1. Working with the adhd student
Brittany n. bates ● Pasadena ISD LSSP

2. Which child has adhd?
This child’s presentation could mirror that of other problems or disorders. Which ones?
What other problem behaviors might this child develop and why?

3. What is adhd?
Persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development
Symptoms presenting in two or more settings (e.g. at home, school, or work; with friends or relatives; in other activities)
Negatively impacts directly on social, academic, or occupational functioning.
Several symptoms must have been present before age 12 years.
The symptoms are not solely a manifestation of oppositional behavior, defiance, hostility, or failure to understand tasks or instructions.
(American Psychiatric Association, 2013)

5. Adhd in adolescence Hyperactivity may be less prevalent.
Restlessness, inattention, poor planning, & impulsivity may persist.
A significant number of children remain impaired in adulthood.
What types of activities may cause concern for adolescents with ADHD?
(American Psychiatric Association, 2013)

6. Presentations of adhd inattentive Hyperactive/impulsive combined
At least 6 symptoms of inattention
Less than 6 symptoms of hyperactivity/impulsivity
Persist at least 6 months
At least 6 symptoms of hyperactivity/impulsivity
Less than 6 symptoms of inattention
Persist at least 6 months
3 core features
At least 6 symptoms each of inattentive and hyperactive/impulsive presentations
Persist at least 6 months
(American Psychiatric Association, 2013)

7. Can be mistaken for: Emotional problems Disciplinary problems
Comorbidity:
Learning Disabilities
Anxiety Disorder
Conduct Disorder
Depression
Substance Abuse
(national institute of mental health, 2016)

8. What is it like to have adhd?
No matter how much you want to force yourself to pay attention, boredom allows curiosity to find the key and open the dungeon door, allowing attention to escape and find some interesting place to visit.
Edward m. Hallowell, M.D.
What is it like to have adhd?

9. 7 executive functions
Cognitive & mental abilities needed to pursue goals
Inhibition
Self-awareness
Working memory (verbal & nonverbal)
Self-motivation
Self-regulation
Planning and problem-solving

10. Executive functioning
Executive inhibition
Executive attention
Motor inhibition
Verbal inhibition
Impulsive cognition
Impulsive motivation
Emotional dysregulation
Poor persistence
Distractible
Low task re-engagement after disruption
Impaired working memory
Decreased self-monitoring
(Barkley, 2013)

11. Other considerations The disorder is not:
Children with ADHD are less mature
Parents, teachers, and caregivers must consider seriousness of the disorder.
Caused by parenting
A lack of desire
Limited by age

12. Academic strategies

13. Productivity in the classroom
Target productivity first and accuracy later.
Give smaller chunks of work at a time.
Use light touch or an inconspicuous signal to redirect to task (talk less).
Use a timer for task completion (externalize time).
Use interactive components in lessons.
Provide immediate feedback.
Preferential seating
Consider alternate methods for providing answers.
(Barkley, 2011)

15. Study tips for adolescents
Have a planner.
Schedule everything in.
Study in increments.
Figure out which study tools work best.
Create your own contingency plan.
Have realistic expectations.
Build a routine (where and when to study).
(Tartakovsky, 2016)

16. Classroom arrangement
Minimize distractions.
Arrange desks so all students can view the instructional area.
Seat the student where he/she can be closely monitored.
Be sure each area of the room has a designated purpose.

19. Personal schedules Incorporate break times ● use visuals as needed

20. Behavior and executive functioning strategies

21. Contingency systems rewards consequences GENERAL RULES
Children with ADHD like immediate gratification.
Consider smaller maintenance rewards with an opportunity to earn a larger reward.
Change the rewards often.
Try group incentives
Do not delay consequences
Use school-home reports for both positives and negatives.
Incentives must be present for consequences to be effective.
Provide mild, private reprimands.
Consider response cost.
Use rewards before punishment.
Maintain a disability perspective.
Focus on approval and recognition; increase positive attention.
Increase accountability to others.
Use when-then contingencies.

22. Chart moves

23. Point cards

24. Reinforcer menu

25. Student tracking form

26. Daily tracking form Older students

27. Handling hyperactivity
Allow some restlessness.
Provide frequent movement or brain breaks.
Use a “chill zone”.
Use fidget tools.

28. Fidget tools

29. Movement tools

30. Impulse control Catch him/her on task and provide praise.
Model your thought process.
Use checklists.

31. Defiance & disruptions
40% of children with ADHD also develop oppositional defiant disorder (ODD).
Aggression
Outbursts
Ignore requests
Argue
Intentionally ignore or disrupt
Share resources between home and school
Accentuate the positives
Avoid power struggles
Carry out the consequences you warn about
Be firm and consistent
(Flippin, Not Dated)

32. Off-task & disruptive behavior interventions
Am I working?
Red dot system
“first, then” language
Provide one task/instruction at a time
Gradually increase on-task expectation
Response cost
Behavior momentum
Calm, neutral tone
Be brief
Provide choices and time to comply

33. Self-monitoring

34. Organization & planning
Use color-coded organization systems
Assign a peer buddy.
Teach the student to use a planner.
Use a to-do list.
Use graphic organizers.

35. Social & emotional functioning

36. Teaching social & emotional regulation
Tootles
(Younger students)
FAST & SLAM
(older students)
Teaching social & emotional regulation
Social skills groups & training
Problem-solving training
Friendship coaching
Communication training
Use social narratives and role play.
Teach coping strategies.
Use social autopsies.

38. Other recommendations
Need collaboration of teachers, parents, and other treating professionals
Encourage parent education
Encourage involvement and participation in activities
Maintain a disability perspective

39. resources ADDitude: Strategies & Support for ADHD and LD ADD Warehouse
ADD Warehouse
ADHD Together
A Shared Focus
Tough Kid Toolbox (available for purchase)

40. references
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth edition. Washington, DC: American Psychiatric Association.
Barkley, R. (2013). ADHD: Diagnosis & Demographics. (PowerPoint slides). Presented at Region 4, Houston, TX.
Barkley, R. (2011). Parent Counseling and Home Management of ADHD. (PowerPoint slides). Presented at Region 4, Houston, TX.
Barkley, R. (2013). School Management of ADHD. (PowerPoint slides). Presented at Region 4, Houston, TX.
Flippin, R. (Not dated). Why is my child so angry? Retrieved from
Tartakovsky, M. (2016). A Toolkit for School Success: 15 Study Tips for Students with ADHD. Psych Central. Retrieved from
National Institute of Mental Health. (2016). Attention Deficit Hyperactivity Disorder. Retrieved from

41. Brittany n. bates