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February 1, 1996
Vol. 53
No. 5

A Holistic Approach to Attention Deficit Disorder

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What do Winston Churchill and Florence Nightingale have in common? Both found inventive outlets for their boundless energy (also called hyperactivity). Here are some strategies for home and school that may help children labeled with ADHD to harness their talents and strengths.

Eight-year-old Billy, in the front row, will have nothing to do with my demonstration of new techniques for teaching spelling. During my visit to his elementary school classroom in upstate New York, Billy is out of his seat during most of the lesson.
When I ask the children to visualize their spelling words, however, I am amazed to see Billy return to his seat and remain perfectly still. Covering his eyes, Billy “looks” intently at his imaginary words—fascinated with the images in his mind!
Later on, I realize that something more important than a spelling lesson went on that afternoon: Billy was able to transform his external physical hyperactivity into internal mental motion—and, by internalizing his outer activity level, was able to gain control over it.
This incident occurred sometime ago but remains memorable to me. Why? Because it suggests that internal empowerment, rather than external control, is often the best way to help kids diagnosed as having ADHD (Attention Deficit Hyperactivity Disorder).

A Decidedly Unholistic Approach

Much of the work currently being undertaken in the field of ADHD looks at the issue from an external control perspective. The two interventions touted in almost all books and programs about ADHD are medication and behavior modification. While these approaches are often dramatically effective with kids labeled as having ADHD, both have troubling features that often receive scant attention.
When children receive medication, some researchers suggest that they may attribute their improved behaviors to the pills rather than to their own inner resources (Whalen and Henker 1980). Others may expect the medication to do all the work and thus neglect underlying issues that may be the true causes of a child's attention and/or behavior difficulties.
Behavior modification programs, which abound, seek to control children's behaviors through some combination of rewards, punishments, or response costs (the taking away of rewards). Some programs rely on token economy systems, while others use behavior charts, stickers, and even machines. For example, the Attention Training System sits on a child's desk and automatically awards a point every 60 seconds for on-task behavior. The teacher can also deduct points for bad behavior using a remote control. Students trade points for prizes and privileges.
Although behavior modification programs may influence children to change their behavior, they do it for the wrong reason—to get rewards. Such programs can discourage risk-taking, blunt creativity, decrease levels of intrinsic motivation, and even impair academic performance (Kohn 1993).

Looking at the Whole Child

What's needed is a new vision of educational interventions to reflect a deeper appreciation for the whole child based upon a wellness paradigm, rather than a deficit perspective rooted in a medical or disease-based model.
Most ADHD researchers and practitioners see children labeled with ADHD in terms of their deficits. Thousands of studies tell us what these kids can't do, but few tell us what they can do and who they really are. (One exception is Crammond 1994.) Where are the studies that tell us what these kids are interested in; what kinds of positive learning styles or combinations of intelligences they use successfully in the classroom; and what sorts of artistic, mechanical, scientific, dramatic, or personal contributions they can make to their schools and communities?
Such research is critical if we are going to develop sound classroom strategies that empower these kids. The above anecdote, for example, suggests that visualization may be a powerful tool. Parents and teachers tell me about cases of ADHD-labeled kids who are talented dancers, musicians, sculptors, and dramatists. The ADHD community needs to conduct research on the positive qualities of these children and what these abilities could mean in contributing to their success in the classroom and in life. Recently, for example, a teacher told me of a child who'd had a terrible time in a traditional straight-rows-of-desks environment—but who was indistinguishable from his “normal” peers in hands-on, project-based classroom activities.
Some research suggests that kids with ADHD do better in environments that are active, self-paced, and hands-on (McGuinness 1985). Video games and computers are powerful learning tools for many of these kids. In fact, their high-speed behavior and thinking lend themselves quite well to such cutting-edge technologies as hypertext and multimedia (Armstrong 1995).

