FOUNDATION OF SPECIAL AND INCLUSIVE  Easily distracted and forgetful

EDUCATION  Often doesn’t listen when spoken to

Prepared by Rafael and Jhude
It is widely accepted that ADHD is a developmental Hyperactivity
condition that can be formally diagnosed. ADHD is
 Fidgets, is restless and can’t sit still in class
a term which is used to describe students who
 Can’t stop talking, noisy
typically have the following problems:
 Runs about when it is inappropriate
 Overactive behavior (hyperactivity)
Impulsiveness
 Impulsive behavior
 Difficulty in paying attention and  Interrupts others
distractibility (inattention)  Blurts out answers without waiting for the
question to be finished
Students typically have a short attention span and
so can find it hard to concentrate and learn,  Difficulty in waiting or taking turns
especially in group situations. This can impact on In adolescence and adulthood, both those
their education and many of these students diagnosed and undiagnosed with ADHD in
underachieve at school. childhood are often associated with continuing
It is important to recognise that not all students emotional and social problems, including substance
with ADHD have all the symptoms. There are three misuse, unemployment and involvement in crime.
presentations of ADHD according to the American What causes ADHD?
Psychiatric Association’s diagnostic scheme (DSM
V) classification. ADHD is a well-recognized developmental disorder
that may result from a number of risk factors. It is
1. ADHD (inattentive often inherited and genetic factors can have an
presentation) describes students who influence in the causation of the majority of
mainly have problems with concentration students with ADHD. It tends to run in families and
and attention span but who are not usually there is an increased frequency of ADHD in first-
impulsive or overactive. degree relatives of students with ADHD. Other risk
2. ADHD (hyperactive/impulsive presentation) factors include low birth weight, smoking, taking
describes students who predominantly have opioids or drinking alcohol during pregnancy, brain
problems with overactive and impulsive injury and lack of oxygen at birth, as well as some
development. conditions such as epilepsy.
3. ADHD (combined presentation) is where
symptoms from the ADHD Unfortunately, as there is no one definitive clinical
hyperactive/impulsive and ADHD test for ADHD, diagnosis can be difficult. Many
inattentive combine, and is the most severe students have problems with self-control
form of the condition. periodically and it is difficult to know when this is
‘ordinary’ development or when it could be as a
Inattention result of ADHD.
 Difficulty following instructions or ADHD diagnosis requires
completing tasks
 Clinical and psychosocial assessment
 Short attention span and difficulty ‘sticking
 Developmental and psychiatric history
to’ an activity
 Observer reports
 Difficulty organising tasks and activities
It is likely that, as the student’s teacher, you may  Autism Spectrum Disorder/Asperger’s
be asked to provide information to enable the syndrome (social and communication
diagnosis to be made or progress to be monitored. difficulties)
The diagnosis of ADHD can be confirmed upon  Anxiety
meeting specific criteria (DSM V) and also the  Depression
ADHD symptoms must have been present before  Tourette’s Syndrome (the person has tics,
the age of 12 years, for the duration of at least 6 involuntary and uncontrollable movements
months, occurring in more than one place (for and sounds)
example both at home and school), not  Sleep problems
appropriate to the student’s developmental age
Teaching and managing students that have ADHD
and must be seriously disruptive to their
performance. One of the most important stages in teaching and
managing a student with ADHD is to try and
What problems can ADHD cause?
understand how they may see the world around
The impact of ADHD goes beyond ‘inappropriate them.
behaviour’ and problems at school. ADHD is a
How does a student with ADHD feel?
developmental condition that presents difficulties
for the student and those around them. A diagnosis Students who have ADHD explain that they get lots
of ADHD will often lead to students being labelled of different thoughts at the same time. It’s
as ‘difficult, demanding and defiant’ and confusing and they are always in trouble with
stigmatized to a greater or lesser extent. Students someone. They feel unpopular and know that
with ADHD stand out from their peers and can sometimes they are difficult to like. From the
struggle to ‘fit in’ at all stages of development and student’s point of view, nobody seems to
the impact of the condition and diagnosis can understand them.
extend to their families and careers.
This is how they feel
Students with severe ADHD can:
 You seem to get the blame for everything.
1. Have low self-esteem It’s miserable and unfair.
2. Underachieve at school  It’s hard making and keeping friends. At
3. Develop emotional and social problems school, other kids wind you up because you
4. Be at risk of school exclusion are different.
 Adults are always annoyed because you’ve
Students with ADHD often have other problems.
forgotten something or done something
Several other conditions can co-exist or overlap
silly. They spend ages telling you off and
with ADHD:
making you feel stupid.
 Oppositional Defiant Disorder (the student  If you had some type of physical disability
is often defiant, oppositional, that people could see, they’d understand,
argumentative, angry, loses temper etc.) but as they can’t see that your brain isn’t
 Conduct Disorder (there are problems such receiving a perfect signal, you don’t get any
as persistent and repetitive lying, stealing, sympathy at all.
truancy, bullying, vandalism, starting fires
ADHD is like a TV set that isn’t receiving a perfect
etc.)
signal. For the student, it’s as if the channel keeps
 Learning disorders
changing. Imagine you are watching the news on
 Developmental Co-ordination Disorder (co-
BBC1. Suddenly, somebody picks up the remote
ordination difficulties)
control and flicks over to ITV. A second later the
programme changes to Channel 4 and then back to
One approach that may help teachers
BBC1. Then it switches to BBC2.
The development of a student with ADHD can be
How do teachers feel?
frustrating and annoying; the key issue to accept is
A student with ADHD presents every teacher with a that the student is not doing it on purpose. ADHD is
challenge; but ADHD can also present an a genuine medical condition that requires specific
opportunity to find ways of teaching and managing support depending on severity of the symptoms.
the student successfully. Understanding and acceptance of ADHD together
with the desire to adapt teaching and learning
Of course, it can be frustrating when a student
strategies can enable many students with ADHD to
seems to be constantly fidgeting, jumping up from
learn more effectively.
their seat, interrupting and disrupting the whole
class. It’s natural for you to feel that one student is Since students with ADHD are often in trouble, they
in danger of holding all the others back. are unable to deal with criticism and can become
defiant and hostile. This can damage their whole
Fairness is not giving every student the same,
attitude to school and to learning, and they may
instead it is giving every student what they need.
ultimately give up on education. It’s very important
Students with ADHD will usually require a greater
to show that education has not given up on them.
level of need than their peers.
One technique that can help is to reframe the
The key is to find the correct balance.
condition by looking at the issues of ADHD as not
Adding to the frustration, to student with ADHD: so much a problem but as an opportunity. Here the
key principles are to look for the positives
 Is distractible and distracting to others
wherever possible.
 Presents work that is sloppy or incomplete
and homework that is late, lost or ignored Reframing ADHD
 May often rock on his/her chair
It’s not always easy or possible to review issues
 May often lose books and materials
that irritate us in a positive way but it may be
 May often show a recklessness and helpful to attempt to do so, for example:
impulsiveness that is ‘scary’
 May make inappropriate comments that  Think of the student who is easily distracted
cause conflict and offence with classmates as having high levels of awareness and
 Is often a victim of teasing and bullying, as observation
they are often perceived as strange or  Think of the restless student as being
quirky energetic and lively
 When the student with ADHD goes off at a
As a teacher, you are an expert at dealing with a
tangent, see it as a sign of individualism and
range of students and different types of learners
independence
and will have plenty of experience of managing
 If the student forgets things, consider that
challenging behaviour. You will probably find that
they’ve been absorbed in their own
the methods you already use with challenging
thoughts
students will benefit some students with ADHD,
 If the student starts interrupting, think of it
but you may want to consider additional solutions
it as enthusiasm to contribute
to manage specific cases.
 When work is sloppy, look for signs of effort
despite difficulties
  Look on a student’s apparent selfishness as
single-mindedness in pursuit of goals
Try to reward good development and ignore the
How do we help them organise their thoughts?
development that you don’t want Although some
teachers will find it difficult to see situations in this A major problem facing students with ADHD is that
way, this growth mindset approach may help to they have problems expressing their thoughts
maintain a positive relationship with students with verbally and on paper. They may also do things in
ADHD. the wrong order. Getting students with ADHD to
learn how to develop a sequence of events in the
The three key elements of teaching and managing
right order will bring about real improvements in
students with ADHD concern systems, strategies
their academic performance.
and solutions in aspects of:
One teacher talking about a student with ADHD
 LEARNING
said that
 BEHAVIOR
 SOCIALIZATION “He is like a computer without the printer attached.
He knows the answer in his head but he can’t give
Set the right tone:
me the hard copy by writing it down on paper.”
The way a teacher reacts to any student can
A fun way of doing this is to ask the student to
strongly affect the way other classmates behave
describe the sequence of events involved in various
towards them. Although you may be very
everyday activities; for example, you could ask
frustrated at times, it is best to try to show
them to explain step by step, how to clean their
patience and tolerance. There's a greater chance
teeth, run a bath or play a computer game. You
that the whole class will follow your example,
could also ask them to describe things in 30
making the student with ADHD feel less isolated.
seconds – like a day at school, their home or their
How can we improve their skills? favorite video.

