Students with attention disorders and hyperactivity need special structure in the classroom. They have to be kept away from sources of distraction, like noise sources or windows, that would not distract other students. They may need special seating in the classroom that allows them to move around or special lessons that incorporate physical movement. Students with significant attention issues may need instructions to be written down, and they may need to be reminded where the instructions can be found. They may need instructions broken into smaller parts, and they may need frequent breaks. They may need special praise and recognition. They may need more than average attention to maintain their self-esteem.
There have been descriptions of hyperactive, inattentive, and impulsive children in the medical and educational literature since the 18th century. In 1902, British pediatrician, Sir George Still described it as “an abnormal defect of moral control in children.” As the medical and psychological establishment has begun to think more in terms of neurological and brain physiological constructs and theories, the conditions of attention deficit and hyperactivity more recently became embedded in psychiatric diagnostic categories. Having those in the DSM (Diagnostic Statistical Manual, American Psychiatric Association) doesn’t really make them easier to understand and treat.
After benzedrine was approved by the U.S. Food and Drug Administration in 1936, Dr. Charles Bradley stumbled across the fact that the behavior of his young patients, suffering from this abnormal defect in “moral control,” improved when they were given benzedrine. In 1955 a newly approved psychostimulant, Ritalin became more popular for treating this still unnamed condition.
Even though parents and teachers have observed problems of attention and impulse control in the classroom for many years, it wasn’t until the late 1960s that the problem was recognized as a mental disorder, originally calling it hyperkinetic impulse disorder. The category, “attention deficit hyperactivity disorder” (ADHD) appeared in the DSM III in 1987. Now, attention disorders fall into two categories: ADHD and Attention Deficit Disorder (ADD), for people who struggle with attention but without the hyperactive component.
The prevalence of children with ADD and ADHD in the classroom actually varies by where children live. In some states in the mid-west and south more and 13 percent are diagnosed. In other states in the west and northeast, the prevalence is closer to 7 percent of students. The prevalence of attention disorders has been going up regularly, from an average prevalence of 7.8 percent in 2003 to 11 percent in 2011. The rate of ADD/ADHD prevalence in Texas is reported as 10.1 percent.
According to an article in World Psychiatry, ADD/ADHD may appear to be largely a condition of American classrooms. Many have said that attention disorder problems may stem from American social and cultural factors. Others say that ADD/ADHD is really universal, but is not widely recognized by the medical communities outside of the United States. An analysis of data from 50 U.S. and foreign studies found the rates of ADD/ADHD internationally were not significantly different.
Diagnostic labeling does vary from country to country. For example, in Great Britain, children with hyperactive behavior may be more likely to be diagnosed as having a “conduct disorder than student diagnosed with ADHD in the US. The lack of true differences in behavior was confirmed by a Scottish study that used an objective behavior measure (the Connors’ 1969 Teacher Rating Scale). The international comparison confirmed that differences in diagnostic practice my account for what appeared to be differences in prevalence.
A Real Disorder:
In the U.S., ADD/ADHD is treated as a permanent condition of the child. Until the 1990s, the medical establishment considered it to be a “childhood disorder.” Now, the perspective has changed, physicians are considering ADD/ADHD a treatable condition that carries across generations, with a probable hereditary component. The bulk of opinion is that treatment for ADHD may be continued throughout life. The American Academy of Family Physicians have concluded that about two-thirds of children with ADHD will continue to grapple with the condition throughout life and may need continued medication.
Children diagnosed with ADHD tend to have fewer, poorer social relationships, have a greater likelihood to commit motoring offenses and are more likely to develop chemical abuse. Parents and siblings also suffer from the behavioral problems associated with clinically notable ADHD symptoms.
There are a variety of approaches families can take to help a child with ADD/ADHD. Many parents have strong opinions about which approach is right for their child. Here are a couple of the more common approaches:
- Medication – With the consultation of a physician, there are numerous medications with the potential to help a child’s attention. The most prevalent medication to treat ADD/ADHD fall within the stimulant family. For children who respond poorly to the stimulant medications, there are also non-stimulant medications available which have been shown to help. In any case, medication is not the right choice for some families. Many families do not believe in medicating their child in this way and many children cannot take medication due to the side effects they cause for them.
- Diet & Exercise – Many families feel they can control the symptoms of ADD/ADHD with proper control of a child’s diet and exercise. This typically involves limiting intake of sugars, processed carbohydrates, and perhaps gluten. To balance blood-sugar, families may schedule smaller but more frequent meals for an ADD/ADHD child. They may also augment food with supplements (zinc, iron, magnesium, or omega-3). An active lifestyle also gives children a productive outlet for their energy and attention.
- Sleep – Children with ADD/ADHD may also struggle to sleep at night. Symptoms of ADD/ADHD worsen when a child is not getting the proper sleep. Diet and exercise may help with sleep, and many families will use Melatonin at night to help their child sleep.
- Limit Use of Electronics – Children with ADD/ADHD are often drawn to electronics. The stimulation they receive from watching and/or playing may exacerbate the ADD/ADHD symptoms when not watching/playing. It’s best to limit the amount of time a child uses electronics.
The Tenney School has had a unique learning approach based on individualized education for students in the Houston area since 1973. For more information, please contact us.