ADHD - Attention Deficit/Hyperactivity Disorder

Phase - 1

Understanding Students with ADHD

Learning Objective: This phase focuses on our prior knowledge

about ADHD, characteristics of these students, various myths
regarding ADHD etc. It will also throw light on whether ADHD is
genetic or not. Few case studies have been provided to bring clarity
to the concept.

ADHD Phase 1 Page 1

 Chapter -1

The term ADHD is associated with attention deficit/hyperactivity

disorder. This course caters mainly to the teachers but parents and
other interested adults can also get benefitted from this course. It will
be an advantage if all are aware of ADHD and how students
with ADHD learn and process information. So, this course is suitable
for parent, teacher, grandparent, or any other adult with an interest
on this topic.

ADHD stands for attention deficit/hyperactivity disorder. Rather than

thinking of these students as having a "disorder" or "disability," let's
approach them as having poor strategy. In the same way that people
sometimes struggle to find ways to work with these students, they
struggle to find ways to make their brains work for them. They do
not know what to do to compensate for the fact that their minds
wander or they find things boring that others don't.

ADHD students are exciting, interesting, and creative, despite their

many challenges. However it can be difficult to teach students with
ADHD, especially when there are 20 or 30 students to attend to in
the classroom—all with varying needs and strengths. The course
focuses on how to help the students who struggle with hyperactivity,
impulsivity, inattention, or difficulty with focusing. Each lesson
provides with strategies for helping the students to become engaged,

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productive, and empowered students so they can learn to channel
their creative thinking towards effective classroom performance.

This course will focus on the practical ways to give all students the
opportunities they need to succeed in school. The course will help to
understand ADHD and how it impacts thinking and behavior. And
the course also includes examples of students with ADHD, their
behavior patterns, and what can be done to help them. Through the
diagnostic process we can help students learn more about
themselves and how they can successfully compensate for their
difficulties and turn them into opportunities.

It's our job to help these students fill their toolbox with effective
strategies.

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 Chapter - 2

What Do We Know About ADHD?

ADHD students show the following behaviour patterns or struggles.

Students with ADHD might:

• Make careless errors in math or writing

• Read their assignments more slowly than their peers

• Have so much energy that you are exhausted just watching

them

• Forget what they learned yesterday

• Regularly forget their homework

• Look at the floor when you talk to them

• Blurt out answers

Most of us don't have to think about how to force ourselves to listen

(at least not all the time). This is not a matter of concern whether the
brain is going to pay attention when we read (usually). There are
things students with ADHD struggle with which usually come

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naturally to us. This is the reason why it helps to learn about ADHD,
what's happening inside the brain, and how this translates into
behavior.

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 Example – Florence

Florence is trying to finish her lesson plan for tomorrow when she is
disturbed by a ringing of some sort. Maybe it's the front doorbell, the
phone, the oven timer, or a reminder on her computer. She takes
care of whatever the ringing indicates, but then she looks at the
clock and realizes she has lost about half- an hour. That should've
been a five-minute interruption—max! Fine, she gets back to work.

But now her thoughts are racing. Did she forget to put that birthday
card in the mail? Did she remind her spouse about the party on
Friday? When is her neighbor's surgery—is that tomorrow? She
needs to make a casserole. Or maybe she can just pick something up
from the market tomorrow. But she has the concert after school
tomorrow. Actually, is tomorrow her dentist appointment?

It can be realized that the only way to resolve all of these worries is
to check the calendar. But once the calendar is checked, people are
suddenly stuck with it for another half-hour.

Have people ever wasted a few hours this way? People had every
intention of getting something done, but a few hours later they are
left frustrated, feeling as if they spent their time flitting from one
thing to another and accomplishing nothing!

That's what it feels like to have ADHD.

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 Case study – Cindy

There was a student named Cindy who always had a lot of questions
to ask, and her body was never still. She moved, fidgeted, wiggled,
and shook all the time. Her parents got her involved in hockey from
the time she was very little, hoping that all the physical activity
would wear her out so that she could sleep better at night. She loved
playing, but to her parents' dismay, it didn't slow her down at all.

It was interesting to learn about what Cindy was thinking, and how
her brain was able to focus when she played hockey but couldn't
focus when she sat during circle time. She was bright, and she was
unusual in the way she operated. She learned things quickly, but she
made so many careless mistakes that she rarely did well in her
exams. Her brain raced from thought to thought, and it was hard to
keep up with her. What a delight—and how exhausting!

All of us have are aware of these experiences to some extent.

Anybody can have moments or even days when he/she is interrupted

from the tasks she/he wants to do. But students with ADHD,
experience this all the time (well, maybe not 24/7, maybe just 20/7).
Gradually it can be seen that there are certain tasks that students

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with ADHD can stay focused on, but these are the exception—not
the norm.

