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Steve  First grade student  Attends a typical public school  Middle- aged female teacher with 27 classmates  Is not currently diagnosed with any kind of disorder or disability  First grade student  Attends a typical public school  Middle- aged female teacher with 27 classmates  Is not currently diagnosed with any kind of disorder or disability

Steve’s Strengths  Very happy  Upbeat  Loves to talk and share his knowledge with his peers  Expressive  Creative  Competitive  Very happy  Upbeat  Loves to talk and share his knowledge with his peers  Expressive  Creative  Competitive

Steve’s Weaknesses Steve can be seen….  excessively talking to his peers  often times out of his seat  making disruptive or disturbing noises  as a “know-it-all”  bothering his peers Steve can be seen….  excessively talking to his peers  often times out of his seat  making disruptive or disturbing noises  as a “know-it-all”  bothering his peers

Observation  Two Problematic setting:  Direct Instruction  Transitions  Two Problematic setting:  Direct Instruction  Transitions

Overall Setting

Direct Instruction  Behaviors  Shouting out  Disrupting classmates- kicking, talking, tapping his pencil  Making loud animal noises  Moving inappropriately  Behaviors are aimed at:  Getting Stimulation 59%  Avoiding boredom 24%  Gets Self-determination 18%  Behaviors  Shouting out  Disrupting classmates- kicking, talking, tapping his pencil  Making loud animal noises  Moving inappropriately  Behaviors are aimed at:  Getting Stimulation 59%  Avoiding boredom 24%  Gets Self-determination 18%

Payoffs of Direct Instruction Payoffs in Direct Instruction Gets Stimulation, 59% Gets Self-determination, 18% Avoids Boredom, 24% Gets Stimulation Gets Self-determination Avoids Boredom

Specific Examples  Getting stimulation  collecting garbage off the floor during math lesson  playing with his shoes for an entire Reading lesson  throwing his pencil at another student  rocking on his knees for 10 minutes- during a word stretching activity  Avoids  Making loud animal noises at the beginning a repetitive lesson on writing the letter “Q”  Shouting “O” loudly several times during an activity “What sound do you hear”  Getting stimulation  collecting garbage off the floor during math lesson  playing with his shoes for an entire Reading lesson  throwing his pencil at another student  rocking on his knees for 10 minutes- during a word stretching activity  Avoids  Making loud animal noises at the beginning a repetitive lesson on writing the letter “Q”  Shouting “O” loudly several times during an activity “What sound do you hear”

Transitions  Description of Behaviors  Shouting out  Disrupting classmates- kicking & talking  Making loud disrupting noises  Moving inappropriately  These Behaviors are aimed at  Getting Stimulation 86%  Description of Behaviors  Shouting out  Disrupting classmates- kicking & talking  Making loud disrupting noises  Moving inappropriately  These Behaviors are aimed at  Getting Stimulation 86%

Payoffs during Transition

Specific Examples Getting Stimulation  Jumping on students  Collecting garbage and throwing it up like confetti  Continuing falling down while walking in line  Making disruptive noises while washing his hands  Disrupting the teacher by making loud gagging noises Getting Stimulation  Jumping on students  Collecting garbage and throwing it up like confetti  Continuing falling down while walking in line  Making disruptive noises while washing his hands  Disrupting the teacher by making loud gagging noises

Getting Stimulation  Largest ‘get’  Steve is attempting to stimulate himself through his misbehavior  He is obviously not receiving enough stimulation  Largest ‘get’  Steve is attempting to stimulate himself through his misbehavior  He is obviously not receiving enough stimulation

Consequences of Misbehavior  He is constantly redirected  He has been since into the hall  His desk has been separated from his peers  He is constantly redirected  He has been since into the hall  His desk has been separated from his peers

ADHD  4% to 12% of school aged children have been diagnosed with ADHD (Barson, 2004)  Most common symptoms  Inattentiveness  Hyperactivity  Impulsivity  Which include  Fidgeting  Leaving seat  Talking excessively  Blurting out answers  Interrupting or intruding  4% to 12% of school aged children have been diagnosed with ADHD (Barson, 2004)  Most common symptoms  Inattentiveness  Hyperactivity  Impulsivity  Which include  Fidgeting  Leaving seat  Talking excessively  Blurting out answers  Interrupting or intruding

