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!
References
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].
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