What to know
First, let’s get the facts straight. According to the Centers for Disease Control and Prevention (www.cdc.gov):
Number of children 3-17 years of age ever diagnosed with ADHD: 5.9 million
Percent of children 3-17 years of age ever diagnosed with ADHD: 9.5%
Percent of boys 3-17 years of age ever diagnosed with ADHD: 13.5%
Percent of girls 3-17 years of age ever diagnosed with ADHD: 5.4%
In the United States. Approximately 11% of children 4-17 years of age (6.4 million) have been diagnosed with ADHD as of 2011. The percentage of children with an ADHD diagnosis continues to increase, from 7.8% in 2003 to 9.5% in 2007 and to 11.0% in 2011.
Next let’s get the words straight:
The DSM-5TM (American Pediatric Association, 2013) defines ADHD as:
a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development, has symptoms presenting in two or more settings (e.g. at home, school, or work; with friends or relatives; in other activities), and negatively impacts directly on social, academic or occupational functioning. Several symptoms must have been present before age 12 years…three presentations of ADHD are commonly referred to: combined-type, inattentive-type and hyperactive/impulsive-type.
Know that we know who, let’s look at what we as teacher can do:
What to do
Schusteff (2016) suggests the place to start is with environmental changes then move into a training program for parents before beginning medications.
Both the American Psychological Association and the American Academy of Child and Adolescent Psychiatry advise that ADHD treatment in children proceed according to the severity of the symptoms. For children who play well with others and who have healthy self-esteem, Carol Brady, Ph.D., a child psychologist in Houston, says that environmental changes can help. “A smaller classroom, with less stimulation, and a strong routine often make a tremendous difference in improving ADHD symptoms in preschoolers.” In most cases, parent effectiveness training or behavior therapy is the next course of action.
Stage 1: Parent Training
Ten-week parent training course in behavior modification techniques, such as offering consistent praise, ignoring negative behavior, and using time-outs.
Stage 2: Medication (such as Ritalin) which must be administered by a pediatrician.
If you are teaching a student who may have or has already been diagnosed with ADHD, here are some practical steps that have been shared by others in the trenches that may help:
- PLAN A VISIT.Some students benefit from an advance visit to the child-care center or school to see the setting and to meet the teachers. The same goes for taekwando classes or Boy Scout meetings. A practice run to the venue will lessen anxiety when they start school or an activity.
- USE A POSITIVE APPROACH.When your student does something inappropriate in the classroom or at home, before you chide, guide. It takes extra explanation for some young students with ADHD to learn the routines and rules.
- BE CAUTIOUS WITH “WE” STATEMENTS.“We share at school.” “We don’t hit.” Egocentricity is developmentally appropriate. Young students don’t know that “we” means “me.“
- CATCH YOUR STUDENT BEING GOOD. Positive reinforcement gives a student incentive to keep going.
- GIVE A QUICK, SPECIFIC COMPLIMENT at the very moment you see your student start to do what you expected, not when it is completed. Say, “Ian, thanks for listening when I said it’s circle time.” This gives him incentive to go to the circle. After a few steps, give another positive statement. “Ian, are you going to sit here or there?” The reinforcement supports the behavior you desire of him.
- RULES/PRAISE/IGNORE. Have only a few rules, make them to the point, and consider using pictures or drawings to illustrate them.
- GIVE PRAISE. Follow the recommended three-to-one ratio of positive statements to negative ones.
- IGNORE MINOR MISBEHAVIOR, such as bouts of forgetfulness or disorganization. Target more serious behaviors.
- USE SONGS AND CHANTS.Students who sing as they do a task maintain focus. A couple of my favorites are “watch the scissor cutting, cutting up the paper” or “watch the crayon color, coloring the …” You can create short songs or chants for anything.
- WRITE SOCIAL STORIES —stories with photos that depict what is expected for a task, activity, or setting. Examples: getting dressed, riding in the car, story time.
- TEACH ORGANIZATION.Form a “back-pack brigade” to teach what goes in and what comes out of the backpack each day. Photos can be cues to help with this.
- ARRANGE THE PHYSICAL SPACEin the classroom and at home to clearly separate play and work areas. Have tubs designated for shoes or lunch boxes, etc.
- LIMIT WORDS.When you talk too much, ADHD students change the channel.
- USE VISUAL MEASUREMENT TOOLS,such as a Time Timer, to help your student understand that time passes and how long he has before going outside to play.
- EMPHASIZE LARGE MOTOR SKILLSover fine motor coordination. Motor skill development will be delayed for about half of ADHD preschoolers, so teachers and parents should have them play games that use large muscles, such as soccer, Red Light, or swimming. To practice fine motor activities, allow students to tear paper into pieces rather than cutting it, and to trace within box lids to feel their shape and limits.
- MORE MOVEMENT = more serotonin…and monitor cortisol levels.
- MAKE PLAY FUN.Put a blanket over the kitchen table to create a fort. Your preschool student can pretend-play in the fort. Give her a flashlight to make it an adventure.
- CREATE ENVIRONMENTAL ADAPTATIONSto help students learn the steps, the routines, and the words. Use pictures schedules that show the steps of routines and tasks for the day in pictures.
It is important to remember that students with ADHD do have difficulties to overcome, but they also may have positive attributes that can be unique gifts that only they can share with the world. Here are few that have been shared by those who enjoy working with these students: creativity, energetic/magnetic personalities, quick to see patterns, quick to see the big picture, move and think quickly, bring an alternative point of view, are athletic, not afraid to try something, courageous, and are fun to teach.! Sounds like some pretty amazing students. This article is offered to help you bring out the best in these students, and in you as their teacher.
Centers for Disease Control and Prevention. ADHD https://www.cdc.gov/ncbddd/adhd/data.html). Accessed January 5, 2017.
American Psychiatric Association (2013). The Diagnostic and Statistical Manual of Mental Disorders – 5th edition (DSM-5TM). Washington, DC: American Psychiatric Association
Schusteff, A. Is preschool too early to diagnose ADHD? http://www.additudemag.com/adhd/article/2488.html Accessed January 5, 2017.
Other resources to check out for practical teaching tools:
Jensen, E. (2009). Different Brains, Different Learners, 2nd ed. Corwin: Thousand Oaks, CA: Corwin.