Professional Documents
Culture Documents
C 2016 NASEN
V
DOI: 10.1111/1467-9604.12121
Introduction
C 2016 NASEN
V Support for Learning Volume 31 Number 2 2016 123
itself in different behaviours, such as aggression or discouragement, leading to
withdrawal (Kendall, 2010). Furthermore, Sherman et al. (2008:351) discuss how
a negative response given by teachers to behaviours by pupils with ADHD can
make these individuals feel ‘embarrassed and socially isolated’, but the teacher
who is patient and has a positive attitude towards a pupil with ADHD can have a
positive impact upon the educational success of that individual.
Bell et al. (2011) report that often teachers have limited knowledge and under-
standing about aspects of ADHD and the impact it can have upon the lives of
children and adolescents. For many children and young people, it is only follow-
ing a diagnosis of ADHD that subsequent support is put in place within school
(Travell and Visser, 2007). The literature discusses the importance of staff train-
ing about ADHD and subsequent management strategies that can support the
pupil within the classroom (Kapalka, 2005; Travell and Visser, 2007; Wheeler
et al., 2008; DuPaul et al., 2011).
Research Approach
Eighteen participants who attended an ADHD support group were initially
approached, with twelve respondents agreeing to take part in the study. The
research design was qualitative in nature with the main source of data collection
being semi-structured interviews. The interview questions were constructed
around two broad areas of inquiry; Living with ADHD and School experience.
Interviews were audio recorded and transcribed verbatim. Transcripts were ana-
lysed; information was coded and then placed into the following five emerging
themes; Diagnosis of ADHD, Medication, Lack of concentration, Teacher sup-
port and understanding and Training for staff.
Participants
Data were generated through semi-structured interviews. The participants
attended an ADHD support group in the North of England. An invitation to
Five of the participants were female and seven were male. Ages ranged from 10
years to 15 years. All participants were in mainstream school. Seven of the par-
ticipants took ADHD medication full time, two did not take any medication for
ADHD and three participants only took medication at specific times such as
examination periods or school days, but not at the weekend or during school
holidays.
C 2016 NASEN
V Support for Learning Volume 31 Number 2 2016 125
time without adverse consequences. (Lambert and Glacken, 2011). Consent/
assent forms were obtained from the parents of the participants and the partici-
pants themselves.
Data Collection
One interview was conducted with each of the participants during the evening
activity session run by an ADHD support group. Each interview lasted between
20 and 30 minutes and was audio recorded and transcribed verbatim. Data was
analysed from the interviews and relevant comments placed within the five areas
of inquiry.
All chosen names were decided upon by the participants themselves and are
gender specific. Prior to each interview, it was made clear to the participants
that they did not have to answer any question that they felt uncomfortable with
and could stop at any time. As Gallagher (2009;16) states: ‘consent must be
renegotiable, so that children can withdraw at any point.’
Data Analysis
For the purpose of this research a thematic data analysis approach was used
(Cohen and Manion, 1994). Following transcription of the interviews, data was
manually colour coded. Following coding, five themes emerged.
Limitations
There are limitations to this study, including that of the small sample size. The
sample was self selected and the views from the twelve participants about their
educational experiences may not be representative of other children/young people
with ADHD; however, the interviews are a rich source of data and identify areas
that can be improved in order to support individuals within a school setting.
For many of the participants, having a diagnosis was important not only for the
individual but also for the family. Participants talked about the ‘relief’ they felt
when being given a diagnosis because they realised that there was a reason for
their ‘behaviours’. The diagnosis also enabled the participants and their families
to access support from external agencies and the school. As Kendall (2010)
acknowledges, often a diagnosis is the first step to effective management of the
condition.
‘The diagnosis has made me understand why I do things and why I day
dream. . .it’s made me feel better about myself.’ (Tony 15)
Other participants described how after having the diagnosis there was an
improvement in school not only because they were able to concentrate more due
mainly to medication, but also because they were able to develop strategies to
help them manage their anger issues, time management difficulties and other
associated difficulties, which is supported by the findings of Shattell et al.
(2008). Two participants stated that they were no longer told off in school, sup-
port was now in place for them and one participant acknowledged that she was
no longer ‘naughty’ in school. When asked what she meant by being ‘naughty’
she stated that she had been defiant all the time, answering back to her teachers
and although she knew what she was doing, she felt that she was not able to
stop her behaviours.
