Adhd

Children with ADHD are not unable to learn,

but their difficulties with inattention and

impulsivity often make them unavailable for

learning. (Fowler, 1992, p. 19)

What is Attention Deficit/Hyperactivity Disorder (ADHD)?

ADHD is a condition that affects both children and adults from all cultural, racial and socioeconomic groups, from all levels of intelligence and from both gender groups (Smith, Polloway, Patton, Dowdy & Heath, 2001; Gaub & Carlson, 1997; and Web 3). According to the DSM-IV, the Diagnostic and Statistical Manual of Mental Disorders, three core symptoms of ADHD include: inattention (i.e. lack of focused attention); hyperactivity (i.e. restlessness); and impulsivity (i.e. a general lack of self-control) (Smith, Polloway, Patton, Dowdy & Heath, 2001). To be considered ADHD, the symptoms must be present before the age of seven, persist for at least six months and be inconsistent with a child’s developmental level. ADHD is the most common psychiatric disorder among children in North America, affecting between 1 to 14 percent of school-age children in Canada (Taylor, 2001 and Web 3). It is interesting to note that the greater reported incidence of ADHD in boys has been explained by the fact that girls with ADHD show evidence of fewer problems than boys, i.e. they exhibit lower rates of hyperactivity compared to boys. (Flick, 1998)

ADHD is diagnosed by applying the criteria found in the DSM-IV and this diagnostic tool also assists in identifying the ADHD subgroup. The four subgroups of ADHD are:

1) predominantly hyperactive-impulsive type; 2) predominantly inattentive type; 3) combined type; and 4) not otherwise specified type (Flick, 1998 and Smith, Polloway, Patton, Dowdy, Heath, 2001).

Neuroanatomical studies have shown that the brains of children suffering from ADHD are characterized by smaller anterior frontal areas and a lack of asymmetry in parts of the basal ganglia (caudate and globus pallidus) (Flick, 1998) In children who do not have this condition, the right side appears larger than the left; in ADHD children there is a lack of this asymmetry. The National Institute of Mental Health also found that the brains of ADHD children and adolescents are 3-4% smaller than those of children who do not have the disorder (Web 3). Other studies have pointed to neuropsychological evidence, i.e. disturbances in the frontal lobe functions; and neurochemical evidence, i.e. the involvement of dopamine and neurotransmitters in ADHD (Flick, 1998).

Most contend that ADHD is a hereditary disorder (Flick, 1998 and Web 4). Where hereditary does not appear to be a factor, difficulties during pregnancy, prenatal exposure to alcohol and tobacco, premature delivery, high lead levels, and damage to the prefrontal regions of the brain have all been found to contribute to ADHD in varying degrees (Barkley, 2000; Flick, 1998; Taylor, 2001 and Web 3).

What are the Characteristics of Children with ADHD?

ADHD is difficult to diagnose because it tends to appear gradually (Taylor, 2001). Moreover, symptoms can change in various settings and from one moment to the next. The DSM-IV criteria enumerate the observable behaviours of children with ADHD (Smith, Polloway, Patton, Dowdy & Heath, 2001, p. 92). Although these behaviours may appear in all children, they appear more often and to a greater degree in ADHD children; i.e. ADHD children appear to be at a younger developmental stage than their classmates. In addition to the three core behaviours of inattention, impulsivity and hyperactivity, many ADHD children share the following mental, physical and emotional characteristics (Taylor, 2001).

Mental Difficulties:

• Distractibility-Children have a short attention span and become easily bored, particularly with long assignments or repetitive tasks. Their inability to maintain concentration may result in them completing work one day but not the next or moving from one unfinished task to another. They make many careless errors and/or may daydream during class.

• Confusion-Children with ADHD have difficulty recognizing an object that stands out from the background. They also have difficulty at prioritizing, remembering and making decisions based on the relevant facts. Their perception is selective and they have difficulty thinking logically.

• Difficulty in Abstract Thinking-The concept of abstract thinking is poorly developed in children with ADHD. They have difficulty understanding what they read, thinking hypothetically and deriving lessons from past experiences. Mathematics and spelling are especially difficult for them.

• Inflexibility-Children with ADHD have difficulty switching from one activity to another and tend to adjust poorly to changes in their surroundings and transition times.

• Aimlessness-ADHD children tend to never plan ahead and they have little concern for the future. These children lack organizational skills. They appear to lack self-control and have difficulty following instructions and/or rules. This is due to the low response stimulation of the brain.

• Perceptual Difficulties- Children with ADHD have a poor sense of the passage of time, become confused about common opposites; e.g., left and right, find it difficult to recognize spatial relationships, like “over” and “under” and have difficulty differentiating between “w” and “m”, “d” and “b”, “was” and “saw”. Consequently, their reading may be poor.

• Inattention to body states-Many children with ADHD appear to be somewhat insensitive to pain and may not feel hungry even though they may have not eaten for the entire day.

Physical Difficulties:

• Constant Movement-Children with ADHD are restless and find it very difficult to sit quietly. They appear to be constantly fidgeting, squirming and getting out of their seats. These children also seem to be constantly noisy and loud at play.

• Poor Coordination- Many ADHD children have difficulty with fine motor tasks (i.e. drawing, writing, colouring). In fact, approximately one-third of ADHD children suffer from very poor handwriting or dysgraphia (Flick, 1998). Such children may also experience problems with large muscle coordination and a poor sense of balance (Barkley,