Teachers (and Parents) - This is Why Your ADHD Student Isn't Working - Part 1 of 4.

"It is less painful to be told that one is lazy than that one is incapable.  In short, laziness serves as a screen to hide the child's lack of faith in himself, prohibiting him from making attempts to cope with the problems confronting him."

 - Alfred Adler**
........."what distinguishes someone with ADHD from someone without it is that they appear to be less mature (are age inappropriate) in their ability to engage in self-regulation toward specific goals and the future more generally. If one is to help someone with ADHD, they must be helped to either overcome these delays or at least compensate for them (make accommodations to them) if they are to be more effective or successful in managing themselves, getting to their tasks and goals, and preparing for their future more generally. 
- Dr. Russell Barkley**

Lack of effort can be one of the most frustrating things in the relationship between a teacher and student.  When a child tries to complete a task or skill, they are providing the teacher with information that indicates how much they do and don't understand.  Absent effort, the teacher is left guessing how much the child knows.  Moreover, when a child is not making any effort, it leaves the teacher feeling like he/she is working their tail off for a child who doesn't really care.  Sometimes it's hard not to take that personally.  However, when you are talking about children with ADHD, coming at it from their point of view and understanding their brain wiring can bring about an "AHA!" moment.  Things aren't always what they seem.  

The solutions that I detail below can be used with the entire class.  Very often they model good communication skills and ways to build good working relationships, thereby providing benefit to the group as a whole in addition to the students that are specifically targeted.  When a teacher provides accommodations to the group as a whole, it is known as Universal Design for Instruction (UDI).

Problem #1 - They don't know what it is that they are supposed to do.

I know you repeated the directions for the assignment more than once.  "They were looking right at me when I was talking!" Yep, and they still may not have gotten what you were saying.  Children with ADHD subconsciously learn how to look like they are attending, even when they are not.  It's a defense mechanism that often comes from hearing things like, "Look at me so I know that you are paying attention," or "Why weren't you listening?", etc.  When a neurotypical person is in a room with lots of low-level background noise, say a classroom or a cocktail party, or a dinner with different conversations happening at a large table, they can "screen" the background noise out and attend to the person right in front of them.  Most ADHD children (and adults) have a very hard time doing that.  Everything seems like it's at the same volume, and the brain seems to want to try to pay attention to everything all at once.  If the room is loud, it can actually be distressing.  Pulling a complete and accurate set of directions out of that sea of competing noises and interests can be very, very, difficult.  In addition, if the child has other things on their mind, (sick pet, Mom's gonna be mad at me because I didn't get my work done today, there was an argument at home last night, etc.) it's difficult to keep the brain from wandering.  All of this is not willful.  It's a lack of Executive Function (EF) that is a result of structural differences in the brain.  If you want to get an idea of what this is like, try the simulation on this link.  http://www.pbs.org/wgbh/misunderstoodminds/experiences/attexp2a.html

Solutions: 

• Check Back - When I'm working with a child who has trouble attending, I stop every so often and ask them to tell me what I've just said.  Usually I phrase it using a question something like, "Can you tell me what you just heard so that I know I said everything I want you to know?" or, "Can you tell me what I just said so that I know that I said it correctly?"  Notice that you are assuming they tried to listen, and that you are taking responsibility for what you said, not asking them to take responsibility for what they heard.  (Even though that's the point of your question) If you are working with a group, assign one or two people to be "check-back" people.  Assign that role to a child with ADHD.  Their job is to help make sure you described the directions completely and accurately.  It gives them practice attending, a chance to contribute, and you have the opportunity to make sure they "got it".

• Do not assume the child will ask for help from you or another child - Even as early as Kindergarten and First Grade, an ADHD child will begin to understand that adults and other children are critical of those who repeatedly miss what it is they are supposed to do.  Therefore, it's often easier to either try to "muddle through" or cop a refusing attitude than it is to ask for help.  Teachers therefore need to be proactive in making sure that the ADHD child really knows what they have to do.  When the child asks for help, even if the directions have been repeated several times and written down, the teacher should reinforce that request with a positive response.  All too often I have heard responses such as, "I have already given those directions several times.  I'm not giving them again."  If asking to repeat directions several times becomes a habit, the adult should meet one-on-one with the child to try and come up with an alternate system.

• Keep the directions clear and simple - I'm going to come back to this point again and again, because it's REALLY important.  Children with ADHD often have EF development which lags 2-3 years behind their chronological age.  Following that logic, if your class is 5th grade, the directions for your children with ADHD have to be in a form that a 2nd or 3rd grader can use to be successful.  You need to remember to include things that other children may take for granted.  For example, if the work involves measuring, the directions for children all the way up through 5th grade should say, "Get a ruler", or "Make sure you have a ruler". 

• Document the directions - Once you have done that, you still need to document the directions.  If you are going to write them on the board, they should stay there until the assignment or work is due.  Better to put them on a website or in email, or Edmodo, etc.  When I get done meeting with a client in high school or middle school that has a phone, I send a text with the week's "homework".  There are appropriate ways for you to do something similar.  Try not to put the directions in paragraph form.  A numbered list or a list with bullets is going to be more effective. 

The next post will talk about the problem of not knowing HOW to get started on a particular task.

You can follow me on FB at "Pamela Mecca Seymour, LPC" or Twitter @pam327.


**The quotes above come from the following works:

Adler, Alfred, and Heinz Ludwig Ansbacher. The Individual Psychology of Alfred Adler, a Systematic Presentation in Selections from His Writings. Ed. and Annotated by Heinz L. Ansbacher and Rowena R. Ansbacher. New York: Harper Torch, 1964. Print.

Barkley, Russell A., PhD. N.d. MS. The Important Role of Executive Functioning and Self - Regulation in ADHD. Web. 1 Feb. 2014. <http://www.russellbarkley.org/factsheets/ADHD_EF_and_SR.pdf>.