1. ADD/ADHD Strategies in School

2. Middle School: What Works? Advance Organization Advance Organization Daily Organization Daily Organization Study Skills Study Skills Attention Attention Planning Skills Planning Skills 80% still need medication (NIMH) 80% still need medication (NIMH) Sleep, Sleep, Sleep Sleep, Sleep, Sleep

3. Advance Organization Background information before new tasks Background information before new tasks Complete a “walk through” to each classroom Complete a “walk through” to each classroom Practice opening lockers and padlocks Practice opening lockers and padlocks

4. Daily Organization Order and Routine in the Classroom Order and Routine in the Classroom Post Schedule Post Schedule Color-coded materials Color-coded materials Designated places for materials Designated places for materials

5. Study Skills Teach study skills (SQ3R) and note taking strategies Teach study skills (SQ3R) and note taking strategies Match tutors/mentors to help students organize and keep up with daily work Match tutors/mentors to help students organize and keep up with daily work

6. Attention Mnemonic strategies Mnemonic strategies Strong visual depictions Strong visual depictions Present in short, brief segments Present in short, brief segments Use overheads Use overheads Audiotapes of lessons available to students Audiotapes of lessons available to students Opportunities for controlled movement in the classroom Opportunities for controlled movement in the classroom

7. Planning Skills Variety and novelty in lessons Variety and novelty in lessons Opportunities for small- group learning Opportunities for small- group learning Peer/Mentor Tutoring Peer/Mentor Tutoring

8. High School: What Works? Experience based curriculum Experience based curriculum Use of demonstrations and role playing Use of demonstrations and role playing Hands-on experiences and activities Hands-on experiences and activities Project-oriented curriculum Project-oriented curriculum Multimedia technology Multimedia technology Mentorship, Tutoring, Coaching Mentorship, Tutoring, Coaching Learning Games Learning Games Compensatory Strategies: hand speller, calculator, study outlines, tape recorders Compensatory Strategies: hand speller, calculator, study outlines, tape recorders Teacher Selection: matching teacher’s style to students’ strengths Teacher Selection: matching teacher’s style to students’ strengths

9. Challenges: Poor Note Taking Skills Hand out a written format for note taking before class Hand out a written format for note taking before class Audiotape the class Audiotape the class Designate a class “note-taker” each day and photocopy the notes Designate a class “note-taker” each day and photocopy the notes Number or Alphabetize information used in the lecture Number or Alphabetize information used in the lecture Review notes with class one time per week and highlight important areas Review notes with class one time per week and highlight important areas Periodically collect notes to determine what helps students the most Periodically collect notes to determine what helps students the most

10. Poor Organizational Skills Allow students to keep one book in class and one at home Allow students to keep one book in class and one at home Use e-mail for homework assignments. Students can look from home to determine assignments Use e-mail for homework assignments. Students can look from home to determine assignments Assign study buddies for the last 5 minutes of class to review notes and assignments Assign study buddies for the last 5 minutes of class to review notes and assignments Have row captains to ensure all homework is turned in Have row captains to ensure all homework is turned in Assign a phone study buddy to each student. They can call one another to discuss homework, tests, or questions Assign a phone study buddy to each student. They can call one another to discuss homework, tests, or questions

11. Difficulty concentrating when reading silently Allow the student to use a colored note card to mark the line being read Allow the student to use a colored note card to mark the line being read Allow students to read anywhere in the classroom Allow students to read anywhere in the classroom Have two students take turns reading to one another Have two students take turns reading to one another Allow students to listen to a book on audiotape before reading it to enhance visualization of the material Allow students to listen to a book on audiotape before reading it to enhance visualization of the material

12. Calendars and Daily Planners Post a large planning calendar in the room to model how to record assignments, test dates, etc. Post a large planning calendar in the room to model how to record assignments, test dates, etc. Teach the student to highlight important dates Teach the student to highlight important dates Encourage the student to carry a daily calendar book Encourage the student to carry a daily calendar book

