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Laura Cerda and Stephanie Davis

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STRATEGIES FOR TEACHING STUDENTS WITH ATTENTION DEFICIT DISORDER (AD/HD)

Introduction

Attention deficit disorders are disorders characterized by serious and persistent difficulties in attention span, impulse control, and hyperactivity. Attention Deficit Disorder (ADD) is a chronic disorder that can begin in infancy and extend through adulthood. It can have a significantly negative effect on an individual's life at home, in school, or in the community. There are two types of attention deficit disorders: undifferentiated Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD). In undifferentiated ADD, the primary and most significant characteristic is inattentiveness but hyperactivity is not present. These students still manifest problems with organization and distractibility, even though they may seem quite and passive. These students also tend to be overlooked more easily in the classroom, and may be at a higher risk for academic failure than those with ADHD.

To be diagnosed as having ADHD a student must display, for six months or more, at least eight of the following characteristics prior to the age of seven:
1) fidgets, squirms, or is restless
2) has difficulty remaining seated
3) is easily distracted
4) has difficulty waiting for his/her turn
5) blurts out answers
6) has difficulty following instructions
7) has difficulty sustaining attention
8) shifts from one uncompleted task to another
9) has difficulty playing quietly
10) talks excessively
11) interrupts or is rude to others
12) does not appear to listen
13) often loses things necessary for tasks
14) frequently engages in dangerous actions

After: "Diagnostic and Statistical Manual of Mental Disorders" (3rd ed., rev.) (American Psychiatric Association, 1987).

CHICAGO, Sept. 30 (AP) - The American Academy of Pediatric Me4dcine has issued its first guidelines for treating attention deficit hyperactivity disorder, suggesting that stimulant drugs may be most effective but that behavioral techniques should also be used. The guidelines appear in the October issue of the medical journal Pediatrics, which will be released Monday.

As many as 3.8 million school-age children, most of them boys, are believed to have attention deficit disorders. Symptoms may include a short attention span, impulsive behavior and difficulty sitting still. The guidelines, which fall in line with those issued in recent years by the National Institute of Mental Health, were created in consultation with child psychiatrists and psychologists. They suggest that the evidence favoring medications like Ritalin is stronger than the evidence about behavioral therapy.

Symptoms improve in at least 80 percent of children on stimulants, and medication should be switched if it is not working, the guidelines say. Critics say that many doctors and teachers turn to drugs like Ritalin as an easy fix and that their long-term effects are uncertain. The guidelines say any treatment should begin only after a diagnosis is certain and doctors, parents and teachers have discussed appropriate treatment goals. The guidelines say drugs should be used with behavioral techniques, including time-outs for hitting. They call for rewarding children when they complete tasks, like homework.

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General Strategies

  • Bring to the student's attention science role models with disabilities with a similar disability to that of the student. Point out that this individual got ahead by a combination of effort and by asking for help when needed.
  • Student monitoring, self management, discipline, and encouragement can be a very important aspect for academic success. Below are the two basic aspects of AD/HD facilitation.
  • Self-monitoring techniques can be very effective in the school setting. Self-monitoring of attention involves cueing the student so that he/she can determine how well he/she is attending to the task at hand. Cueing is often done by providing an audio tone such as a random beep, timer, or the teacher can give the cue. The student then notes whether he/she was on or off task on a simple recording sheet. Self-monitoring techniques are more likely to be effective when tied to rewards and accuracy checks.
  • Behavior management techniques must often be used in the learning environment. By examining a student's specific problem behavior, understanding it's antecedents and consequences, teachers can help students with AD/HD to develop behaviors that lead to academic and social successes.
  • Provide supervision and discipline:
    • Monitor proper behavior frequently and immediately direct the student to an appropriate behavior.
    • Enforce classroom rules consistently.
    • Avoid ridicule and criticism. Remember that students with AD/HD have difficulty staying in control.
  • Providing Encouragement:
    • Reward more than punish.
    • Immediately praise any and all good behavior and performance.
    • Change rewards if they are not effective in motivating behavioral change.
    • Find alternate ways to encourage the AD/HD students.
    • Teach the student to reward himself or herself. Encourage positive self-talk (e.g., "You did very well remaining in your seat today. How do you feel about that?"). This encourages the student to think positively about himself or herself.
  • Bring to the student's attention science role model who has a disability similar to that of the student with an impairment. Point out that this individual got ahead by a combination of effort and by asking for help when needed.
  • Reduce the amount of materials present during activities by having the student put away unnecessary items. Have a special place for tools, materials, and books.
  • Reward more than you punish, especially with positive reinforcers.
  • Try to be patient with an AD/HD student.
  • Seat students with AD/HD in the front near the teacher with their backs to the rest of the class. Be sure to include them as part of the regular class seating.
  • Place these students up front with their backs to the rest of the class to keep other students out of view.
  • Surround students with AD/HD with good peer models, preferably students whom the AD/HD student views as significant peers.
  • Encourage peer tutoring and cooperative/collaborative learning.
  • A class that has a low student-teacher ratio will be helpful to a student with AD/HD.
  • Avoid all distracting stimuli. