In the last post, I discussed the history of ADHD, as well as its signs and symptoms. Diagnostic materials are not created equally. The standard checklist from DSM-5 can be a little confusing and does not check for some of the common signs of ADHD (e.g., lack of social skills, aggression, handwriting). The Vanderbilt Checklist is commonly used by physicians and covers more items; however, it can be hard to determine exact diagnosis from it since it does not have attention and hyperactivity-impulsivity in separate sections.
A common misconception of ADHD in the 1980s and 1990s was that children could grow out of the ADHD diagnosis. This perception was changed once professionals recognized ADHD in adults. Diagnostic materials were then changed to allow for adult diagnosis.
Since you don’t grow out of ADHD, it is imperative to talk about treatment and teaching strategies. Diagnosis is only a small part of the much larger picture. I will discuss a few strategies and teaching sessions, as well as assistive technology in this post. I will also go through the checklist and evaluate myself for ADHD.
There are many different strategies to help children and adults focus and get tasks accomplished, even though there is no cure. Similarly, there are different behavior strategies that can be used to improve concentration and manage hyperactive and impulsive actions/desires.
Applied Behavioral Analysis
Applied Behavioral Analysis (ABA) is the most widely used therapies for Intellectual and Developmental Disabilities. ABA is commonly viewed as behavior modification. While the term “behavior modification” has fallen into ill repute, it is descriptively accurate. You are teaching a child with ADHD what inappropriate behavior is and what behaviors are acceptable in a given situation. As mentioned in a previous post (see here), ABA is more than just giving treats for good behavior. Appropriate behavior must be taught and rewarded. Books in ABA are available in abundance; however, it is wise to consult a board certified behavior analysis (BCBA) before engaging in ABA therapy.
Social Skills Training
Social Skills Training (SST) is built from ABA therapy. The main difference is that you are teaching appropriate ways to interact with other people instead of correcting independent or isolated behavior. Many individuals with ADHD lack social skills to some degree. This deficit can lead to increased anxiety and depression, or sense of loneliness, which can exacerbate other ADHD symptoms. As with ABA, books on SST can be found on online bookstores. Special Education teachers, Speech-language pathologists, psychologists, and BCBAs are all able to provide SST to students and adults with ADHD.
Scripting, Modeling, and Technology-aided Instruction and Intervention
All of these evidence-based practices (EBP) are built from ABA as well. Scripting can provide a template for social interactions and work schedule for school or employment. Modeling–either teacher, peer, or video–can help in many of the same ways previously discussed, as well as how assignments should be completed and how to complete them in the appropriate time frame. Technology-aided Instruction and Intervention can have the same effect as other strategies; however, the incorporation of technology may be better for some individuals who need more frequent examples or reminders, or for those who do not respond well to physical interaction.
There are many other EBP that may be of help to individuals with ADHD. Each person is unique and should be treated as such. The above strategies are merely a small sample to get you started in researching the needs of individuals with whom you work and interact.
Assistive Technology (AT) is not meant to replace teaching strategies. Rather, AT is designed to be combined with teaching strategies and instructional tools to allow students with disabilities to access curriculum and complete assignments. AT is also used in the work place to help employees to complete tasks with the expected high level of proficiency. AT devices will look different for each student or employee. Here are a few ideas to get you started.
Pencil Grips: These can help individuals get a more stabilized grip to improve handwriting. Small grips can be purchased without much cost. You can also create your own with art supplies or tennis balls (if the individual needs a particularly large grip).
Mind Mapping Tools: These can take the form of low tech (pencil and paper) or high tech (computer apps and Web pages). Mind maps help those with ADHD organize thoughts and eliminate wasted time trying to figure out what to write. They can also be used to plan daily activities to optimize productivity.
Fidget Toys: Whether they be hand spinners, cubes, stress balls, or exercise balls or bands, fidget toys can help eliminate stress, anxiety and excess energy to promote focus in those with ADHD. However, they are not one size fits all. You need to find the fidget toy that works for the individual without causing a negative distraction. Try devices–especially home-made ones–before you make any purchase or commitment.
