Impact of ADHD on Learning in the Early Years

Explore a special learning difficulty of your choice. Consider its impact on the learner in a mainstream early years, school or other educational setting and explore ways in which barriers to learning might be moderated or removed

Introduction.

 Attention deficit hyperactivity disorder (ADHD) is rapidly becoming a global phenomenon (LLYOD et al, 2006). The Centre for disease control and prevention (2013) estimated that eleven percent of children aged 4 -17 have been diagnosed with ADHD at some point in their lives (Attitude, 2018). ADHD is a neurodevelopmental disorder, ‘characterised by pervasive and developmentally inappropriate difficulties’ (DuPaul, et al, 201, p. 35) with impulsivity, inattention and hyperactivity. The average age of diagnosis is 7, however ADHD is not necessarily a behavioural disorder mainly associated with early childhood. Brown (2000) developed model which referred to ADHD as a developmental impairment that affects the brain’s executive functions such as memory and emotions (Brown, 2013). Even though, issues with executive functions can be present in early childhood, it is most problematic in high school when there are increased demands for more complex learning and self-management (Brown, 2013). For some people hyperactivity may lessens as they mature, however, symptoms such as impulsivity and inattentiveness may persist (Kewley, 2011). ADHD can affect people in a variety of settings such as work, home and education. I aim to consider the impact ADHD have on adolescents in High school and explore the ways in which any barriers to learning could be removed or moderated.

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Firstly, students with ADHD can experience difficulties with emotion, in respect of managing and modulating their feelings (Selikowitz, 2004). A time in a student’s life that may cause intense emotions is the transition from primary to high school. When transitioning between schools’ students are expected to adapt quickly to a new environment. When a student with ADHD fails to transition, they can experience low self-esteem and anxieties, which can then have a negative impact on their attitudes towards school and academic achievements (Zendarski, et al, 2016). In order to avoid stressful situations, the student may avoid going to school. Adolescent males in years 9 and 12 are eight times more than likely to drop out of school compared to their peers (Zendarski et al, 2016). To prepare for the transition the student could have induction days and school staff could meet with their parents.

   Similarly, eleven percent of students with ADHD have been permanently excluded from school (UKAP, 2018) and seventy five percent have ended up in Pupils referral units (FIND ). Children with the disorder are more than likely to have aggressive outbursts, be unable to control their emotions and have behavioural issues. They may have immature self – appraisal and look for a ‘locus of blame’ (Selikowitz, 2004).  If something goes wrong in the classroom, they may blame the teacher or disrupt other students. Teachers may not know how to handle their behaviour and their peers may reject them. Young Minds (1999) cited in Lyllod et al, (2006) claimed that children who experienced exclusion, truancy or perform poorly at school are more than likely to have ‘mental health’ needs. It has been estimated that 80 percent of people diagnosed with ADHD are also found to have one or more other psychiatric disorders (Attitudemag.com, 2018) such as depression.

   In connection, to deter any disruptive behaviour the school may use behavioural, reinforcement and consequence interventions. Firstly, teachers need to find out what triggers the student’s outburst and if feasible alter the environment to reduce reoccurrence of the behaviour. Also, a reward system could be used, where the student is praised for their behaviour. The rewards need to be based on what the student is interested and change regularly to reduce compliancy (DuPaul, et el, 2011). If these initial interventions do not work then the student may be referred to doctors or educational psychologists (Selikowitz, 2004). Psycho – stimulants can be prescribed to stabilise the main symptoms of ADHD, making behavioural and educational strategies more effective. Teachers need to have a understanding of the role medication in order to understand the effects it will have on the student (Kewley, 2011). However, adolescents may refuse to take the medication because of their ‘lack of compliance and excessive oppositionality’ (Kewley, 2011. P. 58). Furthermore, medication may also be effective for depression when used in combination with councelling. Young Minds (2018) suggested that medication, special educational support (SENCO’s) and referral to child and adolescent mental health service (CAMHS) can help moderate the symptoms of ADHD (Kewley, 2011). Adolescents maybe offered group psychological therapy to help them with their behavioural issues.

A study conducted by Martel et al (2007) into the executive functions in adolescents with ADHD found that their main area of weakness was associated with inattention, disorganisation rather than hyperactivity and impulsivity (Martel, et al 2007). Inattention can cause the student to be easily distracted in the classroom (Selkowitz, 2004) and often procrastinate. To reduce the distractions teaching assistants could work on a one to one basis with the student. (Selkowitz, 2004). Dunlap (1994) cited in George, et al (2011) stated that when students with ADHD were given a choice of assignments they were more likely to be engaged in the task and show lower rates of disruptive behaviour. To overcome the problem of audio processing teachers could ensure that the student has wrote down any work that they must do so that they can refer to it in order to avoid making mistakes.