‘It was like me behaviour was dead energetic. I was putting all my energy into
my behaviour rather than my work. I’m really glad that I got diagnosed with it
because I don’t think that I would be in school now. The teachers said to me
and they were being serious they said we didn’t think that you would get this
far and now you are but I’ve been dead good lately and the head teacher said
that he didn’t think I would get past January so it’s great’. (Emma 13)
Emma was no longer sent out of the classroom and recognised that without the
diagnosis and subsequent changes, she would have been permanently excluded
from school. Laver-Bradbury (2012) discusses the consequences of children
with ADHD being frequently sent out of the classroom and suggests that this
can lead to a cycle of failure in terms of educational achievement, issues around
conflict resolution and can lead to permanent school exclusion with the conse-
quences impacting upon future employment.
C 2016 NASEN
V Support for Learning Volume 31 Number 2 2016 127
One of the participants acknowledged that since the diagnosis, the teaching staff
had supported him more.
‘Well, since I’ve been diagnosed, the teachers have been more helpful; they
didn’t used to understand. . .the new SENCO has put strategies in for me. It’s
so much better than it used to be’. (Emmanuel aged15)
One of the participants had a negative view of the diagnosis of ADHD and felt
that this now meant that he might be viewed differently, particularly by his
peers. This perception of being viewed differently is common for individuals
with ADHD (Shattell et al., 2008) and Wiener et al. (2012) also acknowledge
that a diagnosis of ADHD can be positive in terms of access to support and
services, but there is also the possibility of peer rejection and stigma.
‘I wasn’t happy when I was told that I was diagnosed with ADHD because I
didn’t want to be different.’ (Bob aged10)
The researcher asked Bob what he meant by not wanting to be different and he
stated that other pupils were beginning to notice his behaviours and sometimes
they responded to him in a negative way. When asked what sort of things they
did to him, Bob replied:
‘Like, when I’m day dreaming in class and the teacher tells me off, they all
skit me and laugh at me. I get really upset.’
Responses such as above by teachers and peers can impact upon the self esteem
of the individual with ADHD and the negative way that they perceive them-
selves, and can also lead to bullying by peers. (Castens and Overbey, 2009;
Travell and Visser, 2007)
Medication
All but one of the participants had at some time taken medication for their
ADHD and seven of them were on medication full-time. One participant did not
take medication at the weekend, one participant did not take medication during
the school holidays or the weekend and one participant only took medication at
certain times, namely the revision and examination period in school in order to
support concentration. Two of the participants did not take any form of medica-
tion. Similar to the findings of Gallichan and Curle (2008); Kendall et al.
‘Once I got the medication my grades for my school work have been much
better. I feel better because I knew I could learn more. . ..I can understand
things better and I don’t daydream as much.’ (Tony aged 15)
‘The medication is helpful because I’m not running around the classroom. It
helps me concentrate more. This is my GCSE year and it’s really important.’
(Emer aged 15)
‘Before I had the medication, I was dead naughty. I used to say what I thought
and did things without thinking. . ...then I’d get into trouble and I was always
getting put into isolation in school.’ (Emma aged 13)
Lack of concentration
Similar to the findings of Shattell et al. (2008), participants discussed the impact
that ADHD had upon their learning and a common theme that emerged from
the interviews was their difficulty in being able to concentrate within class,
being easily distracted, impulsivity and day dreaming, even when medicated.
Daley and Birchwood (2010) acknowledge that these difficulties can mean that
the individuals with ADHD may experience problems in academic settings.
‘Sometimes it’s hard to concentrate when the teacher is saying things to you.’
(Poppy aged 10)
‘Sometimes I day dream in school and I lose concentration. . .It just happens
and I really don’t know why. . .it’s no particular lesson or anything. . .It just
happens. I also say stuff. . .an idea will pop into my head and instead of keep-
ing quiet, I just say it out loud, sometimes it will be good and other times it
will be bad and I’ll get into trouble for it.’ (Finn aged 14)
C 2016 NASEN
V Support for Learning Volume 31 Number 2 2016 129
‘It’s really hard to concentrate in class. I find it hard to focus on what I’m
doing sometimes especially if the work is boring and I end up getting hyperac-
tive in places that I shouldn’t be and then the teacher shouts at me and I get
into trouble.’ (Sam aged 12)
As a consequence of not being able to focus and concentrate on his work, Sam
stated that he often felt frustrated and angry.
‘My ADHD makes me more angry because I’m not able to focus on things in
school. It makes you a bit frustrated at times.’ (Sam aged 12)
Children with ADHD can pose a number of challenges to teachers within the
classroom environment (Ohan et al., 2011) and Kapalka (2005) acknowledges
that because of the impulsivity of the individual with ADHD, teachers can expe-
rience difficulty in maintaining order within the classroom and proceeding with
academic tasks.
