Rolling those ADHD dice

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(Still posting mostly for the newbies as they try to figure out what’s going on in their first year.)

From the http://www.healthline.com/health/adhd/facts-statistics-infographic#2 article on the rising rates of attention deficit hyperactivity disorder (ADHD) among America’s children:

Cases and diagnoses of ADHD have been increasing dramatically in the past few years. The American Psychiatric Association (APA) says that 5 percent of American children have ADHD. But the Centers for Disease Control and Prevention (CDC) puts the number at more than double the APA’s number. The CDC says that 11 percent of American children, ages 4 to 17, have the attention disorder. That’s an increase of 42 percent in just eight years.

ADHD & Other Conditions
ADHD doesn’t increase a person’s risk for other conditions or diseases. But some people with ADHD — especially children — are more likely to experience a range of co-existing conditions. They can sometimes make social situations more difficult or school more challenging.

Some co-existing conditions include:

learning disabilities
conduct disorders and difficulties, including antisocial behavior, fighting, and oppositional defiant disorder
anxiety disorder
depression
bipolar disorder
Tourette’s syndrome
substance abuse
bed-wetting problems
sleep disorders
– See more at: http://www.healthline.com/health/adhd/facts-statistics-infographic#5

I strongly suggest reading this article.

In abstract terms, these numbers suggest that a teacher with 30 kids in a class on average will have around 3 students who suffer from attention deficit hyperactivity disorder. In practical terms, every class, every year will be another roll of the dice. You may walk in to find four kids with ADHD in your homeroom of 22 kids. The conventional wisdom has this condition growing more prevalent in the population, like autism. I believe that wisdom. The numbers of kids bouncing off the walls does seem to be increasing. How much of the ADHD increase results from increasing diagnoses, rather than genuine change, I don’t know, but the numbers of kids on meds has unquestionably been increasing.

I want to throw in one more set of observations from the article with the caveat that these are generalizations and some girls manifest ADHD exactly like boys do. I dislike gender generalizations, but I am adding these because atypical symptoms of ADHD do not receive enough focus. In particular, inattentiveness often results in classroom struggles between student and teacher. Teachers can take inattentiveness personally when that inattentiveness has little, or nothing, to do with them.

Boys tend to display externalized symptoms that most people think of when they think of ADHD behavior, for example:

impulsivity or “acting out”
hyperactivity, such as running and hitting
lack of focus, including inattentiveness
physical aggression
ADHD in girls is often easy to overlook because it’s not “typical” ADHD behavior. The symptoms aren’t as obvious as they are in boys. They can include:

being withdrawn
low self-esteem and anxiety
intellectual impairment and difficulty with academic achievement
inattentiveness or a tendency to “daydream”
verbal aggression: teasing, taunting, or name-calling
– See more at: http://www.healthline.com/health/adhd/facts-statistics-infographic#6

Eduhonesty: I recently wrote a post asking for kindness and understanding for the quiet students. This post is for the ADHD kids. They tend to be loud. They leap out of their seats or fidget endlessly. They cause fights. They interrupt and then interrupt your speech about not interrupting. In the middle of math, they will pipe up to say, “I saw a fire engine yesterday.” When you are explaining the procedures for the assembly, they will ask, “How old is the oldest tree in the world?” Frequently they make the class laugh, not always intentionally. They often fall behind academically, although not always. ADHD runs in my family but my kids and I have been “A” students despite this fact.

The movie “Talladega Nights” has a great line: “I don’t know what to do with my hands.” Ricky Bobby was speaking for kids everywhere when he said that line, and for a lot of adults, too. Part of managing ADHD students is understanding that, yes, our ADHD students truly don’t know what to do with their hands since they don’t know how to keep those hands still. They don’t know how to sit attentively listening for more than a few minutes. Some kids are daydreamers and they slip into those dreams like Alice falling down the Rabbit Hole, alighting far from that lesson on fractions droning on in the background.

I suspect the acting out, physical aggression, low self-esteem, anxiety and verbal aggression listed above stem in part from that sense of failure that comes from not meeting expectations. Stress alone may account for more than a sliver of the uptick in ADHD diagnoses. Stress levels are rising. As testing takes up more class time and becomes more heavily emphasized, teachers need to be clear that we are making some challenged students feel like failures far too often.

On a practical level, I’d like to offer some suggestions to help with ADHD students.

