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Attention Deficit Hyperactivity Disorder Archive 2009

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Shari Gent, M.S.,
Educational Specialist

Shari Gent, M.S. is an education specialist with eighteen years of teaching experience. She has taught a diversity of students including those with learning handicaps, mental retardation, and autism spectrum disorders in both urban and rural environments. Her special interest is working with children with attention deficit disorder and associated mental health conditions. Shari has appeared on National Public Radio with leading experts in the field of attention deficit disorder. In addition to her professional work, she is a chapter coordinator for Children and Adults with Attention Deficit Disorder (CHADD) and parents a teenager with AD/HD.

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  • What are some of the "best" strategies for working with students with AD/HD?

Question:

Dear Ms. Gent,

My name is Molly and I am a recent graduate of Cal State East Bay with a BA in Liberal Studies and K-5 multiple subject credentials. I am now back in school getting my special ed credential and masters degree, because ultimately I want to teach special ed. My question is: what are some of what you consider to be the "best" strategies for working with students with AD/HD? How can I most effectively help these students succeed in school? Thank you so much for your time and your knowledge I really appreciate it.

Molly


Answer:

Dear Molly;

Thank you for your excellent questions. All students, including those with AD/HD should be viewed as individuals with individual characteristics and needs. However, research has demonstrated that in general, some strategies may be more effective with most students with AD/HD. Dr. Sydney Zentall of Purdue University has devoted years of research to investigating what works. Her book, AD/HD in Education is a great resource. In addition to research, “evidence-based” strategies include those that teachers themselves have implemented with fidelity and found to work. Both general research and teacher experience point to some basic principles to apply when teaching students with AD/HD.

When choosing strategies and designing a learning environment, keep in mind that students with AD/HD do best with:

  • structure
  • consistency
  • saliency
  • motivation
  • high interest

Reinforcement needs to be positive, immediate, frequent and intense. Students with AD/HD often do not respond to typical behavior plans. Because of their neurological make-up, they are seeking stimulation of any kind – positive or negative reinforcement will do.

Remember that learning and behavior are interdependent. When achievement improves, behavior problems decrease. When behavior problems decrease, achievement improves. When working with students who have AD/HD, you will need to target both. My personal bias is that engagement precedes compliance. I always start by forming a personal relationship with my students and teaching with their personal interests in mind. Students who are emotionally invested in learning will be more motivated and remember better.

Students with AD/HD should be evaluated for support in six basic areas:

  • Communication between home and school
  • Self-Awareness and self-advocacy
  • Behavior
  • Social skills
  • Study skills and time management
  • Academics

If I were starting out with a new class that included students with AD/HD, I would begin with simple strategies that could be helpful for all children.

  • Clarify behavioral expectations . If you are fortunate, you will be teaching in a school that has school-wide positive behavioral support. However, whatever the case, you will want to discuss classroom expectations with your students at the beginning of the year. Elicit suggestions from students about behaviors that are conducive to learning. With the class, list three or four behaviors that are stated in positive, observable terms. Display these, role play them, and refer to them throughout the day. Be sure to have students self-evaluate their own behavior.
  • Design activities with developmentally-appropriate attention span in mind. There is no firm rule about the relationship between developmental level and attention span, but some general guidelines apply. Attention span varies depending on the activity. In general, estimates range from 1 to five minutes per year of age, with a maximum 20 minute average for adults. On the other hand, when material is emotionally engaging, i.e. a favorite TV show, a six year old can usually hold attention for at least 30 minutes. The National Education Association (NEA) and National Parent Teacher Association recommend about 10 minutes per grade level for independent study activities such as homework. Children with AD/HD can lag behind their peers by 3-4 years in adaptive skills and social maturity. Most classrooms that effectively include students with AD/HD will alternate types of activities and types of responses required of students based on the level of success possible for their AD/HD students. Always follow a non-preferred activity with a preferred activity. For example, if your students groan when you assign a writing task, follow it up with an activity they perceive as “fun” such as an interactive game, hands-on art project, or computer-based activity.
  • Incorporate interactive strategies into class discussions to maximize engagement. Have students use response boards, hand signals, call and response, choral readings and total physical response in the course of a discussion. If you must call on individual students, put each name on a popsicle stick or card and draw names randomly to keep students ready to respond. Always leave students with an “out” if they do not know an answer. One teacher I know lets students call on others for “coaching.”
  • Provide frequent feedback and give opportunities to develop social skills . This can be done through cooperative group work or through partner-based activities. If you choose cooperative groups, be sure to structure the groups by providing each member a role in the group. Some teachers assign one student to be the “coach”. Other possible roles include materials manager, recorder, time keeper, reporter and reader. Help students choose roles based on their strengths and ability to contribute.

Paired learning or class-wide peer tutoring provides opportunities to teach social and communication skills as well as academics. Be sure to change partners on a regular basis and to incorporate games on a regular basis.

