AD/HD: The role of teachers in the assessment of children suspected of having AD/HD

In the light of recent guidance published by The National Institute for Health and Clinical Excellence (NICE) on the diagnosis and management of attention deficit disorders in children, young persons and adults, Gill Salmon, a consultant Child and Adolescent Psychiatrist based in Swansea, South Wales, and Amanda Kirby, Professor of Developmental Disorders in Education based at the University of Wales, Newport, give an overview of the rationale for involving teachers in the assessment of children with AD/HD and the development and implementation of subsequent educational interventions. They also review the resulting training implications; explore some of the obstacles to multi‐agency, multi‐disciplinary working; and examine how current special educational needs policy goes hand‐in‐hand with the tiered approach to provision of child and adolescent mental health services in offering a graduated response to these children.     

Social outcomes of children with AD/HD: Contributing factors and implications for practice

The purposes of this article are to provide a review of the literature in the area of social characteristics of children with AD/HD, and to outline interventions for working with specific social problems. Research has consistently documented that children with AD/HD are more rejected and less accepted by their peers. Possible reasons for this peer rejection will be presented in this article and include inappropriate social behavior, social knowledge deficits and biases, and negative interactions with peers and teachers. Because children with AD/HD are at risk for negative social outcomes, multiple intervention options are necessary. © 2001 John Wiley & Sons, Inc.     

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.     

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.     

A neurodevelopmental approach for helping gifted learners with diagnosed dyslexia and attention deficit/hyperactivity disorder (AD/HD)

Abstract

Many intellectually and creatively gifted learners experience barriers to learning and development. These may be incorrectly diagnosed as distinct mental disorders, such as Attention Deficit Disorder, hyperactivity, dyslexia and so on. Medication, behaviour and remedial therapy are among the most frequently cited treatments. Emerging approaches to therapy, based on applied neuroscience and the importance of movement in structuring the brain, are finding that it is possible to ‘heal’ interactive links of dysfunctional behaviours and ensuing learning difficulties. This article presents a neurodevelopmental view of learning and attentional problems that are not uncommon in some gifted learners. By means of two case studies, a neurodevelopmental approach will be illustrated whereby such learners have been helped to overcome their learning barriers.     

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.     

Teachers' ratings of functional communication in students with cochlear implants

The study examined factors associated with teachers' ratings of functional communication skills of students with cochlear implants. Deaf students living in and around a metropolitan area were surveyed to locate 51 with cochlear implants. Teachers rated each student's functional use of the implant, given three defined ratings. Additional information regarding sex, communication option, placement, home language, rural or nonrural address, etiology, and presence or absence of an additional disability was gathered. Chi-square analyses of the data were performed. The data indicated that students with a known etiology and a rural address, and who used sign language at home or school, were less likely than others to use the implant as a primary channel for receptive communication. The authors suggest that the teacher's role in implant use warrants more attention. Speech-language pathologists, otologists, audiologists, and parents of deaf children should consider all factors related to successful implant use before advocating or choosing this financially, emotionally, and therapeutically challenging option.     

DEALING WITH AD/HD IN THE CLASSROOM: ONE TEACHER'S EXPERIENCE 1

In this paper some of the fantasies that arise around the role of the counsellor in schools and how these fantasies, being a measure of the psychic health of the school, impact upon both the referral procedure and the counselling process, are discussed. Illustrated by case studies, ways in which teacher and counsellor are able to combine therapeutic and educational skills to challenge these fantasies and so more efficiently tackle emotionally based learning difficulties are considered. The title refers to the case of a 7 year old boy whose failure to make academic progress could be understood as an emotional refusal to take on further responsibilities of a premature adulthood.     

Assessment of setting in the behavioral ratings of preschoolers with and without high levels of activity

Parents report their preschoolers' excessive activity and inattention as early as age two. Unfortunately, most reports and ratings involve global assessments collapsed across settings. Research has not investigated specific behavior as a function of play, TV, meals, and sleep settings for preschool children. To this end, fifty‐six preschoolers (aged 3–5) were placed in a high active or comparison group based on a preschool rating scale. Individual types of behavior that differentiated between groups and an interaction of group with setting indicated that comparison preschoolers modulated changing activities during play and TV; whereas, preschoolers with hyperactivity demonstrated more stable activity across settings. The implications of these findings are discussed. © 1999 John Wiley & Sons, Inc.     

