Coaching Student-Athletes with Attention Deficit/Hyperactivity Disorder (ADHD)

Published July 2010 • Revised July 2014

Introduction

Attention Deficit/Hyperactivity Disorder (A.D.H.D. or ADHD) affects approximately five percent of school aged children (Johnson & Rosén, 2000, p. 150). Characterized by inattention, lack of concentration, and learning difficulties in addition to some degree of hyperactivity and impulsivity (Corrigan, 2003, p. 535), the condition impacts over thirty-five thousand students in Ontario Secondary Schools. As the exceptionality is further understood by all educators, Physical Health and Education (P.H.E.) teachers but step forward and adjust the curriculum to help all the students in their class.

Studies have shown that A.D.H.D. affected children have difficulties with both gross and fine motor skills plus unsatisfactory levels of overall fitness. Disruptive behaviour led to poor relationships with peers and frustrations for teachers who must work with these students (Harvey, Fagan, & Kassis, 2003, p. 31). Fortunately, there are steps that a P.H.E. instructor can undertake to help students manage their A.D.H.D. symptoms, learn self-control, and get healthy.

Psychologists and physicians diagnose A.D.H.D. using criteria like inattention, impulsivity and hyperactivity. A child must demonstrate the characteristics consistently for a period of six months at a rate greater than their age group. The characteristics should appear in two different settings and manifest themselves before the age of seven. Psychologists will review the a set of standardized questions to determine whether the student falls into the category of Predominantly Inattentive Type, Predominantly Hyperactive-Impulsive Type, or Combined Type (Association of Chief Psychologists with Ontario School Boards, n.d.).

Increasing Focus

Students with A.D.H.D. may experience persistent and extreme distractibility (Hutchison, 2004, p. 199). The student cannot screen out irrelevant stimuli in order to concentrate on tasks long enough to complete them and does not sustain thought processes long enough to do school work (Bennett, Dworet, & Weber, 2008, p. 123).

It may be challenging for them to focus on a single lesson for the length of a seventy-five minute period. P.H.E. classes have natural breaks between different activities as the class progresses (warm-up, introductory activity, skill instruction, guided practice, modified games, cool down). Over the course of a week-long unit, the instructor can alternate between several activities – each with its own simple and precise goals – to keep the class moving forward.

It is hard keep the P.H.E. environment simple because the students may be sharing a space with another class or exercising outdoors. The instructor must create organization with their own routines and personal behaviour (Bennett, Dworet, & Weber, 2008, p. 128). The P.H.E. class should be mostly activity with brief moments allotted for instructions.

During these times, the instructor should make eye contact with every A.D.H.D. student for about five seconds to keep them engaged (Stabeno, 2004, p. 76). Teachers and coaches should give one command at a time and remain mindful of using consistent terminology, such as “full-speed”, “pass and cut”, or “head up (Dahlem, 2007, p. 42).” P.H.E. class must have a common language for both staff and students (Stabeno, 2004, p. 74).

Promoting Self-Control

Though all adolescents experience some degree of impulsivity, A.D.H.D. students consistently demonstrate this behaviour to extreme degrees (Hutchison, 2004, p. 199). Some secondary teachers loathe covering P.H.E. on-call periods because they fear that the class will degenerate into absolute anarchy. This stereotype is incorrect; although there may be some frenzied moments, A.D.H.D. outbursts can be managed with regular intervention ahead of time and prompt action afterwards (Reitman, O’Callaghan, & Mitchell, 2005, p. 62).

Teaching Games for Understanding (T.G.F.U.) takes advantage of the hyperactivity of A.D.H.D. athletes. Given that, skills can never be completely separated from tactics, the well-conceived approach embeds movement and decision-making skills into fun warm-up, practice, and competitive activities. The students need not think much; they must simply do and enjoy themselves. A.D.H.D. students would enjoy experiencing the excitement and spirit of the game instead of being bogged down with technical minutiae (Hopper & Kruisselbrink, 2002, p. 2).

Make Choices Simple: A principle of the Dribble Drive system is that any player can attack the basket if they feel there is an opportunity. A simple rule for those without the ball is that if a teammate drives, they must be given a lane to the basket. Telling an athlete: that “if someone drives, exit cut to a scoring position” is an easy read, like telling the ballhandler to “get to the rim if nobody helps but move the ball if the paint is closed,” that most elite players can understand.

Building Confidence

For a number of reasons, such as other failures in school, inappropriate social behaviours, or poor movement skills, those with A.D.H.D. have poor self-esteem (Johnson & Rosén, 2000, p. 156). In more than one third of cases, the condition persists into adulthood (Association of Chief Psychologists with Ontario School Boards, n.d.). To help them manage the condition later in life, it is imperative that instructors have to build self-confidence in these learners.

