European Journal of Social Sciences Studies
ISSN: 2501-8590
ISSN-L: 2501-8590
Available on-line at: www.oapub.org/soc
Volume 2 │ Issue 1 │ 2017
doi: 10.5281/zenodo.251457
CHILDREN WITH ADHD,
CLASSROOM INCLUSIVE PROGRAMMES
Ana Majkoi
MSc, Department of Pedagogy-Psychology,
Faculty of Social Sciences, University of Tirana, Albania
Abstract:
Attention Deficit/Hyperactivity Disorder (ADHD) is a common disorder known to be
associated with behavioural and academic difficulties. This article describes effective
school-based intervention strategies including programmes designed with the focus on
the importance of the level of information on ADHD, awareness, training of teachers
and school psychologists on the types of intervention in class and supporting children
in classroom. One overlooked aspect of treatment of children with ADHD is the need to
form partnerships among school professionals who can work collaboratively on
interventions for children with ADHD. Approaches to developing effective practices of
training of teachers in the classroom for school based strategies are presented. Multiple
treatment strategies implemented in a consistent fashion across school years can
optimize the school success of students with ADHD. The methodology used to achieve
these objectives is based on the implementation of an experiment (quasi), to measure
the impact of the use of some effective strategies for teachers and children identified
with ADHD in schools. The evolution of the experiment include academic assessment
of children before the intervention, training of teachers for the school intervention
strategies, measuring instruments setup effectiveness of intervention strategies in
school, academic assessment of children after the intervention. This methodology
supports the main goal of treatment of children with ADHD in the classroom through
effective techniques on the school premises for their academic work. The Sample
participating in the experiment were children diagnosed with ADHD, aged 8-9 y.o, by
psychologist or psychiatrist, whose academic results were analyzed. Also, teachers were
trained to produce change in the academic performance of children. The results have
Correspondence: email ana87majko@yahoo.com
Copyright © The Author(s). All Rights Reserved.
© 2015 2017 Open Access Publishing Group
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Ana Majko
CHILDREN WITH ADHD, CLASSROOM INCLUSIVE PROGRAMMES
shown that children with ADHD are faced with many difficulties and often they are
misunderstood by their teachers and parents for their symptoms, like intentional
behaviors. School-based intervention strategies resulted successfully applicable to
children with ADHD symptoms. Although intervention programs for children with
ADHD that include a focus on both home and school are beginning to emerge.
Keywords: ADHD, school performance, school intervention strategies, academic
intervention
1. Introduction
Attention deficit hyperactivity disorder (ADHD) is characterized by pervasive and
developmentally
inappropriate
difficulties
with
attention,
impulsivity,
and
hyperactivity (American Psychiatric Association, 2000). ADHD symptoms cause
significant impairments at home and in school and are associated with a number of
behavior difficulties such as aggression and noncompliance (Barkley, 2006). Research
also suggests that children with ADHD are more likely than typically developing
classmates to be rejected socially and to have greater difficulties with their peers
(Hinshaw, 2002). In addition, teachers are more likely to perceive a child with an
ADHD label less favorably with respect to intelligence, personality, and behavior
(Batzle, Weyandt, Janusis & Devietti, 2010).
Academically, children with ADHD are more likely to have poorer grades, lower
scores on standardized tests, greater likelihood of identification for special education,
and an increased use of school-based services, compared to peers without the disorder
(Loe & Feldman, 2007). Students with ADHD are also more likely to have a higher
absenteeism rate, are three times more likely to be retained during elementary school,
and are at a higher risk for dropping out of high school than their peers without ADHD
(Barbaresi, Katusic, Colligan, Weaver, & Jacobsen, 2007). Students with ADHD who
graduate from high school are less likely than their peers to pursue a post-secondary
education (DuPaul & Weyandt, 2009). Interestingly, less research is available
concerning methods to remediate academic problems associated with ADHD,
compared to studies regarding ways to treat behavioral and social difficulties associated
with the disorder (Jitendra, DuPaul, Someki, & Tresco, 2008). Given the less-thanfavorable prognosis for children with ADHD, it is imperative that empirically
supported interventions are implemented early, particularly during the elementary
school years.
The most common interventions for students with ADHD include psychotropic
medication and behavioral strategies implemented in home and school settings
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CHILDREN WITH ADHD, CLASSROOM INCLUSIVE PROGRAMMES
(Barkley, 2006). Although stimulant medication frequently is used to reduce ADHD
symptoms, pharmacological treatment rarely is sufficient in addressing the multiple,
chronic difficulties faced by students with ADHD (DuPaul & Stoner, 2003). The purpose
of this article is to describe effective school-based intervention strategies for children
with ADHD including the development of an inclusive programme to be followed by
their teachers in order to support children with ADHD in classroom. Also discussed are
approaches to developing partnerships among school professionals including methods
to facilitate collaborative relationships between teachers and school psychologist
consultants.
