Key Strategies For Teaching and Managing Key Strategies For Teaching and Managing Boys and Girls With ADHD Boys and Girls With ADHD

Fintan J O’Regan MAFintan J O’Regan MA

07734 715 378 07734 715 378

fjmoregan@aol.com

www.fintanoregan.comwww.fintanoregan.com

Publications Publications Cooper P and O’Regan F (2001) EDUCATING children with Cooper P and O’Regan F (2001) EDUCATING children with

ADHD: Routledge Falmer PressADHD: Routledge Falmer Press

O’Regan F (2002) How to teach and manage children with O’Regan F (2002) How to teach and manage children with ADHD: LDA a division of McGraw- Hill ADHD: LDA a division of McGraw- Hill

O’Regan F (2005) ADHD : Continuum International O’Regan F (2005) ADHD : Continuum International

O’Regan F (2005) Surviving and Succeeding in SEN Continuum O’Regan F (2005) Surviving and Succeeding in SEN Continuum International International

O’Regan F (2006) Challenging Behaviours Teachers O’Regan F (2006) Challenging Behaviours Teachers PocketbooksPocketbooks

O’Regan F (2006) Troubleshooting Challenging Behaviours O’Regan F (2006) Troubleshooting Challenging Behaviours Continuum International Continuum International

O’Regan F (2008) The Small Change 2 BIG DIFFERENCE series O’Regan F (2008) The Small Change 2 BIG DIFFERENCE series

Hyperactive, Inattentive and Disorganised, Special DirectHyperactive, Inattentive and Disorganised, Special Direct fjmoregan@aol.com fjmoregan@aol.com

What is ADHD?What is ADHD?

Three types of ADHDThree types of ADHD

Predominantly InattentivePredominantly Inattentive

Predominantly Hyperactive/ImpulsivePredominantly Hyperactive/Impulsive

Combined typeCombined type

InattentionInattention HyperactivityHyperactivity

ImpulsivityImpulsivity

Core symptoms of ADHDCore symptoms of ADHD

What does a child with ADHD look like ?What does a child with ADHD look like ?

Funny….. he was Funny….. he was here a minute here a minute ago…….ago…….

The school day..through a child’s eyesThe school day..through a child’s eyes

“Everything distracts you at school. If someone drops a pen on the floor

you know about it…if someone drops a pen…in a different school,

you’d probably know about it.”

“I quite often go into daydreams because of my ADHD. I might drift off

for a few minutes and then when I come back round I realise everyone

else is two pages ahead of me.”

“We do things we don’t mean to do, like fiddling around and

fidgeting and it makes you stick out.”

“If teachers know you are ADHD as soon as

someone does something they will

blame you instantly.”

ADHD: Through the Teachers eyesADHD: Through the Teachers eyes

“It doesn’t really matter what you call it he is real pain and even if you do understand it you still have to deal

with a class of 30 teenagers ”

There is rarely any liaison between consultant and the school. Any

communication or advice etc.. Is instigated by the school

SENCO

The whole mystery of ADHD is shrouded in

mystery and confusion as far as I am concerned.

More guidance is needed

“Their behaviour can annoy and alienate

their peers”

Likely progression unless identified

Age 7 Key Stage 2, low Self esteem

Age 11 Key Stage 3, Disruptive Behavior, Learning Delay, Poor Social Skills

Age 14 Key Stage 4, ODD, Challenging Behavior, Criminal Behavior, School Exclusion, Substance Abuse, Conduct Disorder, Lack of Motivation, Complex Learning Difficulties

DiscussionDiscussion

What are some of the other potential issues of ADHD What are some of the other potential issues of ADHD in a child not either being recognised or supported in a child not either being recognised or supported effectively? effectively?

