International Journal of Student Voice
A peer-reviewed, independent, open-access journal
Pennsylvania State University
Volume 7, Issue 1 IJSV, Special Issue April 2022
Enabling Participation in Voice Research for Adolescent Children with Characteristics of Autism
Citation: Franklyn, R., & Dharan, V. (2021). Perspectives of Students with Attention Deficit Hyperactivity Disorder. International Journal of Student Voice, 7 (1).
Abstract: Although New Zealand is one of the 196 countries that are signatories to the United Nations Convention for the Rights of the Child (UNCRC), many young people remain marginalised in the education system. This article explores the importance of affording children their rights to an education that develops their talents as outlined in Article 29 of the Convention. With an emphasis of students who have attention deficit hyperactivity disorder (ADHD), who tend to have poorer academic and social outcomes compared to their peers, this article explores their experiences in school settings. Although international research includes the voice of students with ADHD in terms of their school experiences, their perspectives in New Zealand remain relatively unheard. This article draws from a study that explored the learning experiences of ten Year 9 and 10 students diagnosed with ADHD. Using semi structured interviews, the results showed that the students were very attuned to their own strengths and weaknesses to learn, and were also aware of the supports that would be helpful for them to learn at school. Students reported that they were most involved in learning when teachers were innovative and creative in their teaching approach. Teachers who had an understanding of the implications of ADHD on learning gave them choice and agency over their learning, and believed in their ability to learn. This study contributes to the discussion on the variation in the way young people with ADHD experience, and value, school.
Keywords: Attention Deficit Hyperactivity Disorder, Student voice, Pedagogy
In Aotearoa New Zealand, every child has a right to education. Under the New Zealand Education and Trainings Act 2020, schools have a mandate to be inclusive of all learners, with attendance being compulsory from ages 6–16, and free from ages 5 to 19. The National Educational Goals set by the Government, stipulate that state schools are responsible for: enabling all students to reach their full potential, providing equality of educational opportunity; removing barriers to achievement and respecting the diverse ethnic and bi-cultural heritage of New Zealand. Yet, students with ADHD have poorer academic, social, and vocational outcomes than their typically developing peers (APA, 2013; DuPaul et al, 2011; Rapport et al, 2013).
More recently, there has been an active shift globally towards considering the rights of children in all matters concerning them, particularly since 2005, when the United Nations Committee on the Rights of the Child highlighted its importance. The 54 Articles of UNCRC firmly anchors the rights of children under the ambit of Human Rights (Human Rights Commission, 2010). Article 12 of the Convention, explicitly gives all children the right to form and freely express their views on all matters and procedures which affect them, and for their views to be given due weight in relation to their age and level of maturity. As a further safeguard to be dismissive of the views of children, Article 3 stipulates that children’s best interests must be ‘a primary consideration’. This places the onus firmly on adults to listen to children and ensure that their views are considered seriously and acted upon (Lundy, 2007).
Children with ADHD and rights to education
ADHD is a developmental, neurological disorder characterised by inattention, impulsivity, and hyperactivity, resulting in functional impairments. It is often associated with decreased levels of self-application to tasks, reduced school performance and academic attainment and early school leaving, resulting in poorer vocational, social, and mental health outcomes (American Psychiatry Association, 2013). In New Zealand, the prevalence rate of ADHD is 3-5% of all children (ADHD New Zealand, 2020). Hyperactivity combined with limited impulse control and difficulty with sustained attention are key barriers to learning for students with ADHD resulting in negative school outcomes. Ministry of Health (2001) statistics note that medication improves both the core symptoms of the condition such as attention span, impulsivity and disruptive behaviours, and increases academic focus and performance for 70 to 80% of children. Though medication may help concentration, for some it reduced cognitive flexibility and creativity (Brady, 2014). Brady’s study of 6-15-year olds highlighted that students were able to clearly understand the implications of taking medication and the effect it had on their thoughts, actions, decisions, and self- identity.
