Childhood

Table 1

Key developmental challenges faced by children aged 6 to12 years

 Note. The table lists key identified developmental challenges that may typically experience by primary school children aged 6 to12 year (Halfon et al., 2018; Lesser & Pope, 2011).

Attention Deficit Hyperactivity Disorder 

A child’s inattention, impulsive or hyperactive behavioural characteristics maybe be indicators of attention deficit hyperactivity disorder (ADHD; APA, 2013b). ADHD is a behavioural disorder that is identifiable in primary children by their inability to concentrate due either to excessive activity or inability to act and maintain concentration. The APA (2013b) defines the two types as “inattentive” and “hyperactive-impulsivity.” This can result in a failure to complete tasks as children are easily distracted or struggle to wait, or both. At home, behaviour is similar and they may be easily overexcited, or seem quite and often daydream. In a child with ADHD the behaviours are more frequent and extreme than would be considered standard child developmental behaviours and as a result relationship and learning at school, at home and in other social settings can be adversely affected (Achenbach et al., 2012).

At school, ADHD affects a child’s capacity to pay attention to instructions and learning content, and their ability to focus and put effort in to their school work (Achenbach et al., 2012). This negatively impacts learning outcomes and in turn the student’s experience of academic success. Students are often restless, talkative and disruptive in class, and this affects their ability to establish, engage in and maintain healthy social relationships with peers and support and instructional relationships with teachers and other school support staff (APA, 2013b). Comorbidities such as Learning Disabilities, Conduct Disorder and Oppositional Defiance Disorder can also adversely affect relationships and the child’s ability to participate in the school system (Achenbach et al., 2012; APA., 2013b). At home and in other social environments, children may struggle to share and take turns, often becoming bored and disengaging. They may not listen or respond to social cues, and struggle to control their emotions making engagement with others challenging (Achenbach et al., 2012).

When these frequently occurring behaviours are identified, scaled and supported by evidence, to be hampering the child’s academic, social and occupational performance ADHD may be diagnosed by specialist health professionals (Becker et al., 2012).

Evidence of Symptoms 

ADHD is the most prevalent neurodevelopmental disorder in Australia  (ADHD Australia, 2019). Behaviourally, it is evidenced by persistent and frequent displays of “inattentive, impulsive, and sometimes hyperactive behaviour” and emotional regulation challenges present as well (ADHD Australia, 2019). Cognitively, these symptoms are the result of an inability to regulate and control attention, emotions and behaviours. Children are also unable to consistently recall information, self-monitor and reflect, problem solve or plan, and also to self-soothe (ADHD Australia, 2019; APA, 2013b). These neurological differences result in developmental delays that in turn impact the child’s ability to self-control. This also has social implications, as children struggle to engage in a positive way at school, make friendships, achieve positive social currency and self-esteem, and can contribute to the development of significant adverse outcomes as they develop (ADHD Australia, 2019; van Stralen, 2016).

Following a model for the collection of evidence and data such as the GRIP Framework (Commonwealth of Australia., 2007), anecdotal and documented evidence from teachers and other key stakeholders, including parents and the child themselves, can be gathered and compared with existing information that may already be recorded on the student’s file on OneSchool. Assessment records and report card comments can also provide insight into behaviour and academic performance. If the child has come from another school, they can be contacted to provide supporting information on prior referral and any support strategies undertaken previously. A functional behavioural analysis (FBA) of behaviours observed and recorded both inside and outside the classroom may provide insight into contextual factors and triggers affecting the student’s behaviour and wellbeing (Northup & Gulley, 2001). Psychometric tests such as the Vanderbilt ADHD Diagnostic Rating Scales are a screen tool that can be used to support the identification of ADHD in children between the ages of 6 and 12, and other comorbidities, such as Oppositional Defiant Disorder, conduct disorder, learning disabilities, anxiety and depression (Wolraich, 2003; Bard et al., 2013).

Impact on the Individual and Interactions

ADHD symptoms are identifiable in early childhood and usually need to appear before the child turns 12 to meet the requirements for an ADHD diagnosis. According to the Diagnostic and Statistics Manual of Mental Disorders (DSM-5; APA, 2013b), children with hyperactive-impulsive symptoms usually are fidgeting, restless and jiggle their legs or tap objects and generally move more frequently than their peers. They also tend to call out and interrupt their classmates and respond immediately, without thought for consequences.

At school, this may present as yelling out answers to questions directed at the whole class, or racing ahead in a task without waiting for instructions. However, it may also have more negative implications whereby children may swear or lash out at peers and teachers due to their lack of self-regulation resulting from issues with executive functioning (Garland, 2014). As a result, more often than not students are faced with negative consequences if identification goes unchecked, meaning early intervention and support are overlooked (Garland, 2014).

At home and in social contexts, children with ADHD may seem to frequently seek their parent’s attention and seem impatient and persistent (Garland, 2014; van Stralen, 2016). This also extends to peers and extended family and community members. Boredom is a trigger and children resort to seeking stimulation, which can translate to unsafe risk-taking behaviours. These characteristics can vary in individuals and can evolve as the child develops. Emotions can escalate quickly into angry verbal or physical exchanges as the lack of self-control fosters psychological distress, compounding regulations issues (Garland, 2014; ADHD Australia, 2019).

Inattentive symptoms in students include struggling to concentrate and maintain focus during learning activities and completing tasks they adjudge as boring. They are also easily distracted and often miss teacher instructions or struggle to remember what they are meant to be doing. They make basic errors or fail to complete tasks. In the home environment, children frequently lose items, are reluctant to do chores, often leaving them incomplete or not done at all. They may struggle to remember, understand and complete homework, or to be ready to leave for school or other social activities. In some cases, both inattention and hyperactive impulsive symptoms can be present (Shaw et al., 2016).

Overall, individuals with ADHD struggle to regulate their emotions; this can be seen as rapid and intense mood swings, ranging from high excitement to aggressive anger. Children may also focus on the negatives in a situation, and experience greater psychological issues as a result (Garland, 2014; ADHD Australia, 2019; Shaw et al., 2016). Unless diagnosed, supported and treated children experience learning difficulties, behavioural issues with disciplinary repercussions and will struggle socially. In turn, they develop poor self-esteem, anti-social tendencies and have an increased like hood of developing other comorbidities that continue into more risky, self-destructive behaviours as they continue to develop into adulthood (Shaw et al., 2016).

Suggested Interventions

The Zones of Regulation (Kuypers, 2011) is a validated, readily accessible support strategy for intervention that focuses on developing the child’s self-awareness and self-control over their executive functioning that support their social capacity and ability to engage positive in the primary school environment (Kuypers, 2011; van Stralen, 2016). It can be implemented for the individual students, for a small group or as a whole-school wellbeing program. To provide equity and support inclusion, any adjustments for learning such as wellbeing strategies and support provision, can be noted in the student’s personalised learning plan (PLP) on OneSchool (or equivalent) to ensure all school staff and parents understand the plan and better support the child as well. This information can then be referenced and developed as the student progresses.