Tobiáš is running around the classroom, shouting loudly and demonstrating the video he saw yesterday. He doesn’t let others talk and he gets angry when his classmate admonishes him. His movements are erratic; before completing one thought he has already jumped to the next one. To a casual observer, Tobiáš may seem like a naughty boy who doesn’t know how to behave. But the reality is more complicated.
Tobiáš suffers from congenital attention deficit hyperactivity disorder (ADHD). He is very intelligent, perceptive and talented in creative activities where there is little need for patience or attention to detail. But his behaviour takes precious time away from his class teacher. In order to teach him, she needs a wide range of skills that are not normally taught at education faculties and that she must supplement with further practical training.
The popular and highly attended courses focusing on ADHD within the Better School for All programme are led by experienced lecturer Jaroslava Budíková. We talked to her about how ADHD manifests itself in children, the causes of the disorder, how teachers and parents are taught “not to lose their cool”, and how people cope with this disorder in adulthood.
What does ADHD mean?
Attention deficit hyperactivity disorder.
How do you recognise a child suffering from this disorder? What are the most noticeable signs and how do you diagnose it?
These children can’t engage in one activity for very long, run from one activity to the next, make comments without being asked, constantly interrupt others and call attention to themselves. Their speech reveals significant psychomotor agitation that the child is unable to control. Their behaviour and mode of expression demonstrates impulsive responses to stimuli, the child cannot understand the consequences of their actions, lives in the moment, often acts thoughtlessly and rashly. The child often responds inadequately, which may be one of the sources of misunderstanding with peers. Consequently, as a result of frequent and repeated failure, there is reduced self-esteem and self-confidence, increasing agitation and internal tension. Children with ADHD do not know how to release tension. They are constantly under the “fire” of stimuli to which they must pay attention. As a result, rapid overload and subsequent irritation or affective behaviour occurs. It is important to realise that it is a syndrome whose manifestations, causes and impacts differ, develop and change from individual to individual.
When working with children, we mainly focus on behavioural manifestations. If we see typical ADHD symptoms over several months (up to half a year) in various environments, we inform the parents and encourage them to seek professional help. Each kindergarten and school has its own facility that the parent or educator can turn to. Within the health system the diagnosis is always made by a psychiatrist.
What are the causes of ADHD?
This disorder may already be affected by pregnancy. The probability of its occurrence seems to increase with incidence of trauma, accidents or excessive stress in pregnancy. Complications in childbirth can also contribute negatively. Genetics or combinations of all influences also play a role. In some cases, the risk factors cannot be determined.
Can we say that this disorder is more common than, say, 20 years ago? Or did we just improve diagnostic methods?
I would say that both statements are true. Today we are better able to recognise ADHD, but the concepts are based on different diagnostic systems.
What should future mothers do to reduce the risk of ADHD?
Be as calm as possible during pregnancy, without unnecessary stress and tension, and generally maintain a healthy lifestyle.
How should a parent proceed if he suspects that his child may suffer from this disorder?
In the school system the parent can turn to a pedagogical-psychological counselling centre, a doctor (child psychiatrist) and a clinical psychologist. ADHD is also related to biochemical processes in the brain, so interdisciplinary collaboration is important. If ADHD is confirmed, then the approach to the child should be discussed with the child’s teachers.
Do you train teachers to work with children suffering from this disorder? What are the main principles and approaches that you recommend?
We have a whole seminar dedicated to this topic. It’s impossible to cover everything, but I would emphasise that each child is unique and requires a different approach. But in practice we have found that there are certain principles that can facilitate work with them.
Frist of all, the teacher and the parent must understand that the child is different and not to take the misunderstandings that arise personally. You need to know how to lead with empathy and kindness and how to set consistent boundaries. Teachers should work on their relationships with pupils.
I would also point out that psychomotor restlessness can be alleviated by certain relaxation techniques, such as massages. It is also a good idea to teach pupils to work with breathing, to allow them to rest. It helps minimise the distractions that make it impossible for them to focus on learning and work. It is important to apply an individual approach that respects the needs of the child. Of course that’s easier said than done. It requires maximum participation from us and working with our own emotions – one might even call it mastery of the teaching profession – and sometimes this is a long-term process.
Clearly working with such a child or children must be very demanding for teachers. How do you work with them to handle it? Do they take courses individually or do you train in each school separately?
It depends on demand. Sometimes I teach the entire teaching staff of a school; sometimes I have a course that interested teachers can attend individually. At the courses we focus on contemporary knowledge from different disciplines, practical skills in working with a class, individual or parent, and working with emotions.
If a teacher correctly understands the symptoms of ADHD, it is easier for him or her to find the motivation to work with children with the disorder. Understanding that a child is not deliberately acting in a provocative manner also makes it possible to solve problems by means other than punishment. The teacher is more likely to be accepting and to try to find a concrete solution. Instead of criticism and shouting, the teacher provides feedback and focuses on the things the child needs to learn.
What do you enjoy most about your work?
When I meet adults who suffered from ADHD as children and see that they have succeeded at school, work and in their family lives. This always confirms that this work has purpose. With the cooperation of all those involved it is possible to live with ADHD, to be successful professionally and to have good relationships with others despite the many obstacles that these individuals must overcome.