Let's look at the research

1. What are the statistics for students with ADHD?

Three times more boys are diagnosed than girls.

Approximately 35% drop out of school before completing high

school.

Approximately 25% of those diagnosed have a serious learning

disability.

Approximately 45% are suspended at least once before they leave

school.

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 2. Who has ADHD and how do people get it?

Research tells us that 80% of all ADHD cases have a strong genetic
basis. This means that if a child has ADHD, it was passed on by a
birth parent. If there's no genetic link, then it may have been caused
by a birth trauma (brain injury) or foetal malnutrition. It is a known
fact that ADHD is not caused by poor parenting. Nor is it something
that a child can "turn on and off." The brains of people with ADHD
actually have some unique features that can be seen during a brain
scan.

3. What are the typical characteristics of students with ADHD?

There are many typical characteristics, but not all children with
ADHD exhibit the same behaviours. Here are the most common
problem areas for students with ADHD:

Learning from mistakes: This is a biggie. Many students with ADHD

have trouble learning from their mistakes because that requires
cause-and-effect thinking. This type of thinking is controlled by the
frontal cortex of the brain, the area most impacted by ADHD. This is
sometimes referred to as the executive functioning centre.

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Sequential order: This is helpful when plans need to be prioritized
but many children with ADHD aren't able to think or work in
sequential order.

Delayed gratification: Delayed gratification doesn't work for many

students with ADHD, so they need immediate feedback about
whether they're doing things correctly (because 10 minutes may
seem like 48 hours).

Time management: Many students with ADHD have many

difficulties with time—estimating it, understanding it, evaluating
how much they have or how much they have used. They might be
able to read a clock, but they do not have an internal sense of time.

4. How many students have ADHD?

In today's typical classroom, between one and three students are

diagnosed with ADHD, or exhibit many of the common symptoms.

Students with ADHD often repeat the same behaviours over and over
again, even if it gets them into trouble—as if they do not recall that it
did not work the last time.

• Impulse control: Many kids with ADHD suffer from poor

impulse control. Children usually say aloud their
thoughts or act on it. It may be the same thought others
have, however most children keep their thinking to
themselves because they have a filter that says, "Not here,
not now!" For example, Peter might be looking at the
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 teacher and thinking, "That's a really ugly dress she has
on. I do not like it at all." Every child in the class might
have the same thought, but they do not say anything
about it. But Peter says, "Hey, where did you get that ugly
dress?" All laugh because they were thinking the same
thing.

• Problem solving: Children who are suffering from ADHD

often lack the ability to solve problem in various ways,
and they tend to think of solutions as black and white.
This kind of rigid thinking often makes it hard to reason
with these children.

Through research, lot can be learned about students with ADHD and
how the brain functions differently for these students.

The next chapter will look at some common myths about ADHD.
Even though the student with ADHD is faces a lot of challenges and
presents us with a lot of challenges too there are some
misconceptions out there that we should clear from the beginning.

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 Chapter - 3

Myths about ADHD

There are many myths about ADHD. So let us take a few minutes to
examine some of them and get some clarification. For each myth, we
will provide the reality and a possible strategy for working with
students struggling with ADHD.

Reflection: How many of these myths have you heard? Put a

checkmark (√) in the box next to the myth you've heard. Then read
and think about the reality and the strategy.

Myths, Realities, and Strategies

√ Myth Reality A Possible Strategy

Students These students have a Provide a Stress-buster

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Myths, Realities, and Strategies

√ Myth Reality A Possible Strategy

with ADHD motor that's running all ball, a Wiggle Seat, or a

can sit still if the time. If they're forced fiddle stick that the
they really to sit still, their brain is student can use quietly,
want to. thinking about sitting so as not to disturb
still and has little power others.
left to pay attention to
what they're supposed to
be hearing or doing.

If these Look at all that's Ask the student, "When

students can involved when students does your brain work
focus when play— physical action, best," and "What it is
playing high interaction, that allows you to stay
video games, immediate feedback, focused?"
they can visual stimulation, sound
focus in effects. These also
class. contribute to attention.

These It's not avoidance as Does the student

students are much as an inability to generate a goal for the
just trying to do whatever it is that task and keep track of
see what you want them to do. progress? Talk with the
they can Their threshold for student about boredom
avoid. boredom is different, so and ways to take

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Myths, Realities, and Strategies

√ Myth Reality A Possible Strategy

they often have to work control of the boredom

much harder to do tasks while appearing to be
that seem easy for "paying attention," like
others. singing in his or
her head,
connecting the
learning to his or
her own interests, or
focusing on how to
make the background
setting more visually
appealing.

If students Time is a huge variable. Teach time-awareness

with ADHD Students with ADHD strategies. Use a
are given need time to implement countdown timer.
more time cognitive strategies that
on tests, they allow them to be more
just waste it. effective.

