Wednesday, March 16, 2011

What is Attention-Deficit/Hyperactivity Disorder Anway?

Before I give you the medical/educational definition, listen to Stacey who decided to home school her son Bobby who had ADHD. She did not feel that Bobby would be able to learn within the confines of a classroom due to the fact that he could not stay in any one place for a prolonged period of time, a typical characteristic of ADHD.


And then, by the time Bobby was four, for sure, I was pretty
convinced that he had ADHD. And, um, and I was also convinced
that I didn’t want to medicate him. And, um, so, but I
know that if he was in a classroom that, well, first of all he was
four and a half. And I’m thinking, he’s supposed to be ready
for kindergarten soon? And I’m thinking, there’s no way this
kid could sit in a classroom for a half-day or a whole day, either
one. So I started thinking, wow, that’s not going to be good for
him. It’s not going to work for him. I realized that he wasn’t going
to be suited for classroom learning. And originally, that was
one of my big reasons was that I knew that a classroom wasn’t
going to be a good place for him.



Other children exhibit the following characteristics in their classroom as noted from an adapted Conners Rating Scale:



✱ Restless in the “squirmy” sense

✱ Excitable, impulsive

✱ Fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities

✱ Is an emotional child

✱ Restless or overactive

✱ Does not appear to listen to what is being said to him

✱ Leaves seat in classroom or in other situations in which remaining seated is expected

✱ Inattentive, easily distracted

✱ Has difficulty waiting his turn

✱ Does not know how to make friends

✱ Fidgeting

✱ Disturbs other children

✱ Talks excessively

✱ Runs about in situations where it is inappropriate

✱ Has poor social skills

✱ Fidgets with hands or feet

✱ Demands must be met immediately—easily frustrated

✱ Blurts out answers to questions before the questions have been completed

✱ Interrupts or intrudes on others

✱ Easily distracted by extraneous stimuli

✱ Restless, always up and on the go

Have you noticed any similar symptoms in your students? Let’s continue on to the accepted definition of ADHD, which has become the umbrella term for attention-deficit/hyperactivity

disorder of all types. So we are all clear on exactly what we mean by attention-deficit/hyperactivity disorder (ADHD), here is the well-accepted, current definition of it according to the Diagnostic and Statistical Manual of Mental Disorders (DSMIV-TR):

The essential feature of Attention-Deficit/Hyperactivity Disorder
is a persistent pattern of inattention and/or hyperactivity impulsivity
that is more frequently displayed and more severe
than is typically observed in individuals at a comparable level
of development (Criterion A). Some hyperactive-impulsive or
inattentive symptoms that cause impairment must have been
present before age 7 years, although many individuals are diagnosed
after the symptoms have been present for a number
of years, especially in the case of individuals with the Predominantly
Inattentive Type (Criterion B). (APA, 2000, p. 85)



The DSM-IV-TR categorizes these children into four types:

✱ Attention-Deficit/Hyperactivity Disorder, Combined Type

✱ Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type

✱ Attention-Deficit/Hyperactivity Disorder, Predominantly Hyperactive-Impulsive Type

✱ Attention-Deficit-Hyperactivity Disorder, Not Otherwise Specified (APA, 2000, p. 87)

The inconsistency of these children’s behavior is very frustrating to teachers who work with them. One of the most difficult things about Timmy’s behavior (whom I have discussed previously in this blog) is that it was evidenced by inconsistency. Please read a portion of my notes that I wrote during the time that I worked with Timmy:

This is the first year that the school has allowed him to have gym. Last year, the teacher did not feel that she could run the gym class successfully because she constantly had to manage Timmy’s behavior. I believe that one of the reasons, among others, that he exhibited socially inappropriate behavior in gym class was that he did not know how to play many of the games that the teacher played. Therefore, I taught him many games this year that he had never been taught how to play. For example, I taught him how to play soccer and kickball. Today, I talked the gym teacher into permitting him to participate in the kickball game that she was facilitating in gym class. After teaching him how to kick the ball properly, and run around the bases according to the rules, he made a big kick that enabled him to get two children “home,” as well as himself.

Timmy ran “home” at the same time as a child threw the ball in an attempt to get him out before he crossed the plate. Timmy then took the ball and threw it at the child’s face, hurting him. When he saw the child cry, he felt very badly. I made him apologize. I also had him sit out of the game for a few minutes. There was clearly no “rhyme or reason” for his behavior. He finally had athletic success, yet behaved in a destructive manner.

On the same day that he had displayed the socially inappropriate behavior I just described, he also exhibited socially appropriate behavior. I simply could not explain Timmy’s enigmatic, inconsistent behavior.

Again, my notes: The social studies teacher finished her lesson earlier than expected and allowed the children some free time. Timmy played a clever variation of a Hang-Man game with Hebrew letters for thirty minutes with three other boys and one girl. He was clearly the leader at this game and set up the rules. He was able to negotiate with all of the children who were playing Hang-Man with him. I have witnessed this positive interactive behavior before. This was not parallel playing as with Legos but interactive behavior, where Timmy was laughing and having a good time. He was an equal member of the group, in terms of social interaction.

On that day, Timmy exhibited both socially inappropriate behavior and socially appropriate behavior. When children with ADHD behave in such an inconsistent way, the people around them often misperceive their behavior. These outsiders, as I call them, view these children’s behavior as representing the child. They view ADHD as a disease. That is why you will hear me referring to children who are diagnosed with ADHD as children with ADHD or children who have ADHD rather than ADHD children. These children, our children, have a disorder that affects their behavior. Children with ADHD and their behavior must be viewed as two separate entities, even though these children are ultimately responsible and accountable for their behavior.

No comments:

Post a Comment