Visual Schedules and Bullet Journals: These items are more suitable for adults, yet can still be used by all age groups. The idea here is to create a schedule that can be easily followed to remind the individual of what needs to be done and when. This can be achieved through low tech (paper and pencil) or high tech (digital calendars with alarms). Bullet journaling is a way for an individual to personally create a structured visual schedule that maintains some flexibility. (Leave a comment if you would like a post on how to bullet journal)
Pomodoro Apps: Pomodoro sessions are periods of focused work with breaks (short and long) worked in. For example, you can set a work session for 25 minutes with a five minute break. After two or three sessions your break may increase to a 15 minute break. Pomodoro sessions can done with a simple alarm; however, dedicated apps will block certain Web sites to eliminate distraction, or block internet access entirely. Pomodoro sessions are great to use in conjunction with teaching strategies, such as ABA therapy.
I have wondered recently if I may have ADHD myself. I often have trouble staying on task for very long (a normal 25 minute Pomodoro session is difficult). I get easily distracted with wondering what is going on in sports, or wanting to repeatedly check YouTube for updates and new videos. My mind wonders easily, sometimes causing me to forget what I was going to write, to have difficulty in beginning or finishing a blog post, or complete a thought when having a conversation with my wife. I even “zone out” at times (though not frequently) when listening to my wife talk about her day at work (she teaches fourth grade), not because I do not care, rather my mind wonders to something else and it is difficult to get the attention back to her. I often fidget by cracking my knuckles, and my office has changed probably a dozen times in the last year just because I needed to do something with my hands or I was going to go crazy (and writing would not do). With all that in mind, I decided to go through the DSM-5 checklist for ADHD and see if I qualify.
- Often fails to give close attention to details or makes careless mistakes in schoolwork, at work, or with other activities.-I make much less careless mistakes than I used to. I do still have to go back to add detail to my writing, or go back to pick out certain details in reading; however, I think most people have to do that to some degree.
- Often has trouble holding attention on tasks or play activities.-I hold attention quite well here, but I frequently need to do something with my hands when watching sports, movies, or T.V., even if it my favorite team or show.
- Often does not seem to listen when spoken to directly.-I listen quite well, with only occasionally zoning out or getting side tracked on a different or related thought.
- Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (e.g. looses focus, sidetracked).-I follow directions quite well, and always complete assignments on time for school. However, completing blog posts in the time frame I set for myself is rarely done.
- Often has trouble organizing tasks and activities.-I am a well organized person.
- Often avoids, dislikes, or is reluctant to do tasks that require mental effort over a ling period of time (such as schoolwork or homework).-I do not shy away or avoid mental effort. However, some days are harder than others to remain on task or begin tasks. Those hard days are usually filled with cleaning, doing something with my hands, or not getting anything done.
- Often loses things necessary for tasks and activities (e.g. school materials, pencils, books, tools, wallets, keys, eyeglasses, mobile telephones).-No more than the average person.
- Is often easily distracted.-Not always/frequently, but some days are worse than others.
- Is often forgetful in daily activities.-No more than the average person.
DSM-5 classifies hyperactivity as:
- Often fidgets with or taps hands or feet, or squirms in seat.-Sometimes
- Often leaves seat in situations when remaining in seat is expected.-No
- Often runs about or climbs in situations where it is not appropriate (adolescents or adults may be limited to feeling restless).-No
- Often unable to play or take part in leisure activities quietly.-No
- Is often “on the go” acting as if “driven by a motor.”-No
- Often talks excessively.-No
- Often blurts out an answer before a question has been completed.-No
- Often has trouble waiting his/her turn.-No
- Often interrupts or intrudes on others.-No
Do I have ADHD? It is hard to say. I am not a diagnostician; I have no experience diagnosing ADHD. I am also evaluating myself, instead of having someone else evaluate me, which creates bias, validity, and reliability issues. If I had to give my best guess, I would say that I have some problems with attention, but I do not have ADHD. What do you think? Leave your feedback on my self-evaluation in the comments below.
There is no cure for ADHD; therefore, not everything mentioned in this post will be applicable to everyone with the disorder. Hopefully, you have a better idea of teaching strategies and what ADHD looks like. Future posts will discuss specific assistive technology tools that can help manage ADHD in the classroom, home, and workplace.
Send me an email, or connect on social media if you have any questions or tips to share.