Running head: ATTENTION DEFICIT HYPERACTIVITY DISORDER IN EDUCATION

Attention Deficit Hyperactivity Disorder in Education

Elizabeth Boyle

EDU 112

Franciscan University of Steubenville

Attention Deficit/Hyperactivity Disorder in Education

The teaching profession is a challenging and rewarding calling that requires patience and

an abundance of perseverance. Every day teachers are acting “in loco parentis” meaning they

take on the responsibility of acting as a temporary parent or caregiver for each and every one of

their students (Beaty-O’Ferrall, Green, & Hanna, 2010). The teachers are responsible for the

wellbeing and educating of every student that enters their classroom, despite the fact that each

child's learning method may be different or unique from those of their peers (Geng, 2011). The

classroom becomes the children’s home for six hours five days a week and it is a place they

should always feel safe and comfortable. According to Maslow’s hierarchy of needs the first

need that must be satisfied is physiological needs, then safety needs, belongingness and love

needs, esteem needs, and finally self-actualization (McLeod, 2018). It is not until all of the

child’s needs are met that he or she can finally begin to learn and achieve to their fullest

potential. It is imperative that teachers are aware of the needs that each individual student has in

order that the learning process may be made easier and more successful (McLeod, 2018).

The educator is there to help the student grow and learn to their fullest potential, no

matter how challenging it may be. Teachers have to develop lessons and teach each individual

student to the best of their ability while forming trusting relationships with all of their students

(Wolk, 2003). Depending on the grade level the teacher is responsible for the number of students

they have ranging from ten to one hundred, all of whom they are constantly teaching both about

academics and life (Beaty-O’Ferrall et al., 2010). Monitoring and having control over students

behavior to help form them into independent students and eventually independent adults is one of

the teacher’s main responsibilities (Beaty-O’Ferrall et al., 2010). There is pressure on the

teacher to be a good role model for their students because students are constantly watching and
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learning from the actions and habits of their teachers (Branscome, Brown, Cunningham, &

Kelley, 2014).

When a teacher has a classroom full of students who are all different, with a variety of

learning styles challenges arise and new experiences are bound to occur. There may be students

who are loud and disrupt the class and some students who are so quiet it is impossible to tell if

they are following the lesson. There may also be students with disabilities or students who need

individual attention (Branscome et al., 2014). There are several tools that can be used to help

these students including, individualized education plans (IEP). IEPs are extremely important

when it comes to teaching students with disabilities (Branscome et al., 2014). Teachers are able

to create a unique education plan that is designed to help the student learn in the best way they

know how. A common disability that requires an IEP is Attention Deficit/Hyperactivity Disorder

(ADHD). ADHD is a perfect example of the diversity and challenges that a teacher may face in

their classroom (Branscome et al., 2014). Students with ADHD struggle in a unique way that is

different from other disabilities and teachers play an extremely important role in helping the

student not only survive but thrive in the classroom.

Definition of Attention Deficit/Hyperactivity Disorder

ADHD is a neurodevelopmental disorder, meaning that it affects the way the brain grows

and develops in a negative way thus affecting the child's behavior (Branscome et al., 2014). The

negative effects of ADHD reveal themselves in three major ways through inattention,

hyperactivity, and impulsivity (Branscome et al., 2014). Inattention is when a child is unable to

focus on a certain topic or activity for an extended period of time causing them to have a limited

attention span (Branscome et al., 2014). Hyperactivity is when a child is overstimulated and

jumps from one activity to the next extremely quickly, often leaving the first activity incomplete
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(Branscome et al., 2014). Impulsivity is when the child makes rash decisions without thinking

about the potential consequences that may result from their actions (Branscome et al., 2014).

ADHD has three types of presentations; combined, predominantly inattentive, and predominantly

hyperactive or impulsive (Branscome et al., 2014). The combined form of ADHD is the most

common presentation, it is when the child shows signs of inattention, hyperactivity, and

impulsivity (Branscome et al., 2014). Predominantly inattentive is when the child shows no

symptoms of hyperactivity or impulsivity, they do not pay any attention to details and rarely

listening to directions (Branscome et al., 2014). Predominantly hyperactive or impulsive is when

the child struggles to sit still and stay on task, typically listening to instructions but then having a

hard time following them (Branscome et al., 2014). ADHD has a potential for overlapping with

other neurodevelopmental problems such as autism spectrum disorders (Cooper, Eyre, Langley,

& Thapar, 2013).

