Learning, behaviour and socialisation

Set the right tone

The way a teacher reacts to any student can strongly affect the way other classmates behave towards them. Although you may be very frustrated at times, it is best to try to show patience and tolerance. There’s a greater chance that the whole class will follow your example, making the student with ADHD feel less isolated.

How can we improve their skills?

With a differentiated approach to teaching and learning, you can help the student with ADHD who may be having difficulty with basic academic skills. The important thing is to help them organise their thoughts and to be aware of what is expected of them.

In order to do this the two key attributes are:

• Structure
• Flexibility

Developing structure

Students with ADHD feel safe and secure if they know what to expect. With regular routines and rituals, they become more familiar with what they need to do. The more you can keep to routines and rituals, the better. Any change simply creates distraction, uncertainty and confusion.

How do we help them organise their thoughts?

A major problem facing students with ADHD is that they have problems expressing their thoughts verbally and on paper. They may also do things in the wrong order. Getting students with ADHD to learn how to develop a sequence of events in the right order will bring about real improvements in their academic performance.

One teacher talking about a student with ADHD said that “He is like a computer without the printer attached. He knows the answer in his head, but he can’t give me the hard copy by writing it down on paper.”

A fun way of doing this is to ask the student to describe the sequence of events involved in various everyday activities; for example, you could ask them to explain step by step, how to clean their teeth, run a bath or play a computer game. You could also ask them to describe things in 30 seconds – like a day at school, their home or their favourite video.

Getting students organised

Developing a sequence of events is important so students can learn how to get organised. They need to understand that things are meant to happen in a certain order. Always begin with a simple overview of what you want them to achieve. Then create a framework with simple steps so that the student knows what is meant to happen next. For some students it helps them to say out loud what they are about to do next.

Supporting memory weaknesses

• Encourage your student to connect information or concepts being presented; for example, they’re more likely to remember that someone who had six wives and was a famous English King and is called Henry is a Horrid Henry, as in the book series when they think of them
• Mnemonics can also be useful for remembering important facts
• Repeat directions individually
• Use visual maps
• Colour code their homework diary
• Use flash cards
• Make reminders and lists – Post-it notes®, student diaries and taping instructions to their book bags can all serve as memory prompts. With adolescents it’s a good idea to plan things with them in advance. You can also help them draw up a checklist of things to do. As they grow older, lists can make their lives easier

Useful classroom strategies

There are a number of strategies that you can use in the classroom to help improve the performance of students with ADHD. Obviously, how much you can do, will be restricted by the resources at your disposal, the size and nature of the classroom, the demands of the curriculum and the rest of the class, and the age of your students.

Where should we seat them?

Students with ADHD tend to get overstimulated when working in group situations. Try the following:

• Pair them with less distractible students who are likely to follow the teacher’s instructions
• Seat them near the front of the classroom away from doors, windows and other distractions or in an area of the room which may be more suitable
• It is often better to have them either sit at a single desk or at most a paired desk within the main classroom
• There should also be another area or workstation set up facing the wall and away from the main classroom area where they can learn as needed

Giving previews

It is worth trying to give students with ADHD a preview of what is going to happen in tasks, projects and lessons. This will prepare them in advance of what will be expected of them and prevent them from feelings of uncertainty and insecurity.

Keeping them focussed

As students with ADHD get bored easily, it is important to try and keep your educational content stimulating and varied.

Also try to change your tone of voice and your pace of teaching presentations.

Students with ADHD tend to respond better to concrete learning experiences. They often have high levels of creativity and welcome the chance to learn independently.

Encourage them to tell you if they do not understand what they are meant to be doing. The key is to reinforce the instructions as many times as possible and to remain positive at all times.

Are there typical classroom problems?

There are a number of typical problems facing the teachers of students with ADHD.

Here are some techniques for dealing with them.

Walking around the classroom

• Instead of trying to get students with excessive motor activity to remain still, find them opportunities for regular seat breaks
• If something needs to be written on the whiteboard, ask them to do it
• Give them a job or task that allows them to be active in a controlled way during the lesson

Dealing with impulsiveness

• As students with ADHD tend to act first and think afterwards, they may need help in processing their thoughts before responding

Encouraging attention

• Provide students with a brief outline of the lesson at the beginning
• During the lesson, try to include a variety of activities
• Break everything into short chunks
• In some cases, it can help to have non-vocal music playing either in the background or through a headset device
• Reduce expectations of written work and use alternative ways of recording information
• Review design of worksheets and tests
• Present only one or two activities per page
• Avoid unnecessary pictures or visual stimuli
• Give prompts
• Provide alternative environments for tests and exams
• If attention seems to be waning, use special cue phrases to stimulate interest. Attention grabbers include “Right, here we go;” “Wait for it;” “Now for the interesting bit;” “The next clip is amazing;” and “We’re nearly there now”

ADHD as an explanation, not an excuse!

The emphasis should be firmly placed on recognising where problems exist and finding ways to solve them. The approach should be solution focussed and on missed opportunities for effective learning and development.

How can we get better development?

Students with ADHD do not have a problem with knowing what to do but rather a problem in doing what they know. As a result, they need lots of praise and encouragement. Once they feel you understand their difficulties, they’ll be more likely to work with you rather than against you.

Getting the message over loud and clear

You will often need to address students with ADHD in the clearest possible way.

