Ummeed Child Development Center School Inclusion Training Program

Understanding Attention Deficit Hyperactivity Disorder

(ADHD)

What is Attention Deficit Hyperactivity Disorder (ADHD)?

It is a medical term given to children, adolescents, adults, who show behaviors which are
consistently seen over a period of time in different settings.
Behaviors such as:
● Difficulty paying attention, distractible
● Interrupting and intruding upon others
● Fidgeting, squirming(moving) in seat

Types of ADHD

INATTENTIVE: Children with this form of ADHD are noticed to lack attention. They may be
described as ‘day-dreamers’ and parents or teachers might say that they seem to be in a
world of their own. They are not overly active. Because they do not disrupt the classroom or
other activities, their symptoms may not be easily noticed.
HYPERACTIVE-IMPULSIVE: Children with this type of ADHD show hyperactive and impulsive
behavior but can pay attention. Children may be overactive and/or have poor self-control.
COMBINED – Inattentive-Hyperactive-Impulsive: Children with this type of ADHD show all
three symptoms. This is the most common type of ADHD. Majority of children with ADHD
have this subtype.

How does inattention look like in the classroom?

● Difficulty in following multi step instructions

● Stares blankly for a long period of time
● Difficulty in listening to or recalling any story or event, heard or seen
Ummeed Child Development Center School Inclusion Training Program

● Constantly shifting from one task to another without completing it

● Frequently losing things or forgetting things
● Seems to be withdrawn and in her own world
● Difficulty in maintaining attention even on tasks of her interest or choice

How does Hyperactivity and Impulsivity look like in the classroom?

● Difficulty in remaining seated

● Difficulty in awaiting turns
● Blurting answers before the question is asked or speaking out of turn
● Constantly shifting from one task to another without completing it
● Frequently keeps fidgeting with things around him
● Constantly on the go
● Difficulty in controlling one’s actions

Executive Functions

Executive functions are an important set of mental/cognitive skills that helps in attention,
memory, organization, time management and flexible thinking. Executive function skills
begin to develop shortly after birth, with a dramatic growth in these skills between the ages
3 to 5.

Children with ADHD often have difficulty with executive functions, as both inattention and
impulsivity are closely related to executive functioning difficulties though not all children
with executive function issues have ADHD.

There are three areas of Executive Functions namely:

Ummeed Child Development Center School Inclusion Training Program

a) Working Memory
Examples:
● Forgetting his/her belongings (bag, bottle) every time before leaving the class
● Forgets to carry his/her cricket bat for his/her favorite cricket match

b) Flexible Thinking
Examples:
● Not able to follow new schedules
● Struggling to take on new, more complicated tasks
● Getting upset when others don’t follow rules

c) Self-Control
Examples:
● Needing repeated reminders to do homework
● Not able to prioritize on achieving task according to timelines
● Not able to control emotions when asked to do something against their
choice

How does ADHD and Executive Functions impact children in the school?

Difficulty with:
● Remembering what is being asked by teachers and peers
● Making friends and maintaining friendship
● Shifting focus from one task to another. Focusing on one task for very long and losing
track of time
● Completing long term projects
● Organizing one’s tasks, time and materials
● Beginning a task

ADHD differs across genders.

- There is not much research that tells us the prevalence of ADHD across different
genders.
- Girls are three to four times less likely to be diagnosed with ADHD than boys.
- Girls are:
● Less likely to show disruptive behavioral symptoms of ADHD
● More likely to show verbal forms of hyperactivity/impulsivity

Does ADHD Change with Age?

Yes, it does.
The behaviors associated with ADHD change as children grow older.

Examples:
Ummeed Child Development Center School Inclusion Training Program

● A preschool child may always be running in the class and frequently shifting from one
activity to another.

● Older children may always be restless and fidget in their seats or play with their chairs,
desks, pencils or peers. They consistently fail to finish their schoolwork.

Adolescents with ADHD tend to react spontaneously without thinking of previous plans or
necessary tasks and homework. They have consistent difficulty with managing time.

Does ADHD go away with age?

No it doesn’t.
Children and adults learn to cope and manage it with age.

Early diagnosis followed by early intervention can help to support and manage ADHD
considerably.

Does it mean that all kids who show such characteristics have ADHD?

While other children may occasionally show some signs of these behaviours, in children with
ADHD the symptoms should be
● Consistently present for at least 6 months
● Seen in the child before age of 12 years
● Present in two or more settings- school, home
● Impacts functioning in school, at home, in playground

Diagnosis:
No single test will confirm if a child has ADHD.
A variety of tools are used for diagnosis and assessment:

● Parental Interview
● Child interview/observation
● Physical/neurological/developmental examination
● School data, including current teacher report and observations

Causes:
Despite multiple studies, researchers have yet to determine the exact causes of ADHD. Few
researches point to the fact that ADHD may be caused by chemical, structural, and
connectivity differences in the brain, mostly as a result of genetics.
Ummeed Child Development Center School Inclusion Training Program

Researchers continue to study the exact relationship of ADHD to environmental factors, but
point out that there is no single cause that explains all cases of ADHD and that many factors
may play a part.

The following factors are NOT known causes:

● Poor parenting
● Traumatic life events
● Digital distractions
● Lack of physical activity
● Excessive watching of video games and television,
● Food additives, or excess sugar

Supporting Children with ADHD

Every child comes with their own strengths and challenges; hence the support will look
different for different children. Research has shown that the most effective support for
children with ADHD is a combination of medication and therapy. The first step towards
successful implementation of strategies to support children with ADHD begins with
identifying the strengths and unique needs of the child.

Supporting children with ADHD should integrate the following four components
● Classroom Environment
● Instructions
● Structuring Content
● Behavioral Interventions

Strategies and Tips for Teachers:

I.Classroom Environment

● Seating Arrangement- away from distractions like doors, windows, peers, cupboards or
wall displays
● Next or close to the teacher OR responsible peers- Teacher and peers can help focus
attention to tasks and clarify doubts. However, this may or may not work for all children
depending on how they are
● U shape seating often helps
● Maintain consistency in using blackboard/ whiteboard
● Organize classroom spaces and resources. Example- marking different sections
Ummeed Child Development Center School Inclusion Training Program

II Instructions

● Given slowly
● Short & specific
● Wait Time- to process the instructions
● Get the child's or the entire class’s attention before giving any instructions
● Ask child to repeat instructions
● Add pictures and written directions to oral instructions

III. Structuring Content

● Begin a class with sharing the agenda

● Define outcomes
● Review previous lesson for few minutes before starting a new one
● Stimulate prior learning
● Break down a task into smaller steps to complete it
● Provide reminder of steps to complete a task
● Use visual cues or prompts to redirection of tasks. It can be pre decided with the child
● Multi-sensorial approach (using audio-visuals, different types of worksheets, etc.)
● Modify assignments/tasks
● Encourage peer learning
● Highlight key words or points while teaching on white board/blackboard
● Provide opportunities for the student to repeat and rephrase important information
● Use timers to indicate transitions
● Multiple opportunities to practice

IV. Behavioral Interventions

A) Setting clear classroom expectations

● Keep the expectations simple and easy to follow

● Have more visuals

B) Attention Grabbers

● Use attention grabbers

● Use “Energizers” and modulate your voice to maintain the students’ energy levels

Few examples of attention grabbers which can be used in the classrooms.

Ummeed Child Development Center School Inclusion Training Program

C) Reinforcements

● Give visual and specific praises for desired behavior- thumbs up

● Give praise immediately
● Give explicit feedback towards improving performance
● Be consistent and sincere with praise
Ummeed Child Development Center School Inclusion Training Program

************