ADHD in class

How does the teacher reduce ADHD symptoms in the

Classroom?

Alba Romero Temporal

Department of Child and Youth StudiesDegree paper, 15 cr, Fisrt cycleChild and Youth StudiesChidren, Culture, Globalization 15 crAutumn term 2013Supervisor: Frankenberg, SofiaExaminer: Payne, David

ADHD in class

How does the teacher reduce ADHD symptoms in the Classroom?

Alba Romero Temporal

AbstractThe ADHD (attention, deficit, hyperactivity, disorder) is not a new disorder, although

nowadays it is a controversial issue that involves our society. Children are constantly in

contact with other infants who suffer this problem during their schooling and they have

to learn and to accept them on equal terms. For this reason, the teachers and parents

have to know the disorder to help these children. These kind of pupils as a concequence

of their disorder have learning disabilities, too such as problems associated with

reading’s, writing’s and claculation’ skills, among others.

For these reasons, the teacher has the role to integrate and include these pupils inside the

ordinary class with the other classmates and to establish a high link between them,

because the motivate state, instead of and to feel part of a group and to be accepted is

one of the main goals to improve the lives of these children.

So, the main goal of this study is to investigate and describe what the teacher has to do

when she or he has a pupil with this disorder, because the teacher has to be trained and

has to follow some strategies and methods in class to get a positive development in the

social, personal and academic context to children with ADHD. Some methods that

teacher uses to minimize the symptoms of ADHD and to help to pay attention in class

are: positive reinforcement, token economy, extinction process, time-out and response-

cost programs.

Keywords

ADHD (attention, deficit, hyperactivity, disorder) · Role · Integrate · Include · Skills · Teacher ·

Methods · Strategies · Context · Disease

”La decisió de desenvolupar una intervenció no deu basar-se exclusivament en un diagnòstic de TDAH, sinó en les necessitats individuals del nen”

"The decision to develop an intervention should not be based solely on a diagnosis of ADHD, but on the individual needs of the child"

Ana Miranda i Cols (2011)

Contents

Introduction……………………………………………………………………………...

Literature review…………………………………………………………………….......

Methods Section………………………………………………………………….............

Results or findings……………………………………………………………………….

Conclusions…………………………………………………………………………….....

Introduction

Nowadays to talk about the phenomenon of attention, deficit, hyperactivity disorder

(ADHD) is also necessary to look back hundred years ago. This is because it is not just

a disorder characteristic of XXI century, if not it has always existed even if, currently it

is more often diagnosed (NICE, 2013).

It is for this reason to start this thesis I have seen fit to look for what are their origins

and to conduct an historical review. In this review we are going to see quickly how

theories have developed and changed during these last years. This paper is going to

describe the main characteristics of children with ADHD and their origins. Furthermore,

it is important to know how many different kinds of this disorder there are.

Finally, I am going to talk about the behaviour of children with ADHD in class, how

they are integrated inside the normal class with the other classmates and the techniques

and methods that the teacher uses in class to promote their integration.

Also, it is true the educational system has searched some solutions to integrate and to

care for pupils with special educational needs (SEN) in general, but even though there is

still a lot of work to do because the idea to integrate this kind of pupils inside the

normal class is relatively actual and it demands both careful teacher training and time to

make changes (Brodin & Lindstrand, 2007).

Therefore, there is no doubt the educational system has to adapt and must ensure the

specific needs of these pupils if it wants to get their social integration goal from the

beginning of their schooling (Molina & Holland, 2010) because if it is not in this mode,

these infants are going to be doomed to the school failure.

In this project is going explain what are the interventions that teachers can do in case

that they find a child with this disorder inside the regular class, which treatment

methods exist and how with them we can foment children’s self-esteem and self-

control.

Children with ADHD frequently have difficulties about reading, orthography, writing,

mathematics and the language (Mena , Nicolau, Salat, Tort, & Romero, 2006).

Consequently, their results are below their intellectual capabilities because they have

many problems, such as to pay attention, to memorize something and to control their

impulses. For these reasons, the probabilities of school failure of these children are very

high.