How teachers view and react to particular behaviours in pupils with ADHD can
impact upon how the individuals view themselves in relation to their peers and
certainly influences the academic and social outcome of the individual (Sherman
et al., 2008). When asked if the teachers were helpful and did they understand
about ADHD, there was a mixed response from the participants. Eight of the
participants expressed very negative responses and one of the common themes
that emerged was the fact that the teachers shouted at them in front of their
classmates. The participants spoke of the impact that had on them in terms of
their self-esteem with a number of them feeling humiliated and wanting to cry.
‘No, they don’t understand. One day, one of me teachers in class called me
thick because I didn’t understand what he was saying. . .he called me thick in
front of the whole class. I wanted to cry. They don’t support me and they
don’t care’ (Beyonce aged 13)
‘They just think that I have a behavioural problem and I get into trouble for
not concentrating. They shout at me in front of everyone and it makes me feel
awful.’ (Sam aged 12)
Not all of the participants had negative experiences and for some, the diagnosis
of ADHD had been beneficial in terms of changing teacher attitudes towards the
individual. When asked if staff behaved or responded in a different way follow-
ing the diagnosis, four of the participants acknowledged that they viewed their
school experience more positively and how staff spoke to them was particularly
important. Kapalka (2005) suggests that when a teacher shouts at a pupil who
has ADHD, this approach only leads to an escalation of conflict.
They used to just shout at me but now they say, Emma please. . .. they ask me
to do things in a nice way, not shouting at me. It’s so much better (Emma
aged 13)
One of the participants stated that since her diagnosis, the school had provided
her with a learning mentor which she felt was extremely useful. At the end of
each day, she would meet with her mentor to discuss any issues that may have
arisen. The mentor helped her to improve her organisational skills, for example,
ensuring that she took the correct homework with her at the end of the school
day. Other participants spoke about the support they received from individual
teachers following diagnosis but that this support was not consistent from all
staff.
Me English teacher is the only one who really helps me, she makes sure me
homework is in me diary and stuff like that. . .other wise I would forget and
then I get in trouble. (Jeanette aged 14)
‘Some of the teachers know about my ADHD. The ones that do know try to
help me. I like being in their lessons.’ (Sam aged 12)
Participants spoke about how they often did not understand instructions the first
time of asking and that they found it useful if the teachers repeated information
in different ways. Daley and Birchwood (2010) discuss academic interventions
for individuals with ADHD and acknowledge that this sort of ‘task/instructional
modification’ can be beneficial.
C 2016 NASEN
V Support for Learning Volume 31 Number 2 2016 131
‘I feel supported by the teachers that understand I’ve got my condition. . .they
like repeat things to me or if I kind of like miss it out, they come and stand by
me or sit by me and tell me what to do.’ (Finn aged 14)
When asked what could be put in place to help and support them within school,
the participants made a number of suggestions including the use of a Teaching
Assistant (TA) but they did emphasise that they did not want a TA sitting next
to them on a regular basis.
‘A TA that comes into class and helps everyone else and can come and check
on me. . .just to say how are you doing? And maybe just bring me back into
focus if I’m a bit out of it.’ (Bob aged 10)
Other participants talked about the need to remove themselves from the class-
room environment sometimes and suggested that it would be helpful if there
were ways of letting the teachers know that they needed to leave the classroom
without them having to explain.
‘Maybe the teachers could have something on their desk and I could take it
with me. I would ask to go to the toilet but if I took something with me, they
would know that I needed some time alone.’ (Sam aged 12)
Participants spoke about their hyperactivity and the things that they did in class
which included swinging on their chair, clicking fingers, tapping on the desk,
talking loudly; and Bob talked about ‘fiddling’ with something in his hands
which he felt really helped him to concentrate and pay attention, although this
often brought him into conflict with his teacher who would question if he was
listening to her. Daley and Birchwood (2010:461) call this a ‘distractor object
‘and acknowledge that it can support the individual by ‘distracting them from
the passing of time and subsequently reducing their delay aversion.’
The participants were asked if they felt that school staff should have training
about teaching pupils with ADHD and all of them stated that this would be very
beneficial, particularly so that staff would know which strategies to implement
within the classroom in order to support the individual and more importantly,
staff would know why the participants behaved in the way that they did.
