Strategies for ADHD: How Counselors Help Todayâ€™s Students Succeed
The Difference Between ADD and ADHD
The term â€œattention deficit disorderâ€ was first coined in 1980 when the Diagnostic and Statistical Manual (DSM) â€” the industry standard publication for psychiatric diagnoses â€” published its third edition. Since then, â€œADDâ€ and â€œADHDâ€ have become relatively ubiquitous in American vocabularies, yet they do not exist simultaneously. In fact, they are mutually exclusive terms.
As research poured in in the 1980s and 1990s, the DSM adjusted the nomenclature to reflect new findings. Specifically, â€œattention deficit hyperactivity disorderâ€ was introduced in the 1987 edition and appeared again in 1994, this time with three subtypes: predominantly inattentive subtype, predominantly hyperactive/impulsive subtype, and combined subtype. With the DSM 5, these have been re-termed as â€œpresentationsâ€ (i.e., predominantly inattentive presentation, predominantly hyperactive/impulsive presentation, and combined presentation) owing to the research suggesting that children can have different presentations over time. TheÂ Attention Deficit Disorder AssociationÂ External linkÂ Â has a helpful fact sheet with more details on the evolution of ADHDâ€™s nomenclature and its subtypes on its website.
Ultimately, while many use the terms â€œADDâ€ and â€œADHDâ€ interchangeably, the latter isÂ technically the correct, up-to-date termÂ External linkÂ .
Symptoms of ADHD
According to theÂ Mayo ClinicÂ External linkÂ , symptoms of ADHD often appear in early childhood, with diagnoses typically occurring before age 12. Typical symptoms of ADHD include fidgeting, excessive daydreaming, continual forgetfulness or losing things, taking needless risks, talking too much, limited self-control, misreading social cues and struggles with social interactions such as taking turns or getting along with others
Some may think,Â â€œDonâ€™t most children experience these â€˜symptomsâ€™ at one point or another during childhood?â€ â€”Â and theyâ€™d be right. The difference for children with ADHD is that these behaviors never subside and often worsen over time, and must result in impairment in key domains of functioning (e.g., social, familial, and academic), and often co-occur in two or more settings. Ultimately, ADHD is chronic for many affected children, impeding their social and academic lives well beyond their childhood and adolescence. According to the nonprofitÂ Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD)Â External linkÂ , â€œmore than 75% of children with ADHD continue to experience significant symptoms in adulthood.â€ As such, school counselors and educators have an opportunity to support children and teens with ADHD to develop effective techniques to manage their symptoms in school, and maintain them into adulthood.
More than 75% of children with ADHD continue to experience significant symptoms in adulthood.
Helping Students with ADHD
Children with ADHD can have a particularly hard time managing their symptoms in school environments. For example, experiencing difficulty sitting still during class, having trouble waiting for a turn during an activity or conversation, or being unable to play quietly and independently are not only disruptive behaviors, they also interfere with a studentâ€™s social, emotional, and academic development and functioning.
With up to roughlyÂ 11 percent of childrenÂ External linkÂ Â ages 4 to 17 diagnosed with ADHD, school counselors serve as an important support system for children with ADHD and their families, as well as an essential resource for teachers and other professionals who work with students in and outside of the classroom. Because ADHD manifests itself in many different ways (most children are diagnosed with aÂ combined form of ADHDÂ External linkÂ ), counselors should be equipped with several strategies to address the many ways symptoms may occur in students.
With up toÂ roughlyÂ 11 percent of childrenÂ External linkÂ Â ages 4 to 17 diagnosed with ADHD, school counselors serve as an important support system
Before jumping into strategies and suggestions, itâ€™s critical to understand what skills, specifically, students coping with ADHD need help developing. â€œChildren need to learn to develop impulse control and time management skills, as well as the ability to focus or concentrate on an undesired task,â€ said Rebecca Newman, an early childhood mental health consultant for theÂ Child Center of NYÂ External linkÂ . If the development of these skills is ignored, â€œthey may experience continual frustration, fatigue, poor self-esteem, or embarrassment,â€ she said.
A big part of successfully managing ADHD symptoms is providing structure.Â The National Institute for Mental Health saysÂ External linkÂ Â that keeping the same routine every day and addressing any changes (such as school assemblies or field trips) as far in advance as possible is imperative. Helping students stay organized is another way to provide structure while keeping them on track with demands and expectations from homework, clubs, and sports.
Strategies for School Counselors
Evidence-based interventions (EBIs) are a primary way school counselors can provide support to students coping with ADHD. EBIs are an important part of managing ADHD symptoms, and usually occur outside of where a change in behavior is needed, such as a classroom.
Anil ChackoÂ External linkÂ , a professor for Counseling@NYUâ€™sÂ online masterâ€™s in school counselingÂ program, said there are specific strategies that school counselors can implement when working with students who have ADHD.