The intention of this paper is to give a survey of this disorder explaining their

symptoms, their consequences and their treatment in class. Furthermore, the most

important is to keep in mind that ADHD is a disorder that society, parents and in this

case the classmates and teachers have to live together with these pupils. It is important

that teachers have capacities to teach, motivate, guide and transmit to pupils their

technic, social and personal knowledge (Mena , Nicolau, Salat, Tort, & Romero, 2006).

They have to develop their role like professionals in the best way possible.

As Inmaculada Moreno said, 2008, “the environmental influence on the behaviour of

children is important. The therapeutic actions have to take place at home and at school

and, have to do them with motivation and with the involvement of adults. Furthermore,

it is hardly likely significant changes are obtained if treatment is developed problems in

contexts outside its natural range” (Moreno, 2008)

Finally, I’ve chosen this topic, first of all, because I think that it is a burning issue in the

actual’s time and teachers, parents, and sometimes some professionals that conduce and

take part of a psychological intervention, have some difficulties and complications to

work and intervene with pupils with ADHD. For these reasons, and because I want to be

a teacher I was excited to know and to research about this topic and methods that

concern it.

MAIN AIMS:

1. To analyze different theories and explanatory concepts of ADHD.

2. To know the role of the teacher

3. To show different methods by the teachers to develop in class to improve the

knowledge of the pupils with ADHD.

Literature review

Historical evolution ADHD is one of the most diagnosed, studied and treated child and adolescent

psychiatric disorders and, nowadays, it is common to hear people in the street talking

about this problem. There has been a controversial issue regarding its diagnosis,

ethology, treatment and methods to improve the life of children (Brodin J. , 2012).

The ADHD was described for the first time almost 100 years ago and for over half a

century the known beneficial effects of stimulant drugs for this treatment (Brown ,

2002). This paper will describe how some of the past terms have included “hyperkinetic

disease”, “minimal brain damage” and “minimal brain dysfunction”, among other

wrong conceptions to describe this disorder.

The ADHD, disorder for inattention with or without hyperactivity, is the term known as

syndrome characterised by three symptoms of disorders such as inattention,

hyperactivity and impulsivity, even if these symptoms do not always have to be

presented all together (American Psychiatric Association, 2013).

The first description we know about ADHD was told by Hoffman, a German doctor

who reproduced an important part of the symptoms in a book’s character; he was called

Phil, a restless child that could not be seated and he was moving constantly (Mark &

Wolraich, 2006). In that book Hoffman was describing Philip with the hyperactive

symptom, the movement’s excess, but the child did not seem to show inattention.

"Let me see if Philip can

Be a little gentleman;

Let me see if he is able

To sit still for once at the table."

Thus Papa bade Phil behave;

And Mama looked very grave.

But Fidgety Phil,

He won't sit still;

He wriggles,

And giggles,

And then, I declare,

Swings backwards and forwards,

And tilts up his chair,

Just like any rocking horse--

"Philip! I am getting cross!"

See the naughty, restless child

Growing still more rude and wild,

Till his chair falls over quite.

Philip screams with all his might,

Catches at the cloth, but then

That makes matters worse again.

Down upon the ground they fall,

Glasses, plates, knives, forks and all.

How Mama did fret and frown.

When she saw them tumbling down!

And Papa made such a face!

Philip is in sad disgrace . . .”

(Hoffman, 1902)

It was published for 1st time by Lancet British journal, 1904

The English paediatrician Still in 1902, unveiled the first description of impulsive,

aggressive and inattentive behaviour. He described them as behaviour problems that he

called “defect in moral character” (Mark & Wolraich, 2006). The concept was logical in

that time because the disorders associated with this syndrome are important and it did

that children were classified as different, uncontrolled and problematic, adjectives that

nowadays some people use to describe them (Martin, 2010).

The relation between the hyperkinetic disorder mainly based on overactivity and

restlessness and a defect in the central nervous system was the first current during the

first half of the XX century; Hohmann, 1922 said that children had a cerebral

dysfunction. In the 60’s most researchers noticed that children with hyperactive

symptoms did not have any brain injury and they called the problem as “minimal brain

damage or cerebral dysfunction” (Mark & Wolraich, 2006). Thus, the ethology

wouldn’t be a specific brain injury; if not a general dysfunction in what the brain is

normal. This term was getting more important by Clements and Peters in 1966 who

described that symptomatology: motor disorders, hyperactivity, impaired coordination,

perceptive and attention disorder, school learning difficulties, difficulties in the control

impulses, impaired interpersonal relationships, affective disorders, ability,

aggressively… (Wright, 2002).

