Attention Deficit Disorder (ADD)

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School support:

What is attention deficit disorder?

Difficulties arise from an inability to sustain and control attention. This may be noted irrespective of the task, although it may be more obvious in certain types of tasks. Usually the child with ADD is very easily distracted and may process information superficially as opposed to deep processing. ADD can also be associated with impulsivity and hyperactivity.

Advice for the classroom:

• Environment:
  Seat the pupil near the front of the class, and beside your desk if possible.
  Seat the pupil among children who do not normally have difficulties sustaining attention, if this is feasible.

• Motivation:
  Consider negotiating a target-setting and reward scheme, to focus him/her upon the need to increase the amount of time spent ‘on-task’. Ensure that targets are short-term and attainable.
  To help the pupil stay on task realistically, put an egg timer in front of him/her, and let him/her take a ‘moving-about break’ after he/she has managed a chunk of sustained and silent work.
  Try to set pieces of work as a sequence of smaller units where possible, to help him/her organise him/herself and his/her ideas, and meet deadlines.Try to keep academic pressures and demands at a level where the pupil can see him/herself achieving them.
  Let him/her know immediately and clearly if he/she is not working as well as he/she should, and that you will discuss it with his/her parents.
  Be endlessly patient in recalling his/her wandering attention.

• Organisation:
  Use a dictaphone for homework diary, and as a daily personal organiser.
  Encourage the use of colour coding to help organise homework diary and work for different subjects.
  Before the pupil starts on a piece of work, ensure he/she has all the materials he/she needs – if he/she moves around to get a piece of equipment or a book, this will introduce a distractive element. It also helps with the planning element of the work about to be tackled if the pupil knows exactly what the work should involve.

• Self-esteem:
  Let the pupil know you are aware of his/her difficulty, and that you are sympathetic – but that you have high expectations.
  Be specially generous with praise and cautious with criticism. Praise can be a natural motivator as long as the child feels the praise is genuine and deserved. It is important to let the pupil know why he/she is being praised rather than just to provide praise. In a behavioural reward system with extrinsic rewards such as stickers or points, the child can easily see why he/she is being praised. This can be an effective motivator, as long as the rewards are meaningful and appropriate.

School issues:

Ensure that all the pupil's teachers know about the difficulty and understand its implications.
Rest breaks or prompters are permitted by some examination boards, and may be worth requesting.
If the problem is severe, medication may be indicated, following medical referral via the GP.
Dim lighting may be better than bright lights for reading and writing.

Books & articles:

• Alban-Metcalfe, John and Alban-Metcalfe, Juliet (2001) Managing Attention Deficit Hyperactivity Disorder in the Inclusive Classroom: practical strategies for teachers (Fulton) – the pros and cons of medication, and case studies of successful inclusion.

• British Dyslexia Association, the Dyslexia Handbook, produced annually by the BDA, contains many short articles on dyslexia and associated difficulties, details of providers of resources and of British Dyslexia Association branches throughout Britain and Europe.

• Cooper, P. and Bilton, K. (2nd edition 2002) Attention Deficit Hyperactivity Disorder: a practical guide for teachers (Fulton) – a sound practical guide.

• Cooper, P. and O’Regan, F. (2001) Educating Children with ADHD: a teacher's manual (RoutledgeFalmer) – managing in the classroom.
  

• Copeland, Edna D., and Love, Valerie L. (1992) Attention without Tension: A Teacher’s Handbook on Attention Disorders (3C’s of Childhood Inc, Atlanta) – a comprehensive guide which gives a useful understanding of the field of attention deficit disorders (ADD) and attention deficit disorders with hyperactivity (ADHD).

  The authors acknowledge five major factors as contributory causes of ADHD and ADD, including heredity, organic factors, diet and allergies, environmental toxins and other medical problems. They also acknowledge that social, cultural, educational and stress factors can cause, or exacerbate, attentional problems in many children.

• Green, C. and Chee, K. Y. (2nd edition 1997) Understanding ADHD: A Parent’s Guide to ADHD in Children (Vermilion).