‘If they have children in the school with certain disabilities, then they should
get training. They need to understand about ADHD, having ADHD is bad at
times. . .if you lash out, feel sad or depressed, they need to know what to do to
take care of you.’ (Chris aged 12)
Participants also discussed the need for better communication within the school
setting so that all staff knew of the individuals who had a diagnosis of ADHD,
although some of the participants did stress that they did not want to receive
what they perceived as ‘special treatment’ or for them to be directly ‘singled
out’ by the teacher as they felt this would be embarrassing for them. This theme
is also discussed by Shattell et al. (2008).
‘There was like an e-mail sent around but I’m not sure if some of the teachers
have actually read it because at parents evening me mum would ask and some
of them didn’t know and some of them would.’ (Finn aged 14)
‘I think the problem is that the school is not telling the teachers that certain
kids have ADHD so the teachers are just telling them off and stuff like that.
They don’t understand how hard it is for people like me.’ (Emer aged 15)
One of the participants stated that a simple way to support her would be for all
staff to read her school records as she perceived that not all of the staff were
aware of her having a diagnosis of ADHD. When asked what would help her
within the school environment, she replied;
‘For them all (the teachers) to read my records. . .it’s all over my records the
word ADHD!’ (Jeanette aged 14)
This small-scale study has sought to elicit the reality of the educational experi-
ences of young people who have ADHD and has identified a number of issues.
For many of the participants, the diagnosis of the condition was considered
important in terms of providing a reason for the difficulties they experience in
C 2016 NASEN
V Support for Learning Volume 31 Number 2 2016 133
certain areas of their lives, and the subsequent impact this had upon their learn-
ing. The diagnosis also enabled them to receive support from outside agencies
such as the ADHD support group, in addition to support within the school set-
ting. However, participants acknowledged that this support within school was
not consistent from all teachers.
It was clear that for some of the participants, they were shouted at on a regular
basis by individual teachers and this had a negative impact upon their self
esteem and subsequent learning. It also raises the issue of bullying by the
teacher and subsequently by the other children within the class.
Raising voices and shouting at pupils as a way of getting them to comply with a
command is rarely effective and can lead to an increase in anger and conflict
(Kapalka, 2005). The teachers who adopted a positive approach to the individual
and spoke to them in a calm and reasonable manner were perceived as being sup-
portive and the pupils were more inclined to be compliant. The need for teachers
to develop positive strategies has been stressed by the participants in this study.
Participants also felt that there was a need for better communication amongst
staff as not all of the teachers were aware that certain pupils had been diagnosed
with ADHD and therefore did not implement supportive strategies.
Wheeler et al. (2008) identified the need for teachers to receive more training
and information on supporting pupils who have ADHD. Within a school setting,
provision of continuing professional development (CPD) that relates to meeting
the needs of pupils with ADHD could address the use of positive strategies/
techniques that would help to avoid conflict between the teacher and pupil.
References
ANDERSON, D. WATT, S. NOBLE, W. and SHANLEY, D. (2012) Knowledge of attention
deficit hyperactivity disorder (ADHD) and attitudes toward teaching children with ADHD;
The role of teaching experience. Psychology in the Schools. 49, 6.
BARLEY, R. and BATH, C. (2013) The importance of familiarisation when doing research with
young children. Ethnography and Education.
BELL, L. LONG, S. GARVAN, C. and BUSSING, R. (2011) Impact of teacher credentials on
ADHD stigma perceptions. Psychology in the Schools, 48, 184–197.
BROD, M. SCHMITT, E. GOODWIN, M. HODKINS, P. and NIEBLER, G. (2011) ADHD
burden of illness in older adults: a life course perspective, Quality of Life Research, 21.
BUSSING, R. And MEHTA, A. (2013) Stigmatization and self-perception of youth with attention
deficit/hyperactivity disorder, Patient Intelligence, 5, 15–27.
CASTENS, A. And OVERBEY, G. (2009) ADHD, Boredom, Sleep Disturbance, Self-Esteem,
and Academic Achievement in College Students. Psi Chi Journal of Undergraduate Research,
The International Honor Society in Psychology 14, 2.
COHEN, L. and MANION, L. (1994)(4th Edn) Research Methods in Education, London,
Routledge.
DALEY, D. and BIRCHWOOD, J. (2010) ADHD and academic performance: why does ADHD
impact on academic performance and what can be done to support ADHD children in the
classroom? Child: care, health and development, 36, 4, 455–464.
DOCKETT, S. EINARSDOTTIR, J. and PERRY, B. (2010) Researching with children: ethical
tensions. Journal of Early Childhood Research, 7, 3, 283–298.
DUNNE, L. and MOORE, A. (2011) From boy to man: a personal story of ADHD. Emotional
and Behavioural Difficulties, 16, 4, 351–364.