Difficulties in the executive functions (EF) of the brain is a causal factor for the academic and social difficulties for students with ADHD (Banich, 2009; Molina et al., 2009; Rapport et al, 2013). The impairment of EF results in specific difficulties such as: prioritising and sequencing tasks, inhibiting distractions and maintaining focused attention to complete tasks, all of which are essential aspects for successful academic outcomes (Banich, 2009; Brown, 2006). Their impulsivity often stands in the way of interpersonal relationships and ability to resolve conflicts with peer groups (MOE, 2015), impacting on their friendships. Often children and young people with ADHD are astute and have a heightened awareness of their learning and social difficulties, which affects their self-esteem and self-worth (Barkley, 2015). Findings from 445 participants from the Dunedin Multidisciplinary Health and Development Research study in New Zealand found the link between reading ability and teacher reports of students with ADHD at age 7 and their academic self-concept (ASC) at ages 9 and 11, with antisocial behaviours in their teen years (Pisecco et al, 2001). There was a stark message from this study on the importance of successful educational experiences for children and young people with ADHD, to ensure positive life outcomes.
Given that children in New Zealand are required to be at school for at least six hours a day from ages 6 to 16, education has a profound impact on the lives of children. UNCRC emphasises that education should promote respect for human rights and cultural identity and be “child-centred, child-friendly, and empowering” (UNICEF, 2006, p.1). As a signatory to UNCRC, all children in New Zealand , including children with ADHD, have a right to education that will develop their “personality, talents, and mental and physical abilities to their fullest extent”(Article, 29 (a). Studies of children and young people with ADHD highlights aspects that both supports and prevents their learning. The perceptiveness of children and young people of their difficulties as well as their solutions are evident in the few studies that included children as participants.
Supportive learning environments
A review of the literature identifies key teaching practices that contribute positively to the learning and participation of students with ADHD in schools. Well scaffolded instructions and activities that do not require sustained periods of sitting at a desk, combined with small group work often had better academic outcomes (Hart, et al., 2011; Martin et al, 2017; MOE 2015).
Teachers play a critical role in successful outcomes for students with ADHD. In a study of 17 students aged between 11-16 years in the UK highlighted the importance of strong teacher student relationship as being critical for the learning of students with ADHD (Travell & Visser, 2006), as was teachers’ knowledge of the neurological implications of the condition (Kendall 2016). Studies in UK and USA also found that teachers who understood the characteristics of ADHD were able to incorporate multi-modal instructions, have clear expectations and provide positive feedback (Kendall, 2016; Singh, 2011; 2012), all of which contributed to the learning of students.
Though seldom acknowledged, students with ADHD are perceptive of factors that supported their learning. A study of twelve 10-15 year olds in UK, found that students were able to identify precise classroom level supports such as clear instructions of learning tasks, access to teacher aides, having frequent breaks, and having objects to ‘fiddle’ discretely to increase their concentration, as well as wider supports such as increased awareness of ADHD in their school communities, and for teachers in training (Kendall, 2016). They are also perceptive of needing support to improve their interpersonal skills and friendships (Puvanendran & Nagaraj, 2014). Their insightfulness was evident in a study of 151 young people aged 9-14 in the UK and USA by Singh (2011, 2012), two thirds of whom had ADHD and conducted over a three year period from 2007-2010. Students with ADHD situated themselves in two distinct categories – Good conduct and Good performance. The former category was associated with behaviours such as physical aggression and bullying, while they associated the latter with doing well in academic tasks. Interestingly, the researcher found that students who identified themselves in the Good performance category preferred to keep their diagnosis secret from their peers, although both groups found medication helpful to stay focused. Classrooms where teachers were creative in managing hyperactivity and distractibility, had a positive effect on them (Singh, 2012).
Conversely, studies show that when teachers had limited understanding of ADHD, their handling of behaviours had an impact on students’ self-esteem and learning (Kendall, 2016; Stamp et al, 2014; Singh, 2011; 2012; Travell & Visser, 2006). A disturbing trend was the levels of aggression and bullying students with ADHD experienced from both peers and teachers (Singh, 2011).
In Aotearoa New Zealand, teachers have an obligation to acknowledge the nation’s bicultural foundations and deliver a curriculum that upholds the Tiriti O Waitangi principles of participation, partnership and protection (MOE, 2020). These principles are inclusive and places all children at the centre of teaching and learning. One of the underlying principles of teaching from an indigenous perspective is the notion of ako, meaning that learning and teaching are reciprocal processes. Ako suggests that the teacher is also the learner, and the learner is also the teacher and there is a mutual relationship of respect for each other’s culture, beliefs, and environments. This reciprocal approach to teaching positions teachers to make a genuine effort to understand all students in their classroom, an aspect students with ADHD have emphasised across the reviewed literature.