The DSM manual

The concept of ADHD appeared for the first time in the diagnostic and statistical of

mental diseases DSM II manual, published by American Association of Psychiatry, in

1968 with the name of “hyperkinetic reaction of childhood” (American Psychiatric

Association, 1967).

Virginia Douglas, in the 70’ years, argued the basic deficiency of hyperactive children

isn’t the excessive level of activity, but the incapacity to pay attention and the

impulsivity, therefore, an insufficient self-regulation that is closer to the actual meaning

(Mark & Wolraich, 2006). Douglas was decisive that the American Association of

Psychiatry changed in 1980 the description in her DSM III, where it included new

criteria and changed the meaning to “attention deficit within and without hyperactivity”

(American Psychiatric Association, 1980).

Between the 80’ and the 90’ years they began to make a lot of studies and researches. In

these last years the OMS made a diagnostic and statistical manual of mental disorders

DSM-IV-TR based in the research made in the 80’ and 90’ years. In this recent manual

there was argued that children should be present the symptoms of ADHD before to be 7

years (American Psychiatric Association, 2010).

Nowadays, there is published the last manual DSM 5 argues that several of the

individual’s ADHD symptoms must be present prior to age 12 years, compared to 7

years as the age of onset in DSM-IV (Association A. P., Highlights of Changes from

DSM-IV-TR to DSM-5, 2013). This change is supported by substantial research

published since 1994 that found no clinical differences between children identified by 7

years versus later in terms of course, severity, outcome, or treatment response

(American Psychiatric Association, Diagnostic and Statistical Manual of Mental

Disorders. Fifth Edition. DSM-5, 2013).

After this historical review until nowadays and after to see the different criteria and

topics that people used throughout history to refer ADHD, the next step is to define this

disease.

Definitions of ADHD

ADHD is a neuro-psychiatric disorder characterized by a pattern of behaviour. It is

divided in two categories related with their symptoms: inattention according with their

stage of development, and hyperactivity and impulsivity (American Psychiatric

Association, 2013). This disorder includes behaviors like failure to pay close attention

to details, difficulty organizing tasks and activities, excessive talking, fidgeting, or an

inability to remain seated in appropriate situations (American Psychiatric Association,

2013).

After to talk about what ADHD and their origins are, it is important to know what the

causes are. It is difficult to give direct or immediate causes about ADHD (Mena ,

Nicolau, Salat, Tort, & Romero, 2006). However, in general, and according to the

Hospital Sant Joan de Déu, 2010, the causes can be divided in 80 % of

genetic/biological factors and the rest from acquired factors (Hospital Sant Joan de Déu,

2010).

- Biological cause: is by disequilibrium chemical or a deficiency of certain

substances on the brain that are located in the brain area charge of attention and

activity (problems about chemical and structural level) (Bakery, 1999).

- Heritage: A lot of biologic parents of children with ADHD shown indices of

ADHD when they were children (Hospital Sant Joan de Déu, 2010).

- Other causes / acquired factors: In some cases, the complications during the

childbirth can be involved in the manifestation of the disorder or the

environmental factors can influence, too. Also, the fact to spend a lot of hours in

front of the television or computer can contribute to have symptoms of ADHD.

(Mena , Nicolau, Salat, Tort, & Romero, 2006), (Hospital Sant Joan de Déu,

2010).

The main symptoms that this disorder gathers are basically, inattention, hyperactivity

and impulsivity. To have a more completed definition of this disorder, it is good can

classify it in:

Inattentive symptom: problems when the child has to start some activities or to pay

attention until to finish their tasks (WebMD, 2013). In this type are gathered some

skills, such as the selection of a stimulus in a concrete time, to pay attention in a

stimulus in a concrete period of time, to be able to inhibit stimulus and the capacity to

change stimulus to finish a task and starting another one. The characteristic of these

children is that the difficulty of pay attention is present in a little but intense mode

(Fundación ADANA, 2009).

