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Symptoms
Children
with ADHD (Attention Deficit
with Hyperactivity Disorder) have issues with attention and/or impulsivity. You
can imagine the cumulative effect this has on achievement in courses since
mistakes are made on assignments and tests because bouts with inattentiveness limit their capacity to focus as facts and
skills are covered in class. Distractibility accompanies the lack of engagement
and teachers observe movement at the desk with hand fidgeting, the inability to
remain seated, as well as excessive talking. Instructors find it quite
disconcerting since the interruptions bother other students and hamper the flow
of the lesson. I was required to fill out evaluations combined with other
faculty summaries that were passed on to a counselor to determine the extent of
ADHD, who prescribed a remediation, often a medicine such as
Ritalin, a brain stimulant.
The
diagnoses continue to climb with almost eleven percent of the United States
population up to seventeen years of age assessed with the condition.1
ADHD appears to be
hereditary but some claim that fetal exposure to toxic substances such as
alcohol and tobacco or exposure to lead might be
contributing factors.2
Teachers
and parents notice that behaviors are not age-appropriate. The American
Psychiatric Association list several of them
in their 2013 report3,4:
· Easily
distracted, miss details, forget things, and frequently switch from one
activity to another
· Seem
to not be listening when spoken to
· Struggle
to follow instructions
· Fidget
and squirm in their seats
· Talk
nonstop
· Dash
around, touching or playing with anything and everything in sight
· Blurt
out inappropriate comments, show their emotions without restraint, and act
without regard for consequences
· Have
difficulty waiting for things they want or waiting their turns in games
· Often
interrupt conversations or others' activities
Nevertheless,
the diagnoses continue to rise, and the fidgeting and classroom disruptions are
real and sometimes unmanageable. There may have been cases of ADD when I was in
high school but rarely saw the discipline issues teachers in this century are
contending. Extensive studies have been undertaken to examine ADHD. One evaluated 184
ADHD subjects and 186 normal individuals and found that specific regions in the
prefrontal cortex delegated for
attention and response inhibition were underactive in the ADHD group,
particularly the brain's impulse-control center.5
Ritalin affects
neurotransmitters in the prefrontal
cortex and consequently
improves concentration. Some consider this method of treatment an overkill6
and feel that non-medicinal remediation should be applied to reduce symptoms so
that students can work effectively in school. However, most children treated
for ADHD are seen by general
practitioners who do not have the time or training to use other non-medicinal
forms of therapy. Psychologists are in short supply and many of them feel the
Ritalin route to be the most expedient, along with insurers since the
prescription is cheaper than ongoing counselling sessions, and the
pharmaceutical companies appreciate the business.
Attention
training
I
recognize that the medicinal approach is a standard method to treat ADD and
acknowledge that it helped many of my students. However, I am concerned that
simply prescribing the drug to 'settle a child down' to get through a school
day without further therapy to improve attention needs to be evaluated
carefully. One study conducted in the Netherlands in 2011 had two groups of
Ritalin-treated ADHD children given a regimen of attention training
for eight one-hour sessions for four weeks.7 One group of sixteen
underwent training in "aspects of vigilance, selective attention and
divided attention", while another sixteen were trained in "visual
perception of figures and position in space". The research team found
significant improvements of "various aspects of attention, including
vigilance, divided attention, and flexibility, while the visual perception
training had no specific effects". The point of all this is that even with
Ritalin, classroom methods must be incorporated to help young people
with ADHD become focused and
productive, and not just subdued observers in the classroom. Furthermore, the
lecture-laden environment is not
conducive to student engagement for ADHD children.
Classroom
innovations
For the
most part, the classroom is not likely to incorporate the same regimen as the
Netherlands research team, but their result is encouraging because it
delineates one method that heightens attentiveness. Can the classroom
include pedagogy to enhance
engagement for all parties, including ADHD pupils? Author Sandra F. Rief, an expert on how to educate children and teens with ADHD
matches engagement procedures discussed in this book: validation, positive interdependence, roles, cooperative learning, and student-led classes. Why
are they relevant for engaging the ADHD student?8:
1
|
Goals are articulated and met as members
receive praise and achieve success. Advocacy and kindness are prevalent;
|
2
|
Members are
held accountable for their contributions when performing tasks as well as
being part of the task completion process because each has a role. The ADD
and ADHD student finds it easier to remain focused under this condition and
is encouraged as his or her talents are acknowledged;
|
3
|
Participation
is at a maximum when the students are in close proximity, maintaining eye
contact. Such an
arrangement increases attentiveness and sharing of resources to maximize
validation;
|
4
|
Students
experience the diversity of temperaments and personalities and become tolerant of
differences, a critical component in the developing ADHD child. This becomes
particularly relevant when each member has a role in the collaborative process and amplifies the teamwork element;
|
5
|
The
evaluative component of positive interdependence provides the necessary feedback to monitor progress and stimulate correction
and meet goals. Using the evaluation table in this book will prove beneficial
toward that end.
|
Consider
the enormous challenge for many students as they contend with classes that are
primarily lectures and worksheets, requiring an unusual focus and drive to cope and succeed in
such an educational environment day after day. For many it is boring and
non-validating. The ADD child is particularly limited in such a setting
and is certain to demonstrate the fidgeting and impulsive behaviors described
by so many educators and documented in American Psychiatric Association publications. To
function well, it is common to prescribe Ritalin to affect
neurotransmitter secretions that
bolster focus and mitigate impulsive behaviors. Though the Netherlands group
used targeted attention techniques that empirically improved "various
aspects of attention, including vigilance, divided attention, and
flexibility" in a controlled laboratory setting, it is incumbent on
educators to incorporate strategies that steer away from teacher-centered
classes to more student-facilitated activities, especially cooperative learning. The American classroom is hedging in that direction but
the structured and well-articulated collaborative process detailed in
this book can promote high level attentiveness in the classroom.
It was my
responsibility to fashion engagement procedures that validated students. Positive
interdependence, roles, cooperative learning, and student-led classes
elicit secure base priming along with the
associated dopamine release that promoted
focus to complete tasks. The unusual rise in attention deficit and impulsivity
in students has changed the landscape of the American classroom, and
implementation of pedagogical devices that enhance engagement through
demonstrative student activities is critical in molding the thinking apparatus
during the school day.
*******
References
1. Centers for
Disease Control and Prevention (2011).
Retrieved from:
http://www.cdc.gov/ncbddd/adhd/data.html
2. My ADHD
Retrieved from:
http://www.myadhd.com/causesofadhd.html
3. American
Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental
Disorders (5th ed.). Arlington:
American Psychiatric Publishing. pp. 59–65.
4. National
Institute of Mental Health (2008). Attention Deficit Hyperactivity Disorder
(ADHD). National Institutes of
Health.
5. Kelly A.M.,
Margulies D.S, (2007). Castellanos F.X., Recent advances in structural and
functional brain imaging studies of attention-deficit/hyperactivity disorder. Current Psychiatry Rep. Oct;9(5):401-7.
6. Drug Enquirer,
Ritalin Side Effects and Warnings (2015)
Retrieved from:
http://ritalinsideeffects.net/
7. Tucha O1, Tucha
L, Kaumann G, König S, Lange KM, Stasik D, Streather Z, Engelschalk T, Lange
KW., (September 2011), Training of attention functions in children with
attention deficit hyperactivity disorder. Attention Deficit Hyperactivity Disorder.;3(3):271-83.
8. Rief, S.,
(2016). How to Reach and Teach Children
and Teens with ADD/ADHD 3rd Edition, Wiley