With a differentiated approach to teaching and Getting students organized

learning, you can help the student with ADHD who
Developing a sequence of events is important so
may be having difficulty with basic academic skills.
students can learn how to get organized. They
The important thing is to help them organise their
need to understand that things are meant to
thoughts and to be aware of what is expected of
happen in a certain order. Always begin with a
them.
simple overview of what you want them to achieve.
In order to do this the two key attributes are: Then create a framework with simple steps so that
the student knows what is meant to happen next.
 Structure
For some students it helps them to say out loud
 Flexibility
what they are about to do next.
Developing structure
Supporting memory weaknesses
Students with ADHD feel safe and secure if they
 Encourage your student to connect
know what to expect. With regular routines and
information or concepts being presented;
rituals, they become more familiar with what they
for example, they’re more likely to
need to do. The more you can keep to routines and
remember that someone who had six wives
rituals, the better. Any change simply creates
and was a famous English King and is called
distraction, uncertainty and confusion.
 Henry is a Horrid Henry, as in the book Keeping them focused
series when they think of them
As students with ADHD get bored easily, it is
 Mnemonics can also be useful for
important to try and keep your educational content
remembering important facts
stimulating and varied. Also try to change your
 Repeat directions individually
tone of voice and your pace of teaching
 Use visual maps
presentations.
 Color code their homework diary
 Use flash cards
Useful classroom strategies Students with ADHD tend to respond better to
concrete learning experiences. They often have
There are a number of strategies that you can do in high levels of creativity and welcome the chance to
the classroom to help improve the performance of learn independently.
students with ADHD. Obviously, how much you can
do, will be restricted by the resources at your Encourage them to tell you if they do not
disposal, the size and nature of the classroom, the understand what they are meant to be doing. The
demands of the curriculum and the rest of the key is to reinforce the instructions as many times as
class, and the age of your students. possible and to remain positive at all times.

Giving previews Are there typical classroom problems?

It is worth trying to give students with ADHD a There are a number of typical problems facing the
preview of what is going to happen in tasks, teachers of students with ADHD. Here are some
projects and lessons. This will prepare them in techniques for dealing with them.
advance of what will be expected of them and Walking around the classroom
prevent them from a feeling of uncertainty and
insecurity.  Instead of trying to get students with
excessive motor activity to remain still, find
Where should we seat them? them opportunities for regular seat breaks
Students with ADHD tend to get over- stimulated  If something needs to be written on the
when working in group situations. Try the whiteboard, ask them to do it
following:  Give them a job or task that allows them to
be active in a controlled way during the
 Pair them with less distractible students lesson
who are likely to follow the teacher’s
instructions Dealing with impulsiveness
 Seat them near the front of the classroom As students with ADHD tend to act first and think
away from doors, windows and other afterwards, they may need help in processing their
distractions or in an area of the room which thoughts before responding.
may be more suitable
 It is often better to have them either sit at a Encouraging attention
single desk or at most a paired desk within
 Provide students with a brief outline of the
the main classroom
lesson at the beginning
 There should also be another area or
 During the lesson, try to include a variety of
workstation set up facing the wall and away
activities
from the main classroom area where they
 Break everything into short chunks
can learn as needed
  In some cases it can help to have non-vocal  For daily routines, stick a timetable to their
music playing either in the background or desk
through a headset device  When they are working on projects, draw
 Reduce expectations of written work and up a checklist to ensure every point is
use alternative ways of recording covered
information  To avoid confusion, don’t give them more
 Review design of worksheets and tests than one assignment at a time
 Present only one or two activities per page  Overall, concentrate on teaching them not
 Avoid unnecessary pictures or visual stimuli what to learn, but how to learn it
 Give prompts
 Provide alternative environments for tests
and exams Helping students to settle
 If attention seems to be waning, use special
It takes time for students with ADHD to settle in
cue phrases to stimulate interest.
different places. It can be difficult for them to wind
 Attention grabbers include “Right, here we
down, especially after break time. Going from the
go”; “Wait for it”; “Now for the interesting
relative calm of the classroom to the playground
bit”; “The next clip is amazing”; “We’re
and back again can be quite difficult for students
nearly there now”
with ADHD to manage.
This means learning to do things in three stages:
After a break, they may need to settle down for a
1. Stop and listen few minutes before focusing on specific tasks. In
some cases, it is a good idea to ask them to come
2. Look and think
back 2 minutes before the end of break to help
3. Decide and do settle them before the next class. Changes to daily
routines are also unsettling. If there is going to be a
Calling out in class
change, explain what’s going to happen in advance.
Calling out and making inappropriate comments
Dealing with fidgeting
are common signs of impulsiveness. You may need
to remind the whole class that doing this is It’s hard to stop students with ADHD fiddling and
unacceptable. If the student with ADHD continues fidgeting but it is helpful to be proactive rather
to call out, don’t address the student personally. than reactive to this. It is a good idea to give them
Instead address the problem in general terms. You something to fiddle with, such as spinners*,
might say: “It makes things very difficult when squeezable balls, tangle toys or small building
people call out and interrupt me when I am blocks.
talking”. If you are running a reward scheme,
*If allowed in your school.
establish a private signal in advance with the
student so that they know that this sort of It takes a student with ADHD about three times as
development will not win points. The signal could long to do the same assignment in the home
be something like visually tapping the reward card environment in comparison with the school setting.
or some other pre-agreed sign.
With this in mind it is recommended that the
Encouraging better organization following options should be considered for
students with ADHD regarding homework:
Students with ADHD typically have problems
organizing themselves and so they really need help 1. Can homework be reduced or differentiated
with study skills: to that which is essential. Is the homework
 really necessary and if so can the amount or what they know. As a result they need lots of praise
style be adapted for the student with and encouragement. Once they feel you
ADHD. Perhaps more one word answers understand their difficulties, they’ll be more likely
than essays or multiple choice answers for to work with you rather than against you.
maths.
Getting the message over loud and clear.
2. Can bonus points be provided for doing
more? In some cases it will be necessary to You will often need to address students with ADHD
have extended assignments and in this case in the clearest possible way. Here are some
can the school provide extra incentives for a examples:
student with ADHD to complete the task as
 Always address the student by name
this arrangement can help to provide
 Keep all instructions short and simple e.g.,
additional focus to task.
“Pick up your books please”
3. Could there be ways of reducing writing
 Try to make eye contact wherever possible
requirements to that which is essential by
using information technology? Writing  Speak clearly and concisely, and maintain an
tends to be a difficult skill for many students even tone
with ADHD. Providing another option for  Don’t ask why, say (for example) what
getting thoughts on to paper will be should you be doing now?
necessary. Encourage the use of technology  Also use when, then and either or; for
to assist the homework process. example, “Nathan when you have put the
4. Can students stay at school to finish book away then you can have a drink, when
homework or complete it during the day? It you have put the chair under the table then
may be more productive to have the you can go”
student complete homework tasks at school  Then give your instructions in a simple step-
where there will be more structure and by-step way, pausing between each step and
fewer distractions. perhaps giving them the chance to do each
5. Can parents be allowed to be a ‘parent activity
secretary’ for students with handwriting Tell them when they are good
difficulties? In some cases technology will
not be appropriate and so if writing is a Praise improves concentration skills in students
problem then look to use the parent to with ADHD. When they do something well, tell
write down the thoughts of the student, but them how pleased you are that they’ve done it.
obviously not to do the work for them. Praise in specific terms rather than generally e.g.,
“That was a really interesting story with an exciting
BEHAVIOUR ending” rather than “well done”. If they have
ADHD as an explanation not an excuse behaved well during a lesson, say so but be precise
about what they did when and where. Always
The emphasis should be firmly placed on remember to praise effort rather than ability.
recognizing where problems exist and finding ways
to solve them. The approach should be solution Setting up a reward scheme
focused and on missed opportunities for effective Rewards change behaviour and students with
learning and development. ADHD respond very well to incentives tied to short-
How can we get better development? term targets.