Hyperactive symptom: not always is present in people with attention disorders, but for

the majority it is true that they are excessively restless (WebMD, 2013). The

restlessness’ grade can vary depending on the situation they find themselves and the

level of interest that an activity has for them. Sometimes, there are evident motor

behaviours, such as walking on the table when the other mates are sitting on their chairs;

others, the movements are made by muscles (to hit with a pen on the desk constantly,

playing with the projects that they have in front and touching everything). Not all

movements of these children are hyperactivity’s indicators and just we can call them

when the movements do not have any proposed, they are given in inappropriate

circumstances and are made without any reason (Fundación ADANA, 2009).

Impulsive symptom: is associated manifested in two ways: cognitive level, when the

difficulty appears at the moment to think conscious about one thing and argue about a

situation and, on the other hand, behaviour level, appears when there is incapacity to

avoid behaviour or a verbal answer (Fundación ADANA, 2009).

It is evident that difficulties to maintain attention/concentration and

hyperactivity/impulsiveness are the most common problems, for these reasons and for

these three symptoms called before; there are established three different types or

subtypes of ADHD:

Inattentiveness and hyperactivity mainly inattentiveness (AD) (First, 2009): It is

difficult for the child to organize or to finish their tasks, to pay attention to some details,

or to follow some instructions or a speech. The affected person is constantly and easily

distracted or does not remember some details of everyday.

Inattentiveness and hyperactivity mainly hyperactivity/impulsivity (HD) (First,

2009): The child is restless and speaks little; to be quiet is difficult for him or her when

he is eating or doing homework; the infant is impatient and has some impulsivity

problems. He or she interrupts the others, speaks in inappropriate moments and is

difficult to wait for his or her turn. They can have more accidents, incidents and injuries.

Inattentiveness and hyperactivity in combination (ADHD): The affected person

experiments the symptoms of both types before called in equal mode.

Informative data

This disease in general affects to 3 to 7 per cent of the infantile and adolescent

population (American Psychiatric Association, 2010).

It is estimated that the prevalence of attention deficit disorder with hyperactivity

stands at the 3 and 5% in school-age children (American Psychiatric

Association, 2013).

As Jane Brodin, 2012, says in her article “the prevalence of ADHD in Sweden is

estimated to 3 to 6 per cent of all school-age pupils” (Brodin J. , 2012).

It is should also be noted that ADHD presents differently depending on a child’s age,

maturity and as the environment requirements for sustained self-control change. During

school years a child may make excessive movements during situations when they are

expected to be calm (Fundación ADANA, 2009). During the adolescence hyperactivity

may present as excessive fidgetiness rather than whole body movement. Often

inattention diminishes and attention span usually increases with age, but there still tends

to be leg when compared to unaffected individuals and the level needed for everyday

attainments. (Taylor & Sonuga-Barke, 2008).

How is it diagnosed and treated?

ADHD sometimes is easy to identify because differs from the normal spectrum because

there are high levels of inattention or hyperactivity/impulsivity (NICE, 2013).

The symptoms of this disorder are detected by parents of children with ADHD because

often they do not know what to do with their children because their behaviour is not at

all correct. Also, the symptoms are usually detected in the school, although in some

cases they have been diagnosed in younger ages. The teachers realize that some pupils

do not follow the rhythm of the other peers. The number of detected children with

ADHD is thus increasing and for these children and people in their immediate

environment neuro-psychiatric disorders cause huge problems with regard to learning,

teaching and social interaction (Brodin J. , 2012). This has resulted in an increasing

demand for special classes in school and today we can note that there are special classes

for children with for instance ADHD. This trend is global in spite of the fact that most

countries for the time being are promoting inclusion of all children in a school for all

(Norwich, 2008).

The diagnostic can be given by medical professionals (paediatrician, psychology or

psychiatrist) (Mena , Nicolau, Salat, Tort, & Romero, 2006). It is important to know the

diagnostic criteria in DSM-IV or ICD-10 (hyperkinetic disorder) (NICE, 2013).

An appropriate intervention to a pupil with ADHD it is important to keep in mind 2

basic aspects: to have clears the symptoms of this disorder and the effect of these

symptoms to the personal equilibrium, the social relations and the academic

performance (Primària & Batxillerat, 2013).

The treatment has to be established from a holistic perspective and trying to follow

these aims:

- Optimize the steps and the educative context.

