Our Approach

Benjamin's* performance in 4th grade has become a significant concern to his parents. His report cards indicate difficulty staying on task, finishing his classwork, and paying attention to his teacher throughout the day. He has become easily distracted by almost anything "new" to the classroom. He often blurts out answers during lessons, which is frustrating his teacher and his classmates. His few friends have become wary of playing with or sitting by Benjamin. Academically, he has much difficulty understanding what he has read and his math papers show numerous careless errors. As far as his writing goes, his papers are very disorganized and his penmanship is deemed "sloppy." These concerns have been present for some time, but they are now at a point where parents and teachers are feeling exasperated.

What may be the source of Benjamin's difficulties?

Benjamin may be struggling with attention deficit hyperactivity disorder, or ADHD. If that is the case, then this youngster is facing challeges shared by 4% to 6% of the school-aged population. ADHD is a commonly diagnosed disorder that is characterized by inappropriate levels of attention, impulsivity, and/or excessive levels of motor activity. These difficulties exist in spite of the child's effort to control and manage them. The learner with ADHD can experience frustrations in academic areas, behavioral skills, social skills, organizational elements of a task, and even with regard to self concept. The manifestations of ADHD can be mild, moderate, or severe.

There are three primary subtypes of ADHD. It is helpful to know those subtypes and the specific characteristics which are present within them.

ADHD - Inattentive

• difficulty giving close attention to details; careless errors
• difficulty sustaining attention at work or at play
• listening difficulties, even when spoken to directly
• failure to complete tasks, but not due to opposition
• difficulty organizing tasks or activities
• reluctance to participate in tasks involving sustained mental effort
• often loses things necessary for work or play
• distracted easily by extraneous stimuli seen as "forgetful" during daily activities

ADHD - Impulsive/Hyperactive

• often fidgets or squirms; difficulty staying in one's seat
• runs about the room or tends to climb; overall restlessness
• difficulty remaining calm or quiet during tasks
• excessive talking; often blurts out responses or ideas
• difficulty waiting one's turn; interrupts or intrudes
• "on the go" or "driven by a motor"

ADHD - Combined

• A collection of the characteristics cited above

To understand and address ADHD responsibly, we must recognize that ADHD is a chronic condition - not episodic - which presents difficulty in more than one setting. In other words, the child with ADHD does not demonstrate inattentiveness and/or impulsivity solely at school; more than likely, these frustrations are also presented at home, on the playground, or when shopping with Dad at the grocery store. The characteristics of ADHD do not suddenly appear, but have been evident before a child turns seven years of age. ADHD cannot be outgrown, but individuals with ADHD can be motivated, productive and self-disciplined learners when provided with the correct intervention(s). Let's be very clear to note that ADHD is not caused by too much television, too much sugar, poor parenting, or lax administration of discipline.

Parents and educators should understand that ADHD can co-occur with learning disabilities, behavioral concerns, and/or specific academic deficits. Students with ADHD may have a learning difference in the areas of reading (word attack and/or comprehension), mathematics (problem solving and/or story problems), or handwriting and written expression. With regard to behavioral matters, some students with ADHD may show significant levels of conduct problems, oppositional behaviors, and/or aggression.

Even when a learning disability or behavior disorder does not co-occur, ADHD can greatly interfere with a child's ability to succeed in class and at home. Successful students are able to organize their work environments, deliberate before responding, and block out distractions. These are vital skills which students with ADHD may not possess. Because content area classes like social studies and science require independent management of notes and prolonged attention to presentations, students with ADHD often find those classes to be particularly puzzling. Impulsive behaviors may lead to peer rejection, and thus lowered self esteem. One study suggests that students with ADHD are 12 times more likely to drop out of high school than their peers without ADHD.

Responsible interventions to assist the learner with ADHD are available. Medical interventions should only be discussed by medical professionals. However, whether or not parents choose medication as part of their intervention, various aspects of the child's environment should be structured in order to support the child. In this paper, we highlight some educational interventions which have proven to be most successful for many students with ADHD.

Provide an organized, predictable environment with clear rules, directions, and standards.

1. Provide explicit instruction to students so that they learn to manage time and space.

2. Provide specific cues or prompts which alert the student that you need his or her attention.

3. Reduce the amount of distractions within the classroom which compete for the student's attention. Limit school supplies to those which are most basic and easily managed.

4. Provide and practice step-by-step strategies for solving problems, and make those strategies accessible within the classroom via posters or charts.

5. Provide plenty of positive feedback. It has been suggested that 80% of the feedback which a child with ADHD receives is negative. In other words, only 20% is positive.

6. Provide a dependable and regularly monitored system for recording assignments, getting those assignments to home, and then ensuring that the completed work gets back to school.

7. Provide periodic "pacing" activities or drills in the midst of lecture presentations, to recapture attention and provide an outlet for energy.

8. Provide hands-on tools when introducing or practicing a concept. Students with high energy levels benefit from using these tools to show the teacher what has been understood.

9. Provide a sound series of lessons on study skills: using the dictionary; taking notes; studying a textbook chapter; writing a multi-paragraph essay; and, using the computer for research.

10. At home, try to maintain regular times for key moments of the day: dinner, homework or study time, recreation, etc. Adhere to those times, building predictability and routine.

11. At home, identify one specific and consistent place where important school papers or homework is to be placed. If a student needs to share those pieces with a parent, the parent knows where those papers will be.Ý If the student needs to return work to school, he or she can depend on the papers being in that place, too.

12. At home, identify one specific and consistent place where important school papers or homework is to be placed. If a student needs to share those pieces with a parent, the parent knows where those papers will be. If the student needs to return work to school, he or she can depend on the papers being in that place, too.

Making a diagnosis of ADHD involves a team approach. The members of that team include the parents, the child, the educator(s), and the medical professional(s). A comprehensive assessment is necessary, with the evaluation and any treatment conducted by qualified professionals. Diagnosis should be based primarily upon the DSM-IV criteria for ADHD. Treatment should be multidisciplinary, as we endeavor to address the strengths and needs of the whole person. Finally and very importantly, ADHD may be suspected but should never be presumed by anyone.

For additional information about ADHD, we recommend these books.

Understanding ADHD by William N. Bender
Driven to Distraction by Ed Hallowell
It's Nobody's Fault by Harold Koplewicz
No Easy Answers by Sally Smith

*=Some names and images used on the de Paul website have been fictionalized in order to respect the privacy of our students. All case studies, accounts, experiences, and quotations are real.