A mastery-based teaching approach is very suitable for building skills and self-confidence. The instructor should adjust the skill, by modifying the target or equipment with the objective of making the movement easier to perform. As proficiency increases, the speed or scale of the activity can be amplified (Hupp & Reitman, 1999, p. 48). These modifications can reduce off-task behaviour by fifty percent (Reitman, O’Callaghan, & Mitchell, 2005, p. 65).

Unsuccessful attempts are not failures but opportunities to explore mental training strategies. Breathing exercises, mental rehearsals, positive self-talk, and reframing are techniques A.D.H.D. students can use to get back on track without losing confidence (Jensen, 2003, p. 29). A caring teacher empowers students to take control of their actions and continue this attitude outside of the gymnasium (Harvey, Fagan, & Kassis, 2003, p. 33).

Negative consequences for poor behaviour lower self-esteem. The rejection (real or perceived) as a result of failure can be demoralizing (Stabeno, 2004, p. 51). People can only do their best so players should be congratulated when they do their best, even if the outcome is less than desirable (Wooden, 1999, p. 2). Skill correction from the instructor should be objective, private, and to the point, perhaps a quick verbal cue word to use in future attempts.

There is a role for every player on a team that enables them to succeed.

While meeting the needs of these exceptional students, P.H.E. instructors can harness the distractibility and impulsivity of the A.D.H.D. student (Stabeno, 2004, p. 72). By emphasizing strengths, like situational awareness and high energy, teachers craft a fun and fit environment that encourages students to develop their self-esteem and social skills. The physical dimension of sport participation has been shown to have a positive effect on the mood and anxiety symptoms of youth with A.D.H.D. (Kiluk, Weden, & Culotta, 2009, p. 504).

Keeping Active

There is some research to indicate that A.D.H.D. boys are more suited to individual sports where they experience less aggression and emotional reactivity than when they play team sports. Consequently, many parents are delaying the participation of their children in team sports until they have developed the necessary social skills (Johnson & Rosén, 2000, p. 156).

A key strand of Grade 9 Healthy Active Living Education is Physical Activity. Students must “demonstrate personal competence in applying movement skills and principles (Ontario Ministry of Education and Training, 1999, p. 8).” Many people – not simply exceptional learners – have painful memories of P.H.E. class because of the social nature of youths playing team sports. Instructors can just as easily evaluate this expectation individually.

However, it is important to keep those with A.D.H.D. moving, for example using a circuit with several stations or a fitness exercise with diverse drills that everyone can do together (Kahn, 2010). Due to short attention spans and excess energy, A.D.H.D. students are experiential learners who “learn by doing (Stabeno, 2004, p. 76).” The classroom strategy emphasizing how “working hard is better than sitting around (Bennett, Dworet, & Weber, 2008, p. 129)” definitely applies in the gymnasium; the worst-case scenario is that students will become healthier. Gross motor skills could be evaluated with a fitness circuit or drills that demonstrate physical performance factors such as agility, aerobic endurance, and power.

It can be hard to find the right motivation for A.D.H.D. students in any class. By presenting a variety of activities and drills, the P.H.E. instructor can gain greater insight for the interests of each exceptional learner (Hutchison, 2004, p. 199). Finding the right activity can light the flame inside the student, establishing “momentum” at school and inspiring them to greater success (Bennett, Dworet, & Weber, 2008, p. 129). The enthusiastic coach will find a place where the A.D.H.D. athlete can be him or herself and use the symptoms of their condition to their advantage (Stabeno, 2004, p. 55).

Teaching Learning Skills

Guided discovery can help students understand the wider team implications of their actions on the playing field. For example, during a passing lesson, the instructor could briefly stop the lesson to ask a question like “How can a player thank a teammate for a good pass?” An A.D.H.D. student may be shy to respond a question and may simply ignore it. Environments where all students feel comfortable taking risks include options for private reflection, Think-Pair-Share, small-group discussion, and whole class discussion (Beers, 2003).

Individual activities may be appropriate in some cases but in order to demonstrate Living Skills, students will need to “use appropriate social skills when working collaboratively with others (Ontario Ministry of Education and Training, 1999, p. 11).” Newer activities such as aerobics, weight training, dance, and yoga have entered the P.H.E. classroom and made fitness exciting for more students but there will always be a significant place for team sports. Although these sports help all students harness their emotions, deal with adversity, and interact with their peers, they can be challenging at first for students suffering from A.D.H.D. (Henley, Schweizer, de Gara, & Vetter, 2007, p. 2).

One of the worst things that a teacher or coach can do is to try to tightly control a student-athlete. Students with A.D.H.D. have high situational awareness and can scan their surroundings very quickly. Sports that suit such athletes are ones that demand a broad external focus, like hockey, soccer, and basketball. There is a high degree of chaos because so much is happening at once: teammates and opponents move around constantly, participants must be able to quickly move around the playing area, and quick reactions are required (Stabeno, 2004, p. 55).

