Saturday, October 26, 2013

ADHD and Anxiety - The Vicious Circle

Nearly every building in a city has an important purpose, and streets connect busy workers from one key location to another.  Each of these systems ensures that the city operates effectively, and a disruption may have serious implications for one particular function of the city, or worse-- for all of the city.  The human brain is much like a busy city, with multiple processes working simultaneously to effectively carry out brain function, making important connections across the brain. 

What happens in the brain of a child with ADHD?

Attention Deficit Hyperactivity Disorder (ADHD) is a disability of the brain that is characterized by difficulty with attention, focus, impulsivity, and over-activity. There are three types of ADHD.

Predominately hyperactive-impulsive type:
difficulty with controlling behavior, over-activity, and impulsivity. 

Predominately inattentive type:
difficulty with maintaining attention and focus. 

Predominately hyperactive-impulsive-inattentive type:
difficulty with attention, focus, controlling behavior, and over-activity

(National Resource Center on ADHD, 2011)

Anxiety refers to students' negative feelings of worry, unease,
or nervousness, or a learner's perceived threat to danger.

Learning involves focused processing
that requires simultaneous brain function
and may cause anxiety for students with ADHD.

It's a “vicious circle.” Here's why.   
In some inservices I've taught, I've presented a simulation that gives an idea of what this feels like. Try it with yourself and your colleagues!

I gave most of the teachers in the room Prompt #1 below, and they were able to answer it fairly quickly. I distributed Writing Prompt #2 to a select few individuals, who took much longer. While they struggled to finish (and a few even gave up!) I prodded them with statements like, "If you don't hurry up, you'll miss recess," "Maybe I need to call your parents," and "Focus!" -- You know, the typical things said to students who seem to be taking forever to finish an assignment and appear off-task.

After the simulation, everyone discussed their anxiety levels, embarrassment, and apathy. It's interesting to see how something that looks like defiance is just simply defeat.

Small adjustments to assignments can be made to level the playing field for our students with ADHD and anxiety related disorders. Here are a few!
  • Divide questions with two parts into two individual questions. This will reduce the anxiety caused by short term memory needs.
  • Test orally, or scribe for students. This will reduce the last two levels of brain processing (i.e., processed question - processed answer - processed verbalization of answer - processed plan for written answer - process of writing answer).
  • Provide an uncluttered test format.
  • Cover questions to display only one at a time.
  • Provide a location free of distractions for testing.
  • Allow for retesting when the student is not displaying heightened anxiety.
What types of things do you implement in your classroom to reduce anxiety? Share in the comments below!


A Peach for the Teach


  1. You just described my son exactly. It was painful for me to read this because I know it must be agonizing for him to go through this everyday. With medication and accommodations he is trying to manage, but I know his reality is fraught with worry that he will miss something or forget something - which he usually does.
    Thanks for the reminder for teachers (myself included!) of what our students endure each day.

    1. Nikki,

      It's important for me to remember what it must be like for parents in this, too. It can be so hard to watch our children struggle with this. It's really great that teachers and parents like you are so understanding and helpful. You're welcome! Thank you so much for sharing your story!


  2. Another important tip is to reduce the amount of bubbles or "non-symmetrical" visuals since the brain jumps around so much on a page that is cluttered with bubbles. I have a blog that deals with kids and young adults dealing with ADHD if you want to check it out! Almost every child I teach has ADHD with some other form of learning disability or social-emotional disability. I am also a mother with a 7 year old with ADHD, a wife to a man with ADHD and I struggle with it myself. Let's just say I am surrounded by it on a daily basis.

    1. Claire,

      That's a great tip! You're absolutely right. I'll definitely check out your blog. You seem to have such a great perspective from multiple angles. Thanks for visiting and for commenting!