ADHD – Why we are still learning about it a century later

A few weeks ago, I wrote about dyslexia, since October is designated as a month dedicated to awareness of its impact upon the lives of our students. Did you know that October is also ADHD awareness month?

Attention Deficit Hyperactivity Disorder (ADHD) was first diagnosed in 1902—yes, over a century ago! The pediatrician (Sir George Still) who made the diagnosis called it “a defect of moral control in children” (Healthline.com, 2017). I’ll address that wording later when we talk about common myths about ADHD; the initial point, however, is that even after nearly 120 years, ADHD is still a commonly misunderstood challenge that many of our students (and adults who may or may not have been diagnosed) face on a daily basis. Just like any other learning difference, ADHD exhibits some unique strengths, in addition to the difficulties caused in learners’ efforts. We’ll explore those briefly today.

What is ADHD?

ADHD is a neurological condition in which the “wiring” of the brain in the frontal lobe (which is responsible for problem solving, planning, memory, decision making, and many other important executive functions) may not operate consistently in the transmission of signals from one part of the brain to another (AACAP.org, 2017). ADHD usually is evidenced by a number of symptoms and expressions, which are of course different from person to person; however, the most common may be:

  • short attention span (especially if it’s something the individual does not enjoy doing)
  • overdoing physical activity, verbal interactions, and/or emotional expressions
  • mood swings/over-reactions more often than others
  • difficulty controlling physical fidgeting/restless behavior
  • inconsistent management of time, tasks, schedule, and/or things (i.e., disorganized)
  • frequent forgetfulness

(ADDA, 2020).

It is easy to spot where these common symptoms align with the major functions of the frontal lobe that were mentioned above—but not always easy to identify what support(s) a student with ADHD needs and when, because personality, treatment, medication, interactions with others (positive and negative), and type of task encountered are all influences in any given circumstance the individual is facing. In short, there is no “predictable” pattern of ADHD behavior. Finally, ADHD also often accompanies another diagnosis—in medical terms, ADHD is often “comorbid” with other neurological differences such as autism spectrum disorders, dyslexia, and other conditions that affect emotional regulation (e.g., depression, anxiety), just to provide a few examples. According to the Centers for Disease Control (2016), 30% – 50% of children ages 3 – 17 who have been diagnosed with ADHD also have an accompanying diagnosis that involves emotional and/or behavioral regulation.

What ADHD is not:

ADHD may be one of the most misunderstood learning differences—perhaps because of the inability to predict a “common” set of behaviors, but also because the societal norms and expectations in a structured education system do not typically tolerate the inconsistent nature of a student’s ADHD expressions (Kessler, 2020). There are many “myths” and undeserved assumptions about people with ADHD—I’ll mention three of the more common ones below:

  1. People with ADHD are just lazy, or use ADHD as an excuse to behave badly.
    • ADHD is in fact a neurological condition—as such, the brain can be trained to overcome many of the difficulties of ADHD, but individuals with ADHD are generally not making deliberate choices to struggle with organization, motivation, and impulse control.
    • In reality, relationship issues and discipline problems are most often the result of the individual’s frustration over trying to overcome their challenges, especially if they are not provided with appropriate supports (ADDA, 2020; Kessler, 2020).
  2. ADHD is just immaturity—they will grow out of it.
    • Although the frontal lobe does not fully develop until an individual is in their mid-20s, typically, again recall that ADHD is a genetic difference in how the brain is wired—those miscommunicating neurotransmitters do not just naturally “correct” themselves over time without appropriate intervention, treatment, and supports (Johnson, Blum, & Geidd, 2009).
    • This inaccuracy, incidentally, may be largely responsible for the fact that males are diagnosed with ADHD at twice to three the rate as females (ADDA, 2020).
  3. ADHD is caused by diet, or by bad parenting, or it is over-diagnosed—in other words, it is not actually a real medical condition.
    • On the surface, this one is easy to discredit—neuroscience has demonstrated the genetic source(s) of the differences in the brain of an individual with ADHD (Johnson, Blum, & Geidd, 2009)—it is not “made up,” by any means.
    • What makes ADHD more difficult to understand is that if an individual with ADHD has a consistently improper diet, has not had positive boundaries and supports from adults, and/or has not had appropriate medical attention to their ADHD, then their behaviors and expressions may be even more prominent and more likely to encourage an assumption that “they just need more discipline” (Kessler, 2020).

