The reality of living with AD/HD: children's concern about educational and medical support

A diagnosis of AD/HD may tell us that the child has the core characteristics of inattentiveness, impulsivity and or hyperactivity, but it fails to convey the extent to which the social context of the child's environment manipulates these characteristics. This article reports on how children with a diagnosis of AD/HD view the impact their social environment has on their behaviour; providing us with insight into how educational and medical intervention strategies are failing to achieve their potential. The findings suggest that if children with AD/HD and their families are to benefit from educational and medical intervention then stakeholders need to work together to provide coordinated and consistent support.     

Inclusion of pupils with ADHD symptoms in mainstream classes with PBS

Inclusion is never only a practical issue of placement. School-wide systemic change, together with well-functioning, multi-tiered support, can promote the inclusion of all pupils. This paper draws on research conducted in two mainstream primary schools in Finland. The primary focus was to gain insight into practical solutions to facilitate the inclusion of pupils with attention-deficit hyperactivity disorder (ADHD) in mainstream teaching. Using an experimental, multiple-baseline, single-case design, we examined the effects of Check-in Check-out (CICO) support on changes in the behaviour of two pupils who displayed ADHD-type behaviours. The key features of CICO are brief morning and afternoon meetings with an adult, the use of a daily report card, regular positive feedback during the day, and parental involvement. This study examined if behavioural gains made during the implementation of CICO support can be maintained. Visual data analysis revealed differences in two CICO-ending strategies on maintenance in pupils with ADHD symptoms. The results suggest that consistent universal positive behaviour support systems together with additional behavioural support can facilitate the successful inclusion of pupils observed by teachers to have even severe disruptive behaviours in a mainstream learning environment.     

Early identification and systemic educational intervention for young children with Attention-Deficit/Hyperactivity Disorder (AD/HD)

This paper focuses on the international experience with early identification and intervention for children with AD/HD. Much less is known about AD/HD in two- to five-year-old preschool children than is known for older school-aged youngsters. Despite this lack of knowledge, AD/HD is increasingly recognized in this population and stimulant medication increasingly prescribed to treat it. The lack of control of temperamental patterns in preschoolers seems related to later observations of hyperactivity, attention problems and antisocial behaviours in school-aged children. The emergence and continuity of AD/HD-like behaviours is influenced not only by genetic, pre- and perinatal factors, but also by social context factors. All these influences interact with a child's developmental needs in complex ways according to a systemic bio-psychosocial model. The undiagnosed AD/HD child will often be labelled by parents as difficult and the family scapegoat. Because of the age of the children and the variety of ‘normal behaviour’ in this group, interventions should include systemic, environmental and play-centred approaches.     

FOCUS ON PRACTICE: Difficulties in initiating and sustaining peer friendships: perspectives on students diagnosed with AD/HD

In this article, Myra Taylor, research fellow, and Professor Stephen Houghton of the Centre for Child and Adolescent Related Disorders at the University of Western Australia, report theory generated from interviews with teachers, students and mothers residing in Perth, Western Australia, on how children with attention‐deficit/hyperactivity disorder (AD/HD) initiate and sustain peer relationships. An initial review of the three sample groups’ respective perspectives reveals that children with AD/HD exhibit three distinct socialisation patterns: a socially integrated pattern (that is, having three or more ongoing friendship pairings with peers); a marginal integrated pattern (that is, having two or less ongoing friendship pairings with peers); and a socially isolated pattern (that is, having no, or infrequent, friendship pairings with peers). Both teacher and maternal perspectives are similar in so far as both perceive children with attention deficit disorders to have marginal to non‐existent friendships. Students with AD/HD perceive themselves, however, as having strongly to marginally formed friendships with their peers. Myra Taylor and Stephen Houghton explore suggestions that differences between adult and child perspectives relate to diagnostic status, age and developmental maturity. They identify opportunities for further research arising out of their work and indicate that a wider evidence base will be needed before robust recommendations for practice can be made.     