2. Actual Research
Child development field of study is very extensive, and increasingly is growing
attention to children with ADHD, whose problems are too big nowadays. There are
many studies done on these children that comprise about 8 to 10% of children attending
primary school. These studies have given their contribution in exploration of the
programs and more efficient treatments for supporting these children's needs.
Complementary general goals of research were to provide an overview of the
symptoms of the disorder of attention with hyperactivity in children attending primary
schools in Tirana. At the same time to explore the possibilities easing symptoms of
attention disorder with hyperactivity in the classroom with the support of trained
teachers, with a focus on their academic performance.
The main objectives were:
1. To explore the unknown a good view of the diversity of symptoms of children
diagnosed with attention disorder with hyperactivity.
2. To explore and evaluate current challenges of educating children with ADHD in
areas lacking attention of professionals.
3. To develop new practical techniques for the classroom for children with ADHD.
4. To train teachers who care about the education of children in the classroom
about the characteristics of the ways of working in the classroom with children
with ADHD.
5. To find out whether the training of teachers with information package on the
techniques of working with children diagnosed with ADHD increased their
academic performance and facilitates their performance in the classroom.
6. To provide some recommendations on how to work with children who have
been diagnosed with ADHD at school but necessary for teachers and other
professionals
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CHILDREN WITH ADHD, CLASSROOM INCLUSIVE PROGRAMMES
3. Methodology
The choice of methods for data collection is determined by the hypothesis or research
questions and research aspects of the topic are the main focus of the research. Research
approach to the problem of choice is empirical methodology including the combination
of qualitative and quantitative methods for data collection. This in turn not only to
draw a statistical result about the search results, but also to give the opportunity to
explore in greater depth some of the issues or factors affecting or arising from the
quantitative data. To measure and maintain the quality and validity of the research will
were triangolare methods of collecting qualitative and quantitative data. Triangolare
method includes quasi-experimental realization of the experiment in natural conditions
practically in classes in schools), intervention and observation. There are three ways
that will provide data collection and above all to make this research as valid. Also, it is
anticipated that looking the part of the pilot, which was a stage that aimed to
standardize instruments and provided more information on training techniques, more
efficient and borrowed into Albanian in the most accurate possible.
3.1 Sample
As research approach is focused on children diagnosed with ADHD, meaning that
representatives in the sample is small, but that allows the search to explore in depth the
hypothesis and not only. The sample were deliberate usually referred to studies
specified small-scale models of research that rely on the selection of qualitative and
quantitative data focusing on the exploration and interpretation of experiences and
perceptions. Children with ADHD are selected on the basis of characteristics or
experiences related directly to the area of interest and research question is chosen. Total
is intended that 32 children respectively aged 8 or 9 years old, in grade 2 and 3, were
part of the quasi-experiment (training of teachers and parents towards the
administration deficits on performance development displayed by children ADHD).
Children were selected in the elementary school age because children with
ADHD can be identified after age 7 years and second grade or third is the age where
children develop the skills of writing, reading and understanding as well as the age
where the symptoms of ADHD were more visible. It was selected a purposeful
homogeneous sample, children with ADHD that belong to the same group and will
have the same features, so children with attention disorder with hyperactivity in
selected schools randomly. Also, intentional part of the sample will be teachers who
will be trained.
Research methodology will be built in accordance with the need of gathering
information regarding variables and relationships between them.
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3.2 Procedure
The first step was identification of the potential school who had identified children with
ADHD symptoms with the support of pedagogical staff. Also was taken into
consideration all the ethics procedures for taking permission from the school
institutions and from the teachers. The research was supported by the experimenter
team composed by 4 psychologist. The team designed and developed the content of the
programme important for the training process of teachers and for children in the
classroom.
Quasi-experiment consists in separating the case into two groups of control and
experimental groups. Experimental group included 15 children where teachers once
they were informed and trained on ADHD guidelines in classroom and were observed
on the facilitation techniques of these features in children with ADHD will apply these
techniques to the children to see the effect. While in the control group included 16
children, teachers applied techniques or exercise routine that usually implemented in
the classroom. The period of implementation of this process was 3 months and after this
phase, quasi-experiment was repeated again to measure the validity of the research and
its credibility. But to understand the factors that may affect these results and to
understand the terms and conditions that may affect and may interfere with the
confirmation of the hypothesis is the analysis difference of the academic performance of
the children before and after intervention.
4. Academic characteristics of children with ADHD
Children with ADHD have low academic achievement, poor academic performance
and education problems. In terms of damaged functions, children with ADHD show the
degree of intelligence reducted compared with the average of normal scale scores. In
terms of activity limitations, children with ADHD reach the lowest point in reading and
arithmetic. Inhibitions in terms of social participation, children with ADHD show
growth in recurring grades and academic services character using "healing". Children
with ADHD are more likely to be excluded, suspended or repeating a grade. Children
with ADHD have 4 to 5 times more likely to use specific educational services than
children without ADHD. Children can use ancillary services, including mentoring,
support classes, after school programs and specific adaptations.
