ADHD and behaviour modification: supporting children in the classroom
Attention-Deficit/Hyperactivity Disorder (ADHD) is a condition characterised by issues with attention, impulse control and hyperactivity. One of the most common childhood neurodevelopmental disorders, ADHD usually presents in school-aged children by 7, however in many cases it’s not diagnosed until adolescence or even adulthood.
As approximately 4-12% of children are estimated to have ADHD – and boys are up to three times more likely to have the hyperactive or combined type than girls – understanding how to support the condition in the classroom setting is crucial to a child’s wellbeing and educational success.
What are the main symptoms of ADHD?
In order to put the most appropriate strategies in place to support children with ADHD, educators must familarise themselves with the symptoms and how they present.
ADHD symptoms are divided into three main categories:
- Inattention – short attention span, easily distracted, forgetfulness, difficulty listening, poor organisational skills, poor study skills, and difficulty attending to details.
- Impulsivity – regularly interrupts others, difficulty waiting for turn, tends to shout out answers before being asked, and risk-taking/not thinking before acting.
- Hyperactivity – constant motion, difficulty remaining in seat, excessive fidgeting, excessive talking, forgetfulness, and inability to remain on task/complete tasks.
A child may have one of three different presentations, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM – the authoritative diagnosis guide to mental disorders and disabilities:
- Combined Presentation – symptoms of inattention and hyperactivity-impulsivity
- Predominantly Inattentive Presentation – symptoms of inattention but not hyperactivity-impulsivity
- Predominantly Hyperactive-Impulsive Presentation – symptoms of hyperactivity-impulsivity but not inattention
With all this in mind, it’s easy to see how school environments have the potential to create multiple challenges for children with ADHD. It impairs executive functions, impacting the ability to focus attention, recall instructions, make plans and multi-task. If left unsupported, children with ADHD may struggle to engage with their learning and exhibit disruptive behaviour, negatively impacting their performance and resulting in irritation, frustration and low self-esteem. It can also damage their mental health further down the line, potentially resulting in anxiety and depression. Further information relating to ADHD diagnosis and treatment can be found on the Centers for Disease Control and Prevention (CDC) website, the American Academy of Pediatrics (ADP) website, and the National Institute of Mental Health government website.
However, with careful planning of effective strategies and support systems – and the patience and care to implement them in the short-term and long-term – children can thrive.
What are the major interventions for children with ADHD?
There has been widespread research concerning ADHD from medical, developmental and educational perspectives. Any planned strategy or intervention should be developed with the specific child and their additional needs or difficulties in mind.
Here are some examples of research-based behaviour management interventions – separate to medication— to support children with ADHD:
- Classroom rules and structure. Establish shared rules and values (ideally in collaboration with the whole class). For example, obeying adults, being respectful of others, working quietly, remaining in an assigned seat, using resources appropriately, raising hand to ask a question or for help, staying on task and completing work to a high standard. Rules should be objective and measurable and used in conjunction with feedback and consequences.
- Behaviour management. There are plenty of behavioural interventions to use in classroom settings that benefit children with and without ADHD. Use positive reinforcement/positive attention and reward good behaviour in the first instance – a rough guideline is five instances of positive praise to one ‘telling off’. Give immediate feedback on classroom behaviour and choose battles carefully; ignore mild, inappropriate behaviour that is not reinforced by attention from peers. Personalised or class-wide behaviour plans, that include both a reward system for good behaviours (such as extra play) and a consequence system for problem behaviours (such as time-out periods), are also useful.
- Individualised adaptations. This will depend heavily on what an individual child struggles with. For example, some may require a peer’s help to copy assignments from the board, assignments may need to be broken down into smaller, more manageable chunks, and corrections may need to be provided before new work tasks are assigned.
- Proactive academic interventions. Offering a choice of tasks – ideally, where work plays to individual strengths, peer tutoring, supporting time management and other key academic skills, a focus on the accuracy and completion of activities, and computer-assisted instruction can all be highly valuable for keeping academic performance on track.
- Daily report card or log. Targets and behaviours are noted daily by the child’s teacher, or another adult, and are reviewed by the parent or caregiver at the end of each day. This could link to home-based rewards, and should be used in conjunction with other behaviour management techniques.
Class-wide and school-wide interventions, behavioural therapy, psychosocial treatments, group contingencies, 1-2-1 support and additional mentoring are also useful avenues for educators to explore.
It’s highly important that a good relationship exists between the teacher and the child with ADHD, as well as between the teacher and the parent or caregiver. This enables better communication and collaboration in terms of progress, changes in behaviour, and any strategies that need to be consistent across school and home settings. Parent training may be an additional requirement, depending on the situation.
How can classroom environments be optimised to support ADHD?
It’s essential to cultivate an organised, tidy, calm and predictable educational environment. Teach all children how to organise their desk and their belongings and set clear expectations to support organisational skills and embed clear daily routines and structures. This could include measures such as developing well-understood processes for completing certain activities, submitting homework, collecting personal items at different times of day, and so on; further to this, displaying obvious reminders of routines helps to reinforce them. Transitions – for example, changing classes or moving to a new year group – can be stressful, unstable times, so managing these ahead of time and throughout is important. If possible, creating a ‘quiet area’ that is available to all children, and placing children who have issues with distraction and focus near the teacher – and away from other distractions – is usually beneficial. Classroom management is a golden thread running through all of this, so embedding effective behaviour management practices will serve to reinforce any ADHD-specific and additional learning-specific adjustments.
What is an Individual Education Plan?
An Individual Education Plan (IEP) is a detailed, regularly updated plan that lists the specific targets and strategies that can support a child with special educational needs to reach their potential in school. IEPs generally contain 3-4 short-term targets, either relating to areas of the curriculum or other aspects of their learning such as social skills, engagement with learning or behaviour.
Teachers and parents may feel that an IEP could benefit a child’s development and learning, and use it to tackle the particular struggles they’re facing. The child, together with their parents or carers, should be in agreement on the plan and its targets and requirements. If, following the implementation of an IEP, the situation doesn’t improve, teachers, school special educational needs co-ordinators (SENCos), in England, school psychologists and parents may agree to take further steps – for example, registering the child for School Action/School Action Plus or involving external support services.
Develop the skills to support children with attention-deficit/hyperactivity disorder in the classroom
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