ADHD Information Leaflets Primary and Secondary School Strategies

Transcription

1 ADHD Information Leaflets Primary and Secondary School Strategies 1 Date of publication: July/09 Ref: 660/ADHD Pennine Care NHS FoundationTrust

2 1. What is ADHD (Attention Deficit Hyperactivity Disorder) ADHD is diagnosed by a child psychiatrist or paediatrician with a special interest, following a full assessment. It is a neurobiological disorder that is evident at a young age. The more severe forms of ADHD is sometimes referred to as Hyperkinetic Disorder in the UK. ADHD is long-term condition that may affect learning and behaviour throughout childhood and into adulthood. The exact cause is not known, but it is believed to be due to an imbalance of dopamine and noradrenaline neurotransmitters in the brain. What are the characteristic features of ADHD? Hyperactivity Inattention Impulsivity How might ADHD affect a child/young person? Children/young people with hyperactivity may be unable to sit still, unable to remain calm, be fidgety, get up and move around when sitting is expected, fiddling and touching things and have sleep problems. Children/young people who are inattentive may have difficulty concentrating for periods of time, forget instructions, be disorganised, swap and change activities frequently, be easily distracted, struggle to complete tasks, have poor listening skills and be forgetful and lose things. Children/young people are impulsive, may speak out and act without thinking, have difficulty in waiting their turn, blurting out answers and interrupting others. The features and severity of ADHD can vary from one person to the other, not all children/young people with ADHD have all these symptoms. ADHD is a highly co-morbid disorder. Three quarters of young people will have associated disorders such as behavioural problems, learning or developmental difficulties, tics and obsessive compulsive disorder. Young people are also more likely to experience low self- esteem and have difficulties in peer interactions. 2

3 The way in which the environment interacts with a particular person will affects whether the symptoms can get better. All young people with ADHD can benefit from the use of strategies at school and at home (National Institute Of Clinical Excellence, 2008). Those with more significant symptoms may also benefit from medication. ADHD presentation may change as a child develops (hyperactivity reduces in adolescence) and requires regular monitoring by a specialist doctor or nurse, who may suggest changes in medication and/or strategies. An ADHD classroom Seat the child/young person near you, near the blackboard, away from windows and away from bright displays limit distractions. When giving instructions stand near to him/her and make eye contact. Break down large tasks into smaller chunks keep the tasks short or as a series of small different tasks. Minimise instructions keep instructions simple and clear. First do this, then do this. Get the child/young person to repeat instructions back to you, to make sure he knows what he is expected to do. Use visual aids checklists, on the board, daily works schedules. Separate the child/young person from others that stimulate the child/young person s over excited behaviours. Regular specific praise for behaviours you want rather than using general, ie, well done, good boy. Make simple classroom rules and have them on display, including rules about asking questions, interrupting and general classroom conduct. Create a daily classroom routine have regular times for stories, desk work use visual prompts i.e., clear, easily viewed visual timetable/time-lives. Use clear systems for keeping track of work, i.e., use different coloured exercise books/folders for different subjects. Ensure the child/young person is given prior warning about any changes to their routine minimise changes. 3

4 Immediate individual rewards systems in place. Avoid singling the child/young person out if displaying inappropriate behaviours, name the behaviours and not the child/young person. Use extra handouts, home-school diary. Plan for more demanding tasks in the morning. Homework Home-school diary. Bring any homework finished or unfinished in home-work clubs. Check that they hand homework in. Use an exchange system i.e., homework/sticker. Discuss any homework issues with parents. Use homework trays three different trays, colour coded. - Red did not understand it at all. - Amber did it, but not fully understood. - Green understood it completely. Friendships Use circle time/seal to promote positive friendships. Allow the child/young person cooling down time following play times. Effective use of lunchtime assistants supervision and scaffold. Organised games at break time/play times. Encourage shared tasks with peers. Model appropriate behaviours. Encourage and support positive friendships. If the child/young person displays problem behaviours, identify the problem 4

5 behaviour, and steps to target it, then identify the target and rewards with the child/young person. Inattention Daydreaming, staring out of the window, bored. - Use lively and varied presentation styles. - Ask pupils to repeat instructions back. - Use visual aids. - Ask questions to keep child/young person s attention. Not following instructions, filling in homework, journals and letters home. - Post all important information home. - Ask buddy to help write in journal. - Repeat instructions back. - Encourage use of homework clubs or allow time in school to catch up on homework or class work. Difficulties following copied text or written instructions. - Allow use of highlighters or underlining on photocopied sheets. - Differentiating text. Being off task especially in group work. - Limit group work. - Make it short and specific. - Use good role models within group vary these role models regularly. 5

6 Impulsivity Shouting out, calling names, interrupting conversations. - Reinforce hand up and stop and think rules to the whole class. - Respond quickly to positive hands up. - Ignore low-level behaviours. - Use praise. - Use visual prompts, i.e., holding toy to indicate when pupils time to talk. - Acknowledge positively (thumbs up) when pupils are keen respond, but allowing other pupils to answer. - Use timer to set limits. Turn taking, pushing and hitting out. - Allow own space. - Anticipate and avoid areas of conflict. - Avoid long waiting times. - Praise appropriate behaviours immediately. Hyperactivity Fiddling, tapping, plucking carpet and touching other pupils. - Use of fiddle toys, e.g., tangle toys, blue tac, bean bags and tissue. - Let them scribble or draw whilst the teacher is talking. Out of chair, wandering around or rocking on the chair. - Allow them to stand by the chair. - Give them regular breaks. - Ask them to collect items from across the classroom 6

7 Over excited behaviour, i.e., pushing in line. - Use front of back line. - Limit waiting time in line. - Distraction. - Special signal to indicate when getting over excited. - Use time out cards. - Allow individual calm down time after break or lunchtime. Support in schools SENCO PBSS SBSS IEP/IBP use SMART targets specific, measureable, achievable, realistic, time limited School nurse Use of medication see medication in schools policy. If the child/young person needs to take medication in school discreetly prompt them to go to the school office at the appropriate time. Avoid singling out the child/young person or repeatedly asking them, have you had your tablet? Doctors try and use long acting medication where possible to avoid pupils needing to take medication in school. These are just ideas to get you started. Please be adaptable, innovative, empathetic and open minded, as not one strategy fits all. We would love to hear any new ideas of strategies schools can use. 7