Educational characteristics and academic achievement in children with ADHD
are different from one child to another. Some studies in terms of academic achievement,
the use of special services, and found similar evaluation rates. However, a large study
of students in primary schools found that children with ADHD-type impulsive were
more likely to be rated as below average or to be loosers in school than children with
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CHILDREN WITH ADHD, CLASSROOM INCLUSIVE PROGRAMMES
ADHD-combined type of ADHD and hyperactive-impulsive type. A category of
children with ADHD-type impulsive are described as children with slow cognitive
swing, leading to the assumption that there is a higher prevalence of the learning
disorders in children with ADHD-type impulsive than to children with ADHD-type
combined.
5. Inclusive programmes for children with ADHD
Schools often try to change the child with ADHD to adapt to the school environment.
Attempt to "normalize" behavior include the adoption of a child outside the classroom,
perhaps applying a remedial strategy and putting the baby to the previous position
with the hope that now it will be successful. This strategy identifies as a problem child,
serves to isolate and stigmatize the child and prevent exploration environments. The
advantage of general designs is that many children with ADHD are educated in general
classes. Benefit from the overall design of all children in the classroom, especially those
with ADHD. These interventions may not reduce the differences between children with
ADHD and their peers without ADHD in some measure, it can be standardized tests.
However, the most important is whether children with ADHD reach a higher threshold
of achievement as may be reading improvement. The second approach includes specific
interventions for children with ADHD. These interventions may include teaching
methods, new curriculum, behavior management and intervention with specific focus
school.
When selecting and implementing successful instructional strategies and
practices, it is imperative to understand the characteristics of the child, including those
pertaining to disabilities or diagnoses. This knowledge will be useful in the evaluation
and implementation of successful practices, which are often the same practices that
benefit students without ADHD.
During the quasi-experiment the inclusive programme that was designed
involved several components important for implementing the intervention. These
components were part of the training curricula for the teachers in order to be treated
with children with ADHD in classroom.
Teachers who are successful in educating children with ADHD use a threepronged strategy. They begin by identifying the unique needs of the child. For
example, the teacher determines how, when, and why the child is inattentive,
impulsive, and hyperactive.
The teacher then selects different educational practices associated with academic
instruction, behavioral interventions, and classroom accommodations that are
appropriate to meet that child’s needs.
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CHILDREN WITH ADHD, CLASSROOM INCLUSIVE PROGRAMMES
Finally, the teacher combines these practices into an individualized educational
program (IEP) or other individualized plan and integrates this program with
educational activities provided to other children in the class.
Because no two children with ADHD are alike, it is important to keep in mind
that no single educational program, practice, or setting will be best for all children.
Successful programs for children with ADHD integrate the following three
components:
Academic Instruction;
Behavioral Interventions; and
Classroom Accommodations.
The article describes how to integrate a program using these three components
and provides suggestions for practices that can help children with ADHD in a
classroom setting. It should be emphasized that many of the techniques suggested have
the additional benefit of enhancing the learning of other children in the classroom who
do not have ADHD. In addition, while they have been used most widely with children
at the elementary level, the following practices are useful for older students as well.
6. Results and Discussions
The study included the development of a structured methodology based on research
issues raised in the design phase of the study. Experimental methods included concrete
measures related to the recognition of the relationship between the implementation of
programs of teachers and improving the academic performance of children with ADHD
and children with ADHDs symptoms displayed. This relationship was explored in two
different times before and after the intervention of an experimental intervention
through instruments that assessed the academic performance and number of symptoms
in children with ADHD in the classroom.
The program was effective for the experimental group and social skills training
gains were successfully transferred to integrated settings. Was concluded that training
which includes modeling, role-playing, behavioral rehearsal, reinforcement, and selfrecording can be effective in teaching skills that maintain over time and generalize to
untreated settings. Since only one of the participants had ADHD, it is difficult to draw
conclusions about the use of this intervention with children with that disorder.
Pelham et al. (1988) studied the adjunctive effects of methylphenidate and social
skills training for children receiving a 5-month course of clinical behavior therapy. The
participants were 32 children (28 boys and 4 girls) with ADD-H ranging in age from 5 to
10 years. The behavior therapy focused on teacher and parent training in contingency
management. The social skills training included weekly three hour sessions for eight
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CHILDREN WITH ADHD, CLASSROOM INCLUSIVE PROGRAMMES
weeks. The sessions focused on displaying appropriate social behavior in a peer group
context and rewards for appropriate peer interactions. Instruction, modeling, and
roleplaying were used to teach and demonstrate appropriate social behavior. The
concepts
addressed
included
communication,
participation,
cooperation,
and
validation-support. Findings indicated that clinical behavior therapy showed
statistically significant improvement on all dependent measures. The addition of the
medication and/or the social skills training did not significantly facilitate the
improvement shown with the clinical behavior intervention. A weakness of this study is
that data was collected only pre- and post-intervention.