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.     

Clinical importance of parent ratings of everyday cognitive abilities in children with learning and attention problems

This study addressed two issues: first, whether parental reports contribute information over and above a standardized psychometric assessment, and second, whether parental reports of everyday cognitive functioning might be useful in distinguishing between children with reading disabilities (RD), attention-deficit/hyperactivity disorder (ADHD), and combined ADHD + RD. Parent-reported information on 159 children with learning or attention problems was obtained using a questionnaire called the Parent Ratings of Everyday Cognitive and Academic Abilities (PRECAA). Psychometric information used for comparison included the Woodcock-Johnson Psychoeducational Battery-Revised, the Bruininks-Oseretsky Test of Motor Proficiency-Short Form, the Vocabulary and Block Design subtests of the Wechsler Intelligence Scale for Children, 3rd edition, and the Developmental Test of Visual-Motor Integration. The PRECAA was found to be sensitive to group differences between children with RD and children with ADHD and combined ADHD + RD. Its inclusion resulted in a significant increase in the number of children correctly classified compared to the use of psychometric measures alone. The PRECAA correctly classified more children (66%) than did the standard psychometric measures (50%). In fact, a very high percentage of children with ADHD (81%) were correctly classified using the PRECAA. These findings suggest that the PRECAA may be a useful aid to clinicians in the identification of children with learning and attention problems.     

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.     

RESEARCH SECTION: The acceptability of psychosocial support interventions for children orphaned by HIV/AIDS: an evaluation of teacher ratings

The AIDS epidemic has created many orphans around the globe. A majority of these orphans live in sub‐Saharan Africa. Children orphaned by HIV/AIDS face many daunting challenges in their struggle to cope with life. The issues they face due to the loss of their parent(s) include poverty, the stigma associated with HIV/AIDS and stress. This study carried out by Morgan Chitiyo of Southern Illinois University Carbondale, Darlington Changara of Midlands AIDS Caring Organisation and George Chitiyo of Tennessee Technological University discusses how different psychosocial and educational interventions have been developed to help the children to overcome these challenges. However, few of the interventions have been empirically tested to determine their efficacy. The authors set out to evaluate the treatment acceptability of a psychosocial support programme using a group of teachers who had received training and were participating in the implementation of the programme across their schools. Findings from the study indicate high acceptability ratings of the programme.     

Australian adolescent boys with attention deficit/hyperactivity disorder (AD/HD): teacher and teaching factors that assess the efficacy of reducing unwanted behaviours within the classroom environment

Students with AD/HD experience difficulty concentrating in the classroom due to unwanted behaviours. This article focuses on what six Australian adolescent boys have to say about teacher and teaching factors that enabled them to regain focus (if distracted) and concentrate on classroom learning. A multiple, instrumental case-study was used to collect data from the boys using semi-structured individual and focus group interviews as well as school reports across a two year period. Findings suggested that interventions including frequent short breaks, humour by the teacher and teachers who operate in a well-structured classroom and who know their subject matter well, were beneficial in reducing unwanted behaviours and resulted in less negative events, thereby making schooling a more positive experience.     

Teachers' self‐efficacy in bullying interventions and their probability of intervention

Teacher intervention is an important factor in stopping bullying. Several studies indicate that teachers who believe they are capable of stopping bullying intervene more often in bullying. But this finding has only been based on hypothetical situations. It remains unclear if these results can be replicated in bullying interventions that the teachers actually performed. In addition, some studies claim that self‐efficacy is only connected to teacher intervention in direct forms of bullying, rather than indirect forms. In the current study, teachers' self‐efficacy in bullying interventions and the probability that they will intervene is investigated using self‐reported real‐life bullying situations in a sample of German teachers. Results show that teachers who feel more confident in dealing with bullying report intervening more often in bullying episodes they observed. Teacher training should include discussions of real‐life experiences to promote teachers' self‐efficacy beliefs and increase the probability of teacher intervention.     