  • Color-code materials to help students organize their work . Use folders color-coded to specific subjects to help students identify assignments. Color-code key concepts that you are covering. For example, if students are learning short vowel sounds, have them highlight or write short vowels in specific colors.
  • Provide accommodations. Some of the most common accommodations are:
    • Seat students with AD/HD close to the source of information.
    • Adapt assignments to teach to the most important goals for all students.
    • Provide advance organizers.
    • Allow alternatives to writing.

Thank you for taking the time to explore options for students with AD/HD. These strategies are just a start. The U.S. Department of Education publishes a free handbook on teaching students with AD/HD that has excellent suggestions and outlines a basic approach. In addition Children and Adults with Attention Deficit Disorder (CHADD) publishes an Educators Manual that details specific approaches. I suggest you explore some of these excellent resources and try additional strategies in your classroom. Remember to keep data on your results.

Good luck in your teaching career. Please stay in touch and let me know what you find works for your students.

Resources:

Pfiffner,L. All About ADHD: The Complete Practical Guide for Classroom Teachers. Scholastic, 1999.

Rief, S. (2005) How to Reach and Teach Children with ADD/ADHD, Second Edition. San Francisco, CA: Jossey Bass

Silverman, S; Iseman,J; & Jeweler, S. School Success for Kids with ADHD. Waco, TX: Prufrock Press, Inc., 2009

U.S. Department of Education, Office of Special Education and Rehabilitative Services, Office of Special Education Programs. Teaching Children with Attention Deficit Hyperactivity Disorder: Instructional Strategies and Practices . Washington, D.C., 2004.

Zeigler Dendy, C. CHADD Educators Manual. Children and Adults with Attention Deficit Disorder. 2006

Zentall, S. ADHD and Education. Upper Saddle River, NJ: Pearson (2006)


  • Is it time to suggest bringing in a speech pathologistat at his upcoming IEP eligibility review?

Question:

I provide support for a 3rd grade child who has been diagnosed with AD/HD.  His reading and math are at Kindergarten/1 st grade levels. Our school moves students to groups where they are with those of similar abilities to ensure they all stay challenged, but successful.  I have noticed that he is having trouble verbally answering questions with any coherency, even when he is given previous notice of a question and plenty of time to answer.  He starts a sentence and then wanders around without any clear direction.  He does not presently have the ability to answer in writing.  When questioned later he usually can (after several minutes) give an answer. 

Right now he is not under the care of a speech pathologist.  Is it time to suggest this at his upcoming IEP eligibility review?  I would appreciate any suggestions you may have.

Sincerely

Barb B.


Answer:

Dear Barb;

Thank you for your interesting question. Your care and concern for the students you support is evident.

You mentioned the possibility that your student’s recall problems may be related to language problems. You are correct in suggesting that this possibility might be explored by a speech and language specialist. Given the information provided, you may want to bring your concerns about your student’s language needs tot a student study team or IEP team meeting if you are the child’s teacher or to the teacher if you are a paraprofessional.

In addition to possible language formulation difficulties, the symptoms that you describe could be related to poor working memory and slow processing of information, common for children with AD/HD. That your student is able to produce the answer orally at a later time indicates that he has the needed information in his memory but it takes longer than his peers for retrieval and formulation of a response. It is possible that your student is using the change of subject as a “filler” to give him time to remember the answer. Because your student has AD/HD, he is may be distractible and this may contribute to his difficulty retrieving the response. Working memory is vital to language comprehension, learning and reasoning and has been linked to school success.

Your student will likely need accommodations such as extended time to respond orally. Additional strategies include:

  • Try a nonverbal hand signal to give your student time to focus his thoughts on the question.
  • Use of visual cues and multiple choice or close-ended questions can be helpful in supporting working memory. The “Wordwall” is an example of a visual cue to jog students’ memory about frequently occurring words. Placement and order of words on the wall serves as a cue to their identity.
  • Ask oral questions by giving choices rather than an open-ended question. For example, an open-ended question would be, “The frog belongs to what animal class?” A close-ended question that would provide more supportive structure would be, “The frog is a member of the reptile, amphibian, or mammal class?”
  • Provide the student with a list of the procedure at his/her desk and teach mnemonic strategies. Use of mnemonic strategies such as the first letter strategy can reduce the load on working memory. Mathematics is a particularly dependent on working memory because the student must hold procedures in mind while recalling specific math facts. The steps for long division are: divide, multiply, subtract, bring down. These steps can be depicted by mnemonics such as “Dead Monsters Smell Badly” or “Dad Mom Sister Brother”.
  • Chunking long numbers and phrases will facilitate memory. We do this when we separate groups of numbers in phone numbers, i.e. 402-653-0134.
  • Rhymes are also effective mnemonics. For example: “i before e except after c.”