ADHDADHD

ADHD is a real condition and not the result of ADHD is a real condition and not the result of poor parenting, food allergies or excess sugarpoor parenting, food allergies or excess sugar

ADHD is considered the most commonly ADHD is considered the most commonly diagnosed psychiatric disorder in children diagnosed psychiatric disorder in children and adolescentsand adolescents

The cause is unknown but scientists classify The cause is unknown but scientists classify it as a neurological disorderit as a neurological disorder

What we knowWhat we know

Genetic influences are very strongGenetic influences are very strong

Several changes in the DNA of chromosomes are Several changes in the DNA of chromosomes are now known to be associated with ADHD, these now known to be associated with ADHD, these changes are in the genes that control specific changes are in the genes that control specific neurotransmitters especially dopamine.neurotransmitters especially dopamine.

Problem with neurotransmission of Dopamine

Neurobiology of ADHD

Social clumsiness / Response Social clumsiness / Response InhibitionInhibition

Got to say Got to say it…… it……

Got to say it Got to say it now….. now…..

QuestionQuestion

What could be some of the reasons for why a child What could be some of the reasons for why a child with ADHD might shout out answers to questions with ADHD might shout out answers to questions posed in a classroom instead of putting up their posed in a classroom instead of putting up their hand and waiting their turn? hand and waiting their turn?

Are individuals with ADHD always Inattentive Are individuals with ADHD always Inattentive and Hyperactive ?and Hyperactive ?

Their behaviour will Their behaviour will vary according to vary according to the degree to which the degree to which rules are managed, rules are managed, the amount of the amount of structure and structure and support for support for compliance and the compliance and the degree to which the degree to which the child is interested child is interested in the activity” in the activity”

Mike Gordon 1992 Mike Gordon 1992

Girls with ADHD

Their problems are frequently under-appreciated

May be inattentive only By adolescence may appear depressed,

to have low self –esteem and to be learning disabled

If hyperactive, may present differently

MedicationBehaviourModification

EducationalIntervention

Mentoring/counselling

AlternativeOptions

Multi-Modal ManagementMulti-Modal Management

ManagementManagement

Full commitment to teach and manage children with Full commitment to teach and manage children with ADHD from the SMTADHD from the SMT

All Teaching and Support staff trained in recognition, All Teaching and Support staff trained in recognition, teaching and management of these studentsteaching and management of these students

Positive and realistic academic and socialisation Positive and realistic academic and socialisation expectations within policies outlined at the start with expectations within policies outlined at the start with parents fully in the loop.parents fully in the loop.

In most cases a part individualised programme outlining In most cases a part individualised programme outlining key academic goals in core subjects, socialisation and key academic goals in core subjects, socialisation and behavioural targets. behavioural targets.

Rules, Routines and Rituals will… Rules, Routines and Rituals will…

Reduce anxietyReduce anxiety

Enhance motivation, confidence and self esteemEnhance motivation, confidence and self esteem

Enhance concentration and reduce distractionsEnhance concentration and reduce distractions

Facilitate independenceFacilitate independence

Application of R/R?Application of R/R?

Band 1Band 1 Band 2Band 2

Physical /Verbal abuse Distractibility Physical /Verbal abuse Distractibility

Theft Disorganisation Theft Disorganisation

Timekeeping Calling out Timekeeping Calling out

Attendance Fidgeting Attendance Fidgeting

Dress Code Engaging others Dress Code Engaging others

Rules and Responsibilities

* Rules, Rights and Responsibilities posted clearly in classes

*Graduated Positive and Logical consequences reinforcement charts explained on a regular basis

*Set up escape hatch for certain students to sound off/diffuse …………”can’t do it in public”

Routines and RitualsRoutines and Rituals

Have you cut out external distractionsHave you cut out external distractions

Are you aware of the danger spotsAre you aware of the danger spots

Can you arrange the seating plan to reduce Can you arrange the seating plan to reduce potential trouble spotspotential trouble spots

Can you see them at all timesCan you see them at all times

Do you control exits and entrancesDo you control exits and entrances

Is your mobility fit for purposeIs your mobility fit for purpose

Does your equipment work and do have Does your equipment work and do have your materials in advanceyour materials in advance

