Consultation With Teachers of ADHD Children:

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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
• Dont 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 Comprehension
• Teach 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 Problems
• Encourage 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-taking
• Provide 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
• Dont assume a student will apply what she has
  learned from previous experience.

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The VAKT Approach
Visual, Auditory, Kinesthetic, Tactile

• 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

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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 regulation
• Teach 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 students desk and backpack

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Loses track of time

• 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)

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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. Directions
• Establish eye Contact
• Give One direction at a time
• Have student Repeat directions

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• Attention-Focusing
• Call child by name
• Get eye contact
• Touch childs should or chin

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• Provide student with daily schedule and keep
  classroom routine regular

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• Trouble imitating modeled behaviors
• Provide 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 techniques
• Mnemonics, Clustering, Visualization, Visual
  Rehearsal, Oral Rehearsal
• Use manipulatives

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• Poor problem solving

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• Poor reading comprehension
• Pre-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 comprehension
• Skim, summarize, SQ3R
• Engage in pre-reading, active reading, and
  post-reading activities

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Immature Self-Regulation of AffectMotivation
andArousal
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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 elses shoes
• Help student draw inferences to their own
  experience not to the experiences of others.
• Have concrete written social rules on the
  students 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
• Dont get frustrated
• Dont 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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Impaired Executive/Cogntive Functioning Results
In

• Behavioral Disinhibition
• Poor interference control
• Disinhibited responses
• Deficits in perseverance

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Behavioral Disinhibition
Self-Control
Self-Observation
Self-Perservence
Self-Evaluation
Self-Redirection
Self-Interruption
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Behavioral Symptoms

• Inattention
• Hyperactivity
• Impulsivity

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Behavioral Interventions
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Accommodations

• Strategic Seating
• Away 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 Communications
• Communicate 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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Self-Monitoring

• Prescriptions
• Listen, Look, and Think (ADD Warehouse)
• Vibrating Watch

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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 behavior
• Focus 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 clock
• With 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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Social/Interpersonal Symptoms

• Poor peer relationships
• Lack of friendships
• Poor social skills
• Poor conflict resolution and problem solving
• Oppositional Defiance
• Low self-esteem
• Strained family relationships

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Social/Interpersonal Interventions
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Self-Esteem

• Clear Messages
• Clear 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 Model
• Check it out
• Reach out
• Try it out
• Work it out