注意缺陷/多动性障碍儿童教育训练的个案报告

近年来 ,国际特殊教育领域内儿童期被诊断的行为障碍中最普遍和最具争议性的是注意缺陷 /多动性障碍。大约 3- 6%的学龄儿童患有注意缺陷 /多动性障碍。本文对一例注意缺陷 /多动性障碍儿童的教育训练过程进行了分析研究 ,探讨了多种训练方法的过程和效果。并结合国内外最新文献 ,分析了造成注意缺陷 /多动性障碍的原因     

Responses to Interpersonal and Physically Provoking Situations: The utility and application of an observation schedule for school‐aged students with and without attention deficit/hyperactivity disorder

The present research describes the development and pilot testing of a new instrument, the Responses to Interpersonal and Physically Provoking Situations Schedule (RIPPS), designed to measure the reactivity of students with and without attention deficit/hyperactivity disorder (AD/HD) in the naturalistic setting of the classroom. For this study, 29 pre‐service teachers from one university graduate school of education conducted structured observations on two students each, one clinically diagnosed student with AD/HD and the other with no diagnosed disorder, resulting in 58 Year 8–11 students (aged 13–17 years) participating in the study. Each student pair was observed for 40 minutes, with alternating observational blocks of two minutes per student. Observational data in the form of responses to emotionally provoking events and the triggers to the responses were clustered together and systematically coded, resulting in four distinct categories for responses and four distinct categories for triggers. Students with AD/HD exhibited significantly more solitary off‐task behaviours, interactional off‐task behaviours, and challenging behaviours than their non‐AD/HD peers. There were no differences between the students in the perceived severity of responses. For triggers, failure to begin assigned tasks and peer‐initiated triggers were the most common, with nearly half of the solitary off‐task behaviours being attributed to environmental distractions and over a quarter attributed to teacher behaviours. While the RIPPS is a relatively new instrument, important data have been gathered in ecologically valid contexts and provide the framework for further development of an instrument of this nature.     

Effects of information on perceptions of stimulant medication efficacy for treatment of attention‐deficit hyperactivity disorder

A study on the perceptions of stimulant medications prescribed for children with attention‐deficit hyperactivity disorder (AD/HD) was conducted. Students, enrolled in introductory level psychology courses at a midwestern university participated voluntarily in the study (N= 36). After viewing a video that simulated the feelings a child with AD/HD experiences, participants were randomly assigned to two treatment groups. The popular information group read an article on AD/HD similar to that which is most often presented to the public. This article included personal testimonials and lacked a discussion of side effects and areas where the medications have not been demonstrated to be efficacious. The scientific information group read a page of information that was compiled from the scientific literature and included both the positive effects, side effects, and areas where the medication has not been demonstrated to be efficacious. All participants then completed a questionnaire regarding their perceptions of the efficacy of the medications. A second scale measured participants' likelihood of recommending the use of stimulant medications for children with suspected AD/HD. Two 2×2 between‐subjects ANOVA's were employed. There were main effects for the type of article that was read, but no main effects for gender of participant. No significant interactions were found. There were no differences found between the gender of participants and their perceptions of stimulant medications based on the reading material presented to them. However, the type of information presented to the participants did influence their view of the efficacy of stimulant medications. In addition, the type of reading material also influenced the participants' view of the safety and recommended use of stimulant medications prescribed for children with AD/HD. © 1999 John Wiley & Sons, Inc.     

AD/HD: Attention deficit/hyperactivity disorder or attention seeking? Ways of distinguishing two common childhood problems

Nigel Mellor recently retired from his work with the educational psychology service in North Tyneside. In this article, he proposes that attention-seeking behaviour may lead to major difficulties at home and school and indicates the ways in which recent research is beginning to clarify the area. Attention deficit disorders also cause great concern. However, the extremely widespread range of attention-seeking behaviours may easily lead to their being confused with attention deficit/hyperactivity disorder (AD/HD). Nigel Mellor explores ways to distinguish these two behaviour problems. This, he argues, may help target interventions more efficiently. However, a great deal of further research is called for.     

Facilitating the social participation of pupils with special educational needs in mainstream schools: A review of school-based interventions

Inclusive education of pupils with special educational needs (SEN) has become a global trend. However, a considerable number of studies have shown that mere enrolment in mainstream classrooms is not enough to support the social participation of pupils with SEN. These children are at risk of experiencing difficulties in their involvement with peers at school. Thus, the question arises of how social participation can be fostered in mainstream classrooms. A systematic review of 35 studies was conducted to investigate which interventions are effective in inclusive mainstream preschool and elementary classrooms. Teaching interaction strategies to typically developing pupils, group activities in the academic context (cooperative learning and peer-tutoring), support groups for pupils with SEN, and training paraprofessionals to facilitate social interactions, were found to improve the social participation of pupils with SEN in general education classrooms. Nevertheless, there is need for more intervention studies implementing a variety of strategies and including different groups of pupils with SEN.     

