Integration of L.S. Vygotsky's psycho-pedagogical theory and methodology to a pupil who has AD/HD Syndrome, to educational intervention process
Viktorija Piscalkiene and Gediminas Merkys
Institute of Educational Studies, Kaunas University of Technology, Kaunas, Lithuania
Paper presented at the European Conference on Educational Research Post Graduate and New Researcher Pre-Conference, University of Crete, 20-21 September 2004
ABSTRACT. Attention deficit and hyperactivity disorder (AD/HD) of children is being discussed within an educational aspect in this paper. The task is to show that educational means to overcome this syndrome in the context of the educational science are not completely disclosed. Children with AD/HD are notable for their active behaviour, inattention, high level of activity, impulsivity, attention problems. For an education of such children importance is not only in the selection of special teaching strategies, but also the maintenance of dominant and positive emotional tone. Thus, today‘s experience is allowing to state, that in Lithuania, as one of the post-soviet countries, situation is a little bit different in regard to the above thoughts, because scientific research shows frequent differences between declarative ideas and reality. The idea of this paper is to link an action against AD/HD with a socio-cultural theory of psycho-pedagogy by Vygotsky. Most important for a child is the environment one is growing in. Based on the wealthness of such environment is the perfect one‘s psychosocial development (Vygotsky, 2000). Adults: parents, teachers - they are the basic source on which help to children with or without development problems should be based. A phenomenon of story integration into the process of an educational correction for children with AD/HD is described in this paper. This phenomenon is not have been adopted in the educational science yet. The value of this method is easily described in just a few aspects. First of all, it is well applied either at home or at the teaching institution. Also, it opens wider capabilities of learning and socialization, because of the development of self-awareness, motivated activity and cognitive abilities.
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. For more than a half of the people, who were diagnosed with AD/HD, the onset of the disorder arrived before the age of seven years. About 40% of them show symptoms that persist to adulthood. The disorder occurs more frequently in males than females. Descriptions in the ICD-X, DSM-IV include three diagnostic subtypes based on a predominance of symptoms - either inattention or hyperactive-impulsive symptoms. A child can be classified as having either: inattention, hyperactive impulsive or combined type, if both symptoms are present.
High levels of activity, impulsivity and inattention affect children from the first months of their lives through their school years, through adolescence and into adulthood.
Most children with AD/HD will exhibit significant problems with academic performance, such as slow work completion, inconsistent accuracy on seatwork and homework, and poor study skills. Behavioral features, exhibited with AD/HD, include low-frustration tolerance, temper problems, persistence, emotional liability, depression, peer rejection, poor self-concept and poor self-esteem.
Typically, AD/HD begins early in one’s life, with most symptoms becoming apparent prior to elementary school. In order to facilitate practitioners in identifying and supporting young children at risk for this disorder, some research has been conducted.
Teaching of such children requires a lot of competence from teachers (pedagogues, parents). In this context, sustaining of a positive emotional tone, motivating merit system, development of child‘s self-control capacities are the most important. Unfortunately, teaching system and customs in post-communist countries are more authoritarian than those in the Western democracies (Saparnis, 2000, Ruskus, 2000, Gribaciauskas, Merkys, Useckiene, 2002). Nevertheless, this environment with autocratic traits also allows to search for specific educational means, which would empower the formation of child‘s personality based on humanitarian principles.
The task of this paper is to start a discussion on which capabilities of learning and socialization could be reached by Vygotsky‘s story integration into the process of an educational correction for children with AD/HD syndrome. In this case, the process of pedagogic intervention phenomenon is being applied.
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, a recommendation is for story-telling phenomenon (creativeness, performance, interpretation). A story-telling phenomenon, as one of the creativity development forms, helps to observe the merits that stimulate harmonious development of a child. Rogers (1951) statement was that creativity development helped a child to recognize oneself with very own merits and deficiencies. It was a basis for a child to analyse oneself by also stimulating a self-control.
As Vygotsky‘s, if adults are likely to help children, they must be active in the process of the development of a child cognition. In this case, the development of child cognition must be implied by a co-operation with other children and / or adults. This one, as well as the other thoughts of Vygotsky, is being balanced within the context of story-telling for children and interpretation.
