Attention Deficit Hyperactivity Disorder (ADHD)

Definition:
The American Psychiatric Association (2000, in Wilkes et. al. 2011, p.231) defines Attention
Deficit Hyperactivity Disorder (ADHD) as a common neuro-behavioural disorder which is
characterised by developmentally inappropriate levels of hyperactivity, impulsivity and
inattention. In the third edition of the American Psychiatric Associations Diagnostic and
Statistic Manual of Mental Disorders (DSM-III) (1980 in Block, Macdonald & Piotrowski
2014, n.p.) first defined Attention-deficit Disorder (ADD) with or without hyperactivity. The
definition evolved later on and changed to Attention Deficit Hyperactivity Disorder (ADHD)
in an updated DSM edition released in 1987. ADHD is a condition characterised by an
individual having the inability to sustain attention or to abstain from impulsive, hyperactive
behaviours (Block, Macdonald & Piotrowski 2014, n.p.). It is important to remember that
individuals who do not have ADHD may exhibit these types of behaviours, at times.
However, individuals with ADHD who have been formally diagnosed must display these
symptoms in multiple settings and most of the time (Block, Macdonald & Piotrowski 2014,
n.p.). The Diagnostic and Statistic Manual of Mental Disorders (DSM-5, in Block,
Macdonald & Piotrowski 2014, n.p.) states a child must demonstrate at least six of the ADHD
symptoms for a minimum period of six months in order to be diagnosed with the disorder.
ADHD is also commonly linked with comorbid disorders including: depression, anxiety,
motor skill development problems, learning difficulties, behavioural disorders and
verbal/cognitive difficulties (Storebo et. al, 2011, p.1)

Characteristics
There are three primary characteristics of ADHD: inattention, hyperactivity and impulsivity.
Depending on which characteristics are dominant, children with ADHD may present very
differently from one another. Children with ADHD may be:
1. Impulsive and impulsive, but are able to pay attention
2. Inattentive, but not impulsive or hyperactive
3. Hyperactive, impulsive and inattentive (Smith & Segal, 2014, n.p.)

Children with ADHD will usually have some but not often, all- of the characteristics of the
condition. Individuals may have either hyperactive-impulsive (meaning and/or) form of
ADHD, or inattention type (Selikowitz 2009, p.5).
Selkowitz (2009, p.6) outlines some of the common features of ADHD:
Inattentive type
Forgetfulness
Disorganisation
Impersistence with

Hyperactive-impulsive type
Noisiness
Impulsivity
Over-activity

tasks
Poor concentration

May be present in both types

Short-term memory

issues
Low self-esteem
Learning difficulties
Social issues
Inconsistency with
performance

Effects on peer relationships:

Many children with ADHD have social difficulties leading to troubles with peer relationships
which may then extend into adolescence and even adulthood (Wilkes et al., 2011, p.231).
Children with ADHD may have difficulties in forming friendships due to their tendency
towards dominant, destructive and egocentric nature during play time (Cordier et al., 2009, in
Wilkes et al., 2001, p.232). Social skills necessary in order to form and maintain meaningful
friendships include: problem-solving, perspective-taking, sharing, negotiating, supporting and
creating mutual enjoyable experiences (Wilkes et al., 2011, p.238). If a child with ADHD is
overcome with hyperactivity, poor impulse control, inattention and low-self-esteem, these
behaviours all have the potential to interfere with the social skills necessary to form
friendships.
The types of social skills that may need to be taught to children with ADHD include: learning
to read subtle social cues, take turns, how to read emotional expressions and body language
of others (Storebo et al., 2011, p.2). It is important these social skills are taught as early as
possible to try and alleviate the problem of peer-rejection that may occur. Many children with
ADHD have serious difficulties with peers due to their lack of social and emotional abilities
which can lead to children with ADHD becoming isolated and lonely (Storebo et al., 2011,
p.10). It is important to address these issues early on, as once a cycle begins it is often
difficult to break.
Effects on learning:

Picture a school setting and what students are expected to do on a day-today basis e.g.
listening, paying attention, sitting quietly, concentrating, following instructions. These are all
things that a child with ADHD would find extremely difficult due to their brain refusing to let
them do so (Smith & Segal, 2014, n.p.). When a child is continually getting out of their chair
or perhaps staring off into space or at the butterfly outside, obviously these behaviours will
interfere with learning.
Whether or not a child with ADHD is struggling with hyperactivity, impulsivity, inattention
or a combination of all three, these symptoms have the potential to lead to lots of struggles
with school (Smith & Segal, 2014, n.p.). If a child with ADHD begins to feel frustrated due to
these difficulties, this could lead to low self-esteem which can have a huge impact on a
childs academic achievement. If teachers are not educated about ADHD and have a student
in their classroom, this could have serious impacts on the childs learning. For example, if a
teacher is not aware that individuals with ADHD may have low self-esteem and have
difficulties in sustaining eye contact, they could misinterpret this as the student being rude
(Selikowitz 2009, p.110). If a student is not properly diagnosed with ADHD, a teacher may
incorrectly assume the child is not paying attention and being hyperactive on purpose. It is
important for teachers to be educated about ADHD and how to support a child with ADHD in
the classroom to ensure the impacts on the students learning is minimal.

