Learning Difficulties ? Taking a closer look at AD/HA Attention-Deficit/Hyperactivity


Attention-Deficit/Hyperactivity Disorder is a neurobehavioral disorder that affects an estimated 5 ' 10% of the school age population. There are three subtypes of AD/HD:

'Inattentive ' can't seem to get focused or stay focused on a task or activity

'Hyperactive-impulsive ' very active and often acts without thinking

'Combined ' inattentive, impulsive and too active

AD/HD usually persists throughout a person's lifetime. It is not limited to children. Approximately one-half to two-thirds of children with AD/HD will continue to have significant problems with AD/HD symptoms and behaviours as adults, which impacts their lives on the job, within the family and in social relationships.

How is AD/HD diagnosed'

Currently, there are no medical tests, such as blood tests or electrical imaging that diagnose AD/HD, therefore if a parent or teacher suspects a child has AD/HD a full assessment should be made by the parents, teachers, psychologists, doctors and possibly a prereferral support team. Information from all the sources is reviewed carefully and the clinician has to make a judgement about whether the symptoms of AD/HD impair academic achievement, classroom performance, family and social relationships, independent functioning, self-esteem, leisure activities, and/or self-care. So it usually takes two or more visits to the clinician before a diagnosis can be made.

In order to meet diagnostic criteria, these behaviours, including distractibility, hyperactivity and impulsivity, must be excessive, long term and pervasive. The behaviours must appear before the age of 7 and continue for at least 6 months. Symptoms need to be present in at least two places, e.g., at school, home, community and childcare setting.

Signs and Symptoms

Inattention

The child often:

'Has trouble organising tasks and activities

'Misses details or makes careless mistakes in school work or other activities

'Has trouble sticking to tasks or play activities

'Is easily distracted

'Does not seem to listen when spoken to directly

'Loses things needed for tasks or activities, e.g. toys, school assignments, pencils

'Is forgetful in daily activities

'Tries to get out of things that require a lot of thinking and concentrating

Hyperactivity/Impulsivity

The child often:

'Fidgets with feet or hands, or squirms in her seat

'Has trouble playing quietly

'Is constantly 'on the go'

'Talks 'all the time'

'Runs about or climbs excessively (more than most other children)

'Has difficulty awaiting her turn

'Butts into conversation or games

'Blurts out answers before the questions have been completed

And

'The behaviour pattern is different from most other children of about the same age

'The behaviours happen in ore than one place, e.g. at home and school

'The behaviour has lasted more than 6 months

'The child does not have other major health or development problems, and

'The behaviour is causing the child problems with school work, friends and daily living.

What does this mean for the child'

Kids with AD/HD may be delayed as much as 30 percent of their actual age in their ability to pay attention and remember. This means that a 9 year old may act like a 6 year old in his ability to focus and use self-control. Imagine how hard it might be for a first grader to sit and concentrate on instructions in a fourth grade classroom, and you'll get an idea of how hard it is for many kids with AD/HD to function in groups their own age. It doesn't mean his intelligence is any less; it's just the ability to control impulses that's affected.

What causes AD/HD'

Despite at least 40 years of research worldwide there is no clear explanation for why AD/HD happens in some children.

How is AD/HD treated'

Depending on the child's needs, more than one of the following may be appropriate and/or necessary to help the child succeed.

'Medication

'Behaviour management strategies at home and at school

'Classroom accommodations

'Family and child counselling

How can teachers help'

'Find opportunities to use her strengths and talents at school

'Provide individual accommodations as appropriate

'Reinforce appropriate behaviour

'Follow a consistent behaviour management plan

'Work collaboratively and communicate regularly with parents

References

American Psychiatric Association. 'Diagnostic and Statistical Manual of Mental Disorders, DSM-IV'

National Health and Medical Research Council. 'Attention Deficit Hyperactivity Disorder (AD/HD)'

Robb AS, Surman CHB, 'Diagnosis and management of ADHD from adolescence through adulthood' Medscape

Books

Answers to Distraction by Edward M. Hallowell

Green C, Chee K. Understanding ADHD: a parents guide to ADHD in children.

Cooper P, Indeus K. Attention deficit hyperactivity disorder: a practical guide for teachers