Introduction
I found this week’s assigned readings and viewings extremely beneficial and highly relevant to teaching in today’s dynamic classrooms. I wish I had the base knowledge offered within these resources prior to beginning my career as an uncertified teacher. Sadly, I did not receive any training (nor was I directed to such resources) and, therefore, was not fully equipped to support students with Attention-Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), Conduct Disorder (CD), anxiety disorders, depression, or brain injuries. My only saving grace was my extensive experience with children (having been an empathetic and nurturing mother of three), which gave me the ability to get down to children’s levels and walk them through their emotions, feelings, and behaviours.
My previous experience with children helped me gain student attention, aided in de-escalating heightened behaviours and feelings, and guided me when I needed to “sit in the muck” with a student until they were ready to get up and carry on. However, as discussed in this week’s resources, children with ADHD, ODD, CD, anxiety disorders, depression, and brain injuries struggle above and beyond most children when it comes to executive function and managing feelings, emotions, and behaviours, which often leads to the magnification (or spiraling) of feelings, emotions, and behaviours. Thus, despite my experience with children, there have been times when I did not know what to do or how to help a student because I was never adequately informed or trained to meet the needs of specific diagnoses. It is with this lack of knowledge and training that I now act as a sponge and reflect upon this week’s resources!
ADHD
Attention-Deficit Hyperactivity Disorder results from differences in the brain and The Understood Team (2022) does a great job synthesizing and summarizing the causes and effects of these differences. The Team outlines how areas of the brain involved in executive functioning take longer to develop in people with ADHD; how ADHD effects women and girls just as often as men and boys; and how ADHD is genetic and tends to run in families. The Team details the struggles that go along with ADHD, particularly around executive functioning: paying attention, self-control, sitting still, following directions, managing emotions, getting and staying organized, setting priorities, managing time, planning, remembering information long enough to use it, and shifting focus from one thing to another; but also the strengths, outlining how individuals are able to focus intently on things they find interesting and are “outside-the-box-thinkers” that (with the right support) thrive in school and in life.
I appreciate The Understood Team’s emphasis on ADHD not being about laziness or lack of discipline, noting that “people with ADHD are often trying as hard as they can to focus and keep their impulses in check.” As I have witnessed, and as the Team points out, fidgets, movement breaks, frequent reminders, subtle cues, reward systems, and medication are particularly helpful in managing symptoms and helping students focus and be successful in the classroom. The evolving nature of ADHD was also evident in the Team’s article: “ADHD doesn’t just go away as people get older. Most of the time, hyperactivity and impulsivity lessen or disappear by the teen years or a little longer. But trouble with focus usually continues.” They also highlight the myth of the “ADHD kid”: “the stereotype of kids with ADHD is that they’re always in motion, they’re impulsive and hyperactive, and that they act out at home and at school. But some people with ADHD never have those symptoms [and] only struggle with focus” (2022).
The additional video links on Understood’s website illuminate what it is like to be a child with ADHD—children saying it is like living in “la la land” with “so many distractions that make it hard to focus on the teacher and instruction”; one boy speaks of how it is “impossible to stay on task when his brain is always in overdrive”; another tells of how it helps to “doodle, fidget, or go for a lap around the school once in a while”; and another says “it’s like I can’t think, like I don’t even have a brain when I need to know what needs done first, second, third, or where I put things, where things were left, or where they need to go!” These glimpses can help teachers better understand and meet the needs of students with ADHD. With understanding and knowledge, we can provide structure and routine; we can ensure students have time to practice; we can break big jobs into small tasks; we can have ample patience and give students time and encouragement; we can build in movement and develop individual strategies to get, keep, and re-gain student attention (eye contact proximity, reminders, and/or cues).
CADDRA’s (2021) infographic is another wonderful resource to consult, utilize, and disseminate to ensure that there is adequate ADHD awareness, knowledge, and consideration in our classrooms. CHADD’s Tips for Teachers Video Series (2022) is an additional place to start, especially when thinking about how to differentiate student work for productivity, learning, and student success; how to make accommodations for students with ADHD in the classroom and what intervention may be appropriate; and how to create a positive dialogue with parents of students with ADHD.
