The family way (From Kidderminster Shuttle)

The family way

7:00am Saturday 11th February 2012 in Lifestyle

ADHD charity ADDISS has expressed concern about the number of children diagnosed with the hyperactivity condition being excluded from school. This week's column reveals how schools should deal with ADHD children, and how to tell the difference between a youngster with ADHD and a problem child.

By Lisa Salmon.

It's easy to label a child who constantly misbehaves as a problem child - but the truth may be that the child can't help misbehaving, because their problem is ADHD (attention deficit hyperactivity disorder).

The genetically-determined condition is thought to afflict around 3-7% of school-age children, but it often remains undiagnosed. Only 1-2% of children are diagnosed, and many of the remainder don't get appropriate support and exhibit such problem behaviour that they are excluded from school.

In fact, ADDISS, the charity that supports the families of children with ADHD, says that recently it has noticed more ADHD children than ever being excluded from school.

Children with ADHD show disruptive behaviours which can't be explained by any other psychiatric condition, and are more extreme than simple misbehaving.

They have difficulty focusing their attention to complete specific tasks, can be hyperactive and impulsive, and can suffer from mood swings and "social clumsiness".

But the condition doesn't necessarily prevent those who have it from achieving - famous people who are said to have, or are thought to have had, ADHD include Mozart, Pablo Picasso, Elvis Presley, Einstein, John F Kennedy, Tom Cruise, Billy Connolly and Justin Timberlake.

"Every school will have some diagnosed children, and lots of undiagnosed children," says Holly Evans, an educational advisor for ADDISS.

She explains that it's particularly children with undiagnosed ADHD that are excluded, as those who've been diagnosed have an 'official' disability and shouldn't be excluded under the Equality Act.

She says they still are excluded, but if parents contest the exclusion it's usually winnable at a disability tribunal.

"Children tend to be excluded because teachers don't understand the nature of the condition and think they're being wilfully naughty, as opposed to having a disability," she explains.

ADHD is caused by a combination of factors, including changes in the parts of the brain which control impulses and concentration, and genetic and environmental factors.

Problems often arise at school with ADHD children because they're impulsive and emotionally immature.

"They'll get upset with someone, but they can't walk away and because they're impulsive they might hit them," says Evans.

"They make the same mistake over and over again, so schools start to feel exasperated as they put interventions in and they look like they're not making any difference.

"They don't understand that children with ADHD need a lot longer for interventions to work."

She explains that those with ADHD don't have the inner voice that tells normally-functioning people how to control their daily life such as by getting to school/work on time, learning from the past, and understanding time periods.

Children with ADHD have a working memory deficit and can't learn from the past, or predict the future.

They may have lots more energy than other children, and while they have difficulty concentrating, they can concentrate on the things they love, a symptom of ADHD called hyper-focusing.

"If teachers understood these difficulties, then they'd change their expectations, and kids with ADHD wouldn't end up in so much hot water," stresses Evans.

She says schools need to have realistic expectations about the interventions they use, which might include specialist cognitive behaviour therapy (CBT) programmes, or mentoring.

Evans says the condition is more likely to be dealt with inappropriately in secondary schools, as in primary schools there will be other children who have similar difficulties just because they haven't matured.

In secondary schools an ADHD child's emotional immaturity "will stand out like a sore thumb", she stresses, and this may eventually lead to exclusion.

"There are lots of good schools that try really hard with these kids, but there are also lots that don't try as hard and just think they'll get rid of them.

"There's such a misunderstanding about what ADHD is - teachers often don't understand that the condition affects children's learning and the way they process information. They think it just affects their behaviour."

She says parents often feel their child isn't just misbehaving and has ADHD, because they realise the child can't help their behaviour.

"These children act without thinking, and when it's pointed out that they've done something they shouldn't, they're usually quite apologetic and promise they'll never do it again - and then of course they do it again five minutes later.

"It's working out whether they've done it on purpose or they can't help it. For parents and teachers it's about knowing and understanding the child."

She says that, conversely, some parents may think their child has ADHD, when in fact their behaviour is linked to parenting, abuse or just having a tough time.

"They have ADHD-type symptoms, but with the right interventions, those symptoms can go away. But if a child has ADHD, the symptoms will never go away, you just manage them."

Children with ADHD aren't choosing to be in trouble all the time, and they'll often become anxious about their behaviour, she says.

"Lots of parents are relieved when their child is diagnosed with ADHD, because they realise it's a neurological disorder and not about how they've been parenting.

"But there's still a stigma attached to it, and some parents are embarrassed.

"It's never going to be an easy ride if you've got an ADHD child, but with the right parenting, the right support from clinicians and teachers who are aware of the condition, they can do well and be successful adults."

ADDISS offers specific ADHD training for individual teachers or whole schools, and local authority behaviour support teams can also help teachers understand the condition.

Christine Blower, general secretary of the National Union of Teachers (NUT), points out that many schools have excellent arrangements for identifying and supporting children with ADHD, explaining that the school's special educational needs co-ordinator (SENCO) should be the first port of call.

She says: "Plans can then be put in place to continue the child's education at the school in a way that's sensitive to their needs and those of fellow pupils."

She agrees that teachers also need access to appropriate training, but points out that swingeing budget cuts mean many local authorities are currently making entire behaviour support teams, which are "a vital force in understanding ADHD issues", redundant.

"This leaves nowhere for teachers or head teachers to turn," she stresses.

:: For more information about ADHD, visit www.addiss.co.uk Ask the expert Q: "I don't like one of my eight-year-old son's friends, because I know he lies all the time, and hits my son. Should I discourage the friendship, or leave my son to work out that this boy is no good? I'm worried his behaviour might rub off on my son."

A: Educational psychologist Dirk Flower, who specialises in helping parents deal with challenging children, says: "You have a number of possible options for addressing this situation. These include discouraging the relationship by favouring a better possible friend, talking through the behaviours of the other child with your son and discussing the implications of the concerning behaviours, or letting your child play and learn for himself the consequences of the behaviour.

"You could also help the other child understand the consequences of his behaviour and ask if this is what he wants.

"In deciding which option, it's worth asking yourself whether it will help your child to grow up and learn from the situation.

"Is it going to damage their confidence or willingness to try, and what skills and strengths have you got to enable a positive outcome from the choice you're about to make?

"Once you've worked out your best option it's good to spend time deciding how to make it happen before implementing action."

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