I am a trainee and I have been very pleased at the amount of time my course has spent discussing SEN and strategies for teaching. However, I am still a little in the dark on the issue of teaching pupils with (diagnosed or undiagnosed) Attention Deficit and Hyperactivity Disorder.

My parents are both teachers (now in FE) and they say that this disorder was largely unheard of when they started teaching and are rather sceptical about its actual existance. There were badly behaved kids who were dealt with and that was the end of it.

Accepting that it is a medical condition, I am interested in finding out how do you engage these pupils? What are people's views on Ritalin and other drugs, especially in the light of certain documentaries and news items revealing how it is developing as a recreational drug and being bought and sold as any other?

I appreciate that this a somewhat contraversial issue but it is something I am very interested in.

There is great controversy about ADHD and I think that these students are some of the most challenging to deal with in the classroom. In fact attention deficit children were identified as early as 1902 and have been known by such names as Hyperkinetic Impulse Disorder and Minimal Brain Dysfunction. Boys are more likely to be identified as having ADHD and as a consequence girls with the disorder can be more at risk of long term academic, social and emotional difficulties.

I find that these students respond to a positive and individual approach from teachers particularly during the beginning of a school year when ADHD students are coping with transition. Computer assisted learning is more able to hold their attention. Self monitoring, where students act as observers of their own behaviour usually results in students achieving better self control. Ignore minor negative behaviour but praise the student when your expectations are met. Maintain a close proximity to the student and spend a few minutes each lesson having a brief conversation with him. The work should be in bite-size chunks with careful monitoring to ensure that the ADHD student does not get left behind and feel discouraged.

There are a range of strategies discussed in publications such as The ADD Hyperactivity Handbook for Schools(ISBN O-9621629-2-2) and The Attention Deficit Disorders Intervention Manual (pub-Hawthorne)


I can understand a parental reluctance to give a their children Ritalin. However, without medication some ADHD students are unable to respond to behaviour modification and face long term exclusion from school.
Anne Jakins

I think we need to remember that some of those children who were just called "naughty" were in fact ADHD. In the past they could be punished by being removed, caned, or put in behaviour units etc. After primary school they could be found jobs and exempted from school. If your parents taught in a grammar school or selective school they may never have seen the teachers dealing with these kids in a secondary modern. Now we have them all in one place.
We sometimes described them as the workaholics of this world, or the "fidgeters" or the ones who wee "always on the go". Now we diagnose more scientifically.
It's a bit like Dslexia. There are many kids who are genuinely dyslexic and many who are genuinely ADHD, but it is also a fairly easy excuse/diagnosis for poor parenting. You have to be able to distinguish betweeen the two and that is sometimes very difficult.
Often pediatricians don't have the time to delve deeply into kids' backgrounds and prescribe Ritalin etc as an easy solution. Others try to work more through the families but that is resource hungry and can't always be done.
it is a very complex issue. There are lots of good books about it. One by an Australian author whose name I've forgotten, but I'll try to find it for you.

Because I am a Teaching Assistant working in mainstream education I have worked with quite a few students that have been diagnosed as ADHD. I have to say that I was not always convinced that they were truly ADHD. Some definately were but some struck me as either just very naughty or they had other learning difficulties which led to behaviour problems. ADHD can be very hard to deal with in mainstream classes because the behaviours can be so disruptive that it interferes with other students learning. As a TA it is my job to help these students access the curriculum and get the best out of their lessons but sometimes it is difficult to do this without it impacting on the other students learning. If anyone has any advice I would be grateful.

An Alternative to Ritalin for Hyperactivity


*'Hyperactivy is caused by a chemical imbalance in the brain. Hyperactive children do not have enough norepinephrine, a neurotransmitter in the limbic system, the part of the brain that allows us to ignor unimportant events in our environment... These childrn are typically low in levels of calcium and magnesium.

