RINE Final Summary: ADHD

AD/HD Final Research Journal Summary

The name Attention Deficit Hyperactivity Disorder, or AD/HD, refers to a family of disorders which interfere with a person’s capacity to regulate their physical activity level (hyperactivity), inhibit their behaviour (impulsivity), and properly focus on tasks (inattention) (National Institute of Mental Health, 2000, in Rief, 2005, p. 4). The disorder has attracted controversy and has had its legitimacy questioned by some, who would reinterpret the problem behaviours exhibited by children with AD/HD as being simply energetic, lazy, naughty, and so on (Rief, 2005, p. 4). In spite of its detractors, the disorder has been identified as one of the most common additional needs in school-aged children, affecting between 2.3% and 6% of students (Krause, Bochner & Duchesne, 2003, p. 256). With such a high incidence rate, teachers can expect to teach approximately one student with AD/HD in every class. Therefore it is imperative that teachers are equipped to appropriately respond to this additional need.

Craig Wright offers several practical suggestions for accommodating students with AD/HD in an inclusive classroom environment. Students with AD/HD often experience deficient working memory and difficulty internalizing rules and expectations, so Wright recommends regular external reminders of school and classroom rules, such as with posters or other visual aids (Wright, 2006, p. 4). Wright also explains that working memory deficiency affects an individual’s perception of time, and as a result students with AD/HD often exhibit less goal-oriented behaviour. For educators, this may require a reevaluation of systems of long-term goals such as delayed rewards or large, ongoing assessment projects (Wright, 2006, p. 4). By breaking down tasks into smaller, more readily achievable components, we can scaffold a student with AD/HD’s eventual completion of the task. Similarly, when implementing behaviouralist rewards for behaviour, teachers should aim to minimize the time delay between the behaviour and the reinforcer (Wright, 2006, p. 4).

AD/HD can have a particularly detrimental effect on academic achievement when it impacts on a student’s literacy levels. Owing to their deficiency in working memory, many students with AD/HD experience difficulty reading, and comment that by the time they have read to the bottom of a page, they have forgotten what they had read at the top (Wright, 2006, p. 7). Wright recommends that students with AD/HD be explicitly taught “active reading” skills including strategies for note-taking, highlighting texts, making notes in margins and writing short summaries as they read (Wright, 2006, p. 7). Strategies such as these are useful study tools for all students, as are the above recommendations for posting class rules, breaking down tasks into smaller components, and establishing a strong link between behaviour and reinforcer when using positive and negative reinforcement for behaviour management (Wright, 2006, p. 4, and Krause et al., 2003. pp. 110-124).

Many of the above strategies for accommodating students with AD/HD in an inclusive learning environment fall under the framework of Universal Design for Learning (CAST). Scaffolding tasks by breaking them down into more management components, reinforcing rules and expectations, providing external motivation, encouraging “active reading”; these are all strategies that will benefit every student in any given class. Above all, ensuring lessons and tasks are interesting and engaging, thereby heightening a student with AD/HD’s state of arousal and hence their attention, is a goal teachers should be aspiring to wherever possible, and one which will benefit all students and provide a better quality educational experience (NSW DET, 2003, in McLeod & Reynolds, 2007, p. 47).

Much of the literature surrounding AD/HD focuses on the early childhood and primary school years, with hopes that early intervention can minimize the disorder’s disruption in later life. However, as Noël Gregg asserts, the disorder is an enduring, life-long condition and requires ongoing efforts to accommodate it in secondary and tertiary settings. As a secondary school teacher, this is the domain in which I personally will encounter students with AD/HD. Gregg is particularly interested in the systemic discrimination in assessments for students with AD/HD; that is, how the formative and summative assessments that are commonly administered in secondary and tertiary education marginalize students with AD/HD.

Gregg has identified a number of areas in which students with AD/HD and related learning disorders are disadvantaged by secondary and tertiary education assessment structures. As the majority of high-stakes, standardized assessment in both America and Australia, such as college entrance exams, the HSC and NAPLAN are administered in an exam environment, they do not successfully accommodate students with AD/HD. These students’ reduced ability to focus on tedious tasks, as well as their lower inhibition, puts them at risk of underperforming in exam situations. However, reasonably simple accommodations could go a long way to inclusively assessing these students. They could be allowed regular breaks from exam conditions, or be able to sit the exams over multiple sessions; they could undertake exams in a less distracting environment or in an environment in which they are less likely to distract their neighbours. Other options are available for students with related and often co-morbid learning disabilities such as dyslexia, including providing a human or screen reader (Gregg, 2009, p. 232)

People with Attention Deficit Hyperactivity Disorder experience working memory deficiency, diminished inhibition and self control, and difficulty attending to tasks which do not provide adequate arousal. They have difficulty internalizing expectations, maintaining intrinsic motivation for tasks, and controlling impulsive behaviour. Students with AD/HD, and several other learning disabilities, benefit from a range of strategies for inclusion which fall within the Universal Design for Learning framework, meaning that teachers can accommodate their needs with methods that will benefit their entire class (CAST). Recasting medical descriptions of the disorder into considerations of its day-to-day impact, for example recognizing the impact of deficient working memory on activities such as reading and completing ongoing tasks, internalizing rules and expectations, and motivating goal-oriented behaviour, allows teachers to implement practical strategies to better include their students with AD/HD. These strategies include more structured scaffolding of tasks, breaking down projects into attainable chunks, reinforcing desirable behaviour, regular reminders of expectations, and explicit teaching of metacognitive strategies such as active reading. More research and consideration of inclusive assessment practices, especially in the secondary and tertiary fields, is required to improve inclusive education and, by extension, improve later life outcomes for adults with AD/HD.


Source List
Centre for Applied Special Technology (n.d.). What is Universal Design for Learning? Retrieved from http://www.cast.org/research/udl/index.html

Cherkes-Julkowski, M., Sharp, S., & Stolzenberg, J. (1997) Rethinking attention deficit disorders. Cambridge: Brookline Books.

Gregg, N. (2009) Adolescents and Adults with Learning Disabilities and ADHD: Assessment and Accommodation. New York: The Guilford Press.

Krause, K., Bochner, S., & Duchesne, S. (2003) Educational Psychology for Learning and Teaching. Southbank: Thomson.

McLeod, J., & Reynolds, R. (2007) Quality Teaching for Quality Learning: Planning through Reflection. South Melbourne: Thomson Social Science Press.

Rief, S. (2005) How to reach and teach children with ADD/ADHD: practical techniques, strategies, and interventions. San Francisco: Jossey-Bass.

Wright, C. (2006) "Practically Speaking: ADHD In The Classroom", Special Education Perspectives, 15(2), 3-8.