What can teachers and schools do to support students with ADHD in the classroom?
Firstly, it is important for teachers to realise that children with ADHD are not bad or
naughty children who are being impulsive, inattentive and/or hyperactive on purpose. On
the contrary, they would usually love to be more successful with areas that cause them
difficulties such as; school, friendships and home life, but they just cannot (Block,
Macdonald & Piotrowski 2014, n.p.). Imagine not being able to control impulsive or off-task
behaviour, not being able to sort what information is important and what is not and not being
able to focus and maintain attention on tasks. You can imagine how difficult and draining it
would be for an individual to try and focus for an entire school day.

School children spend the majority of their time at school which involves time within the
classroom and also in the playground with peers. Negative experiences in either of these

settings can have severe impacts on students academic achievement, social skills and selfesteem (Selikowitz 2009, p.105). Considering individuals with ADHD may have struggles in
these areas already, this shows the importance of teachers being educated in what they can do
to best support a student with ADHD.

Three techniques for teachers to use when working with a child with ADHD:
1. Teach instructions for task through use of multi-sensory teaching strategy. By
connecting multiple sensory inputs, new learning is connected with input from the
ears, voice, eyes and/or hands e.g. first, directions for task will be sung, then tap the
table for how many steps there are, then make a picture list of prompts for each step
(Copper-Khan & Dietzel 2009, p.18). This strategy would be used to help overcome
issues of poor short-term memory, inattention and distractibility characteristics of
individuals with ADHD.
2. Teachers should build a positive relationship with the child and the childs family.
Building rapport with any child in your class should be high on your list of priorities.
All children need to feel safe and supported in order to be able to reach their full
potential. A child with ADHD is no different. Set up a communication book which is
sent home each night with the child. The purpose of the book should be to keep
communication lines open, keep the parents up-to-date with what progress their child
is making at school and what you, as the teacher, are putting in place in order to best
support their child (Selikowitz 2009, p.109). If you are having more serious issues
with the child within the classroom, organise a parent-teacher meeting after school or
even a simple phone call to discuss what has been happening at school. Ensure you
remember to use parent-teacher meetings and/or phone calls as means for passing on
positive feedback as well!
3. Teachers should set up their classroom in a way to create a supportive learning
environment for students with ADHD. Teachers can do this by seating a child at the
front of the class (whilst seated at their desks and share time on the floor) to ensure
they have the childs attention before they begin speaking. By the child having their
back to the rest of the class, this lessens the possibility of distractions. However, it is
important the child is seated with the rest of the class so they are not made to feel like
an outsider. The teacher could also place students who may be seen as good role

models either side of the student with ADHD in hope they will be less distracted as
they are surrounded by students with good work habits (Selikowitz 2009, p.107-108).

References:
Block, R, Macdonald, N & Piotrowski, N 2014, 'Attention deficit hyperactivity disorder (ADHD)',
MagillS Medical Guide (Online Edition), Research Starters, EBSCOhost, viewed 15 September
2014.
Cooper-Kahn J & Dietzel L 2009, Changing School Behaviour: Helping Children with Executive
Functioning, Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) 2014 ,
viewed 16 September 2014,
<http://www.chadd.org/Portals/0/AM/Images/Understading/Feb09_ExecutiveFunctioning.pdf>.
Selikowitz, M 2009, ADHD / Mark Selikowitz, n.p.: Oxford ; New York : Oxford University Press,
c2009., DEAKIN UNIV LIBRARY's Catalog, EBSCOhost, viewed 15 September 2014
Smith, M & Segal, R 2014, ADD/ADHD in Children, Helpguide, viewed 16 September 2014, <
http://www.helpguide.org/mental/adhd_add_signs_symptoms.htm>.
Storeb, O, Pedersen, J, Skoog, M, Thomsen, P, Winkel, P, Gluud, C, & Simonsen, E 2011,
'Randomised social-skills training and parental training plus standard treatment versus standard
treatment of children with attention deficit hyperactivity disorder - The SOSTRA trial protocol',
Trials, 12, 1, pp. 18-28, Academic Search Complete, EBSCOhost, viewed 16 September 2014.
Wilkes, S, Cordier, R, Bundy, A, Docking, K, & Munro, N 2011, 'A play-based intervention for
children with ADHD: A pilot study', Australian Occupational Therapy Journal, 58, 4, pp. 231-240,
CINAHL Complete, EBSCOhost, viewed 15 September 2014.