Students with ADHD do not have a problem with  Agree certain achievable targets such as
knowing what to do but rather a problem in doing sitting still for 10 minutes
  Negotiate rewards with the student and vary what they shouldn’t; e.g., instead of saying
them regularly to keep up the interest “Liam, can you stop talking and bothering
 Make sure the rewards are age appropriate Sadie?” say “Liam, please listen to me and
finish the writing in your book.”
Try to catch them being good and take every
 When you impose sanctions, it’s helpful to
chance to help the student recognize their
remind the student that poor development
achievement. Reward schemes could be used by
will have a consequence; remember it is
any member of staff who works with the student.
never the severity, but the certainty, if you
But remember it’s not just the reward that matters,
say it you must follow through
it is often.
 Sometimes dig for empathy; for example, if
Building on Success the student has knocked a pot of paint over
a classmate, you could say: “I’m so upset/
Usually there is something that students with
disappointed that this paint has gone all over
ADHD do well. They may be good at painting,
Emma and caused such a mess on the floor.”
singing, swimming or computer games. Make your
student feel he/she has a real talent. Create a Remind students in specific terms
feeling of success and it will boost confidence.
Students with ADHD may simply not be doing what
Nothing succeeds like success
you’ve asked because they have forgotten the
Dealing with challenging development specific task. Instead of telling them in broad terms
to get on with their work, remind them of the
Although you need some degree of flexibility in
actual specific task.
dealing with students with ADHD you will often still
need to address challenging development. Dealing with outbursts
However annoying they have been, it is important
Students with ADHD can have explosive outbursts.
to make sure the student feels that it is his/her
When things go wrong they may feel very
poor behaviour that you do not appreciate and not
frustrated and take it out on those around them.
the student personally, as students with ADHD may
When the rage subsides they feel even more
be hypersensitive in these situations.
frustrated with themselves. Be calm, try not to
Rules and responsibilities show any emotion and show the student that you
are in charge of the situation.
Many students with ADHD do not actually
understand what is expected of them in terms of Time out or take a break
behaviour. So it may be helpful to sit down with
There will be occasions when the student is so
the student to explain the issues specifically. Draw
unruly and awkward that they need to have time
up a list of specific rules and responsibilities to
away from other students. The idea of taking time
address particular problems.
out or taking a break is to have a stimuli-free place,
Be crystal clear on what is and what is not perhaps a quiet corner in the classroom where the
acceptable. student goes for a short period of time. This should
not exceed a time span which is more in minutes
What about discipline?
than the age of the student; e.g., if the student is 5
Students with ADHD often feel that they are being years old 5 minutes should suffice. This place could
picked on. be called the ‘thinking space’ or ‘the time away
corner’. This technique can also be used with older
 With discipline be specific. It’s best to tell
students to create some head space.
them what they should be doing rather than
Allow no conversation or involvement while the 6. Know that your job is to set boundaries and
student is there. When the time is up, move on that discipline means being prepared to make
with the lesson and do not refer to the recent unpopular decisions.
issue. The slate is clean. It’s important that you 7. Use assertiveness as opposed to
welcome the student back into the class with aggressiveness but eliminate sarcasm and
warmth and carry on as usual. You could also other forms of put downs.
suggest the student goes to the ‘thinking space’ if 8. Don’t ask “Why?” ask “What?”; “What should
they feel they need to. you be doing now?” and use either/or and
when/then “Lewis either put the phone in
OPPOSITIONAL DEFIANT DISORDER
your bag or on my desk”; “Sheena when you
Oppositional Defiant Disorder is term given to have put the chair back under the table then
describe when a student displays a certain pattern you can go”.
of behaviours that includes losing their temper 9. If it’s not working in class get to know them
frequently, defying adults, being easily annoyed better. “Everybody has a price” and
and deliberately annoying others. “everybody listens to someone” find out what
motivates them and who has influence with
The key elements displayed by students with ODD
them.
include the following:
10. It’s not behavior management, its mood
 Argues with adults management – their mood, your mood and
 Refuses and defies the mood of others. Analyze your own mood
 Angry and defensive and don’t take it personally.
 Spiteful and vindictive SOCIALIZATION
Tips for behaviour How should we approach ADHD?
Students with ODD are often very challenging A diagnosis of ADHD can be an opportunity for
individuals – here are some key tips to help you: teachers, students and parents to start again and
1. Have clear expectations of academic and build a better relationship. As with all good
development targets and agreed rewards and relationships, the keys are to understand the needs
consequences. of others and to recognize the problems that they
2. Make sure they are clear that they are face.
responsible for their actions no matter “that When people understand that ADHD is not an
she started it”, “I’m tired” etc. excuse but an explanation of why the student
3. Be consistent in your approach and handle behaves in a different way, this provides an
disruptions with a response that includes no opportunity to develop new methods for improved
emotion and not too much talking. Consider learning and development. This co-operative effort
non aggressive body language and offer the between all teachers, parents and all concerned
student an escape hatch to calm down. with the welfare of the student will be of great
4. Catch them doing it right. Praise to correction benefit, when old attitudes of ‘them and ‘us’
of behavior in a 4:1 ratio. become ‘we’.
5. Sometimes look for a draw. Let very defiant
students save face by providing them with
two options where either one is ok with you. How do we deal with difficulties with peers during
and outside the classroom?
Students with ADHD are easy to distract and often  Educational interventions and support at
overreact to teasing and bullying. Try to help them school
not to respond to teasing and make sure that other  Psychological treatment to help your student
students are aware that they may be more cope with his/her feelings and development
sensitive to this type of development than other  Social skills training – teaching people to be
students in the class. It may help to structure break more socially aware in their relationships with
time and lunch by having inside activities and clubs other people
that students with ADHD may attend across the age  Medication is also available to treat ADHD
range. Rituals for learning and praising students
NICE (National Institute for Health and Clinical
with ADHD frequently in class may help raise their
Excellence) is the independent organization
general levels of self-esteem and make them less
responsible for providing national guidance on the
vulnerable. If possible set them up with a ‘buddy’
promotion of good health and the prevention and
or peer mentor, ideally from an older class, who
treatment of ill health. They have produced
can help to support them especially during breaks
national guidelines which recommend medication
and lunchtimes. Try to involve them proactively in
to be used in severe ADHD or moderate ADHD
games and activities with close supervision and
where developmental or other approaches have
support from conflict.
not proved effective.
Building bridges with the student and parents
Medication may be a valuable addition to help
Having ADHD is not about “shame or blame” but students concentrate, learn and behave more
that there is a medical reason for the student’s effectively. Most students with ADHD respond well
performance and development. No one is at fault, to medication but it should only be used as part of
neither the student nor parents. As a result: a wide range of psychological, educational and
developmental therapies. A child and adolescent
 Try to assure both parents and student that
psychiatrist or pediatrician can assess if medication
you have an understanding of the issues of
is appropriate. Dietary fatty acids supplements are
ADHD
not recommended for the treatment of ADHD.
 Inform all colleagues, support staff and lunch
assistants of the student’s difficulties so that Medication is not recommended for pre-school
everyone can prepare and adopt a consistent children.
approach; this is an opportunity to have a
Developmental Parent
fresh start and for everyone to be proactive
rather than reactive Training is recommended for parents of students
 Try talking regularly with the parents and the with symptoms of ADHD or Hyperkinetic Disorder.
student, to let them feel you are concerned
What kinds of medication are available to treat
about how they are feeling and coping.
ADHD?
How is ADHD treated?
There are two types of medications – stimulant and
Management of students with ADHD may involve non-stimulant – that are recommended as options
the following: for the treatment of ADHD. The dose of medication
will be tailored to the student’s needs and may
 Parent training/education program
change as they get older, depending on their
– a structured training program with
response and any side effects.
developmental strategies to improve
parenting skills in order to manage Why is taking medication important?
your student’s challenging behavior
To ensure that your student receives the full Health and safety
benefit of their medication, it is important that it is
Some students may have to take medication at
taken as prescribed. Some medications are taken
school – this could mean a supply is kept at school.
before school and their effects last for the whole
ADHD medications (those that are stimulants) are
school day. Other medications last for a shorter
controlled drugs so they must be kept in a locked
amount of time and will have to be taken during
container and, like all medications, they must be
the school day.
kept out of reach and sight of children.
It is important to address any issues around taking
Tips for socialization and friendship
medication at school to ensure that they do not
miss a dose for any reason. The student’s doctor or Students with ADHD often find it difficult to make
parents will explain the dosing regimen and and keep friendships. This can be more of a
appreciate your cooperation in ensuring your concern to teachers and parents than even
student takes the medication. academic issues.
Why is monitoring important? Social skills can be difficult for students with ADHD
who cannot always wait to take their turn, blurt out
It is important that student progress is monitored
inappropriate comments and may be overtly
when they start treatment for their ADHD. The
antagonistic and even aggressive. The following
student’s doctor will want to monitor not only their
ideas may help to improve friendships and peer
development and learning and whether their
relations in schools:
treatment is working, but also whether they are
experiencing any side effects if they are taking 1. Unstructured break time/lunch times can be
medication. tricky parts of day unless careful thought is
given to the amount of free time and groups
The student’s parents may give you a monitoring
that students with ADHD have access to. It is a
booklet and ask you to complete it at school. It’s
good idea to create options for inside
very straightforward. The HCP will need to see this,
activities and clubs.
so that treatment can be adjusted if necessary. Any
2. Assign a student with ADHD a study buddy
medication that is recommended by your student’s
and/or peer mentor. Students with ADHD who
HCP has the potential to cause side effects. These
have difficulties with study skills and
can be different in each student. It is important
socialization should be assigned another
that your student’s HCP is aware of any changes
student who could act as an “auxiliary
that occur, once they start taking their medication.
organizer” in the classroom and advocate in
So please try to keep a record of anything you
the playground. The peer mentor could be
notice at school.
rotated on weekly basis.
What is length of treatment? 3. Educate the other students about differences