ADHD is extremely prevalent in the classroom, in some cases it is not until the child is

expected to function in a structured classroom for six hours of their day that their ADHD

becomes noticeable or evident (Branscome et al., 2014). The percentage for boys with ADHD is

12.1% and the percentage for girls is 5.5% (Branscome et al., 2014). A large percentage of

children with ADHD are diagnosed at the age of six when they enter elementary school

(Branscome et al., 2014). The age at which the child is diagnosed also depends on how severe

the child's ADHD is if the child has severe ADHD they are more likely to be diagnosed at a

much younger age than someone who has less severe ADHD (Branscome al., 2014). The

prevalence of ADHD has increased in recent years because the age level of diagnosis was

changed (Sikstrom, 2007). It is a common misconception that the increase in the number of

diagnoses is due to misdiagnosis (Sikstrom, 2007). While misdiagnosis may occur occasionally it
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is not the reason that the number of diagnoses has increased (Sikstrom, 2007).

The exact cause of ADHD is not known but there are several factors that are believed to

be influential in the causing of ADHD (Cooper et al., 2013). It is believed that ADHD can be

caused by genetics and that it is familial and heritable (Campbell, et al., 2018). If a child’s parent

has ADHD the child themselves are at a higher risk of inheriting it and being diagnosed (Cooper

et al., 2013). The structure of a child's brain can also cause ADHD (Cooper et al., 2013). If a

child’s overall lower brain structure is different or it has a lower volume than a typical brain it

can cause ADHD (Branscome et al., 2014). The prefrontal region of the brain controls executive

functions such as attention, planning, organization and decision making so when that is effected

in a negative way it can cause ADHD in children (Branscome et al., 2014). There are several risk

factors that can also influence the probability of a diagnosis of ADHD in children (Cooper et al.,

2013). One of these risk factors is pre or postnatal exposure to lead which can cause the child’s

brain to be underdeveloped or developed in an atypical way (Cooper et al., 2013). Other risk

factors include low birth weight and prematurity, both affect brain function and development of

the child (Cooper et al., 2013).

There are a variety of assessments that can be used to diagnose ADHD in childhood and

in some cases young adulthood. There is a certain criterion that the children must meet in order

to be diagnosed with ADHD (Cooper et al., 2013). The child must show symptoms of ADHD for

six consecutive years and it has to have been present before they were twelve years old. The

symptoms must have a negative impact on some part of the child’s life (Cooper et al., 2013). It

could impact the child socially, academically, or for older children occupationally (Cooper et al.,

2013). The symptoms must be present in several settings in the student’s life whether it is school,

home or extra-curricular. This specific criterion was put in place to ensure that the child is not
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simply inattentive because they are in the classroom setting but the challenge is constant in all

settings (Cooper et al., 2013). ADHD is most often diagnosed in elementary school as it is when

children begin to experience the structure of the classroom for the first time and only then is their

disruptive behavior evident and noticed (Branscome et al., 2014). ADHD has a developmental

diagnosis meaning the diagnostic process looks different for every age. The majority of young

children are fidgety and have constant energy but with ADHD the symptoms are more intense

and happen more often (Branscome et al., 2014). The individualized Target Behavior Evaluation

is used to diagnose ADHD as well. For this evaluation parents or teachers observe the child by

independent observation and record their findings (Branscome et al., 2014). The evaluation does

not require prior training, as the observation data is used to help decide whether or not the

student should be diagnosed with ADHD (Fabiano, Massetti, & Pelham, 2005).

Inattention, hyperactivity, and impulsivity greatly affect the student’s performance and

behavior in the classroom. Children with ADHD also struggle to follow directions and

understand details because they are hyperactive, making it extremely hard for them to focus

(Branscome et al., 2014). Children with ADHD struggle to keep organized and they often lose

things they need for certain tasks and classes (Branscome et al., 2014). Because children with

ADHD are hyperactive they have a hard time tuning themselves into play without making noise

and are talkative in a disruptive manner. Impulsivity makes it hard for students to stay in their

seat and follow rules that are put in place by their teachers (Branscome et al., 2014). To other

students and their teachers, children with ADHD may appear aggressive and disruptive which

may scare or and anger other students. Because of their impulsivity children with ADHD

struggle to form relationships with both their teachers and peers (Branscome et al., 2014).
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Children with ADHD struggle in the majority of the aspects of school because of the attention,

patience, and concentration it requires (Branscome et al., 2014).