 Furthermore, they can also experience disorganisation and find it hard to follow instructions when unsupervised (Selkowitz, 2004). They may forget their homework, scheduled activities and leave school supplies at home or visa versa. Teachers and parents may view a child that is continuously disorganised as being lazy (Attitude, 2018). However, disciplining students will not help them become more organised but strategies to help with their organisational skills will. Schools could provide extra supplies for the student if they forget their equipment as well as colour coded books, so they can associate the book with the subject such as red for art (Attitude, 2018). However, the most important is communication between parents and teachers. Teacher can liaison with parents to keep them informed about activities and work the students has complete.

  In addition, Cooper and Bilton (2013) cited in Peer and Reid (2016) suggested a range of teacher led interventions that can help adapt the environments and engage the student in academic activities. These range from having a designated quiet area for the student to work in, providing stimulating and hands on activities as well as having a set timetable and breaking down tasks into small manageable sections (Peer and Reid, 2016). Teacher led strategies can improve a student’s inattention, behaviour and disorganisation. However, teachers may experience a wide range of needs in the classroom as no two students will have the same qualities. Students with ADHD can have additional learning difficulties such as Autism, alongside the behavioural, social and academic issues that they face (Kewley, 2011). Teachers need to consider individuality when developing lesson plans and interventions. conversely, interventions can be time consuming and often unsustainable in a busy school environment. 

Students with ADHD can find it hard to make friends because of their ‘social clumsiness’ (Selkowitz, 2004). Adolescence with ADHD have more verbal and emotional impulsions rather than physical (Kewley, 2011). They find reading social situations difficult and often interrupt others, offend people and will not compromise. According to teachers and parents children with ADHD have a higher proportion of friends with learning difficulties (Marton, et al, 2012). Students with ADHD are more than likely to lack maturity and will often associate with younger children. In order to help students build friendships the school could ask an older child to be a mentor as the they are more than likely to listen to other students rather then their teachers or parents (Eldman, 2018). Also, the student could be encouraged to take part in team activities such as sports. This will help them to interact with their peers and build their social skills. Furthermore, school could raise awareness of ADHD by teaching other students about the condition, so are more understanding and sympathetic towards the student. Strategies to improve peer relationships must be employed over a long duration (DuPaul, et al, 2011).

  Furthermore, students with ADHD can experience difficulties with working memory and accessing recall (Selikowitz, 2004).  A poor working memory can lead to them to have difficulties in reading and writing with them being unable to remember or retain information. Subjects such as mathematics and English can be more challenging. Quantative research has shown that students with ADHD perform worse than their peers in reading and mathematical tests (Hart, et al, 2010). Similarly, a student with the disorder may fall behind in high school because there is a greater demand for concentration, harder work and perform poorly in examination (Selkowitz, 2004). With this, difficulties with memory can cause delays in speech and language. They can struggle with audio processing and therefore struggle to listen to the teacher or their peers. It is important for teacher to be aware of the signs of working memory difficulties and try avoid memory overload. Tasks could be broken down into manageable sections and important information written down. Teachers could also supply information before the lessons for the  student could familiarise themselves with the activity. Students could also be encouraged to use memory aids such as pictures and practice recall. Similarly, game activities on computers such as Cogmed working memory training could help improve memory (Gathercole and Holmes, 2014). However, research has shown that memory training is not always successful (Gathercole and Holmes, 2014).

  Conversely, is it not just the students learning difficulty that can affect their educational experience, teachers have an influence on the learning process as well. The Eton report (1989) stated that a teacher’s level of competency can have a major influence on their student’s behaviour (Peer and Reid, 2016). Teacher’s lack of knowledge or beliefs on a subject may have an impact on how they perceive or teach their students. Teachers may view student with ADHD less sympathetically in terms of personality, behaviour and intelligence (George, et al, 2011). To overcome any preconceived beliefs about ADHD and improve teacher proficiency and knowledge, teachers should be given training on how to identify and work with students with ADHD. Aguilar et al (2012) cited in Peer and Reid (2016) noted that more than half of teachers will have a student with ADHD in the classroom at some point in their career (Peer and Reid, 2016). A time limited intervention program has been found the successful in improving a teacher’s knowledge of the condition and management in the classroom, as well as raising awareness (Peer and Reid, 2016).