in learning styles such as ADHD. All students
If treatment improves your student’s development,
should receive information regarding issues
it may be continued for several years as long as it is
such as ASD and ADHD and how they affect
effective, but this can vary as every student is
people as part of PHSE classes. ‘Circle Time’ is
different.
also an opportunity to discuss these issues.
It is recommended for the student’s doctor to 4. Have specific support and plans for situations
review at least annually the clinical need, benefits such as field trips and sports, planning for
and side effects of medication, views of the these in advance will prevent situations
student, parent and teacher and the need for other occurring in terms of proactive supervision,
developmental and psychological therapies. groupings and activities.
 5. Plan groups carefully. Students with ADHD can International Classification of Diseases (ICD 10) and
often do well in 1-to-1 situations so often a the NICE guidelines on ADHD.
group of two is the best arrangement. The
How does it work?
other common issue is that students with
ADHD often appear to socialize more As a teacher you may wish to complete this
effectively with older and younger students questionnaire if you have identified a child in your
rather than their peers. class who is struggling in the classroom or with
6. Teach social skills. The issues of helping his/her peers or for whom your normal teaching
students recognize the need for impulse strategies do not appear to be working.
control and to listen more effectively does
What happens next?
take time but this will pay long term dividends
in the end in terms of helping to forge If a child scores a high level of A and Bs, it does not
successful friendships. mean they have ADHD, as this is a screening guide
not a diagnosis tool. CAST can be seen as the first
CAST TOOL
stage of the referral mechanism for the school
Child ADHD Screening Tool SENCO to organise a full diagnostic assessment if
needed. The classroom teacher may also wish to
What is it?
implement some key strategies for proactive
CAST is a guide to aid teachers in identifying management of children with ADHD symptoms to
specific children who may be struggling in the see if they help.
classroom and/or socially with other children. It is
Child ADHD Screening Tool Scoring:
not a definitive diagnostic tool but the first stage in
determining the level of need of specific students  If a child scores twelve or more out of A
who may be having difficulties due to Inattention, and/or B then further assessment should be
Hyperactivity and/or Impulsivity, which are the undertaken
core symptoms of ADHD (Attention Deficit  If a child scores between six and eleven out of
Hyperactivity Disorder). A and/or B then further assessment should be
strongly considered
Who is it by?
 If a child scores less than six then further
It has been developed by Fintan O’Regan, SEN assessment may not be needed
Advisor for Surrey, Dr Somnath Banerjee, Associate
Specialist in Community Paediatrics and a multi-
disciplinary group of specialists working in the area
of ADHD, including an Educational Psychologist, a
SENCO, an ADHD Specialist Nurse, and a Mental
Health Practitioner. The project was initiated and
funded by Shire Pharmaceuticals as part of an
educational, awareness program in Primary schools
on ADHD.
The characteristics of ADHD included in CAST
highlight a number of issues that certain children
may have in school. They have been adapted from
the Diagnostic and Statistical Manual of Mental
Disorders, published by the American Psychiatric
Association, the World Health Organisation
BEHAVIOUR: Socialisation:
Monitoring your student’s development at school 10 suggestions for SENCos and Teachers to pass on
to parents/carers in home management of children
This monitoring booklet can help your student’s
with ADHD
progress. Their doctor needs to know what effect
the medication is having on your student’s 1. Be firm and establish clear ground rules,
development and whether there are any side- rituals and routines for meals, homework,
effects. Computer/TV/Phone and getting up and going
to bed.
Please monitor your student’s progress once a
2. Accept absent mindedness which will often
week over the next few weeks, preferably on the
happen with children with ADHD. They will
same day every week. This booklet will play an
need numerous prompts and reminders to
important role in informing their doctor about their
complete tasks and follow instructions.
well being at their next check up.
Develop visual aids, post it notes and or charts
Each monitoring chart covers a week and different to reinforce the spoken word.
aspects of your student’s behaviour. It also includes 3. Support and encourage organisational
possible side-effects. If you have any concerns, weaknesses in terms of putting away clothes,
please let their parents know as soon as possible. shoes, sports equipment and materials for
school.
Looking at your student over the week, please
4. Use simple language and short instructions.
assess each statement on the chart and how well it
Children with ADHD find it difficult to process
relates to them during the last week. Then score
multiple requests quickly and accurately so
the statements from 0 (Not at all) to 3 (All the time)
keep to clear one concept commands. Maybe
by ticking the appropriate box for that statement. If
ask the child to repeat what you have said and
you notice anything else, please write it down in
speak at a slower rate if this is still not
the box at the bottom of the chart.
working.
5. Be patient and try not to sound irritated or helping with questions however conceptual
frustrated when children are finding it difficult support often leads to strained relationships.
to relate to an event in a proper sequence.
CHILDREN WITH EMOTIONAL AND BEHAVIORAL
You may need to ask who, what, where and
DISORDERS
when questions to reinforce specific issues.
6. Try to teach turn taking as children with ADHD CLASSIFICATION from IDEA:
find it difficult to wait their turn in terms of a
Four distinct categories:
conversation or an activity. Using something
to distract them by maybe using a tangle or 1. Conduct disorders.
another suitable manipulative may initially
Conduct disorders involve such characteristics as
help in this process.
overt aggression, both verbal and physical;
7. Establish good behavior in public and do not
disruptiveness; negativism; irresponsibility; and
wait until you get home to deal with
defiance of authority -- all of which are at variance
inappropriate behavior. Act as quickly and
with the behavioral expectations of the school and
firmly as possible, otherwise the child with
other social institutions.
ADHD will not be able to relate to the incident
after the lapse of time. 2. Anxiety-Withdrawal.
8. Talk to siblings about how ADHD may affect
Anxiety-withdrawal contrasts sharply with conduct
their sister or brother and why as a parent
disorders. It involves over anxiety, social
you may have to sometimes do something
withdrawal, seclusiveness, shyness, sensitivity, and
different. Try to explain to them why fairness
other behaviors that imply a retreat from the
is not giving everybody the same but its giving
environment rather than a hostile response to it.
everybody what they need.
9. Find a club or an activity that suits your 3. Immaturity.
children’s strengths and interests. Children
Immaturity characteristically involves
with ADHD can often find group activities
preoccupation, short attention span, passivity,
difficult to master and supervisors may not
daydreaming, sluggishness, and other behaviors
always have the appropriate management
not consistent with developmental expectations.
skills. It may take a while to find the right club
or activity for your child but don’t give up. 4. Socialized Aggression.
Also children with ADHD often get on better in
Socialized aggression typically involves gang
terms of socialisation with younger and older
activities, cooperative stealing, truancy, and other
children so perhaps find an activity across the
manifestations of participation in a delinquent
age range.
subculture.
10. Be a Mum or a Dad rather than a teacher
especially when it comes to trying to tutor or CAUSES
teach your child with regards to schoolwork
The causes for emotional and behavioral disorders
and/or homework. In most cases this may
are not always clear, but several researchers have
cause conflict between both sides and if there
found a few possible causes.
are problems with completion of tasks contact
your child’s tutor at school. This does not 1. Biological factors:
mean that parents cannot provide  Genetics
“secretarial” support in reading out difficult  Abnormalities in the neurological and
text and listening to developing readers and biochemical development of the child
 Injuries to the central nervous system
2. Psychoanalytical factors may develop into vandalism, malicious mischief,
 Traumatic childhood experiences truancy, drug and alcohol use, and various forms of
3. Behavioral factors violence, from school bullying to robbery, assault,
 Lack of adaptive behaviors and rape.
 Exposure to maladaptive behaviors
B. Emotional Disturbances:
 Exposure to poor environmental stresses
that lead to maladaptive behaviors Emotional disturbances that manifest themselves
4. Phenomenological in violence and similar extreme behavior occur less
 Improper use of defensemechanisms frequently than those with a more complex and
 Failure to learn about oneself subtle effect. And some disorders, such as eating
5. Sociological/Ecological disorders and substance abuse, are deliberately—
 Destructive family life and often successfully—hidden by the child. Some
 Poor living conditions children develop a negative or maladaptive pattern
 Rejection by peers of behavior and interaction that becomes deeply
 Expectations of the child that cause a lot of entrenched and seems to be part of their
stress on the child personality.
 Labeling of the child  Severe Depression is a disorder that was once
 Culture believed to be only experienced by adults, but
TYPES ACCORDING TO THE Diagnostic & statistical now studies show that 2 out of every 100
children have been experiencing this disorder
Manual of Mental Disorders (DSM) - also. Severe depression is marked by:
A. Conduct Disorder  Severe lost of interest in friends
 and activities
― a destructive pattern of antisocial behavior that  Very low self-esteem
violates the rights of others.4 out of every 100  Lack of any type of motivation
children with age ranging from 9-17 have this  Changes in sleeping and eating
disorder.  patterns
Signs that a child may have this disorder are:  Increased amount of sadness
 Thought of suicide
 Aggressiveness with peers, teachers, pets,  Bipolar Disorder is a disorder that affects the
and strangers child’s mood. Bipolar disorder is recognized by:
 No regard for rules  Mood swings that range from
 Repeated destruction of others’ property extremely high to extremely low
 Constant criminal activity  High moods will be marked by
hyperactivity, little sleep, and careless
The diagnosis of conduct disorder is based on
judgement
antisocial behavior, and it says little about the
 Low moods will be marked by
child’s inner life, motives, and disabilities. The
depression
disorder is classified by type: aggressive versus
 Eating Disorders affect the way a child views
non-aggressive, and overt (with violence or
their body and how they consume food. Girls
tantrums) versus covert (with lying, stealing,
are more likely to have eating disorders, but
and/or drug use).
boys have been diagnosed with them also.
Early symptoms include stealing, running away
There are different types of eating disorders and
from home, habitual lying, cruelty to animals, and
they are:
fire setting. As the child grows older, the pattern
  Aneroxia Nervosa- where the child has  Inability to think logically in situations
a fear of weight gain therefore they  Irregular emotional responses to situations
starve their bodies of food and  No emotion
nutrients that the body needs.  Hyperactive emotions
 Bulimia Nervosa- where the child will  Paranoia
consume food very quickly then vomit
or take laxatives to rid their body of D. Anxiety Disorders
the food in order not to gain any
Anxiety disorders are a prevalent form of
weight.
emotional difficulty, sharing with depression the
 Binge Eating- where the child will
dubious honor of most pervasive emotional
consume an excessive amount of food
disorder. Children with anxiety may be fearful,
at one time. They will not vomit, but
nervous, shy, and preoccupied, and they often
they will repeatedly put themselves on
strive to avoid the source of the anxiety—if there is
a strict, unhealthy diet afterwards.
a specific source.