- Avoid the emotional and behavioural impairment for the difficulties that ADHD

generates.

- To give some positive strategies to the child to confront the adversities, develop

compensation strategies, accepted him or herself and enhance his or her

qualities.

- Avoid the secondary pathologies such as oppositional defiant disorder or

dissocial disorder (Primària & Batxillerat, 2013).

The best treatment for his effective results until nowadays has been evaluated in a

controlled study and has been called “Multidisciplinary treatment/Multimodal

Treatment of Children with ADHD” to look for solutions for the problem. It is a

combination of treatment between parents (family), teachers (school), psychologist

(professionals). It has to include:

-Information to the child or young boy, family and teachers.

-Pedagogical support inside the school.

-Psychological treatment (individual or familiar).

-Pharmacologic treatment (if it is necessary for his or her symptoms) (Primària

& Batxillerat, 2013).

Methods section

This method section is based on Bryman writings (Bryman, 2004). This thesis is a

scientific work made through a qualitative research. So, the topic presented is about

social research, specifically an explicative research because it intends to know what

ADHD is and how these children can be integrated in the normal class with the other

peers. For that, it is important the role of the teacher. This paper pretend to give some

answers to meaningful questions such as:

- How does the teacher reduce ADHD symptoms in the Classroom?

This question includes another one as:

How does the teacher manage to promote and to include children with ADHD in class

and which are the methods that they use to do it?

To know if these hypothesis are true or not from different perspectives, it is important to

create literature review, the mode how I got the information (collect data) and their

treatment. It is important to know the population that is addressed this thesis, but in this

case ADHD is an actual issue that involves society and concerns it and it is good to

explain and to know the strategies that teachers use to improve the lives of children with

ADHD in the ordinary class.

First of all I had some problems to create my research questions, but finally I got the

hypothesis that I wanted to research. For this reason, the first step was to create a

research design that consisted on to collect the data, in this case, some articles,

documents, books and webpages about ADHD. The technique used to collect the data

was personal according with the goals and the question research. I was looking for some

keywords in some articles such as: ADHD, symptoms of this disorder, integration,

children, role of the teacher in class, inattention, impulsivity, hyperactivity… It was

essential to read and compare some different documents from different authors. In the

same time, was important to think about the aims of the thesis to select the best

resources to do it:

1. To analyze different theories and explanatory concepts of ADHD.

2. To know the role of the teacher

3. To show different methods by the teachers to develop in class to improve the

knowledge of the pupils with ADHD.

It is important to follow the goals, because they are with the research question, a guide

to write and develop the paper. Also, the qualitative research has the possibility to be

more flexible but planned, formal and uniform.

The documents have to be clears and strategically selected. Also, it is much important to

give adequate references about the documents that are used to do it, because they are the

origin and the base of the research.

The next step was to think about the introduction. Introduce of the topic’s choice with

the research questions and goals are important to structure this paper. After that, the

next step was to relate orderly and with logical procedure the theory of ADHD with the

chronological historical context, explaining the main characteristics of the disorder,

their different symptoms and types and their treatment. Subsequently, the next point of

this research was the explanation and answer about the research question. Finally, the

last past is the conclusion with the thinking and beliefs after to do this project.

Results or findings

It was important to know all these characteristics about children with ADHD before to

focus on these children in class.

Until this moment was presented the general meaning of ADHD with their types, main

characteristics and the historical review; an overview of children with ADHD. From

here, this paper will present the main findings regarding the social relations with the

other people, especially in class, with their schoolmates and teacher and how the

teachers manage to improve the educational stage of these pupils.

Behaviour and learning problems are not exclusive of ADHD, because all people have

them but have lesser level, and for this reason when the specialist have to diagnose a

child with ADHD, he or she has to be sure that the infant’s behaviour and his or her

level are much lower than the rest of the mates of the class; it has to be a significant

difference (Mena , Nicolau, Salat, Tort, & Romero, 2006).

Aspects related with the academic live of children with ADHD:

Children with ADHD and with the same intellectual capacity that other mates, they have

more probability to fail in the school because they have more difficulties to keep

concentration. To follow the lessons and the indications that teacher gives is necessary

to have concentration during a long period of time in the same activity, although more

often there are stimulus that cause distractions (Mena , Nicolau, Salat, Tort, & Romero,

2006).

