ADHD- Some Expert Opinions

We asked some experts the following questions:

     •  What are the common errors that school counsellors can make while dealing with a child with          ADHD?
     •  What can be the role of the schoolteacher in helping the child with ADHD?


Here's what they had to say -

According to Dr.Sona Bharti (Neuro Psychologist) , most parents, teachers and sometimes even school counsellors are unaware of ADHD as psychiatric disorder. Commonly, such children appear to be physically healthy, but very active, extremely restlessly, and unfocussed. They run from one activity to another without completing any task, make spelling mistakes, are unable to solve simple addition and subtraction problems. They do not concentrate or pay attention towards what is told to them, leave chores half-done, talk excessively, answer out of turn, are very fidgety and quarrelsome. Thus children who suffer from ADHD get erroneously treated at school and at home as a child with sever discipline problems. The child is punished for unruly behaviour and the counsellor may make unwarranted attempts at helping the child through assertive disciplining techniques. None of these will resolve the issues. Parents and teacher should be vigilant of their child's behaviour. Early detection of ADHD and proper counselling and treatment may save many children from severe mental disorders later in life. Dr.Bharti is of the strong opinion that teachers and parents must be trained and educated about ADHD so that they can contribute in the child's treatment. She also opines that if school counsellors feel unequipped to handle such cases, they should have an available resource, like a list of child therapists and psychiatrists in the vicinity, which can be provided to the parents.

According to Ms.Geetanjali Kumar (School Counsellor, Hansraj Model School ) , school counsellors must be cautious whenever they are dealing with a child who may seem hyperactive. The common error that counsellors can commit while assessing is that:

•  A child can be wrongly diagnosed as suffering from ADHD. According to her, some children may be more active than others in their class, but their excess activity need not always be a result of ADHD.
•  Another area in which, Ms.Kumar thinks that counsellors have to be sensitive is while disclosing the child's diagnosis to the parents. How a parent is informed about their child's problem plays a crucial role in their future probability to seek treatment and then comply with the same. Ms.Kumar feels that parents are more often then not in denial and its difficult for them to accept that their child is suffering from a psychiatric problem. This is understandable, given the taboo associated with mental illnesses in our culture.

It therefore becomes all the more crucial that the counsellor is sensitive to this issues and instead of stating the problem, adopt a more solution-focused approach. The parents should be left behind with solutions to think about rather than a problem to deal with after meeting the counsellor.

As for the teachers' role in assisting a child with ADHD, Ms. Kumar suggests that

•  Teachers should work in coordination with the school counsellors.
•  They should create a positive and accepting atmosphere in the classroom and facilitate the sense of achievement for the child.
•  They should focus on the positive behaviour in the child and help the child develop a healthy self-esteem.
•  Teachers can also play an important role, in helping the parents identify the child's learning styles, which will help him/her in their academic progress.

 

According to Dr. Deepak Gupta (Child and Adolescent Psychiatrist, Sir Ganga Ram & Inderprastha Apollo Hospital ) , one of the most common errors while assessing a child with ADHD is that:

•  Counsellors confuse ADHD with LD (learning disability). Counsellors misinterpret the poor performance in studies shown by the child as a symptom of LD and the real problem of ADHD gets overlooked.
•  The second problem that is harmful for the child within the school setting, is that once diagnosed, the child suffers through the pain of ‘labelling'. This labelling, as a child with a psychiatric problem, occurs even before any concrete help is provided to the child or the parents. Labelling attacks the child's self esteem and complicates the situation further. Instead the counsellor should work in close association with the teacher and develop a structured plan to help the child cope with his/her difficulties.

 

Dr.Gupta has the following guidelines for the teachers in their role while helping a child with ADHD:

•  Make the child sit at a desk, which has minimum distractions. E.g away from the door and windows. At the same time remember to no seclude the child from the rest of the class.
•  To help in increasing the child's attention span, while giving a task to do, break the task into smaller chunks so that the child can follow easily. E.g instead of asking the child to copy different things from different pages of a text after marking them, ask the child to copy one thing at a time from one single page.
•  Another thing to do to increase a child's attention span is, give brief and clear instructions instead of long and lengthy procedures for any task.
•  When a teacher comes into the class, she can write her scheduled task on the black board for that period. This ill help a child with ADHD to prepare and orient himself/herself for the task and also help the teacher complete her task efficiently within the timeframe.
•  Reinforcement plays an important role while dealing with a child with ADHD. Reinforcing the child's desired behaviour, focusing on positive aspects and giving constructive feedback, also boosts the child's self esteem.
•  Helping the child in impulse control can be done through making visual timetable, facilitating organising skills and making labels to deal with forgetfulness.
•  Lastly Dr.Gupta addresses the issue of developing social skills in a child with ADHD. He opines that very often these children need assistance in making and keeping friends and a schoolteacher can help a child develop fulfilling relations with his/her peer. One of the things that the teacher can do is assign a task-buddy for the child and then guide him/her in maintaining this relationship.

 

In conclusion it appears that helping a child with ADHD demands a close coordination between the school counsellor and the teacher. The school counsellor can help the teacher develop a structured plan and then the teacher can follow through in the classroom. In her individual sessions with the child, the counsellor can help the child deal with emotional distress caused by the problem, carry out activities that will help in increasing the child's attention span, strengthen the child's positive coping mechanisms and guide the parents in their dealing with the child.

Compiled by: Nilima Barde (Psychologist)