WHAT IS ATTENTION DEFICIT HYPERACTIVITY DISORDER?
Inattentive pupils, disturbing themselves and others, children of a different behaviour, teenagers, adults, are of a high interest to the scientists for more than twenty years. In most cases, the majority of children and some adults posses insufficient control upon their behaviour. Above characteristics could lead to a diagnosis of an attention deficit syndrome, accompanied with a hyperactivity, known as AD/HD (attention deficit/ hyperactivity disorder).
As seen from this abreviation, AD/HD stands for the disorder of attention deficit and hyperactivity. In literature one would find that these terms are similar but not the same. AD/HD notion (Dendy, 2000; DuPaul, Stoner, 2003), consists of nine disordered behaviour symptomes, grouped within two main categories - attention deficit and hyperactivity. Diagnosis is based on to which of these categories at least six characteristics are due to be attributed by psychiatrists or neurology doctors, also indicating their subtypes. Criteria of AD/HD are in ICD-X, (International Statistical Classification of Diseases and Related Healtk Problems) and DSM-IV, (The Diagnostic and Statistic Manual of the American Psychiatric Association). In Lithuania these notions are well known since 1997, when TLK-10 - International Classification of Diseases (tenth edition) was adopted.
Inattention/poor concentration symptoms of AD/HD (Dendy, 2000), that interfere with learning, are definable in these areas: difficulties while listening in a class (spacing out, daydreaming or missing lecture content and homework assignment); lack of attention for details (careless mistakes at work; heeding no grammar errors, as punctuation, capitalization, spelling, sign (+, -, x) or exponent change); difficulties while staying at a task and finishing school work, state of being distracted (moving from one uncompleted task to another, having difficulty for refocusing on a work); unconscious whether passing or failing in a class.
Children with AD/HD show basic signs of attention problems at their school age. Although the research is sparse on this topic, discovery is that children which refer to the problems with attention, tantrums, and defiance, are less attentive on structured tasks and more impulsive on laboratory tasks than controlled children between the age of 2 and 3 years (Campbell et al.,1982). More research is needed on attention and memory capacities for this age group. Then, definitive statements can be made on how AD/HD interferes with skill development in preschool. It has been suggested that preschool children may miss out on academimic readiness activities due to the inattention and constant discipline. Attention deficit was explored in more detail in the discussion of middle childhood (Teeter, 1998).
The most noticeable behavioural characteristic in AD/HD symptom pattern is hyperactivity. Some mothers of children with AD/HD have noted that hyperactivity was often present even before their birth (Grad L. Flick, 1998). This problematic hyperactivity may not have been recognized as a real symptom until a child is placed in a situation that requires some self-control of any movement.
Attention deficit/hyperactivity disorder is one of the most often behavioural disorders among children and teenagers, from 3 to 11 percent of the general children population. And it is systematically growing (Lesauskas, Kuzmickas, 2004, DuPaul, Stoner, 2003). In the prekindegarten and kindergarten age groups from 14 to 20 percent of the boys and approximately 5-7 percent of the girls have AD/HD. Such variation in reported prevalence rates appears to reflect a lack of standartization of the research reporting criteria indicating that, (Flick, 1998): a) different diagnostic criteria may be used; b) methods of assessment may vary; c) cultural factors may not be considered; d) age variation may not be recognized; e) sex variation may be ignored.
If considered, that an ordinary class consists of 25 pupils, it is more than obvious that such class would have from 1 to 4 children with AD/HD.
Although researchers still do not know what exactly causes such a condition, they do know that it is an inherited one (Dendy, 2000). This is why most of the research examining the etiology of AD/HD is on a correlational basis. Advice is warranted in attributing causal status to identified variables. Variables within a child, such as neurobiological factors and hereditary influences, have been recognized the most (Barkley, 2002).
Syndrome discussed above is not a rarity, alternatively, this is a massive thing, which a pedagogue from a general school meets almost every day. It is worth noting that AD/HD is very often recognized at this school age and during the school activities of a child. Last occurrence actualize the interest of teaching and it‘s practice in regard to the discussed syndrome.