The prevalence of psychiatric disorder in children attending a school for pupils with emotional and behavioural difficulties

The research presented in this article suggests that young people attending schools for pupils with emotional and behavioural difficulties are more likely to experience concurrent psychiatric disorders (comorbidity) than their peers in mainstream schools. Dr Cassidy (Consultant in Child and Adolescent Psychiatry), Dr James (Consultant and Honorary Senior Lecturer in Child and Adolescent Psychiatry) and Dr Wiggs (Research Psychologist) used questionnaires and interviews with parents and teachers, together with pupil self-reporting, to gather their data. The two-stage investigation suggested that 89% of the adolescents in one school for pupils with EBD met established criteria for the diagnosis of a psychiatric disorder. Conduct disorder and attention deficit hyperactivity disorder (ADHD) emerged as the most common psychiatric difficulties, but emotional disorders were also prominent in the data. These untreated problems are likely to have significant long-term implications for the psychological and educational development of the pupils concerned, and the authors speculate on some of the ways in which psychiatric and education services might work together in order to improve the outlook.     

Including pupils with autistic spectrum disorders in mainstream schools

The number of pupils with autistic spectrum disorders (ASD) being educated in mainstream schools is increasing. However, there is growing concern about their educational experiences. Research suggests that such pupils make easy targets for bullies, and are considered difficult to teach by teachers. Furthermore, pupils with ASD are more than 20 times more likely to be excluded from school than those without special educational needs. In light of such evidence, the aim of this article is to outline evidence‐based strategies to facilitate the presence, participation, acceptance and achievement of pupils with ASD in mainstream settings. The strategies are presented thematically, as follows: (i) challenge stereotypes and raise expectations, (ii) create order from chaos, (iii) promote peer understanding, (iv) develop social skills, (v) adapt academic subjects, and (vi) modify conversational language. These strategies are not intended to be completely comprehensive – rather, they are starting points on a journey towards inclusion for those with ASD.     

The Schooling Experience of Adolescent Boys with AD/HD: An Australian Case Study

This study explored the experience of schooling of six adolescent boys diagnosed with AD/HD from the perspectives of the boys, their mothers and their teachers. The study utilised social constructionism as the theoretical orientation and the Dynamic Developmental Theory (DDT) of AD/HD as the explanatory framework. Utilising a multiple, instrumental case-study, data were collected by means of semi-structured individual and focus group interviews as well as a review of school reports across a two year period. Findings of the study suggest that taking medication as prescribed together with supporting the students to make and manage friendships, utilising classroom strategies that support learning, and providing an engaging classroom environment are important considerations to promote a positive schooling experience for adolescents with AD/HD.     

A Developmental Investigation of Inattentiveness and Hyperactivity

The development of inattentiveness and hyperactivity in middle childhood was investigated using a prospective longitudinal approach. Endogenous and exogenous predictors measured in infancy and in early and middle childhood were examined independently and in combination. In early childhood, quality of caregiving more powerfully predicted distractibility, an early precursor of hyperactivity, than did early biological or temperament factors. Caregiving and contextual factors together with early distractibility significantly predicted hyperactivity in middle childhood. While environmental variables also predicted hyperactivity in later elementary years, these factors did not improve the prediction beyond the influence of hyperactivity in early elementary years. The findings support a developmental view of the origins and course of hyperactivity in childhood, that is, that the emergence and persistence of AD/HD symptoms depend on developmental history along with current circumstances.     

HELIOS Education Gold Award Winner

ABSTRACT

This paper describes a collaborative project between the staff of twelve mainstream schools and Suffolk Local Education Authority staff which has aimed to develop differentiated teaching strategies. The project has developed teaching and assessment techniques for pupils with literacy difficulties and approaches to delivering aspects of the whole curriculum to pupils with special educational needs. The project recognizes the central importance of mainstream teachers if integration for pupils with special educational needs is to be a truly meaningful educational experience.     

Inclusive provision options for pupils on the autistic spectrum

In the last decade, there has been a dramatic increase in the number of pupils with autism spectrum disorders (ASD) attending mainstream schools. However, particular concerns have been expressed about their inclusion, focused on an increased risk of peer rejection and lack of staff knowledge about appropriate teaching approaches. Parental views of inclusive placements are consistently more positive where there is an ASD resource base in the school. This study was designed to investigate characteristics of the provision available to pupils with ASD in mainstream schools with and without a specialist ASD resource base. Information was gathered from semi‐structured interviews with staff in 26 schools about levels of inclusion and support, about the strategies used to support pupils with ASD, both at an individual and whole school level, and about changes considered desirable. Interviewees were also asked to describe how they would respond to scenarios depicting situations that are commonly experienced in working with pupils who have ASD. Findings confirmed that the features of mainstream placements identified as important by parents of children with ASD were more likely to be found in schools with ASD resource bases. However, it was found that comparable provision could be made across settings given appropriate staff training. Scope for further development across settings was also identified, particularly in the use of evidence‐based peer‐mediated strategies.     

