Best Practice

ADHD: Spotting the signs and supporting students

Neurodiversity Inclusion
How can teachers support students who have or might have ADHD? JenCatling looks at spotting the signs, recognising their strengths, and what to do if you are worried about a young person

 

Diagnosis rates for ADHD – attention deficit hyperactivity disorder – are on the rise (Robertson, 2022) and many professionals who work with children and young people, including myself, believe this is the tip of the iceberg.

Although ADHD is being recognised more it is generally believed to be under-diagnosed and so it is important to remember that many school children could well be unaware that their difficulties are linked to ADHD.

Part of the issue is that children and young people often mask their difficulties and masking can be done unconsciously as well as consciously.

I was diagnosed with ADHD at the age of 34. I went through my whole school and academic career not understanding my difficulties – thinking that I was just “stupid” when it came to some things.

I showed my ability and intelligence in my own way and was generally well-behaved and so my ADHD was never picked up as a problem while I was at school.

I now see this happening with many of the eight to 18-year-olds who are referred to me due to their difficulties relating to things like anxiety, low mood, and low self-esteem. The young people I see who are having difficulties associated with ADHD are sometimes diagnosed but sometimes they are awaiting diagnosis still (on an assessment pathway) or sometimes they are not on an assessment pathway at all for various reasons, including barriers to the screening process (e.g. masking at school meaning that schools feel unable to fill out the required paperwork) or because the young person is not sure if they want to go through the assessment process.

 

Also from SecEd

 

 

Spotting signs of ADHD

ADHD is classed as a neuro-developmental condition, which is to say that it is characterised by certain traits that are considered to be distinguishable from what is “usual”.

A hallmark trait to look out for/be aware of isdifficulty around shifting focus of attention. This may manifest as hyper-focus on one task or as a continual tendency to change focus between several tasks.

This can lead to students getting easily distracted, over-stimulated or bored/under-stimulated. This can, for some, lead to difficulties taking in or understanding information or instructions, and even memory difficulties.

The “hyperactivity” part of ADHD can also show up in various ways. For many, it is an invisible, mental hyperactivity rather than a physical one, but of course many can experience physical hyperactivity as well.

Perhaps confusingly – all of these things can manifest in several different ways. For example:

  • Being quiet or withdrawn (due to feeling overwhelmed by surroundings or absorbed in overthinking/worrying). This is sometimes seen when a young person is masking their difficulties in other ways.
  • Being loud or distracting others (due to being under or over-stimulated).
  • Not completing work in the classroom (due to difficulty concentrating on one task only).
  • Not listening or losing/forgetting personal items (due to being hyper-focussed or distracted).
  • Not completing homework or handing it in late (due to forgetting, difficulties taking in information in class, or being unable to concentrate at home).
  • Restlessness, e.g. tapping the table, leaning back on the chair, getting up from the chair a lot (due to hyperactivity).
  • Lateness due to difficulties with time-management and/or “time blindness”.

 

Being mental health-aware

Unfortunately, many of the issues above can be mistaken for deliberate “bad” behaviour or not having the “right attitude” to learning.

ADHD often coincides with mental health difficulties such as anxiety, worry, panic, emotionally based school avoidance (EBSA), obsessive compulsive disorder (OCD), low mood/depression, emotional intensity (often presenting as anger), and low self-esteem – to name just a few.

This is because having a hyperactive mind that struggles to use or to shift focus of attention in the way that is expected of us can represent a continual swing between overwhelm and boredom. It can lead to being misunderstood and being painfully aware of our failure to meet the expectations of others.

All of this can feel like a lot of pressure, make us feel out of control, hopeless and alone. Secondary school children can be particularly prone to this due to their life stage and the real and perceived expectations that come with taking GCSEs and what comes next.

So, the least helpful way to support a young person with difficulties associated with ADHD is to punish them or pile on the pressure. Doing this could well worsen their mental wellbeing and will not help their ability to engage in their learning.

 

Supporting a young person who has (or might have) ADHD

People with ADHD have a combination of many strengths that, just like their difficulties, are unique to them. So, it is important to look out for these too in order to help them to realise their learning and their social potential. Consider the following strengths:

  • Being able to dedicate a lot of focus and energy to subjects/activities of interest. Encourage students who struggle to engage to identify what their interests and passions are and to connect with these in their own way.
  • Being able to think deeply about a subject, enabling a critical and analytical mindset that can grasp and investigate complex concepts. Be patient with your students who may seem to be day-dreaming or slow to get their work done.
  • Thinking “outside of the box”, seeing the limitations of the “status quo”, and challenging unhelpful or outdated social norms. Support students to be curious, think for themselves and have an innovative mindset.
  • Attention to detail or being able to see the “bigger picture”. Help students to recognise where their strengths lie, to identify if they are in “hyper-focus” or “multi-focus” mode, and how to make the most of that at any given time.
  • Compassion for others due to own experience of suffering. Encourage self-compassion, e.g. what advice or kind words would you say to a friend if they were struggling in a similar way to you?
  • Being sociable, pro-social and having a positive influence on others. Recognise, encourage and celebrate social as well as academic development.

 

If you have concerns about a young person

If you are concerned about a young person's engagement difficulties or mental/emotional wellbeing, share your worries with colleagues, and collaboratively formulate a plan with the young person's family and, importantly, with the young person themselves.

Engaging the student themselves is an easier method if we want to identify the reasons why they are having difficulties. Doing this also prevents us from trying to guess!

Key staff members to consult could include the school SENCO, head of year, pastoral staff, and school counsellor/mental health practitioner (if you have one) as well as the safeguarding lead if there is a risk of harm.

Make sure the young person's needs are at the centre of this plan as focusing on engagement or attendance targets alone is likely to be unproductive if there are unmet support needs.

If they do not already have one, an Education, Health and Care Plan (EHCP) may be required. Additionally, consider whether a referral for mental health support is needed and if the young person needs (and wants) to be referred for an ADHD assessment or for specialised support. What is available will also depend on your geographical location.

 

Seeing things differently

Young people with ADHD think and experience the world differently than is often expected of them. Remember: this can be an advantage as much as (if not more than) a barrier because this is how we as a society learn to innovate and evolve socially.

By understanding strengths and difficulties through this lens, the learning relationship between young people and teachers can be improved for all those concerned and can promote better learning and social outcomes.

ADHD is classified as a neurodivergence, but we are all – as humans – neurodiverse as everyone has their own unique combination of traits.

In fact, I often contemplate the definition of "neurotypical" – which is essentially defined as the absence of what is considered to be different from what is "usual" – because what is perceived as "usual" seems to be ever-changing.

With ADHD diagnosis rates on the rise and an increasing number of young people not acting in the "usual" way, it might be helpful to suspend the use of labels from time-to-time and remember that all young people are individuals with their own difficulties, strengths, needs and unique way of experiencing the world.

We must remember too that it is our responsibility to support and encourage these young people in as many of those areas as we can, especially encouraging their many strengths. But, of course, that is why so many of us love working with children and young people.

  • Jen Catling is a mental health practitioner who works with children and young people within the NHS. She also works with Anxiety UK as a group facilitator for adults.

 

 

Further information

 

 

Further listening

 

SecEd Podcast: Jen Catling was among the experts on a recent episode of the SecEd Podcast focused on supporting students’ mental health and wellbeing in schools. Listen here.