10 year-old Jacob cannot sit still in class. In fact, it seems he is in the hallway more than the classroom some days. Emily is in Jacob's class, but unlike him, she is well liked by the teacher. Quiet and compliant, she is hardly discernible amidst the clutter of the Grade 5 classroom. She works slowly and takes most of her work home to finish. The problem is, she forgets to record assignments and looses track of papers, which means that her homework is not always done. Her parents are frustrated, but her teacher doesn't seem to care because Emily is never a problem in class. Although Jacob and Emily are classroom opposites, both students have attention deficit disorders that contribute to their academic struggles. While Jacob gets a lot of attention for his problems, Emily's are hardly noticed. This can be fairly typical of girls who do not have associated symptoms of impulsive or hyperactive behaviour.

It is estimated that 5-10 % of the population is affected by Attention Deficit Hyperactivity Disorder (ADHD), characterized by a reduced ability to pay attention and symptom onset before the age of seven.

Students with ADHD often struggle with the demands of school because of difficulties with listening to lessons, organizing materials, remembering instructions, managing time, setting goals, breaking large tasks down into steps and following through on tasks independently. Boys are diagnosed earlier and more frequently than girls because of a higher frequency of behaviour problems; however, incidence rates are quite similar between the two sexes.

Approximately 45% of affected children have associated language and learning impairments. Jacob had problems understanding language abstractions (e.g. indirect requests like "Cut it out") and struggled to "find" words when he talked (i.e. word retrieval problems). Emily's recall of spoken instructions was poor (i.e. reduced auditory memory) and her oral and written communication (i.e. discourse formulation) skills) were weak, which contributed to slow working speed.

Speech-Language Pathologists play a key role in identifying and treating language based learning disorders. Early identification and treatment are critical in preventing academic failure and social/emotional problems common in children with ADHD. Speech-language pathologists also consult with teachers and parents to develop coping strategies to improve students' behaviour and social skills.

Students often require educational assessment and specialized tutoring to provide the one-on-one teaching and skills development (e.g. time management, study skills, test-taking strategies) required for school success.

Tips For Parents:

• Request a Speech-language pathology assessment if you have any concerns about your child's reading, writing, listening, memory, speech or social skills.
• Learn how to advocate for your child. Consider joining a support group for parents of children with communication disorders (OAFCCD), ADHD (i.e. CHADD) or learning disabilities (LD Association).
• Provide as much structure as possible at home. Establish routines for important tasks (e.g. chores, homework) to decrease the impact of organization and memory problems.
• For young children, provide advance warning of any changes in routine or transition times to reduce associated anxiety.
• Teach strategies for organizing your child's workspace and written work (e.g. labeled storage areas, written outlines for projects).
• Give instructions that are clear and simple.
• Involve your child in physical activities to allow constructive ways to burn off excess energy.
• Use consistent behaviour management strategies. Focus on the use of positive and specific praise for appropriate behaviour.
• Teach social skills (e.g. conversational topics to avoid, expressing concern using verbal and nonverbal communication) that will help children to make and keep friends.
• Teach conflict resolution skills and problem-solving strategies.

Tips For Educators:

• Remain calm, patient and understanding regarding behaviour difficulties. Encourage students to build self-control and take responsibility for their actions.
• Modify the classroom environment to enhance attention (e.g. seat student closer to the teacher and away from distractions).
• Maintain an organized classroom (a place in the room for all materials and completed assignment).
• Teach list making, day planning, note-taking and social skills explicitly.
• Keep rules to a minimum and enforce them consistently.
• Praise effort and give specific praise for improved work and behaviour.
• Use subtle cues to remind students of expectations (place hand on desk to indicate that it is time to work)
• Modify the curriculum and daily schedule to incorporate student's interests and learning preferences; allow choice of tasks/activities; alternate high and low interest tasks
• Make instructions clear and simple and augment with visual information (i.e. notes, graphs, diagrams) whenever possible. Ask students to repeat and/or paraphrase important directions to ensure comprehension and retention.
• Teach planning and organizing skill explicitly, e.g. help students collect materials that will be needed before each activity.

Workshop: For more information on intervention strategies for ADHD and Auditory Processing Disorders, attend the "Children Who Tune Out" workshop at London Speech and Language Centre. Call the office (519-642-7370), register on-line, or obtain more information on speech-language pathology and special education services for children with ADHD.

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