ADHD & Tourette Syndrome  Tourette’s is an disorder characterized by involuntary motor and vocal tics (Munson, 2005)  Males are more often affected with Tourette’s (Leckman, 2002)  Most people with this syndrome have normal IQs (Munson, 2005)  60% of children diagnosed with tourette's also have ADHD (Denckla, 2006)  Tourette’s is an disorder characterized by involuntary motor and vocal tics (Munson, 2005)  Males are more often affected with Tourette’s (Leckman, 2002)  Most people with this syndrome have normal IQs (Munson, 2005)  60% of children diagnosed with tourette's also have ADHD (Denckla, 2006)

Tourette Syndrome  Examples  Making loud animal noises at the beginning a repetitive lesson on writing the letter “Q”  Shouting “O” loudly several times during a “What sound do you hear activity”  Disrupting the teacher by making loud gagging noises  Examples  Making loud animal noises at the beginning a repetitive lesson on writing the letter “Q”  Shouting “O” loudly several times during a “What sound do you hear activity”  Disrupting the teacher by making loud gagging noises

Tests  Steve should be tested for ADHD  Steve should have a MRI to test for Tourette syndrome  Steve should be tested for ADHD  Steve should have a MRI to test for Tourette syndrome

Interventions  Give Steve more stimulation by…  Peer tutoring  Assigning him special chores (organizing the library area, sharpening pencils, or picking up garbage)  Add fun and exciting surprises to lessons  Praising him when he is behaving properly  Give him more small group activity time  Give Steve more stimulation by…  Peer tutoring  Assigning him special chores (organizing the library area, sharpening pencils, or picking up garbage)  Add fun and exciting surprises to lessons  Praising him when he is behaving properly  Give him more small group activity time

References  Barzman, D.H., Fieler, L., & Floyd, F.R. (2004). Attention-Deficit Hyperactivity Disorder and Treatment. The Journal of Legal Medicine, 25,  Denckla, M.B. (2006). Attention-Deficit Hyperactivity Disorder (ADHD) Comorbidity: A Case for “Pure” Tourette Syndrome? Journal of Child Neurology,21,  DuPaul, G.J., & Hoff, K.E. (1998). Reducing disruptive behavior in general education classrooms: The use of self-management strategies. School Psychology Review, 27,  Egger, H.L., Kondo, D., & Angold, A. (2006). The Epidemiology and Diagnostic Issues in Preschool Attention-Deficit/Hyperactivity Disorder. Infants & Young Children, 19,  Furman, L. (2005). What is Attention-Deficit Hyperactivity Disorder. Journal of Child Neurology, 20,  Leckman, J.F. (2002). Tourette’s syndrome. The Lancet,360,  Munson, B.L. (2005). About Tourette’s syndrome. Nursing, 35,  Zentall, S.S. (2006). ADHD and Education- Foundations, Characteristics, Methods, and Collaboration. New Jersey: Pearson Educational, Inc.  Barzman, D.H., Fieler, L., & Floyd, F.R. (2004). Attention-Deficit Hyperactivity Disorder and Treatment. The Journal of Legal Medicine, 25,  Denckla, M.B. (2006). Attention-Deficit Hyperactivity Disorder (ADHD) Comorbidity: A Case for “Pure” Tourette Syndrome? Journal of Child Neurology,21,  DuPaul, G.J., & Hoff, K.E. (1998). Reducing disruptive behavior in general education classrooms: The use of self-management strategies. School Psychology Review, 27,  Egger, H.L., Kondo, D., & Angold, A. (2006). The Epidemiology and Diagnostic Issues in Preschool Attention-Deficit/Hyperactivity Disorder. Infants & Young Children, 19,  Furman, L. (2005). What is Attention-Deficit Hyperactivity Disorder. Journal of Child Neurology, 20,  Leckman, J.F. (2002). Tourette’s syndrome. The Lancet,360,  Munson, B.L. (2005). About Tourette’s syndrome. Nursing, 35,  Zentall, S.S. (2006). ADHD and Education- Foundations, Characteristics, Methods, and Collaboration. New Jersey: Pearson Educational, Inc.