• Hawley, G. (2002) SpLD Resources: a guide to the help available to parents of children with special needs – a useful 80-page compendium of information covering difficulties with reading and writing (dyslexia), numeracy (dyscalculia), handwriting (dyslexia), developmental coordination (dyspraxia), language impairment, autism and ‘attention deficit disorder’. Contains details of the national organisations that address it, together with a list of books, pamphlets and websites. The guide costs £4.50, including p & p, from Gillian Hawley (cheques to Gillian Hawley SpLD account), The Old Bakery, Radwinter Road, Ashton, Essex CB10 2ET (01799 584424). Readers in East Anglia, Rutland, Bedfordshire and Hertfordshire receive a free 30-page supplement listing more than 150 special needs teachers in the district.

• Javorsky, James (1993) Alphabet Soup: A Recipe for Understanding and Treating Attention Deficit Hyperactivity Disorder – A Handbook for Parents and Teachers (Minerva Press) – a comprehensive and informative guide to both parents and teachers who are involved with children with ADHD. It outlines the characteristics of ADHD as well as of some of the causes of diagnostic procedures, and provides suggestions for dealing with ADHD by altering the classroom environment, developing individual learning plans and giving medical treatment. A useful appendix contains a parents’ guide to test results and outlines of individual learning plans.

• Kewley, G. (2001) Attention Deficit Hyperactivity Disorder: recognition, reality and resolution (Fulton) – accepts the medical model, but offers invaluable advice and insight.

• Lloyd, G. and Norris, C. (1999) ‘Including ADHD?’, Disability and Society, 14, 4, 505–17.

• Munden, A. and Arcelu, J. (1999) The AD/HD Handbook (Kingsley).

• O’Regan (2003) How to teach and manage children with ADHD (LDA)  excellent introduction to the subject for mainstream teachers and teaching assistants.

• Pentecost, D. (2000) Parenting the ADD Child, Can’t do? Won’t do? (Kingsley) contains strategies for managing behaviour problems in children with ADD and ADHD.

• Rasmussen, P. and Gillberg, C. (1999) ‘AD(H)D, Hyperkinetic Disorders, DAMP, and related Behaviour Disorders’, in Whitmore, K., Hart, H. and Williams, G. (eds) A Neurodevelopmental Approach to Specific Learning Disorders (MacKeith Press).

• Reid, G. (2003) Dyslexia: A Practitioners’ Handbook (Wiley, 3rd edition).

• Richardson, A.J. (2002) ‘Dyslexia, Dyspraxia and ADHD – Can Nutrition Help?’, paper presented at Education Conference, Durham County Council, June 2002

• Richardson, A.J. and Puri, B.K., (2000) ‘The potential role of fatty acids in Attention deficit/hyperactivity disorder (ADHD)’, Prostaglandins Leukotr. Essent. Fatty Acids, 63, 79–87.

• Rief, S. (2003) The ADHD Book of Lists (Wiley) – information about definitions, interventions, medication and legal issues: a useful resource for parents and professionals.

• Spohrer, K. (2002) Supporting Children with Attention Deficit Hyperactive Disorder (Questions Publishing) – photocopiable activities for any age, at home or school: covers brain gym, yoga, sequencing exercises, affirmations and nutritional advice.

• Stein, D. B. (1999) Ritalin is not the answer – a drug-free, practical program for children diagnosed with ADD or ADHD (Jossey-Bass).

• Woods, K. and Reason, R. (1999) ‘Concentrating in exams: The use of prompters and breaks’, Educational Psychology in Practice, 15, 1, 20–4.

Programmes, games & software:

• Dyslexia, Dyspraxia, Attention Disorder Treatment (DDAT) – DDAT is the name given to the exercise-based treatment (Dore and Rutherford, 2001) based on the cerebellar deficit theory (Fawcett and Nicolson, 1994; Nicolson and Fawcett, 1999. This theory implies that the cerebellum has an important function in relation to dyslexia and other learning difficulties and their hypothesis supported by earlier work on automaticity and more recent work on the role of the cerebellum in language.
  The treatment programme also implicates other aspects of neurological/biological development such as the functioning of the magnocellular system, the inhibition of primitive reflexes and fatty acid deficiencies. Controlled studies which have sought to provide clinical evaluation of the DDAT treatment have been implemented and reported (Reynolds, Hambly and Nicolson (in press), although earlier reports on improvements have not been without criticism, Wilsher (2002) commented on the ‘placebo effect’ in this type of treatment.
  While the transfer of these improvements to reading has yet to be demonstrated, it is encouraging that physiological and cognitive changes have been noted, and additionally it is encouraging that the developers of the programme are utilising data from school-based as well as clinic-based programmes in their evaluations.

• Dore, W. and Rutherford, R. (2001) ‘Closing the Gap’, paper presented at the BDA 6th International Conference on Dyslexia, York, on Dyslexia, Dyspraxia, Attention Deficit Hyperactivity Disorder Treatment Centres (DDAT) – also see the DDAT website (www.ddat.co.uk) for latest research reports

• Wilsher, C. R. (2002) ‘A miracle cure? “Tonight with Trevor McDonald”, ITV, 21.01.02’, in Dyslexia, 8, 2, 116–17.

Useful addresses & websites:

Much useful information is available on the Dyslexia UK website: www.dyslexia.uk.com

Other helpful sites include:

• ADHD/ADD natural solution – www.iwr.com/becalmd

• ADHD behaviour management – www.StressFreeADHD.com

• Attention Deficit Disorder Association – www.chadd.org and www.add.org

• A wide range of books on ADHD (and dyslexia, available online with reviews) is available from www.adders.org and www.addwarehouse.com. See also the publications from Guildford Press and Psychology Press (www.tandf.co.uk).

• ADHD diet – Feingold Association: the Feingold diet for ADHD – www.feingold.org

• ADD/ADHD Family Support Group (UK), 1a High Street, Dilton Marsh, Westbury, Wiltshire BA13 4DL; tel: 01373 826045.

• ADDISS The National Attention Deficit Disorder Information Service – website: www.addiss.co.uk

• ADDnet UK (search on Internet) lists support groups, ADD-informed doctors, psychologists, etc.

• ADHD UK Alliance, 209-11 City Road, London EC1V 1JN; tel: 020 7608 8760.

• Dyscovery Centre, 4a Church Road, Whitchurch, Cardiff CF14 2DZ; tel: +44 (0) 29 2062 8222; fax: +44 (0) 29 2062 8333 website: www.dyscovery.co.uk – a multidisciplinary assessment centre for dyslexia, dyspraxia, attention deficit disorder and autistic spectrum disorders.

• Dyslexia in Scotland, Stirling Business Centre, Wellgreen, Stirling FK8 2DZ; tel: 01786 446650; website: www.dyslexia-in-scotland.org

• Dyslexia Institute, 133 Gresham Road, Staines, Middlesex, TW18 2AJ; tel: 01784 463851; website: www.dyslexia-inst.org.uk

• Dyslexia Institute, Head Office and National Training and Resource Centre, Park House, Wick Road, Egham, Surrey TW20 0HH; tel: 01784 222300; fax: 01784 222333; email: info@dyslexia-inst.org.uk; website: www.dyslexia-inst.org.uk

• Dyslexia Research Trust, website: www.dyslexic.org.uk – a detailed site giving current research, newsletter, conferences and publications, upcoming talks and lectures.

• Dyslexia UK charity, website: www.dyslexia.uk.com – a knowledge site providing information and guidance on all topics relating to dyslexia.

• Fledglings, 6 Southfield, Ickleton, Saffron Waldon, CB10 1BE; tel: 0845 458 1124;
  e-mail: enquiries@fledglings.org.uk; website: www.fledglings.org.uk – a free product and service search for families of children with special needs, for educational items and developmental toys.

• Helen Arkell Dyslexia Centre, Frensham, Farnham, Surrey GU10 3BW; tel: 01252 792400; website: www.arkellcentre.org.uk

• Hornsby International Dyslexia Centre, Wye Street, London, SW11 2HB; tel: 020 7223 1144; website: www.hornsby.co.uk

• Mental Health Foundation – website: www.mentalhealth.org.uk – produces a clear and useful booklet All about ADHD.

• National Association of Special Educational Needs (NASEN), Nasen House, 4-5 Amber Business Village, Amber Close, Amington, Tamworth B77 4RP; tel: 01827 311500; fax: 01827 313005; email: welcome@nasen.org.uk ; website: www.nasen.org.uk

• Office for Advice, Assistance, Support and Information on Special Needs (OAASIS), Brock House, Grigg Lane, Brockenhurst, Hants SO42 7RE; helpline tel: 09068 633201; website: www.oaasis.co.uk – an advice, training and resource centre for parents and professionals.

