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Consultation With Teachers of ADHD Children:

Strategies To Increase Success and Decrease Stress in the Classroom

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ADHD: Overview

• A neurodevelopmental disorder which primarily affects executive functioning.

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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

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Overview

Cognitive Interventions

Behavioral Interventions

Social/Interpersonal Interventions

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Cognitive Interventions

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Poor Nonverbal Working Memory

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Inability to hold events in mind

Unable to manipulate or act on the events in mind

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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

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Poor Reading ComprehensionTeach 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

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Trouble With Word ProblemsEncourage students to use objects/manipulatives

Encourage students to draw out the problem and create a visual representative

Help student highlight main points

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Trouble With Note-takingProvide guided notes of the class lecture

Require students to take notes in 10 minute intervals

Provide copy of notes

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Defective hindsight & foresight

Delayed cross temporal organization

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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.

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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 ApproachVisual, Auditory, Kinesthetic, Tactile

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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

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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

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Limited self-awareness

Diminished sense of time

Deficient nonverbal rule governed behavior

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This means:Trouble with delayed gratification

Provide immediate feedback on behavior

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Difficulty with behavioral regulationTeach organizational skills

Organize books and notebooks daily in the same order in desks

Provide basket under chair for extra materials not needed for class

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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

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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

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“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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Trouble applying rules in one known situation to a novel situation

Provide social skills training

Remind student of unspoken social rules

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Impaired imitation of complex sequences

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This means:Difficulty with multi-step directions

Keep directives simple

Give one directives at a time

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C.O.R. DirectionsEstablish eye Contact

Give One direction at a time

Have student Repeat directions

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Attention-FocusingCall child by name

Get eye contact

Touch child’s should or chin

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Provide student with daily schedule and keep classroom routine regular

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Trouble imitating modeled behaviorsProvide a step-by-step visual guide for assignments

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Delayed Internalization of Speech

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Reduced description and reflection

Poor self questioning/problem solving

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This means:Difficulty with mental math

Teach memory techniquesMnemonics, Clustering, Visualization, Visual Rehearsal, Oral Rehearsal

Use manipulatives

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Poor problem solving

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Poor reading comprehensionPre-read, Active read, Review

Scotopic Sensitivity

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Deficient rule governed behavior (instruction)

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This means:Trouble applying rules to behavior

Use cues to remind of rules and give feedback on behavior

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Class Reminder Checklist

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The Cueing Strategy

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Less effective generation of rules/metarules

Delayed moral reasoning

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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

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Impaired reading comprehensionSkim, summarize, SQ3R

Engage in pre-reading, active reading, and post-reading activities

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Immature

Self-Regulation of

Affect

Motivation

and

Arousal

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Diminished self-regulation of motivation

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

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This means:Trouble getting motivated; not usually a “self-starter”

Establish external reinforcers/motivators

Break assignments into small steps

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Less objectivity/social perspective taking

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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

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Limited self-regulation of affect

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This means:Hard to control feelings/emotions

Teach coping skills and relaxation techniques

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Specific strategies“Australia”

The Turtle Technique

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Impaired Reconstitution

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Limited analysis and synthesis of behavior

Reduced verbal & behavioral fluency

Deficient rule creativity

Less goal directed behavioral creativity and diversity

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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

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In sum:

Be concrete

Be repetitive

Be short

Keep it simple

Write it down

Don’t get frustrated

Don’t take it personally

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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

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Behavioral DisinhibitionPoor 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

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Behavioral Symptoms

Inattention

Hyperactivity

Impulsivity

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Behavioral Interventions

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Accommodations

Strategic SeatingAway from visual & auditory distractions

Good natural light

Near a study buddy

Close to the teacher

Has a storage area that helps with orgization

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Daily CommunicationsCommunicate with parents on a daily or weekly basis

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“Pre-Mac” your day

Reduce Load

Extra Time

Frequent Monitoring

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Prescriptions

Listen, Look, and Think (ADD Warehouse)

Vibrating Watch

Self-Monitoring

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Behavior Modification

1-2-3 Magic (Dr. Thomas Phelan, 1984)

Reinforcers include:Praise, privileges, tangibles

Consequences include:Losing privileges, restriction, time-outs

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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

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Improving a specific behaviorFocus on only one behavior

List specific goal and a schedule to evaluate progress

Gradually increase the number of points needed to earn reward

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Beat the clockWith 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

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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

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Social/Interpersonal Interventions

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Self-Esteem

Clear MessagesClear 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

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Social Skills

The Friendship ModelCheck it out

Reach out

Try it out

Work it out