Drugs such as Ritalin, as we know, are meant to keep people quiet in schools and to warehouse them until they can be passed on to the next level of social services where yet more toxic chemical compounds will be prescribed.

Sometimes a trigger to bad behaviour is poor nutrition. But the problem could be more complex than simply what a child had for breakfast, the most important meal of the day for a child.


The first step is to solicit the help, or advice of a homeopathic doctor or visit a reputable Health Food Store for the nutititioanl supplements that can provide relief for the child, whether it is an emotional, nutritional, or physical condition.

On line try: http://www.alive.com

From the web site there is a access to a 34 issue set of Natural Healing Guides of which Hypertension is one title: Price per copy is US$9.95


My reference for the above information was:

*Gursche, S and Rona, Z. (1997) 'Encyclopedia of Natural Healing:A Practical Self-Help Guide'. Alive Books, Burnaby, British Columbia, Canada.

If I can be forward other information please e-mail


Peter.

I would agree that not enough time is invested in looking for alternatives to ritalin. However,some of our students are only able to complete their education at school because ritalin goes some way to modify their impulsive behaviour. In response to Jane, the role of the TA is such a crucial one in student management. As well as setting the necessary boundaries and guidelines the TA is in the unique position of being able to form a positive and personal relationship with the student. I know these students are highly complex and often seem to exhibit signs of other 'disorders ' such as ASD . I have no magic answers but would like to recommend 'The Attention Deficit Disorders Intervention Manual', (1994) by McCarney, published by Hawthorne. I found this very useful for finding strategies and setting targets.

My teaching experience has been short compared to some, but I'e taught in many schools and over many age groups and I've experienced a wide range of challenging behaviours - ADHD being a common disorder I have come across in my teaching.

My current grade 2 class has one female student who is being satisfactorily medicated for ADHD, one male student who is unsatisfactorily being medicated (keep changing medications, no consistency in taking tablets, sometimes not medicated at all) and another who I believe is suffering from either ADHD/ADD or something very similar. It is a very challenging class at the best of times, but these three students in particular make the world of difference to the dynamics of the room and my educational program.

I do believe that some children are inaccurately diagnosed, and innapropriately medicated for ADHD/ADD. I have seen some students who appeared over-drugged which caused even more problems, but I also know that my female student with ADHD was a nightmare problem child last year before finally being diagnosed and medicated for ADHD. Although she can have difficult days still, she appears to be an average child with no problem disorders. Her learning is now very far behind due to problems with her disorder in the past 3 years or so, but she's now able to concentrate on catching up to her peers.

I wish there was an easy test to do to assess the presence of ADHD ... easier for children, their families, their peers and teachers. It's a hard one to know.

As for my educational program for these students if you are interested, the program involves a lot of individualised planning for these three students, and a lot of flexibility in altering the program to keep them under control and a lot of adaptability on my part in assessing their behaviours daily (every minute actually) and adjusting my prgram to best suit their, and also my own, needs.

The educational focus involves a shorter focus, constructivist (physical and concrete learning) and varied program to maintain their attention span as much as possible and focus their attention onto the most important concepts in the learning. I have to assess what is most important and ensure that these particular students are prepared to deal with the way in which I deliver the lesson/concept/idea to them.

For example, I know that Jim* (for name's sake) is generally unable to sit for 20 minutes and do his journal writing with the rest of the class after having sat on the mat for 10-15 minutes. Typically he must stay on the mat for at least 5 minutes and when I see his attention focus disappearing (and it disintegrates rapidly) he knows he is permitted to go to the book box suited for his level and is allowed to read without disturbing everyone. When we're ready he sits to write in his journal with us until he loses focus again and then he is allowed to go and type what he has written so far onto the computer. When he finishes typing that up he has to return to his desk and write some more, and continues the process until the time is up. He still achieves the same goals as the rest of the class but he has a very roundabout way of getting to that point. It also means things like asking Jim* to come to me to show me his writing instead of going to him to see how he's going. I know that for Jim that 20 second walk is enough to retrain his focus on his work when he returns.