To have a good behaviour and efficiency in school’s tasks by children is required by the

teacher control processes, establish some priorities with the child and to know how to

organize their time together. If children feel confidents with an appropriate level of self-

efficacy and self-esteem to do a task, they are more predisposed to do another one and

they get personal motivation. The next time that they are going to do a task, they are

going to work harder and with high level of persistence and they will get better yields

(Fundación ADANA, 2009).

The main goal of a child with ADHD is to be responsible for his or her behaviour, to get

educative level and to become a contributing person in the society. As Bonet and other

authors in 2007 said, the school is the place where is important to keep in mind in our

society because children spend there a lot of hours learning and trying to acquire

knowledge, and it is the institution where the adults (teachers, professionals, parents)

have to implicate on their lives with resources to improve them. For these reasons it is

important to help and support the adults that are working with these children.

“[…] in the school sphere is where less help, orientations, publications, programs, etc.

exists and, however, it is the place where there are more difficulties of ADHD, where

the pupil needs more self-control, to follow-up rules, relations with peers and, above

all, to pay needed sustained attention to learn. There are many bibliography and

documentation to parents, to those children, specific programs of individual

psychological and pedagogical treatment. Also, it has been progress in understanding

the neurological and pharmacological treatment. […] . However, we understand that

there is just the teacher support and teacher that day and hour after hour is working

with the child in the classroom, and the rest of the class at a time. It is clear to all

professionals who work with this disorder; only intervening in an interdisciplinary way

is how you can get consistent changes. This is a team effort where everyone has their

place of intervention, with specific objectives and not just a mere coordination, which in

itself would already be very important".

TRINIDAD BONET, YOLANDA SORIANO y CRISTINA SOLANO. Aprendiendo

con los Niños Hiperactivos. Un reto educativo. Thomson editores. Madrid 2007

ADHD in class

- What happens when a child with ADHD arrives at school with their

characteristics and symptoms?

It is important that teachers and the professionals that work in the school have

knowledge about ADHD and how to act with the pupils inside the classroom (Mena ,

Nicolau, Salat, Tort, & Romero, 2006). However, sometimes there are teachers not good

qualified to do and manage this task with these children. Many teachers do not have

clear the idea of ADHD because they are old and their knowledge is based in many

years ago (traditional perspective) when this disorder was insignificant and a mystery

for the society; for these reasons, nowadays, these kind of teachers unknown the

strategies to use in class with children with more needs (Brodin J. , 2012).

For this reason, the schools should have some guidelines to guide teachers in case to

find a child with ADHD in class such as (Martin, 2010):

- Give clear and concise instructions: the rules must be clearly stated and if it is

possible, graphically and visually. In younger children work well with a paper

called self- instructions time and work to do. In older children work well with

contracts.

- Be sure that they understand the tasks without making them feel different from

the rest of the class.

- Give them a physical space or time to move: make him run errands outside of

the classroom.

- No change inappropriate behaviour all at once, it would be better to agree with

him three goals that the teacher wants to achieve during the classroom and

ignore other behaviours.

- Physical contact is important: a soft touch on the shoulder when he or she is

"turned off "or be nervous can be enough.

- The experimental and manipulator methodology will be better than theory.

- It is preferable to use prizes before punishment.

- Avoid situations that the child cannot control : wait a long time in the queue, let

him participate in class ...

- It is better to disregard inappropriate behaviours and strengthen opposite.

- They must be aware of its limitations: the pace of education of these children is

different.

Another important aspect to control their behaviour is establish some good rules or

limits. Generally children or youth have an excessive list of “NO” (not run, not

shout…). Therefore, it is necessary to make rules and limits in a positive way (walk

slowly, speak softly…).

- Centre

According to the articles 23 and 28 about children with disabilities and right to

education respectively, in the United Nations Convention on the Rights of the Child,

1989 (UN., 1989):

Article 23: If you have a disability, you should receive special care and support so that

you can live a full and independent life.

Article 28: You have a right to an education. Discipline in schools should respect

children’s human dignity. Primary education should be free.

During the last decades one of the most important goals by professionals, family and

institutions has been to ensure a quality education to pupils. So, to have a good quality

in the education of children it is important to focus on the current about inclusive

education.

