In a class of forty school children, there is an estimate that at least two of them exhibit symptoms of ADHD. It is therefore imperative for teachers to be aware of the basic facts that make ADHD unique and distinct from the other disorders or behavioral problems.

Teachers must bear in mind the following facts to better understand their students with ADHD:

1. ADHD is a complex neurobiological disorder. Research shows that individuals with ADHD have some structures in their brain that are smaller. It is also believed that the chemical messengers of the brain called neurotransmitters do not work properly or efficiently. Specifically, these neurotransmitters are dopamine, norepinephrine and serotonin.

2. Approximately 5 percent of all children worldwide have ADHD. The percentage of children with ADHD,however varies around the globe and in the United States. In the US alone reported rates vary: 3 percent in Salt Lake City while several states including parts of Arizona and upstate New York have a rate of above 10 percent. In other parts of the globe: rates of 8.9 percent were reported in China, 9.5 percent in Puerto Rico, and 29 percent in India. Significantly, the boy-girl ratio shows that the boys diagnosed with ADHD outnumber girls approximately three or four to one. Studies also show that the boys are usually more aggressive and oppositional than the girls.

3. Attention deficit disorders have two distinctly different types. In the US, federal education law refers to those with hyperactivity and impulsivity as having ADHD (attention deficit hyperactivity disorder) and those who are predominantly inattentive as having ADD (attention deficit disorder). The American Psychiatric Association however, has established ADHD as the technically correct diagnostic label.

4. Children with ADHD are not alike. Adults may see variability in skills and maturity levels in students with ADHD. This is because of the fact that symptoms of ADHD may be mild, moderate, or severe, or combined with other conditions.

5. ADHD often co-exists with other conditions. Based on a major study of the National
Institute of Mental Health (NIMIMH), two-thirds of children with ADHD have at least one other coexisting condition. When symptoms are severe and there are co-existing conditions present, the challenge of diagnosing and treating the child more effectively will be greater for the child’s family and the school.

6. Students with ADHD have a two to four year lag in age-appropriate developmental skills (adaptive functioning). The developmental delays are often observed in motor skills, self-help abilities, personal responsibility, independence, and peer relationships. Accordingly, these students may seem less mature and responsible than their peers. To illustrate, a sixteen year old with ADHD acts more like a twelve year old.

7. Behaviors linked to deficits in neurotransmitters often accompany ADHD. These behaviors often cause problems at home and school. Students with ADHD may experience problems some of these behaviors:

• Executive functioning difficulties: These skills are essential for success in school, and yet they are often lacking in students with ADHD. Deficits in key executive function skills that interfere with the ability to do well academically may include:

Working memory and recall: briefly holding facts in your head and using them to your advantage;
Activation, arousal and effort: starting
on work, staying on task and and completing or finishing work;
Impulsivity: saying or doing things “at the spur of the moment” before thinking;
Control of emotions: low frustration tolerance, emotional blow-ups;
Internalizing language: using “self-talk” to guide behavior;
Complex problem solving: taking the whole apart, analyzing it, and putting it back together.

• Forgetfulness and disorganization: These problems greatly interfere with completion of school work such as homework and projects. They may forget to do or turn in homework and tests, due dates for projects, and other important school activities.

• Inconsistent performance in school work. This is one big dilemma for both teachers and parents. Some days a student with ADHD can do work excellently, completely and accurately, but some days they will just go through the motion of submitting a so-so work.

• Children with ADHD do not learn from punishment and rewards as easily as other children. This definitely makes teaching and disciplining children with ADHD much more difficult. They may repeat
their misbehavior and teachers may get the impression that they “don’t seem to learn from their mistakes”. To put it more aptly, these children “know what to do but don’t always do what they know.”

• An impaired sense of time: Students with ADHD may have difficulty managing their time – they may be always tardy in school, or may miss out deadlines for school projects since they do not allot adequate time for such tasks. They may also have difficulty planning ahead, most specially long term projects.

Although some teachers may feel that they are already adequately informed about ADHD, there is still no harm to learn more about it. There is no such thing as overload of information when a child’s best interest is at stake. As they say, knowledge is power!

Editha R. Martelino is the current president of the ADHD Society of the Philippines. A parent of two children with Attention Deficit/Hyperactivity Disorder (ADHD), she initiated and played an active role in the ADHD School Caravan, a public awareness campaign on the disorder. She is an AB Literature graduate of the University of Santo Tomas and is a writer by profession.