Additional interventions that you may encounter outside of school include medication and mental exercises often presented by computer software. Treatment with medication has been shown to provide some improvement in working memory in children with AD/HD. Whether or not a child will be prescribed medication is a decision reserved for the family and physician.

I hope this information provides you with a good place to start supporting your student. Please keep me posted about his progress.

Resources:

American Psychological Association. A Workout for Working Memory. Monitor on Psychology. Vol.36, no. 8, September, 2005. (available at APA online)

Gathercole, S.& Alloway, T. (2008) Working Memory and Learning: A Practical Guide for Teachers. Thousand Oaks, CA: Sage Publications.


  • Should he go on to 7th grade and we just hope for the best?

Question:

Dear Shari,

I have an 11 year-old son that is in 6th grade. He will not turn 12 until July of this year. He has been diagnosed with ADHD and OCD and been on medication since he was 4 years old. The school year is almost over and we have just been informed he is failing most classes but yet his teacher says he will probably be promoted on to 7th grade (which here in our town is middle school. Just this past week he also got in-school suspension because they said he was being defiant and they had already warned him if he was in trouble anymore that he would be suspended. I am very concerned that my son will not succeed in 7th grade because I know going out of elementary the teachers won't work as close as they do in elementary and they haven't been doing a great job in elementary. He needs structure always and I would like for him to been in something for the summer but our school district doesn't offer any classes during summer. Do you have any suggestions as what direction we should go? Should he stay back or should we try to find a private school? Should he go on to 7th grade and we just hope for the best? Your thoughts would be greatly appreciated.

Thank you,

Tina


Answer:

Dear Tina,

The transition to middle school is scary for most parents and for parents of children with AD/HD is doubly difficult. Suddenly your child is facing the challenges of adolescence: discovering their identity, differentiating from parents, accepting responsibility, dealing with body and hormone changes, and finding acceptance from peers. Because children with AD/HD are often four to six years delayed in their social and emotional maturity and in executive function skills, they are at a disadvantage when faced with the increased organizational demands of middle school. Now they have not one teacher but five or six. In most schools, each teacher has different expectations and different grade requirements. Teachers have more students, and less time to deal with individual situations. Academic problems can worsen, as students struggle with increased demands for memory, organization, and abstract thinking. While many symptoms of AD/HD such as hyperactivity, may improve with puberty, recent research (Langberg, et al) indicates that the transition to middle school can aggravate other AD/HD symptoms. AD/HD teens , especially those who are impulsive, are at increased risk for social difficulties with lasting consequences. They are more likely to experiment with drugs and alcohol and to be the victim of teasing or bullying.

Faced with all this, parents might think that retention is a good option. Why not give your child another year to mature before he or she faces these challenges? In this age of pressure to meet grade level standards, retention might seem to make sense. Unfortunately, what seems a simple solution is simply not effective.

Dr. Shane Jimerson, researcher and authority on the effects of retention concludes that retention initially seems beneficial but has poor long term outcome:

  • Achievement gains decline within 2-3 years following retention.
  • Retained students are more likely to experience behavior and social problems and low self-esteem in adolescence.
  • Students who have been retained are five to eleven times more likely to drop out of school.
  • For most students, grade retention has a negative impact on academic achievement.
  • A recent study of sixth grade attitudes found that sixth graders consider retention as one of the most stressful life events, even ahead of the loss of a parent.
  • Retention may help some students who have missed much school, for example for a serious illness, but only if their attendance improves and if the child will not be much older than his/her grade peers.

Unfortunately, social promotion, the practice of passing a student along simply to keep him or her with age peers has poor outcome. The only effective solution is to identify specific intervention strategies needed to promote the child’s learning and social and behavioral success. Effective, evidence-based strategies for any struggling student, with or without AD/HD, are similar to instructional strategies for the general education student, but more intense and individualized. Effective alternatives to retention and social promotion (Jimerson, Pletcher, Kerr) include:

  • Parental involvement
  • Age-appropriate and culturally sensitive instructional strategies.
  • Tutoring and peer mentoring programs.
  • Progress monitoring with accompanying adaptations to instruction that reflect assessments and promote improved achievement
  • Intervention to improve reading skills when appropriate
  • Use of student support teams to assess and design interventions
  • School-based mental health programs
  • Behavior management and cognitive behavioral support
  • Extended year, extended day, and summer school programs
  • Comprehensive school-wide programs in which there is collaboration and consistency between general, remedial, and special education programs

There is much you can do to support your son in the transition to middle school:

  • Stay involved with your son’s schooling. Together, you and he can contact each teacher at the beginning of the year to establish a line of communication. Chris Dendy (see Resources) has several articles available on her website .
  • If your son’s school has a homework hotline or website where homework is posted, get to know it. If each of your son’s teachers has a different homework policy, create a display incorporating all expectations and post this in a prominent place at home.
  • Be sure that your son has a quiet place to complete homework and that all the homework tools he needs are readily available.
  • Many teens with AD/HD have difficulty waking up in the morning or other sleep problems. If your son is not sleeping well, talk with his physician. Sleep problems have been linked to memory and attention difficulties.
  • Help or find someone to help your son organize his backpack and paperwork. This may need to be done on a daily basis. As children become teens, they often become more resistant to parental help in this area so if your son still allows you to look through his backpack, be pro-active now.
  • Consider searching out an older student to mentor or tutor your son. Many high schools have programs to provide tutors for free or at a low cost.
  • Be sure that your son has the opportunity to visit the middle school and walk through his schedule before the first day of class.
  • With your son and the school try to identify one adult on the new campus who your son feels he can trust and with whom he can check in on a regular basis.
  • If you haven’t already started, begin to teach your son about the impact of AD/HD and self-advocacy skills. Contact your local Children and Adults with Attention Deficit Disorder (CHADD) for support and information.

Resources:

Articles

Dendy, C. The ABC’s of ADD and AD/HD: Impact on School Performance; Executive Function: What Is This Anyway? Available at: www.chrisdendy.com

Jimerson, S. Woehr, S. Kaufman, A. (2007) Home and School Grade Retention and Promotion: Information for Parents. National Association of School Psychologists (NASP). www.nasponline.org

Jimerson, S. Pletcher, S. Kerr, M. Alternatives to Grade Retention, PL February, 2005. (available at www.nasponline.org)

Langberg, J; Epstein, J; Altaye, M; Molina BSG; Arnold, LE; Vitiello, B. The transition to middle school is associated with changes in the developmental trajectory of ADHD symptomatology in young adolescents with ADHD. Journal of Clinical Child and Adolescent Psychology. 2008; 37(3):651-663 An abstract of this article is available online from the National Institute of Mental Health (NIMH) at: www.nimh.nih.gov/science-news/2008/

NASP Position Paper on Grade Retention. Available at: http://www.nasponline.org/about_nasp/pospaper_graderetent.aspx

Wrightslaw. Retention or Promotion? What’s best for my child? www.wrightslaw.com/blog/?p=51

Websites

Wrightslaw resources about retention: http://wrightslaw.com/info/retain.index.htm

Shane R. Jimmerson, PhD. University of California, Santa Barbara. “Beyond Grade Retention and Social Promotion.” http://education.ucsb.edu/jimerson/retention/

Organizations

Children and Adults with Attention Deficit Disorder (CHADD). www.chadd.org


  • What can I do to offer support to a student who has difficulty taking notes?

Question:

Dear Shari,

I provide support for a seventh grade student with AD/HD who has difficulty with note-taking from lectures. He is currently enrolled in a program called AVID, which teaches the Cornell method. Students divide the paper into two columns and record the main ideas on one side and the corresponding details on the other. The social studies teacher writes the notes on the overhead transparency. All the students need to do is copy them on their paper. However, this student has difficulty copying and misses a lot of the information or records it incorrectly. What can I do to offer support?

Linda
Resource Specialist


Answer:

Dear Linda,

Your student is fortunate in having the opportunity for direct instruction in a notetaking method. Many students with AD/HD have co-existing handwriting difficulties that interfere with writing and copying information quickly and accurately. Some students with AD/HD have working memory difficulties that interfere with retaining information they see long enough to write it down. This type of student can read the information and has adequate writing skills, but experiences memory difficulties. However, the key to effective notetaking is determining important points and remembering these, not necessarily copying accurately.

If your student has difficulty copying, start by proposing an accommodation such as having the teacher provide the lecture notes in advance to your student. If the teacher is willing to do this, copying may not be required. Your student may be able to follow along with the lecture and use a highlighter to emphasize key points. Another option that would require more participation from the student would be to have your or the teacher provide skeletal or guided notes. In this method, cues for the main idea are provided ahead of time. The student records his own notes in the space provided. Here is an example of guided notes using the Cornell format:


Topic

 

 

Similarities- Frogs and Toads

 

 

Differences- Frogs and Toads

 

____________________________________________

 

 

A.______________________

 

 


B.______________________


A. Frogs

  1. ____________________
  2. ____________________
  3. _____________________

 

B. Toads

  1. _____________________
  2. _____________________
  3. _____________________

 

Summary

 

 

 

The “Summary” is generally completed after class. Train your student to use these first before expecting him to be able to use this format in class. Try cooperative groups where one person is the presenter, perhaps reading an article, one person is the recorder, who records notes on a transparency, and one person reports back to the class about the content in the notes.