While medication can be helpful, the evidence points clearly to teacher knowledge and pedagogy as critical factors for the learning of students with ADHD. To become successful learners, these students require more reciprocity in teaching and learning situations, instructions that are innovative and motivating ; a high degree of structure, and a deliberate focus on fostering positive social interactions (Kendall, 2016; Reeve, 2013). Supportive learning environments that had the most positive outcomes, had teachers who understood the implications of having ADHD on learning , and firmly believed in the capabilities of the students to learn
The current study
This qualitative study explored the educational experiences of ten Year 9 and 10 students diagnosed with ADHD across 12 schools. Understanding the educational experiences of young people with ADHD is a relatively under-researched field in New Zealand. So, Senior school leaders of Year 9 and 10 students (i.e., 13-14 years old), Special Educational Needs Coordinator (SENCO) and Learning Support Co-ordinators were approached in 12 Secondary schools in Central North region in New Zealand. At the time of the study (2020), schools were experiencing the effects of Covid-19 lockdown, and this made it difficult to access the required number of participants through schools. Therefore, the National Co-Ordinator for ADHD New Zealand was contacted and with approval from ADHD NZ, their social media website was accessed to e-mail members to obtain participants. The first 10 students (8 boys and 2 girls) who agreed to participate were included from various parts of the country. Semi-structured interviews of up were conducted through Zoom meetings.
As the study involved working with children and a vulnerable population, all aspects of the study were carried out in keeping with the Massey University Revised Code of Ethical Conduct (2017). Personally (first author), having a son with ADHD who struggled through the New Zealand education system meant that a reflective journal was kept throughout the study to reflect on the researcher’s values, assumptions, beliefs, and closeness to the research topic to try to mitigate researcher bias and subsequent impact on data analysis. Interview transcripts were sent to students for checking for accuracy, and the collective data from the 10 participants were analysed thematically. All students were on some form of medication, and they accepted this was an inevitable aspect of their condition. Nine students said that medication improved their focus in the classroom and decreased distractibility. While most participants discussed medication in terms of their learning, one of them said that ADHD is part of his personality and that although medication makes a difference, he recognises that ADHD is part of who he is.
You can’t get rid of ADHD, you know, you’re gonna have to deal with it. You’re gonna have ADHD. And, that’s just, it’s just you. With my medication and ADHD I feel like there’s things to help it but it’s still going to be there. (Owen)
What the students reported
The students talked about group work, teachers, friendships and their own levels of motivation. They had a mixed opinions for group work, with some showing a strong preference especially if there were “right” people in the group, while two of them preferred to work alone as they were less likely to be distracted.
I prefer to learn in a group … it’s, I’m not pressured if I can’t get something right, because most of the time someone else in the group will know about it and they can just tell me what we’re doing. (George).
I find it easier to process things alone I’d say. And like, working with myself I can be more connected to it. Yeah, working in groups I can get quite side-tracked. (Abby)
Teacher dispositions and attitudes featured prominently when the participants talked about their learning. The teachers they liked were caring, supportive and believed in them.
People always have different opinions, but if you’re told by someone that you’re good at something, it makes you want to do it more. Like for maths, if I was told by my teacher “you’re doing good”, I want to keep doing better, because I was told I’m doing good. (Owen)
The teacher characteristic mentioned most often in terms of supporting their learning was one who could make learning fun and innovative, and showed an understanding of the impact of ADHD.
A good teacher is one that explains things in different ways, and also a teacher that shows you how to do things. (Grayson)
But the funness also means that … say she does like a dance to something to help us memorise it. And then we laugh so much, like we laugh at it so much, along with her of course, then we remember that better than if she just tells us. (Ethan).
Last year, I had a teacher, and he was like incredibly engaging and would give us like half an hour to ask questions and would embrace our difficulties and differences. (Abby)
Some understand ADHD better than others. The difference is they don’t immediately give me a detention. They kind of understand what I’m going through and that it’s not easy. (George)
Friendships in the classroom was critical in supporting both their learning and behaviours, particularly friends who understood the condition. Seven students said it was very important for friends to know about ADHD and its effects on their behaviours. Half of them had friends who also had ADHD, and they spoke of being more connected with each other due to the similarities.