Classroom layoutClassroom layout

Identify a safe haven / quiet areaIdentify a safe haven / quiet area

Sit away from door, window, corridorSit away from door, window, corridor

Sit away from resources not in useSit away from resources not in use

Sit away from resources needed by other studentsSit away from resources needed by other students

Sit near teacherSit near teacher

Sit near student with good study and attention skillsSit near student with good study and attention skills

If available use work stationsIf available use work stations

Use horseshoe layout for discussionUse horseshoe layout for discussion

Poor attention skillsPoor attention skills

Try and work out what are the main distracters Try and work out what are the main distracters (auditory, visual, kinaesthetic, internal)(auditory, visual, kinaesthetic, internal)

Reduce expectations of seat work and use Reduce expectations of seat work and use alternative ways of task completion alternative ways of task completion

Only one or two activities per pageOnly one or two activities per page

Avoid unnecessary pictures or visual stimuliAvoid unnecessary pictures or visual stimuli

Ensure white space on each pageEnsure white space on each page

Provide alternative environments for some tasks Provide alternative environments for some tasks and activitiesand activities

Group situationsGroup situations

Have the child sit near teacher / away from Have the child sit near teacher / away from distractionsdistractions

Pair the child with strong role models (both Pair the child with strong role models (both academic and social)academic and social)

Use ‘dead/alive headphones’ / study carrelsUse ‘dead/alive headphones’ / study carrels

Move the child ‘away from temptation’Move the child ‘away from temptation’

Use preferential seating arrangementsUse preferential seating arrangements

Take the child’s strength and group with Take the child’s strength and group with children weak in that areachildren weak in that area

Excessive motor activityExcessive motor activity

Allow student to fiddle with an agreed object e.g. Allow student to fiddle with an agreed object e.g. stress ball, concentrators, bar magnets etc… stress ball, concentrators, bar magnets etc…

Give short breaks between assignmentsGive short breaks between assignments

Plan ahead for transition timesPlan ahead for transition times

Use alternative technology e.g. computer, musicUse alternative technology e.g. computer, music

Set variety of tasks and activities, where possible Set variety of tasks and activities, where possible include ‘hands on’ activityinclude ‘hands on’ activity

Give whole class stretching exercises midway Give whole class stretching exercises midway throughthrough

Self esteem

Plan for success, catch them being good and praise

Recap emphasising the student’s achievement Explore what motivates student and build this into programme

If they have grasped a concept allow them to share this success with another student who is struggling (boosts self esteem and reinforces knowledge)

Problem subject areasProblem subject areas

Tend to be subjects where:Tend to be subjects where:

There is no right/wrong answersThere is no right/wrong answers

Pupils are expected to debate/express their opinionPupils are expected to debate/express their opinion

Lots of social understanding (i.e. group work)Lots of social understanding (i.e. group work)

Lots of writing involvedLots of writing involved

Lots of listening and processing of verbal Lots of listening and processing of verbal instruction rather than visual presentation and instruction rather than visual presentation and practical involvementpractical involvement

OrganisationOrganisation

Clearly identify certain places in the room, trays, shelves, Clearly identify certain places in the room, trays, shelves, boxes where students know where to put assignmentsboxes where students know where to put assignments

Have a daily assignment schedule booklet/sheetHave a daily assignment schedule booklet/sheet

Colour Code books folders, materialsColour Code books folders, materials

Clipboard for papers on deskClipboard for papers on desk

Use post it notes for recording information, ideas, Use post it notes for recording information, ideas, thoughtsthoughts

2nd set of key text books at home2nd set of key text books at home

Get them to use a timer/watch with alarms and set it to Get them to use a timer/watch with alarms and set it to vibrate or beep at certain intervals during the dayvibrate or beep at certain intervals during the day

DiscussionDiscussion

Think about some of the key study skills needed to Think about some of the key study skills needed to support children with ADHD that you work with? support children with ADHD that you work with?

