disorder In Children
By Leah Davies, M.Ed.
Attention-Deficit/Hyperactivity Disorder (AD/HD) begins in childhood and can
last into adulthood. In the majority of cases, symptoms appear in children
between the ages of four and six, although they sometimes occur earlier. According
to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR)*,
there are three patterns of behavior that indicate an AD/HD disorder. The categories
are the predominantly inattentive, sometimes called ADD; the predominantly
hyperactive-impulsive, that does not show substantial inattention; and
the combined type that displays both inattentive and hyperactive-impulsive
symptoms. Having this disorder can contribute to a child having low self-esteem,
problematic peer interactions, and poor school performance. However, students
with the disorder can be highly intelligent.
In a classroom of 25 to 30 children, it is probable that at least one child has
AD/HD. Distinguishing a hyperactive-impulsive child from that of a normal, active
child can be difficult. One clue is that children with this disorder tend to
be sensitive to stimuli such as sights, sounds and touch. If they become overstimulated,
they can exhibit out-of-control behavior. On the other hand, children with the
inattentive form of AD/HD may seem oblivious to their surroundings. Different
settings bring about different symptoms in these children depending on the demands
of the situation and the child's self-control. A child who is in constant motion,
disruptive, and acts before thinking will be noticed, but the inattentive child
may not. Yet, both of these students may be viewed by a teacher as unmotivated.
Since a child's symptoms may be caused by another disorder, he or she must receive
a thorough evaluation and be diagnosed by a well-qualified professional. The
child's impairment should exist in a minimum of two areas of a child's life,
for example, in the classroom, on the playground, or at home. Thus, if the problem
is with a particular teacher or only with parents, the child does not have the
Children who have the inattentive form of AD/HD are easily distracted
and forgetful. These children make careless mistakes and fail to complete schoolwork.
They have trouble listening, sustaining attention, and following through on instructions.
They avoid work that requires sustained mental effort and have difficulty learning
and organizing new tasks. These students often skip from one activity to another
and may appear easily confused or lethargic. However, if they are doing something
they enjoy, they can pay attention for extended periods of time.
The signs and symptoms of children who have hyperactivity-implusive disorder
are fidgeting with their hands or feet and/or squirming while sitting. They are
in constant motion and have difficulty playing quietly. They are often out of
their seat and may run or climb excessively. Other traits these children can
exhibit are excessive talking, interrupting, and being unable to wait their turn
or to contemplate consequences of their actions. These children may make inappropriate
comments and openly display their emotions.
The most common treatment for children with AD/HD is the use of psychostimulant
drugs such as methylphenidate or dextroamphetamine. Many students on medication
show academic improvement due to an increased ability to concentrate and stay
on task. However, the use of these drugs is being evaluated, since psychostimulant
medications do not cure the disorder. Although they relieve the symptoms of AD/HD,
some students report that the medications make them feel "restricted" or "empty" inside.
Preferential classroom accommodations, school counseling, and individual or family
therapy can help these students improve overall functioning. With appropriate
assistance and self-confidence, social interaction skills and academic performance
Children with AD/HD need:
Understanding, creative teachers who believe in their worth and make accommodations
for their disorder
AD/HD students progress when the adults in their life provide firm, caring discipline.
If the child is out of control, the adult needs to remain patient and in control.
Structure and consistency
Plan the learning environment to be as predictable as possible. Since children
with AD/HD have difficulty adjusting to change, provide an ordered classroom
with clear rules that are prominently displayed.
These children can easily feel overwhelmed with too much information. When possible,
give them one instruction at a time, and if needed, provide the directions both
verbally and visually. Set goals with the child and notice when he or she has
Frequently acknowledge a new, appropriate behavior (see Rewards
in the Classroom). Use special privileges, such as being a class helper,
having computer time, or free choice time as reinforcers. (Also see 30 Ideas for Teaching Children with ADHD.)
A close working relationship among educators involved with the child
Open discourse with the student's parents is critical.
A guidance counselor and/or special education teacher can help teachers and parents
understand the student's disorder and share effective ways to help the child.
Guidance counselors can work with individual or small groups of AD/HD children
to foster social and anger management skills as well as feelings of self-worth.
Depending on the severity of the disorder, these children may receive Special
R E F E R E CN C E
*DSM-IV-TR workgroup The Diagnostic and Statistical Manual of Mental
Disorders, Fourth Edition, Text Revision. Washington, DC: American
Used by permission of the author,
Leah Davies, and selected from the Kelly Bear website [www.kellybear.com],
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