Even though parents are often reluctant to interfere with children's relationships with their peers, active intervention techniques are useful in helping a child with ADHD enjoy success in interpersonal situations. The earlier the difficulties are addressed, the more successful intervention can be. Specific techniques that parents and teachers can use to facilitate the development of positive peer relationships include the following:
- Identify, discuss, and post rules (and the reasons for them), as well as examples of effective social interaction.
- Utilize stories, movies, etc. that illustrate positive human characteristics.
- Encourage the child to keep a journal to improve written expression and develop increased sensitivity as awareness of emotions develops.
- Spend time teaching the child to play "How, When, Where, and Why" to help address misinterpretations of social rules. For example, a child might think it is fun to climb a wall in a store because it is built to be easy to climb.
- Actively supervise situations to avoid negative peer interactions and misinterpretations. For example, a child may think that a peer is angry simply because the peer did not want to play outside one day. Once a parent is aware of such a faulty perception, s/he can take steps to correct it.
- Gradually increase the time spent in peer interactions as the child becomes more skilled.
- Encourage the child to appreciate the uniqueness of others, as well as similarities.
- Discuss each person's role in helping the other child to become the best person he or she can be.
- Help children place their problems in context by helping others. Facilitating participation in projects and organizations, or engaging in volunteer work can be especially meaningful.
Both teachers and parents should immediately praise the child's efforts to use appropriate social skills and also provide an immediate negative consequence for aggressive behaviors. Parents must remain aware of how their child is doing with peers in school and facilitate social involvement by communicating with other parents, sports coaches, etc. Parents should try to be respectful if the child identifies specific extracurricular activities of interest, while also setting reasonable limits on participation. However, if a child is uncertain about which activities to select, parents can help the child choose activities that mesh well with their unique interests and skills.
Problems in school or at work are the most universal and arguably the most troubling symptom of ADHD. Performing poorly at school can not only demolish a child's sense of self-worth, but also has numerous implications for the future. However, many children can perform adequately in a regular classroom with teachers who are willing to try to work with them.
Many of the techniques that are helpful to children with ADHD can also benefit other classmates. For example, many children with ADHD have trouble with organization. Teachers can establish a predictable routine that includes a consistent time for events and a consistent place for classroom materials, which can provide structure for the rest of the class. Writing the routine on the board can help reinforce learning. In addition, teachers can set aside a few minutes at the beginning and end of each day when children are expected to collect and organize materials.
The teacher's use of visual cues and designs such as placing boxes around key elements can provide external structure that may gradually become familiar and internalized. Using Powerpoint slides with pointers, arrows and markers can also help the student with ADHD learn to organize information. Breaking information into small segments, listing tasks by number and marking them off as they are completed can also be helpful techniques. Older children may benefit from learning how to take notes (e.g., always write down: all major and key minor points, anything the teacher writes on the board, information that is repeated, and anything the teacher refers to from the text).
Even with making modifications to the regular classroom, Special Education services may be the most beneficial option for many children with ADHD. Typically, regular classrooms have a number of students in different ability ranges. As students move to higher grades, most teachers cannot continue to adequately address the individual needs and wide range of skills present in such a large group of children. Most children with ADHD can benefit from smaller, more structured classrooms with fewer distractions and more individualized attention. They also flourish with predictable, consistent routines and caring, flexible teachers who use direct eye contact to help promote clear communication.
Children with ADHD require frequent discussion of assignments and deadlines and extra help in organizing tasks. In special education classrooms, there is more direct supervision and the teacher can provide immediate and meaningful rewards for positive behaviors. In addition, the teacher has time for active planning and involvement with each student. Decreasing distractions, providing immediate and direct feedback to the child about his or her state of control, and providing help with specific learning disabilities are important. The most successful Special Education settings would also include medication management and a consistently applied behavioral program.
Other accommodations that a Special Education teacher could use when working with an ADHD child include:
- Being sensitive to and shaping the curriculum around the interests, abilities and needs of each student
- Allowing mobility in the classroom (e.g., a child could get a breath of fresh air from the window or a drink of water from down the hall while completing a writing assignment)
- Avoiding large quantities of worksheets
- Organizing collaborative learning (e.g., assigning a large project to a small group of students to complete together, rather than one project per student; allowing each person to contribute their own unique skills to the assignment).
- Minimizing formal tests
- Making accommodations for tests (e.g., allowing a child to go to the bathroom during the test, or to take half of the test before lunch and the rest after lunch).
- Communicating with parents and working together to increase a child's success
- Making learning fun!
The utilization of a clear behavioral plan with reinforcement at school that is implemented in a kindly manner can enhance an ADHD student's ability to learn. A behavioral plan in the classroom can not only teach desired behaviors, but provide the child with a structure within which s/he can perform well.
Despite their specialized needs, children with ADHD have lots of strengths. They are often verbal and creative thinkers; "idea people" who can see the "big picture" without getting lost in the detail. They tend to have good long-term memory, or the ability to remember facts or details of things they learned long ago. They tend to learn complex material by understanding the gestalt or how the different elements fit together to create the whole concept. Areas of challenge for students with ADHD often include rote learning (memorization of lists of facts), organization, sequencing, and short-term memory (the ability to focus on learning a new piece of information only to repeat it soon afterward; e.g., remembering a friend's phone number).