It's very tiring watching out for these three particular students every minute but I know if I don't, all hell may break lose at any moment when they lose that concentration and focus.

We have special rules which we decided together, between myself and these three students and they get drilled into them every day so by now (half way through the year) they know and can act accordingly. That's not to say we still don't have days which are horrid, but they are less and less from a huge effort earlier in the year to focus on goals which are realistic to their capabilities.

I don't look at it as a disability as such, but just another way of learning to be considered and prepared for.

Hope that helps.

I was at a conference on Learning Styles addressed by Dr Rita Dunn a couple of years ago. She gave us an account of some on-going research her team was doing with children diagnosed as having ADHD.

They didn't start their research until they had enough subjects who had a medical diagnosis of ADHD (mostly via brain scans), and the preliminary results (which was all they had at the time of the conference) were quite interesting.

For one thing, the diurnal rhythm of the kids in questions was such that most of them didn't start really functioning until around 4.00 pm. They also needed subdued lighting and a very ordered environment. A couple of years later I listened to a member of a Swedish support team describing the environment they had worked out was best for kids with a severe condition. Their recommendation was a cubicle, where you gave the kid one question/sentence/problem at a time. When the kid was finished with it, you put it on the wall behind the kid, out of his or her line of sight. At the end of the day, he or she would be amazed at how much had been done … but if you gave the same number of problems to the kid on one piece of paper, the result would be total mental paralysis.

If this is the way things are, you can see why conventional school systems have such a problem with kids with ADHD.

I don't know how far Dr Dunn's team got with their research, but their web site is at:

http://www.learningstyles.net/

A bit of a late reply as I am a new member...

A few pupils at my school have got diagnosed ADHD and are on medication (I can think of two pupils who are on two different medication, but I don't know their names, sorry). One of the two lads started at my school while he had not been diagnosed and he was totally bonkers. e is now, still quite mad to be frank but it is possible to have a full lesson with him in the classroom.

I understand your concern, especialy with tales from the US whereby parents have had their kids on Ritalin when the children weren't suffering from the condition but just healthy active kids. However, I think that for some of them who genuinely suffer, there may be a solution in administering drugs, when all else fails.

A.B.

The psychiatrist R. D. Laing, wrote just before his death in 1989, that the parameters of deviant behaviour was reaching a stage where anyone who didn’t see, think or do things in exactly the “right” way would be classed as having a mental health problem and treated as such.

A recent survey shows that the mental health of teenagers has sharply declined in the last 25 years and the chances that 15-year-olds will have behavioural problems such as lying, stealing and being disobedient have more than doubled. (Time Trends in Adolescent Mental Health). The study looked at three generations of 15-year-olds, in 1974, 1986 and 1999 (over 18,000 case-studies).

The rate of emotional problems such as anxiety and depression has increased by 70% among adolescents. The study also discovered that there was a higher rate of adolescent mental health problems in single-parent families. However, this appears not to be the main reason for this decline in mental health. For example, over 50% of children now experience the breakdown of their parents’ relationship before they are 16. Children in intact two-parent families may be anxious about the possibility of divorce.

The World Health Organization recently reported that Britain has more of a problem with this than other industrialised countries. John Coleman, director of the Trust for the Study of Adolescence claims that: “The route people take to adulthood has become much more difficult with the pressure on for qualifications.”

Whatever the cause of this decline in mental health and the increase of bad behaviour, the solution has been to prescribe medication such as Ritalin (for ADHD), Risperidone (anti-psychosis) and a wide range of different anti-depressants.

It is tempting for teachers facing difficult students to welcome the idea of them taking a course of drugs. However, this stops society from asking serious questions about why students are behaving in this way.

In a recent article in the TES, Mark Edwards claimed:

The SEN lobby is fast becoming a willing partner in the pathologising of our children. It may be with the best of intentions, but in the long term it could be doing untold damage.