ODD & CD
Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) are disruptive behaviour disorders that often get confused with ADHD (Morin, 2022). Prior to this week, I do not recall reading about or hearing the terms ODD or CD. As such, I was highly interested in Morin’s article and what she had to say about disruptive behaviour disorders in general:
All kids act up and act out from time to time. It’s normal to test limits to see when no really means no. Most kids have angry outbursts and sometimes use aggression to solve problems. These things are part of growing up and learning to be independent. Most kids learn that refusing to listen to a parent, throwing tantrums and hitting people have consequences. But some kids act angry, defiant and aggressive in spite of the consequences. If this behavior is severe and continues for six months or more, it can be a sign of disruptive behavior disorder.
Morin, 2022
What Morin had to say about ODD and CD, in particular, was also interesting: “There are two main disruptive behavior disorders—conduct disorder (CD) and oppositional defiant disorder (ODD). They’re different from each other, although kids with CD may also have ODD” (Morin, 2022). Morin states that “Conduct disorder is a serious condition that typically isn’t diagnosed until the teenage years”; she goes on to say that it is “believed to be caused by a combination of genetic, psychological and environmental factors.” Signs of CD include causing harm and hurting other people; lying without feeling bad about it; threatening behavior toward others (fighting, bullying, and emotional abuse); stealing and destroying things; refusing to follow rules or laws; and an overall disrespect or disregard for other people’s rights or feelings (Morin, 2022). This is different from ODD, which typically shows up before age 8 and includes the following signs: being uncooperative on purpose; not following the rules; arguing, even about small and unimportant things; and an overall irritable and negative attitude (Morin, 2022).
Looking back on my three years of teaching, I can think of several students who fit the description of ODD, and perhaps one that fit the description of CD. However, as Morin points out, I probably mis-diagnosed these students as having ADHD:
Kids with ADHD can have problems following the rules and may be easily frustrated and angry, but those are just some of the many symptoms. The way the brain works in kids with ADHD makes it harder for them to stay still and to control impulsive behavior. The brain matures more slowly in kids with ADHD than in kids without. Kids with ADHD may also have lower levels of the brain chemicals that help regulate mood and movement. The result of these differences in brain development may look like disruptive behavior issues. But not all kids with ADHD have an ongoing pattern of negative behavior. Kids with ADHD may react to their environment and get upset. But kids with disruptive behavior disorder seem to be looking for arguments and ways to break rules and rebel.
Morin, 2022
Armed with this information, I am now aware and understand the differences and similarities between CD, ODD, and ADHD and will be better at distinguishing and helping students who struggle with behaviour in the classroom.
Anxiety & Depression Disorders
Anxiety and depression seem to be more prevalent in schools today than ever before, especially in the aftermath of Covid-19. As such, it is crucial that teachers make themselves aware of the signs and symptoms of anxiety and depressive disorders and arm themselves with the knowledge and tools to help students cope and find treatment. According to Anxiety Canada: “As educators, increasing your awareness of the impact of anxiety is important for supporting your students and yourself” (2022). Knowing what to look for and how to address anxiety is an essential part of a teaching:
Students spend between 25-30 hours or more in school each week. As teacher or administrative staff, you’re in a position to play an essential role in identifying and assisting students with unwanted anxiety. The first step is to become educated about what anxiety disorders look like in students within the classroom setting. Anxiety specialist have identified that when a child or teen experiences anxiety more often (e.g. most days, and for months at a time), and more intensely than other peers of the same age, it is more likely that the student has an anxiety disorder.
Anxiety Canada, 2022
Here, Anxiety Canada reminds us that some anxiety is normal and healthy, but too much is unhealthy and can be indicative of an anxiety disorder. Anxiety Canada also points out that anxiety is often obvious—giving an example of a young student who cries and clings to his mother’s leg daily for months, or the student who has lost her sibling to suicide and now withdraws from others, skips class, and has difficulty concentrating—but it can also be invisible: “not necessarily noted by the busy teacher”—giving an example of the student who is performing below their capacity, is late to school most days, and is reluctant to read out loud in class, or the child who is known as the “dream student” but, unbeknownst to the teacher, spends upwards of six hours daily doing homework to perfection, has trouble sleeping due to fear of failure, and refuses to engage in non-educational activities for fear it will rob her of essential learning opportunities (2022).
Anxiety Canada urges teachers to consult the school counselor or principal if they suspect a student is experiencing excessive, intense, or disruptive symptoms of anxiety that interferes with attendance, completing assignments, joining social, athletic, or recreational clubs, learning, making friends, or participating in class. Once a consultation has been completed, scheduling a meeting with the student and/or their family is recommended; this allows one to gather more information and provide resources. Knowing this process, and the steps one should follow, relieves the burden of not knowing what to do or how to handle situations involving students with anxiety. I also appreciated Anxiety Canada’s “Caretoons” and will be incorporating them into future Health Education classes as a way to introduce mental health topics, help students recognize anxiety in their lives, teach them coping techniques, and help them realize that it is ok to ask for help.
