Psychology

INTRODUCTION
ADHD (Attention Deficit Hyperactivity Disorder), also referred to as ADD (Attention Deficit Disorder) is a disorder which appears early in childhood and creates inhibition of spontaneous response among the affected children. The symptoms and signs appear before the child attains seven years. The major characteristics of the disorder are impulsivity, hyperactivity or excessive motor actions and inattention or high levels of destructibility. The disorder is diagnosed after the child shows six or more definite signs of hyperactivity and or inactivity for not less than six months in not less than two settings on a regular basis. Its diagnosis thus has to rely on information from various sources which would include parents, caregivers, and the school that the child attends among others (WebMD).

Attention deficit hyperactivity disorder affects 3 -5 of the total population of school going children according to Pelhan  Gnany (1999) which is quite a lot of children in the United States. The symptoms that characterize the disorder not only affect the social lives of the children but also their academic aspect of life. This is because, for children to learn, they need to be attentive and have some level of control over their actions.

Parts of these functions are referred to as executive functions and they are essential for the intellectual functioning of individuals. According to Biederman et.al (2004), it includes abilities such as reasoning, attention, inhibition, planning, interference control, set-shifting, and working memory. A research done, as quoted by these authors, reveal that ADHD have a deficiency in these executive functions. Overall, ADHD especially coupled with executive functions deficit was associated with decreased academic achievement. ADHD, if not treated or control can be a problem among school going children. Luckily, with adequate help, these children can fit even in regular schools and classrooms.

REVIEW OF LITERATURE
Graham (2007) quoting ABS (2006) states that there is an increase in the number of school age children who are being diagnosed with ADHD. According to the ABS report, the rate of ADHD among boys aged between five to fourteen yeas increased between 2003 and 2005. Due to the impact of ADHD diagnoses, the rate gets to its highest at children of age five years and is steadily maintained there until it drops again during the age after compulsory schooling. This is further confirmed in APA (1994) as quoted in Robert (2007) who says that approximately three to five percent of children of school going age are affected with ADHD. Robert observes that 50 of children with the disorder will be eligible for special education due to either their behavioral disorder or learning disability. ADHD is however strictly not a problem of special education and most children with the disorder are mostly able to fit in the general education classroom especially if the teacher has knowledge on how to handle them.

A multimodal approach to ADHD treatment proposed by Barkley (1998) as quoted by Robert ( 2001) covers four major areas one of them being educational accommodations which makes it possible for children with ADHD to be accommodated for in the system of education.

ADHD in some instances was not recognized as a learning difficulty or a discrete disorder. The education department in Queensway State, for instance, did not even discuss ADHD specifically within the rhetoric espousing inclusive initiatives (Graham, 2007). This meant that the special needs of the ADHD child in the school setting were not catered for. There is need for inclusive initiatives to cater for the needs of the ADHD child.

The provision of time for recess or the lack of it has been seen to have an effect on both children with ADHD and those without it. Mulrine (2007), as quoted in Ridgway et.al (2008), notes that recess has been removed or there is consideration to eliminate it by more than 40 of school districts in the United States. The research reveals that children concentrate less when confined in class for a long period of time, children are physically and socially more active during recess as an age function and children fidget less and focus more when they had recess compared to when they did not and focus more after recess than before recess. It is thus essential to provide opportunities for recess for children to have chance for active play because as research reveals, an increase in ADHD diagnosis could be as a result of lack of enough opportunities for active play. Therefore, it is important that recess is not eliminated from schools as research has proved that this can lead to a reduction in the diagnosis of ADHD in children.

When ADHD children reach the school going age, certain issues need to be considered to help them reach their optimum potential. They require a lot of routine and structure, and to learn in a method best understood by them. Their learning should be very practical (Bass). Bass outlines several ways that ADHD children can be helped in schools. They need to be put in groups of other children with similar abilities in terms of education, and in similar maturity levels. Since most ADHD children are less mature in comparison to their peers, they would better suit in a classroom graded system. A strict but fair organization of daily activities following a clear routine is essential so the child knows what is required of them. Teachers need to be warm and sympathetic to these children but also control the class firmly. These children are generally very loving and emotional and respond well to individual attention and praise.

While giving instructions, the teacher needs to maintain eye contact and the instructions should not be given in big chunks but should be given in bits. The system should be such that, children are allowed to repeat years when need arises. These children need minimal destructions hence should be put in small groups or should sit at the front of the class or facing walls to minimize on the destructions. Remedial classes are useful even for those ADHD children who are highly gifted in order to help them direct their intellect. Speech and occupational therapy would be useful too.

