Piscalkiene Viktorija Ph.D. candidate Institute of Educational Studies, Kaunas University of Technology, Kaunas, Lithuania
Braziene Nijole Doctoral of Educational Science
University of Siauliai, Siauliai, Lithuania
Correction of Behaviour and Cognitive Activity of Children with AD/HD by Story Telling: Case Study
Paper presented at the European Conference on Educational Research, University College Dublin, 7-10 September 2005
Attention Deficit Hyperactivity Disorder (AD/HD) is a disorder of neurobiological origin that is met in children and adults who are experiencing significant behavioural and cognitive difficulties in important aspect of their lives in personal relationships and at school. These difficulties can be attributed to problems of impulse control, hyperactivity and inattention.
Much concern lies in the fact that these children are often unsuccessful at school, their self-esteem is very low, destructive relationships with their teachers, parents and other close relatives form most often than not. This can stimulate an asocial behaviour and the formation of pathological behaviour. Due to the progress and further development of this disorder later in life and psychological, social and health problems for people having AD/HD, early evaluation of this disorder and pedagogical and psychological help in early age and childhood is very important. The paper discloses the importance of the fairy-tales as the special instrument of upbringing and training for the development of cognitive capabilities and behaviour correction of children with AD/HD at primary school.
Introduction
Attention Deficit Hyperactivity Disorder (AD/HD) is characterized by symptoms of inattention, impulsivity, and hyperactivity at levels that are considered maladaptive and inappropriate for a child’s age or stage of normal development. Abut 40% of them show symptoms that persist to adulthood. Most children with AD/HD will exhibit significant problems with academic performance, such as slow work completion, inconsistent accuracy on seatwork, or homework, and poor study skills. Behavioural features, exhibited with AD/HD, include low-frustration tolerance, temper problems, persistence, emotional liability, depression, peer rejection, poor self-concept and poor self-esteem.
Attention deficit/hyperactivity disorder is one of the most often stated behavioural disorders among children and teenagers from 5 to 8 per cent of the general children population. And it is systematically growing. Today, it is well known, that AD/HD syndrome has a negative impact either on cognitive learning, or the development of social sphere. As the above mentioned disorder may continue and even progress at the later age by causing psychic, social and physical problems, early aid is advised at the youngest possible age (Chris A., Zeigler Dendy, 2000; Cooper P. & Bilton K.M., 2002; Dupaul G.J., Stoner G., 2003).
There is emerging research identifying cognitive correlates of AD/HD symptoms in young children. Language, attention and memory problems may be present early. AD/HD symptoms affect normal development and adjustment in many areas, including attachment and bonding, self-control, cognitive development, social and emotional development. The significant activity of a child, lack of attention, impulsive behaviour, impatience, inability to fulfill the tasks etc. has the negative effect on learning.
Education of such children requires a lot of competence from teachers (pedagogues and parents). In this context, sustaining of a positive emotional tone, motivating merit system, development of child’s self-control capacities, organizing of special learning environments are the most important tasks to be fulfilled.
In order to look for the particular means by which sort of correction for children with AD/HD syndrome should be chosen, that would also help developing their self-control, positive self-estimation, story-telling phenomenon was chosen (story-telling, analysis and interpretation of fairy-tales, fantasy journeys while listening, re-creating and dramatizing of fairy- tales, games, story-telling according to pictures and cards). A story-telling phenomenon, as one of the creativity development forms, helps to observe the merits that stimulate harmonious development of a child. The following grounded suppositions disclosing story telling advantages determined the choice of story-telling phenomenon for children with AD/HD.
In the context of humanistic psychology, where creativity is understood as a transformative force, strengthening the sense of a human value (Rogers, 1951), story analysis and interpretation, individual story-telling are to help a child in acknowledging oneself with own merits and deficiencies. Specifically, a main task here is to teach a child how to discover oneself and develop self-control. C. Rogers idea that a child’s harmonious emotions and will, inner development process and personality development is determined by interrelations among members of educational process, educator’s ability to create favourable conditions for a natural child’s self-expression, is discussed by modern educators, (Jovaisa, 2001; Rajeckas, 2002). Narratives, such as story telling or retelling, giving directions, or recounting a past experience, play a central role in daily social interactions (Zinkevic-Jevstignejeva, Grabenko, 2002).).
Up to now the undisclosed importance of the story-telling phenomenon for children with AD/HD allows framing the problem of the research with the following question: what are the new opportunities of the story-telling phenomenon for pupils with hyperactivity and attention deficit disorder for the development of their cognitive activity, and formation of their behaviour. The object of this paper is to disclose the fairy-tales genre as the special instrument of upbringing and training for the development of cognitive capabilities and behaviour correction of children with AD/HD at primary school.