Your student may benefit from checking his finished notes with those from a note-taking buddy in the class. Should he continue to have difficulty recording information quickly and accurately, have him use a small recording device. If a cassette recorder is available, be sure to teach him to set the counter to zero. For convenience, have him write the number on the counter under each main topic so he can return to listen to the needed section rather than having to listen again to the full lecture. If your student has funds available, he may be interested in purchasing one of the many digital recorders on the market that can be bookmarked. With one of these, he could mark significant sections to review by listening later. Sony, Philips and Olympus all make voice recorders that can interface with speech recognition software, and the software most often used in this capacity is Dragon NaturallySpeaking by Nuance. Dragon Naturally Speaking can take speech notes and transcribe them into print. The following website lists recorders compatible with Dragon Naturally Speaking. For additional details, contact venders.

http://www.voicerecognition.com/solutions/digital_recorders/

Additional Resources:

Boyle, J. (2001) Enhancing the Note-Taking skills of Students with Mild Disabilities.Intervention in School and Clinic. Vol. 36, pp. 221-224. Pro-Ed Inc. available online at: www.ldonline.org

Muskingum College Center for Advancement and Learning. Learning Strategies Database. http://www.muskingum.edu/~cal/database/general/notetaking3.html

 


  • Have you had any direct experience with neurofeedback as a treatment for ADHD?

Question:

I am a Speech Pathologist in Northern California. I have been hearing and reading about the positive effects of neurofeedback for treatment of ADD/ADHD. Have you had any direct experience with this? Could you share your opinions on this form of treatment?

Thank you 
Greg


Answer:

Dear Greg;

Any personal experience I may have had or have heard about would only be testimonial. Instead, I can share the research that has been done regarding using neurofeedback to treat AD/HD from the American Academy of Pediatrics (AAP) and National Resource Center on AD/HD (NRC), a program funded by the U.S. Centers for Disease Control and Prevention. This information has the advantage of being reviewed by peer researchers.

Neurofeedback, also known as electroencephalographic biofeedback, is based on the premise that many people with AD/HD demonstrate low levels of arousal in the frontal brain area, with excess theta waves and reduced beta waves. The human brain emits four types of electrical waves. Alpha waves are those emitted by the brain in a relaxed state. Beta waves are evident when one is concentrating, thinking or solving problems in interaction with the environment. Theta waves are more prominent during drowsiness, daydreaming or light sleep and suggested to also occur during periods of restlessness and overactivity. Delta waves, a fourth type of brain wave, are present during deep sleep. In neurofeedback sessions, individuals are attached to electrodes that monitor brain wave activity. The participant receives feedback about the types of brain waves in the form of sounds or computer images. While observing the feedback, the individual is taught techniques to increase the waves associated with arousal. Well-known proponents of this approach include longtime researcher Dr. Joel Lubar, University of Tennesee, and psychologist, Vincent J. Monastra.

The supporting research is controversial, however, and the AAP and NRC classify neurofeedback as a “promising” but “unproven” intervention for AD/HD. The NRC “What We Know” article (see Resources) elaborates on a review by Dr. Russell Barkley, a pre-eminent authority on AD/HD, and Dr. Sandra K. Loo of the neurofeedback research. Drs. Barkley and Loo found significant weaknesses in the existing research on neurofeedback including:

  • Lack of control groups.
  • Treatments other than neurofeedback not accounted for (confounding variables). These alternative treatments could have contributed to the alleged results.
  • Small sample sizes.
  • Lack of placebo control.
  • Absence of “blinding.” Some of the researchers may have been aware of who received what treatment and the results of the study could have been biased.
  • Lack of “randomization.” In some cases, the subjects or their parents chose, at their own expense, to receive neurofeedback.
  • Lack of rigorous peer review.

Regardless of these criticisms, many families continue to seek these treatments with the hope that they may provide an alternative to medication. Many of the studies about the effectiveness of neurofeedback were completed on subjects who were simultaneously taking medication. The effects have not been shown to be permanent and in many cases, individuals need to return later for “refresher” treatments. Families take a significant risk when they participate in treatments that have not been thoroughly and systematically researched.

There is a glimmer of hope on the neurofeedback horizon. In June, 2008 the National Institute of Mental Health (NIMH) announced funding of a new grant to scientifically study the efficacy of treatment of AD/HD symptoms with neurofeedback. L.Eugene Arnold, M.D. and Nicholas Lofthouse, Ph.D. of Ohio State University will conduct a random study of 36 boys and girls, ages 6-12 years. The children will receive either EEG neurofeedback through a computer game or placebo EEG treatment in which the game effects are not influenced by his or her brain wave activity. Participants will also be randomly assigned to receive their treatment either twice or three times weekly to assess the effects of treatment frequency. This study has advantages in that the number of participants is considered sizeable, it is randomized, blind, and placebo-controlled.

It is reassuring to know that the future holds promise for alternative treatments.