If they can These kinds of athletic Help the student list the
stay focused games and activities feed strategies he or she
when they on students' uses to be successful in
play hockey strengths. The coach hockey or whatever

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Myths, Realities, and Strategies

√ Myth Reality A Possible Strategy

or soccer, rewards them for the sport or task that

they can very things that get them works. Then help the
stay focused in trouble in class: student adapt these
in class. constant movement, split natural strategies to the
focus (360 degrees all classroom setting. For
the time), aggressive example, the constant
behaviour and impulsive movement in hockey
behaviour. could translate to
learning to do
isometrics quietly
during class.

Students The hyperactivity seems Help the student

with ADHD to lessen with age, but identify the situations
will grow the executive that are the most
out of it. functioning difficulties difficult. Also, identify
remain. jobs, careers, and
settings that value the
student's strengths.

Students Many adult Let the student research

with ADHD entrepreneurs describe famous people with
can't be their success as a direct ADHD. Read or listen to
successful. result of ADHD and parts from

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Myths, Realities, and Strategies

√ Myth Reality A Possible Strategy

their learning how to autobiographies of

compensate for it. individuals with
ADHD.

ADHD The impact differs from Create a Venn diagram

impacts all student to student, but detailing tasks that are
kinds of many students with impacted by ADHD and
learning ADHD can learn those that aren't
equally. relatively easily if the impacted.
information is presented
through their individual
learning strengths.

Reading isn't Students with ADHD List the behaviours that

affected by may not be able to pay decrease reading
ADHD. attention when they comprehension for this
read. They might have to student (for example,
read the same sentence mind wandering, losing
or paragraph three times place, misreading a
to make sense of it. Poor word). Then, help the
performance on student do an item
multiple-choice tests is analysis of the pattern
often the result of of errors that occur. For
misreading or example, did the errors

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Myths, Realities, and Strategies

√ Myth Reality A Possible Strategy

misunderstanding the occur at the beginning

question—not poor of a test (student wasn't
content knowledge! focused yet), in the
middle of a test
(student ran out of
steam), or at the end
(student ran out of
time)? Or did the
student just not get the
information? Or did
the student misread a
word in the question
that caused him or her
to pick a wrong
answer?

Colleges Extended time is the Contact your local

don't allow most common test college's support
students accommodation in service provider, and
with ADHD colleges and national get information about
to have certification the number of students
extra time exams. Students need with ADHD enrolled,
on tests. current, clear and types of
documentation of their accommodations

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Myths, Realities, and Strategies

√ Myth Reality A Possible Strategy

disability in order to be available for these

eligible for this. students.

What should people do if they hear these myths? How can people
counter them?

There are a few things we can do. First, listen. The people repeating
the myths are probably frustrated with the behaviours they're seeing,
and they don't know what to do about them. So hear them out. Listen
to their concerns, and respond to their frustration. Second, share the
research. In a positive, supportive way, it can be suggested that
there's another perspective.

A bit has been discussed about common behaviours associated with

ADHD, but let's delve deeper into ADHD behaviours in the next
chapter. In chapter 4 we are going to discuss about behaviours and
what's going on in the brain that's responsible for these behaviours.

_______________________________________________________

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 Chapter - 4

ADHD Behaviour and Executive Functioning

Though every child with ADHD is unique, there are some major
areas of thinking and behaviour that are typical of a student with
ADHD. Let's take a few minutes to explore some behaviour patterns
or areas of concern (things that get in the way of students' success in
school), and what might be happening inside the ADHD brain that
causes the behaviour. Fortunately, a student with ADHD probably
won't have all of these.

Effort: Think of these students as firecrackers. They go off, and then

there's nothing left. They want to do more, but they've run out of gas
and can't seem to get going again.

Activation: Think of these students as having no sparkplug. They just

can't get started on something unless it's extremely interesting to
them.

Activity level: Think of these students as having a brain that's only

working when their body is moving. They need the activity to keep
from falling asleep or being bored.

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Attention: Think of these students as having no blinders. Their minds
shift between things in the environment and internal thoughts, and
they have no way to control the weaving in and out of the moment.

Memory: Think of these students as having poor storage systems, so

they keep forgetting things—both new and old. The storage systems
are even worse when there is more than one thing happening at a
time.

Emotion/Effect: Think of these students as being so worried or

anxious about doing things correctly that they are immobilized and
cannot get anything done.

Timing: Think of these students as having no internal clock, no way

to judge or anticipate how long something takes. They have no gas
pedal, so everything happens at the same speed, regardless of
difficulty.

Impulse control: It's okay to think of it without doing it.

Think of these students as having no amygdala (the trapdoor in the

brain that blocks people from saying anything they think), so they
immediately act on any thought.

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Effort, activation, activity level, and the other issues described above
are often classified as executive functioning abilities. Various
difficulties with these categories of behavior in children with ADHD
can be seen very often. However, just because a student has some
executive functioning problems, that student does not necessarily
have ADHD. Gradually the course will discuss each of the executive
functioning abilities listed above, which will give a better
understanding of how they work, what happens when the brain is
unable to control them and the strategies that can be used to help
students overcome or compensate for these problems.

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 Case Study – Jenny

For now, let's meet Jenny a bright sixth-grader. Her teachers

describe her as intelligent, quick to answer questions in class, but on
the verge of failing most of her classes. She doesn't hand in
homework, so they assume that she didn't complete it (even though
she does seem to know the information when it's discussed in class).
When she gets home, she tells her parents that she doesn't have any
homework, or that she forgot to write down the assignment.

In class, she fiddles and fidgets with her pens, pencils, and papers in
her desk, and she never looks like she is paying attention (but she is
usually able to answer when called on). She yawns and acts bored.
She doesn't seem to care what happens (she doesn't get upset very
often). And when she's given a task to do in class, she finishes very
quickly. She's often the first one done, but if her work is checked it's
full of careless mistakes (especially in math and spelling)—things
she could probably catch if she'd just take the time to go back and
recheck her work (or slow down to begin with).

When Jenny does admit to having homework, she takes forever in

her room. When her mom checks on her she' still not done—and she
doesn't know what she's doing up there for so long.

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Now let's look at these same behaviors through the lens of the kinds
of executive functioning difficulties people with ADHD experience.

Executive
Behavior What Jenny is Thinking Functioning

Quick to If I know it, I should say it. If we've Impulse

answer talked about it before, I probably control
questions in already know it.
class

Doesn't hand I did it. I know the information, and Memory

in homework that's what really matters. Besides,
I'm not sure where I put it. And I do
not have to prove to someone else
that I know it!
Forgets to I do not have any idea how Attention
write down everyone else knows what the
the assignment assignment is. I never even heard
her say it.
Fiddles and I need to move. If I do not move, my Activity level
fidgets brain turns to mush. I have to move
to focus.
Never looks If I look at the teacher, I think Attention
like she's about how many zits she has on

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 Executive
Behavior What Jenny is Thinking Functioning

paying her face, and that distracts me. If I

attention look at the floor and twirl my pen, I
can focus better on what she's
saying.
Yawns and There's nothing exciting about this Activation
acts bored stuff. It's boring, and I'll never use
it. I want to like it, but I don't know
how to.
Doesn't seem There's no point getting angry. This Emotion/Effect
to care what kind of stuff happens to me all the
happens; time, and I cannot do anything
doesn't get about it. I may as well just accept it.
upset

Finishes very My brain races through a Timing

quickly challenge. I can't slow it down. It's
like a game to get through as
quickly as possible. I don't know
how to slow it down.
Careless Anyone can tell that I knew what I Timing
mistakes was doing. I was thinking the
answer was six. I don't know why I
wrote a four instead. I do know

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 Executive
Behavior What Jenny is Thinking Functioning

how to do this, but I get caught up

in the thinking, and then this kind
of stuff just comes out on the paper.
I do not know how to change that.
They tell me to proofread, but when
I do, it all looks great—I see what I
was thinking and not what I wrote
down.
Takes forever When I work on my own, my mind Timing
wanders. I try to do the reading—
and I do it—but when I stop, I
cannot recall what I was reading. I
see the words, but they don't make
sense. I have to read the same thing
five times before my brain gets it to
sink in. It is so hard to keep doing
the same thing over and over, but I
don't know any other way to get
my brain to not get sidetracked.
Finished I worked really hard on this Effort
product isn't project. I did all the research, and I
exemplary spent hours putting it together. I
loved working on it. But my teacher

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 Executive
Behavior What Jenny is Thinking Functioning

cares more about how it looks than

what I learned. She doesn't
understand that looking at it over
and over again to find and fix any
mistake is really, really hard. I just
can't force myself to do the editing
and refining that she wants. It
actually hurts. So she thinks I don't
care. But I do! I just can't force
myself to do the busywork she
grades on.

It changes the perception. Some of these thought processes and

behaviors can be recognized in a friend or loved one.

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 Chapter – 5

Summary

This course teaches how to find out what's really going on with
students with ADHD—how to question them and understand their
thought processes. And we will also work on our own feelings about
students with ADHD. It's important that we don't "blame" them. It's
not their fault that they're bored easily or can't attend for long, and
asking them over and over again to "stop it" doesn't work. It assumes
that they could do it if they just tried harder. Try what harder? They
don't know what to do to make their outcome different.

Glossary

ADHD - attention deficit/hyperactivity disorder

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