Challenges due to ADHD One

The first major challenge of ADHD is hyperactivity which, as previously mentioned, is

one of the three symptoms of ADHD. When a child is hyperactive they are overstimulated and

struggle to focus in all settings, including the classroom (Branscome et al., 2014). Hyperactivity

is a challenge for children with ADHD that leads to several other challenges most especially

when it comes to education (Branscome et al., 2014). When students are hyperactive they have

an extremely hard time sitting still and listening to the instructions that teachers are telling them,

leading to the improper completion or total incompletion of an assignment (Branscome et al.,

2014). Students also struggle to follow rules that are set by their teachers in the classroom. It is

hard for them to stay quiet and slow down long enough to remember to raise their hand for

permission to speak (Branscome et al., 2014). Their hyperactivity gets them in trouble often with

the school rules because they are physically incapable of containing themselves with ease

(Branscome et al., 2014). Because the students are unable to focus easily they have a hard time

staying organized and remembering the assignments they need to get done (Campbell, et al.,

2018). There are several strategies that can help children with ADHD succeed in the classroom

despite hyperactivity.

Strategies to Support One

A strategy that can be used to support a child who is being challenged by hyperactivity

and has ADHD would be the self-management system (Branscome et al., 2014). When the

student becomes responsible for their own actions the teacher is better able to help and connect

with that student (Beaty-O’Ferrall et al., 2010). The self-management system can be
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implemented easily into any classroom setting and it has proven to be effective (Branscome et

al., 2014). Using the self-management system the student monitors and evaluates their own

behavior throughout the day (Branscome et al., 2014). This method of self-evaluation puts the

responsibility for their actions on the student themselves and takes it off of the teacher

(Branscome et al., 2014). The student and teacher each separately review the student's behavior

and rates it using a number system, the higher the rating the better the behavior (Branscome et

al., 2014). If the student is honest in the way that he or she rates themselves and they rate

themselves appropriately they get points (Branscome et al., 2014). Points are awarded when the

student and teacher ratings are the same confirming that the student was honest about how they

behaved (Branscome et al., 2014). Within the self-management system point levels are formed so

that when the student reaches a certain level in the point system they are rewarded, encouraging

them to keep building points (Branscome et al., 2014). The reward system is very effective in

ensuring that students who struggle to focus and make decisions become more conscious about

their actions and the rules they are being asked to follow (Gureasko-Moore et al., 2006).

There was a study done to support the self-management system as a method of helping

students with ADHD be more prepared and better behaved in the general education setting

(Gureasko-Moore et al., 2006). There were three seventh-grade male students chosen to

participate in the study. Both males are diagnosed with ADHD and go to public middle school in

Northeastern Pennsylvania (Gureasko-Moore et al., 2006). The students were chosen because

their teacher reported they were ill-prepared and misbehaving in class (Gureasko-Moore et al.,

2006). The study began by ensuring that the students did, in fact, have ADHD through testing the

child’s inattention, impulsivity, and hyperactivity (Gureasko-Moore et al., 2006). The students

then went through training during their homeroom period (Gureasko-Moore et al., 2006). All of
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the participants were taking methylphenidate during the study and the dosage remained constant

throughout the entirety of the study (Gureasko-Moore et al., 2006). Students were observed

before the study began to create a baseline of what should be expected regarding behavior and

preparation (Gureasko-Moore et al., 2006). A survey was completed by both the teacher and

participants that outline the classroom expectations for behavior and preparation, this criterion

was then the rating tool for the student's behavior (Gureasko-Moore et al., 2006). The observer

and the students rated the behavior separately and then they compared the results of the

observations and awarded points to the rates that matched (Gureasko-Moore et al., 2006). After

the study ran for an extended period of time the experimenters asked for both the student and

teacher feedback on how effective they thought the intervention was (Gureasko-Moore et al.,

2006). The results of the study and feedback showed improvement in all the participant's

preparation and behavior, as well as the students, agreed that the intervention was effective

(Gureasko-Moore et al., 2006).