Resources:

National Institute of Mental Health (NIMH. “New NIMH Research to Test Innovative Treatments for Children with ADHD.” Science Update, June 5, 2008. Available at: www.nimh.nih.gov

National Resource Center on AD/HD. (2008) What We Know 6A. Complementary and Alternative Treatments: Neurofeedback (EEG Biofeedback) and AD/HD.www.help4adhd.org

Reiff, M. with Tippins, S. (2004) ADHD: A Complete Authoritative Guide. American Academy of Pediatrics.


  • What can I do to help him become more independent in completing his work in class?

Question:

Dear Shari;

I have a student with AD/HD who has no independent work skills. He is extremely dependent on having a paraprofessional remind him of the next step in the assigned task. We’ve tried all kinds of reward systems for getting work done, but he doesn’t seem to respond to any reinforces. What can I do to help him become more independent in completing his work in class?

Misty, 7 th grade Special Day Class teacher


Answer:

Dear Misty;

Students with AD/HD commonly need to depend on external cues to organize tasks and for motivation to complete tasks because they lack internal controls. Students with AD/HD have a quality of “insatiability” in which they are internally driven to seek out stimulation. Whether that stimulation is positive or negative is less important than the intensity of input.

We often feel we need to offer reminders when a student is off task. This can result in the self-fulfilling prophesy of “learned helplessness” ; the student who enjoys social stimulation is rewarded by the attention he or she receives when he is off task. The key to changing dependence to independence is shifting the reward from dependent to independent behavior. When designing a program for your student, consider a few basic steps:

STEP 1

Choose one activity or period of time in the day that you will designate as a time for your student to improve his independent work. Take baseline data for three days on how much work your student can complete during that time. Completion of math calculation problems is a common goal activity. Written language is an example of another. Designate a short time period for your student to work. This should be short enough that you expect he can be successful. Count the number of problems, words, or sentences your student can complete in that time. Use this to track his or her progress.

STEP 2

You mentioned that your student does not respond to any rewards that you have offered for work completion. Have you considered asking your student directly? For example, you might consider giving him a reinforcement survey. Some of the most successful surveys are those that you create on your own. Talk with your student about his interests and hobbies. Attempt to incorporate some of these into the classroom environment. Make a list together of those activities and items already in the classroom that are of interest. Have your student check those for which he would be willing to work. Below is an example of a general reinforcement survey: 

Student Name ______________ Date __________________

Teacher ___________________

If you had ten minutes in class to do anything that you liked, what would you do?

____ Watch a video.

____ Talk with an adult (name).

____ Talk with a student (name).

____ Play on the computer.

____ Listen to music.

____ Listen to a book.

____ Read a library book.

 

 

 

 

 

 

 

 

 

 

 

These are just examples. You can have your student complete a reinforcement schedule online at the link below:http://www.jimwrightonline.com/php/jackpot/jackpot.php

I strongly advise you to do this with your student or at least check in with him as he is working. My guess is that he probably enjoys social interaction and might respond to having some time to talk with a trusted adult as a reward for working for short periods of time.

STEP 3

Create a “contract”, preferably written, with your student. For example:

I (name of student) will complete (goal).

I (name of teacher) will make sure that (name of student) has (agreed upon rewarding activity).



(Student signature) (Teacher signature)

STEP 4

Provide your student with a “cue card” of the steps needed to complete the activity. The cue card can be printed on an index card, laminated and taped to the student’s desk. Below is a sample cue card for a period of “Daily Oral Language”. This cue card has also been designed so that the steps are in the form of a mnemonic or memory device to help the student internalize the steps:

SCAPS for Daily Oral Language

will look for and fix these in each sentence:

____ Subject. Does the sentence have a person, place or thing that is doing something?

____ Capitalization Does the sentence start with a capital letter? Are all proper names

capitalized?

____ Action Does the sentence have an action word?

____ Punctuation Does the sentence end with the right punctuation?

____ Sense? Read the sentence to yourself to be sure it makes sense.

Instruct your student to check off each step at completion and raise his hand. The paraprofessional should then walk to his desk, check to be sure he’s been honest and congratulate him for working independently. This is the “turn around “step. Your student will now be getting attention for positive behavior.

STEP 5

Be sure to follow through with the agreed upon reward. A general rule of thumb in the classroom is to follow a non-preferred activity with a preferred activity. Have your student chart his or her daily progress and compare this with the baseline information.

Here are some of my favorite resources for designing behavior plans:

Websites

Positive Environment Network of Trainers (PENT) http://www.pent.ca.gov/posenv.htm

Dr. Mac’s Amazing Behavior Management Advice Site. http://www.behavioradvisor.com

Intervention Central. http://www.interventioncentral.org/ Includes “Jim Wright Online”.

Books

Jensen, W; Rhode, G.; & Reavis, H. The Tough Kid Book and The Tough Kid Tool Box. Longmont, CO: Sopris West

Flick, G. ADD/ADHD Behavior- Change Resource Kit. West Nyack, NY: Center for Applied Research in Education.