Teachers must ensure medication is taken correctly since most ADHD children are on medication, alongside counseling. The best way to assess these children is continuous assessment to be followed by shorter exams since they are not able to concentrate for longer periods of time. Parents and teachers and everyone dealing with children with this disorder need to realize that ADHD children have much talent that is hidden have a lot they can give and they should thus learn to enjoy them.

IMPLICATIONS FOR COUNSELORS
Purdie et al (2002) as quoted in Graham (2007), in their review of interventions which set to be used in dealing with ADHD behavior, found out that the consequences on outcomes in education were more for educational interventions compared to any other types of interventions including psychosocial, medical and parental training interventions. It is further observed that disruptive behavior in schools is being medicalized which poses a danger as it might cause educators to view such behavior as strictly biological and thus beyond their expertise.

Most ADHD children can experience a lot of success in a regular classroom if given some help. They have special education needs, but not always. The teachers and school counselors have a lot that they can do to help ADHD children fit in the school system well and reach their maximum potential in school and by extension, in their entire lives.

According to Linda et.al (2003), school counselors, by virtue of being relationship and behavioral specialists, are able to give support to ADHD children and even their teachers. A position statement was in this regard published by the American School Counselor Association which strongly supported school counselors involvement in the multidimensional treatment of ADHD students. A school guidance and counseling program can be developed aimed at helping children learn more efficiently and effectively. This would include small group or individual counseling, large group guidance, counselor consultation with teachers, parents and administrators and peer facilitator training to enable the ADHD children support each other.

Individual counseling is very helpful in ADHD treatment especially with the use of cognitive-behavioral methods. ADHD children need, more than anything else, to be taught skills skills on how to self-monitor their own behavior, how to solve problems, and how to reduce their impulsivity. The better at these skills the ADHD child becomes, the further successful they will be at school, home and in life (The ADHD Information Library). Group counseling should be used more often since it is more close to real life relationship situations with peers. Being in groups especially with children at the same maturity level is very important to ADHD children as it helps them to acquire the needed skills relevant to their maturity level. Members of the group can help others make generalizations and acquire skills. Through activities in these groups, feelings and behaviors related to social and academic problems are elicited which makes it possible for counselors to intercede and help ADHD children with the problem, using interventions that are consistent with the school program. The Rational Emotive Behavior Therapy theory has been used to develop a group guidance intervention for ADHD students. The process which is likened to a journey consists of six steps and different skills are learnt at each step in a progressive manner. A survey done for counselors and schools indicated that the intervention was very successful in helping ADHD students (Webb). This method can be implemented in schools with ADHD children and used by school counselors to help them.
It is possible to prevent behavior problems by manipulating the environment of the classroom to be suited to the needs of the child. This is particularly important in the general classroom since the teacher needs to attend to other students. These changes can be effected in classroom management, tasks and materials used and the curriculum and mode of instruction. Schools can suit their approach in these areas to benefit the ADHD child.

The main difficulty area for ADHD children, as earlier mentioned, is inconsistent control over impulses and attention. Such children thus often feel demoralized and thus frequently develop self esteem problems. Newton (1997) thus advices on the importance of therapists demystifying the disorder and helping the children understand that they do not always have control over their behaviors and should also be educated on reasons why this happens to them. This makes it possible for them to stop self blame and start forgiving themselves. School counselors can come up with peer educator programs to create more awareness on ADHD not just to the ADHD students but to the entire school community. According to the ADHD Information Library, family therapy can be very helpful in helping ADHD children. The family needs to be taught on how to adjust to the child with this disorder. Parents should know what to expect from the child and the siblings need to be taught also since there is usually a lot of jealousy as the ADHD child receives more attention from the parents. Programs can be created that can allow school counselors to interact with families of affected children and see how best to help them adjust to the ADHD child.

CONCLUSION
ADHD appears early in childhood and its symptoms appear before the child attains the age of seven.  ADHD is a problem of special education and it is therefore imperative that the counselor has knowledge of it.   School going children with DHD have issues which should be considered in delivering optimum assistance such as routine maintenance such as being put in groups depending on their level of education.  And since they require less destruction they should be assembled in small groups to minimize their destructions.  ADHD, as revealed in the in this study is a common disorder in children of school going age. It is thus important that structures are put in place both in schools and homes to cater for this child.