C. Personality Disorders Anxiety disorders include generalized anxiety
disorder, phobias, panic disorder, obsessive-
The DSM defines a personality disorder as ―an
compulsive disorder, and posttraumatic stress
enduring pattern of inner experience and behavior
disorder. Separation anxiety disorder specifically
that deviates markedly from the expectations of
affects children and adolescents and can make
the individual’s culture, is pervasive and inflexible,
separation from home and loved ones extremely
has an onset in adolescence or early adulthood, is
distressing.
stable over time, and leads to distress or
impairment. The following descriptions of a few Anxiety Disorders: The most common childhood
categories of personality disorder illustrate these disorder with 13 out of every 100 children, whose
maladaptive patterns: age range is from 9-17 years old , having at least
one of the different types of anxiety disorders.
 Schizotypal personality disorder: ―a pattern
Some common symptoms are:
of acute discomfort in close relationships,
cognitive or perceptual distortions, and  excessive fear
eccentricities of behavior.  excessive worrying about incidents that
 Borderline personality disorder: ―a pattern of they have never experienced
instability in interpersonal relationships, self-  unnecessary repeated behaviors and
image, and affects, and marked impulsivity. thought patterns
 Dependent personality disorder: ―a pattern  sudden rapid heartbeats and dizziness
of submissive and clinging behavior related to  repeated flashbacks of traumatizing events
an excessive need to be taken care of. that have occurred in the child’s life such as
a car accident, sexual assault, or any other
Schizophrenia is a disorder that affects the child’s
type of violence
mental ability to differentiate between what is real
or unreal. This disorder develops slowly through a Anxiety Disorders:
child’s life till their adult years. 5 out of every 1,000
A phobia (from the Greek: φόβος, Phóbos, meaning
children develop this disorder. The symptoms are:
"fear" or "morbid fear") is, when used in the
 Inability to separate real experiences from context of clinical psychology, a type of anxiety
unreal experiences disorder, usually defined as a persistent fear of an
 Hallucinations object or situation in which the sufferer commits to
great lengths in avoiding, typically disproportional opening and closing a door a certain number of
to the actual danger posed, often being recognized times before entering or leaving a room.
as irrational. In the event the phobia cannot be
Posttraumatic stress disorder (PTSD) is a severe
avoided entirely, the sufferer will endure the
condition that may develop after a person is
situation or object with marked distress and
exposed to one or more traumatic events, such as
significant interference in social or occupational
sexual assault, serious injury or the threat of death.
activities.
The diagnosis may be given when a group of
10 Common Phobias symptoms such as disturbing recurring flashbacks,
avoidance or numbing of memories of the event,
1. Arachnophobia: spiders
and hyperarousal (high levels of anxiety) continue
2. Ophidiophobia: snakes
for more than a month after the traumatic event.
3. Acrophobia: heights
4. Acrophobia: difficult situations Separation anxiety disorder (SAD) is a
5. Cynophobia: dogs psychological condition in which an individual
6. Astraphobia: thunder & lightning experiences excessive anxiety regarding separation
7. Trypanophobia: injections from home or from people to whom the individual
8. Social Phobias: social situations has a strong emotional attachment (e.g. a parent,
9. Pteromerhanophobia: flying grandparents, or siblings).
10. Mysophobia: germs or dirt
According to the American Psychology Association,
Panic disorder is an anxiety disorder characterized separation anxiety disorder is the inappropriate
by recurring severe panic attacks. It may also and excessive display of fear and distress when
include significant behavioral changes lasting at faced with situations of separation from the home
least a month and of ongoing worry about the or from a specific attachment figure. The anxiety
implications or concern about having other attacks. that is expressed is categorized as being atypical of
The latter are called anticipatory attacks (DSM- the expected developmental level and age. The
IVR). Panic disorder is not the same as agoraphobia severity of the symptoms ranges from anticipatory
(fear of public places), although many afflicted with uneasiness to full-blown anxiety about separation.
panic disorder also suffer from agoraphobia. Panic
E. ADHD
attacks cannot be predicted, therefore an
individual may become stressed, anxious or Doubtless, the most prevalent behavioral disorder
worried wondering when the next panic attack will in schools today is attention- deficit/hyperactivity
occur. disorder (ADHD), sometimes referred to as
attention deficit disorder (ADD).
Obsessive–compulsive disorder (OCD) is an anxiety
disorder characterized by intrusive thoughts that According to the U.S. Department of Education
produce uneasiness, apprehension, fear, or worry; (2000), approximately 3 to 5 percent of the school-
by repetitive behaviors aimed at reducing the aged population have ADHD.
associated anxiety; or by a combination of such
The essential feature of Attention-
obsessions and compulsions. Symptoms of the
Deficit/Hyperactivity Disorder is a persistent
disorder include excessive washing or cleaning;
pattern of inattention and/or hyperactivity-
repeated checking; extreme hoarding;
impulsivity that is more frequent and severe than is
preoccupation with sexual, violent or religious
typically observed in individuals at a comparable
thoughts;relationship-related obsessions; aversion
level of development.
to particular numbers; and nervous rituals, such as
ADHD can include nine specific symptoms of Three Factors to Determine BDs
inattention and nine symptoms of
1. Intensity
hyperactivity/impulsivity.
2. Pattern
Individuals with ADHD may know what to do, but 3. Duration
do not consistently do what they know because of
Serious Emotional Disturbance
their inability to efficiently stop and think prior to
responding, regardless of the setting or task. Condition exhibiting one or more of the following
characteristics over a period of time (chronicity)
The DSM describes four subtypes of ADHD:
and to a marked degree (severity) which adversely
inattentive, hyperactive/impulsive, combined
affects educational performance
(showing both inattention and hyperactivity), and
“not otherwise specified.” - Having schizophrenia but not the socially
maladjusted
Attention- deficit/Hyperactivity
Emotional and Behavioral Disorders
Disorder is a disorder that affects the way a child is
able to focus. Usually identified when child is 1. Characterized by emotional or behavioral
displaying the following symptoms at home or responses which are inappropriate in terms
school. Apparent symptoms are: of age, culture and others
2. Coexist with others disabilities
 Inability to focus
3. Include children with schizophrenia
 Inability to follow directions
 Inability to sit still Other Factors
 Inability to remain quiet
1. Rate
 Inability to cooperate with others
2. Latency
STUDENTS WITH EMOTIONAL AND BEHAVIORAL
PHYSICAL DISABILITIES, HEALTH IMPAIRMENTS, &
DISORDER (PPT)
ADHD
 Adaptive vs Maladaptive Behavior
Children with physical disabilities and health
 Abnormal vs Maladaptive Behavior
conditions who require special education are
Patterns of Personality Development served under two of the IDEA disability categories:
orthopedic impairments (and neuromotor
1. Dependence to Self Direction
impairments)and other health impairments.
2. Pleasure to Reality and Self Control
3. Ignorance to Knowledge DISABILITY CATEGORIES:
4. Incompetence to Competence
Health Impairment: “A chronic or acute health
5. Diffuse to Articulated Self-Direction
problem such that the physiological capacity to
6. Amoral to Moral
function is significantly limited or impaired and
Definition of E and B D results in one or more of the following: limited
strength, vitality or alertness including a
1. Social Construct
heightened alertness to environmental stimuli
2. No clear meaning of terms
resulting in limited alertness with respect to the
3. Difficulty in Measurement
educational environment. The term shall include
4. Cultural Influence
health impairments due to asthma, attention
5. Frequency and intensity is difficult to
deficit disorder or attention deficit with
measure
hyperactivity disorder, diabetes, epilepsy, a heart
6. BDs occur in conjunction with MR and LDs.
condition, hemophilia, lead poisoning, leukemia, Hundreds of physical impairments and health
nephritis, rheumatic fever, sickle cell anemia, and conditions can adversely affect children’s education
Tourette syndrome, if such health impairment performance. A few include: cerebral palsy, spina
adversely affects a student's educational bifida, muscular dystrophy, spinal cord injuries,
performance”. (MA DOE) epilepsyand diabetes.
Physical Impairment:“The physical capacity to PHYSICAL IMPAIRMENT CAUSES
move, coordinate actions, or perform physical
Cerebral palsy: Permanent condition resulting from
activities is significantly limited, impaired, or
a lesion to the brain or an abnormality of brain
delayed and is exhibited by difficulties in one or
growth. Many diseases can affect the developing
more of the following areas: physical and motor
brain and lead to cerebral palsy. Also attributed to
tasks; independent movement; performing basic
the occurrence of injuries, accidents or illnesses
life functions. The term shall include severe
that are before birth, at or near the time of birth or
orthopedic impairments or impairments caused by
soon after birth and result in decreased oxygen to
congenital anomaly, cerebral palsy, amputations,
low-birth-weight newborn.
and fractures if such impairment adversely affects a
student's educational performance”. (MA DOE) Spina bifida: Congenital malformation of the spine
in which the vertebrae that normally protect the
IMPAIRMENT DEFINITIONS:
spine do not develop fully
*Orthopedic Impairment: Impairment of the
Muscular dystrophy: Refers to a group of 40
skeletal system- bones, joints, limbs, and
inherited diseases marked by progressive atrophy
associated muscles.
(wasting away) of the body’s muscles.
*Neuromotor Impairment: Involves the central
Spinal cord injuries: Result of a lesion to the spinal
nervous system, affecting the ability to move, use,
cord caused by a penetrating injury, stretching the
feel, or control certain parts of the body.
vertebral column, fracture of the vertebrae or
*Other Health Impairments: A disability category compression of the spinal cord. The most common
in the IDEA Act under which a child is eligible for causes include: motor vehicle accidents, acts of
special education; includes diseases and special violence, falls and sports.
health conditions that affect a child’s educational
HEALTH IMPAIRMENT CAUSES
activities and performance such as cancer, diabetes
and cystic fibrosis. (ADHD is also included in this Epilepsy: The cause of epilepsy for approximately
category). 30% of cases is identified from among at least 50
different conditions known to result in seizure
*Chronic/Acute Conditions: Chronic conditions are
activity, such as cerebral palsy; infections of the
long lasting, most often permanent conditions
brain or nervous system; metabolic disorders; high
(cerebral palsy is an example) where are acute
fever; an underlying lesion; interruption in blood
conditions may produce severe and debilitating
supply to the brain or rough handling of a baby
symptoms but it is of limited duration.
(shaken baby syndrome).
*ADHD (Attention-Deficit/Hyperactivity Disorder):
Diagnostic category of the American Psychiatric
Association for a condition in which a child exhibits Diabetes: Type 1 is caused by having insufficient
developmentally inappropriate inattention, insulin (a hormone normally produced by the
impulsivity, and hyperactivity. pancreas and necessary for the metabolism of
glucose). Type 2 is the result of insulin resistance
CAUSES
(the body failing to properly use insulin), combined  Environmental modifications are necessary
with relative insulin deficiency. to enable a student with physical and health
impairments to participate more fully and
Cystic fibrosis: Genetic disease of children and
independently at school. These
adolescents in which the body’s exocrine glands
modifications include: adaptations to
excrete thick mucus that can block the lungs and
provide increased access to a task or an
parts of the digestive system. May result from a
activity, changing the way in which
missing chemical or substance in the body.
instruction is delivered and change the
HEALTH CAUSES matter in which the task is done.