I help my friends when they need it and they help me … in class if they don’t know how to do something and I do, I’ll tell them how and they will tell me how if I don’t understand something. (Lucas)
When I’m going off task my friends can rein me in and tell me to get back on task … some of my closer friends, they calm me down whenever I’m being agitated … they’ll just talk to me or play a game with me. (George)
There were challenges for their learning in the classroom which they felt were due to inflexible pedagogy and lack of curriculum adaptations. This was seen as a result of their teachers’ lack of knowledge around the nature of cognitive and physical implications of ADHD. For example, half the participants had difficulty with taking notes, especially on paper.
And when I do write with paper, it’s extremely hard to get my ideas onto the paper. But with a computer, I guess it’s more instant, and I can instantly do it as soon as they come to my head. And then arrange them. And spelling and grammar can kind of be sorted. So that’s handy. Definitely. (Abby)
Other challenges included the length of time they were expected to be seated to do work, difficulty in remembering tasks, and noise levels. Often their concentration span declined during subjects they did not enjoy, or when there were distractions in the classroom such as the temperature level of the room, or other students’ talking.
Sometimes if it’s too loud it stops me from working and I can’t concentrate on my work. (Grayson)
I get distracted very easily. Um like, say someone laughs at something, I’ll try my hardest to find out what it is. And sometimes I get distracted by something and not someone. Like in Science there’s always this heater … When it’s cold, I always just lean up against it, and sometimes I can just get lost in the heat and not focus. (Ethan)
Another common difficulty mentioned by participants was difficulty in understanding the tasks they were asked to do. Not being able to comprehend the purpose or meaning of what they were learning affected their motivation and the amount of effort they put into completing the tasks. The lack of having choice and input into their learning was highlighted as a significant barrier. The students were unanimous in saying that they were not involved in making decisions related to their learning, other than choosing their elective subjects. Half the participants wanted to have more input into how subjects were taught, and more choice, for example, selecting books to read in English, or the type of sports they played during PE. Similarly, two participants said students should be able to make decisions about timetabling, and six wanted input into learning contexts such as who they worked with, and where they worked. Most participants identified choice as being motivational, as it was typically linked to fun and interests, and the appeal of the activity.
I’d look forward to the choices I’d make rather than doing something I was really not …. didn’t want to do … I’d find school a lot more enjoyable, having decisions there. (Abby)
Well, you know, just so it’s suitable for me. So that I don’t have to be sitting there and just be like “but I’m confused” and be like, “What am I supposed to do? But when I get to choose, I can just be like, “Oh yeah, I know how to do this, it’s easy.” (Jackson)
In contrast, there was a sense of agency and independence among them when speaking about out of class activities such as sports teams and clubs, to the extent that they did not feel it was necessary for the extra-curricular staff to be told that they had ADHD. Half of them reported that their interest, and the fun and enjoyment of the activities meant they were more focused.
No. I don’t need any [supports]. I’m just treated like the rest of the other people at Scouts. (James)
Well, I do a lot of sports. And I’m driven towards it because it’s something I enjoy, so it makes me want to be good at it. (Sara)
With sports, you just learn as you go and then just do it. We listen. We mostly forget it but during the game you learn the rules. (Lucas)
It is worth noting that ADHD traits that could be challenging in a classroom setting were their strengths during out of class activities. For example, when asked what he was good at in school and why, George replied: “PE. Probably my height and I don’t normally run out of energy that fast, so I can run around a lot more than others”.
In New Zealand, schools are responsible for ensuring all students reach their full potential, for removing barriers to achievement, and to individualise the curriculum (MOE, 2020). Further, as stipulated in Article 29(a), children have the right to an education that develops their personality, talents, and physical and mental capabilities to their fullest extent, and optimising students’ learning opportunities is one of the foundational imperatives of schooling.
Consistent with existing literature, students in the study reported that difficulties associated with their condition such as impulse control, following instructions, staying organised, planning tasks and distractibility were barriers to their learning. The majority of participants reported that attentional difficulties interfered with their learning especially if there were other distractions such as a noisy environment, or non-preferred subjects and tasks (Banich, 2009; Kendall, 2016). To alleviate their anxiety caused by these barriers and in an attempt to stay focused, these young people actively developed strategies such as listening to music, fiddling with objects and taking breaks, talking to friends; and using devices rather than writing (Andreou et al, 2016; Kendall, 2016). Although there are debates around the pros and cons of medication, it enhanced these students ability to focus and learn (Kendall, 2016; Singh, 2011, 2012).
