The support programme was based on Bronfenbrenner’s (1979, 2005) ecosystemic model and was developed by a speech-language therapist, with a special interest and experience in ADHD, in collaboration with a psychologist, focusing on different role players in the ecosystemic framework. According to the bio-ecological model, speech-language therapists and psychologists form part of the exosystem, which also includes district facilitators, remedial and learning support teachers, and therapists and educational psychologists, among others (Mahlo, 2011). These role players, including speech-language therapists, collaborate with teachers and implement teacher support programmes. They also assist teachers with the assessment and management of learners with barriers to learning (Mahlo, 2011), as their role in the educational context includes programme design and prevention (Wium & Louw, 2013).

Bronfenbrenner (2005) states that children, in this case learners, should be viewed holistically within different social contexts. These contexts highlight the role of mutually dependent relationships between individuals and the systems that they are exposed to, as well as the structures in the environment that shape the development of a human being (Mahlo, 2011). Learners therefore do not exist in isolation, but are part of different systems. These systems should effectively work together to the advantage of all learners in schools, including those who experience barriers to learning.

This study placed emphasis on the relationship between Grade R teachers and learners with barriers to learning and how Grade R teachers could support learners with behavioural difficulties and co-morbid conditions within an inclusive environment (Denis, 2012; Lewthwaite, 2011). In addition, the interdependency between ADHD and associated educational problems within a broader social ecological model was also highlighted (Lopes, 2009). The training stressed the relationship and responsibilities of different role players within the educational context. These role players in the educational management of ADHD include teachers, parents and peers, school governing bodies, the Department of Basic Education, school districts and so on. These role players are considered representatives of Bronfenbrenner’s (1979, 2005) ‘meso-’ and ‘exosystems’ working together in implementing policies and ensuring that all learners with ADHD receive adequate support (Lewthwaite, 2011).

A literature review (including a Google Scholar search between 2008 and 2015) that focused on previous training programmes for teachers (both internationally and in the South African context) on ADHD and the consequent development of early literacy, as well as recommendations offered by these researchers in the field of ADHD, provided guidelines for the development of the support programme (Amod et al., 2013; Jones & Chronis-Tuscano, 2008; Perold et al., 2010; Procaccini, 2013; Syed & Hussein, 2010; Wessels, 2011; Wium, 2010). These recommendations obtained from the literature search indicated that the following need to be addressed throughout the training; that is, general knowledge on ADHD; the early identification of behaviour associated with ADHD and the management of ADHD. The basic outline of the support programme, as a result of the literature review, is presented in Figure 1. This specific support programme is, however, unique as it focuses on the early identification and management of barriers to learning, including both ADHD and emergent literacy, and is likely the first of its kind to be implemented for Grade R teachers in the South African context.

As a result of the process followed, two main themes were identified for the training, which included ADHD and emergent literacy. The ADHD theme included different topics such as defining ADHD; the features, prevalence and aetiology; the symptoms and risk factors associated with ADHD; the co-morbid conditions related to ADHD; the risk factors aggravating the condition; the identification and diagnosis of ADHD; and coping strategies for teachers managing ADHD, as well as the multimodal treatment of ADHD including pharmacological and non-pharmacological interventions. The emergent literacy topics comprised the impact of ADHD on emergent literacy and reducing the risk of educational complications such as emergent literacy. An improved knowledge on the above will affect teachers’ management and support of learners with ADHD and co-morbid barriers to learning.

Additionally, the content of the support programme is sequenced in such a way that the simple or less complicated information is presented before the more complex information, as implied in Figure 1. The components such as the facilitation of general knowledge on ADHD is presented first, after which the identification and management of this barrier to learning is offered. Finally, the figure emphasises the interdependency between ADHD and co-morbidities, which infers that the risk of further educational complications might be reduced should teachers’ knowledge on early identification and referral improve.

A training manual was developed as a resource guide and corresponds with the training content and the information provided in the workshops. The manual comprised the rationale for the training, newspaper clippings, case scenarios and PowerPoint slides as well as material to be used in the classroom context. Information on the identification and management of specific barriers to learning, including ADHD and emergent literacy problems, as well as the training process and training content presented in Figure 1 and Table 3, was similarly included in this resource manual. A directory of services available, such as the relevant role players for the identification, diagnosis and management of ADHD, was also incorporated into the manual. The manual was handed to the Grade R teachers during the training.

The workshops comprised training, as well as interactive components that had opportunities for further practice in the classroom context in order to support the Grade R teachers. These included the initial identification and, as a result, the management of specific barriers to learning, such as ADHD and emergent literacy problems. The identification of barriers to learning is recognised as one of the seven roles of educators (Rossouw, 2009). Consequently, the use of handouts, newspaper clippings, PowerPoint slides and icebreakers; the presentation of case studies and real-life scenarios; small group discussions; group work; problem-solving activities; and roleplay, among others, were included in the training.

Considering that teachers are adult learners, the training was additionally designed in accordance with adult learning principles, as suggested by the adult learning theories such as Andragogy, originally proposed by Knowles (1975, 1984). Consequently, additional theories of adult learning (such as experiential learning, self-directed learning, transformative learning as well as the principles underlying these theories), the factors that may influence adult learning, and the way all these aspects influence learning were explored and integrated to provide the underlying basis of the support provided (Conlan, Grabowski & Smith, 2012; Freire, 2004; Killen, 2012; Kolb & Kolb, 2005; Wessels, 2011). The underlying principles also recognise that adults are internally motivated and that their self-concept changes from being dependent learners to being self-directed learners. Furthermore, as adult learners accumulate experience, these experiences become resources for obtaining added knowledge, which can then be incorporated and applied to work-related tasks and problem-solving (Knowles, 1984).

Additionally, these principles also suggest that training is most effective when groups are smaller; training is applied for shorter periods and, where possible, is preventative in nature. Recommendations provided by researchers such as Wium (2010) and Wessels (2011) also suggest that training should be interactive and collaborative, that the needs of the teachers should be addressed and that the support and knowledge of the teachers should be integrated and transferred into the school context.

The stated theories, principles and recommendations provided guidelines for the development of and the manner in which the workshops were delivered. The training was therefore designed around and based on various adult learning theories and in accordance with the adult learning principles, and not ‘the way … [they] … were [initially] taught’ (Zoller & Harrison, 2007, p. 1). As a result, the training was interactive and the Grade R teachers were dynamic participants and in control of their own learning (Killen, 2012; Wessels, 2011). These principles, as integrated into the teaching and learning strategies, are reflected in Table 2. The learning strategies included hands-on tasks performed by the Grade R teachers, such as completing checklists related to simulated cases. An outline of the support programme, the sub-aims, specific outcomes, assessment criteria and activities, including the teaching and learning strategies, as well as the different topics offered, is presented in Table 2.

Additionally, Table 2 provides a summary of the workshop content and procedures presented to the teachers to facilitate their understanding of ADHD and emergent literacy. An improved understanding of ADHD will support the Grade R teachers’ identification of ADHD as they utilise identification procedures such as rating scales and checklists in the classroom context. In addition, the accurate identification of ADHD will enable the Grade R teachers to manage the disorder fittingly. The management may include parental discussions and referrals to relevant allied health and medical professionals for further investigation of Grade R learners’ behaviour and attention.

The outline of the programme, the different sessions and the themes and topics presented is shown in Table 3. Table 3 aligns with the information presented in Table 2 as well as with the information provided in the training manual.

After the development of the programme content and the manual, the programme was piloted (Phase 2), as shown in Table 1.