â€œSchool counselors should utilize methods that support studentsâ€™ time management, planning, and organization,â€ Chacko said, citing the work ofÂ Joshua LangbergÂ External linkÂ Â at VCU andÂ Howard AbikoffÂ External linkÂ Â at NYUâ€™s School of Medicine â€“Â both leaders in ADHD research for children and adolescents. â€œI would also encourage school counselors to work directly with parents to create a school-home note system to support cross-setting changes.â€
Research as recent as 2016 found that withÂ early intervention for behavioral therapyÂ External linkÂ , children who received behavioral therapy first before other interventions (such as medication) received â€œfour fewer rules violations an hour at school than the medication-first group.â€ This is not to say medical treatments should be dismissed, as they have proven benefits for helping children as well, but rather demonstrates the importance of a school counselorâ€™s role in encouraging behavior modification. This form of therapy is also cost-effective, as the reports found behavior-first therapy cost roughly $700 less per year compared to medication-first treatment. The CDC agreesÂ both behavioral therapy and medicationÂ External linkÂ Â are important for treatment moving forward.
These intervention techniques can be implemented at any point in a studentâ€™s academic career; itâ€™s equally applicable for elementary students as it is for high schoolers. Whatâ€™s more, social and emotional learning isÂ increasingly appearingÂ External linkÂ Â in schoolwide curricula, which can further support a student coping with ADHD in a formal classroom setting, as well.
Strategies for Teachers
In addition to EBIs, school counselors can train teachers to support children coping with ADHD in the classroom. It can be as simple as suggesting that teachers implement point- or token-based systems in class to reward good behavior, or as robust as dedicating a day of in-service training to identify symptoms and provide additional intervention strategies.
As for some immediate tips, for students who are easily distracted (predominantly inattentive), theÂ National Resource Center (NRC) on ADHDÂ External linkÂ Â suggests:
- Seating the student near the teacherâ€™s desk or away from distractions like windows or the corridor.
- Splitting longer assignments into smaller segments, and providing more breaks during class time.
For students who squirm and fidget often (predominantly hyperactive/impulsive), the NRC recommends:
- Seating students in an area where there will be the least disruption, such as along the side of the classroom.
- Creating opportunities for movement throughout the day, such as completing assignments sitting on the floor or helping with class activities (e.g., handing out activity sheets).
Newman adds that using â€œfirst/thenâ€ statements â€” such as â€œFirst push your chair in, then come sit for story timeâ€ â€” with children, and directing them to assist during class time will help them both refocus their energy and also feel valuable. A general best practice is for school counselors, teachers, and parents to offer praise and reward when children coping with ADHD exhibit good behavior.
The NRC has additional resources for teachers on supporting students with ADHD forÂ readingÂ External linkÂ ,Â writingÂ External linkÂ , andÂ mathÂ External linkÂ Â accommodations, and generalÂ classroom instructionÂ External linkÂ .
Strategies for Parents
ADHD is a relatively well-known mental disorder and is subsequently stigmatized â€” discussions of ADHD as aÂ â€œfakeâ€ disorder on mainstream news sitesÂ External linkÂ Â donâ€™t help, either. As such, ADHD is oversimplified or even appropriated with things like â€œAD/HDâ€ T-shirts and an endless meme stream across the internet. Beyond the web, stigmas of ADHD are found in television. Season 2 of Netflixâ€™s wildly successfulÂ Unbreakable Kimmy SchmidtÂ references an ADHD medication,Â Dyziplen, that transforms rambunctious kids into slow-moving, deadpan pseudo-robots.
A big part of empowering children to manage their ADHD is providing them with interventions, therapies, medications, and lots of support from adults in all aspects of their life. But when it comes to stigma, speaking up in defense of your child is a great way to fight it, just asÂ this parent didÂ External linkÂ Â in reaction to theÂ Kimmy SchmidtÂ episode last year.
When it comes toÂ stigma, speaking up in defense of your child is a great way to fight it.
While misconceptions of ADHD are seemingly omnipresent, there are many strategies parents can use for helping their child with ADHD at home:
- Provide positive communication and reinforcement; praise and reward good behavior with things as simple as stickers.
- Create and maintain as muchÂ structure in their day-to-day lifeÂ External linkÂ Â as possible, such as providing written to-do lists for chores.
- Practice strategies at homeÂ External linkÂ Â that are covered during therapy sessions.
Additionally, Chacko encourages parents to learn more about available behavior parent training programs â€“ arguably the most well-studied and effective â€œtherapyâ€ for children with ADHD and related oppositional problems.
â€œItâ€™s important to remember that many students with ADHD also have a learning disability or learning issues,â€ Chacko said. â€œSchool counselors, teachers and parents should appreciate that the challenges these children face may be more than just â€˜ADHD.â€™ â€
As with many misunderstood mental disorders, the best way to change the conversation is through an amplified voice. In terms of supporting parents, school counselors can educate them onÂ support groupsÂ External linkÂ ,Â online forumsÂ External linkÂ , and through websites likeÂ CHADDÂ External linkÂ .
Republished with permission: Counseling@NYU, theÂ online masters in school counselingÂ program from NYU Steinhardt.
ADD and ADHD are used interchangeably for Attention-Deficit/Hyperactivity Disorder.
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