AIDS: Caused by HIV which is found in the bodily TECHNOLOGICAL

fluids of an infected person. HIV is transmitted
 Assistive technology: Any systematic
from one person to another through sexual contact
method based on scientific principles for
and blood-to-blood contact.
accomplishing a task or purpose. IDEA
ADHD: Specific causes are unknown, but many defines assistive technology as both
consider ADHD to be a neurologically based assistive technology devices and the
disorder. Significant evidence indicates that genetic services needed to help a child obtain and
factors may place individuals at a greater- than- effectively use the devices.
normal risk of an ADHD
ANIMAL
CHARACTERI S TI CS /S TRATEGI ES
 Animal assistance: Guide dogs for
Parallel curriculum for students with physical and individuals who are blind, hearing dogs to
health impairments includes adaptive methods and help people who are deaf and dogs who can
assistive technologies for mobility, communication carry books or other objects in saddlebags
and daily living tasks (helper or service dogs). Monkeys have also
been trained to serve as personal care
CONTACTS AND AIDS
attendants for people with disabilities.
Students with physical disabilities and health
GUIDANCE/PARENTS
impairments come into contact with more types of
teachers, physicians, therapists and other  The aid and support of the students’
specialists than any other group of exceptional parents can prove to very valuable as well,
children. as a collective team, they can work with the
teacher. Creating an Individualized health
TYPES OF STRATEGIES
care plan (IHCP): Part of the student’s IEP
There are Roughly Three main strategies teachers and can help state specialized medical
can you use to help aid in the education of students attention students may need.
with special needs
 Environmental HEARING IMPARED
 Technological
HEARING:
 Animal
Hearing refers to the reception of sound by the ear,
its analysis, and its transmission to the brain.
ENVIRONMENTAL

IMPAIRMENT:
An impairment is any loss or abnormality of
psychological, physiological or anatomical structure
or function.

HOW HEARING IMPAIRMENT OCCURS

TYPES OF HEARING IMPAIRMENT
CAUSES
 Conductive
 A gradual buildup of earwax.
 Sensorineural hearing loss
 Ear infection and abnormal bone growths or
 Mixed hearing loss
tumors.
CONDUCTIVE HEARING IMPAIRMENT:  Ruptured eardrum.
 Damage to the inner ear.
A conductive loss refers to a decrease in
sound caused by a problem in the outer or middle SYMPTOMS
ear.
 Muffling of speech and other sounds.
SENSORINEURAL HEARING IMPAIRMENT:  Difficulty understanding words, especially
against background noise or in a crowd of
A sensorineural loss refers to a problem
people.
located in the inner ear or along the nerve pathway
 Frequently asking others to speak more
between the inner ear and the brain.
slowly, clearly and loudly.
MIXED HEARING IMPAIRMENT:  Needing to turn up the volume of the
television or radio.
A mixed loss refers to a conductive loss and
 Withdrawal from conversations.
a sensorineural loss occurring at the same time.
 Avoidance of some social settings.
AGE OF HEARING IMPAIRMENT:
RISK FACTORS:
Pre lingual is the loss of hearing before speech and
• Aging.
language developed Post lingual: is loss of hearing
after spontaneous speech and language has • Heredity.
developed.
• Occupational noises.
• Some medications.
• Some illness
PSYCHOLOGICAL EFFECTS PREVENTION FOR HEARING IMPAIRMENT
Depression Protect your ears in the workplace:
Anxiety
• Specially designed earmuffs that resemble
An often false sense that others are angry
earphones can protect your ears by bringing most
with you.
loud sounds down to an acceptable level. Foam,
Shame, guilt and anger.
pre-formed, or custom-molded earplugs made of
Lack of concentration.
plastic or rubber also can effectively protect your
Worry and frustration.
ears from damaging noise.
Insecurity.
Embarrassment Have your hearing tested:
Self-criticism and low self confidence
. Consider regular hearing tests if you work in a
Adjustment problems.
noisy environment. Regular testing of your ears can
COPING AND SUPPORT provide early detection of hearing loss. Knowing
you've lost some hearing means you're in a
These tips can help you to communicate more
position to take steps to prevent further hearing
easily despite your hearing loss.
loss.
Position yourself to hear:
Avoid recreational risks:
Face the person with whom you're having a
• Some activities, hunting and listening to
conversation.
extremely loud music for long periods of time, can
Turn off background noise: damage your hearing.
For example, noise from a television may interfere • Wearing hearing protectors or taking breaks from
with conversation. the noise during loud recreational activities can
protect your ears.
Ask others to speak clearly:
• Turning down the volume when listening to
Most people will be helpful if they know you're
music can help you avoid damage to your hearing.
having trouble hearing them.
TEST AND DIAGNOSIS
Choose quiet settings:
GENERAL SCREENING TEST:
In public,such as in a restaurant or at a social
gathering, choose a place to talk that's away from • Doctor may ask to cover one ear at a time to see
noisy areas. how well hear words spoken at various volumes
and you respond to other sounds.
Consider using an assistive listening device:
TUNING FORK:
Hearing devices, such as TV-listening systems or
telephone-amplifying devices, can help you hear • Tuning forks are two-pronged, metal instruments
better while decreasing other noises around you. that produce sounds when struck.
BENEFITS OF TREATMENT • A tuning fork evaluation may reveal whether
hearing loss caused by damage to the vibrating part
• Greater self-confidence
of middle ear, damage to sensors or nerve of inner
• Closer relationships with loved ones ear or both.

