Successfully Teaching and Managing Children with ADHD

A Resource for SENCOs and Teachers

Fintan O'Regan, Fintan J O'Regan

• Publisher: Routledge
• Year: 2019
• Print ISBN:
  9780367109998
• eBook ISBN:
  9780429656637
• Topic: Education
• Subtopic: Classroom Management

Written by one of the UK's leading experts in ADHD, O'Regan's Successfully Teaching and Managing Children with ADHD is an invaluable resource offering practical and effective strategies for managing the difficult and often disruptive symptoms of ADHD in the classroom setting. Alongside the accessible and user-friendly resources that have made the first edition so valued, this second edition offers:

• A greater number of case studies addressing the key issues surrounding ADHD in education
• Up-to-date information and advice regarding medication and behavioural strategies
• Specific advice on recognising and managing ADHD in girls and adults

Chapters in this book explore topics such as recognising and managing ADHD behaviour; working with parents of children with ADHD; whole school approaches to ADHD; and professional development for teachers and assistants. With accompanying assessment and management resources including the CAST (Child ADHD Screening Tool), this is an essential tool for teachers, SENCOs, behavioural management staff and senior leaders.

Chapter 1
Why is the issue of ADHD so important?

One of the questions often asked is: ‘Why do we appear to have an explosion of ADHD cases in UK schools?’ Part of the answer is a growing awareness and understanding of the condition by people from all sectors of society. In common with other categories of special educational needs, ADHD has become a much more familiar term in recent years as it has escaped the confines of medical and psychological realms and entered into the consciousness of educators and the general public.

But there is a marked reluctance amongst UK professionals to copy what is regarded as ‘over reaction’ to this condition of child behaviour (for example, by countries such as the USA). This results in some of our children who have ADHD remaining unidentified and ‘untreated’. Parents are all too often having to fight for recognition that ADHD is a real condition, and having to argue for the resources and services to support their children.

As greater awareness and understanding of the condition develops amongst a range of professionals, this situation should improve. There is a pressing need for the classification and diagnosis of ADHD in the UK to be seen within a multi-agency context. This will mean that professionals from health, education and social services come to a shared agreement about what it is, and what can be done to help people who experience difficulties because of the condition.

ADHD has become a much more familiar term in recent years as it has escaped the confines of medical and psychological realms and entered into the consciousness of educators and the general public

Research

A research report conducted across health professionals in the UK in 2006 (‘ADHD: Paying enough attention?’) raised three key issues:

1. There are barriers to diagnosis and treatment
2. ADHD is under-diagnosed
3. If undiagnosed and untreated, ADHD has a significant impact on a person’s life.

A survey of child and adolescent psychiatrists and paediatricians in the UK had informed the report. The majority of respondents (54%) thought that ADHD was under-diagnosed in the UK, and that fellow professionals in health and education lacked understanding of the condition (see BOX 1).

The Key Recommendations for the future included the following points:

• Teachers need increased education, resources and support in order to improve their approaches to children with ADHD, and to provide advice to parents about how to access the healthcare system
  Box 1 Survey of psychiatrists and paediatricians

  Amongst those health professionals who responded to the survey:

  • 54% stated ADHD is under-diagnosed in the UK
  • 43% of specialists stated that teachers were not aware of ADHD so don’t realise children should be referred
  • 54% of specialists felt GPs are unsure of which patients to refer
  • 90% felt ADHD can lead to difficulties in finding a job and keeping a job
  • 97% stated that children with under-diagnosed ADHD are more likely to drop out of school
  • 85% said that not treating childhood ADHD can lead to adult mental health problems such as depression and even suicide
  • 98% of specialists stated that behavioural therapy together with pharmacotherapy is the most effective for treating ADHD, yet only 34% use this for their patients
• GPs should receive education about ADHD in order to improve diagnosis and levels of appropriate referral for secondary care
• Secondary care needs additional specialists to ensure that the waiting time is shortened for a first referral and patients can be seen more often
• Patients should have access to the most effective management strategy; currently this does not happen, due in part to parental concerns regarding medication
• There needs to be a greater understanding of ADHD amongst the general public and the media in order to remove the fear of being branded or blamed as a failure
• There needs to be increased information for parents to increase their understanding and ensure they seek help from their GP.

It is interesting to consider how far we have moved on since these recommendations were made–if at all. Certainly, there remains a great deal of scepticism, particularly amongst a number of GPs, that ADHD is a genuine condition and not an environmental issue of poor parenting. This is despite the guidance from NICE whose recommendations on ADHD in 2008 were as follows:

• ADHD is a real and genuine condition
• A range of measures including educational and behavioural strategies can improve the outcomes of children with ADHD
• Medication can and should be used to improve the outcomes of individuals who suffer with ADHD symptoms
• Adult services should recognise the need to monitor and treat individuals with ADHD and continue to treat individuals previously under CAMHS when necessary.

A steadily improving awareness and understanding of diverse needs and acceptance of an ethos of ‘equal rights’ will hopefully bring about changes in attitude to how we identify and provide for children and young people with ADHD, within an inclusive and multi-agency approach.

A shared understanding and ethos

Is ADHD an excuse or an explanation for inattentive, hyperactive and impulsive behaviour? Is it used as a ‘smoke screen’ for badly behaved children by incompetent parents who provide too many carbonated drinks, an inappropriate diet and fail to ration time spent on video and computer games? This continues to be the debate in many schools, not just in the UK, but across the globe. Whether or not these factors contribute in any way, the established fact is that many children are exhibiting behaviours that will affect not just their own opportunities and success levels, but the opportunities, achievement and well-being of the children and teachers around them. Family life at home can also be seriously affected. Within schools, professional development and good leadership and management is central to establishing a shared understanding of the issues surrounding ADHD and appropriate ways of supporting the children and young people affected.

