Examine Counselling Children With Attention Deficit Hyperactivity Disorder for Emotional Adjustment in Primary Schools in Keffi West Senatorial Zone, Nasarawa State Nigeria
Chapter One
Research Objectives
The aim of the study is to examine counselling children with attention deficit hyperactivity disorder for emotional adjustment in Primary Schools in Keffi west senatorial Zone. Nasarawa State Nigeria. The specific objectives are to:
- Identify the issues with counselling children with attention deficit hyperactivity disorder for emotional adjustment in Primary Schools in Keffi west senatorial Zone. Nasarawa State Nigeria.
- Evaluate the role of counselling in counselling children with attention deficit hyperactivity disorder for emotional adjustment in Primary Schools in Keffi west senatorial Zone. Nasarawa State Nigeria
- Assess ways of improving counselling children with attention deficit hyperactivity disorder for emotional adjustment in Primary Schools in Keffi west senatorial Zone. Nasarawa State Nigeria
- To investigate the impact of counselling on children with attention deficit hyperactivity disorder for emotional adjustment in Primary Schools in Keffi west senatorial Zone. Nasarawa State Nigeria.
CHAPTER TWO
LITERATURE REVIEW
This chapter examined the various concepts on the phenomenon of study at hand. Conceptual clarification was done, empirical studies were revealed while related theories were also discussed.
Conceptual Review
ADHD in Children: Overview
Attention-Deficit/Hyperactivity is a neurodevelopmental disorder in which a child displays persistent, significant problems with inattention and/or hyperactivity-impulsivity (American Psychiatric Association [APA], 2013; US Department of Education [USDOE], 2008). Although all children will display inattentive, hyperactive and impulsive behaviors, for CWA, these core behaviors of ADHD will be more severe and will occur with greater frequency than for children without ADHD (National Institute of Mental Health [NIMH], n.d.). According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM 5), to be diagnosed with ADHD a child must have symptoms a minimum of six months prior to diagnosis and those symptoms must have been present prior to 12 years of age (APA, 2013). Additionally, the inattentive and/or hyperactive/impulsive symptoms must cause a negative impact in significant areas of functioning (e.g., social, academic, occupational). Children must also experience difficulties in more than one setting (e.g., home and school) to ensure that the problem is one of attention and/or hyperactivity/impulsivity, rather than one of environment (APA, 2013).
Limits Of ADHD Symptoms Predicting Impairment
Current treatments for individuals with ADHD were developed based on the premise that core symptoms of ADHD lead to the educational, occupational, and social impairments that these individuals often experience. These treatments aim to reduce symptomology in order to decrease impairment in these areas. Although many of the current available treatments for ADHD have effectively reduced symptoms for individuals (e.g., Abikoff et al., 2004; see review by Hinshaw, Klein, & Abikoff, 2007; MTA Cooperative Group, 1999; Pelham, Carlson, Sams, Vallano, & Dixon, 1993; see reviews by Van der Oord, Prins, Oosterlaan, & Emmelkamp, 2008), research examining their impact on impairment in educational, occupational, and social settings has had varied results. A review of the literature examining psychopharmalogical, psychosocial, and academic treatments follows.
It appears that psychopharmacological treatment is the primary treatment for many individuals with ADHD (Abikoff et al., 2004; Fabiano et al., 2013; Hinshaw, Klein, & Abikoff, 2007; MTA Cooperative Group, 1999; Pelham, et al., 1993; Rowland, Umbach, Stallone, Naftel, Bohlig, & Sandler, 2002; Van der Oord, Prins, Oosterlaan, & Emmelkamp, 2008). Stimulant medication use has been associated with improvements in intelligence scores, sustained attention, memory, and executive functions for many individuals with ADHD (Graziano, Geffken, & Lall, 2011). However, psychopharmacological treatments often fail to impact target behaviors of greatest concern in schools (e.g., academic productivity and accuracy; Rapport, Denney, DuPaul, & Gardner, 1994; Hoffman & DuPaul, 2000). Further, use of stimulant medication alone, has not been associated with long-term improvements (e.g., Langberg & Becker, 2012; Molina et al., 2009; Pelham, 1999). Thus, while in some cases stimulant medication facilitates some aspects of achievement, it does not alter the underlying deficits in cognitive processing that compromise learning (e.g., phonemic awareness, phonological processing related to reading; Miller & Hinshaw, 2012) and is insufficient to address the range of problems these individuals face in an array of areas over time.