Tasks are as follows:
- To describe AD/HD and its impact on Cognitive Activity and Social Adaptation with the help of reference literature.
- To substantiate and validate the possibilities of experimental education theoretically and hypothetically with the use of fairy-tale genre.
- To present the project of a case study.
Keywords: Attention deficit hyperactivity disorder (AD/HD), behaviour, cognitive, activity, experimental development.
AD/HD and its Impact on Cognitive Activity and Social Adaptation
For several decades the scientists of pedagogy, psychology, and medicine have been interested in children and adults who are inattentive and unable to control their behaviour appropriately. These characteristics enable to define the syndrome of attention deficit and hyperactivity disorder. These are the following prototypes of attention deficit and hyperactivity disorders: a) AD/HD Predominantly Inattentive Type, when a person is inattentive but not hyperactive, b) AD/HD Predominantly Hyperactive Impulsive Type, when a person is predominantly hyperactive and impulsive, c) AD/HD Combined Type, i.e. combined classical type. In this case one can notice hyperactivity and impulsiveness and attention deficit indications that are really problematic (DSM-IV, Diagnostic and Statistic Manual of the American Psychiatric Association, ICD X International Classification of Diseases).
Epidemiological studies show that there are about 5 – 7 % of children with AD/HD syndrome (Barkley R.A., 1998; Barkley R.A., Fischer M., 1990; Dupaul G.J., Stoner G., 2003; Flick G.L., 1998; Ludwikowski K., 1998). This deficit is by 2 – 3 times more peculiar for boys if compared with the girls (Barkley R.A., Fischer M., 1990; Pastor P.N. & Reuben C.A., 2002).
Such percentage of prevalence practically shows that it is really difficult to find a class at school with no children suffering from this syndrome. If we make the presumption that the average statistical number of pupils in the classroom is 25 children, then it is very expedient that every classroom would have from 1 to 4 children suffering from AD/HD syndrome. Thus the discussed syndrome is not a rarity of some kind, but on the contrary, this is a common phenomenon that school teachers have to shoulder and endure practically every day. It should be mentioned that AD/HD syndrome very often shows up especially at the school age and in the context of the school activity of the child. The latter circumstance makes actual and significant, namely, the interest of education and training from the point of view of the discussed syndrome. The long-term tests show that the attention deficit hyperactivity disorder practically has been lasting the whole life, as only 50% of children can be cured, the rest still suffer from it during their adolescence (Barkley R.A., 1998; Barkley R.A., Fischer M., 1990; Pastor P.N. & Reuben C.A., 2002; Flick G.L., 1998; Teeter P.A., 1998). Sometimes these symptoms may persist to adulthood.
Today we know for sure, that AD/HD syndrome negatively affects the child’s cognitive ability and the sphere of social development. Any particular irritant makes it impossible to concentrate, to accept the information presented by the teacher and to fulfill the tasks by oneself. Such a pupil suffers from the inner disorganization of schoolwork activity and self-learning or slow work completion. In a way we can state that AD/HD syndrome limits the possibilities of the mental and intellectual activity, but the paradox lies in the fact that even the children with normal and even high intellect may suffer from AD/HD syndrome.
Pupils with AD/HD syndrome more often than not leave the school or are expelled from school. The coefficient of expelled children is higher (approximately 10%) among the pupils with this syndrome if compared with general population (Barkley, Fischer et al, 1990). Even at vocational schools students with AD/HD syndrome more often met with learning and behavioural problems that can explain their retirement from school (Beekhoven, Dekkers, 2005).
The differences between children with AD/HD syndrome and the healthy ones are noticed in several cognitive spheres. First of all, children with AD/HD often met with difficulties while doing various test tasks to fulfill which one needs the strategies of complex problem solving and organizational abilities and efforts (Barkley, 1998; Rapport et al., 2000). The language problems of children with AD/HD (unclear language, bad pronunciation, difficulties while retelling the text, inability to answer the questions of the text etc.), enable to understand the relation of this disorder with the cognitive sphere, i.e. the language. The fact that 10 – 54 % of the children with AD/HD may have language problems helps to understand this, if compared with 2 – 25 % of the healthy children population (DuPaul J., Stoner G., 2003). Specific Deficits Associated with AD/HD are memory, attentional, intellectual, reasoning and neuropsychological Specific Deficits: Intellectual – low coding, IQ may be 7 – 15 points lower; Memory – low verbal fluency, working memory; Attentional – poor sustained, poor selective, poor divided; Reasoning and neuropsychological – decreased response inhibition; poor sustained effort; poor complex problem solving; poor organizational skills (Teeter & Semrud-Clikeman, 1995).
The children with AD/HD syndrome are less successful at school than their intellectual abilities could allow. They usually get lower marks than the rest classmates with positive behaviour, besides their estimation in general standard tests are usually lower. It is obvious that AD/HD is related not with the lack of capabilities and skills, but with the insufficient fulfillment of the test tasks (Barkley, 1998; Forness and Kavale, 2001). But the rest part of children with AD/HD can be attributed to the group with the higher risk that meets with the difficulties while studying due to specific learning disabilities. The empirical testimonies disclose that the learning disabilities (LD) and AD/HD are the separate but interlaced dimensions. The fact that over 40% of the children with AD/HD at the same time have learning problems – Learning Disabilities (Cantwell and Baker, 1991; Frick et al., 1991; Pastor & Reuben, 2002; Barkley, DuPaul & Murray, 1990, Lerner, 2003). The rest authors, such as Mayes, Calhoun (2000) show that much more, i.e., even 70% of the pupils with AD/HD at the same time suffer from learning disabilities (LD).
It is obvious that the lack of the cognitive capabilities may cause learning problems. The differences between the pupils with AD/HD and those who are healthy may be noticed not in one learning sphere. These pupils may have speaking, reading, calculating and writing problems (Barkley, DuPaul & McMurray, 1990; Zackheim, Edward, Conture, 2003; Susan de La, 2001).
The solution of educational problems of hyperactive children most often depends on the individual needs of the children with AD/HD. The teaching of such children is the real challenge to the pedagogues. Only innovative teacher able to use new methods and means can help such pupils achieve the best learning results.
The children with AD/HD often lack social capabilities. These children are impulsive, authoritative, aggressive, and apt to create conflict situations while socializing with their friends (Teeter, 1998; DuPaul & Stoner, 2003; Resourse for school and home, 2003). These children are unable to find friends and often are unable to retain friendship for a long time, which brings to social isolation, sadness and depression (Guevremont, 1990).
Statistics shows that the pupils with AD/HD have low self-esteem (Weiss & Hetchman, 1986; Sprich, 2002). They more often are diagnosed as the ones having the socially unacceptable behavioural features. Even 40 % of the pupils of the primary schools and 65 % of the adolescent pupils with AD/HD have the disobedient behaviour (Jensen et al., 1997). 25 % of the pupils have the features of socially inappropriate behaviour – they steal, are aggressive, and do not attend classes (Barkley, Fisher et al, 1990). The socio-metric measurements show that the children with AD/HD are less valued from the point of view of socialization than the rest peers (Stormont, 2001).
The way to effective progress of this disorder – is the early statement of AD/HD expression features and the employment of pedagogical means at due time. The unnoticed disorder of attention deficit and hyperactivity creates the problems of social adaptation, such as asocial behaviour and early use of the drugs, low self-esteem, failures in professional activity, besides the greater risk of depression rise.
Theoretical-Hypothetical Substantiation of the Experimental Education with the Use of the Fairy-Tales
Vygotsky’s causal-genetic method and its educational-correction abilities
Despite the fact that psychologists and educational researchers have recognized AD/HD as the scientific problem, it is quite obvious that there are no theoretical methods of psycho-pedagogical approach of the above mentioned syndrome. It has been unnecessary to create new theoretical models the possibility to utilize some kind of classical psycho-pedagogical theory should be discussed and attempt to try to make it actual as the overcoming of the technological model of AD/HD syndrome should be made. n our opinion the scientific heritage of Vygotsky and his followers has become especially important.
The principal approach to the disability of any kind in childhood makes Vygotsky the prominent initiator of special pedagogy and psychology. Vygotsky understood one particular moment. According to him, more harmful is not the primary bio-medical disability of a child, but inadequate approach of grown-ups or unfavourable and adverse reaction to it. Thus with the help of the interiorization mechanisms the secondary “social disability” has been created which because of the consequences limiting upbringing and socialization is much more dangerous than the primary biological disability (Vygotsky, 1978). Vygotsky’s psycho-pedagogical approach to the child’s disability has been especially absorbing and fundamental because of the fact that it incites not only to adapt the education conditions to the disability by making them didactically more simple and at the same time rendering them innocuous socially and culturally, but to strive to create such socio-cultural and educational surrounding that would be oriented to the emancipation of education and socialization of the disabled child.