Is ADHD an excuse or an explanation for inattentive, hyperactive and impulsive behaviour? Is it used as a ‘smoke screen’ for badly behaved children by incompetent parents who provide too many carbonated drinks, an inappropriate diet and fail to ration time spent on video and computer games?

Everyone involved in education needs to understand that ADHD affects all aspects of a child’s life. In Chapter 2 we look in more detail at how the condition manifests itself in different ways, but there are some basic tenets to be established within a shared ethos:

• Children with ADHD are often distractible and demanding and, if not managed effectively, can also be defiant, disruptive and possibly even dangerous
• ADHD can hinder a child’s communication and interaction with other people, it can stop him or her from learning facts and skills essential for success in life, and it can cause behavioural, emotional and social difficulties which affect his or her psychological well-being
• In spite of their difficulties, children and young people with ADHD can be highly creative and positive learners, excelling in some areas.

Some facts and figures

In school, the impact of ADHD on both the child and other children can be difficult to manage successfully and in some cases there are negative outcomes. In an ADDISS (Attention Deficit Disorder Information and Support Service) survey of over 500 parents of children with ADHD, 39% reported that their child had been excluded from school for a ‘fixed term’ as a result of their condition, with 11% having been excluded permanently (ADDISS 2006). Anecdotal evidence suggests that more recent figures do not show any significant improvement.

ADHD persists into adolescence and adulthood in a significant proportion of people. In a recent survey, 90% of health professionals agreed that having ADHD can lead to difficulties in finding a job (see BOX 1). Furthermore, people with ADHD are at higher risk of antisocial behaviour; substance misuse disorders and substance misuse; criminal activity and imprisonment (Waslick and Greenhill 2006).

To illustrate this further, data collated by the Youth Justice Board shows that a high percentage of young offenders are considered to be impulsive and to act without thinking, clearly showing linkage to the key symptoms of ADHD. It seems that these individuals act without premeditation. One experienced police officer commented: ‘the first time they think about it, it’s too late–they have already done it’.

A steadily improving awareness and understanding of diverse needs and acceptance of an ethos of ‘equal rights’ will hopefully bring about changes in attitude to how we identify and provide for children and young people with ADHD, within an inclusive and multi-agency approach

People with ADHD can continue to find socialisation difficult and are more likely to have relationship problems and suffer from social isolation than people without the condition. A reported 50–70% are more likely to have few or no friends (Cooper and O’Regan 2001). This group is 40% more likely to experience teenage pregnancy and 20–30% more likely to experience depression (Barkley 2002).

ADHD can hinder a child’s communication and interaction with other people, it can stop them from learning facts and skills essential for success in life, and it can cause behavioural, emotional and social difficulties which affect their psychological well-being

Research has shown that children with ADHD can be very unhappy at school. The following quotes are taken from the Parent and Child Research Document produced by the national Parent ADHD advocacy group, ADDISS, in 2006:

‘I get picked on every day, I got picked on today, and I got picked on yesterday. Every single day. They make names up and they always do it when there aren’t any teachers around. If they knew, they wouldn’t be able to do anything about it. I just get treated weird. Like an Alien.’

‘I just wish I didn’t have it. I’d do anything not to have it. It ruins your life.’

Parental views

The views of parents and their concerns about the treatment of children with ADHD are regularly reported by ADDISS. The time taken for diagnosis of the condition is a continuing source of frustration. Whilst the process can take less than 6 months, many families have reported that, for them, the route to diagnosis took between 1 and 5 years, thereby placing their children at an extreme disadvantage.

Some other findings of an ADDISS conference for parents included:

• 75% of children with ADHD received medication
• For 1 in 6 of these children, medication started before the age of six
• Diagnosis of ADHD is usually made by a consultant in psychiatry, psychology or paediatrics
• Very few consultants provide details of a support group, yet more than half of parents reported that a support group had been of most value to them
• Social Services were repeatedly regarded as the most unhelpful group. Most respondents said that professionals in this sector didn’t recognise ADHD as a disability and rarely offered support for respite care
• Parents agreed that training of teachers in handling children with ADHD was vital yet only a minority found that teachers in their child’s school received specific training in ADHD
• 50% of children with ADHD had a Statement of Special Educational Needs providing a range of support in school (it will be interesting to note how this compares with the proportion of children afforded an Education, Health and Care Plan under the new SEN system).

People with ADHD can continue to find socialisation difficult and are more likely to have relationship problems and suffer from social isolation than people without the condition. A reported 50–70% are more likely to have few or no friends

Finally the parents were asked to say what had made the most difference to them and their family, of which the majority said: ‘Getting a diagnosis and treatment’.

However, members of one family were quite clear when they said ‘it was the teacher of Year 3 Class’ (in a school in Suffolk) who had made all the difference to their child.

A summary of key points that paren...

Table of contents

• Cover
• Half Title
• Series Page
• Title
• Copyright
• Dedication
• Contents
• Foreword
• About the author
• Introduction
• 1 Why is the issue of ADHD so important?
• 2 When is it ADHD?
• 3 How can we manage ADHD behaviour?
• 4 How can we help non-traditional learners to access the curriculum?
• 5 Whole school approaches
• 6 How does medication help?
• 7 Are there any additional options for managing ADHD?
• 8 How can teachers work with parents of children with ADHD?
• 9 How can transitions be made less problematic?
• 10 Professional development for teachers and assistants
• Appendix 1: CAST (Child ADHD Screening Tool)
• Appendix 2: Assessing girls with ADD/ADHD
• Appendix 3: School policy for managing medicines
• References
• Index