Teacher and Student Teacher Ratings of Attention-Deficit/Hyperactivity Disorder in Three Cultural Settings

Since the criteria for diagnosis of childhood attention-deficit/hyperactivity disorder (AD/HD) include that the symptoms present in at least two situations, usually home and school, the role of teachers in the identification and diagnosis of this condition is crucial. There is, however, evidence of inter-cultural differences in ratings of AD/HD in children and young people, by teachers and others, though it is not possible to make comparisons between the various studies, because the conditions were not comparable. The focus of this article is the cultural influences on ratings of AD/HD-type behaviour. Evidence is presented of culturally related differences in such ratings, under conditions designed to ensure directly comparable conditions, involving teachers and student teachers from mainland China, Hong Kong, and the United Kingdom. There was some evidence that the teachers from mainland China rated the behaviour of a "target" child, presented on video, higher on a number of items than either the teachers from Hong Kong or the United Kingdom. There was only limited evidence of differences between the ratings of teachers and student teachers within the same culture.     

Bullying among pupils with and without special needs in Slovenian primary schools

Bullying and violence pose widespread problems for contemporary society. In this paper, special attention is given to violence against pupils with SN. The empirical research analyses perceptions of peer violence according to differing roles in relation to violent acts (observer, victim and perpetrator) among pupils with and without SN, regarding gender and age. We used the School Bullying Scales measuring instrument, translated and adapted for Slovenia. The main findings of the research are as follows: there is no statistically significant difference between pupils with and without SN in terms of the different roles of peer violence in regular Slovenian primary schools. Among specific subgroups of children with SN, pupils with long-term illnesses (including pupils with activity deficit and/or hyperactivity disorder) were statistically significantly less often observers of violent acts compared to other groups of pupils with SN.     

Preferential treatment or unwanted in mainstream schools? The perceptions of parents and teachers with regards to pupils with special educational needs and challenging behaviour

This study explored the perceptions of parents and teachers regarding the differential treatment or stigma experienced by pupils with challenging behaviour – more specifically, those with behavioural, emotional and social difficulties (BESD), as well as children with visible special educational needs (Down's syndrome and/or profound and multiple learning difficulties) who frequently displayed challenging behaviour as a characteristic of their SEN. Semi‐structured interviews were conducted with ten parents of children with challenging behaviour, together with 15 educational practitioners employed in mainstream and BESD schools. Findings revealed how several parents, and staff employed in BESD schools, viewed pupils with challenging behaviour as ‘unwanted’ in mainstream schools. The remaining parents, as well as mainstream practitioners, reported the opposite and indicated that these pupils received treatment deemed to be ‘preferential’ in the mainstream. This has direct implications for those concerned with supporting pupils with challenging behaviour in mainstream settings.     

Child AD/HD severity and psychological functioning in relation to divorce,remarriage, multiple transitions and the quality of family relationships

Both Attention-Deficit/Hyperactivity Disorder (AD/HD) and divorce are very prevalent in western societies, and they may occur together. AD/HD is generally viewed as a neurobiological disorder, which has led to a commonly held belief that social-environmental factors play little role in the symptom profile of children diagnosed with the disorder. This study investigated the association between parental divorce, remarriage, multiple transitions, the quality of relationships with family members and the psychological well-being of children and adolescents with AD/HD. First, differences in children’s AD/HD symptom profiles in relation to parents’ divorce status (single/multiple divorce) and family composition (single parent/stepfamily) were examined. Second, the association between the quality of children’s relationships with each family member and parents’ marital status (divorced/non-divorced) and family composition was investigated. In addition, age, gender and AD/HD subtype differences were assessed. Third, the association between the quality of children’s interactions with family members and children’s AD/HD symptom profile was explored. No significant differences in children’s behavioural profiles were found in terms of parents’ divorce status. Living in stepfamilies was associated with greater AD/HD severity and social malfunctioning. Disruptive parent–child and sibling relationships were found to be related to children’s age, gender, AD/HD subtype and parents’ marital status. Further, poor interactions with family members correlated with children’s AD/HD severity and psychological well-being. In summary, divorce, remarriage and the quality of relationships with family members are important correlates of the symptom profile of children with AD/HD, and this emphasises the need for special treatment modules for these families.