Children who have been labelled ADHD or as having Oppositional Defiance Disorder or Conduct Disorder have sometimes felt relieved at this “explanation” for their behaviour. Others have used it to justify it: “I can’t help it – I’m ADHD”. But, either way, this is disempowering; it suggests that they can’t do much about their behaviour.

Edwards goes on to argue that the “biological basis to these disorders is inconclusive; all we have is a set of behaviours that occur with a certain regularity.”

There is however considerable evidence that suggests that there is a link between diet and poor behaviour. If that is the case, the idea of filling them up with even more chemicals, is indefensible.

John
I wouldlove to include your article above in our union journal, acknowledged of course. Could you send it to me as a word document if that;s OK with you?

My pleasure. Mind you, when I was a classroom teacher I thought half the class should have been on Ritalin.

To get it into Word just highlight the text and copy (Ctrl C) and paste (Ctrl V) into your document.

I think there are several linked issues here:

1. Does ADHD exist?

I don't think there really any doubt here. It does. There is a minority of students who are simply incapable of operating in a "normal" classroom environment without some sort of help, be it in the form of drugs like Ritalin, or through carefully planned behaviour modification programs properly staffed. As someone observed (sorry I can't say who, but I haven't learned how to move backwards and forwards from what I'm writing and the posts I'm writing about!), these students used to be labelled as "naughty" and "treated" through the application of more or les draconian discipline. When I was teaching 10-12-year-olds 25 years ago, it used to worry me that our school's only response to inappropriate classroom behaviour was some form of punishment. Sometimes, of course, this was both appropriate and effective, but on other occasions, it was more or less totally useless -- the students concerned simply couldn't modify their behaviour without help.

2. Has the "problem" been exaggerated?

I think it has. Parents and counsellors have tended to label increasingly minor behaviours as evidence of ADHD, and many misguided parents have strong-armed doctors to prescribe Ritalin inappropriately. There are students who behave inappropriately from choice, and treating the symptoms without attempting to look at the underlying causes is most counterproductive. And, on some occasions, traditional methods of "negative reinforcement" may, indeed be appropriate.

I once talked to a teacher from a prestigious private school in the New York area. Some years earlier, the school had netered into an agreement with a top local university dept of educational psychology to come in and do a survey to see the extent of ADHD "problems" in the school. They were shocked to find that there were around 8% of students who were judged in need of help. They immediately set up a programme with the university to deeal with these students. All went well for a couple of years, until an in-coming headmaster reviewed the programme and discovered that 30% of the student body were now being "treated" in the programme. He cancelled it...

3. Is Ritalin a solution or part of the problem?

You have to understand that Ritalin isn't a "quick fix". That is part of the problem. Sometimes parents (who have the excuse of being emotionally involved and often desperate) and teachers (who ought to know better) think of Ritalin as a "magic bullet" which will make all the problems go away. It isn't, and it doesn't. What it can do, sometimes, is provide a window of opportunity during which the student is given sufficient self-control to be able to benefit from a serious and carefully thought out behaviour modification programme.

When it is used that way, the effects can be dramatic. I have seen 11-year-olds go from being virtually uneducatable, to being intelligent, hardworking students in a few months. But only if it's done properly. And doing it properly can be very time-consuming. I had to fill out detailed hour-by-hour observation checklists and be interviewed by the prescribing doctor. Our (very small in those days) support team had to design appropriate behaviour modification goals and teachers all had to sign-on to curriculum modifications and changes in classroom practice.

On the other hand, I had another student who wasn't doing very well because he just seemed disconnected from his surroundings. He seemed to spend most of his time in his own dream world. When I mentioned this to his mother, she told me that that would probably be the Ritalin. That was the first time I'd even heard that the child was on medication. She'd apparently been to her doctor and insisted that her child needed it because on of her friend's children was on it and it had work for him... The specialist she was sent to prescribed the drug with minimal initial evaluation and no follow-up whatsoever... We mananged to persuade her to drop the medication and the improvement was, again, dramatic...