Strategies to Support Two

In order to help students with hyperactivity, the cost system is used as negative

reinforcement in the classroom (Branscome et al., 2014). At the beginning of the day, students

are given a baseline number of points that they want to maintain throughout the day (Branscome

et al., 2014). When the student arrives unprepared to class without their homework or folder they

lose points from their daily total (Branscome et al., 2014). If the student misbehaves or talks out

of line in class they lose more points. When the students behave well and arrive prepared to class

they get points added to their daily total. Students are able to receive prizes once they get to a set

amount of points or maintain their daily baseline number (Branscome et al., 2014). The cost

system has been found to be effective for managing classroom behavior for students with ADHD
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10
(Branscome et al., 2014). A study was done testing the effectiveness of the cost system in a

public school classroom. The study was done on a class of eight students in the second grade

(Geng, 2011). At the beginning of the year, the students were given a baseline of ten pints (Geng,

2011). If the students spoke out in class or did not show up with their homework completed

points were deducted. On the other hand, if the students remained quiet and complete the tasks

they were asked to complete in the correct amount of time they were awarded points (Geng,

2011). If a student got enough points they were rewarded with ten minutes of computer time,

then for a day, they could sit wherever they liked and so on (Geng, 2011). The study results

showed that student behavior improved greatly when points were used as both a reward and

punishment. The students with ADHD were more likely to complete their homework and remain

in their seats throughout the day if they were rewarded for their good behavior (Gureasko-Moore

et al., 2006).

Challenges due to ADHD Two

The second challenge that students with ADHD experience are misunderstood peer and

teacher interactions that lead to a difficulty in forming relationships and friendships (Branscome

et al., 2014). Because students with ADHD struggle to follow rules and focus on a topic for an

extended period of time it is extremely hard for them to have healthy relationships with their

peers and teachers (Beaty-O’Ferrall et al., 2010). Impulsivity and hyperactivity may cause

children with ADHD to act out and break classroom rules. When this misbehavior happens the

child's peers may begin to view them as aggressive and rude (Branscome et al., 2014). The

negative view that the peers have of the child prevents them from being able to form

relationships and friendships in school (Branscome et al., 2014). When students with ADHD act

impulsively and break rules it is frustrating for their teachers and puts a strain on their
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11
relationship and interactions (Beaty-O’Ferrall et al., 2010). Students can easily tell when their

teacher is mad at them and it hurts them to know they are misunderstood and they may be trying

as hard as they can to control their outbursts and misbehavior (Branscome et al., 2014).

Strategies to Support One

A successful strategy to help students with ADHD improve their peer and teacher

interactions is mindfulness training (Branscome et al., 2014). Mindfulness training works to help

the child control their attention and reduce automatic responses (Branscome et al., 2014). The

training is specially tailored to each individual child for maximum effectiveness (Branscome et

al., 2014). The training is behavior correction that focuses on managing classroom behavior

effectively improving the interaction between fellow students as well as the teacher (Branscome

et al., 2014). When the student is using mindfulness training they are attempting to stop and

think before they act, preventing outbursts and classroom distracting which is helpful for the

teacher (Beaty-O’Ferrall et al., 2010). When the teacher sees that the child is making an effort to

behave in their classroom it improves the teacher's opinion and view of that child making the

healthy relationship easier to maintain (Branscome et al., 2014).

A study was conducted with two male students and their respective teachers in a public

school setting (Singh et al., 2009). The students and teachers attended twelve training sessions

in order to be trained to help the student with ADHD (Singh et al., 2009). The students were told

why they should be mindful of their behavior in the classroom and how it would affect those

around them, their peers and teachers (Singh et al., 2009). Each training session had a very

specific outline of what the student would learn that day, for example, Session 4–7 the student

does meditation exercises to begin then learn about loving kindness, a beginner’s mind, and

letting go (Singh et al., 2009). The results of the study showed an increase in child compliance
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with classroom and school rules and a decrease in impulsive behavior (Singh et al., 2009). The

training helped the student behave and appear to be less threatening to other students who then

began to respond positively to them (Singh et al., 2009).

Strategies to Support Two

A second strategy that helps support students with ADHD who are struggling to connect

with their peers and teachers is clear communication (Beaty-O’Ferrall et al., 2010). Students with

ADHD are constantly struggling to focus on the instructions of the teacher so it is important to

focus on clear communication ensuring that the student understands and knows what to do

(Branscome et al., 2014). Positive teacher behavior, including clear communication, creates a

positive and productive learning environment for all students (Beaty-O’Ferrall et al., 2010).

When teachers take the time to get to know their students and communicate clearly with them it

creates a strong teacher-student relationship that increases the achievement of each student

(Beaty-O’Ferrall et al., 2010). Communication leads to a positive classroom environment which

helps to promote positive student behaviors (Beaty-O’Ferrall et al., 2010). Poor communication

skills can lead to disruptive behaviors which affect the teacher's ability to manage the classroom

which is what should be avoided (Beaty-O’Ferrall et al., 2010). Anxiety and uncertainty in

students are feelings caused by miscommunication and can lead to behavior that is inappropriate

(Beaty-O’Ferrall et al., 2010). It is imperative that teachers communicate clear standards for their

students to follow in the classroom (Beaty-O’Ferrall et al., 2010).

