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Let’s talk about ADHD.  Most people have heard of ADHD but unless you have a child who struggles with it, many might not completely understand what it is and all the effects it has on cognitions and behaviors.  However, ADHD gets a bad rap but there are also many, many positive aspects as well. In the words of Dav Pilkey, “ADHD is a superpower!” Many bright, talented, creative famous people have come out as being diagnosed. More on the positives later. 

According to the DSM-V (the diagnostic criteria):
There are 3 types of ADHD:
    1.  Inattentive Type
    2.  Hyperactive/Impulsive Type
    3.  Combined Type

 In order to meet the criteria for diagnosis, a professional will evaluate for the following symptoms:
        ‣ Displays poor listening skills
        ‣ Loses and/or misplaces items needed to complete activities or tasks
        ‣ Sidetracked by external or unimportant stimuli
        ‣ Forgets daily activities
        ‣ Diminished attention span
        ‣ Lacks the ability to complete schoolwork and other assignments or to follow instructions
        ‣ Avoids or is disinclined to begin homework or activities requiring concentration
        ‣ Fails to focus on details and/or makes thoughtless mistakes in schoolwork or assignments.
◦ Hyperactive Symptoms
        ‣ Squirms when seated or fidgets with feet/hands
        ‣ Marked restlessness that is difficult to control
        ‣ Appears to be driven by “a motor” or is often “on the go”
        ‣ Lacks the ability to play and engage in leisure activities in a quiet manner
        ‣ Incapable of staying seated in class
        ‣ Overly talkative
    ◦ Impulsive Symptoms
        ‣ Difficulty waiting turn
        ‣ Interrupts or intrudes into conversations and activities of others
        ‣ Impulsively blurts out answers before questions are completed.

Although these are the criteria that have been narrowed down to diagnose ADHD, it truly encompasses so much more and affects the individual greatly in many areas of his/her life.  

ADHD is a disability in the area of the brain that is responsible for “executive functions”.  This term is very important and I like to think about it as the “CEO of the brain”.  Some people also describe executive functioning as “the air traffic controller of the brain”.  ADHD severely impacts this part of the brain that is responsible for so much in life.  

For all my brain geeks out there (like me!), the frontal lobe in the brain controls executive functions.

Dr. Peg Dawson describes 12 different executive skills in her incredible book (highly recommend!), Smart But Scattered.  These include:

1. Emotional Control – ability to manage emotions
2. Flexibility – Ability to revise plans in the face of obstacles
3. Goal-directed persistence
4. Metacognition – thinking about one’s own thoughts
5. Organization
6. Planning/Prioritization 
7. Response Inhibition – tend to be very reactive
8. Stress Tolerance – low frustration tolerance
9. Sustained Attention – being able to keep engaged in a task that is not interesting
10. Task Initiation – starting a task 
11. Time Management – understanding the amount of time certain things require
12. Working Memory – ability to hold onto information while attending to another task (see previous blog post on memory from 3/15/22.

Addressing all the needs that ADHD encompasses can be a daunting task.  My advice is just to take one little piece or goal to work on at a time, maybe two. Once you get that nailed down, add in another one. 

Let’s start with a common issue for kids with ADHD which is struggling with transitions.  It’s important to also understand WHY that particular behavior is challenging to the student.  With transitions, task initiation and sustained attention are very hard and require a lot of effort.  Therefore, when we need a student to focus on a task and then task switch, it’s already required an immense amount of effort to start the first task, and stay engaged in the task, and now we are asking them to switch, usually to a completely different set of cognitive skills.  For example, a class may be in an active discussion about a particular topic.  Then, the teacher announces that now they are going to go back to their desks “quietly, and without talking, answer a set of written questions”.  

          What happens in the kids’ brain:  You just asked the child to completely switch cognitive skills, and many of these skills that are necessary are challenged with the child’s ADHD.  

So, what can we do to help these kids?

    1.  Be very explicit about the need to transition with a warning ahead of time.  
            • Use clear, direct language letting the student know you are transitioning.
            • “Start wrapping things up because in just a few minutes we are going to transition into our quiet places so we can work on answering some questions at our desks.”
            • After a few minutes, say “we are now going to transition from our discussion to our desks.”

    2.  Ease the transition by not making drastic changes in cognitive functions.  
            • “With a partner, you can quietly discuss your answers to the questions on the sheet”
            • Give a few minutes to do so, with more language, “we are going to get ready to quietly transition to finish the sheet on our own in a couple of minutes”.
            • “Let’s transition now to filling out the questions on our own”.

    3.  Make sure it’s also visually represented for the student(s).  Point to the class schedule of events that are on visually represented.  
            • “On the schedule, you will notice that after our class discussion, we are moving onto independent work”…. or
            • “What comes after Spanish?  That’s right, we are going to transition into math.”

Rewards can be dicey but creating goals is a good way to increase student motivation (see blog post from 3/3/22).  Set an attainable goal that your student may be struggling with. Understand the need to be flexible when goal setting. We don’t want the child feeling like they’re letting themselves or anyone else down, so explaining to them what a “goal” actually is might help. Work with the student to come up with a goal to work on for a particular day or week.  

For example, “Jimmy will transition without being reminded more than once”.  

There are many great attributes in kids with ADHD.  I always say they are my most fun, students, to work with.  They are captivating and engaging.  They are usually quite verbal and interesting.  They are usually my most curious and creative students.  They are thinking all the time.  It’s exhausting for those little brains!  Their minds are constantly going and going and it’s our job to help give them the tools to hone in so that they can function effectively in the world. The world responds well to these types of people, but we just need to help support them and help them develop skills to use their extraordinary gifts appropriately!            

Some famous people with ADHD:

Simone Biles – Olympic gymnast.

Jim Carrey – Actor/Comedian

Michael Phelps – Olympic swimmer

Richard Branson – founder of Virgin

Dean Kamen – Inventor

Justin Timberlake – Popstar

Dav Pilkey – author/creator of Captain Underpants, Dog Man, etc.

I also want to highly recommend this podcast with Penny Williams if you want to learn more about ADHD.

Caroline Towery

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