ADHD is Real but What Does this Mean for Teachers?
Over the years teachers have been suspicious of the diagnosis Attention Deficit Hyperactivity Disorder (ADHD). It seemed that every child who presented with behavioural problems came with, or soon obtained that special diagnosis. I believe a reason for this is that some parents use the diagnosis as a justification for their child’s misbehaviour and a reason to abdicate their permission for schools to deliver consequences.
The diagnosis requires the display of a range of behaviours that could be categorized as having problems of paying attention or difficulty in controlling behaviour. Studies of the brain structure of those with ADHD also show a reduction in the neural density of the left side of their frontal lobe and a reduced number of neurons in the posterior parietal cortex.
The behaviours displayed are exactly the same as those for children who have suffered early childhood abuse and/or neglect (PTSD) and the abnormal brain structures are also present in children who suffer from PTSD.
Another commonality is that the presence of both disabilities is much more common in boys than in girls.
The use of medication varies between the two with stimulants such as Ritalin seeming to be the most prescribed for ADHD. The object is that the stimulant will support the frontal lobe increasing the child’s ability to focus. In the case of PTSD there is some use of serotonin reuptake inhibitors, SSRI’s for adults and some trials being undertaken for children. This has the goal of calming the child, making them less hyper-vigilant or dissociative.
The bottom line is that both do exist and even if ADHD is over diagnosed and PTSD is under diagnosed this is irrelevant for teachers. Teachers deal with the behaviours presented in the class. What is effective for ADHD is effective for PTSD, is effective for a whole range of ‘disorders’ including ‘puberty’ because the teacher’s approach is to provide the environment in which these students operate.
The environment is the classroom and as you know or will come to understand, my view of what makes a ‘quality’-learning environment is much more than the criteria set out in the National Standards.
Of course the pedagogy and the presentation of content is vital and should be at the forefront of preparation but for these disadvantaged kids the social and psychological elements in the classroom must be in place before they will get to any lesson content. These are:
- Relationships – Just how they are accepted, how they feel they ‘fit in’ is vital and because their behaviours are frustrating and sometimes repulsive it takes a special teacher to provide that sense of belonging.
- Expectations – Any insecurity about what might happen will quickly distract these children. Those with ADHD will soon look for something to occupy their attention, those with PTSD will begin to focus on perceived threats or escape routes just in case they are attacked.
Structure – Structure is much like expectations but expectations is about what may happen in the future Structure is about knowing what will happen when you have done something. These students feel disempowered, they don’t have a sense of control over their life but if we provide this connection between what they do and what happens to them, they will slowly gain the sense that they do have some control, they become empowered.
The real reward for teachers that provide an environment that supports these dysfunctional students is that the approach that works for them is the gold standard for all students.