Joint storybook reading and joint writing interventions among low SES preschoolers: differential contributions to early literacy

This study compared two interventions: one focusing on language and storybook reading and the other on alphabetic skills and writing. Seventy-one preschoolers aged 3–5 from a low SES township in central Israel (35 in the reading program and 36 in the writing program) participated in evaluation of the interventions. Twenty-four untreated preschoolers served as a control group. The children were tested twice, at the beginning and at the end of the school year, in: phonological awareness, word writing, letter knowledge, orthographic awareness, listening comprehension, receptive vocabulary, and general knowledge. Both programs involved games and creative activities. The writing program encouraged letter knowledge, phonological awareness, and functional writing activities. The reading program utilized 11 children's books for focusing on language and exploring major concepts raised by these books. Results indicated that children in the two literacy programs progressed significantly more than the control group on phonological awareness and orthographic awareness. However, the joint writing group significantly outperformed both the joint reading group and the control group on phonological awareness, word writing, orthographic awareness, and letter knowledge. We also found that children as young as 3–4 years gained from literacy programs as much as did older children, aged 4–5, on all the measures assessed in our program.     

Efficacy of the TELL language and literacy curriculum for preschoolers with developmental speech and/or language impairment

The purpose of this investigation was to examine the efficacy of a new preschool oral language and early literacy curriculum package (Teaching Early Literacy and Language [TELL]) for children with developmental speech and/or language impairment (DSLI) either as a primary (e.g., specific to speech and/or language) or secondary impairment (e.g., developmental delay that includes DSLI). Participants included 118 children (30 females, 88 males, M age = 53.58 months) with DLSI and their 29 preschool teachers. The design was a randomized controlled trial (RCT) with assignment to experimental versus contrast conditions at the classroom level. Teachers in TELL classes received formal training, in-class support, and mentoring to implement the curriculum. Dependent measures for the children included scores on the Clinical Evaluation of Language Fundamentals-Preschool 2nd edition (CELF-P2), the Phonological Awareness Literacy Screening for Preschool (PALS-PreK), the Renfrew Bus Story (BUS), and a receptive and expressive vocabulary measure developed for this investigation (VOCAB). Results indicated that when compared to the contrast group, children in the TELL condition demonstrated greater gains on the phonological awareness subtest of the CELF-P2, the sentence length score of the BUS, the letter sounds, beginning sound awareness, and rhyme awareness subtests of the PALS-PreK, and VOCAB. Results suggest that the TELL curriculum package has promise for promoting gains in early literacy and oral language skills in preschool children with DLSI.     

关注教师职业倦怠 促进教师专业成长

近年来,中小学教师的职业倦怠,已经成为教育界普遍关注的问题之一。教师职业倦怠是指教师不能顺利应对工作压力时的一种极端反应,是教师伴随于长时期压力体验而产生的情感、态度和行为的衰竭状态。通常表现为工作满意度降低,工作热情和兴趣丧失以及情感的疏离和冷漠,可表现为生理、心理多种症状,已影响教师自身的身心健康、学生的健康成长,还影响到教育事业和整个社会的发展。教师职业倦怠的成因,本质上是由于个体对自身工作的付出与得到的回报之间不平衡的认知而导致的心理与行为上的消极反映,主要涉及个体、学校和社会等三个方面因素。消解教师的职业倦怠,应当从三方面着手。     

Socio-emotional climate of storybook reading interactions for mothers and preschoolers with language impairment

The current study describes the storybook reading behaviors of 45 preschoolers [30 with language impairment (LI) and 15 with typical language (TL)] and their mothers. Each dyad was observed reading a storybook within their homes, and sessions were subsequently coded for indicators of emotional and instructional quality as well as for child participation. Mothers of children with LI showed lower levels of emotional support than mothers of children with TL, although all mothers exhibited similar quality of instruction. The two groups of children were equally enthusiastic about the book; however, children with LI were observed to be less compliant than children with TL and showed a trend to be less persistent. For the children with LI, participation in the book reading task was found to be high only when mothers’ behaviors were observed to be highly sensitive in nature, demonstrating the importance of exposing children to maternal behaviors that are responsive to their unique abilities and needs.