Curriculum flexibilityCurriculum flexibility

Reinforcement in reading, written Reinforcement in reading, written language and language and spelling, creative language, study skillsspelling, creative language, study skills

Touch Typing, Computer, Dictaphone skills Touch Typing, Computer, Dictaphone skills

Teaching the language of Maths and Science Teaching the language of Maths and Science

Extra Extra work on Fine or Gross Motor Skillswork on Fine or Gross Motor Skills

Target strengths and weaknesses in specific non-Target strengths and weaknesses in specific non-core subjects i.e. Art, Sports, Music, Drama, DTcore subjects i.e. Art, Sports, Music, Drama, DT

Use of Headphones for independent learningUse of Headphones for independent learning

Speech and Language TherapySpeech and Language Therapy

Use of Video, Interactive Whiteboards Use of Video, Interactive Whiteboards

ComputersComputers

Children with ADHD respond well to an individualised or 1 -1 Children with ADHD respond well to an individualised or 1 -1 settingsetting

Attention is focused on the screenAttention is focused on the screen

Multi-sensory experienceMulti-sensory experience

Non-threatening: can retry problems, constant feedback and Non-threatening: can retry problems, constant feedback and reinforcementreinforcement

Impersonal: computer doesn't yell or have favouritesImpersonal: computer doesn't yell or have favourites

Variety of presentation; attend to novel stimuliVariety of presentation; attend to novel stimuli

Student can control pace, flexible: programmed to do thingsStudent can control pace, flexible: programmed to do things

Rapid assessmentRapid assessment

Game like approach: challengeGame like approach: challenge

  

HomeworkHomework

Ensure homework diary being used efficientlyEnsure homework diary being used efficiently

Reduce homework to only that which is essentialReduce homework to only that which is essential

Shorten assignments (bonus points for doing more)Shorten assignments (bonus points for doing more)

Find ways to reduce writing requirements i.e. dictate into tape Find ways to reduce writing requirements i.e. dictate into tape recorder /allow computer userecorder /allow computer use

Use chart instead of written report, mind mapping etcUse chart instead of written report, mind mapping etc

Give choices/let students design their own homeworkGive choices/let students design their own homework

Earn free homework passesEarn free homework passes

Have student stay at school to finish homeworkHave student stay at school to finish homework

Allow ‘partnering’/Build in social componentAllow ‘partnering’/Build in social component

Let student use ‘parent secretary’Let student use ‘parent secretary’

Some personal skills could be Some personal skills could be

Listen actively to what they sayListen actively to what they say

Use assertiveness as opposed to aggressivenessUse assertiveness as opposed to aggressiveness

Bring energy and optimism into the classroomBring energy and optimism into the classroom

Eliminate Sarcasm and other forms of put downsEliminate Sarcasm and other forms of put downs

Challenge damaging talk about student’s by Challenge damaging talk about student’s by colleaguescolleagues

Use of signs and signals to prevent escalation of Use of signs and signals to prevent escalation of behaviourbehaviour

Feigning shock and surprise at the student’s choice Feigning shock and surprise at the student’s choice of actionof action

Problem solving Problem solving

When do the problems occur (after break, When do the problems occur (after break, start/end of lesson, quiet timestart/end of lesson, quiet time

What are the triggers (interaction with What are the triggers (interaction with other students, boredom, particular tasks)other students, boredom, particular tasks)

In confrontation how does he/she reactIn confrontation how does he/she react

In what way does your response to the In what way does your response to the student affect the outcomestudent affect the outcome

What seems to have a positive affect (your What seems to have a positive affect (your approach; humour, peer pressure, change approach; humour, peer pressure, change of task)of task)

DiscussionDiscussion

Please think or a recent incident involving a child Please think or a recent incident involving a child with ADHD and reflect on the following:with ADHD and reflect on the following:

What happened?What happened?

What did you do?What did you do?

How did it end?How did it end?

How did you feel afterwards?How did you feel afterwards?

