Senior Speech and Language Therapy Technical Instructor and founder of Chatterpack (a voluntary-run, special education needs and disabilities hub) Claire Ryan talks about her own diagnosis of ADHD and how to help support children and young people who have ADHD.
I come from a very colourful, neurodiverse family and it was no surprise when I was diagnosed with ADHD in 2004. I always knew I was different; I just didn’t know ‘how’ ‘why’ or what to do about it. Diagnosis answered some of my questions, but I still needed to understand what ADHD meant to me, what it meant to my child, and what it meant to some of the children I work with through my role as a senior SALT TI for the NHS.
Through my studies I have learned that effective support and improved outcomes are achieved through reflection of on what we 'know' about ADHD and through enabling adults and children develop a better understanding of what ADHD means to individuals. It is this that led me to write ‘ADHD and Me’, a guide for children and young people to help them understand what ADHD means to them as a unique individual.
It is common for children with ADHD to have more than one diagnosis and trying to unpick strategies for each, is not always possible, nor always the best place to start. Instead, try assessing core executive functioning skills in a range of situations.
Typical areas of need are switching and maintaining attention, organisation, planning, reflection, prediction, and so on. These are skills which are needed to get back on track after a change to routine, therefore, it is common for children with ADHD to become very distressed during transitions. Try using countdowns, visuals, reassurance and let them know if expectations will remain the same or change.
Try analysing situations in which the child succeeded, and those in which they struggled. Gather information on when and why they needed support as well as when and why they were able to achieve unaided, as it is this information which will provide you with a starting point for your planning.
An under recognised strength of ADHD is the ability to find creative, unique solutions to problems. ADHD brains do not think in a linear way, so they might come up with what seem to be bizarre suggestions. But it is incredibly empowering for a child when adults highlight and utilise their unique skills and, with some gentle guidance, it is likely they’ll come up with an idea which you’d not considered before!
An area which is often of most concern to adults, is behaviour difficulties. However, ADHD isn’t a ‘behaviour problem’ and many children with ADHD do not exhibit any behavioural difficulties at all. Children with ADHD experience emotions to a much greater degree and are unable regulate them. They might be thought of as ‘over-reacting’ or ‘too sensitive’ but this isn’t a choice they make; it is a difference in their brain’s functioning. Emotional dysregulation can be crippling. It batters self-esteem and fuels the internal negative dialogue: ‘Everyone else can do it, why can’t I?’ If the child struggles with the transition, try switching from a rules/consequences approach, to a positive, solution-focused approach using motivation, reward and understanding.
Ensure that expectations are achievable and individualised, rather than setting ‘typical’ expectations. One example might be to break the transition down into small, achievable chunks rather than talking about it as a single, large, complete event. This can really help lower anxiety, improve understanding and help them to feel as if it is something they can manage.
Children (and adults!) with ADHD struggle with the most basic of everyday tasks due to core difficulties with executive functioning and we are often much harder on ourselves than people realise. This means we often don’t trust ourselves, but having someone else trust us can really help. Try to find creative ways to show that you trust and believe in them, as this can really help boost their self-esteem during a transition which they might struggle to visualise being successful.
'Top tips for Transition' for children with speech, language and communication needs (SLCN’s)
The key to a successful transition for children with speech, language and communication needs (SLCN’s), is for staff in their new school to fully understand their individual needs and how to support them effectively, but it can take time for a good level of understanding to develop. Making a transition plan can really help this process, so here are a few top tips which you might like to try.
- Tip 1: Discuss the transition with the child and obtain a good understanding of their wishes, their likes, their dislikes, any worries they might have, and so on. This might be more appropriate to do on a one-to-one basis but it’s not always easy to find the time (sometimes it’s simply impossible!) If it is difficult to find time to do this, you could try adding visuals, resources, or stories relating to a range of transition discussion topics into timetabled, daily activities.
- Tip 2: Misunderstandings are common when interacting with children who have SLCN’s and they can happen as a result of a vast range of needs. For example, they might omit words from sentences, have speech sound errors impacting intelligibility, a literal use and understanding of language, or a limited vocabulary, to name just a few. It is natural for adults to ‘fill in the gaps’ and assuming meaning of what children are communicating, however, it is really important that you’re able to gain an authentic representation of their views, wishes and concerns. Again, this is not always easy, but it is important, and can be achieved by being persistent and creative when seeking clarification.
- Tip 3: Gather information about the child’s individual needs from as many sources as possible. Medical reports, education, health and care plans (EHCP) and individual support plans are all good sources of information, but keep in mind that SLCN’s can change rapidly, and ensure that the information is an accurate representation of how the child’s current needs present in various school-based situations.
- Tip 4: Identify effective support by asking key adults about common anxiety triggers, if they can describe environments in which the child succeeds and those in which they might struggle, which lessons or topics they like or don’t like, and so on. This information should provide you with a good understanding of how, where and why the support does or doesn’t work, and it is these details which are vital to include in the transition plan.
- Tip 5: Using positive language can be tricky when discussing needs, particularly when it is necessary to include details of difficulties within a transition plan. However, details of what works and how the child achieves are also important to include and can really help to keep the planning and the transition solution-focused and positive.
- Tip 6: Make a Transition passport to present the information you’ve gathered within. This is a small, practical resource made up of a few cards, each relates to a school-based need and includes a brief explanation and a suggestion of support to help the child succeed.
- Tip 7: If the child’s SLCNs make them difficult to understand, ensure you provide new staff with information and context relating to topics the child might want to tell new adults and peers about. For example, you could add images of their family, pets, skills or interests to the transition plan or passport.
- Tip 8: If the child struggles to make friends, there are many things you could try to ensure they’re not isolated within their new social group. The most effective being education of the peer group and school community as a whole. Another idea is to create ‘social prompts’ cards which include prompt phrases for the child to use when starting, continuing and ending conversations.
- Tip 9: Teach the child how and when to use any transition resources you create by helping them to practice with familiar adults and children before the transition begins.
- Tip 10: Finally, consult and include parents/carers in the planning and creation of the transition plan. They can be the best source of information and are a vital part of the transition ‘team’ as they can ensure consistency and continuity of approaches used during and after the transition.
Please challenge what you ‘know’ about ADHD. For example, inattentiveness and hyperactivity are core features of ADHD, but the ways in which they present and impact a person can manifest in countless ways. No two children are alike just as no two children with ADHD are.
ADHD is underdiagnosed and under medicated in the UK (REF: https://www.thelancet.com/pdfs/journals/lanpsy/PIIS2215-0366(17)30167-0.pdf & NICE Guidance) Early identification and the right support can help to avoid significant mental health problems which can improve long term outcomes. So, please, please seek assessment if you are ever in doubt.
ChatterPack creates accessible, effective, practical information, and resources to support children with special educational needs. We share these via our free monthly SEND newsletter and store them on our website for future use. We have also written a book, ‘ADHD and Me’, a guide to help children figure out what ADHD means to them as a unique individual. Find out more at ChatterPack.net