Students with ADHD experience difficulties not only in the classroom but also in the home as well. It is important for parents and schools to work in collaboration with each other and have effective communication. A study by Mautone, et al (2014) showed that when parents where involved in their child’s education it had a positive effect on their child academic achievements, attitude towards homework and more self-efficient  (Mautone, et al, 2014). Communication programs such as daily report cards could be used to give continuous feedback to the student and the parents on how they have performed in lessons and monitor their behaviour (George, et al, 2011). Daily report cards have been proven to be successful in developing academic performance and improving overall behaviour. Conversely, reports cards may not always be practical in secondary schools as students could misplace them or not show their parents, also parents need to take a active role in working with the school to reinforce any positive behaviours and set goals.  However, many mainstreams schools have been accused of failing students with ADHD and parents may prefer to send their children to special schools. For example, Sheppard (2005) stated that since their son was let down by mainstream school, he is now flourishing in a special residential steiner school (Quarmby, 2005).

In general, many of these strategies used to help moderate or remove the barriers to education that a student with ADHD may face are all based on trying to teach them to be self-regulating. When self – management interventions are used in conjunction with teacher led interventions it encourages the student to monitor and reinforce their behaviour.  An example, of self – management that may be used in the classroom is the likert scale (DuPual, et al, 2011). Students are encourage to evaluate their behaviour and work at regular intervals along with the teacher. Joint evaluations continue until the student can monitor their own behaviour. Recent studies have shown that self – management strategies have been successful in improving the academic performance of student with ADHD (DuPaul, et al, 2011). However, many adolescences with ADHD maybe opposed to doing this or lack interest.

  According to Kewley (2011) interventions in UK schools for adolescents with ADHD vary; some schools offer nurture groups to help with social skills whereas others concentrate on behaviour and academia. However, research by National institution for mental health in the USA showed that the best results for improving a students educational experiences was by using the Multi modal treatments of ADHD (MTA) (Selkowitz, 2004). This model requires the combination of medication alongside strategies such as behavioural intervention. For this model to be implemented successfully professionals and parents need to work in collaboration with each other. Collaborations between teachers and school psychologists have proven to improve a students approach to school and their grades. Promoting academic success in students (Project PASS) is one example of a collaborative consultation model used by teachers and school psychologists to produce educational mediations for students with ADHD (DuPaul, et al, 2011). Furthermore, other professionals such as SENCO’s and school nurses maybe able to provide support. Many SENCO’s and school nurses are now trained in neurodevelopmental disorders (Kewley, 2011). Similarly, a whole school approach could be used with everyone being informed about ADHD. Thus, increasing awareness and understanding of the disorder (Kewley, 2011).

On balance, for barriers to education to be removed or moderated all members that play a role in the adolescences life such as teachers and parents, should work in collaboration with each other. Educational interventions should be proactive, reactive and based on outcomes from initial assessments (DuPaul, 2011). Conversely, when exploring adolescence and ADHD it came to light that there is not enough research on this area. One reason for this maybe from the DSM – IV, it states that symptoms no longer create impairments over the age of 12 rather they are just present (Rabiner, 2013). However, approximately 3.3 million children aged 12 – 17 in the USA have been diagnosed with ADHD (US Department of Health and Human Resources, 2018) This shows that ADHD is not just a childhood disorder rather support and understanding needs to be given throughout a persons life.

References

DuPual, G. J., Weyandt, L. L., and Janusis, M. J. (2011) ADHD in the classroom: effective intervention strategies, Theory in to practice. 50 1 pp. 35 -42. Doi: 10.1080/00405841.2011.534935

Martel, M, M. A., Nikolas, M, M. A., and Nigg, J. T. Ph.D. (2007) Executive functions in adolescents with ADHD, Journal of the American academy of a child and adolescent psychiatry. Issue number 11, volume 26 pp. 1437 – 1444. Doi 10.1097/chi.0b013e31814cf953.

Selikowitz, M. (2004) ADHD, the facts. Oxford. Oxford University Press.

Peer, L., and Reid, G. (2016) Special educational needs, A guide for inclusive practice. 2nd edn. London. Sage Publications Ltd.

Lllyod, G., Stead, J., and Cohen, D. (2007) Critical new perspectives on ADHD. Oxon. Routledge.

Kewley, G. (2011) Attention deficit hyperactivity disorder, what can teachers do? 3rd edn. Oxon. Routledge.

Mautone, J. A., Marcelle, E., Tresco, K. E., and Power, T. J. (2014) Assessing the quality of parent and teacher relationships for students with ADHD, Psychology in schools. Issue number 2, volume 52 pp 196 – 207. Doi https://doi-org.apollo.worc.ac.uk/10.1002/pits.21817

Quarmby, K. (2005) Rebels without a cause. Available at: https://www.theguardian.com/society/2005/dec/06/children.schools (Accessed: 2nd December 2018).

Hart, S. A., Petrill, S. A., and Willcutt, E. (2010) Exploring how symptoms of how Attention Deficit/ Hyperactivity Disorder are related to reading and mathematical performance, General genes, general environment. Volume 21 issue 11. Pp 1078 – 1715. Doi 10.1177/0956797610386617.