Other key areas to consider

• Break time/lunch time• Sports• Field trips• Assemblies/Group gatherings• End of terms

RelationshipsRelationships

Peer understanding about ADHDPeer understanding about ADHD

BullyingBullying

Developing friendshipsDeveloping friendships

Making the class a teamMaking the class a team

Trying to get other parents to Trying to get other parents to understand the issues of ADHD understand the issues of ADHD

Other issues

• Mentoring• Coaching• Counselling

Dealing with issues such as relationships, self esteem, anger management, appropriate interaction with others, lying, stealing, academic expectations, future options etc…

DiscussionDiscussion

What are your own and the views of others that you What are your own and the views of others that you work with on the issue of the use of medication to work with on the issue of the use of medication to support children with ADHD in learning and support children with ADHD in learning and behaviour ? behaviour ?

Medication Options

When ?

• Only after comprehensive evaluation

• When earnest attempts at non-medical interventions have proved insufficient

• When the child is at risk of emotional and/or academic failure

•  

Documented benefits of MedicationDocumented benefits of Medication

CognitiveImproves attention, short term memory, increase amount and accuracy of work completed

MotorReduce activity level, improve handwriting, decrease talkativeness, noisiness, disruptiveness

SocialImprove cooperation, reduce anger, improve parent child interactions, reduce non compliance

Benefits of Long-Acting PreparationsBenefits of Long-Acting Preparations

Provide unbroken coverage throughout the school Provide unbroken coverage throughout the school dayday

Avoid social embarrassment for the child by not Avoid social embarrassment for the child by not having to take medication during the school dayhaving to take medication during the school day

Negate administration of medication during external Negate administration of medication during external activities such as field trips, sports etc..activities such as field trips, sports etc..

Schools do not have the responsibility to store Schools do not have the responsibility to store medication on sitemedication on site

Impact of MedicationImpact of Medication

Medication initially treats the core symptoms of Medication initially treats the core symptoms of ADHDADHD

Flow on effect to improved self esteem and social Flow on effect to improved self esteem and social skillsskills

Improvements allow other strategies to be more Improvements allow other strategies to be more effective i.e. behavioural management, effective i.e. behavioural management, educational strategies etceducational strategies etc

Partnership with ParentsPartnership with Parents

Frequent telephone contactFrequent telephone contact

Frequent parent teacher conferencesFrequent parent teacher conferences

Daily report cardsDaily report cards

– Children with ADHD can place a great deal of Children with ADHD can place a great deal of pressure on family relationshipspressure on family relationships

– Behavioural modification strategies are Behavioural modification strategies are important - to be followed through at home important - to be followed through at home

– Parents must try and look after themselvesParents must try and look after themselves– In persistently difficult situations the In persistently difficult situations the

possibility of unrecognised parental ADHD possibility of unrecognised parental ADHD issues could be consideredissues could be considered

Summary of key ADHD management Summary of key ADHD management optionsoptions

Teach hesitation and attention span skills Teach hesitation and attention span skills

Seating needs to reflect levels of hyperactivity Seating needs to reflect levels of hyperactivity impulsivity and distractibilityimpulsivity and distractibility

Create options for fidgeting, distraction, Create options for fidgeting, distraction, calling out and time keeping.calling out and time keeping.

Set up a 1-1 facility using support staff or other Set up a 1-1 facility using support staff or other resources resources

Use of response cost systems and short term Use of response cost systems and short term token economies token economies

Consideration of Medication in some cases Consideration of Medication in some cases

The Ideal TeacherThe Ideal Teacher

Thoroughly knowledgeable about ADHD and Thoroughly knowledgeable about ADHD and accepts legitimacy of the disorderaccepts legitimacy of the disorder

Tough as nails about rules but always calm and Tough as nails about rules but always calm and positive and runs an absolutely predictable and positive and runs an absolutely predictable and organised classroomorganised classroom

Deals with homework in a pragmatic wayDeals with homework in a pragmatic way

Provides immediate and consistent feedback Provides immediate and consistent feedback regarding behaviourregarding behaviour

Willing to work with outside agenciesWilling to work with outside agencies

Avoids ridicule and criticism and can find a SoH Avoids ridicule and criticism and can find a SoH in trying circumstancesin trying circumstances

ResourcesResources

www.specialdirect.comwww.specialdirect.com