By Valeria Purcia for the project Up to the nines

1. PSYCHOPEDAGOGICAL INTERVENTIONS IN
YOUNG SCHOOLCHILDREN WITH ADHD
PhD. PURCIA VALERIA ECATERINA
County Educational Resource and Assistance Center
"Ghe. Lazăr" National College
Sibiu, Romania
Abstract: Attention Deficit Hyperactivity Disorder is a cerebral dysfunction frequently
occurring in the case of children, being one of the most common disorders for this age.
ADHD can be defined as a syndrome with an early debut (before the age of 7) and it consists
of a combination of inattention, hyperactivity and impulsivity that persists in time,
sometimes until adulthood. By means of the psychopedagogical intervention program we are
now putting forward, we wish to offer parents and teachers information about ADHD and
also provide a few simple and easy-to-use techniques which can be applied both in school
and family.
Keywords: ADHD, psychopedagogical intervention program, young schoolchildren, family,
school.
Attention Deficit Hyperactivity Disorder, also known as minimal cerebral
dysfunction, is a condition frequently occurring in children, being one of the most common
disorders typical for this age. ADHD can be defined as a syndrome with an early debut
(before the age of 7) characterized by a combination of inattention, hyperactivity and
impulsivity that persist in time, sometimes until adulthood, occurring in individuals with
normal mental development. When these symptoms become manifest they lead to difficulties
in adapting to family, school and social environment. (Măgureanu, 2004) It is highly
prevalent and has a strong personal and social impact, being often associated with other
developmental or psychiatric disorders.
It is a problem of psychic nature, which, although not permanently curable, can be kept
under control. Researchers believe that a neurologically inattentive, hyperactive child is an
individual with a hidden disability, who is in urgent need of intervention. (Sauvé, 2006)
Irrespective of how severe the situation may be, the therapeutical strategies especially
developed will help the young children to gradually lead a normal life.
Through the psychopedagogical intervention program we have put forward we wanted to
provide parents and teachers with information about ADHD, as well as with a few simple
and easy-to-use techniques which could be applied in both school and family environment.
Research methodology
Research purpose:
Studying the effectiveness of a psychopedagogical intervention to alleviate symptoms of
Attention Deficit Hyperactivity Disorder in young schoolchildren.
The program has been structured on three intervention axes:
 child-focused intervention;

2.  family-focused intervention;
 teacher-focused intervention.
The reason behind elaborating this program structure was to allow control and manipulation
of the main levels at which the symptoms associated with Attention Deficit Hyperactivity
Disorder become manifest:
 family level;
 school level;
 social level.
Research objectives:
1. To study the effectiveness of the psychopedagogical intervention program concerning the
alleviation of the major symptoms of Attention Deficit Hyperactivity Disorder in young
schoolchildren:
• impulsivity;
• hyperactivity;
• inattention.
2. To study the effectiveness of the program concerning the low level of socialization
associated with Attention Deficit Hyperactivity Disorder, and to increase learning efficiency.
Research hypotheses:
Getting the young schoolchildren diagnosed with ADHD involved in a psychopedagogical
intervention program would lead to:
1. Alleviation of the major symptoms associated with ADHD;
2. Alleviation of the socialization difficulties associated with ADHD and an improvement in
learning efficiency.
Methods and tools
A. The interview
B. The structured (quantitative) observation
C. The experiment
D. Raven Standard Progressive Matrixes
E. Vanderbilt evaluation scales – Parent Answer Sheet
Vanderbilt evaluation scales (monitoring) - Parent Answer Sheet
Vanderbilt evaluation scales – Teacher Answer Sheet
Vanderbilt evaluation scales (monitoring) - Teacher Answer Sheet (Wolraich, et all,
2003), adaptated by us with the author’s permission, on Romanian population, for Sibiu
County
F. The case study
G. Statistico-mathematical methods
Population universe
The population on which this research was focused, and which provided the cases that lay at
the basis of its elaboration, is represented by the sum total of the young schoolchildren in
primary school that are on the records of the “Gh. Preda” Psychiatric Hospital of Sibiu for
the February-March 2008 period, and who suffer from ADHD.
Selection of subjects
For the proceedings of the research we have selected 33 cases of young schoolchildren with
ADHD from the “Gh. Preda” Psychiatric Clinic of Sibiu, Department of Pediatric Psychiatry,
according to the following criteria:

3. 1. The child’s psychosocial profile:
• Presence of ADHD symptoms in behavior;
• Good level of development of the cognitive function – I.Q. higher or equal to 90 –
mental age corresponding to chronological age.
• Low level of integration in school and social group.
• Low school performance.
2. Family:
• high interest in the child’s biopsychosocial development;
• quality of collaboration with school;
• interest in getting involved in a psychopedagogical intervention program.
3. Primary school teacher:
• interest shown in applying personalized educational techniques to the schoolchildren
diagnosed with ADHD.
Criterion 1 – the child’s psychosociobehavioral profile
Following the discussions with the specialist team from the Department of Pediatric
Psychiatry concerning the schoolchildren with ADHD that were under observation and
treatment, 33 children have been identified as follows: 21 pupils – 1 st grade, 6 pupils – 2nd
grade, 5 pupils – 3rd grade, 1 pupil – 4th grade.
The selection of subjects has been made after interviews with the children’s parents and
primary teachers, as well as according to the results obtained after the parents and primary
teachers of the 33 children with ADHD filled in the Vanderbilt Scale for Primary Teachers
and Parents. The scores obtained by each of the schoolchildren has been recorded in their
individual charts, because of the methodological requirement of using these results in
building the pre-test profile for each of the children that would eventually remain subjects of
the experiment.
It should be mentioned that until this stage of sampling, all the schoolchildren have met the
requirements of the 1st selection criterion.
Criterion 2 – The Family
The parents of the schoolchildren have been contacted, and during some meetings, have been
explained the purpose, objectives and strategies of unfolding the program, along with the
educational reponsibilities that they would have to undertake within the program. Also, these
meetings have made it possible to evaluate the interest and resources of each family for the
child’s education in general, and for the proposal of getting involved in an educational
program, in particular.
It has been concluded that in the case of 6 children there is a weak response from the family
regarding the collaboration for the proposed psychopedagogical program, and as a
consequence, the children have been excluded from the program.
It has been concluded that in the case of 6 children there is a weak rrr
Following the interviews, 27 of the families have agreed to get involved in the program.
The group under research was made up of : 18 pupils – 1st grade, 6 pupils – 2nd grade, 2
pupils – 3rd grade, 1 pupil - 4th grade.

4. Criterion 3 – The Primary Teacher
During some meetings with the primary school teachers of the children with ADHD who
remained beneficiaries of the program, they have been informed about the purpose,
objectives and strategies of unfolding the program, along with the educational
responsibilities they ought to undertake. All the approached primary teachers have responded
positively, expressing their position of active supporters of the program.
Common problems of the selected cases:
The children selected in view of getting involved in the psychopedagogical program have
been diagnosed as suffering from ADHD by the interdisciplinary team of the “Gh. Preda”
Psychiatric Hospital of Sibiu, Department of Pediatric Psychiatry. Following the collecting
of psychological, family, school and social data of the children, we could conclude that
ADHD affects the children in all these respects. Consequently, they have a poor self-image,
and strong inferiority feelings due to the difficulties they are faced with in school and in
society. These difficulties have to do with a weak sensory-motion experience, partial lack of
behavior control, deficient acquisition of skills needed for daily activities, as well as
shortcomings in developing correct learning and social skills and abilities.
The stage of case construction
Psychological profile – symptom evaluation
Testing of cognitive function:
It has been carried out based on the following tests:
- Standard Raven Progresive Matrixes - development of cognitive function– I.Q. higher or
equal to 90 in all examined subjects.
-Vanderbilt ADHD Symptom Evaluation Scale for Parents and Primary Teachers
The pre-testing stage of the experiment
Between March and April 2008 the aplication of the ADHD Symptom Evaluation
Scale for each of the 27 schoolchildren selected for being included in the program has been
concluded, their results being recorded in their psychological charts (before becoming
beneficiaries of the psychopedagogical program).
1. Evaluation of ADHD symptoms by the family
(Vanderbilt ADHD Symptom Evaluation Scale for Parents)
2. Evaluation of ADHD symptoms by the primary teacher
(Vanderbilt ADHD Symptom Evaluation Scale for Teachers)
The stage of experimental manipulation
Full coverage of the stages of the psychopedagogical intervention program has been
achieved between April and June 2008.
Stages covered for the application of the psychopedagogical intervention plan:
Step 1: The parents observe the child’s behavior in the home.
Step 2: The primary teacher observes the child’s behavior in school.
Step 3: The parents and the primary teacher meet and talk about what they have observed
concerning the child and highlight the worrying aspects that concern the child.
Step 4: The parents meet the psychologist and share with him/her their observations, as well
as those of the primary teacher; they also offer means of getting in contact with the child’s
primary teacher: telephone number, his/her schedule in school etc.