• Professional Association of Teachers of Students with Specific Learning Difficulties (Patoss), website: www.patoss-dyslexia.org

• SpLD Resources, www.dyslexia.org.uk  hosts a guide to the help available to parents of children with special needs – a useful compendium of information covering difficulties with reading and writing (dyslexia), numeracy (dyscalculia), handwriting (dyslexia), developmental coordination (dyspraxia), language impairment, autism and ‘attention deficit disorder’. Lists details of the national organisations that address a range of SEN needs, together with a list of books and pamphlets.

• www.dyslexiaa2z.com

• www.dyslexics.org.uk – highly recommended coverage of things that can be done at home.

Home support:

What is attention deficit disorder?

Difficulties arise from an inability to sustain and control attention. This may be apparent irrespective of the task, although it may be more obvious in certain types of tasks. Usually the child with ADD is very easily distracted and may process information superficially. ADD can also be associated with impulsivity and hyperactivity.

How will this affect my child?

Your child will seem dreamy and inattentive, and sometimes rather passive.
He/she may seem disorganised, and unable to finish off things that have been started.
Homework is likely to seem a considerable chore, as will anything that is not specially enjoyed and requires effort.
He/she will probably be under-performing at school.
He/she will appear to be lazy and unmotivated.

How can I help?

• Homework:
  Allow only one activity at a time – e.g. using the computer, then listening to music or watching television. Your child may have a preference for simultaneous stimulation such as listening to music, watching TV and working on homework at the same time. This should be avoided: try to reduce stimulation to one thing at a time.
  Dim lighting may be better than bright lights for reading and writing.
  Try to allocate a quiet area for homework with no distractions. Music or television can be used during break times as these may help to relax your child and make him/her more able to resume work.
  If supervising homework, only expect short periods of intense effort – allow frequent breaks.
  Always check over the homework when it is finished. Very importantly, when it has been marked, ask your child if it was correct and go over the teacher’s comments with him/her.
  It is always best to link with the school as far as possible – a space for parent’s comments is often available in homework books.

• Motivation:
  Children with attention difficulties may be interested in everything or nothing. Very often they do not get as much pleasure from learning as they should, because they are not ‘processing’ the information deeply enough. It is therefore a good idea to try to follow up any activity with some questions and a discussion – even if the activity was fairly brief.
  Rewards are always a good motivator, but ensure that the reward is valued by the child.
  When giving rewards to motivate, it is important that these should be consistently applied and be attainable.

• Effort and Fatigue:
  Children with a difficulty in attention can often expend more effort than other children in completing a task. It is important therefore when doing homework to allow for short breaks between periods of work, to allow your child to rest.

  Children with attention difficulties require overlearning in order to consolidate new learning. This means that they may take longer to fully assimilate the new material. In order for new learning to be fully assimilated, it is necessary for your child to use the information which is being learned, in as many different situations as possible. Encourage your child to talk about what is being learned.

• Behaviour management:
  It is not uncommon for children with ADD to have behaviour difficulties. Reward and reinforcement are necessary and this can be achieved through praise and by trying to raise the child’s self-concept. Rewards should be achievable and worthwhile. You will know what type of reward is likely to be successful with your own child. But one of the key factors is consistency. This gives the child security and a structure which is necessary in order for them to focus their attention on a task.

  Try to make any behavioural management strategy as constructive and as positive as possible. While punishment may be justified in some situations, this should be in the form of withdrawing rewards.

Rewards may have to be provided frequently, as long-term goals may be too far off for some children with ADD to be meaningful. Try to find some form of reward which can be frequently applied, rather than one major long-term reward.

Provide alternative activities as much as possible, so that when your child is finished with one activity he/she can turn to another one which has been pre-planned.

• Hobbies and interests:
  It is not unusual to find the child with attention difficulties being involved in some way in an extraordinary number of interests and hobbies. Many of these are fleeting, however, and it is preferable to limit these to only a few. This will help your child take more interest in one, persist with one or two hobbies and make it more possible to cement friendships with others sharing the same interest.

