1 Consultation With Teachers of ADHD Children: Strategies To Increase Success and Decrease Stress in the Classroom

2 ADHD: Overview A neurodevelopmental disorder which primarily affects executive functioning.

3 ADHD: Overview This results in behavioral and cognitive symptoms that include deficits in: –Non verbal working memory –Internal anticipatory problem solving –Decision making –Internalized language –Time orientation –Regulation of affect/arousal/motivation –Goal directed/behavioral completion –Rule-governed behavior –Ability to inhibit behavior –Self regulation

4 Overview Cognitive Interventions Behavioral Interventions Social/Interpersonal Interventions

5 Cognitive Interventions

6 Poor Nonverbal Working Memory

7 Inability to hold events in mind Unable to manipulate or act on the events in mind

8 This means: Trouble Following Directions Don’t give too many commands at once Make sure the student is paying attention Ask the child to repeat the command Instructions should be simply stated and written on the board Have the student write down the assignment

9 Poor Reading Comprehension Teach student to skim for important information in text as a pre-reading activity Ask student to summarize the information after each paragraph or page For older children: SQ3-R

10 Trouble With Word Problems Encourage students to use objects/manipulatives Encourage students to draw out the problem and create a visual representative Help student highlight main points

11 Trouble With Note-taking Provide guided notes of the class lecture Require students to take notes in 10 minute intervals Provide copy of notes

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13 Defective hindsight & foresight Delayed cross temporal organization

14 This means: Inability to use previous memories of events for future planning of behavior Don’t assume a student will apply what she has learned from previous experience.

15 Say the words, count letters, talk about patterns of letters during spelling or rote memory tasks Write words in sand, sand paper, finger paint, etc. Rehearse objectives to help with memory. Student indicates when they are ready to try without model The VAKT Approach Visual, Auditory, Kinesthetic, Tactile

16 VAKT con. Use smell and taste when appropriate Use visual aids Encourage use of tape recorder, a computer, or oral reports as alternatives methods for student responses Read assignments out loud when appropriate

17 Difficulty knowing when to retrieve which information from long term memory When building on a previous learned concept, provide written or verbal refreshers on the previously learn concept

18 Limited self-awareness Diminished sense of time Deficient nonverbal rule governed behavior

19 This means: Trouble with delayed gratification Provide immediate feedback on behavior

20 Difficulty with behavioral regulation Teach organizational skills Organize books and notebooks daily in the same order in desks Provide basket under chair for extra materials not needed for class

21 Organizational techniques con. Create a homework folder Daily clean out all paper and debris that are not needed from the student’s desk and backpack

22 Prepare the student for transitions During independent work, use a visual timer so that the student can see how much time he/she has to complete the assignment Prepare the student for transitions (let he/she know when 10, 5, 2 minutes remain) Loses track of time

23 “Lose Track of Time” con. Use self-monitoring techniques Have the student frequently monitor thier behavior with the use of visual cues.

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25 Trouble applying rules in one known situation to a novel situation Provide social skills training Remind student of unspoken social rules

26 Impaired imitation of complex sequences

27 This means: Difficulty with multi-step directions Keep directives simple Give one directives at a time

28 C.O.R. Directions Establish eye Contact Give One direction at a time Have student Repeat directions

29 Attention-Focusing Call child by name Get eye contact Touch child’s should or chin

30 Provide student with daily schedule and keep classroom routine regular

31 Trouble imitating modeled behaviors Provide a step-by-step visual guide for assignments

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33 Delayed Internalization of Speech

34 Reduced description and reflection Poor self questioning/problem solving

35 This means: Difficulty with mental math Teach memory techniques Mnemonics, Clustering, Visualization, Visual Rehearsal, Oral Rehearsal Use manipulatives