So, basically, Ritalin can be a useful tool in addressing ADHD, but it is never enough on its own, and over- or inappropriate use can be very counter-productive...

Jean, I think you should also include Mike's excellent contribution in your union journal.

If it's OK with him I will.
I have a special interest in this topic as I have a grandson, now 14, diagnosed quite young with ADHD. His sister is perfectly normal, they had the same sort of upbringing, but he had severe infantile asthma and stopped breathing briefly when he was 18 months. He has "classic" ADHD - impulsivity, unawareness of consequences, insomnia etc etc. He set fire to things, vandalised school, got in with a gang - it was all quite awful. He has come close to breaking up his parents marriage, but they have thankfully survived. He was put on Ritalin but it made him Zombie like and his mother took him off it. His schools have done their best, but he was beginning to get into serious trouble. This is going to sound odd, but as a last resort, a close friend with a family of her own, offered to "take him in" and see what she could do. It's had a wonderful effect - he phoned me last week to thank me for his birthday present, the first time he has done of his own volition ever.
Now, you could say he was being badly brought up, but I think what happened was that his parents' responses to him had set them into a pattern they couldn't break by themselves. Someone new without their emotional baggage seems to have done it for him. So, I guess I agree with whoever said that one to one is the answer, but it's too expensive for schools.

Jean

Very interested to read about your grandson. Has that family friend spoken to you about how she changed his behaviour?As a parent it must be all too easy to get caught in that spiral of destructive responses and despair. I have met several parents who have unjustly had to live with the label of being a 'bad parent' and therefore the cause of their child's difficult behaviour.

I haven't spoken to them much about it, but I gather that she is fairly strict with her own children, has the same expectations for him, and brooks no nonsense in a kind-hearted way which for some reason, he accepts. I think his parents were giving in to him as they were exhausted by his behaviour, and he was emotionally blackmailing them because he knew he could, whereas in the new situation, it doesn't work. He probably needed the rigour but wasn't getting it for obvious reasons. We're all only human after all!

I found this advice by John D. Clare on a educational website that might be of interest.

I strongly advise you to start your son on the Eye-Q capsules. These are obtainable from Boots. Although they are a bit expensive, they are worth every penny. They are ABSOLUTELY PERFECT for a child like your son - who WANTS to concentrate, but can't. The results of the Greenfield secondary trial showed MASSIVE gains in concentration span for 50% of the subjects (and also some spectacular gains in behaviour at the extremes). Madeleine Portwood's contention is that the speed of thought in the brain is controlled by the transmission of signal across the synapses, where the 'spark' has to travel as a chemical reaction across a gap filled with Omega 3 and Omega 6 fatty acids. For maxiumum efficiency, this gap should contain Omega 6 and Omega 3 fatty acids in the ratio 2:1. Madeleine's argument is that, because of modern diet, many children have utterly the wrong ratio. Her idea, therefore, is to 'flood' the brain with fatty acids in the right proportion (i.e. by taking 6 Eye-Q capsules a day) for 3 months, and then to relax back to one or two tablets a day to maintain the correct balance after that. This is NOT the same as eating a healthy diet, which many people also advocate - the body does not manufacture these fatty acids, and most modern food has them in entirely the wrong proportions (whereas butter, for instance, has them in the proportion 2:1 - ie correctly - magerine has them in the proportion 2500:1, a proportion which threatens to clog up the brain altogether).

Although the immediate effect is sometimes to make the problem worse for a very short time, many parents claim that they see noticeable results after a fortnight, but I would press on beyond the 3 months WHATEVER - in one case, the substantive improvement only occurred after a year. These capsules can only do good, though I would seek doctor's advice if your child has diabetes, or is taking ritalin.

