Using Clinical Interventions toTreat Academic Problems in

Children With ADHD:Evan Flamenbaum MA, MSW

Monday January 7th, 2013

Goals of this Presentation

• Outline a general process of helping students with ADHD with their academic struggles

• Clinically Informed Tutoring™• Provide you will easy and ready to use

techniques• Present the bridge between clinical and

academic interventions

First Step:Enroll the Client

• Kids don’t go to a therapist / learning specialist they are brought there

• Learned Helplessness• Dissonance: I know I am smart . . . But my

intelligence doesn’t translate to success• Give the chain a tug!!!

First Step

Enroll the Client

Motivational Interviewing

• Assess where a child is on the spectrum of change

• Develop change talk

• Cost-benefit analysis technique

Stages of Change

• Precontemplation: “Ignorance is bliss”

• Contemplation: “On the fence”

• Preparation: “testing the waters”

• Action: “let’s do this!”

• Maintenance: “stay the course”

Cost/Benefit Analysis

• Letting teacher down (95)

• Making parents upset (95)

• Not getting good grade

(100)

• Being stressed about the

process (85)

• Rather hang out with friends/TV/do nothing (50)

• Would have spent less time (40)

• Avoid caring about the grade (60)

_ +

“Getting paper done on time (without all-nighter)”

Second Step

Setting Goals

Solution Focused Therapy

• Miracle question

– What would be different?

– How could people tell?

– How would it feel differently?

Reaching your goals First, think about your dreams

Think about how you would like to be in the future.

Imagine yourself at the end of the term/year. Write it down.

Reaching your goals

Second, set goals

1. Goals are things you want. State them positively not negatively.

Example: I want to get an A in Spanish.Instead of… I don’t want to fail Spanish.

Reaching your goals

Second, set goals

2. Be specific. Write down exactly what you mean. Include numbers and times and exclude vague words

like “lots” and “more”.

Example: I want to get above an 80 in science class.

Instead of…I want good grades.

Reaching your goals

Second, set goals

3. Check to see if your goal is reasonable.

Example: I will run for president of my class.

Instead of…I will run for president of the United States.

Reaching your goals

Third, define objectives

1. Objectives are what you do to achieve your

goals.

2. Make a commitment. Use words like “I

will…” instead of “try” or “maybe.”

Reaching your goalsObjectives continued . . .

3. Make sure your objectives are

measurable and assess them regularly.

4. Every goal will have one or more

objectives.

Intrinsic Motivation

• WIFM• What’s in it for me!

– Parents giving me a privilege or object– Feeling happy at school– Not being so anxious about _______– Getting into college– Improved grades

Reaching your goals

Objectives continued . . .

Goal: I want to get above an 80 in science class.

Objective: I will re-read my notes from class everyday.

Objective: I will meet with my teacher once a week after school.

Objective: I will raise my hand at least twice a class period everyday.

Step Three

Creating a Learning Profile

Solution Focused TherapyThree Tenets

• If it works do more of it

• If it does not work do less of it

• If it isn’t broken then don’t fix it

Scaling Questions

• On a scale of 1-10 how focused are you right now?

• On a scale of 1-10 how motivated are you to change how you take notes?

• Test anxiety• Procrastination• Worry

Your learning style

• Visual

• Auditory

• Kinesthetic

The Visual LearnerCharacteristics

• Talk and move fast• Neat, orderly, good

planners• Use eye contact• Strong, fast readers• “I see what you mean.”

Suggestions

• Graphic organizers• Give space when speaking• Provide big picture• Use color• Charts, tables• PowerPoint, Smart Board

Tools: journaling, visualize, pictures, etc.

Auditory LearnerCharacteristics

• Talk in rhythm and eloquently

• “Radar ears’• Great impersonators• “I hear what you are saying.”

Suggestions

• Ask clarifying questions

• Give same directions as written

• Repeat info

Tools: affirmations, self-talk, tape recorders, etc.

Kinesthetic LearnerCharacteristics

• Talk slowly and gesture.

• Move a lot• Disorganized• Always touching

something, can’t sit still• Tactile• “I feel like you…”

Suggestions

• Talk slower• Use more motions when

speaking• Give student/child

something to hold• Give student/child tasks

involving motion.

Tools: Q-tip, squeeze ball, tactile media, take a walk, breathing, somatic awareness, movement.

“How are you smart?”

Spatial (sculptor, pilot)

Linguistic (writer)

Interpersonal (teacher, salesman)

Musical (composer)

naturalistic (environmental scientist)

Bodily/kinesthetic (athlete, dancer)

Intrapersonal (accurate view of self)

Logical/mathematical (scientist)

What type of thinker are you?

• Thinking styles vs. Learning styles– Learning styles - perception– Thinking styles – processing

• Many different types of thinkers• Helps you relate to others better • Helps you explain your ideas, thoughts,

and opinions better

Thinking Styles• Structured

– Ordered, step by step, concrete

• Logical– Concrete but less structured

• Flexible – Feelings and emotions

• Exploratory– Theory and thought

Thinking Styles

• How to maximize your style:

– Find someone who compliments your style

– Example: Structured pairs with flexible

Step 4

• Clinically Informed Tutoring™ in Practice

13 (1-1-1) Review Strategy

Time

Reca

ll

1 hour

1 wee

k

3 months!

1 day

1 mo

Long Term Memory

70%

20%

The Importance of Breaks

Reca

ll

Time (hr)1 2 30

Time Quadrants

“Necessity”

The Procrastinator

(MANAGE)Anxiety

“Productivity and Focus”

The Prioritizer

(FOCUS)Well-Being

“Deception”

The Yes Man

(MINIMIZE)Low Self-Esteem

“Waste & Excess”

The Slacker

(AVOID)Depression

Urgent

Impo

rtan

t

Not Urgent

Not

impo

rtan

t

Procrastination to Production

Thought

1. “I have to.”2. “I should.”

3. “I must finish.”4. “This is so big.”

5. “I must be perfect.”

6. “I don’t have time to _____.”7. “I will never finish.”

8. ______________

Counter-thought

1. I choose to.2. It would be better if…3. When can I start?4. I can take one small step.5. I can be human.

6. I must make time to _____.7. Every turn of the wheel is a step closer.8. ______________

Procrastination Busters

1. THE 5-MINUTE PLAN: Work 5 minutes at the thing you have been putting off. After you have completed 5 minutes, schedule another 5 minutes, etc.

2. T3 (The Tiny Task Technique): Break up a big task into smaller pieces. Complete one piece at a time.

3. WORST FIRST APPROACH: Jump in the deep end, get it over with!

4. SELF-REWARD: Reward yourself with something pleasant when you’ve finished any difficult task.

5. COST-BENEFIT ANALYSIS: Make a list of all good things and bad things that will happen if you stop procrastinating on an important task.

35

Triple Play (Study Preparation)

1. Preview (“Recon”) - find out in advance what is going on.

2. Review (13)

3. Self-Test