Nursing Children and Young People With ADHD by Tim McDougall & Noreen Ryan

Author:Tim McDougall & Noreen Ryan
Language: eng
Format: mobi
Tags: Behavioral Sciences
ISBN: 9780415454117
Publisher: Routledge
Published: 2008-12-15T22:00:00+00:00

Introduction

It has been estimated that as many as 1% of school-age children in England and Wales have severe ADHD. In addition, as many as 5% experience symptoms which fulfil the criteria for ADHD as defined by ICD-10 (NICE 2008).

This equates to around 69,000 children in England being severely affected, and approximately 345,000 mildly to moderately affected (Hill 2005). The symptoms of hyperactivity, impulsivity and inattention frequently manifest

School-based interventions

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as overt behaviours which are disruptive in the classroom and school environment (DuPaul and Eckert 1997a). Almost two-thirds of children with hyperkinetic disorder are behind in their overall scholastic ability, and almost three-quarters have officially recognised special educational needs (Green et al.

2005). Population studies show that children with ADHD are more likely to be ‘school refusers’, or to have been absent from school for long periods at a time than other children (Green et al. 2005). The oppositional behaviour of between one-quarter and one-third of children and young people with ADHD

will lead to their exclusion from school (Tannock 1999; Green et al. 2005; Barbaresi et al. 2007).

Research has shown a clear link between ADHD and impairment in overall academic functioning (Frazier et al. 2007; Barbaresi et al. 2007). Children and young people with ADHD have higher rates of specific and generalised learning problems (NICE 2008), poor reading skills (McGee et al. 1992; Swanson et al. 1999; Ford et al. 2004) and more speech and language difficulties (Hinshaw 2002). As many as half will have learning problems in reading, writing, spelling, mathematics and language and traditional teaching and learning systems may present many difficulties for pupils with ADHD

(Green et al. 2005). Not surprisingly, the costs of education are high for this group of children and young people (Agency for Health Care Policy and Research 1999).

The behavioural difficulties that children and young people with ADHD

show in school partly arise from their symptoms of hyperactivity, impulsivity and inattention, and the inability to meet demands for academic and social performance. As the school curriculum progresses, these demands may escalate, leading to a breakdown in the relationship between the child, school or college and family (McArdle 2005). Despite a vast international literature on the medical and behavioural management of children and young people with ADHD, there has been a lack of longitudinal studies and well-designed studies of direct relevance to the class or school setting (Merrell and Tymms 2004).

School-based mental health services

To date, much of the learning about school-based mental health services has come from the US where various models of intervention exist. These include support from school-based professionals including nurses; training for educational staff and school nurses; consultation for teachers and other school-based professionals and outreach from specialist child and adolescent mental health services (CAMHS) (Rones and Hoagwood 2000; Leighton 2006).

Social skills programmes and student mediated conflict resolution programmes have been effective for some children and young people with ADHD in schools (Rhodes and Ajmal 1995; Wells et al. 2000), and nurse-led, school-based services have been successful in supporting children with ADHD develop positive self-esteem (Frame et al.

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