DUPAUL, G. WEYANDT, L. and JANUSIS, G. (2011) ADHD in the Classroom: Effective
Intervention Strategies, Theory Into Practice, 50: 35–42.
EISENBERG, D. and SCHNEIDER, H. (2007) Perceptions of academic skills of children
diagnosed with ADHD, Journal of Attention Disorders, 10 (4), 390–397.
C 2016 NASEN
V Support for Learning Volume 31 Number 2 2016 135
ELLIS, S. and TOD, J. (2014) Special educational needs and inclusion: reflection, renewal and
reality. Journal of Research in Special Educational Needs, 14, 192–218.
FRANCE, A. (2004) Young People. In S. Fraser, V. Lewis, S. Ding, M. Kellett and C. Robinson
(eds). Doing Research with Children and Young People. London: Sage Publications.
GALLAGHER, M. (2009) Ethics, r in K. Tisdall, J. Davis and M. Gallagher(eds) Researching
with Children and Young People; Research Design, Methods and Analysis. London: Sage
Publications.
GALLICHAN, D. and CURLE, C. (2008) ‘Fitting Square Pegs into Round Holes: The Challenge
of Coping with Attention-Deficit Hyperactivity Disorder.’ Clinical Child Psychology and
Psychiatry, 13: 343.
GOLDER, G. NORWICH, B and BAYLISS, P. (2005) Preparing teachers to teach pupils with
special educational needs in more inclusive schools: evaluating a PGCE development. British
Journal of Special Education, 32, 2.
JONES, P. (2005) Inclusion: lessons from the children. British Journal of Special Education, 32, 2.
KAPALKA, G. (2005) Avoiding repetitions reduces ADHD children’s management problems in
the classroom, Emotional & Behavioural Difficulties, 10, 4, 269–279.
KENDALL, J. HATTON, D. BECKETT, A. and LEO, M. (2003) Children’s Accounts of
Attention-Deficit/Hyperactivity Disorder. Advances in Nursing Science 26, 2, 114–130.
KENDALL, L. (2010) ‘Now he has a label, we can cope!’ Parent perceptions of attention deficit
hyperactivity disorder.’ in R. Sage, Meeting the Needs of Students with Diverse Backgrounds.
London and New York, Continuum International Publishing Group.
LAMBERT, V. and GLACKEN, M. (2011) Engaging with children in research: Theoretical and
practical implications of negotiating informed consent/assent. Nursing Ethics, 18, 781–801.
LARA, C. FAYYAD, J. DE GRAFF, R. et al. (2009) Childhood predictors of adult Attention-
Deficit Hyperactivity Disorder. Results from the World Health Organization World Mental
Health Survey Initiative. Biol Psychiatry, 65, 46–54.
LAVER-BRADBURY, C. (2012) Reducing the social and emotional impact of ADHD. British
Journal of School Nursing, 7, 5.
LOE, I. and FELDMAN, H. (2007) Academic and Educational Outcomes of Children with
ADHD, Journal of Pediatric Psychology, 32, 6, ADHD Special Issue.
MANOR, I. GUTNIK, I. BEN-DOR, D. APTER, A. SEVER, J. TYANO, S. WEIZMAN, A. And
ZALSMAN, G. (2010) Possible association between attention deficit hyperactivity disorder
and attempted suicide in adolescents-A pilot study, European Psychiatry 25, 146–150.
MASSON, J. (2004) ‘The Legal Context’. in S. Fraser, V. Lewis, S. Ding, M. Kellett and C.
Robinson. ‘Doing Research with Children and Young People.’ Sage Publications, London.
MAUTONE, J. LEFLER, E. and POWER, T. (2011) Promoting Family and School Success for
Children with ADHD: Strengthening Relationships While Building Skills, Theory Into
Practice, 50: 43–51.
MULLIGAN, S. (2001) Classroom Strategies Used by Teachers of Students with Attention
Deficit Hyperactivity Disorder, Physical & Occupational Therapy in Pediatrics, 20, 4.
OHAN, J. VISSER, T. STRAIN, M. and ALLEN, L. (2011) Teachers’ and education students’
perceptions of and reactions to children with and without the diagnostic label ’ADHD‘,
Journal of School Psychology 49, 81–105.
SHATTELL, M. BARTLETT, R. and ROWE, T. (2008) ’I Have Always Felt Different‘: The
Experience of Attention-Deficit/Hyperactivity Disorder in Childhood. Journal of Pediatric
Nursing, 23, 1.
C 2016 NASEN
V Support for Learning Volume 31 Number 2 2016 137