Like anxiety (where some is ‘normal’ and healthy), it is ‘normal’ for students to sometimes feel sad, down, or to be in a bad mood; however, if such feelings last for extended periods of time, a student could be suffering from depression: “a low mood that lasts for more than a few weeks and makes it hard for a child to function at school, with friends or in their daily lives can be a sign of depression” (Kelty Mental Health, 2022). According to Kelty Mental Health (2022), depression is a mood disorder characterized by sad, irritable feelings that last longer than a few weeks and includes the following signs and symptoms: negative thinking, changes in appetite or sleep, and loss of enjoyment in activities (2022). Kelty Mental Health says that there is no one single cause of depression; rather, it is often due to a combination of genetics, environmental factors, psychological vulnerability, comorbidities, stressors, and biology. More importantly, though, is that depression is a treatable condition and educators are uniquely situated to observe and intervene when depression is suspected. Helping students seek treatment is a top priority and I am thankful for the advice offered by Kelty Mental Health.
Brain Injuries
Brain injuries range in severity depending on the area of the brain that was damaged. I know, from personal experience with an adult who suffered a severe frontal lobe brain injury, that the road to recovery is a difficult and lengthy process. For students, and their teachers, this road can be particularly challenging. According to Bowen (2008), “Students who have sustained a traumatic brain injury (TBI) return to the school setting with a range of cognitive, psychological, and physical deficits that can significantly affect their academic functioning” (Abstract). I witnessed first-hand how difficult this return to the classroom can be when a young adolescent in our community suffered a TBI and spent months in hospital before gradually returning to school—a few hours at a time, with modified workload, until full days were realized. Still, adaptations were necessary (preferential seating near the teacher to help with focus, reduced workload, frequent reminders, one on one support with directions, etc.). This example aligns with what Bowen outlines in his article:
Children with frontal lobe injury typically experience greater difficulty with executive function, which includes attentional processes, self-regulation, goal setting, initiating, and inhibiting behavior. Many behavior and social problems observed in children with TBI are related to executive functioning. They may also have problems with organization—planning, prioritizing, analyzing tasks, and completing a sequence of activities. Cognitive impairments can include memory problems, slowed information processing, and language disturbances. Memory impairment (recalling and retaining information) is one of the most common deficits associated with pediatric TBI
2008, Common Sequelae of TBI.
Understanding and anticipating the challenges of brain injuries and how they present in students and in the classroom is important and can help us, as teachers, structure our classrooms and environments, make necessary accommodations, seek out available resources and services, and adopt specialized teaching strategies that are beneficial to students with brain injuries. “Although some children with brain injury experience persistent cognitive and behavioral changes, when provided appropriate resources and strategies, all students can reach maximum potential” (Bowen, 2008, Summary).
Summary
Teachers—both new and old, service and pre-service—stand to benefit from this week’s assigned readings and viewings, and many of the resources (websites and infographics) are valuable resources that can be shared with families of students (both with and without said disorders) to help spread knowledge and awareness of the strengths and stretches of students with ADHD, ODD, CD, anxiety disorders, depression, and brain injuries.
References
Anxiety Canada. (2022). Educator Resources. Accessed August 2, 2022, from
Bowen, J. M. (2008, July 25). Preventing School Failure. Classroom Interventions for Students with Traumatic Brain Injuries. brainline. https://www.brainline.org/article/classroom-interventions-students-traumatic-brain-injuries
CADDRA. (2021). Talking About ADHD. [Infographic].
https://www.caddra.ca/wp-content/uploads/Copy-of-ADHD-Language-Guide-Infographic_DEC2021_CADDRA.pdf
CHADD. (2022). Teacher Training & Video Series. Tips for Teachers Video Series. Accessed August 2, 2002 at https://chadd.org/for-educators/teacher-training-video-series/
Kelty Mental Health. (2022). Depression and Depressive Disorders. Accessed August 2, 2022, from https://keltymentalhealth.ca/depression
Morin, A. (2022). The difference between disruptive behaviour disorders and ADHD. Understood. https://www.understood.org/en/articles/the-difference-between-disruptive-behavior-disorders-and-adhd
The Understood Team. (2022). “What is ADHD?” Understood. Accessed August 2, 2022, from https://www.understood.org/en/articles/what-is-adhd
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