In a regular classroom of 50 students, a teacher will usually spot at least two or three students who are always moving around, talking to their seatmate, endlessly sharpening their pencils, fixing their bag, etc. Well, simply put, doing anything but paying attention to the teacher.

Can the teacher then label these kids as possible ADHD cases? Or are they just seeking attention (kulang sa pansin) or undisciplined?

Attention Deficit Hyperactivity Disorder (ADHD) is primarily used to describe children who have problems with high levels of distractibility or inattention, impulsiveness, and often with excessive motor activity levels or hyperactivity.

In cases of students with Attention Deficit Disorder (ADD), they may have deficits in attention and impulse control but they do not manifest symptoms of hyperactivity at all.

Recent studies show that as many as 40 percent of the ADHD kids may not be hyperactive.

Research also reveals that there are several things happening in the brain of the ADHD child which cause the disorder. The primary problem, however is that certain parts of the central nervous system are under-stimulated, while others may be over-stimulated. Tests show that some hyperactive kids have an uneven flow of blood in the brain - with some parts getting too much blood flow, and other centers not getting as much. Medications and other forms of treatment can be used to address these problems.

TEACHER’S INITIAL CHECKLIST

Spending as much as five hours a week or a total of 20 hours a month can give a teacher headway in assessing a student who has special needs. In the case of ADHD, a teacher could bear in mind the following questions in order to evaluate the child’s behavior as a simple misdemeanor or if it could be considered as a case of ADHD:

1. Can the child pay attention in class?

It is not so much in getting the attention of a student with ADHD, but more so, the problem lies in sustaining it until the lesson for the day is completed.

Another problem with these students is that they cannot pay attention to just one thing at a time and they easily get distracted with small things such as the ringing of the school bell or the sound of the ceiling fan. Thus, the teacher should check if the student gets easily distracted or if they have difficulty sustaining interest and lose focus on school tasks.

2. Is the child impulsive? Does the student call out in class or bother his/her classmates with his/her impulsivity?

A teacher will often be surprised to hear an answer to her question even before she finishes her question. Or worse, a student suspected to have ADHD will most likely just go out of the classroom unnoticed. These students often cannot think first before they act. They seldom think of the consequences of their actions first.

3. Does he/she have trouble staying in his/her seat when he/she’s supposed to? How is he/she on the playground? Can he/she wait in line, or does he/she run ahead of the rest of the class? Does he/she get in fights often?

This type of student can easily be spotted in class because of his/her fidgety behavior.

He/she cannot stay put in his/her seat, or if he/she does, he/she will find something else to do like twiddle with his/her school necktie or check his/her bag instead of listening to the teacher. Outside the classroom, he/she would seem rowdy and at times may seem like a bully in that he/she wants to get his/her way around or be the first always.

4. Can he/she wait?

Studies show that children with ADHD have as much as a four-year delay emotionally.

Hence it is not surprising that children with symptoms of ADHD often cannot delay gratification or may often seem to be impatient in wanting to get praise or reward for tasks they have done well.

5. Is he/she calm?

Students with ADHD symptoms may always seem too conscious or constantly looking for clues as to how they are doing.

Their moods may often vary, often on the extremes: either they act too sad, too angry, too excited, etc.

6. Is the child working at grade level? Is he working at his potential? Does he/she stay on task well?

Does he have poor handwriting?

Most students with ADHD have trouble staying on task and teachers often regret seeing them underachieve in the academics department. Teachers know they are intelligent and talented, and yet they do not seem to perform “at their maximum capacity”. Many of these students may have terrible handwriting- either writing too small, or they have difficulty with cursive writing that they use print more often.

7. Does he/she have difficulty with rhythm? Or the use of his/her time? Does he/she lack awareness about “personal space” and what is appropriate regarding touching others? Does he/she seem unable to read facial expressions and know their meanings?

As many as 10% to 20% of children with ADHD may have some degree of Sensory Integration Dysfunction (SID) or the ineffective processing of information received through the senses. Because of this, children with ADHD have problems with learning, development,
and behavior.

8. Does he seem to be immature developmentally, educationally, or socially?

Research suggests that children and teens with ADHD may lag 20% to 40% behind children without ADHD developmentally. This means that a 10-year old with ADHD may behave, or learn, as you would expect a seven year old to do the same.

PRIMARY TASKS

With the above-mentioned questions answered, a teacher could work on the following even in the absence of a student’s formal diagnosis:

Discover and learn about ADHD. High school teachers often have a harder time “believing” in the condition since older students no longer appear physically hyperactive.

An adolescent ADHD students’ organization and planning problems are commonly misinterpreted as lack of preparation and motivation.

Do not take things personally. Do not interpret ADHD behaviors as personal challenges. Just remember that a student with ADHD cannot turn off his/her ADHD symptoms as he/she wants to.

Thus, their behaviors are not meant to offend you, but rather keep in mind that they can not stop what they do and say unlike other students in your class.

Try to rate on a regular basis, the ADHD behaviors exhibited by your student using Dr. Phelan’s brief checklist (1 means very little; 10 means a lot) This can be used as is a starting point. These behaviors are most likely to be expected from the ADHD student every day. Once the teachers and the parents accept this starting point (bear in mind that the child does not exactly want, either), it is easier not to take everything so personally. At the same time, anger on the caregiver’s part is reduced because it usually arises when there is a big difference between what you expected versus what you got. Teachers could ask the child’s parents to fill out the checklist, so they could discuss it later on.

Consider the following in presenting lessons or seatwork or exams to children with ADHD:

• Have child sit in the front of the class.

• Establish good eye contact.

• Tap on the desk (or use other code) to bring the child back into focus.

• Alert child’s attention with phrases such as “This is important.”

• Break down longer directions into simpler chunks.

• Ask students to underline the key words of directions.

• Encourage students to mark incorrect multiple-choice answers with an “x” first. This allows them to “get started” quickly, while forcing them to read all of the choices before making a final selection.

• Allow physically hyperactive children out of their seats to hand out and pick up papers, etc.

Recognize that disorganization is a major disability for almost everyone with ADHD. They can write a good term paper and yet forget to submit it to the teacher on time. This glaring disparity in skills makes it a learning disability. Help them get organized by:

Inform about typical routines (such as short quizzes on Fridays, long tests every two weeks, etc.)

• Sign the student’s assignment notebook at the end of each period. Check if the student got the details (page number, lesson, etc.) correctly. More importantly, deadlines on submission of school projects should be properly noted down by the student.

• Inform the parents immediately of non-submission of assignments or projects. Do not wait for parent-teacher conferences to do so since it will be too late for the student with ADHD to notice the connection between his/her performance and the consequences.

• Some simple accommodations may be considered for other frequently associated problems like Dysgraphia (hand writing problems) like the use of a computer; use of graph paper for math problems; providing a copy or arranging for a classmate to make carbon copy of the notes of the lesson; and minimizing deductions for neatness and spelling but instead, give extra points for neatness.

These suggested accommodations may seem difficult and even frustrating at the start. Remember that getting the desired results will not be easy and it may take some time to be realized. But it in the end, it will both be rewarding for both the student and the teacher. Aside from finding an ally in each other, the student, despite his/her ADHD is managed effectively in the classroom and gets to work to the maximum of his capabilities (thus boosting his/her self esteem); while the teacher further enhances her teaching skills, most specially in dealing with students with special needs. As they say, it takes two to tango!

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.