What Supports are Best for People with ADHD?

The key is consistency when it comes to accommodations and supports for ADHD—particularly because ADHD is expressed differently from person to person. According to CHADD (Children and Adults with Attention Deficit Disorder), some of the most common effective accommodations in the classroom (all of which are used at Greenwood School) include:

  • Minimizing physical distractions in the classroom (displays, seating arrangements, etc.).
  • Clear and frequent communication (in a supportive manner) of boundaries, including demonstration and examples of expectations.
  • Minimize interruptions in instruction, especially when giving guidance/steps for completing work (if the teacher is organized, it is easier for the student to learn ways to be organized!).
  • “Chunk” larger assignments and lists of steps for tasks in order to assist memory and prevent overloading due to multitasking.
  • Descriptive feedback—particularly when it involves validation, praise for successes, reassurance at checkpoints that they are “on the right track” (provide corrective feedback privately whenever possible—embarrassment or humiliation should never be a deliberate motivation tactic with any student!).
  • Promote self-awareness—help the student talk through what they are feeling when they are struggling to get organized or to prioritize their work, or when they are having difficulty controlling impulses and emotions. Making this a supportive teaching moment empowers the student to learn to “take a pause” to assess and advocate for the support(s) they need.
  • Patience—and using off-task behaviors as teaching moments. Do not excuse or permit behaviors, but seek to understand the cause(s) and help the student make deliberate choices.
  • Encourage creativity—many ADHD students will focus intensely on certain topics, which can be a real strength if we support their exploration and encourage them to connect their interests to other subjects.

What can I Do to Help these Students?

You’ll notice that this section will be quite similar no matter what learning difference I am discussing—because support and empowerment are always needed by all students! First and foremost—take the time to understand them as individuals! If you are their parent/guardian, you’re already well ahead of the rest of us on this one, so please use that understanding to communicate clearly and supportively with your child’s school. If you are the classroom teacher or school administration, encourage and support the student by modeling and teaching them how to advocate for what works best for them as a learner, and then consistently provide appropriate accommodations like those listed above. If you are neither the parent/guardian nor educator, consider supporting the student by becoming a partner with their School (see the “Sponsor a Student” section of our webpage at www.greenwoodjax.org/giving). No matter what role you have in the student’s life…encourage them!

References

ADDitude. (October, 2020). ADHD symptoms checklist. ADDitude magazine: Inside the ADHD mind.
https://www.additudemag.com/adhd-symptoms-checklist/

ADHD Awareness. (2020). Common questions, reliable answers. https://adhdawarenessmonth.org/

American Academy of Child and Adolescent Psychiatry (AACAP). (February, 2017). ADHD & the brain.
Facts for Families, 121.
https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/ADHD_and_the_Brain-121

Centers for Disease Control (CDC). (2016). Data and statistics about ADHD.
https://www.cdc.gov/ncbddd/adhd/data.html

Children and Adults with Attention Deficit Disorder (CHADD). (2020). For educators: Classroom
accommodations.
https://chadd.org/for-educators/classroom-accommodations/

Johnson, S. B., Blum, R. W., & Geidd, J. N. (2009). Adolescent maturity and the brain: The promise and pitfalls of neuroscience research in adolescent health policy. Journal of Adolescent Health, 45(3), 216-221. doi: 10.1016/j.jadohealth.2009.05.016

Kessler, E. (September, 2020). School suspension for ADHD? Smart kids with learning disabilities.
https://www.smartkidswithld.org/getting-help/emotions-behaviors/school-suspension-for-adhd/