Teach students to make and keep a to-do list. Teaching them how to use phones for this purpose will help them enormously. The sooner they learn to use smartphones and apps to remind the of appointments and deadlines, the better. Setting reminders can be problematic — beep, beep, beep. Still, reminder rules can be agreed upon, allowing for the occasional beep in unusual times.
alexis
For students who don’t have smartphones, agendas and notebooks work fine. If your school issues agendas, great. If not, buy a few cheap notebooks (or actual agendas if they have them) at the Dollar Store and give these to students who need help organizing themselves. Check written agendas before and after school. Help your students to make a daily to-do list and remind them to read that list later. Enlisting parents in this effort will improve the odds that lists get read as well as written.

Showing students how to organize themselves requires an extra time commitment on your part, but students (usually) appreciate the extra attention. Many also need the help. Part of the reason why some students suddenly suffer a precipitous academic decline when they enter middle school lies in organizational issues. When one elementary teacher laid out what to do and when to do it, these kids were fine, but that first year of six teachers with six different assignments can blow kids right out of the water, whether they have attention deficit issues or not. Many students can’t compartmentalize six sets of expectations with four different worksheets and three reading assignments, not in their heads anyway. Without help, some kids will begin stuffing books and assignments randomly into their locker, never taking them out of that locker, and never looking back. A few will do the assignments, stuff the completed assignments in their locker, lose them, and never turn them in.

Tips for managing that ADHD component of any classroom:

♦ Help your students get organized.
♦ Make them write out daily to-do lists.
♦ Don’t take inattentiveness personally. Some kids just live in a field of rabbit holes.
♦ Learn techniques to reclaim the attention of drifting kids. Do something out of the ordinary. Bells work. Singing works.
♦ Find fidget toys or activities to keep wandering hands occupied. If you type “fidget toys” into google, you will find numerous options, many of them inexpensive.
♦ Don’t get upset about the “blurts” that pop up. If my assembly instructions were interrupted, I’d say something like, “Right now, we have to go over the assembly rules. If you want, we can look up the oldest tree after school or at lunch.” Then I’d look up the tree. (The tree is named Methuselah. At 4,846 years old, this ancient, bristlecone pine can be found in the Inyo National Forest in California, but the forest service doesn’t let people know Methulelah’s specific location for the tree’s protection.)
♦ Encourage ADHD students — and all students — to exercise. Push them to join the soccer team if possible. Sinking excess energy into sports helps kids focus later.
♦ Encourage ADHD students — and all students — to eat well. I’m not sure if a diet of Flamin Hot Red Squiggly Things makes behavior worse, but I can’t see the remotest benefit to living on spicy-hot, squiggly things. Fruits and vegetables may help. They can’t hurt.
♦ Appreciate your ADHD students. I would never have known about the world’s oldest tree if not for one boy who was a joy to have in class despite his many interruptions.
♦ Empathize with the struggles of ADHD students. When they say, “I try, Ms. Q, I really do, but then I just forget to take the homework home,” believe them. Then try to come up with a system that will help them to remember the homework.
♦ Let your ADHD kids know you are on their side. You want them to succeed. Then work together with them to find the individual plans that will help with their particular issues. “I can’t do the work and then I get mad” requires a different plan than “I have to get out of my seat. I hate to sit.”
♦ Get help. Find out if your ADHD student has a social worker. Talk to counselors and social workers for advice.
♦ Have students bring all books and materials every day.
♦ Regular routines help ADHD and other students. Don’t vary your routines too often.

This last tip always proved hard for me. I am ADHD enough so that routines don’t appeal to me and sudden inspirations can make me change course in the middle of the river. As time went by, though, I realized that certain kids needed regular routines. Those routines helped them manage stress and helped them manage classroom procedures.

Simplifying procedures improves everyone’s life. If all students have to bring all materials every day, then students won’t forget to bring the fungus textbook or their markers. Class can start without supply issues. Students don’t have to feel that they messed up again when they missed the previous day’s instructions on the fungus book and markers. Anything that can be a routine, should be a routine. Routines free class time for learning and decrease the stress and challenges that students, especially ADHD students, face daily.

(I read my last paragraph and I think, “ooh, that sounds boring.” But especially for new teachers, routines are your friend. If the kids always pick up the opener from a table by the door and know what to do with that opener from previous practice, you have freed 5-10 minutes to take attendance and handle individual student issues. Students can settle down. You can complete clerical tasks. Routines free us to work on content, rather than classroom management, and content’s almost always much more fun than management.)