Alternative Avenues

While the ADHD worldview tacitly approves of a teacher-centered, worksheet- and textbook-driven model of education (almost all of its educational suggestions are based on this kind of classroom), current research suggests that all students benefit from project-based environments in which they actively construct new meanings based upon their existing knowledge of a subject.
We need to initiate a new field of study to help children with behavior and attention difficulties—one based upon their strengths rather than their deficits. Such a field would develop assessment strategies geared toward identifying their inner capabilities. Gardner's theory of multiple intelligences (Gardner 1983) is one possible framework for developing appropriate assessment instruments to help identify such abilities (a refreshing change from the behavior rating scales and artificial performance tests currently used to assess ADHD in children). We must develop individualized educational plans (IEPs) that give more than lip service to a child's strengths and that solidly reflect, in their goals and objectives, that IEPs help the child achieve success.
  • Cognitive. Use focusing and attention training techniques (for example, meditation and visualization), self-talk skills, biofeedback training, organizational strategies, attributional skills (including the ability to attribute success to personal effort), and higher-order problem solving.
  • Ecological. Limit television and video games, provide appropriate spaces for learning, use music and art to calm or stimulate, find a child's best times of alertness, provide a balanced breakfast, and remove allergens from the diet.
  • Physical. Emphasize a strong physical education program, martial arts training, use of physical touch and appropriate movement, outdoor activities, noncompetitive sports and games, and physical relaxation techniques.
  • Emotional. Use self-esteem building strategies; provide positive role models and positive images of the future; employ values clarification; offer individual psychotherapy; and identify talents, strengths, and abilities.
  • Behavioral. Use personal contracting; immediate feedback; natural and logical consequences; and consistent rules, routines, and transitions. Involve the child in a selection of strategies.
  • Social. Stress effective communication skills, social skills, class meetings, family therapy, peer and cross-age tutoring, and cooperative learning.
  • Educational. Use computers; hands-on learning; high-stimulation learning resources; expressive arts; creativity development; and multiple intelligences, whole language, and attention-grabbing activities.
This tentative list provides a far richer storehouse of interventions than the instructional strategies given in the ADHD literature—for example, seating the child next to the teacher, posting assignments on a child's desk, maintaining eye contact, and breaking up assignments into small chunks. Such a deficit-oriented perspective gives differential treatment to the “ADHD child.” Most of the above strategies, by contrast, are good for all children. Thus, in an inclusive classroom, the child labeled ADHD can thrive with the same kinds of nourishing and stimulating activities as everyone else and be viewed in the same way as everyone else: as a unique human being.

The Creative Roots of ADHD

Because research has long suggested that many children labeled ADHD are actually underaroused (Ritalin provides enough medical stimulation to bring their nervous systems to an optimal level of arousal), a strength-based approach makes more sense than a deficit-based one (Zentall 1975). By providing these kids with high-stimulation learning environments grounded in what they enjoy and can succeed in, we're essentially providing them with a kind of educational psychostimulant that works as well as Ritalin but which is internally empowering rather than externally controlling.
Remember that a hyperactive child is an active child. These kids often possess great vitality—a valuable resource that society needs for its own renewal. Look at the great figures who transformed society, and you'll find that many of them had behavior problems or were hyperactive as children: Thomas Edison, Winston Churchill, Pablo Picasso, Nikola Tesla, Charles Darwin, Florence Nightingale, and Friedreich Nietzsche (see Goertzel and Goertzel 1962). As educators, we can make a big difference in the lives of these kids if we stop getting bogged down in their deficits and start highlighting their strengths!

Armstrong, T. (1995). The Myth of the ADD Child. New York: Dutton.

Crammond, B. (1994). “Attention-Deficit Hyperactivity Disorder and Creativity: What Is the Connection?” Journal of Creative Behavior 28: 193-210.

Gardner, H. (1983). Frames of Mind. New York: Basic Books.

Goertzel, V., and M. G. Goertzel. (1962). Cradles of Eminence. Boston: Little, Brown.

Kohn, A. (1993). Punished by Rewards. Boston: Houghton Mifflin.

McGuinness, D. (1985). When Children Don't Learn. New York: Basic Books.

Whalen, C., and B. Henker. (1980). Hyperactive Children: The Social Ecology of Identification and Treatment. New York: Academic Press.

Zentall, S. (July 1975). “Optimal Stimulation as a Theoretical Basis of Hyperactivity.” American Journal of Orthopsychiatry 45, 4: 549-563.

End Notes

1 Tesla, an electrician, invented the Tesla coil, the AC generator, and other innovations.

Thomas Armstrong, educator, psychologist, and writer, is the Executive Director of the American Institute for Learning and Human Development. Over 30 years, he has given more than 1000 keynotes, workshop presentations, and lectures on 6 continents, in 29 countries, and 44 states.

He has written for numerous magazines, newspapers, and journals and is the author of 18 books, including the ASCD books Multiple Intelligences in the Classroom, Neurodiversity in the Classroom, The Power of the Adolescent Brain, The Best Schools, The Multiple Intelligences of Reading and Writing, ADD/ADHD Alternatives in the Classroom, and Awakening Genius in the Classroom.

Armstrong has also appeared on NBC’s The Today Show, CBS This Morning, CNN, the BBC and The Voice of America.

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