5. Step 5: The psychologist innitiates an interview especially structured for the factors involved
in the program: parents, child, primary teacher, from whom he/she may obtain data
concerning the child’s educational and medical record.
Step 6: The parents receive a number of brochures or information about ADHD, following
which both them and the primary teacher fill in child behavior evaluation scales.
Step 7: The scales filled in by both primary teacher and parents are examined by the
psychiatrist.
Step 8: Following the results obtained in the evaluation scales filled in by the parents and
primary teacher, the psychiatrist determines the psychopedagogical intervention areas.
Step 9: The psychologist ellaborates a psychopedagogical plan focused on the intervention
areas established together with the parents and the psychiatrist.
Step 10: The psychologist carries out, and the psychiatrist monitors the application of the
intervention program, as well as the evolution of the child. The parents and the primary
teacher fill in child behavior evaluation scales at the beginning and at the end of the
psychopedagogical intervention program. (according to Feldman, 2007)
The Psychopedagogical Intervention Program
The program has taken into account the building of a home and educational
environment that would favor the harmonious development of children with ADHD, by
building a partnership that would involve the folowing intervention agents:
The County Educational Resources and Psychopedagogical Assistance Center of Sibiu
Manager – psychology professor Daniela Moldovan
Psychologists / school psychologists:
Valeria Purcia, Elena Morariu, Simona Crăciun, Simona Câmpean, Maria Opriş, Lidia
Draghiţă, Silvana Şerb, Cătălina Nechita.
The “Gh. Preda” Psychiatric Hospital of Sibiu, Department of Pediatric Psychiatry:
Dr.Cornelia Acaru, primary care physician– child neuropsychiatry; Dr.Sanda Elena Barb,
primary care physician - psychiatry; Dr. Angela Muntean, primary care physician –
psychiatry; Răzvan Pleteriu, chief clinical psychologist, Laura Orlandea, chief clinical
psychologist.
The primary teachers and the parents of these children.
The interdisciplinary partnership has been designed on various intervention levels, in
view of:
-as full a coverage of the family, school and social levels where ADHD symptoms become
manifest, as well as of the associated disorders;
-identifying the basic educational principles in raising a child with ADHD;
-identifying the main areas for psychopedagogical intervention in view of alleviating ADHD
symptoms, as well as those of the associated disorders;
-an active involvement of the intervention agents in controlling and alleviating ADHD
symptoms in young schoolchildren, beneficiaries of the psychopedagogical intervention
program;
Objectives of the psychopedagogical intervention program
General objective:
Facillitating a global development of the children with ADHD included in the
program by means of creating a socio-educational environment adapted to their specific
needs.
Specific objectives:

6. 1. Ensuring informational as well as formative aid needed by the parents of children with
ADHD;
2. Facillitating the professional optimization of the primary teachers working with children
affected by ADHD;
3. Facillitating the development of the communicative as well as of the socioaffective
function in children affected by ADHD;
4. Integrating the activities carried out by the members of the intervention team in a coherent
educational and formative partnership to the benefit of the children who are subjects of the
program.
Beneficiaries of the psychopedagogical program:
• Children with ADHD
• Parents of children with ADHD
• Primary teachers of children with ADHD
The intervention team:
Professionals:
• School psychologists
• The interdisciplinary team of the „Gh. Preda” Psychiatry Hospital of Sibiu
Volunteers:
• Parents of children with ADHD
• Primary teachers of children with ADHD
The unfolding of the informative/formative program for parents
The program for parents has amounted to a sum total of 10 formative (weekly) sessions. The
parents of children with ADHD have acted both as representatives of the family as well as
beneficiaries of this formative course.
Objectives:
●Familiarizing the parents with: the particularities of the Attention Deficit Hyperactivity
Disorder in young schoolchildren; the problems posed by ADHD; information connected
with the psychology as well as with the diagostic criteria, with the particularities and
difficulties that these children have to deal with along the learning and development process
(in terms of behavior as well as social and school integration).
●Observation and evaluation of the child’s behavior; making the parents aware of
educational mistakes that may occur in the behavioral correction of a child with ADHD.
●Improvement of atmosphere within the family; active listening; emotional communication;
parent-child communication.
●Ways of reinforcing the parent-child relationship; focusing on the positive aspects of the
child; unconditional acceptance; time dedicated to the child.
● Acquisition of behavioral management notions, as well as of behavioral methods and
techniques of positive disciplining by the parents;
●Rewarding of positive attitudes; designing a plan for viable behavior; types of rewards;
solving problematic situations;
●Co-operation with the child’s primary teacher; behavioral monitoring cards; daily plan;
●Increasing the child’s self-esteem; nurturing the child’s self-confidence; highlighting the
positive achievements; increasing awareness of the distinction between the child’s behavior
and person;
●The influence of games in the therapy of children with ADHD; developing socialization
abilities; suitable types of games and toys.
The unfolding of the informative/formative program for primary teachers
This program has amounted to a sum total of 7 of (weekly) formative sessions.

7. Objectives:
●Familiarizing the primary teachers with the particularities of Attention Deficit
Hyperactivity Disorder in young schoolchildren. Informing them about the set of problems
associated with ADHD by offering them information concerning the psychological aspect
and the diagnostic criteria, the particularities and difficulties that these children have to deal
with along the learning and development process (in terms of behavior as well as social and
school integration).
●School teaching-learning process; school adaptation; behavioral interventions;
●Well-established structure and routine; using the gradual system of structuring the class;
the three „R”s: routine, regularity and repetition; careful monitoring of behavior; class
management.
●Acquisition of ergonomic principles and rules by the teachers that would offer the ADHD
child a secure environment.
●Lessons that are as attractive as possible, getting the child involved in a work group;
primary teacher-child interaction; combining verbal explanations with practical
demonstrations.
●Identifying behavioral problems; behavioral class management system; rewarding well-
achieved tasks;
●Partnership among children; well-defined rules; co-operative learning; playing and
socializing time.
Counselling children with ADHD
Objectives:
• To enable the child to get over difficult emotional problems;
• To enable the child to achieve a certain congruity among thoughts, emotions and behavior;
• To make the child feel good about himself/herself
• To enable the child to accept his/her limits;
• To determine the child to change behavior that has negative consequences;
• To enable the child to function comfortably and in an adaptive manner in an external
environment (both at home and in school);
• To create such conditions for the child that he/she could follow his/her development stages.
Result Analysis and interpretation
Age group distribution (school class) in the lot under study has been as follows:
18 pupils – 1st grade, 6 pupils – 2nd grade, 2 pupils – 3rd grade, 1 pupil – 4th grade (Fig. 1).
In this paper we have chosen to deal with the age group between 6 and 7 (1 st grade),
which has turned out to be the most numerous one, further proof to a correct identification of
the disorder by both parents and primary teachers mostly at the child’s entering the school
system.
The next age groups are 7-8 years old (2nd grade), 8-9 years old (3rd grade).
In contrast to this, the age group 10-11 years old (4 th grade) is significantly low in the
studied lot.
This fact is in accordance with DSM-IV which requires that core ADHD symptoms
should become manifest before the age of 7.

