ADHD: Screening and Intervening in Schools Peter Tymms

Attention Deficit Hyperactivity Disorder Children with ADHD fall behind academically Often unpopular Social difficulties Behavioural problems

Context PIPS Schools and authorities pay to join Large scale

Frequency of symptoms Loses equipment Can’t sit still, runs around/ always on the go Leaves Seat Forgetful Can’t play quietly/ talks excessively/ interrupts/ blurts Can’t wait Doesn’t listen Fidgets Difficulty organising Doesn’t follow instructions/ doesn’t finish work Reluctant to engage in sustained mental effort Makes careless mistakes Difficulty sustaining attention Easily distracted Least frequent Most frequent

End of Reception scores Graph shows just how few children are meeting a high number of criteria.

A Dilemma Feeding names back to schools One psychologist: “You must not do this” Another: “You must take action”

Interventions Randomly assign to schools Booklet Identification No Identification Information booklet was written by Peter and me. It describes the latest thinking on the cause of ADHD (impaired executive functions) and research about effective classroom management and teaching strategies. It is called ‘Working with difficult children in Years 1 and 2: A guide for teachers, and is available at a cost of £4.50 now that the research is drawing to a close. Contact Lisa for an order form. Identification was included in PIPS end of Primary 1 feedback highlighting children with high scores. Some schools got nothing. Some schools got feedback. Some schools got the booklet. Some schools got both. No Booklet

Interventions Randomly assigned to LEAs Conference & packs Nothing In addition to school level treatments, we have LEA treatments. Some LEAs were invited to send 4 personnel to a conference where leading specialists talked about ADHD and managing children with these behavioural problems in the classroom. This was free of charge. Some LEAs got information packs that included the behaviour book sent to schools and a further book written for LEA personnel. Some LEAs got both of these. Some LEAs got nothing at all. We will be analysing the data this summer to see if any of the interventions have had any impact. We will be looking at achievement in terms of effect size so that comparisons for each group can be made with the earlier data. Nothing Information packs

Numbers 24 Authorities 2040 schools 60,000 pupils Over 2 years Currently taking place. Tracking 1 cohort of children from reception to year 2. The children are currently in Year 2 and we have recently sent out questionnaires to teachers to follow their behaviour as well as collecting PIPS Y2 assessment data and End of KS1 results this summer.

Major Issue Implementation Getting authority people involved Schools using the booklet

Results School Interventions LEA Interventions No impact on any of the outcome measures School Interventions Pupils All Just those with ADHD characteristics Teachers Rating of pupils’ behaviour Quality of life

Results All Pupils For booklet Identification Higher Y2 reading scores Associations with increased book use Identification No impact The best kind of rewards are things that the child can see such as stars on a chart that lead to a larger treat. If they can see their achievement, they don’t forget that they have behaved well/worked hard. Reprimands have to be short and at the time of the incident. Children forget the point of the reprimand if it is too long or if it is given at a later time. Time out is going to a quiet place to calm down and reflect on behaviour. Productive physical movement is doing things like taking a note to the secretary, watering plants, going outside to take the air temperature.

Use of Books and Outcomes The best kind of rewards are things that the child can see such as stars on a chart that lead to a larger treat. If they can see their achievement, they don’t forget that they have behaved well/worked hard. Reprimands have to be short and at the time of the incident. Children forget the point of the reprimand if it is too long or if it is given at a later time. Time out is going to a quiet place to calm down and reflect on behaviour. Productive physical movement is doing things like taking a note to the secretary, watering plants, going outside to take the air temperature.

Results Pupils with ADHD characteristics For booklet More positive attitudes Better behaviour in Year 2 For Identification No impact BUT book + identification Negative impact on maths and reading The best kind of rewards are things that the child can see such as stars on a chart that lead to a larger treat. If they can see their achievement, they don’t forget that they have behaved well/worked hard. Reprimands have to be short and at the time of the incident. Children forget the point of the reprimand if it is too long or if it is given at a later time. Time out is going to a quiet place to calm down and reflect on behaviour. Productive physical movement is doing things like taking a note to the secretary, watering plants, going outside to take the air temperature.

Teachers’ Quality of Life Your perception of work: Relaxing Stressful Enjoyable Unpleasant On top of things Overwhelmed The behaviour of the pupils in your class: No problems Challenging

Teachers’ Quality of Life Your perception of work: Relaxing Stressful Enjoyable Unpleasant On top of things Overwhelmed The behaviour of the pupils in your class: No problems Challenging Teachers more positive if given information books

Three More Issues Validity of findings which were not part of the design Publishing Cost Effectiveness