Ask your colleagues what ADHD means to them and they will usually speak of the symptoms and signs they see in terms of behaviour. I have invariably had this response whether the young person has had a diagnosis or not, because it is what adults see and experience.
ADHD is actually a neuro-developmental, spectrum condition. We should be able to support and work with our ADHD students in much the same way as we do with our autistic learners because the traits are similar – such as signs of anxiety or stemming.
What causes it?
ADHD is caused by poor regulation of dopamine, a transmitter in the brain linked to learning, memory and motivation. There is underdevelopment of the areas of the brain responsible for controlling excitability, impatience and impulse.
A hyperactive nervous system makes it difficult for someone to be still. Concentration and focus are difficult and poor memory skills make it hard to take in instructions.
Repeated failure and censure from teachers have an erosive effect on motivation and engagement. The classroom environment becomes a source of stress and so pupils’ “poor” behaviour is actually their response to this stress – it is not what constitutes the condition. There is almost always co-occurrence/co-morbidity with other conditions or learning disabilities.
Effective support
How can you effectively support a pupil who has ADHD?
- Positivity from everyone who works with and supports the child or young person.
- Structure and consistency in routines, expectations, challenge and their learning.
- Understanding which aspects of their environment (the classroom, the playground, to and from school) can cause them anxiety which in turn leads to inappropriate behaviour.
In the classroom
How can you make your teaching more ADHD-friendly? We can use three Ts: traits, triggers and tactics. What are the traits we see in school?
- Impulsivity: Experiences difficulty waiting for his or her turn, has trouble waiting until a question is finished before answering, often interrupts, has no insight into danger.
- Inattention: Unusual levels of distractability, has trouble following directions and finishing tasks, difficulties getting organised, forgets about daily activities, short-term memory problems and forgetfulness, has a tendency to day-dream.
- Hyperactivity: Squirms or fidgets when sitting, does not stay seated, is restless and always on the move, talks excessively.
What are the triggers we might see?
- Lack of structure, rules and procedure.
- Stress caused by this vacuum.
- Excessive stimuli and over-stimulation.
- Lack of sleep.
- Being told and expected to sit and keep still.
- Being in a situation where they might need to articulate feelings/emotions.
- Unmanaged stress.
- Foods and additives – nutrients can diminish signs of ADHD, foods full of sugar and fat can have the opposite effect. MSG, red/yellow dyes and sodium benzoate tend to aggravate symptoms (Stevens et al, 2010).
Finally, what supporting tactics can we try?
- Patience.
- Avoid over-stimulation or excessive stimuli.
- Structure, especially around starting, completing and transitioning to tasks.
- Clarity and a lack of ambiguity.
- Predictability.
- Shorter work periods.
- Positive re-enforcement – look for them doing or saying something correctly and praise.
- A more interesting, accessible curriculum.
- Positive expectations/consistent use of positive language.
- Simple, clear instructions delivered calmly, firmly, fairly and consistently.
- Brevity and clarity around boundaries – avoiding long narratives/discussions.
- Scaffolding of work/tasks into component parts.
- Use “Stop, think, do” and “when and then” instructions.
- Pre-prepared sheets and stickers where possible.
Other lesson advice
Keep the pace moving in a lesson: A slightly faster-paced lesson has its challenges for all learners and so we should work out how we can balance pace with sufficient depth so that students can understand and apply what they have learned. Prepare more activities than you might use and then you can challenge ADHD learners with additional tasks (for which you can praise them further).
Allow movement in your lesson: This can be part of group activity or students using the main whiteboard. I remember an autistic young man who also had a diagnosis of ADHD. He spent at least half of every lesson wandering around the room as he struggled to physically keep still. Initially, staff found this hard to manage but they soon realised that, despite his movement, he was listening to their – and other students’ – every word, participating confidently in discussions and Q&A sessions. For him, it was a small but significant adjustment.
Focal points: I have seen teachers use focal points to excellent effect with ADHD learners. These can be physical objects, sticky notes, dots on fingertips or whatever might work for you and your students. Also, try to incorporate new ideas into learning as often as possible – novelty can be effective.
Structure teaching and learning: Do not be tempted to leave it up to them. Make your expectations and aspirations clear, set challenges and expected outcomes. Focus on their understanding (mastery) rather than completing every task.
- Garry Freeman has taught for 41 years. He is a SENCO and assistant principal in West Yorkshire. He is a National SEND System Leader and chair of Nasen’s 0-11 Advisory Group. Read his previous articles for SecEd via http://bit.ly/2qdL56J
Further information & resources
Dietary sensitivities and ADHD symptoms, Stevens et al, Clinical Pediatrics, December 2010.