A.D.H.D. has been called the most frequently diagnosed psychiatric disease of childhood. According to the American Psychiatric Association (APA), 5 percent of American children have the diagnosis. The Centers for Disease Control and Prevention (CDC), puts that number higher, at 11 percent of American children. With numbers this significant, teachers need to become better educated about what A.D.H.D. actually is, and how these children should be taught.
What Is A.D.H.D.?
In 2010, Dr. Nora D. Volkow, the Director of the National Institute on Drug Abuse (NIDA) at the National Institutes of Health decided to study what was going on in the brains of adults with an A.D.H.D. diagnosis. Using a PET scan she and her colleagues studied the dopamine receptors in the brains of unmedicated adults with A.D.H.D. and a neurotypical control group. What the study found was that the adults with A.D.H.D had significantly fewer dopamine receptors than the neurotypical group. Moreover, the amount of dopamine receptors in the brain could be linked to the severity of the symptoms in the individual. The less receptors there were, the more A.D.H.D. symptoms were presented.
Dopamine is one of the chemical receptors in the brain that passes information from one neuron to another. With less receptors, individuals with A.D.H.D are less able to feel rewarded by normal experiences than a neurotypical individual. This means that descriptions of children with the diagnosis as “inattentive”, “distracted”, or “lazy” are not only misleading, but inaccurate. These children are none of these things. In fact, they can show an incredible amount of focus and dedication to those things that are interesting to them. Even the term “hyperactive” in the diagnosis is misleading because it leads to the impression of a physicality of constant motion, when the constant motion is really internal.
It is also important for educators to stop thinking about A.D.H.D. as a brain defect, when, in fact, it is a different way of dealing with stimuli that has many advantages, and may have even developed as an important part of our evolutionary history. In 2008 Dan Eisenberg, Benjamin Campbell, Peter Gray, and Michael Sorenson set out to study the dopamine receptors of the Ariaal tribe of Kenya. 35 years before the study, a portion of this tribe that had traditionally been nomadic split off and began farming. The researchers studied a genetic variant in both groups that leads to less reception of dopamine in the brain. They found that those in the nomadic group who had the genetic variant (and therefore had brains that behaved like those with A.D.H.D) were better nourished than those without it. However, the opposite was true for the agricultural group, where those with neurotypical brains were the individuals that were better nourished. A constant search for novelty would be an advantage to a group with a nomadic lifestyle, but it becomes a disadvantage once that group settles down, and, I would posit, becomes less and less desirable to a society the more sedentary it becomes.
As teachers, we need to stop treating A.D.H.D as something we need to “fix” and start treating it for what it is: a different method of mental processing with it’s own unique strengths and weaknesses.
Teaching Children With A.D.H.D.
When I was taking a class on teaching children with special needs in college, I was amazed at how every practice I learned that was designed to help adapt teaching for the needs of individuals could be beneficial to all children in the classroom. When I brought this up to the professor, she told me something that has stuck with me, “Good teaching is good teaching.”
When we make adjustments to our curriculum or methodology to include everyone in the learning, we are not narrowing the learning that occurs in the classroom--we are broadening it and deepening it, expanding the learning the occurs for everyone. When we make changes that make learning more accessible for those with A.D.H.D, we are making changes that can help our neurotypical children as well.
How can we adapt our teaching for our A.D.H.D. students? According to Dr. William Dodson, a psychiatrist specializing in A.D.H.D., in his article Secrets of the ADHD Brain:
"For people with a neurotypical nervous system, being interested in the task, or challenged, or finding the task novel or urgent is helpful, but it is not a prerequisite for doing it. Neurotypical people use three different factors to decide what to do, how to get started on it, and to stick with it until it is completed:
1. the concept of importance (they think they should get it done).
2. the concept of secondary importance--they are motivated by the fact that their parents, teacher, boss, or someone they respect thinks the task is important to tackle and to complete.
3. the concept of rewards for doing a task and consequences/punishments for not doing it.
A person with an ADHD nervous system has never been able to use the idea of importance or rewards to start and do a task. They know what's important, they like rewards, and they don't like punishment. But for them, the things that motivate the rest of the world are merely nags.”