  It is important that friendships are formed, as this can build self-esteem and help children with attention difficulties to develop a feeling of self-worth. This is important for channelling their abilities in a positive rather than a destructive way.

  Try to encourage friends to visit him/her at home, but limit these to one or two at a time.

• Memory:
  Children with attention difficulties may have difficulty in remembering details. Some suggestions to help with this at home are given below.

  Encourage memory games using cards or articles, toys, etc. Some board games also require memory skills and can be fun, involve others and be helpful in developing memory skills.

  Provide only short lists of things to remember – this can provide practice at remembering. Start with only a few things, then add other items to the list.

  Encourage the use of memory strategies – such as writing things down in a related group. For example, if doing shopping, list all the items for the kitchen together, then for the bathroom, clothing, etc.

  Try to encourage the use of drawings – children with attention difficulties can often remember things better if they have some sort of visual image of the item or the material.

  Many everyday family-type outings can be used to reinforce aspects such as processing speed, memory, organisation and reading, without it being obvious to the child. A visit to a museum, a shopping outing, word and picture games and ‘I spy’-type games can all reinforce school activities in a leisurely and stress-free manner.

Where can I find out more?

The technique called Mind Mapping© is usually an effective way to remember items visually, and this technique also helps to organise items. The Mind Map© Book by Tony Buzan (BBC Books) provides good examples of the use of this strategy.

Ritalin is not the answer – a drug free, practical program for children diagnosed with ADD or ADHD, by D. B. Stein (1999) (Jossey-Bass).

ADD/ADHD Family Support Group (UK), 1a High Street, Dilton Marsh, Westbury, Wiltshire BA13 4DL; tel: 01373 826045.

ADDISS The National Attention Deficit Disorder Information Service – website: www.addiss.co.uk

ADHD UK Alliance, 209-11 City Road, London EC1V 1JN; tel: 020 7608 8760.

Dyscovery Centre, 4a Church Road, Whitchurch, Cardiff CF14 2DZ; tel: +44 (0) 29 2062 8222; fax: +44 (0) 29 2062 8333 website: www.dyscovery.co.uk – a multidisciplinary assessment centre for dyslexia, dyspraxia, attention deficit disorder and autistic spectrum disorders.

The Dyslexia Handbook, produced annually by the British Dyslexia Association (98 London Road, Reading, RG1 5AU; website: www.bda-dyslexia.org.uk), contains many short articles on attention difficulties usually associated with dyslexia, but can still be a useful resource and provide some tips for home support, details of providers of resources and of British Dyslexia Association branches throughout Britain and Europe.

Fledglings, 6 Southfield, Ickleton, Saffron Waldon, CB10 1BE; tel: 0845 458 1124;
e-mail: enquiries@fledglings.org.uk; website: www.fledglings.org.uk – a free product and service search for families of children with special needs, for educational items and developmental toys.

Mental Health Foundation – website: www.mentalhealth.org.uk – produces a clear and useful booklet All about ADHD.

Much useful information is available on the Dyslexia UK website: www.dyslexia.uk.com

Other helpful sites include:
ADHD/ADD natural solution – www.iwr.com/becalmd
ADHD behaviour management – www.StressFreeADHD.com
Attention Deficit Disorder Association – www.chadd.org and www.add.org
A wide range of books on ADHD (and dyslexia, available online with reviews) is available from www.adders.org and www.addwarehouse.com . See also the publications from Guildford Press and Psychology Press (www.tandf.co.uk).
ADHD diet – Feingold Association: the Feingold diet for ADHD – www.feingold.org

Alphabet Soup – A Recipe for Understanding and Treating Attention Deficit Hyperactivity Disorder: A Handbook for Parents and Teachers, by James Javorsky (1993) (Minerva Press) provides a comprehensive and informative guide to both parents and teachers who are involved with children with ADD. It outlines the characteristics of ADD as well as some of the causes and diagnostic procedures, and provides suggestions for dealing with ADD, including medical treatment. A useful appendix contains a parents’ guide to test results and outlines of individual learning plans.

Office for Advice, Assistance, Support and Information on Special Needs (OAASIS), Brock House, Grigg Lane, Brockenhurst, Hants SO42 7RE; helpline tel: 09068 633201; website: www.oaasis.co.uk – an advice, training and resource centre for parents and professionals.

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