During such in-class competitions, winning is not as important as effort and social interactions (Stabeno, 2004, p. 105). Student-athletes should pride themselves on setting personal bests and continually improving while recognizing their limitations. These core objectives can be carried over into other classes (Bennett, Dworet, & Weber, 2008, p. 126).

Providing Support

A protective factor in a child’s life is their relationship with friends, families, and other adults (Henley, Schweizer, de Gara, & Vetter, 2007, p. 3). In P.H.E. class, the lack of emotional control possessed by an A.D.H.D. student manifests itself in aggressive behaviour and emotional reactivity (Johnson & Rosén, 2000, p. 156). Strong peer relationships can be constructed by putting the emphasis on sportsmanship during games. Positive reinforcement (verbal and non-verbal) for good sportsmanship generates more sporting behaviour and increases sport-specific performance. Furthermore, such unqualified praise increases interest in sport and fitness (Hupp & Reitman, 1999, p. 49), building a self-feeding circle of fun, participation, and exercise.

Put Athletes in a Position to Succeed: After losing to the Orlando Magic in the 1995 Eastern Conference Semi-Finals, the Chicago Bulls realized that they needed to add more intensity to the team. As Phil Jackson put it, they needed someone to “fetch the basketball.” Dennis Rodman had finished a disastrous season in San Antonio so Jackson did not ask him to follow a series of strict rules or play within a complicated system. He consulted with the players on the team and everyone agreed to welcome Rodman for his defense and rebounding and accept his personality. The result was three championships (Isaacson, 2011).

At the beginning of the class, teachers and coaches should clarify the definition of sportsmanship. It is not an abstract concept but a series of specific actions that are achievable by the entire class on a daily basis (Bennett, Dworet, & Weber, 2008, p. 126). Many Toronto basketball teams will identify the sporting behaviours that team members should represent, such as “let’s see who can be the first player to pick a teammate up off the floor” and “stay involved in the game by giving energetic encouragement from the bench.”

Another requirement the Healthy Living strand is that students must “identify the factors that contribute to positive relationships with others (Ontario Ministry of Education and Training, 1999, p. 10).” Sport settings are a fitting location to practice appropriate social behaviours. For some A.D.H.D. adolescents, social trial and error in a sports setting is much more tolerable option than clinic-based treatment (Reitman, O’Callaghan, & Mitchell, 2005, p. 59).

Modelling the Way

A.D.H.D. students see how teachers act and use them as an example for managing emotions (Bennett, Dworet, & Weber, 2008, p. 127). Throughout the secondary school curriculum, P.H.E. students learn about conflict resolution. Emotional students must first practice self-control strategies before they progress to resolving conflicts in sport and life.

Teachers must monitor their own professional conduct since they are role models for students. Modelling the way is the first principle of strong leadership (Kouzes & Posner, 2003, p. 4). Coaches should consistently greet players and provide constructive feedback when they exit the game. If appropriate (without comprising supervision) staff members or other school leaders can participate in extra-curricular sport and show good sportsmanship.

Physical Activity is further exemplified by “demonstrate knowledge of guidelines and strategies that can enhance their participation in recreation and sport activities (Ontario Ministry of Education and Training, 1999, p. 8).” A program which placed A.D.H.D. athletes with older students who served as coaches increased personal self-confidence and happiness scores, reduced disruptions in class, and improved peer relationships (Johnson & Rosén, 2000, p. 151).

Staying Safe

One expectation that cannot be changed is the Active Living requirement that students “demonstrate safe practices regarding the safety of themselves and others (Ontario Ministry of Education and Training, 1999, p. 9).” Difficulty attending to instructions and risk taking behaviour contributes to a higher injury rate for A.D.H.D. children.

Impulsivity causes students to act without considering the consequences, repeating the behaviour without learning from experience (Bennett, Dworet, & Weber, 2008, p. 123). Well-established classroom routines should emphasize safety (for both oneself and others). The entire class must understand the consequences of risky behaviour, for example how the student could hurt themselves or somebody else. If there is a breach of the safety rules, the teacher should reprimand the student in a discreet and non-punitive manner (Coakwell, 2010).

Conclusion

Firstly, P.H.E. instructors can improve the fitness and motor skills of A.D.H.D. students. This will make them healthier and happier. Secondly, P.H.E. class can be a place for students to take advantage of their energy and become enveloped by the myriad of activities. Thirdly, team sports are tremendous opportunities to experience positive peer interactions and receive unqualified praise from the instructor. Finally, the A.D.H.D. students can take their enhanced self-confidence and social skills to their other classes and better manage their condition.

Works Cited

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