8. 7,40%
3,70%
22,22% 1st grade
66,66% 2nd grade
3rd grade
4th grade
Figure 1 Age group distribution (school age) in the studied group
Sex ratio – in the studied lot has been of 5,75:1. The distribution according to sex indicates
the predominance of boys as compared to girls. These values are similar to those in the
general population. (Fig.2)
In children, ADHD is more frequent in males, with a sex ratio of 3,6:1. The difference
between the sexes is highly significant. Girls diagnosed with ADHD are affected from a
cognitive or attention point of view. (Ivanesei, 2008)
85,1
100 8
%
80
%
Boys
60
%
40 14,8 Girls
1
%
20
%
0%
Figure 2 – Lot distribution according to sex ratio
According to the degree of family disintegration (fig.3), in the group studied, 4
subjects out of 27 come from disintegrated families, however a cause-effect connection
between the family environment and ADHD diagnosis could not be established.
3,70% 7,40% 3,70% Maternal assistant
Divorced parents
85,18%
Monoparental family
Biparental family
Figure 3 – Degree of family disintegration in the studied lot
In the group analyzed according to ADHD subtypes, the combined subtype is predominant,
the other ones ranking very low; a possible explanation would be that spotting children with
a high degree inattention, hyperactivity and impulsivity was easier because this type of
behavior can be perceived faster by parents and primary teachers. (Fig. 4).
DSM trials and other subsequent clinical studies have shown that the combined type is
predominant, as compared to the type where attention deficit prevales. However, because the

9. attention deficit subtype has the highest probability of being underdiagnosed, its prevalence
cannot be deduced from clinical groups. (Iancu, 2007).
18,51%
Combined
subtype
70,37%
11,11% Inattentive
subtype
Hyperact./impuls.
subtype
Figure 4 – Distribution of ADHD cases according to subtypes
The statistical processing – (SPSS, t test ) of data concerning the effects of the independent
variable upon the dependent variables - has been carried out by means of the t test for the
difference between the average of two dependent samples (pairs), by comparing the
significant differences between the pair sample average data as following the results
obtained from the pre-testing and the post-testing in the following tests:
- Vanderbilt ADHD symptom evaluation sheet– filled in by parents
- Vanderbilt ADHD symptom evaluation (monitoring) sheet– filled in by parents
- Vanderbilt ADHD symptom evaluation sheet– filled in by primary teachers
- Vanderbilt ADHD symptom evaluation (monitoring) sheet– filled in by primary teachers
The t test concerning the difference between the average values of two dependent
samples allows for the evaluation of the significance of the variation in a certain
characteristic, in the same subjects, in two different situations (for example, “before” and
“after” a certain condition has been acted out), or in two different contexts, irrespective of
the moment when they become manifest. The advantage of this statistical model is that it
captures the so-called “intrasubject” variation, because the calculation basis is represented by
the difference between the two values measured for each subject separately. (Popa, 2008)
Reporting the research results
Considering that in all the obtained results the p value <0.05, the null hypothesis is rejected.
It has been accepted as research hypothesis, that getting young schoolchildren with ADHD
involved in a psychopedagogical program leads to:
1. Alleviation of the major symptoms of Attention Deficit Hyperactivity Disorder:
● inattention
● impulsivity
● hyperactivity
2. Alleviation of the socialization difficulties associated with Attention Deficit Hyperactivity
Disorder and an increase in learning efficiency, as observed from a sample of 27 subjects,
for:
Parent evaluation
t.o5(26)= 9,36, p<0,05, ADHD prevalently inattentive subtype
t.o5(26)= 11,19, p<0,05, ADHD prevalently hyperactive/impulsive subtype
t.o5(26)= 12,23, p<0,05, ADHD combined inattentive/ hyperactive subtype
t.o5(26)=6,o67, p<0,05, school efficiency / socialization
Teacher evaluation
t.o5(26)= 10,01, p<0,05, ADHD prevalently inattentive subtype
t.o5(26)= 8,34, p<0,05, ADHD prevalently hyperactive/impulsive subtype
t.o5(26)=11,13, p<0,05, ADHD combined inattentive/ hyperactive subtype
t.o5(26)= 7,13, p<0,05, school efficiency / socialization

