ADHD: School- Based Interventions

 What do teachers see in the classroom?  Can we base interventions on subtype alone?  The role of Functional Behaviour Assessments in intervention  The role of the teacher  Evidence-based approaches to behaviour and academic interventions/ classroom principles

 Academic Underachievement  Disorganization  Frequent distraction  Less attention to rules governing a task  Decreased ability of shift attention  Poor test performance and study skills  Inconsistent completion of independent work/decreased productivity/more errors  Frequent shifting of activities  Forgetting/Losing assignments (DuPaul, Stoner & O’Reilly, 2002; Silverman, Iseman & Jeweler, 2009;

Disruptive &/or off-task classroom behaviour  Failure to listen to instructions  High rates of Noncompliance/Aggression  Disrupts learning of others  Difficulties with peer relations  Easily angered when encountering challenging tasks  Calling out/frequent talking (DuPaul, Stoner & O’Reilly,2002; Silverman, Iseman & Jeweler, 2009)

 Higher rate of High School dropouts  25-36% of students with ADHD do not complete High School (Silverman, Iseman & Jeweler, 2009)  Higher risk for grade retention  30-50% of student with ADHD are retained at least once (Silverman, Iseman & Jeweler, 2009)

 ADHD-I  Characterized by:  slow cognitive processing  low levels of curiosity & enjoyment of learning  Prefer less challenging tasks  Prefer cooperative work environments  Greater reliance on external criteria for success (Pfiffner, DuPaul & Barkley, 1998)  Intervention:  emphasize non-competitive external incentives for meeting goals  Plan assignments that address slow work style and incorporate preference for cooperative groups

 Behaviour interventions in the classroom are most effective when they are based on the information gathered through a functional behaviour assessment (DuPaul & Weyandt, 2006).  Observation of the student in the classroom setting:  What are the target behaviours?  What are the antecedents?  What are the consequences?  Design intervention  Implement  Review progress (DuPaul & Weyandt, 2006; Pfiffner, DuPaul & Barkley, 1998; Iseman, Silverman & Jeweler, 2010)

Behaviour FunctionAntecedent Based Intervention Consequence Based Intervention Obtain teachers attentionRemind class of classroom rules & the connection between student behaviour and teacher attention Provide attention for appropriate behaviour; ignore disruptive behaviour Task avoidanceIncrease stimulus value of task; reduce amount of work required Provide “attention breaks” upon completion of selected portions of work

 When working with students with ADHD, teachers must:  Develop a positive working relationship with the student, based on understanding of the student and knowledge of the disorder.  Work collaboratively with school psychologist/behaviour specialist; on-going consultation  Facilitate effective and consistent communication between home and school (Pfiffner, L., DuPaul, G., & Barkley, R.,1998, Silverman, Iseman & Jeweler, 2009).

 Stimulant medication  Behavioural Interventions: Target on-task & disruptive behaviour  Academic Interventions: manipulation of antecedents (type of instruction, materials, outcomes...) (Raggi & Chronis, 2006)

1.Swift, frequent & significant consequences  “Parallel Teaching”  Reprimand  Token Reinforcement  Response Cost

2. “Positives before Negatives” 3.Frequently change/rotate rewards 4.Anticipate! “Think Aloud, Think Ahead” (Antecedent based strategies) 5.Hold students accountable 6.Continued monitoring & modification for maximum effect

 Strengths-Based Approach  Boosts self-confidence  Adaptations/Accomodations  Examples: Modify pace of instruction, allow extended time for task completion, allow frequent breaks, allow ‘fidget toys’...  Computer-Assisted Instruction  Improves sustained attention and work performance  Self-Monitoring  Improve social and academic behaviour in classroom  Strategy Training  Places responsibility on the student to improve performance  Peer Tutoring  Allows for instruction that is tailored to academic ability & pace (DuPaul, Stoner & O’Reilly, 2002; Iseman, Silverman & Jeweler, 2010; Raggi & Chronis, 2006; Silverman, Iseman & Jewelwe, 2009)

Conclusion School-based interventions can be quite powerful while they are being administered, particularly when they: are administered consistently by teachers who are actively engaged in working with students are based on FBA, tailored to the specific student Include active engagement on the part of the student Include effective communication between home and school

DuPaul, G., & Stoner, G. (2003). ADHD in the Schools: Assessment and Intervention Strategies. New York, New York:The Guilford Press. DuPaul, G., Stoner, G., & O’Reilly, M.J. (2002). Best Practices in Classroom Interventions for Attention Problems. In A. Thomas & J. Grimes (Eds.), Best Practices in School Psychology: Volume 2 (4 th ed., pp ). Bethesda, MD: National Association of School Psychologists. DuPaul, G., & Weyandt,L. ( 2006). School-Based Interventions for Children with Attention Deficit Hyperactivity Disorder: Effects on Academic, Social, and Behavioural Functioning. International Journal of Disabilities, Development and Education, 53, 2, doi: / Iseman, J., Silverman, S., & Jeweler, S. (2010). 101 School Success Tools for Students With ADHD. Waco, Texas: Prufrock Press Inc. Pfiffner, L., DuPaul, G., & Barkley, R. (1998). Treatment of ADHD in School Settings. A Handbook for Diagnosis and Treatment. New York: Guilford Press.

Raggi, V., & Chronis, A. (2006). Interventions to Address the Academic Impairment of Children and Adolescents with ADHD. Clinical Child and Family Psychology Review, 9, 2. doi: /s Silverman, S., Iseman, J., & Jeweler, S. (2009). School Success for Kids With ADHD. Waco, Texas: Prufrock Press Inc.