An inclusive school or an inclusive class are words called where in a concrete place can

learn different pupils from different backgrounds, believes and cognitive level too

(Pujolàs i Maset, 2006).

In an inclusive center, the pupil with Special needs need to go to the normal class where

the other mates of the same age follow the lessons. Perhaps, the child sometimes needs

a support teacher to help him in some tasks with some adapted tasks to the curriculum.

However, the pupil with special needs often follows some lessons in other classes

during a short part of time.

It is important by the teacher to give participation to the child, the diversity is crucial

and natural; implicate him on the center’s activities and all the tasks lived inside the

ordinary class (Konza, 2008).

- Classroom organization

This refers to create a favourable environment. This comfortable context is organized so

that pupils are stimulated and to reduce the symptoms that impede the learning and

adaptation process (Primària & Batxillerat, 2013).

The child with ADHD gives the better of him or herself when he or she works in a quite

atmosphere with a teacher. In choosing a class, the most important is to reduce the

distractions to a minimum.

The best place to these children inside the class is to sit them in the first tables in front

of the teacher that gives them confidence and help and in the same time in front of the

white or blackboard to look better what the teachers writes on it. Also, if the teacher has

close to him the pupil with ADHD is easier to control their tasks and to maintain a

visual contact. Thus, if the teacher realizes that the child does not pay attention, he or

she can make a signal to return the concentration to the child quickly. Also, the teacher

has to ensure the student’s timetable or schedule is easily accessible to them in an

understandable form and also making organizational structures, rules and routines

simple and easy to follow and recall too.The classroom should have a good lighting. It

is preferably to sit these children between two calm classmates, they could be their

guides. Always sit them with pupils, avoiding the exclusion of children with ADHD.

However, the teacher has to avoid organizing the tables gathering them as a square,

because they have to pay attention to teacher and not to other mates. Further, it is

important to sit the children far away from the window and from the other possible

distractions such as murals on the wall, the door, colourful posters or toys. (Mena ,

Nicolau, Salat, Tort, & Romero, 2006).

- Methods

Child with ADHD used to have problems in the school; their symptoms make hard that

these children are calm in class, without annoying the other mates and they are able to

finish their tasks correctly and on time (E. Brock, 2002).

However, the teacher can help them with his or her effective practice. The role of the

teacher is to minimize the child’s weakness and to maximize their strengths.

To perform these changes is important to know some strategies and methods:

To modify the behavior:

First of all it is important that teacher knows what is the behavior that child with ADHD

has to improve or what the disruptive behavior is. Also, it is important to know the

frequency and the intensity of that behavior and where, with who and when it appear.

So, to do this, there are some techniques:

- Positive reinforcement: the role of the teacher consists on to praise, reinforce or

reward children with ADHD after a good behavior. The consequence of the

positive reinforcement is children are more motivated to maintain a good

behavior and to increase the frequency to do it well.

The object that teacher gives to child as a reward in front of their good behavior

is called positive reinforcement.

There are four steps that teacher has to follow:

-Identify the behavior that he or she wants to reinforce.

-Plan which type of reinforce he or she wants to use.

-Reinforce immediately and continuously.

-Observe the child’s success in relation to the desired behavior.

Depending on the factors such as the age of the child, their interests or the

moment, the teacher can give different reinforcements:

-Social reinforce: Attention by the teacher, mates and professionals

working in the school.

-Verbal reinforcement: Praise the child and tell him specifically what is

thing he or she did well.

-Contact reinforcement: touch his shoulder, make him a hug…

-Prize reinforcement: award the child with a break to let him rest a little

bit or to use another method called “Token economy”.

- Token economy: The main goal of this technique is to encourage and motivate

the child with ADHD to learn and to foment positive behaviors (Mena , Nicolau,

Salat, Tort, & Romero, 2006). The token economy system consists on to

establish some rules based on goals that teacher wants to improve on his or her

pupils. The result will be to achieve the goals established (good student behavior

in some specific tasks) and also, the pupil get a desired and agreed prize. It is

called “token” economy because the child before to get a prize, he or she has to

collect a number of points or token that are marked on a paper. The role of the

teacher is to give to the child some cards or points when he or she does things

rights (Reiber & McLaughlin, 2004). The prize can change in function of the

interests of the child. For example, the pupil with ADHD sometime wants to

choose sweets as the prize.