  • Could his behaviors be related to AD/HD?

Question:

I teach second grade and have a student in my class who disrupts everyone else. He is constantly making tapping sounds, poking others, pulling apart pencils, and annoying other children by calling out their names and waving things in front of their face. Could his behaviors be related to AD/HD? He seems unable to internally control himself. Is this attention-seeking behavior or does he have a behavior disorder? What can I do to contain this whirlwind in my classroom?

Cathy


Answer:

Dear Cathy,

The symptoms you describe could very well be related to AD/HD. However, the only way to find out if he has AD/HD is to refer him for an assessment. Your first step in getting an assessment done should be to refer your student to the school psychologist or student study team. Your student may also be eligible for a behavior support plan to address specific behaviors. In the October, 2008 Ask A Specialist response, I listed the steps that a teacher should go through when she suspects that a child might have AD/HD. For specifics, please visit the link at:

http://www.askaspecialist.ca.gov/archives/2008/ADHD/Oct_2008.htm

Avoid suggesting possible diagnoses or medical intervention when conferencing with the family as this is the responsibility of the psychologist, physician, or other qualified mental health professional. Talk with the family about the behaviors and attempt to implement some basic strategies and accommodations. Document your success and share this with the school psychologist or student study team.

Identify one behavior that you would like to help your student change. Choose the behavior that is most troublesome. Take data on the number of occurrences during the day so you can gage the effectiveness of your interventions. An anecdotal journal of his behavior or a simple datasheet such as the one below will be useful to use in sharing with the family, student study team, and student.

Choose one target behavior such as touching others or calling out and record the number of occurences.

Activity

Time

Monday

Tuesday

Wednesday

Thursday

Friday

Morning Circle

8:30

/ /

 

 

 

 

Reading Group

9:00

/ / /

 

 

 

 

Independent work

9:30

/

 

 

 

 

Snack

10:00

/ / / /

 

 

 

 

Discuss your concerns with the student and the effect he has on others. Enlist his cooperation.

To help your student maintain his personal space and refrain from annoying the other students start with these accommodations and interventions:

  • Children who have a need to touch others frequently are often seeking sensory stimulation. Experiment with giving your student fidget toys or textured materials such as squeeze balls, kooshes or squishy toys available in toy stores. Some teachers have successfully used the technique of putting a Velcro strip under the child’s desk for him or her to touch.
  • Provide a mousepad or soft, thick shelf paper on the student’s desk to eliminate the annoying sound that tapping can make.
  • Provide positive recognition for specific students who have quiet hands and are ready to work. Research indicates that five positives to every criticism is most effective in shaping classroom behavior.
  • With your student, create a list or “menu” of items and activities he would like to earn for keeping his hands to himself. Post a picture of quiet hands behavior at his desk. Have him mark the number of times you compliment him for maintaining quiet hands and provide him with a rewarding activity or treasure when his meets acceptable criteria.
  • Use group rewards to enlist peer support and pressure for appropriate behaviors.
  • Carefully define your student’s personal space with visual cues. When students sit on the floor, define space visually. For example, have them sit on carpet squares or taped-off areas on the floor. Have them practice finding their space.
  • Whether standing in line or sitting, have your students practice arms length distance between peers. Have periodic checks to be sure all students are appropriately spaced so that no one can touch or bother another.
  • Teach a specific attending behavior and establish a nonverbal signal, such as a specific hand movement to prompt compliance.
  • Provide your student with preferential seating, directly across from the source of information at the time. During table work, seat the student directly across from you so that you can maintain eye contact at all times.
  • Provide frequent movement breaks.

Good luck with your fidgety student. Below are some resources that may provide further helpful information:

Resources:

McConnell, K. & Ryser, G. (2005) Practical Ideas that Really Work for Students with ADHD, second edition. Austin, TX: Pro ED

Rief, S. (2005) How to Reach and Teach Children with ADD/ ADHD. San Franciso, CA: Jossey Bass

Zentall, S. (2006) ADHD and Education. Upper Saddle River, NJ: Pearson Education, Inc.


  • What can I do to help get a teacher on board?

Question:

Dear Shari,

My son is in second grade and is newly diagnosed with AD/HD. I have told his teacher about this, but I’m not sure that she believes that AD/HD can be a real problem. What can I do to help get her on board?