The role of friends was identified as important, and experienced as an enabling aspect of their learning and well-being in school.The young people had developed strong friendships, in contrast to earlier international studies where students with ADHD were found to have difficulty in making and keeping friends (Puvanendran & Nagaraj, 2014; Stamp et al, 2014; Travell & Visser, 2006). Instead, similar to the findings of Singh (2011), half the participants discussed the importance of friends in helping them manage their behaviours and supporting their learning.
Perhaps not surprisingly, characteristics of teachers featured prominently when these young people spoke about their educational experiences and who they considered to be a ‘good’ teacher. The characteristic mentioned most often was ‘innovative’ teachers who were able to engage them in learning. These teachers included movement and actions in their teaching sessions, used multimedia, incorporated online games, encouraged questions, used humour and linked learning experiences to their interests. When learning was fun, the young people reported increased motivation and ability to stay on task longer and also were more likely to retain what they had learnt. While engaging pedagogy was seen as important, even more critical to their learning was the caring attitude of teachers and their belief that young people with ADHD were capable learnersThese aspects are well embedded in the indigenous Māori concepts of Mana motuhake (teachers caring for students’ performance); Wananga and Ako (teachers engaging in effective interactions and relationships with their learners).
Overall, this study showed a heightened sense of self-awareness among these students of a number of factors that would support their learning. They identified both personal and ecological factors that facilitated their learning and participation both in and outside the classrooms. The personal factors included their interest levels in a subject, the ability to use self-identified strategies for managing distractions, having agency of their learning, and taking medication regularly. The external factors that enhanced their learning were working with friends, and pedagogy that accommodated the characteristics of their condition. But, the most important factor that supported their learning were teachers who were responsive to the implications of having ADHD. As Vygotsky observed, learning involves interactions between individual, social, and contextual factors which impact motivation, resulting in both cognitive growth and actions. This calls for teachers to be more informed about the individual student’s needs, and reach out to the affordances that multi-media can offer for classroom learning situations. More importantly, listening to students must be at the heart of planning and teaching.
Better academic outcomes is directly proportional to positive self-efficacy and relational supports (Martin et al, 2017). The young people in this study showed that although they had a strong sense of awareness of the impact of their difficulties on learning, they were less understood by their teachers. The participants described being motivated at school when they were interested in a subject and felt they were good at it. However, they were most motivated when they were able to choose what and how they learnt.
This study reiterated the importance of giving children and young people opportunities to make decisions about their learning to enhance their sense of agency and autonomy. Although students in this study had good insights into what works for them in and out of classrooms , they had little or no opportunity on a daily basis to have a voice in deciding how or what they learn (Elwood & Lundy, 2010). As UNCRC Article 12 states, educational outcomes can be meaningfully enhanced if students’ opinions are sought and actioned, as they are capable and perceptive of how they learn best. Therefore, it is imperative that teachers foster a sense of agency by providing choice of learning activities that are motivating and creative (Bandura, 2006; MOE, 2015).
In New Zealand, children with a range of additional learning needs have been particularly vulnerable to marginalisation and having their rights ignored (Kearney, 2011). Expectations and practices are often geared to fit these students into existing systems of ‘normal’ schooling. However, the National Educational Goals require schools to enable all students to reach their full potential by providing equal opportunities and removing barriers to their learning. So, schools have a legal mandate to be inclusive of all students including those with ADHD. More importantly, as a signatory of UNCRC, New Zealand government is committed to work towards, and report on, how children are being consulted about matters that concern them. MacArthur and Rutherford (2016) encourage schools to be responsive to and value diversity, by focusing on children’s strengths, interests, and capabilities. A rights-based approach to education they argue, will focus on equity, and in developing children’s capabilities to their full potential. Such an approach to education will allow for more equitable learning opportunities for children and young people with neurological differences such as ADHD to develop their personality, talents, and mental and physical abilities (UNCRC Article 29a). This study serves as a reminder that a holistic development, learning and care for young people in school settings irrespective of a particular identified disability or need, requires an integrated focus on academic, social and life events for these young people.
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