This article was originally published in Headteacher Update 10/5/18.
The hyperactive version of ADHD is well-known and often spotted, but students with inattentive ADHD frequently go undiagnosed, as Daniel Sobel knows from his own experience.
When I mention to leaders in the field of education that I was probably undiagnosed ADHD and that I struggled at school, I get an uncanny amount of responses along the lines of: “Oh, me too.”
I remember well that I simply couldn’t concentrate. My GP asked me how I cope now with writing books, articles and running an ever-growing business supporting around 1,000 schools. I tell him that “well, I have two PAs”, which may sound overly indulgent to most but without that support I doubt I could operate as others might.
This is my way of saying that the topic of this article is very personal and I genuinely hope it reaches out to colleagues and has some impact in your school. The hyperactive version of ADHD is well-known and talked about – and thankfully so. This article is about the inattentive ADHD and how it so often, cruelly, goes unnoticed.
George is 10 and is in his SATs year. He appears to mess around in the classroom and can’t seem to focus on his phonics, reading and writing, which are two years below his expected level – and his teacher is frustrated with him.
One day a teaching assistant takes George aside and tries to find out what’s going on for him. He says: “I get fed up with grown-ups telling me to pay attention. I try, but they want me to do too many things. Even in school the teacher expects me to remember everything. I can’t do the same work as the others, so why should I bother? I’m just stupid.”
Such an example is not uncommon, yet a diagnosis of Inattentive ADHD (formerly known as ADD) will frequently get missed and instead mistaken for laziness – unlike Hyperactive Attention Deficit with its distinct degrees of hyperactivity, impulsivity and adverse behaviour.
As a result, students like George, being reluctant to ask for help and not wanting to draw attention to themselves, can sadly go under the radar for years.
ADHD is a common disorder. Recent UK surveys of children aged five to 15 found that 3.6 per cent of boys and 0.85 per cent of girls have ADHD. Importantly, a recent review of follow-up studies of individuals who had ADHD as children found that 65 per cent of people at the age of 25 still retain some symptoms of ADHD, indicating that this disorder can be disruptive on a long-term basis, and that addressing it at school is vital (for more, see https://aadduk.org/symptoms-diagnosis-treatment/).
Arguably, the most significant impact of not addressing ADHD appropriately is the sense of guilt, blame and low self-esteem which can develop. A typical undiagnosed student would express it thus: “I’m always told to concentrate, focus, and try harder, but I don’t know what I’m doing wrong. I just know I’m not like the other kids, I’m not ‘normal’, and I feel like the worst student in the class.”
What to look out for?
First, consider the child’s presentation:
- Would you describe him as a “day-dreamer”?
- Does he struggle to maintain concentration?
- Does he work slowly but “get there in the end”?
- Does he become emotional or frustrated when trying to concentrate?
- Is he often forgetful and disorganised?
- Does he have difficulty completing a task?
- Does he adopt tactics to try and avoid doing certain subjects?
Of course, a diagnosis of ADHD and other SEN should be carried out by a specialist such as a qualified community paediatrician or a psychiatrist, both of whom could refer to other professionals if appropriate in order to get the correct diagnosis. But the above questions about a student (whom, in this article, I refer to as male) may help you to decide whether a referral to your SENCO is advisable. A GP can refer to an appropriate professional.
Following a diagnosis
The impact of personalised differentiation can be revolutionary. An ADHD student, when effectively taught and supported, can in time achieve in many areas. I remember visiting a school where the ADHD students with their improved sense of self-worth felt more empowered, which as such had an impact on their motivation levels.
I’m grateful to Ann Freeman, author of Help Me Understand ADHD, for her assistance in working with me to compile this article and the following 10 suggestions for supporting your ADHD students in the classroom (while still being able to provide fully for your other 29 students):
- Focus on building his sense of self-worth, motivation, and belonging – this will be your gateway to enthusiastic, effective participation. Though this applies to all students, it applies beyond measure for students who have suffered under the weight of “not being good enough”.
- Avoid saying to him anything that could come across as a criticism, like “pay attention”. It will reduce his motivation, and will be too vague to elicit improved behaviour. Your aim is to motivate him to engage with you, his teacher, and to make him feel that you are on his side.
- Be consistent. Adopt a strategy and stick with it.
- Regularly chat with him – encourage him to feedback to you how the strategies are helping him (or not), and work together to continually improve his situation.
- Use buddies – who can sit with, support and “hang out” in the playground with your target student/s. This will address the issues of loneliness and poor self-esteem, and provides someone with whom to check task instructions.
- Allow him to fiddle with something, like some Blu Tack, to help focus his concentration.
- Give him some areas of responsibility in the classroom, but no more than three. The student should tick them off as they go. This gives a model for task-completion as well as esteem for participating in their own way in the classroom – and, of course, provides another opportunity for you and others to bestow praise. The trick with the endless praise you are hopefully bestowing on your students is to be as specific with it as possible.
- Agree together with him on a sign that indicates when they need to pay attention. This could be anything from a gentle tap on the shoulder to a covert sign from the front of the classroom such as a hand gesture or a certain word.
- With the support of home, the SENCO and, of course, the student himself, focus on how he can apply his own self-management strategies in your class. This means, that if they are struggling in your class then they are probably challenged everywhere and with developing their new coping strategies and skills it can also help them with situations in the future. They should be guided to develop strategies. The issue you as their teacher should focus on is not to reinvent the wheel but to make sure they are consistently applying their strategies in your class.
- When something goes wrong, like (commonly) forgetting homework, work with home and the student to come up with solutions, such as the student putting each subject in different coloured file. The more creative and bespoke the solution, the more likely it will work.
If you can keep these tips in mind, you will have a significant impact on the student both during his school days and as he adapts to an often-unsympathetic world once he leaves education. Students like George have much to offer if given the chance and the more that we can differentiate and make his time at school easier and more enjoyable, the more he will flourish.
I wish that myself and quite a few people I know who are now leaders of education had encountered teachers with more understanding and compassion. Inattentive ADHD can lead to a lifetime of struggle for people who don’t get help with it at school. I hope this article has gone some way to supporting some children in your classrooms.