Finding the Lost Girls

One of the things that has come to the surface over the last few years is the number of girls with ADHD where their needs were completely missed. ADHD is hard to spot in girls as they are good looking like they are doing the right thing. They quietly and subtly seek support from their peers to fill in what they miss. What does come out midway through secondary (just as the exam years hit) is anxiety, poor self esteem, frustration and underachievement. This impacts social relationships and well being. If left too long it can lead to mental health problems. The blame is too often put on the student for simply not trying hard enough when in reality they are working overtime to keep up and blend in.

My journey started 3 years ago when I moved back to Europe from Asia to start a whole school Inclusion role. This led me to spend more time in secondary school than I had in my previous roles. One of my first experiences was a meeting with an upset mother and daughter who was in Year 11. The daughter had just been diagnosed with ADHD after having performed poorly in her Year 10 mock exams. In her end of year report and in parent teacher meetings many teachers had suggested that she simply hadn't worked hard enough or spent enough time preparing for the exams. Both mother and daughter knew this simply wasn't true, she had worked hard and prepared carefully for the exams. However working memory difficulties which are part of ADHD had meant a lot of what she thought she had learnt did not stick. This along with impact of stress on her memory during the exam and difficulty sustaining her focus to read the questions thoroughly and use time wisely all impacted her performance.

It wasn't a case of working harder but working smarter. She needed to be introduced to revision strategies that actually work for those with ADHD. Revision strategies need to be active and they need to ensure that the subject material is processed at a deeper level so that working memory difficulties are overcome. Exam access arrangements like extra time and separate invigilation helped to reduce stress which impacts working memory. Being able to move around and talk aloud greatly improved her performance. She also needed teachers to regularly check in with her in lessons so that she did not lose focus and if she had missed information they could offer clarification. She benefited from some private sessions with teachers to go through some concepts more carefully.

This was only the first of many experiences of girls who were misunderstood and faced stress and failure as a result. I had to rethink what I understood about ADHD and how it presents itself in girls. One of the main lessons that I have learnt is that observation is not an effective tool for identifying ADHD in girls. If they are fidgety it is in subtle, socially acceptable ways. They might fiddle with their hair and reorganise their pencil case for example. If they tune in and out of lessons it can also be hard to see as they will be facing the teacher and look like they are paying attention. If they miss an instruction or an important bit of information, girls quietly look for ways to fill in the gaps. They will check the information on the board, look through previous notes, quietly ask a friend for help or copy the answer from the person next to them. Sometimes they will even try to look busy and then complete the work at home when they have time to make sense of what was being asked. Whichever strategy they use it is rarely noticed by the teacher. For many girls with ADHD the distraction or daydreaming is internal. Inattentive ADHD is more common in girls and if there is hyperactivity it can be in social acceptable ways like being very talkative or sporty. 

"I think my ADHD was missed because I was never a huge problem in the classroom. Sure, I was talkative, and distracted my peers when I got bored, but I never disrupted the class as a whole. It was more internal for me; I zoned out, procrastinated, and had issues regulating my emotions."  Year 11 student

The key to identifying ADHD in girls is in listening to parent observations and listening to the student themselves. Most girls with ADHD have this nagging sense of 'what is wrong with me?' as they struggle to meet the expectations of friends, family and teachers. They are aware that they are often working much harder than their peers to keep things together.

"For the longest time, I had thought there was something wrong with me. My ADHD affected me socially, often making it more challenging to make and maintain friendships, as well as academically– I basically failed my first two years of high school. And a lot of my teachers assumed it was because I was lazy and unmotivated. "

Girls tend to suffer in silence and will go to great lengths to hide the struggles they are facing. Academically difficulties are often only noticed when a girl gets an unexpected low mark on an assessment. Even then teachers may overlook it and think the student is having an 'off' day. Friendship issues can also be a red flag as sometimes girls with ADHD have difficulties managing their emotions. They may overshare and discuss things that were meant to be secret or they will misunderstand conversations as they lose track of what is being said. Forgetfulness can also be interpreted as not caring. Again adults may dismiss the difficulties as just a 'phase' that the girl is going through.

Creating a climate in school where students feel safe to disclose their concerns is important. They might not realise that ADHD is the issue but they will wonder why they are finding life so hard. If the school has a counsellor or nurse, then this might be the first port of call. This is why it is important for schools to have student support teams where concerns about student well being is discussed and shared. When interviewing a concerned student it is important to let them talk rather than working through a ADHD checklist. Open ended questions about how they find their school day, what they like to do at home, what their morning routine is like or how they tackle homework can all be very revealing.

The parent view point is also an important piece of the puzzle. Sadly as much as schools talk about parent partnership, there remains a distrust of parent perspectives. Some students who seem like model students in school can be very difficult at home. The teacher assumption is often that the parent is not being firm enough. Occasionally this could be the case but more often it is simply that the student feels safe to be themselves and let out emotions that they have holding together all day. We know as adults that we behave differently in different situations. We also know that we can be unhappy in job, but nonetheless smile at work and try to make the best of it. We should not be surprised when children do the same. Students have no choice but to attend school and so it is only natural to try to make the best of it or compensate outside school with activities that they enjoy. Parents see a different side of their child which is crucial information is identifying ADHD. Again they may not necessarily associate the behaviours they see with ADHD as there still a lot of misinformation about the signs of ADHD. ADHD does run in families which is an important factor to consider - there may be a family member with diagnosed ADHD which we were not aware of. Equally the parents may have ADHD which has not been diagnosed and they may see their child's approach to activities as typical behaviour. 