Hiya folks,

I've had a class of ADHD and behavioral problem students this afternoon to teach
(8-13yrs).I do the rope through neck trick to start these classes off. It gives me an idea of the sort of kids I'm dealing with from the confessions they make. This afternoon the kid confessed to throwing a brick at a bloke.
Going through the early lessons of tricks with ropes, toothbrush twirling, one + two ball juggling tricks and yo-yo's it was fairly chaotic. About 10-12 kids. I don't think they sat still long enough in one place for me to count them accurately.
Started to notice the first kids focussing in the toothbrush twirling and getting a degree of satisfaction from achieving this.
I offer a challenge with the plate spinning. If they can learn to spin it from scratch, ie from a vertical position, and jump it up and down on the stick, they can keep it.
This is a nice motivating factor which encouraged the focussing of a few more students. Some were still running riot. Lastly the diablo was introduced. Some students had prior experience of this though had not learned it.
About half the students were showing a degree of focus towards the end of the 65 minute lesson. Most concentated on the the diablo and plate spinning when they had free choice.
I thoroughly enjoy working with these kids and am looking forward to the session tomorrow. I have 90 minutes in the morning with them. They will be learning stiltwalking as a new skill. I shall bring in some of my novelty carts + bikes as well. This should help burn off some of their energy. Lovely big sports hall to work in.
I expect as least one girl to win the spinning plate. She may have done the challenge today but one of my conditions is that I see it being done!

I shall update you tomorrow on how the second session goes.

Circus Kevin

My huge concern for ADHD students is post 16. Many of them view this as the time to dispense with all medication which of course is their choice. When following the progress of some of our ex-students with ADHD it appears that their continued impulsive behaviour can land them in significant trouble. For example, impulsive attitudes towards money coupled with poor social skills can make these students difficult to employ successfully. I have also heard of students with addiction to chat lines running up high expenditure that impacts on their families.
Post 16 is a time when many young people tend lose touch with the professionals who have supported them throughout their school life. Surely there needs to be life coaching or some sort of accessible support available to those who continue to live with this condition.

I remember when I was Head of Sixth Form that there was no special needs support allocated in the College budget for post 16 students. Neither were they entitled (being over 16) to the whole range of support networks younger students can draw on.
Surely if the governemnt is being honest about its committment to post 16 education this must change.

Hi again folks,

I shall now report on yesterday's session with the kids. Last night I was at my magic class. This morning I have taken my van in for service and ridden 3 miles back on my mini penny farthing - much to the amusement of onlookers.
Only 9 kids at yesterday's class. The girl who so nearly won the spinning plate was missing which was a shame. The kids had the chance today to go on an array of novelty carts which was great for them.
I discovered who the ADHD kids were. One was the lad who confessed to 'throwing a brick at a bloke' in the previous session. He wasn't at this session. The other, rather to my surprise, was the best behaved most hardworking kid of the two sessions. I'd wrongly assumed it was a rather rude, wild, completely undisciplined child. Apparently he was completely normal! This 'rude' child did improve enormously once put on stilts. Rather exeptionally for a boy he was immediately able to walk unaided on them. Girls incidentally are far better than boys on average at primary school age in learning this discipline. This 'rude' child - his behaviour springs to mind rather than his name - then started to regularly appeal to be allowed to take the stilts home. Come to think of it I don't remember any hassles with him after his go on the stilts - maybe I'll remember his name next time!
Going back to the lad with ADHD. I asked him if he was on Ritalin. He said he was and had taken his tablets that morning. I'd arrived half an hour early and played football and basketball with them at the start. The 'ADHD' lad had been passing the ball and was generally very sociable. Before being told of his condition I'd assumed he was a brother possibly of a more difficult member of the group. Apparently he goes to Shenstone Lodge residential school in Lichfield. He's unlikely to get the opportunity to develop his circus skills there which is a shame. Acquiring new and different skills is such a confidence booster. Confidence is great for later life.

All for now folks

Circus Kevin