13. Test Taking Strategies Allow the student to write the # or letter of the correct answer only Allow the student to write the # or letter of the correct answer only Allow the student to write directly on the main copy of the test Allow the student to write directly on the main copy of the test Demonstrate how to check carefully that the # on answer sheet matches the # of the ? Demonstrate how to check carefully that the # on answer sheet matches the # of the ? Teach your students to check the page # every time they turn a page Teach your students to check the page # every time they turn a page

14. General Accommodations Maintain a positive atmosphere Maintain a positive atmosphere Give students a blank piece of paper to jot down anything they can remember and let them use this page during the test Give students a blank piece of paper to jot down anything they can remember and let them use this page during the test Suggest students learn to read the answers first, then read the ? to ensure they read all the details of the answers Suggest students learn to read the answers first, then read the ? to ensure they read all the details of the answers Encourage visual recall to the lecture in class if they cannot remember an answer Encourage visual recall to the lecture in class if they cannot remember an answer

15. General Accommodations Seat placement (front is not always best) Seat placement (front is not always best) Small group activities Small group activities Encourage students to pause before answering questions Encourage students to pause before answering questions Keep assignments short or break them into sections Keep assignments short or break them into sections Close supervision with frequent, positive, (subtle) cues to stay on task Close supervision with frequent, positive, (subtle) cues to stay on task

16. Test Taking Options Taped response test rather than writing the answers Taped response test rather than writing the answers Individual conferencing Individual conferencing Small group tests Small group tests Teacher-read tests Teacher-read tests Essay test Essay test Audiotaped tests—allow use of earphones to reduce distractions Audiotaped tests—allow use of earphones to reduce distractions Take home tests Take home tests Alternative project Alternative project Study questions Study questions Student designed tests Student designed tests Chunking—Use highlighters to divide sections of the test. Use color, tricks, & visual impact to trigger memory & recall Chunking—Use highlighters to divide sections of the test. Use color, tricks, & visual impact to trigger memory & recall

17. Study Tools Clipboard Clipboard Electronic handspeller w/ dictionary Electronic handspeller w/ dictionary Post it Notes Post it Notes Three hole punch Three hole punch Large 3 ring notebook with colored inserts Large 3 ring notebook with colored inserts Mechanical pencils/Fine tipped pens Mechanical pencils/Fine tipped pens Hand held tape recorder Hand held tape recorder Highlighters Highlighters Colored index cards/paper clips Colored index cards/paper clips Personal organizational planners Personal organizational planners

18. Classroom Interventions What works What works And what does not work And what does not work

19. Not recommended!

20. What we know works:  Drug Therapy  Behavior Therapy  Combined Behavioral/Drug Treatments APA Task Force on Evidence-Based Treatments, JCCAP, Pelham, Wheeler, & Chronis, 1998 American Academic of Pediatrics

21. AAP Guidelines 1. Establish a management program that recognizes ADHD as a chronic condition (strength of evidence: good; strength of recommendation: strong).

22. AAP Guidelines 2. Clinician, parents, and child, in collaboration with school should specify appropriate target outcomes to guide management (strength of evidence: good; strength of recommendation: strong).

23. AAP Guidelines 3. Recommend stimulant medication and/or behavior therapy as appropriate (strength of evidence: strong).

24. AAP Guidelines 4. When management has not met target, clinicians should evaluate the original diagnosis, treatments, adherence and coexisting conditions (evidence: weak; recommendation: strong).

25. AAP Guidelines 5. Periodically provide systematic follow-up to monitor targets and adverse effects by gaining information from child, parents, and teachers (evidence: fair; recommendation: strong).