• Improved outlook on life AUDIOMETRY TEST

• Test conducted by an audiologist, you wear  Closed captioned DVD’s and videos
earphones and hear sounds directed to one ear at  TCD
a time. The audiologist presents a range of sounds  Microphone system
of various tones and asks you to indicate each time  Sign language interpreter
you hear the sound.  Partner with better hearing
 Audio- visual lab with headphones
• The audiologist will also present various words to
determine your hearing ability, ACCOMMODATION
TREATMENTS:  Qualified sign language interpreters for
public programming,
Treatment depends on the cause and severity of
 A staff person knowledgeable for sign
your hearing loss.
language.
Options include:  Telephones
 Instant messaging
• Removing wax blockage.
 Video calling
• Hearing aids.
• Cochlear implants. MANAGEMENT

REMOVING WAX BLOCKAGE:  Clear signs

 Visual alert
Cleaning the outside of the ear by wiping with a
 Equal accessibility to all programs and
cloth.
services.
• Putting cerumenolytic solutions (solutions to  Paper and pencil
dissolve wax) into the ear canal.  Assistive listening devices
 Amplification system
• Irrigating or syringing the ear.
 Headsets and neck loops
• Removing the wax manually using special  Compatible hearing aids.
instruments.
EDUCATIONAL OPTIONS
HEARING AIDS:
 Where should deaf students be taught?
A hearing aid is a small electronic device that you  How should the deaf students be taught?
wear in or behind your ear. It makes some sounds  What should the deaf students be taught?
louder. A hearing aid can help people hear more in
INSTITUTIONS
both quiet and noisy situations.
 Deewa in Islamabad.
Hearing aid parts:
 Hamza foundation for the deaf.
• Microphone: detects the sound.  Govt school for special children Ravi road
Lahore.
• Amplifier: make the sound stronger.
 Govt school for hearing impairment
• Battery: provides power to the electronic parts Sahiwal.