Those with A.D.H.D. are perfectly capable of completing and focusing on tasks, but only if the task is intrinsically interesting to them. Rewards are frustrating to them because they seem constantly out of reach of their natural way of thinking. Punishments are similarly depressing because they seem impossible to avoid. They want to seek out new and novel experiences that excite them internally and have intrinsic rewards. They are continual seekers with voracious appetites. In order to help our students with A.D.H.D., we need to start focusing on what excites each child in our class from within. This will be beneficial to all our students, as studies have shown that the key to achieving goals in life is intrinsic motivation and that too much focus on external motivators can actually hinder one’s ability to succeed. We need to start keying in to what actually motivates our students, start teaching them how to recognize motivation in themselves, and to give them strategies to accomplish tasks that seem menial. All of the students in our classroom can benefit from learning about their own motivations and mental processing, and doing so can be as simple as giving voice to a child’s internal thoughts, which helps him/her to learn more about his/her own thinking. For example, “I noticed it was hard for you to write that story. Making the letters look so nice was really slowing down your storytelling and I could see that was frustrating you. But look how much of your story is now out of your head and on paper where everyone can see it! I bet that feels good to be able to share what you were thinking doesn’t it!” Or, “I can tell that this story we are reading really isn’t interesting to you, but I know that you are interested in waterfalls, and there is a giant waterfall in 2 more pages. I bet if you think about the waterfall that is coming up, that will help you to focus on what I’m reading at the moment.”
Of course, hooking into a child’s mental process and interests can be challenging. Parents can be helpful, as they can give us a sense of what their child likes and dislikes, but children with A.D.H.D. are such novelty seekers, that what might be the most beneficial for them is the information they can provide themselves. Help them to realize when they can “zone in” on a task and when they can’t, take observational notes of what helps the child, and then share that information with him/her. “I noticed that you were having a really hard time solving that math problem until Jane came over and talked to you about it. Talking about problems must make them more interesting for you.” Children will need to figure out how their brain is going to function in a neurotypical world, and it will be useful for them to build their own set of rules for accomplishing tasks. Does it help to talk about a problem? Does it help to rock in your seat while writing? Does it help to chew on a pencil? These are the individual discoveries that we want to help children make in order to provide them with a unique set of tools to help them get through the necessary tasks that to them are so frustratingly mundane.
We should also make our teaching more exciting, more interesting, and more novel. This will help not only our A.D.H.D. students engage more with the learning, but our neurotypical students as well. However, we should keep in mind that we have stiff competition. In his article, A Natural Fix for A.D.H.D., Richard A. Friedman writes, “I think another social factor that, in part, may be driving the “epidemic” of A.D.H.D. has gone unnoticed: the increasingly stark contrast between the regimented and demanding school environment and the highly stimulating digital world, where young people spend their time outside school. Digital life, with its vivid gaming and exciting social media, is a world of immediate gratification where practically any desire or fantasy can be realized in the blink of an eye. By comparison, school would seem even duller to a novelty-seeking kid living in the early 21st century than in previous decades, and the comparatively boring school environment might accentuate students’ inattentive behavior, making their teachers more likely to see it and driving up the number of diagnoses.” As we plan lessons that are in depth, novel, and engaging, we also have the difficult task of teaching all of our students the difficult skill of delayed gratification. This can be difficult for neurotypical students, and seem impossible for A.D.H.D. students, for whom it may seem impossible to focus on long term goals, when there are so many short term distractions.
One way that we can help our students learn to delay gratification, is by breaking down tasks into small tasks that they can accomplish successfully. Does the child need to write a long paper? Show them exactly what they need to do each day in order to accomplish the task, and then help them focus on the parts themselves instead of the overwhelming whole. Give the child a large whiteboard calendar on which he or she can write down what has to be done each day in order to be successful at long term goals. Color code tasks in a way that makes it obvious to the child how each step leads into successive ones. Simplify large projects as much as possible in order to increase the possibility that the child can be successful and make all tasks as transparent as you can. In the meantime, focus on what the child can do, instead of what he/she cannot do. Our A.D.H.D. students are keenly aware of their shortcomings, and it is our job as teachers to help them see and build upon their strengths.
We can also improve our teaching for all students by changing the way we teach. We need to plan lessons that teach subjects in depth and are tied to real world situations in order to tie into the natural curiosity of children. We need to have more classroom time dedicated to free exploration, so that children have a chance to learn about their unique interests and metacognition. We need more time outside, so that children can connect to the outdoors as well as well as their peers. All of these activities encourage brain development and proper brain wiring that can help our students gain the neurological strength they need in order to encourage the tasks we set for them. Teaching in this way will not only help our students with A.D.H.D. become successful learners, but it will help all of our students be successful learners as well.