In addition to psychopharmacological treatments, individuals with ADHD-related difficulties may be treated through psychosocial interventions, which typically consist of cognitive and/or behavioral approaches (Barkley, 2006). There is some early evidence that cognitive interventions for ADHD (e.g., focusing on changing self-talk, verbal mediation) are effective in reducing symptoms in subclinical cases (e.g., Kendall & Braswell, 1982). However, Sibley, Kuriyan, Evans, Waxmonsky, and Smith (2014), in a systematic review of the literature on ADHD treatments published from 1999-2014, found no evidence that cognitive enhancement trainings (e.g., working memory training, Electroencephalogram [EEG] Neurofeedback training) improved functioning of adolescents with ADHD. There is more support for psychosocial treatments grounded in learning theory, such as contingency management strategies (e.g., token economy, contingent teacher attention, home-school contingencies), behavioral management training with parents and teachers, and self-management strategies (e.g., homework completion strategies, interventions that target organization), in terms of reducing ADHD symptomatology (e.g., Evans et al., 2009, Langberg, Epstein, Urbanowicz, Simon, & Graham, 2008; Pelham, Wheeler, Trilby, & Chronis, 1998; Pfiffner, Villodas, Kaiswer, Rooney, & McBurnett, 2013; Raggi, Chronis-Tuscano, Fishbein, & Groomes, 2009).
In 2009, Fabiano et al. conducted a comprehensive research synthesis of literature on behavioral treatments for ADHD that reviewed all behavior modification treatments and study designs since 1976. The authors analyzed one hundred, seventy-four studies from 114 separate reports with 2094 participations and found a large effect size (as classified by Cohen, 1992) of between group effects from 20 studies approaches the range classified as “large” by Cohen (1992). The weighted effect size of .74 for between-group studies indicates that behavioral interventions implemented at home, school, or peer settings, result in substantial improvement for individuals with ADHD. Sibley et al.’s (2014) review found small to medium improvements in ADHD symptomology (d’s=.34-.49) and small to large effect sizes for improvement in impairment domains (.31-1.20) in 22 studies that implemented behavioral strategies (published between the years of 1999 and 2014). Combining cognitive and behavioral strategies through use of cognitive/behavioral treatments (e.g., verbal self-instructions, problem-solving strategies, cognitive modeling, self-monitoring, self-evaluation, and self-reinforcement) have also shown to be effective for students with ADHD (Pelham, et al., 1998; Pfiffner, et al., 2013).
Although psychosocial interventions have shown to be effective for some individuals with ADHD, they are not sufficient for all individuals with the disorder (Pelham et al., 1998; Trout, Lienemann, & Epstein, 2007). For instance, children with moderate to severe impairment are unlikely to respond to any one psychosocial intervention when provided individually (Evans, Schultz, & Sadler, 2008), which may make implementing psychosocial treatments more complex and time consuming. Further, research has shown that difficulties often present with obtaining generalization and maintenance for psychosocial interventions (Miller & Hinshaw, 2012; Pelham et al., 1998). Further, methodological limitations are apparent in many of the studies that do exist. For instance, in Fabiano et al.’s literature synthesis of behavioral interventions, the authors found that of the studies published between 1979 and 2009, only 12% conducted randomized, controlled, between-group studies, with many studies employing within- subject and single subject designs.
CHAPTER THREE
METHODOLOGY
This chapter covered research methodology which was divided into the following themes; research design, target population, sample size and sampling procedure, data collection instruments, pilot testing of the instruments, validity of the instrument, reliability of instruments, data collection procedure and data analysis techniques.
Research design
A descriptive survey design was used to obtain the data that was used to describe the existing phenomena. It was used for exploring the existing two or more variables at one given point of time. It was the method suitable for collecting original data for the purpose of describing a population which was too large to observe directly, (Mugenda and Mugenda, 1999).