Here are some examples:

• Always address the student by name
• Keep all instructions short and simple e.g. “Pick up your books please”
• Try to make eye contact wherever possible
• Speak clearly and concisely, and maintain an even tone
• Don’t ask why, say (for example) “What should you be doing now?”
• Also use when, then and either or; for example, “Nathan, when you have put the book away, then you can have a drink” or “When you have put the chair under the table, then you can go”
• Then give your instructions in a simple step-by-step way, pausing between each step and perhaps giving them the chance to do each activity

How should we approach ADHD?

A diagnosis of ADHD can be an opportunity for teachers, students and parents to start again and build a better relationship. As with all good relationships, the keys are to understand the needs of others and to recognise the problems that they face.

When people understand that ADHD is not an excuse but an explanation of why the student behaves in a different way, this provides an opportunity to develop new methods for improved learning and development. This co-operative effort between teachers, parents and all concerned with the welfare of the student will be of great benefit, when old attitudes of ‘them’ and ‘us’ become ‘we.’

How do we deal with difficulties with peers inside and outside the classroom?

Students with ADHD are easy to distract and often overreact to teasing and bullying.

Try to help them not to respond to teasing and make sure that other students are aware that they may be more sensitive to this type of development than other students in the class. It may help to structure break time and lunch by having inside activities and clubs that students with ADHD may attend across the age range. Rituals for learning and praising students with ADHD frequently in class may help raise their general levels of self-esteem and make them less vulnerable. If possible set them up with a ‘buddy’ or peer mentor, ideally from an older class, who can help to support them especially during breaks and lunchtimes. Try to involve them proactively in games and activities with close supervision and support from conflict.

Building bridges with the student and parents

Having ADHD is not about ‘shame or blame’ but that there is a medical reason for the student’s performance and development. No one is at fault, neither the student nor parents. As a result:

• Try to assure both parents and student that you have an understanding of the issues of ADHD
• Inform all colleagues, support staff and lunch assistants of the student’s difficulties so that everyone can prepare and adopt a consistent approach; this is an opportunity to have a fresh start and for everyone to be proactive rather than reactive
• Try talking regularly with the parents and the student, to let them feel you are concerned about how they are feeling and coping

How is ADHD treated?

Management of students with ADHD may involve the following:

• Parent training/education programme – a structured training programme with developmental strategies to improve parenting skills in order to manage your student’s challenging behaviour
• Educational interventions and support at school
• Psychological treatment to help your student cope with his/her feelings and development
• Social skills training – teaching people to be more socially aware in their relationships with other people
• Medication is also available to treat ADHD

NICE (National Institute for Health and Care Excellence) is the independent organisation responsible for providing national guidance on the promotion of good health and the prevention and treatment of ill health. They have produced national guidelines which recommend medication to be used when ADHD symptoms are still causing a persistent significant impairment in at least one domain (e.g. home, school, etc.) after environmental modifications (i.e. changes that are made to the physical environment to minimise the impact of a person’s ADHD on their day-to-day life) have been implemented.

Medication may be a valuable addition to help students concentrate, learn and manage the core symptoms of ADHD; inattention, hyperactivity and impulsivity. When medication is required, most students with ADHD respond well but medication should only be used as part of a wide range of psychological, educational and developmental therapies.

A child and adolescent psychiatrist or paediatrician can assess if medication is appropriate. Dietary fatty acids supplements are not recommended for the treatment of ADHD. Medication is not recommended for pre-school children.

Developmental Parent Training is recommended for parents of students with symptoms of ADHD or Hyperkinetic Disorder.

What kinds of medication are available to treat ADHD?

There are two types of medications – stimulant and non-stimulant – that are recommended as options for the treatment of ADHD. The dose of medication will be tailored to the student’s needs and may change as they get older, depending on their response and any side effects.

Why is taking medication important?

To ensure that your student receives the full benefit of their medication, it is important that it is taken as prescribed. Some medications are taken before school and their effects last for the whole school day. Other medications last for a shorter amount of time and will have to be taken during the school day.

It is important to address any issues around taking medication at school to ensure that they do not miss a dose for any reason. The student’s doctor or parents will explain the dosing regimen and appreciate your cooperation in ensuring your student takes the medication.

Why is monitoring important?

It is important that student progress is monitored when they start treatment for their ADHD. The student’s doctor will want to monitor not only their development and learning and whether their treatment is working, but also whether they are experiencing any side effects if they are taking medication.

The student’s parents may give you a monitoring booklet and ask you to complete it at school. It’s very straightforward. The HCP will need to see this, so that treatment can be adjusted if necessary. Any medication that is recommended by your student’s HCP has the potential to cause side effects. These can be different in each student. It is important that your student’s HCP is aware of any changes that occur, once they start taking their medication. So please try to keep a record of anything you notice at school.

How long does treatment last?

If treatment improves your student’s development, it may be continued for several years as long as it is effective, but this can vary as every student is different. It is recommended for the student’s doctor to review at least annually the clinical need, benefits and side effects of medication, views of the student, parent and teacher and the need for other developmental and psychological therapies. Recent studies suggest that 50–65% of children diagnosed with ADHD continue to have symptoms, and therefore require treatment, into adulthood.

Health and safety

Some students may have to take medication at school – this could mean a supply is kept at school. Some ADHD medications (those that are stimulants) are controlled drugs so they must be kept in a locked container and, like all medications, they must be kept out of reach and sight of children.*

* For more information about keeping drugs at school please read Managing Medicines in Schools (Primary Professional Development) by Joe Harvey