To 'Find the Lost Girl's there needs to be a proactive approach where we carefully explore unexpected academic struggles and monitor student well being. We need to educate students themselves in the signs of ADHD and take away to the stigma of having a learning difference. We also need to make it easy for students to seek help when they need it. As educators we need to value parents' viewpoints and we need to support them in understanding the signs of learning differences at different stages. Together we can find the lost girls and save them from years of self doubt and struggle.

Individuals not checklists

When a teacher hears that a student has a diagnosis - whether it be dyslexia, ADHD or Autism - out comes the mental or written checklist of strategies. Assistive technology, word lists, movement breaks, clear targets, sensory circuits, visual timetables..... While it is encouraging that teachers want to meet the needs of the students in their class, in my opinion this is the wrong approach.

Every student is different and equally every student with an additional need is different. While there are common traits of course, the first step should really be about getting to know the student - what are their specific strengths and weaknesses, what are their interests, what makes them tick?

One of the reasons that interventions sometimes don't work or progress is slow is that they are not well matched to the student. It could be that it is targeting an area that they are not ready for or there is too much emphasis in an area of weakness without acknowledging areas of strength.

Motivation is a key factor for any student, this is even more important when there is a challenge involved. Understanding what makes a student tick helps greatly with motivation. Students need to be involved in their learning journey and should understand why different approaches are being suggested. Students have different levels of maturity and it is true that they don't always see the bigger picture or know what might benefit them. However, even young children can understand a reason they need to do different activities if we explain it in an age appropriate way. When a student is invested in an activity because they see it will benefit them rather than just doing it because the teacher says so, their approach is different. They will be more willing to persist longer and cope with the discomfort that learning new things can bring. For example: if they have the goal of learning 10 more words so they can read a book they like, they can cope with having to practice every day. When I taught young students who struggled with phonics and I would explain that our lesson was 'brain exercise'. We talked about how when we run around in the playground and get out of breath, we might feel tired or uncomfortable. I explained that learning to read is similar and that as we exercise our brain it also might feel uncomfortable. It really helped the students to give things a go even when they were hard. As they made progress and found themselves reading words they thought they could not do their confidence  and motivation grew.

Parent input is also vital for students with learning differences. Teachers see one side of a student while parents see another. It really isn't that one is right and the other.is wrong. There is difference in perspective, along with a genuine difference in the way students behave at school and at home. Most parents never actually see the way their child is at school, equally teachers rarely see students in their home setting. As a teacher in the school my son attends I have the unique opportunity to see my son in both contexts. I have seen him look 'happy' at school and conform to what the teacher asks, while at home he cries and doesn't want to school because he is not learning anything new. I have seen him be quiet and withdrawn in school while at home he talks non stop and constantly asks questions. 

There is a reason for these differences. Teachers have a curriculum to follow with specific goals, they have a whole class of students to manage which impacts their approach. As a teacher we can often have a narrow view of a students skills and abilities as we view things through our school goals lens. We do not see the things students do at home when they are relaxed and are involved in activities they enjoy. I have worked with a student who could barely write a sentence at school but at home made intricate, custom alterations to his bike. Parents see their child at their best and worst, they see the spark when they are doing something they enjoy and the frustration when things don't go their way. They are thinking about the child's whole life and long term goals not just what they achieve in school. If we think of ourselves as adults, we know that we would behave very differently in a meeting with our boss than we would on a night out with good friends. In my opinion too much time is spent 'arguing' about who is 'right' and who is 'wrong' rather than respecting the different view points and learning from it. The wisdom and insights a parent brings can help to shape our approach to a student and bring a deeper understanding of their strengths and weakness. This can often be the key to selecting appropriate activities that will lead to positive results. Equally when parents reinforce key messages and practice specific skills at home greater progress in school is seen.

Let's take the time to get to know students and their families well so that we can confidently offer the type of support they actually need. When a child and a parent feel understood and 'seen' positive outcomes follow.

Find me on Sveriges Talare . Swedish Speakers website

 I am very excited to have a profile on the Swedish Speakers website. It is an easy way to book me for a speaking engagement or presentation. I can speak virtually or in person.

https://www.sverigestalare.se/helen-trethewey

March Webinar

 

Join me for my March webinar on 'The informal assessment of Dyslexia'. In this webinar I will explore the benefits of screening and informal assessment in allowing early intervention which is so vital for dyslexia students. We need to move away from the 'wait and see' and offer timely support. This webinar is free, please register to join me live or receive a recording. https://htrethewey71.clickmeeting.com/the-benefits-of-informal-assessment-for-dyslexia/register

Understanding Different Learning Styles: How to Support Every Student’s ...