Facts, Reality and Suggestions to help Understand And Support the Child with ADHD

ADHD is an internationally-recognised condition.  It is the subject of an enormous amount of scientific research. However, despite this, fears and/or prejudices about ADHD and its treatment remain.
 
ADHD is a complex neurobiological disorder.  Researchers consider that people with ADHD have a few structures in the brain that are smaller and that their neurotransmitters – the chemical messengers of the brain  - do not work properly.  It gives rise to usually significant problems with concentration, hyperactivity and/or impulsivity that impact adversely on education and home/social life

ADHD occurs in approximately 5% of children worldwide.  

In practice, there are two distinctly different types of ADHD – those with hyperactivity and impulsivity and those who are predominantly inattentive.

40-50% children with ADHD have at least one parent with the condition and 30% have a sibling with it.

Children with ADHD usually behave about a third less than their chronological age with a 2-4 year lag in age appropriate developmental skills – they know what to do but don’t always do what they know. Most children with ADHD have a few activities where their impairments are absent.  The impairments unfold as they get older.

Ratio of boys to girls diagnosed with ADHD is about 5:1.  Boys are often more aggressive and oppositional.  Girls more often have the inattentive form of ADHD and are currently significantly under-diagnosed.

All children with ADHD are not alike – symptoms can be mild, moderate, severe or combined with other conditions.  This means adults will see variability in skills and maturity levels in these students.

ADHD often occurs with other conditions – two thirds of children with ADHD have at least one other co-existing condition, such as Oppositional Defiant Disorder (ODD), dyslexia, depression, anxiety.

Children with ADHD are not “problem children” but children with a genuine problem.  They have a medical condition that is difficult for them and difficult for you.  They stand out as different from peers and siblings at all stages of development. 

Think of the child with ADHD as emotionally fragile – try to avoid regarding him as a nuisance
 
Children with ADHD are slower to learn self management skills, like problem-solving, anger management, conflict resolution, self advocacy and monitoring their own behaviour.  Research and reality tells us that they often experience a significant developmental delay and are not ready for the same level of independence and responsibility as their peers, needing parents/teachers support for longer.  Their skills deficits are real and not due simply to laziness or lack of motivation.

Individuals with ADHD usually have many talents and gifts.  The challenge is to help them develop their potential.

Early identification and effective treatment, after comprehensive multiprofessional assessment, that may include appropriate medication, allows a child to achieve to his potential and have an improved quality of life

A child’s confidentiality should always be respected – special arrangements for medication should not be common knowledge to the class.
 
A teacher’s unprejudiced comments are vital for evaluation and monitoring of progress, especially before and after medical assessment

The child with ADHD on medication will not become an angel overnight – there will still be problems in some situations.  

Even with the best laid plans, there are always instances when the child with ADHD cannot conform.  School can be a hostile place for a child with ADHD.
 
It is often in group situations and at unstructured times that things go wrong for the child with ADHD

The threat of punishment has little effect on the child with ADHD because of poor appreciation of cause and effect and consequences of actions

Try not to assume that the child with ADHD will behave well because of getting a treat or reward
 
Rather than being given a “label”, a child with an appropriate diagnosis of ADHD should then have the best chance of receiving the most appropriate interventions and supports to help him achieve to his potential and have an improved quality of life.

Try to be conscious of the hypersensitivity of the child with ADHD – he often over-reacts to apparently minor – to the observer – triggers and easily becomes overwhelmed by stress and pressure

Try to accommodate skills difficulties;  acknowledge and note vulnerabilities

Sufferers have difficulty monitoring situations and themselves at the same time and adjusting their action to the setting.  They have problems with managing frustration/modulating emotion which takes over and causes over reaction to frustration, hurts, wants and worries.    They are often unaware of how they come across to others or unable to interpret emotions in themselves and others

A comprehensive specialist assessment of a child is indicated - if reasonable educational and other strategies alone have been unsuccessful in improving the difficulties - to establish whether or not there is a diagnosis of ADHD and/or related conditions. 

Medication may be advised in combination with educational, behavioural and other individually-determined strategies to help the child. The aim of medication is to  normalise the brain’s deficient neurochemistry and should be seen as providing a “window of opportunity” to treat the core ADHD symptoms of inattentiveness, hyperactivity and impulsiveness.  
 
Significant improvement in core symptoms is possible in up to 95% of children carefully managed for ADHD.  Side effects – if they occur – are usually mild and transient under careful management. There is also usually a subsequent flow-on effect to many of the other difficulties – ie self esteem, social skills.   A child with associated specific learning difficulties will generally cope much better when able to concentrate; a child who is impulsive or fidgety in class can become aware of the consequences of his/her actions or words.  Hence, the child with ADHD is able to proceed through schooling more appropriately to potential and thus to have a more positive outcome in adulthood. There is also less disruption in the classroom setting.  
 
ADHD is a hidden disability.  The diagnosis is not an excuse – rather an explanation. Symptoms of ADHD present lifelong challenges.  Untreated and misunderstood, it damages a childhood and blights a future and can lead to family dysfunction.  Treated, its many gifts can outweigh its challenges.  

A good understanding of the facts and reality of ADHD – rather than reliance on myth and misinformation – enables teachers to have realistic expectations so they are better able to help and support the child and family