How AD/HD syndrome may influence learning and emotional / behavioural problems?
Today, it is well known, that AD/HD syndrome has a negative impact either on cognitive learning, or the development of social sphere. Any soreness is disturbing attentiveness and accuracy, information reading on a seatwork, doing exercises. Such a pupil is not able to finish an activity that was already commenced without the aid of others, because the attention is disturbed with other things. Inner disorganization of learning is characteristic for such a pupil. Therefore, it is possible to report that AD/HD syndrome is limiting the capacities of learning activities.
One of the most common and potentially weakening difficulties exhibited by children with AD/HD is a chronic academic underachievement, which is relative to their intellectual capability (Barkley, 1998). Children with AD/HD (approximately 40 percent or more) are placed in the special education programs for students with learning disabilities or behavioural disorders (Barkley, 1998). Typically, children with AD/HD are at a higher risk for a number of weaknesses in areas of test performance and cognitive functioning in relation to their peers. Specifically, a significant percentage of children with this disorder show problems with problem-solving and organizational skills, expressive language abilities and fine or gross motor control (DuPaul, Stoner, 2003).
Explicitly, 10-54 percent of children with AD/HD may exhibit expressive language problems in relation to 2-25 percent of the normal population. (Barkley, DuPaul, &McMurray, 1990). Studies indicate the overlap between AD/HD and the following learning problems: 20 percent have reading difficulties, 60 percent have serious handwriting difficulties (Paul Cooper & K.M.Bilton, 2002).
Children with attention deficit disorder quite often become impulsive, their spontaneous behaviour is provoking dangerous situations among their peers, parents, teachers. Hyperactive children are different from ‘normally active‘children, because their behaviour is chaotic, less motivated, heavier to control. Therefore, because of spontaneous behaviour severe accidents take place. Thus, not all the children with attention deficit are hyperactive. Alternatively, sometimes they are very quiet, not less problematic at the time.
Unfortunately, these children are less successful in the school, their self-estimation is reducing, their relation with pedagogues, parents, relative people is becoming destructive. This may lead to pathologic and unsociable behaviour.
For many years, it was assumed that children with AD/HD would ‘outgrow‘their behaviour control difficulties upon reaching adolescence or early adulthood. But several prospective longitudinal investigations have followed children with AD/HD into young adulthood (18-25 years old). In general, these have found that over 50 percent of children with AD/HD will continue to evidence symptoms of the disorder, especially with respect to inattention and impulsivity, into adulthood, especially when parent report rather than self-report data are used. Furthermore, more than 40 percent of teens with AD/HD display significant antisocial behaviours such as physical fighting, stealing, and vandalism (Barkley, Fischer, et al., 1990).
Problems of academic achievement and antisocial behaviour that were noted for adolescents with this disorder continue to be the highest risk for this group in adulthood.
Almost a third of these adults will have dropped out of high school, with only 5 percent completing a university degree program as compared to over 40 percent of control group subjects (Barkley, Fischer, et al., 1990). Observably, 66 percent of adults report at least one symptom (i.e., restlessness, poor concentration, impulsivity, explosiveness) of the syndrome; 64 percent give a complaint of being restless and 44 percent are noteworthy restless during a clinical interview (Weiss&Hechtman, 1993).
As the above disorder may continue and even progress at the later age by causing psychic, social, physical problems, early diagnosis and aid is advised at the youngest possible age.