Study Area
The study was conducted in Nasarawa West Senatorial District which covers five local governments which include Karu, Keffi, Kokona, Nasarawa and Toto. Keffi is the headquarters of Nasarawa West Senatorial District. Nasarawa West Senatorial District has a total population of 716,802
Target population
Mugenda and Mugenda (1999) noted that target population was a population to which the researcher wanted to generalize the results of the study. In this case the target population for this research would comprise of 120 teachers in both public and private schools in the area of study. This was based on the assumption that each school will have a minimum of ten teachers
CHAPTER FOUR
DATA ANALYSIS AND INTERPRETATION
This chapter presents data analysis, presentation, interpretation and discussion in the following subtitles: Respondents return rate, Background information of the respondents, the influence of teacher’s level of academic qualification, teacher’s attitude, teacher’s workload, teacher’s professional advancement on students’ performance in public and private primary schools in Kefi Senatorial District.
CHAPTER FIVE
SUMMARY, CONCLUSIONS AND RECOMMENDATIONS
Conclusion
ADHD is a commonly diagnosed behavioural disorder of childhood that represents a major health problem. Pupils with this disorder usually have pronounced difficulties and impairments resulting from the disorder across multiple settings. Although an independent diagnostic test for ADHD does not exist, evidence supporting the validity of the disorder can be found. The teachers are expected to apply these skills in assisting the pupil who may manifest the symptoms of ADHD. Teachers and School officials should also be educated and involved in the process. In addition to behaviour therapy for the pupil, school intervention may help ADHD pupils and their parents and siblings cope with the emotional conflicts that nearly always arise in the lifelong management of the condition.
Although an independent diagnostic test for ADHD does not exist, evidence supporting the existence of the disorder has been established (Egbochuku & Abikwi 2006). Given that the related “medical” fields have acknowledged their limitations in diagnosing ADHD and that the school setting is the context within which the vast majority of ADHD behaviours are recognised as being problematic, it is most typically the school psychologist who enacts the primary role of diagnostician for this condition. Subsequently, it is incumbent that school psychologist have some valid and reliable means of structuring and conducting these evaluations
Recommendations
i. Teachers should explore avenues to learn more about ways of identifying pupils who manifest the symptoms of ADHD to enable them make proper referral.
ii. The knowledge of teachers should be updated through organised workshops, in-service training on how and what to do when pupils manifest defiant behaviour.
iii. Support group programmes should be put in place where government agencies and other reputable health organizations can educate teachers’ and other stakeholders on management of Attention Deficit Hyperactivity Disorder.
iv. Teachers are encouraged to maintain a closer relationship with parents and other professionals’ bodies’ e.g. educational psychologist, paediatricians and child psychiatrist to increase the knowledge base of teachers and reduce the incidence of misdiagnosis.
v. Teachers should not punish or bully pupils with ADHD symptoms rather they should be encouraged and given the needed support, for educational survival skills to foster their self-concept and improve their academic performance.
vi. Colleges of Education and Universities should organize programmes on ADHD and include such programme in the school curriculum. Counsellors should be trained in behavioural interventions which have no side effect in the treatment of ADHD.
vii. It is recommended that an ADHD resource centre be developed by the government for training, information, counselling and rehabilitation of pupils who are infected or affected with attention deficit hyperactivity disorder. At such a centre the latest research on ADHD should be available to teachers.
viii. There is an urgent need to include in the curriculum of Guidance and Counselling courses in Attention Deficit Hyperactivity Disorder; its symptoms and management.
ix. Counselling units should be established in primary schools in line with the provisions in the National Policy Education. This will reduce most of the problems ADHD pupils face during learning tasks as it will be easy to make referral for adequate management of the results.
REFERENCES
- Abikoff, H., Hechtman, L., Klein, R. G., Weiss, G., Fleiss, K., Etcovitch, J &
- Pollack, S. (2004). Symptomatic improvement in children with ADHD treated with long-term methylphenidate and multimodal psychosocial treatment. Journal of the American Academy of Child and Adolescent Psychiatry, 43, 802-811.
- Abramowitz, A. J., & O’Leary, S. G. (1991). Behavioral interventions for the classroom: Implications for students with ADHD. School Psychology Review, 20(2), 220- 234.
- American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders. (4th ed., Text Rev.). Washington, DC: Author.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. (5th ed.). Washington, DC: Author.
- Appleton, J. J., Christenson, S. L., Dongjin, K., & Reschly, A. L. (2006). Measuring cognitive and psychological engagement: Validation of the Student Engagement Instrument. Journal of School Psychology, 44(5), 427-445.
- Appleton, J. J. & Lawrenz, F. (2011). Student and teacher perspectives across mathematics and science classrooms: The importance of engaging contexts. School Science and Mathematics, 111(4), 143-155.
