What is ADHD? According to the fourth edition of the Diagnostic Statistical Manual of Mental Disorders (DSM-IV) of the American Psychiatric Association (APA) (1994), ADHD can be defined by behaviors exhibited. Individuals with ADHD exhibit combinations of the following behaviors:
• Fidgeting with hands or feet or squirming in their seat (adolescents with ADHD may appear restless);
• Difficulty remaining seated when required to do so;
• Difficulty sustaining attention and waiting for a turn in tasks, games, or group situations;
• Blurting out answers to questions before the questions have been completed;
• Difficulty following through on instructions and in organizing tasks;
• Shifting from one unfinished activity to another;
• Failing to give close attention to details and avoiding careless mistakes;
• Losing things necessary for tasks or activities;
• Difficulty in listening to others without being distracted or interrupting;
• Wide ranges in mood swings; and
• Great difficulty in delaying gratification.
It is important to note that these symptoms must be present in more than one setting, i.e. school and home; symptoms must be harmful to the child socially or academically for at least six months. While all children may have these symptoms at times, with ADHD, the symptoms are more frequent and severe. Many children with ADHD simply can’t control their behavior even when they try. This often leads to frustration for these children. Frustration is shown with anger, giving up, or a sense of hopelessness. Frustrated children seem to just “shut down.”
There are three subtypes of ADHD (DSM-IV):
Inattentive type: These children are the hardest to detect. They are the daydreamers who may have difficulty following directions and completing work.
Hyperactive/Impulsive Type: These children are not only constantly on the go, but they also the lack impulse control appropriate for their age. They may have a hard time sitting still and need to fidget a lot. In older children and adults, this will mostly appear as impulsive behavior
Combined Type: These children show symptoms of BOTH types of ADHD.
Many children have ADHD in combination with other disorders. According to the US Department of Education, approximately one-third to one-fourth of children with ADHD also have learning disabilities. Children with ADHD also have a higher than average rate of having other psychiatric disorders such as Oppositional Defiant Disorder, Conduct Disorder, Autism Spectrum Disorders, and mood disorders.
As educators, we are not qualified to make an ADHD diagnosis. However we are often the first to notice signs of it in a child. So, if you suspect a student may have ADHD, contact your school counselor. Your counselor can observe the child and talk with the child to rule out other problems that may have similar symptoms such as depression, anxiety, and abuse. You can mention to parents that their child shows some signs of ADHD and recommend that they talk to their doctor or other professional. Never recommend medication for a child. Only a licensed medical professional can do that.
Teachers need to be sympathetic with parents. In making decisions regarding their child’s ADHD, they most consider the child’s overall well-being. School behavior is just one part of that. Most ADHD medications have serious side effects that the child may or may not be able to tolerate. I know this only too well. My son has ADHD and is not able to tolerate the side effects from stimulant medications. As parents, we are constantly weighing the risks and benefits of different medications and treatments for our son. We are always watchful to make sure that the current treatment is still working and wondering what the next growth spurt will bring. It is very complicated to manage his ADHD and we are often faced with very difficult decisions. The best thing that teachers can do to help is communicate with parents. Report changes in the student’s behavior so that the parents can notify the doctor when behavior changes become significant.
Adults need to always keep in mind what is best for the child as whole. When parents, teachers and doctors work together, children get the help they need to thrive and be successful in school and in life.