Marilynn


Answer:

Dear Marilynn,

As a parent, you are the only adult who has the responsibility for ongoing support for your child. You are in the best position to observe your son’s growth and development year after year and will need to become an advocate for your child and a resource for your son’s school and teachers. Many parents are surprised to find that they become the “experts” on their child’s needs. Some guiding principles in this new role include:

  • Educate yourself 
    Become an AD/HD “expert.” Read books, articles and, if possible, attend conferences. Join parent support organizations such as Children and Adults with Attention Deficit Disorder (CHADD) and become active in these.
  • Be proactive 
    Do not wait for the teacher or professional to contact you first. Invite communication by providing the teacher with complete contact information including your e-mail address and all phone numbers. If possible, propose a regular check-in schedule to the teacher. For example, volunteer to contact him/her every Friday by e-mail to hear the news of the week.
  • Be open and honest 
    Be sure to share information about your child’s diagnosis, medication, changes in medication, and past concerns. Concealing information can lead to mistrust and false assumptions.
  • Follow through
    Be sure to meet commitments to attend meetings, send back forms, and attend conferences. If the teacher requests that you support your child at home by following through with study strategies or assignments, be sure to complete these. If you agree to provide items such as extra pencils, be sure to check that your child has these.
  • Provide home supports 
    Children who have behavioral or organizational difficulty often have similar problems at home. Be sure to have a consistent routine, provide a designated, organized place for homework. Teach organizational strategies for your child’s bedroom and backpack. If your child is distractible or has behavioral difficulties, become informed about strategies for teaching appropriate behavior at home. Seek support from a counselor if necessary.
  • Put your child’s best interest first 
    Avoid squabbling with school authorities and treat them as partners in your child’s development. Arguments between parents and the school create mistrust and self-doubt much as arguing between parents. Be open to criticism and make sure the teacher realizes that you accept your child’s limitations and understand that that teaching him can be challenging.
  • Show appreciation 
    Give the teacher positive feedback when your child is doing well. Send thank-you notes and make complimentary phone calls or send positive e-mails to the administrator. Avoid complaining to an administrator without first attempting to speak directly with the teacher about educational concerns.
  • Learn about your child’s legal rights
    Become acquainted with laws that support your child’s education and support the school in complying with these. Avoid making threats if you notice an oversight. Instead, enlist the school’s help to provide your child with the best possible education.

To assist with the communication process, I suggest that you create a binder or “Teacher Toolkit” to share with the teacher. Use an appropriately-sized three ring binder equipped with a heavy-duty pouch for materials. Consider including:

  • A short, one-page letter introducing your child. If possible, include a current picture. Briefly describe your child’s strengths, personal interests, and strategies that have helped in the past.
  • Short description about AD/HD and how this condition can affect education.
  • Extra classroom materials such as pencils, erasers, and markers. Consider including a digital or small visual timer such as an egg timer or Timetimer.
  • A calendar, planner, homework folder, and other organizational aides.
  • Information about behavior management systems you might use at home. Experiment with including coupons that can be earned at school and traded in for rewards at home.
  • Contact information.

CHADD has a series of handouts, entitled “What We Know”, produced in cooperation with the National Center for Disease Control that could provide a short description about AD/HD. Also, consider sharing:

Ten Facts Teachers Should Know About AD/HD

  1. AD/HD is a neurobiological condition and is not caused by environmental factors such as social environment, allergies, diet, or poor parenting.
  2. AD/HD is a condition that occurs in about 7% of the population worldwide. AD/HD does not occur more frequently in the US than in other countries, but may be treated more frequently in the US. AD/HD occurs with the same frequency in all racial and ethnic groups in the US, but is not treated equally in all groups. Variation in the availability of health insurance and cultural perceptions are factors.
  3. AD/HD is passed on genetically. Although statistics vary, about forty to fifty percent of all children with AD/HD have at least one parent with the condition.
  4. Up to 70% of individuals with AD/HD have additional conditions including: learning disability, anxiety, depression, bipolar disorder, substance abuse, oppositional defiant disorder, conduct disorder, tic disorder.
  5. AD/HD is a lifelong condition for most. Some individuals may learn compensatory strategies and up to 30% may outgrow the condition by age 30.
  6. Youth with AD/HD may experience a 4-6 year lag in development of adaptive skills such as motor, self-help, and social skills.
  7. AD/HD usually involves executive function difficulties that impede working memory, planning, control of emotions, arousal, ability to sustain effort, impulsivity, and organization.
  8. School performance of students with AD/HD is inconsistent. A student may be able to do a task one day, but unable the next.
  9. Medication is effective for 75-90% of students with AD/HD. Medication will improve impulsivity and availability for learning but will not teach organizational skills, improve popularity, or increase test scores. Any decision regarding medication is the responsibility of the parent and physician. 
  10. Students who receive multi-modal intervention that involves educational accommodations and interventions, positive parenting, behavioral support and medication as needed have the best chances for a positive outcome.

Shari Gent, M.S.

Additional Resources:

Illes, T. School Days or School Daze? Attention Magazine. October, 2006 39-41

Jensen, P. (2004) Making the System Work for Your Child with AD/HD. New York, NY: Guilford Press

The Disorder Named AD/HD. What We Know series. National Resource Center on AD/HD. Available at: www.chadd.org

Timetimer visual timer. www.timetimer.com A small, pocket-sized timer and a wristwatch model are available.