A study was conducted that tested the effectiveness of communication in the classroom

by observation (Geng, 2011). The teacher began by explaining the rules to all her students and

then asked them to repeat the rules and instructions back to her (Geng, 2011). The teacher used

this method for all of her instruction over several days for which the observer was present (Geng,
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13
2011). The results showed that the students with ADHD showed an increase in good behavior

and that their peers were no longer avoiding them because of their misbehavior (Geng, 2011).

The clear communication allowed the student to focus and remember what the rules and

instruction were in the classroom (Geng, 2011).

Conclusion

ADHD is a neurodevelopmental disorder that affects the child’s brain development and

thus affects their behavior (Branscome et al., 2014). ADHD causes the child to be inattentive,

hyperactive, and impulsive (Branscome et al., 2014). ADHD has an effect on 5% of children and

is more prevalent in girls than in boys (Branscome et al., 2014). It is extremely important as a

teacher to remember that all students are unique and it is beneficial to teach the whole child. No

matter what is happening in the classroom teachers must remember that students have other

things happening in their lives that may be affecting their behavior. Teaching is most effective

when you consider where the child has come from and why they may be acting the way they are.

Knowing and understanding the child to the best of your ability can help them learn to the best of

their ability because you will know what method works the best. Keeping this in mind

throughout the day will require patience and it is a good quality to have in order to keep your

classroom comfortable and controlled. Communication with parents is a vital part of teaching,

the more you know from the parents, and the more the parents know from you, the better the

situation. If the student is behaving well and having a great day, tell the student's parents so that

when the students misbehave it is not the first time that parents are hearing from you. Clear

communication with the students is also extremely beneficial in the classroom because the better

the students know what you expect the easier discipline will be. In order to be a successful

teacher, the student must feel safe and cared for in your classroom, even when they are
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experiencing a difficult day.

References

Beaty-O’Ferrall, M. E., Green, A., & Hanna, F. (2010) Classroom management strategies for

difficult students: Promoting change through relationships. Middle School Journal, 3-11.

Branscome, J., Brown, C., Cunningham, T., & Kelley, H. (2014). Adhd: Implications for school

counselors. Georgia School Counselors Association Journal, 21(1).

Campbell, R. A., Naftel, A. J., Qeadan, F., Rabiner, D. L., Rowland, A. S., Skipper, B. J., &

Umbach, D. M. (2018). Attention-deficit/hyperactivity disorder (adhd): Interaction

between socioeconomic status and parental history of adhd determines prevalence.

Journal of Child Psychology and Psychiatry, 59(3), 213-222.

Cooper, A., Eyre, M., Langley, K., & Thapar, A. (2013). Practitioner review: What have we

learned about the causes of ADHD? Journal of Child Psychology and Psychiatry, 54(1),

3-16.

Fabiano, G. A., Massetti, G. M., & Pelham Jr., W. E. (2005). Evidence-based assessment of
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attention deficit hyperactivity disorder in children and adolescents. Journal of Clinical

Child and Adolescent Psychology, 34(3), 449-476.

Geng, G. (2011). Investigation of Teachers’ Verbal and Non-verbal Strategies for Managing

Attention Deficit Hyperactivity Disorder (ADHD) Students’ Behaviours within a

Classroom Environment. Australian Journal of Teacher Education, 36(7), 17-30.

Gureasko-Moore, S., Dupaul, G. J., & White, G. P. (2006). The Effects of Self-Management in

General Education Classrooms on the Organizational Skills of Adolescents With ADHD

Behavior Modification, Australian Journal of Teacher Education, 30(2), 159-183.

McLeod, S. (2018, August 9). Maslow's Hierarchy of Needs. Retrieved November 17, 2018.

Sikstrom, S., Soderlund, G. (2007). Stimulus-dependent dopamine release in

attention-deficit/hyperactivity disorder. Psychological Review, 114(4), 1047-1075.

Singh, N. N., Singh, A. N., Lancioni, G. E., Singh, J., Winton, A. S., & Adkins, A. D. (2009).

Mindfulness Training for Parents and Their Children With ADHD Increases the

Children’s Compliance. Journal of Child and Family Studies, 19(2), 157-166.

Wolk, S. (2003).Hearts and minds. Educational leadership, 61(1), 14-18.