by Gary Flowers, Pharm.D., PGY1 Pharmacy Practice Resident, Suburban Hospital
According to the Centers for Disease Control and Prevention (CDC), 9.5% of school children between the ages 4 and 17 have been diagnosed with ADHD, and this number is rising.1 Undiagnosed, untreated ADHD can wreak havoc in an individual’s life and in the lives of loved ones.2 I’ve watched my brother’s daily struggles as they tried to improve his son’s grades at school. My brother tried many methods at home to help his son but to no avail. After much frustration, my brother sought help. My nephew was diagnosed with ADHD.
ADHD is commonly treated with psychostimulant medications. Psychostimulants have shown to be beneficial in the majority of people with ADHD by helping to diminish hyperactivity as well as improve attention problems which cause many of the behavioral symptoms. Long-term studies have shown that these medications have protective effects against later psychopathology and reduced the chances of substance abuse in adolescents with ADHD.3
After evaluation of the individual’s needs, a teacher can devise a lesson plan built around the student’s needs and strengths. These accommodations are incorporated in educational activities with other students in the class. These lesson plans are best constructed with the input of a multidisciplinary team and the parents of the child. Teachers can often use assessment tools, such as learning style inventories, to better understand how to instruct the student and enhance his or her learning. For consistency, there should be one designated teacher that is used as an advisor or coordinator for the student to rely on and report.
Short-term and long-term goals should be set for the student with ADHD and reassessed periodically over time (i.e. quarterly) and edited as needed to adjust for advancements or emerging deficits. The goals should be written in the SMART format: specific, measurable, attainable, realistic, and timely.
Students with ADHD benefit from the teaching best practices we’ve all learned. For example, teachers should explicitly explain learning objectives at the beginning of the lesson so students know what is expected. At the beginning of each class the teacher should review previous topics and then connect that information with the information being covered that day or week. Using a variety of audiovisual materials can help reinforce concepts.
Simplifying and breaking work into smaller units makes information easier and more palatable for students with ADHD to digest. Time limits during tests may need to be relaxed or eliminated in order for the student with ADHD to successfully demonstrate what he or she has learned and retained.4
Although the media typically focuses on children, many adults have ADHD too. Adults tend to have similar challenges as children, such as, disorganization and staying attentive for long periods of time. Unfortunately, it is more difficult to diagnose ADHD in adults due to the variability and vagueness of their symptoms. Moreover, the symptoms must have began in childhood and persisted into adulthood in order to make the diagnosis of ADHD.5
Combination treatment, medications plus behavioral interventions, work best for the majority of people with ADHD. Adjustments may need to be made throughout life to control one’s actions and minimize the urge to take unnecessary risks. Teachers (and parents) need to remember that it’s important to be patient, experiment with different strategies, and seek support.
Fortunately, my brother sought help early and my nephew received the help he needed. They tried medication but focused on behavioral modification using positive and negative feedback. Teachers at his school and my brother set short and long term goals for my nephew. He is now seventeen and has plans to join the military after graduation!
1. Centers for Disease Control and Prevention (US). Attention-deficit/hyperactivity disorder (ADHD). [Internet]. 2011 Dec 12 [cited 2013 Mar 10].
2. Pliszka S. Practice parameter for the assessment and treatment of children and adolescents with attention-deficit/ hyperactivity disorder. J. Am. Acad. Child Adolesc. Psychiatry 2007 46(7):894-921.
3. Albert P. Drugs for kids: Good or bad? J Psychiatry Neurosci 2012; 37(5):293-5.
4. U.S. Department of Education. Teaching children with attention deficit hyperactivity disorder: Instructional strategies and practices. [Internet]. 2004 Feb [cited 2013 Mar 10].
5. National Institute of Mental Health. Attention Deficit Hyperactivity Disorder (ADHD). [Internet]. 2009 Jan 23 [cited 2013 Mar 10].