Tutoring Students With ADHD By Kenneth Stefano, PsyD kstefano@spodakstefano.com

What is ADHD? Attention-Deficit/Hyperactivity Disorder ATTENTION Focus, concentration, screening out/ignoring distractions DEFICIT Inaccurate name – more a problem with regulating attention HYPERACTIVITY Restless, fidgety, impulsive, poorly controlled DISORDER Causes problems in school, home, and/or community

What is ADHD? ADHD is NOT the result of: ADHD is the result of: Laziness Poor nutrition Bad parenting Lack of self-discipline ADHD is the result of: Heredity (your genes) and biology (how your brain develops)

What Causes ADHD? Top 3 genetically predisposed disorders 65-75 percent of cases Many genes under investigation Probably a combination of genes needed to develop ADHD Cause areas of brain to develop differently Motor areas develop faster Control areas develop slower

Biology Some ADHD is biological Premature birth Exposure to toxin About 25-30 percent, due to : Premature birth Exposure to toxin Alcohol, cigarettes, lead, infection Brain injury Side effect of cancer chemotherapy

3 Types of ADHD Hyperactive-Impulsive Type Fidgets and squirms Can’t stay seated Runs, climbs, or acts restless Talks excessively Blurts out answers Can’t wait turn Interrupts or intrudes on others

3 Types of ADHD Inattentive Type Makes careless mistakes/misses details Difficulty sustaining attention or listening Does not follow through with or finish tasks Difficulty organizing tasks/activities Avoids homework, chores, other boring tasks Loses things easily Easily distracted by sights, sounds, etc. Forgetful

3 Types of ADHD Combined Type A combination of inattentive and hyperactive-impulsive symptoms Most common type

What Does ADHD Look Like? Tapping desk, shaking feet, swinging legs Can’t stay seated Goes to bathroom, gets a drink, etc. Rushes through work Makes careless errors Can’t stop talking Interrupts Starts conversations

What Does ADHD Look Like? Works slowly Acts bored, wants to stop early Responds to sounds, sights, etc. Asks off-topic questions Is not prepared Doesn’t have materials Doesn’t know assignment Gets easily frustrated

What Does ADHD Look Like Inconsistent performance Some days student works well, other days student can’t focus at all Forgets previously learned procedures

Strategies Check in with parent Did student take medication today? How was student’s day at school? Has student had a snack, play break, etc. before session? What strategies do parents use to help student focus/behave?

Strategies Be prepared Have extra supplies handy (e.g., pencils, erasers, calculator, etc). Bring along a “fidget toy” (e.g., stress ball or Koosh ball) so student can channel excess energy. Have clear expectations for behavior Provide a list of “rules” Make rule list visible

Strategies Communication skills Speak softly and slowly Get eye-contact before speaking Move closer to student when giving instructions Have student repeat instructions

Strategies Communication skills, cont. Provide frequent praise Be clear and firm when student gets off task Tell student what you want them to DO, not what you want them to NOT DO E.g., say “please sit still” instead of “stop fidgeting”

Strategies Be organized Have a schedule of the session’s activities. Make the schedule visible (allow student to cross off activities as session progresses) Change activities often – at least every 15 minutes Provide “reward” at end of session if student is compliant (e.g., listen to a song, play a quick game of Uno, etc.)

Strategies Manage the environment Minimize distractions No TV's/radios on Have session in low traffic area Keep work area clear Only have out what you are working on Present only a few problems at a time Rewrite problems from a work sheet onto several sheets Allow student to stand while working or walk around in between problems

Strategies Build in breaks For younger students (5th-6th grade) Allow for brief movement between activities Jumping jacks Healthy snack For younger students (5th-6th grade) Consider using a sticker or token chart Use a clock/timer to help student stay on task

Take Away ADHD kids are not lazy Be Prepared Be creative and flexible