The teacher has to keep in mind that their pupil with ADHD has clear the rules

of this system and also, the teacher has to focus on just two or three simple goals

to achieve, not more in the same time (Banús, 2012). Also, it helps them to

increase his or her self-esteem.

To decrease a certain behavior:

Also, there are some strategies to decrease certain behaviors before to modify them

because it is necessary to spend more time to do it.

- Extinction process: This method is used to know what the origin of the

behavior is to decrease it, avoiding their repetition. This method consists on

focus on a behavior of the child with ADHD to decrease and modify it. To do

that, the teacher should not pay attention to the bad behavior that the pupil is

doing (not look, not listen to him…), so, acting as in a normal context. For

example, if the child with ADHD raises his hand to ask teacher some questions

without any reason, the teacher can propose if he or she is able to ask just 10

times during a day. The other times the child will not be attended (Mena ,

Nicolau, Salat, Tort, & Romero, 2006). The teacher will try to teach and

transmit the pupil that only the important doubts have to be asked. After that, the

teacher can decrease the times to raise the hand it be required. When the child

knows how to use his behavior, the teacher should congratulate him.

- The punishment: It is important to avoid the punishments because is better that

teacher reduces the positive reinforcements before to punish the child with

ADHD (Mena , Nicolau, Salat, Tort, & Romero, 2006). The punishment can

become by the pupil to hate the class, the teacher or the other mates and also,

because a punishment involves emotional instability in the future (Martin L.

Kutscher MD, 2002). The teacher can use the Token economy System or the

next strategies to improve the behavior of the child.

- Time-out: This methodology consists on isolate the child during a concrete and

short time into a place without distractions. It is important to choose a good

place to remove the child (in another class, in a corner of the same class…)

(Mena , Nicolau, Salat, Tort, & Romero, 2006). This technique is used when the

pupil with ADHD has a bad behavior about a specific task or because the child

was aggressive with the objects of the class or with the other mates (E. Brock,

2002). Once the time-out is finished, the teacher gives the instruction to the

pupil to continue following the lesson. Perhaps, the teacher needs to talk about

what happened, and, for this reason, the kid and the teacher can talk about the

disruptive behavior.

- Response-cost Programs: It happens when there are disruptive behaviors in

class. That bad behavior has consequences in class. There were some activities

given to pupil as a positive reinforcement when his or her behavior was correct.

So, when the child with ADHD does not want to follow correctly the goals

established, those positive reinforcements or prizes that teacher gave, now the

teacher gives less of them (E. Brock, 2002) .

Conclusions

Once read and analyzed a lot of articles, chapters of books and some documents in

general from many authors and associations, personally I can say that ADHD is a

common diagnostic in childhood and lasting into adulthood. It is difficult to attribute a

specific cause about the origin of this disorder, because there are a lot of factors that

involves it, although, as many researches explain, the most important cause is from

genetic/biological factors.

To act from the school it is much important the multidisciplinary intervention of the

family, school and other professionals to improve and help the lives of these children.

So, as a future teacher I think that our society has to try to help the pupils with ADHD

and implicate us on the integral development of these kids. It is important the role of the

teacher, but further, it is clear that the effort must be set by all the people that live

around children with ADHD.

In this project I have try to introduce the ADHD disorder explaining a brief about the

historical evolution. Also, I have looked for the causes, symptoms and types of ADHD

before to focus my paper on the methods that the teacher uses to integrate these pupils

in the normal class with the other mates.

So, I think that it is important to:

- Integrate the child in all contexts that society concerns us.

- Implicate the child in their own personal objectives to get on, according with his

or her level, age, schooling, family…

- Create routines and habits following the schedule.

- Avoid the stimulus that causes distraction.

- Observe the child and follow different methods according to the task, moment

and preference of him or her.

Finally, to help these children we have to spend time with them and act like a guide,

because I think that for them, we are a model to follow. For this reason, the teacher has

to be constant with his work. With some patience and dedication from everybody

around children with ADHD and from the own children, they are able to achieve their

challenges and to acquire an adequate academic level like the other mates.

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