IMPLICATION OF L. S. VYGOTSKY‘S PSYCHO-PEDAGOGICAL IDEAS FOR CHILDREN WITH AD/HD: A STORY-TELLING PHENOMENON
Therefore, teaching and it‘s well organized practice have their extraordinary role in disclosing the essentials of AD/HD syndrome by helping to overcome it, as much of the potential is within. Teaching of children with AD/HD should follow a contemporary humanistic paradigm of teaching, which never recognizes psychological tensions in the environment of teaching. It is obvious, that children with a syndrome discussed in this paper during a process of educational correction should experience not only positive emotional tone, but also a clever merit system without any penalties for children. Thus, on the other hand, alternative experience is still possible, when a child is encountering the authoritarian environment of teaching. Research in Lithuanian context demonstrates that teaching system and customs in post-communist countries are more authoritarian than those in the Western democracies (Saparnis, 2000, Ruskus, 2000, Gribaciauskas, Merkys, Useckiene, 2002). Authoritarian teacher and humanistic teacher construct different environments of education and obtain different results of teaching in a classroom. Regulations of authoritarian pedagogues (penalties as the aspect of teaching) were researched by Gribaciauskas, Merkys, Useckiene in 2002. Regulations of authoritarian pedagogues are reflected by incorrect psychologic means (shouting, insulting, etc.), positive estimation of capable pupils only, drawing a strict line between good and bad students (Gribaciauskas, 2003).
If remaining at the occurrence, that in this society some remains of authoritarianism are still vivid, it is worth remembering one of the most outstanding psychologists and pedagogues of the beginning of the XXth century -- Lev Semionovich Vygotsky (1896-1934), who‘s ideas were anti-authoritarian already then. Therefore, the question remains -- exactly which ideas of L. S. Vygotsky would be the most important to integrate into the process of an educational correction for children with AD/HD.
L. S. Vygotsky acknowledged that a child begins learning from people around him, own social world, which is the source of all one‘s notions, ideas, statements, knowledge and the rest. This social world, particular culture implies all the stimuli a child will experience. Every culture has it‘s different selection. From a particular set of social and cultural phenomenon children interiorize already selected aspects of the world. Therefore, the source of cognition development is in the cultural interaction of people much earlier, than psychic processes of a child become available – the reflection of particular ideas, occurrences, statements and strategies. All the individual psychic processes start as social processes between people, most often between adults and children (Vygotsky, 2000).
It is important to remind L. S. Vygotsky‘s principal view towards the disability of any nature in the childhood. L. S. Vygotsky was probably the first among world‘s pedagogues and psychologists to acknowledge an essential tendency. L. S. Vygotsky believed that the original disability is not so much a problem, but a way the disability alters the conditions of how a child can participate in the sociocultural activities. Lack of participation in these activities can block the development of higher mental functions, such as self-regulation. Therefore, it is most important for children with learning and behaviour problems to improve their social interactions with adults and peers (Vygotsky, 2000). Accordingly, the basic damage is not within a primary biomedical disability of a child, but in a non adequate reaction of adults. This is why by the means of interiorization a second ‘social disability‘ is being created, which on the other hand is more dangerous than a primary biomedical disability, because of the various limitations for a socialization (Vygotsky, 2000). L. S. Vygotsky‘s psycho-pedagogical view towards the disability of a child is very attractive, because he is not insisting on the proper conditions of teaching, but creating such an educational and sociocultural environment, that would be targeted towards the emancipation of socialization of a child, sometimes making it even culturally weaker (Vygotsky, 2000). In the context of this paper, AD/HD syndrome is in part attributed to the disability phenomenon, because in the description of this disorder attention deficit and hyperactivity are indicated. The presence of attention deficit and hyperactivity has a negative influence towards a learning of a child, relations with one‘s peers, adults. At the same time, additional requirements are due for the environment.
As per the account of S. Vygotsky, if adults are willing to help a child, they must set two things for themselves - at first, to learn what is today‘s development level of a child. In other words, what is the ability of a child to overcome the problems without the interference of an adult? Secondly, what a child is capable to do, if led by an adult? When child is engaged individually, one can find that development level. When child is in a contact with an adult, one can follow the abilities of cognition development at particular circumstances, i. e. learning with competitive mediator (Gage, Berliner, 1994). This idea of L. S. Vygotsky includes a key which has been influencing the stage of early childhood development. The Zone of Proximal Development is the distance between the actual developmental level as determined by independent problem solving and the level of potential development as determined through problem solving under adult guidance or in collaboration with more capable peers (Vygotsky, 2000).