• Volume control: increases or decreases the INSTRUCTIONAL STRATEGIES

volume of the sound.
 Circular seating
 Desk arrange in rows
 Repeat the questions of students
Technologies
 Teamwork for assignments
  Assist the students Giftedness is not an automatic guarantee of
 Transcripts of audio information success. A range of environmental variables affect
 Avoid interruption talent development, such as parental
 Visual information encouragement, family relationships, the
 Be Flexible provisions the child’s school makes, or fails to
make, to develop his or her gifts into talents, and
What should deaf students be taught?
even the social ethos of the community that can
 General education subject content. dictate that talents are valued and, therefore,
(English ,Math, Science, general knowledge which programs of talent development will be
etc) established or funded.
 Special curriculum features for the deaf.
Encouragement and assistance from home and
(Rhythm, auditory training, speech &
school are essential if gifted children are to develop
language)
as talented, but the children themselves must
Teaching strategies: maintain their motivation to succeed. Children, no
matter how gifted, will not achieve high levels of
 Get the attention before signing.
talent unless they are prepared to work and study
 Keep your hand and face toward the deaf
to develop their abilities. A child may be gifted in
while speaking.
any domain of ability, intellectual, creative,
 Make sure your signs and finger spelling are
physical, or social. However, although talent in
clearly visible.
music, sports, or athletics is valued and actively
 Adjust your signs according to the level of
sought and fostered in many cultures, high
the deaf.
intellectual ability is often undervalued (Gross
 Use of flash cards
1999). This can affect how gifted children come to
 Charts
view, or value, their gifts.
 Dioramas & models
Identification of Gifted Children
Students who are Gifted and Talented
Contrary to the myth that every parent thinks her
Gifted And Talented Children
child is gifted (whether he or she is gifted, or not)
Gifted children comprise a minority of the parents are highly effective identifiers of high
population, although not such a small minority as is ability in their children (Robinson and Robinson
sometimes thought. Internationally, the most 1992); indeed, they are significantly more accurate
widely used definition of giftedness and talent is than teachers, who are rarely trained in how to
that of FrançoysGagné of Quebec. Gagné (1985, identify and respond to gifted students and who
2000) defines gifted children as those who have may not notice high academic ability if they present
high levels of innate ability, in any domain of the gifted child only with work set at the level and
human ability, that places them within the top 10 pace of the average child in the class (Jacobs 1971).
percent of their age-peers—even if their high The majority of parents of intellectually gifted
potential is not yet being demonstrated as high children become aware, in the early years, that
performance. Talented children, by contrast, are their child is very bright (Louis and Lewis 1992).
those whose abilities have already been translated
Intellectual and physical characteristics of young
into achievements, and who are currently
gifted children that parents are likely to notice
performing at a level thatplaces them within the
include unusually early and fluent speech; early
top 10 percent of their age-peers. Gifts are natural
mobility (the child crawls, walks or runs earlier than
abilitieswhereas talents are systematically
age-peers); early reading (the child spontaneously
developed skills.
picks up reading from television, street signs, or effect. This occurs when a gifted student is
advertisements); unusually retentive memory; assessed using a teacher- developed or
intense curiosity; unusually long attention span; standardized test designed for average ability
eager desire to learn; unusually mature sense of students of his or her age. Gifted students may
humor; and less need for sleep than age peers of score at the uppermost limits of the test and,
average ability (Gross 1993). Of course, not all although in one sense this affirms their high ability,
gifted children display all these characteristics, but it also means that there is no way of knowing how
the possession of a cluster of the characteristics much higher these children would have scored if
described above could suggest that the child may they had been assessed on a test with a higher; It is
indeed be unusually bright. rather like measuring the height of the Harlem
Globetrotters on a pole that only goes up to six
Furthermore, intellectually gifted children differ
feet. The Globetrotters all come out at the same
from their age-peers in many aspects of their social
height foot and, unless a longer pole is used, there
and emotional development (Silverman 1993).
is no way of measuring their relative heights
They are often more socially and emotionally
beyond that point!
mature than other children of their age, their play
interests are more like those of children some To combat the problem of ceiling effect,
years older, and they tend to seek out, for psychologists working with gifted children
companionship, children who are older but of recommend above-level testing—assessing their
average ability, or age-peers who are also achievements using tests designed for students
intellectually able. They may be unusually some years older (Assouline and Lupkowski-Shoplik
perceptive and sensitive to the feelings of other 1997). For example, a third grade students who has
children or adults and because of this capacity to (made a score at or near the maximum) on a third
empathize they may become concerned, much grade math test may then be assessed on a fifth
earlier than their age-peers, with ethical or moral grade test. Finding that this student scores at the
issues (Webb, Meckstroth, and Tolan 1983). 70th percentile on a test designed for students two
However, this sensitivity may also make them years older is much more meaningful, in terms of
aware, even in the early years of school, of other curriculum planning, than affirming that she tests
students' wariness towards, or even at the 99th percentile of her age-peers.
resentment of, their high abilities, and many gifted
Family Relationships
students deliberately underachieve for peer
acceptance (Gross 1989; Colangelo and Assouline Because intellectual ability is in part genetically
2000). determined (Plomin 1997), children in a family
where one child has been identified as
Standardized testing of ability and achievement can
intellectually gifted are likely, also, to be highly able
assist in identifying high academic ability in children
(Gross 1993). This does not mean, however, that
and adolescents. Used appropriately by qualified
either the parents or the school will view all
professionals (for example, it is important that
children in the family as academically gifted.
culturally appropriate tests are
Teachers, for example, tend to assume that their
used) IQ (Intelligence Quotient) tests can provide a
gifted students are the academically successful
wealth of information about a Student’s
teacher pleasers (Betts and Neihart 1988).
intellectual profile, and can assist educators to
Additionally, if the sibling has a learning disability
develop an appropriate educational response to his
or is not motivated to achieve, his or her high
or her learning needs.
abilities may go undetected.
However, a problem that frequently arises in
testing academically gifted students isthe ceiling
When a child is identified as intellectually gifted, young people or adults who have achieved
parents sometimes worry about how this will effect eminence in their fields, forexample, Victor
the self-esteem of his or her siblings. In making Goertzel and Mildred Goertzel’s international study
such a comparison, a range of factors needs to be (1962), Benjamin Bloom’s (1985) study of 120
taken into consideration, including birth order, the young Americans, and Miraca Gross’s (2000) study
ages of the children and the gaps between them of exceptionally gifted young Australians. These
and the children’s gender and levels of intellectual studies found parents to be an enormous influence
ability, as well as parental values, education, and on the degree to which the young people accepted
relationships. Oldest or only children are more their high abilities and worked to translate them
frequently identified as gifted, as are children of into high achievement. Some of the major findings
parents who encourage in their children a love of were:
learning (Pfouts 1980; VanTassel-Baska 1983).
1. Even where the parents were not themselves
However, research suggests that the self-esteem of
highly educated, they placed a high value on
siblings in a family where at least one child has
education and learning.
been identified as gifted, is more dependent on
existing family relationships and attitudes towards 2. They tended to choose hobbies and interests
one another, than on the singling out of a child for that required practice and learning, and studied the
special treatment at school or for admission to a performance of others to increase their own skill
gifted program (Cornell and Grossberg 1986). and enjoyment. They modeled, for their children, a
Families where members interact cooperatively, delight in learning and a desire to improve their
with a respect for each other’s differences of performance.
personality, opinions, and values, are strongly
3. At least one parent or close relative had a
facilitative of children’s healthy self-esteem and
personal interest in the child’s area of talent.
acceptance of differences in ability.
4. The parents encouraged and rewarded the
Healthy family relationships occur when members
development of the child’s talent at home, while
are assured that their individual roles are accepted
seeking outside assistance from teachers or
and valued by the others in the family. Sibling
mentors.
rivalry may arise when children compare
themselves with siblings, and feel less valued or The parents did not their children; however,
accepted. If a child who has been identified as through their pursuit of their own talent areas and,
gifted receives special attention at the expense through their encouragement of the children, they
of the non-identified sibling, then the self-esteem provided a model that taught that talent is fostered
of that sibling is likely to fall. Constant negative through accepting one’s abilities and striving to
comparison with a sibling of perceived superior fulfill them.
ability, together with a relative lack of recognition,
Educational Responses
may damage self-esteem. It is important to
remember, however, that it is a result of the Educational responses to children with special
family’s attitude towards the child who has not needs are based not on the that has been given (for
been identified as gifted, rather than the school’s example, a child having been diagnosed as hearing
recognition of the one who has, which results in impaired, intellectually disabled, or academically
the sibling’s decline in self-esteem (Grenier 1985). gifted) but on the fact that the child differs, in some
way that will affect their learning, and that this
How Families Foster Talent Development
difference will require a different educational
Beginning in the 1960s, research studies have response from the school.
examined the influence of parents and families on
Acceleration—advancing gifted students to work ♦ In SpEd, children who are blind are differentiated
with students older than themselves—also has from those who have low vision. Blind children use
substantial research support, showing that, where their sense of touch to read Braille and train in
the acceleration program is well-designed and orientation and mobility to move around and travel
monitored, accelerated students experience both independently.
academic success and social acceptance by their
Types and Causes of Problems of Vision
new classmates (Gross 1993; Passow 1996). In the
considerable majority of cases the advancement is 1. Errors of Refraction
by a single year, either through allowing students  Hyperopia or Farsightedness - In hyperopia
to enter primary, elementary, middle, or high or farsightedness, the lens fails to focus the
school one year early, or by allowing them to light rays from near objects on the retina.
advance a grade within a school building. Students The focus falls behind the retina because
may also be allowed to go to an upper grade for a the eyes are too short from front to back.
single subject in which they excel, while remaining Convex lenses are prescribed to converge
with age-peers for the majority of the school day. the light rays on the retina to correct
hyperopia.
MODULE 10: STUDENTS WHO ARE BLIND AND
 Myopia or Nearsightedness - In myopia or
HAVE LOW VISION
nearsightedness, the eyes are abnormally
Blindness or low vision blindness can be defined long from front to back and the lens fails to
legally and educationally. refract the light rays from distant objects on
the retina. Concave lenses to correct
Legal definition based on measurement of:
myopia are prescribed to converge the light
Visual acuity, the ability to clearly distinguish forms rays from far objects on the retina.
or discriminate details at a specific distance.  Astigmatism - In astigmatism, cornea’s lens
is deformed, light becomes blurred and
Normal vision acuity is measured by reading
faulty cylindrical lens is
letters, numbers, or symbols from a chart 20 feet
2. Imbalance of the eye muscles
away.
 In strabismus, different images are cast on
Example: the Snellen chart ⁄ Legal blindness – each retina resulting to cross-eyedness or
condition where visual acuity is 20/200 in the squinting.
better eye.  Diplopia or double vision results when the
brain cannot fuse the differences in the
The field of vision refers to the area that normal
images cast on the retina into a single
eyes cover above, below and on both sides when
image. The condition can be corrected by
looking at the object or when gazing straight
prescription lenses, exercises, surgery or a
ahead.
combination of the three.
Normal = approximately a range of 180 degrees.  Amblyopia occurs when vision is
suppressed in on eye and it becomes weak
Central field of vision – being used when looking
or useless.
directly at an object.
 Nystagmus is a condition in which there
Tunnel vision – results from an extremely are rapid involuntary movements of the
restricted field of vision. eyeball that can result to nausea and
vomiting and dizziness.
EDUCATIONAL DEFINITION
3. Diseases of the Eye
♦ Not all legally blind persons are totally blind.
  Cataract is caused by the clouding of the 2. Large Print - Some books and other materials
lens which results to progressive blurring of are available in large print.
vision and eventually blindness occur. 3. Classroom Modification - providing materials
 Diabetic retinopathy occurs when diabetes that would enable the student to use vision.
mellitus interfere with the flow of blood to Adjustable Desk Special Writing Paper
the retina causing it to degenerate. 4. Recorded books, magazines and other
 Diseases of the retina, the most sensitive materials - come with the synthetic speech
part of the visual mechanism, can be equipment that plays the tapes at a faster rate.
congenital or present at birth. Example: Audio Books
 Retinitis pigmentosa is a hereditary
The Education for Students with Visual Disabilities
condition that results in the degeneration of
retina. This started during 1960s as a component of
 Glaucoma is the condition in which there is teacher training program for selected public school
excessive pressure in the eye. teachers. Blind boys and girls with average or
4. Traumas or accidents better mental ability were enrolled in regular
classes at the School Division of Pasay City, Manila
SPECIAL ADAPTATIONS, AIDS, AND TECHNOLOGY
and the Teacher Training Department of the then
FOR STUDENTS WHO ARE BLIND AND WITH LOW
Philippine Normal College. At present, the
VISION
Resources for the Blind Incorporated collaborates
For Blind Person Definition Example: with the Department of Education in training
teachers in mainstreaming blind and low vision
1. Braille - is the system of reading and writing, in
students in public schools all over the country.
which letters, words, numbers and others are
made from arrangements raised by embossed Most children learn visually through the remaining
dots. senses: audition, touch, olfaction, gestation and
- Blind students learn to read and write in other non-visual experience. Blind children receive
Braille by using Braille like a typewriter
With the advent of inclusive education for children
with 6 keys.
and youth who have disabilities, more and more
2. Typewriter or Braille Typewriter - for
students who are blind, deaf, with mental
communication and handwriting is taught for
retardation, or with orthopedic impairments are
them to sign needed papers.
enrolled in regular classes
3. Manipulative and Tactile Aids - are used in
learning mathematics, sciences and social Rules that can help to make your student with
studies. Cranmer Abacus visual impairment feel comfortable inside the
4. Technological Aids (Kurzweil Personal Reader) - classroom:
is a sophisticated computer with an optical
1. Use the words “look” and “see”.
character recognition (OPR) system that scans
2. Introduce him or her as you would in any of
and reads via a synthetic voice typeset and
your students.
other printed matter. Kurzweil Personal Reader
3. Include him or her in all class activities.
5. Assistive Technology - enables blind person to
4. Extend to them the opportunity of being a
access to (putol ang nasa module)
leader in class activities.
For a person with low vision: 5. The same disciplinary rules that apply to the
rest of the class should apply as well to the
1. Special optical devices - to enlarge and to see
child with visual impairment.
regular prints clearly Corrective Eyeglasses
Contact Lenses
 6. Encourage the blind child to move around
the classroom. (e.g. to get materials or to
do certain activities)
7. Give verbal instructions or oral cues.
8. Provide space to accommodate his or her
special materials.
9. Motivate the seeing classmate to become
interested in topics related to vision and
visual impairment.
10. Your acceptance of the child with visual
impairment will serve as a positive example
to his or her seeing classmates.
11. When approaching the blind student,
always say who you are.
12. The blind student may exhibit certain
mannerisms. Consult the special education
teacher on how to deal with these
behaviors.
13. Possible accommodations by area of
disability for students who are blind or have
low vision
PS. Same lang po ang nasa module at PPT