Their results indicated that children had a mean increase in target behaviors with
the onset of intervention implemented by the teachers with the support of trainings.
However, intervention effects were only evident during analogue observations. This
suggests that the behavior change did not generalize to the child's real world
experiences. However, the results express that this is evidence of how intractable social
skills deficits are in children with ADHD. Perhaps the length of the training was too
short and a longer intervention would have demonstrated greater behavioral change.
Frankel, Myatt, Cantwell, and Feinberg (1997) examined the effectiveness of an
outpatient social skills training program for children with ADHD which used parents to
aid in transfer of training. In their study, the children were given 12 one-hour sessions
of social skills training. All children with ADHD were on stimulant medication. Each
child session consisted of reviewing homework from the previous session, a didactic
presentation, behavioral rehearsal between children and coaching, coached play, and
contracts for homework for the coming week. The children were taught conversational
techniques, group entry techniques, "rules for a good host," handling teasing and
confrontations with adults. Concurrently, the mothers of the children participated in 12
one-hour sessions as well. Each parent session included a review of homework, reading
and discussing handouts related to what parents can do to promote good social skills,
planning the next homework assignment, and returning to the child group to make
homework contracts. Results indicated that children with ADHD showed improved on
all teacher and parent-reported measures of peer adjustment and social skills, except
teacher reported withdrawal. It was concluded that children with ADHD are best
helped by a combination of social skills training for themselves, collateral training for
their parents, and stimulant medication. This study demonstrates that social skills
training can be effective when generalization is strategically planned for. However, the
amount of parent involvement in this intervention may be problematic for many busy
parents of children with ADHD. Further, no direct measure of generalization was used,
only teacher reports and instrument of academic evaluation.
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CHILDREN WITH ADHD, CLASSROOM INCLUSIVE PROGRAMMES
Children with ADHD can have a better academic performance in the classroom
settings if the classroom environment, teacher programme, and behavioural treatment
is constructive and inclusive. Teachers have a big role on implementing suitable
programmes for children with ADHD and not only. They face the biggest difficulties on
managing symptoms of children with ADHD in the classroom and if they do accept and
implement such programmes for supporting children with ADHD in the classroom
could have the possibility not only to discipline the children symptoms in the classroom
but in the same time facilitate their learning in the classroom and their emotional and
social problems. The research indicated that children with ADHD can benefit from
these programmes if the programmes are inclusive and if their content considerate such
kind of interventions that support in the same time all the children of the classroom.
7. Conclusions
There are still needs to be informed on how to improve the academic and educational
outcomes in children with ADHD, despite decades of research on diagnosis, prevalence
and effects of short-term treatment. It may be impossible to carry out tests in the long
term, controlled and randomized medications and behavior management used as
treatments, for ethical and practical reasons. However, large scale studies using
statistical methods suggest that should be considered the number and type of
interventions, duration of treatment, the intensity of treatment and implementation of
protocols. Educational interventions for children with ADHD should be studied.
It is recommended to be conducted studies on large scale, prospective study to
assess the impact of educational interventions. These studies may be related, including
universal design improvements and specific interventions for ADHD. They can include
multiple, with an emphasis on academic skills, graduation and successful completion of
nine years of education. A broad coalition of parents, educators and health
professionals can work together to advocate for a more ambitious and looking after the
design, implementation and interpretation of research findings. Changes in local
policies, the central may facilitate these efforts by creating relevant databases and
collaborations.
What was achieved on the basis of statistical analyzes and those interpretative it
is:
1. A higher level of knowledge about the ADHD features and symptoms and their
identification in natural conditions in the classroom.
2. Perspectives and new insights regarding the evaluation of children with ADHD
specifically in classroom conditions.
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CHILDREN WITH ADHD, CLASSROOM INCLUSIVE PROGRAMMES
3. Training of teachers and parents with a set of exercises and techniques for
managing the situations where children with ADHD show low academic
performance in the classroom.
4. Reduction of symptoms and therefore academic progress as well as the
facilitating role of working memory that affects performance in school.
5. Mirroring a reflection of how this target group of children facing learning
difficulties when display these deficits.
6. It is considered the most important is the construction of a set of techniques and
exercises in the form of a manual with recommendations for teachers as well as
parents to help children cope with learning difficulties and contribute to their
education.
7. Information on a wide scales for the features and characteristics of children with
ADHD and deficits of working memory and thus facilitates the process of
identification and intervention at the right moment.
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