Vygotsky‘s statement was that learning could be good only if the development was left behind. Teaching must influence the activity of those functions, which take part in the process of maturity, i.e. the Zone of proximal development (ZPD). As this is a way, direct teaching and other forms of education give a huge impact on the development of child‘s cognition (Gage, Berliner, 1994). The axis of ZPD theory is a social knowledge, gained during a social interaction and therefore becoming as an individual knowledge.
Implication for pedagogy:
In Vygotsky‘s psycho-pedagogy for children with AD/HD syndrome, story-telling phenomenon is the most significant, as one of the child‘s behaviour creating condition.
The development of a child‘s psychic functions in an ontogeny is based on the Zone of proximal development (ZPD), active operation, leading action, role of mediators (signs, symbols), which allows to acknowledge that with the help of story-telling phenomenon these outlines would increase the capabilities of AD/HD children teaching and socialization:
Besides, L. S. Vygotsky did not execute experiments with stories himself, the combination of above projected ontological outlines and story-telling phenomenon gives a possibility to look carefully at the recent statements of different authors on this subject.
As stated by psychologists, uniqueness of a story is connected not only with a fantasy, it‘s notions, but also with a fact, that stories stimulate imagination and thinking by helping to fortify human values and get accustomed with a permanent life change (Оклендер, 1997). Stories are important for a normal psychic development of a child. As per the explanation of the best children psychologist on a worldwide level -- Bruno Bettelheim, a story helps to understand own negative emotions and solve psychologic problems in a positive way, a story helps to feel safe, because it‘s images derive from unconsciousness, while consciously it is difficult to comprehend. Stories stimulate unconsciousness of a child, aid in forming child‘s sense of independence, give a new quality to life by provoking new experiences and impulses of creativity (Bettelheim, 1976).
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 a self-control. During a creative activity emotionally pleasing atmosphere is being created - goodwill, empathy, psychological comfort, security, sense of self-reliance (Petrulytė, 2001). This explanation reminds L. S. Vygotsky‘s statement, that teaching must influence the activity of those functions, which take part in the process of maturity, i.e. functions of the closest development sphere. In order to have a good development of a child, one must be oriented towards new challenges every time (Vygotsky, 2000). Tendencies, which make child‘s development slower are being described by psychologist as a sphere for pupils‘independent work left too big.
Brazienė‘s (2004) research on the influence of story-telling for the infants‘ creativity change demonstrated that after the experiment for the pupil of elementary school was over creativity level changed positively. Also, positive improvements of created complex and cognitive stories were set, as well as the change in the plots of stories created by children, because of the new actors and marvellous things appearing, clear and lucid mind, emotionality of the story content, etc. This research also allows to observe the improvement of pupils‘communicative skills (problem solving, initiative, activity, kindness, tolerance, attentiveness, etc.). Based on the studies of the above author, further development of such research for children with ADHD syndrome is of an explicit value in the context of educational intervention.
OVERVIEW AND A DISCUSSION
When looking for the psycho-pedagogic means how to conquer ADHD syndrome, L. S. Vygotsky‘s scientific research is of an exceptional value. L. S. Vygotsky‘s psycho-pedagogic view towards the disability of a child is aimed at creating such an educational and sociocultural environment, that would be targeted towards the emancipation of socialization of a child.
As per the account of L. S. Vygotsky, if adults are willing to help a child, they must be active in taking part themselves in the process of the development of child‘s cognition. Therefore, the development of child‘s cognition should be supported by a close co-operation with adults and other children. This is why stories are of the unique value in aiding a child to reach higher functional levels. Help of an adult is a necessity. As teachers and parents provide an intellectual platform, which a particular child will climb.
Braziene‘s (2004) research on the influence of story-telling for the infants‘ creativity change demonstrated not only the improvements of complex and cognitive stories created by children themselves, their creative development, but also the improvement of pupils‘ communicative skills. From this issue a following question results - what are the new opportunities of the story-telling phenomenon for pupils with hyperactivity and attention deficit disorders, their cognitive activity, formation of their behaviour.
