Teaching Children with ADD/ADHD

Attention deficit disorder is a syndrome characterized by seriousand persistent difficulties in the following three specific areas:

1. Attention span
2. Impulse control
3. Hyperactivity (sometimes)

ADD is a chronic disorder that can begin in infancy and extendthrough adulthood. It can have negative effects on a child's life athome, in school, and within the community. It is conservativelyestimated that 3 to 5% of our school-age population is affectedby ADD.

The condition previously fell under the headings "learningdisabled," "brain damaged," "hyperkinetic," and/or "hyperactive." Theterm attention deficit disorder was introduced to describe thecharacteristics of these children more clearly.

Diagnosing ADD/ADHD

According to the criteria in the Diagnostic and Statistical Manualof Mental Disorders (4th ed., rev., American PsychiatricAssociation, 1994), to arrive at a diagnosis of ADD/ADHD, theclinician must note the presence of at least six of the nine followingcriteria for either Attention Span or Hyperactivity/Impulsivity.

Attention Span Criteria

Pays little attention to details; makes careless mistakes.
Has short attention span.
Does not listen when spoken to directly.
Does not follow instructions; fails to finish tasks.
Has difficulty organizing tasks.
Avoids tasks that require sustained mental effort.
Loses things.
Is easily distracted.
Is forgetful in daily activities.

Hyperactivity Criteria

Fidgets; squirms in seat.
Leaves seat in classroom when remaining seated is expected.
Often runs about or climbs excessively at inappropriate times.
Has difficulty playing quietly.
Talks excessively.

Impulsivity Criteria

Blurts out answers before questions are completed.
Has difficulty awaiting turn.
Often interrupts or intrudes on others.

Establishing the Proper Learning Environment

• Seat students with ADD near the teacher's desk, but include them as part of the regular class seating.

• Place these students up front with their backs to the rest of the class to keep other students out of view.

• Surround students with ADD with good role models.

• Encourage peer tutoring and cooperative/collaborative learning.

• Avoid distracting stimuli. Try not to place students with ADD near air conditioners, high traffic areas, heaters, or doors or windows.

• Children with ADD do not handle change well, so avoid transitions,physical relocation (monitor them closely on field trips), changes in schedule, anddisruptions.

• Be creative! Produce a stimuli-reduced study area. Let all students have access to this area so the student with ADD will not feel different.

• Encourage parents to set up appropriate study space at home, with set times and routines established for study, parental review of completed homework, and periodic notebook and/or book bag organization.

Giving Instructions to Students with ADD/ADHD

• Maintain eye contact during verbal instruction.

• Make directions clear and concise. Be consistent with daily instructions.

• Simplify complex directions. Avoid multiple commands.

• Make sure students comprehend the instructions before beginning the task.

• Repeat instructions in a calm, positive manner, if needed.

• Help the students feel comfortable with seeking assistance (most children with ADD will not ask for help). Gradually reduce the amount of assistance, but keep in mind that these children will need more help for a longer period of time than the average child.

• Require a daily assignment notebook if necessary:
  1. Make sure each student correctly writes down all assignments each day. If a student is not capable of this, the teacher should help him or her.
  2. Sign the notebook daily to signify completion of homework assignments. (Parents should also sign.)
  3. Use the notebook for daily communication with parents.

• Give out only one task at a time.

• Monitor frequently. Maintain a supportive attitude.

• Modify assignments as needed. Consult with special education personnelto determine specific strengths and weaknesses of each student.

• Develop an individualized education program.

• Make sure you are testing knowledge and not attention span.

• Give extra time for certain tasks. Students with ADD may work slowly. Do not penalize them for needing extra time.

• Keep in mind that children with ADD are easily frustrated. Stress, pressure, and fatigue can break down their self-control and lead to poor behavior.

Modifying Behavior and Enhancing Self-Esteem

Providing Supervision and Discipline:

• Remain calm, state the infraction of the rule, and avoid debating or arguing with the student.
• Have pre-established consequences for misbehavior.
• Administer consequences immediately, and monitor proper behavior frequently.
• Enforce classroom rules consistently.
• Make sure the discipline fits the "crime," without harshness.
• Avoid ridicule and criticism. Remember, children with ADD have difficultystaying in control.
• Avoid publicly reminding students on medication to "take their medicine."

Providing Encouragement:

• Reward more than you punish, in order to build self-esteem.
• Praise immediately any and all good behavior and performance.
• Change rewards if they are not effective in motivating behavioral change.
• Find ways to encourage the child.
• Teach the child to reward himself or herself. Encourage positive self-talk (e.g., "You did very well remaining in your seat today. How do you feel about that?"). This encourages the child to think positively about himself or herself.

• Educational, psychological, and/or neurological testing to determine learning style and cognitive ability and to rule out any learning disabilities (common in about 30% of students with ADD).
• A private tutor and/or peer tutoring at school.
• A class that has a low student-teacher ratio.
• Social skills training and organizational skills training.
• Training in cognitive restructuring (positive "self-talk," e.g., "I did that well").
• Use of a word processor or computer for schoolwork.
• Individualized activities that are mildly competitive or noncompetitive such asbowling, walking, swimming, jogging, biking, karate. (Note: Children with ADD/ADHD may not do as well as their peers in team sports.)
• Involvement in social activities such as scouting, church groups, or other youth organizations that help develop social skills and self-esteem.
• Allowing children with ADD to play with younger children, if that is where they fit in. Many children with ADD have more in common with younger children than with their age-peers. They can still develop valuable social skills from interaction with younger children.

American Psychiatric Association. (1994). Diagnostic andstatistical manual of mental disorders (4th ed., rev.) (DSM-IV-R).Washington, DC: APA.

Suggested Reading

Bender, W. (1997). Understanding ADHD: A Practical Guide for Teachers andParents. Upper Saddle River, NJ: Merrill/Prentice Hall.

Fiore, T. (1993). "Educational interventions for students with attention deficit disorder."Exceptional Children, 60(2), 163-73.

Gardill, M. (1996). "Classroom strategies for managing students with attention deficit/hyperactivity disorder." Intervention in School and Clinic, 32(2), 89-94.

Hallowell, E. (1994). Driven to Distraction: Recognizing and Coping with Attention DeficitDisorder from Childhood through Adulthood. Tappan, NJ: Simon & Schuster.

Hartmann, T. (1993). Attention Deficit Disorder: A Different Perception. Novato, CA:Underwood-Miller.

Reeve, R. (1996). A Continuing Education Program on Attention Deficit/HyperactivityDisorder. Reston, VA: Council for Exceptional Children.

Rief, S. (1997). The ADD/ADHD Checklist. An Easy Reference for Parents andTeachers. Reston, VA: Council for Exceptional Children.

Robelia, B. (1997). "Tips for working with ADHD students of all ages." Journal ofExperiential Education, 20(1), 51-53.

Schiller, E. (1996). "Educating children with attention deficit disorder." OurChildren, 22(2), 32-33.

Contact your local school psychologist, examiner, or personnelin charge of assessment and diagnosis in your school district forspecific information and local programs.