36 Poor problem solving

37 Poor reading comprehension Pre-read, Active read, Review Scotopic Sensitivity

38 Deficient rule governed behavior (instruction)

39 This means: Trouble applying rules to behavior Use cues to remind of rules and give feedback on behavior

40 Class Reminder Checklist

41 The Cueing Strategy

42 Less effective generation of rules/metarules Delayed moral reasoning

43 This means: Not able to take rules learned and understand the moral principle of the rule Be concrete with behavioral expectations and expect the need for constant repetition Classroom rules should be clearly posted and used consistently and quickly

44 Impaired reading comprehension Skim, summarize, SQ3R Engage in pre-reading, active reading, and post-reading activities

45 Immature Self-Regulation of Affect Motivation and Arousal

46 Diminished self-regulation of motivation Poor self-regulation of arousal in the service of goal directed action

47 This means: Trouble getting motivated; not usually a “self- starter” Establish external reinforcers/motivators Break assignments into small steps

48 Less objectivity/social perspective taking

49 This means: Trouble putting self in “someone else’s shoes” Help student draw inferences to their own experience not to the experiences of others. Have concrete written social rules on the student’s desk

50 Limited self-regulation of affect

51 This means: Hard to control feelings/emotions Teach coping skills and relaxation techniques

52 Specific strategies “Australia” The Turtle Technique

53 Impaired Reconstitution

54 Limited analysis and synthesis of behavior Reduced verbal & behavioral fluency Deficient rule creativity Less goal directed behavioral creativity and diversity

55 This means: Poor problem solving Hard to express themselves fluently Hard to get from A to B without a lot of extra things getting in the way

56 In sum: Be concrete Be repetitive Be short Keep it simple Write it down Don’t get frustrated Don’t take it personally

57 A Word About Classroom Routines Enforce consequences fairly, consistently & consistently Stick to a regular class routine Establish a procedure that allows for frequent, structured breaks Use activities such as running errands to help students relax and refocus Give the students a prescribed number of passes to move around the room Change positive reinforcers fairly often to maintain interest

58 Behavioral Disinhibition Poor interference control Disinhibited responses Deficits in perseverance Impaired Executive/Cogntive Functioning Results In:

Behavioral Disinhibition Self-Control Self-Interruption Self-Observation Self-EvaluationSelf-Redirection Self-Perservence

60 Behavioral Symptoms Inattention Hyperactivity Impulsivity

61 Behavioral Interventions

62 Accommodations Strategic Seating Away from visual & auditory distractions Good natural light Near a study buddy Close to the teacher Has a storage area that helps with orgization

63 Daily Communications Communicate with parents on a daily or weekly basis

64 “Pre-Mac” your day Reduce Load Extra Time Frequent Monitoring

65 Prescriptions Listen, Look, and Think (ADD Warehouse) Vibrating Watch Self-Monitoring

66 Behavior Modification Magic (Dr. Thomas Phelan, 1984) Reinforcers include: Praise, privileges, tangibles Consequences include: Losing privileges, restriction, time-outs

67 Charting A chart which clearly helps the child see what behaviors need improvement Serves as a daily visual reminder of behavior goals Mark the chart each day with stars, stickers, etc. when behavior standards are met Select a reward and points needed to earn the reward Gradually increase the number of points needed to earn rewards

68 Improving a specific behavior Focus on only one behavior List specific goal and a schedule to evaluate progress Gradually increase the number of points needed to earn reward

69 Beat the clock With each assingment the student tries to guess how much time will be needed to finish Use a kitchen timer and set the time Student tries to finish before timer goes off

70 Poor peer relationships Lack of friendships Poor social skills Poor conflict resolution and problem solving Oppositional Defiance Low self-esteem Strained family relationships Social/Interpersonal Symptoms

71 Social/Interpersonal Interventions

72 Self-Esteem Clear Messages Clear messages are thoughts that help people feel good about themselves Muddy messages are thoughts that cause people to not feel good about themselves Encourage children to replace muddy messages with clear ones

73 Social Skills The Friendship Model Check it out Reach out Try it out Work it out