ADHD is one of the most commonly diagnosed childhood ‘disorders’, and numbers of diagnoses are increasing both in the UK and internationally. In essence, the neurocognitive deficits associated with this disorder are executive functions associated with cognitive control such as ability to control movement, planning, organisation, and inhibitory control.
There is much controversy regarding the veracity of diagnoses (highlighting the potentially subjective nature of self report survey and observation) and the treatment of ADHD using medication. Many commentators have highlighted the nature/nurture debate and suggested that in some cases, taking a closer look at family, school and peer contexts could enable better functioning than just medication, and that in some cases, there may be no need for the medication.
It is widely understood that children with a diagnosis of attention deficit / hyperactivity disorder may present challenges in terms of behaviour, and academic engagement. Sometimes, behaviour can mask what is going on cognitively, and as such, teachers have to work hard to ensure work is at sufficient level of challenge and that support is structured in a way that enables the child to thrive.
In a recent article published this year by the Canadian Psychological Association, it is claimed by the authors (Climie and Mastoras) that ADHD is most commonly viewed by schools and other support agencies through a ‘deficit’ lens. That is to say that children with a diagnosis of ADHD are more commonly identified by what they struggle with or cannot do, rather rather than the strengths and abilities the children already have and what can be done to build capacity for the future.
It is argued (from a positive psychology perspective – the foundations of a strengths based perspective) that by starting with an individual’s abilities both in terms of assessment and intervention, can create more accurate picture of progress and capability.
Mental health and emotional wellbeing perspectives have been through three major transitions. Pre WWII, alleviating mental illness was closely aligned with improving life satisfaction and promoting positive characteristics. Post war psychology turned towards a deficit model, in which an understanding of how and why people struggle and attempts to explain and control aspects of the ‘illness’ took precedence. In the final turn, at the start of the 21st Century, the concepts of capacity and talent once again regained status in psychology research and practice.
In general ‘positive psychology’ (the emergent wave mentioned above), emphasises building and maintaining personal well-being by concentrating on key elements including positive emotion, engagement, relationships, meaning, and achievement.
Taking a strengths based approach also acknowledges the complex systems and influences on the individual – there may be some aspects of the individual’s life that is going really well or they are successful in, even if they experience difficulties in other areas.
Informed by resilience perspectives, the authors of this article propose “looking for and learning from success trajectories to identify critical protective factors within children and their environments most important for this population (Masten, 2014)”. The justification for this approach is that there is no ‘cure’ for ADHD and neither medical nor behavioural techniques alone eradicate the elevated risk for negative outcomes children with this diagnosis typically face.
Resilience research talks about protective Vs risk factors (protective factors helping to increase resilience whilst risk factors threaten resilience). Although research into risk and protective factors associated with ADHD are underdeveloped – the article does highlight some initial research in this area that suggests that “higher IQ, family marital and financial stability, lower early behavioural problems, and social skills were more predictive of better out- comes than the type of treatment received” (e.g., medication vs. behavioural training; Molina et al., 2009).
Maternal mental health, socioeconomic status, individual intelligence
and positive parenting practice (in research looking at parent training programmes) may also act as a ‘buffering’ factors , according to research cited in the article.
So what to do in schools?
The first suggestion the authors make is to introduce strengths based assessment. This means that “in addition to evaluating core ADHD symptomology and co-morbid risks, a strengths-based assessment would use interviews and/or strengths-based rating scales to probe positive areas”, for instance, if football is a skill and strength, how and why is this going well and how can these successes be applied in other contexts in the school environment? A strengths based assessment would also explore how a child is coping with challenges, what is helping to cope well with some challenges and how to transfer these coping skills to other contexts. Finally, a strengths based assessment will look at multiple outcomes rather than just academic progress – such as subjective well-being, life satisfaction, optimism, motivation, and self-esteem. This more valuable assessment technique is likely to be more time consuming but show a clearer and more complex picture of progress.
Within the classroom, the authors suggest that ‘using collaborative group activities, a child with ADHD might be valuable in contributing out-of-the-box ideas, whereas he or she may be less successful in a role of organizing group tasks, taking notes, or creating the timeline’. Planning will obviously need to be differentiated based on individual students, but a detailed data collection of past and current experiences both and out of school should inform this process. Therefore it is suggested that teachers audit specific strengths and skills a student has and create ‘islands of competence’ from these points, so that the individual feels more confident, has higher self esteem and receives more positive feedback from peers, improving self perception. Encouraging active participation, wide range in variety of tasks, providing task-related choice, using computer-assisted instruction, and scheduling more expectations in morning periods are also all likely to build on strengths.
Children at risk of educational underachievement (not only those with ADHD) will benefit from improving and strengthening relationships with both staff and peers. This will also significantly support staff who are working with children with ADHD, since studies have suggested that developing a meaningful relationship in which staff feel they are an important influence in the child’s life go some way to ameliorating the stress and frustration sometimes experienced by challenging behaviour.
Here is the link to the article : https://www.questia.com/library/journal/1P3-3786190811/adhd-in-schools-adopting-a-strengths-based-perspective
We would welcome any ideas about good existing practice and suggestions for future practice.
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