It is worth noting, that conquering of the AD/HD by educational means has no common theoretical programme yet. Empiricism of recommended means is being observed. Quite a number of arguments prove that a perspective theoretical programme could be L. S. Vygotsky‘s psycho-pedagogy. Advise herewith would be to connect such conquering of AD/HD syndrome, which is based on the theoretical programme above, with a story-telling phenomenon.
Barkley, R .A., DuPaul G. J., &McMurray M. B. (1990). A comprehensive evaluation of attention deficit disorder with and without hyperactivity as defined by research criteria. Journal of Consulting and Clinical Psychology. 58, p. 775-789.
Barkley, R. A. (1998). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment. New York: Guilford Press.
Barkley, R. A. Fischer M., et al., (1990). The adolescent outcome of hyperactive children diagnosed by research criteria. Journal of the American Academy of Child and Adolescent Psychiatry. 29, p. 546-557.
Bettelheim B. (1976). The uses of enchantment: The meaning and importance of fairy tales. New York: Alfred A.Knopf.
Brazienė, N. (2004). Pradiniu klasiu mokiniu kurybingumo ugdymas pasakomis. Daktaro disertacija. Siaulių universitetas.
Campbell, S.B. et al. (1986). Parent-referred problem preschoolers: Mother-child interaction during play at intake and one-year follow-up. Journal of Abnormal Child Psychology, 14, p. 425-440.
Chris, A., Zeigler Dendy (2000). Teaching teens with ADD and ADHD. USA: Woodbine House.
Cooper, P. & Bilton, K. M (2002). Attention Deficit/Hyperactivity Disorder. London:David Fulton Publishers.
Dendy, C.A. (2000). Teaching Teens with ADD and ADHD. USA: Woodbine House.
Dupaul, G. J., Stoner, G. (2003). ADHD in the schools: Assessment and Intervention Strategies. New York, London: The Guilford Press.
Flick, G.L. ADD/ADHD Behaviour –Change Resource Kit. USA: Jossey-Bass.
Gage, N.L., Berliner, D.C. (1994). Pedagogine psichologija. Vilnius: Alna litera.
Gribaciauskas, E. (2003). Pedagogu autoritariniu nuostatu turinys ir raiskos ypatumai. Daktaro disertacija, Siauliu universitetas.
Leskauskas, D., Kuzmickas, K. ir kt. (2004). Kauno miesto pradiniu klasiu moksleiviu aktyvumo ir demesio sutrikimo bei gretutiniu psichikos sutrikimu tyrimas// Medicina. ISSN 1010-660x. 2004 6 (40), p. 589-597.
Merkys, G. (1998b): Kulturhistorische Mehoden. In: Handbuch der Angewandten psychologie: Grundlagen, Methoden, Praxis. 6. Erg. Lfg.8/98. Rosenstiel&Molt (Hrsg.). Landsberg : Ecomed Verlagsgesellschaft. S. 1-20.
Merkys, G., Gribaciauskas E., Useckienė L. (2002). Pedagogų autoritarizmas kaip diagnostinis konstruktas: struktūros klausimai// Socialiniai mokslai, ISSN 1392-0758. 2002, 1 (33), p.27–41.
Petrulyte A. (2001). Kurybiskumo ugdymas mokant. Vilnius: Presvika.
Ruskus, J. (2000). Specialiojo pedagogo socialiniu nuostatu, pedagogines saveikos ir mokyklines socializacijos rysys. Daktaro disertacija. Siaulių universitetas.
Saparnis, G. (2000). Socialiniai-profesiniai santykiai tarp mokyklu vadovu ir svietimo skyriaus: kooperacija, konformizmas, rezistencija // Socialiniai mokslai. ISSN 1392-0758. 2000, 4 (25), p. 101-116.
Teeter, P.A (1998). Interventions for ADHD. Treatment in Developmental Contex. New York, London:The Guilford Press.
Weiss, G.&Hechtman, L.(1993). Hyperactive children grown up: ADHD in children, adolescents, and adults. New York: Guilford Press.
Выготский Л.С. (2000). Психология. Москва: Апрель Пресс.
Оклендер В. (1997).Окна в мир ребенка. Москва: Класс.