26. What we know DOESN’T work:  Play therapy  Individual or family counseling (without altering the environment)  Dietary management  Megavitamin therapy  Sensory integration therapy/chiropractics  EEG Biofeedback

27. Doesn’t work... Optometric vision training Optometric vision training Anti-motion-sickness medication Anti-motion-sickness medication Treatment for candida yeast infection Treatment for candida yeast infection Applied kinesiology (realigning bones in the skull) Applied kinesiology (realigning bones in the skull)

28. What we know works:  CNS Stimulant Medications o 250 studies (N > 5000)  Behavior Therapy o 48 classroom studies (N > 900) o 80 parent/home studies (N > 5,000)  Combined Behavioral/Drug Treatments o 25 studies (N > 800)

29. Behavior Therapy for ADHD Components  Highly structured  Immediate feedback  reinforcer or reward for appropriate behavior  consequence for inappropriate behavior  Salient/meaningful feedback  Programming at home and school

30. School Behavior Intervention Examples: 1. The Attention Training System (ATS) System (ATS) 2. Home School Note 3. Self-monitoring

31. School Behavior Intervention: The Attention Training System (ATS) 1. Technology Teacher Module Teacher Module Student Module Student Module 2. Immediate feedback 3. Meaningful consequences 4. Structured “time”

32. School Behavior Intervention The ATS: Lisa Days % Time Off Task No ATSATSNo ATS AT S

33. School Behavior Intervention The ATS: Troy Days % Time Off Task No ATS ATS Meds Only

34. School Behavior Intervention Home School Notes Address Problems With  Academic effort  In-class behaviors  Assignment completion

35. School Behavior Intervention Home School Notes Procedures  Identify target behaviors

36. School Behavior Intervention Home School Notes Academic Behaviors  Working on assignments  Completing homework  Handing in assignments  All work up to date  On time for class Social Behaviors  Out of seat  Talking without permission  Disrespectful behavior  Bothering peers  Following instructions  Hands to self

37. School Behavior Intervention Home School Notes Procedures  Identify target behaviors  Design school note form

38. School Behavior Intervention Home School Notes GOAL: 8 of 12 YES Desk neat and organized Homework written neatly, accurately in book by class bell Class assignment neat and 80% accurate or better Math L. Arts HistoryScience Yes No

39. School Behavior Intervention Home School Notes Procedures  Identify target behaviors  Design school note form  Identify reinforcers and consequences

40. School Behavior Intervention Home School Notes Reinforcer Examples  Wear an outfit of your choice to school  Get out of a chore  TV/video games/telephone/computer time  Allowance  Token toward weekend activity

41. School Behavior Intervention Home School Notes Procedures  Identify target behaviors  Design school note form  Identify reinforcers and consequences  Establish criterion for reinforcement  Increase criterion as progress is made  Plan for generalization and maintenance

42. School Behavior Intervention Home School Notes What makes it effective:  Frequent, immediate feedback (school).  Highly structured (short time).  Salient consequences (home).

43. Date: Cross off each picture each time you talk without raising your hand or having permission. Teacher will cross off two pictures if you don’t.

44. RESOURCES Attention Deficit Disorder: Strategies for School-Age Children by Clare B. Jones, Ph.D. Attention Deficit Disorder: Strategies for School-Age Children by Clare B. Jones, Ph.D. Treatments that Work with Children: Empirically Supported Strategies for Managing Childhood Problems by Edward R. Christophersen, Susan L. Mortweet Treatments that Work with Children: Empirically Supported Strategies for Managing Childhood Problems by Edward R. Christophersen, Susan L. Mortweet Taking Charge of ADHD, Revised Edition: The Complete, Authoritative Guide for Parents by Russell A. Barkley Taking Charge of ADHD, Revised Edition: The Complete, Authoritative Guide for Parents by Russell A. Barkley

45. ADHD and the Nature of Self Control by Russell A. Barkley ADHD and the Nature of Self Control by Russell A. Barkley Attention-Deficit Hyperactivity Disorder: A Clinical Workbook, Second Edition by Russell A. Barkley, Kevin R. Murphy Attention-Deficit Hyperactivity Disorder: A Clinical Workbook, Second Edition by Russell A. Barkley, Kevin R. Murphy Effective School Interventions by Natalie Rathvon Effective School Interventions by Natalie Rathvon