Attention Deficit Disorders (incl. Attention Deficit Hyperactive Disorder)
ADD ? ADHD ?
... or just a high-spirited child ?
The Secretary of State for Education and Skills,
Ruth Kelly, has outlined in 'Teaching Today' (NASUWT – October
2005) the government's plans for an integrated children's
service, entitled 'Every Child Matters.'
In this article she recognises the impact that problems which children
have from outside school can have on their attendance, learning and behaviour
within the school setting.
A primary objective in the 'Every Child Matters' programme
is to ensure that whatever problems children have, are identified and
treated early before they become intractable, thus enabling a successful
outcome. She intends to provide for 'safer and healthier children.' by
the provision of a multi-agency response to children's problems,
with targeted and specialist services for children with additional/specific
Children with behavioural problems will be amongst those needing the
Children with limited concentration, either when in play, listening
to adults / siblings or when participating in a task, can have great
difficulty when trying to succeed in the school setting. Also, any such
concentration might be interrupted by impulsive, hyperactive and/or inattentive
behaviour making learning impossible or at best, a slow process. Additional
difficulties arise when such children are regarded by others as underachieving,
talked about by their peers and eventually 'labelled' albeit
kindly, by both parents and school staff. 'Catching–up' with
others in the class or with siblings might prove to be difficult and
stressful for the child who will probably learn to adopt avoidance strategies
towards the tasks in which he/she is 'falling behind'.
Adults working with children will recognise inappropriate behaviour
in a nursery age child but a socially immature child (relative to its
peers) however, might simply need help in how he/she should behave in
various situations. Hence, it is essential that a sympathetic and supportive
approach is adopted when a change in behaviour is needed.
Attention Deficit Disorder (A.D.D.)
All children have different levels of concentration. However, there is
a difference between a lack of interest and the inability to concentrate
for more than a few minutes. There might be physical reasons for the
inability to concentrate such as a hearing loss, current yet unrecognised
sickness, or current emotional problems.) Where it is possible to address such reasons a change can be effected.
Concern is expressed when children are inattentive in several ways,
for example, when they:
- Regularly 'avoid' tasks that require effort or sustained
- Do not 'seem' to listen when others converse
with them directly,
- Do not respond to invitations to assist in classroom
or home tasks,
- Misplace items such as clothes, games, and toys which
are regularly needed,
- Make guesses rather than think of solutions to issues,
on others or start a task and immediately stop and walk away,
not follow simple instructions and becomes easily distracted and
spend time simply staring at something outside or unrelated to the
task 'in hand'.
However, a more complex problem exists when additional behavioural issues
such as hyperactivity and impulsivity are manifested. The condition is
entitled 'attention deficit hyperactivity disorder (A.D.H.D.).
Children with ADHD might display an excessive degree of hyperactivity
- Running around excessively and inappropriately,
- Acting clumsily
and be distractive in play, showing an inability to play quietly,
excessively, often distracting others by being intrusive,
a seat or queue without any apparent reason and
- Climbing or moving
from one place to another in an unorthodox manner.
Impulsivity is also displayed by the above children. When they blurt
out answers before a person has completed a question, are unwilling to 'wait
a turn' and intrude in different situations others affected can
become angry and willing to tease or joke about them. Indeed, children
with ADHD might become very unpopular, be bullied and become very lonely
Clearly, a lack of appropriate behaviour would also have adverse affects
in other social situations, resulting in:
- Inadvertent damage to other children's possessions,
or 'taking over' discussions or conversations
peers or members of the family,
- Disrupting situations by acting 'silly' in
order to seek attention and
- Inadvertantly causing physical damage
to others, resulting from
overactivity or 'rough play'.
Peers or siblings would be likely to feel insecure in the presence
of ADHD children and therefore not inclined to select them to be team
members, to their parties, and even involve them in 'play' situations.
ADHD is considered by experts to be due in part, to the presence of
a chemical imbalance (neurotransmitter chemicals) in the brain (prefrontal
cortex) affecting the areas controlling aspects of behaviour as well
as having a link to a possible genetic factor. However, the exact cause
is still not known.
It is a condition which has been named as; a morbid defect of moral
control (George Still – 1902), minimal brain damage (1930), minimal
brain dysfunction (1960), hyperkinetic reaction of childhood (1968) and
attention deficit disorder-ADD (1980), ADHD (1997) and hyperkinetic disorder
(a narrower definition relating to the more serious cases, by The World
Health Organisation (1987).
Although it is not considered that family stress causes ADHD, it is
considered that it could affect the emergence of the condition in a child
with a genetically prone family background. Also, whilst bad parenting
does not cause the condition family circumstances can affect the ease
or otherwise with which the child can manage to cope with it.
Recognition of a problem and the provision of effective support.
Within the education system children can be assessed by educational
psychologists, language specialist and occupational therapists at the
request of the school. Parents can of course seek help from their own
A detailed analysis of a child's temperament (attitude & personality),
a genetic link (80-90%) and possible brain injury will be studied by
a doctor. It will be decided on how many symptoms a child has in two
behaviour categories – inattention and hyperactivity-impulsivity.
Effective assessment and treatment of ADHD requires good communication
between the various professionals involved
ADHD is treated with behaviour therapy, medication and indepth support
Controversial considerations relating to ADHD.
The following facts have been raised by experts to point out that considerable
progress needs to be made in the process assessment for ADHD.
- There is no physical test (e.g. blood test).
- No single cause has been established.
- There is no standard method of assessment(clinician based).
- Overlapping conditions can affect any assessments.
- Family circumstances- modern lifestyle can raise questions in
- Any child can have self-control difficulties at some stage in
which can continue in adulthood.
- Labelling is detrimental to children and affects parental and
esteem, but without that label children and parents might be denied support.
- Prescribed drugs should be avoided until all possible forms of
- Some of the symptoms of ADHD are very similar to certain syndromes.
The value of assessment is to list problem areas and provide as many
effective means of treatment to support both the children concerned and
those who care for them.
This article was written for IvyRose by an experienced
"Special Needs" teacher based in the UK.
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