10. Psychometric data of the Vanderbilt Evaluation Scales
The reliability studies (by calculating the Cronbach alfa index) show a very high value
(α > 0,70) for most of the sections in the scale referring to ADHD. The exception is the
“anxiety/depression” section in the Vanderbuilt Evaluation Scale for Parents, where α =
0,52. (Some authors consider as acceptable a value of 0.5 of the Cronbach alfa index in the
case of scales with a small number of items: 10-15). This value is somewhat justified, since
the section comprises a small number of items (7). There has been no further pressure to
modify or replace the items in this section, because this paper has focused especially on the
ADHD symptoms, and less on co-morbid disorders.
The obtained data support the high psychometric qualities of the instrument in
question. An “internally consistent” scale offers us the guarantee that the items of our
instrument “go hand in hand”, that they measure the same psychological “construct”;
nevertheless, this does not as yet allow us to affirm that it measures exactly what it purported
to measure in the first place. (Popa, 2008) This problem has been checked through validation
studies.
Testing the validity by comparing the results obtained using the Vanderbuilt Evaluation
Scales for ADHD to the result obtained using the CIM 10 Structured Diagnosis Interview
shows that the instruments measure attributes and behavioral aspects which are similar but
not identical.
Research limitations
●The Vanderbuilt scales for the evaluation/monitoring of ADHD symptoms have a
restrictive transcultural adaptation, for Sibiu County only;
● The results obtained in this research cannot be generalized to the scale of the entire
community in question. The factors that could influence it negatively are as follows: the
nature and representativity of the sample; the manner of data collection; the period during
which the research has been carried out; the various systematic error sources, among which
the overevaluation of the obtained results by the evaluators, parents and teachers,
respectively. However, this aspect may have a positive connotation, as far as the
effectiveness of the proposed program, as well as the positive appreciation of results go.
Conclusions
● The processing and evaluation of the research data have revealed the effectiveness of the
psychopedagogical program ellaborated by us, concerning the symptoms of attention deficit
hyperkinetic disorder in young schoolchildren.
● The structure of this program (on three intervention axes: parents, primary teachers and
children) has allowed for the control of the main areas of manifestation of attention deficit
hyperactivity disorder (family, school and social ones), and its application has entailed
significant alleviation in ADHD symptoms (attention deficit, hyperactivity, impulsivity), as
well as in associated disorders (socioaffective integration, learning efficiency).
● The objectives of the program have been achieved, by developing both in parents and in
primary teachers a set of educational and developmental abilities adapted to children with
ADHD, as well as through their correct application by parents (in the family as well as
social environment), by the primary teachers (in class), and by the school psychologists (in
the school psychopedagogical counselling office), in view of relieving ADHD symptoms.
● The present paper meets the needs of school psychologists, teachers, parents and especially
those of the children with ADHD, by offering a model of intervention in attention deficit
hyperactivity disorder in young schoolchildren, a model which has aimed the following
aspects of the problem in question:

11. - as full coverage as possible of the main areas of manifestation of attention deficit
hyperkinetic disorder (family, school, social);
- identification of the educational principles which are basic and mandatory in the raising of
ADHD children;
-active involvement of intervention agents (psychologists, psychiatrists, parents, teachers) in
controlling and alleviating the associated ADHD symptoms, in young schoolchildren that
were beneficiaries of the psychopedagoical intervention program;
● the psychopedagogical intervention programs can be an alternative for the parents that are
resistant to the idea of medicating their child on an indefinite term, or for those children that
develop intolerance to Strattera (atomoxetine), enabling an improvement in the lives of the
children and of the family members alike.
● Behavior changing techniques, the training, educating and counselling sessions for the
children, parents and teachers are enough for controling light forms of ADHD symptoms.
Usually, behavioral interventions are used along with medication in the moderate and severe
forms.
● The psychopedagogical therapy, initiated by specialists and later applied by the parents
and teachers, represents a basic element in approaching children with ADHD. The
psychopedagogical intervention program we have put forward could prove to be an effective
learning tool for parents and teachers alike, by means of simple and easy-to-use techniques.
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Feldman, Howard, (2007) – Evaluating Your Child for ADHD, American Academy of
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Iancu, Mirela, (2007) – ADHD la copil şi adolescent [ADHD in children and teenagers],
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Ivanesei, Mihaela, (2008)-Tulburarea cu hiperactivitate/deficit de atentie (ADHD) la copil
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http://www.nordlitera.ro;
Măgureanu, Sanda, (2004) – Cum diagnosticăm hiperkineticii [How to Diagnose the
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Popa, Marian, (2008) – Statistica pentru psihologie. Teorie şi aplicaţii SPSS [Psychology
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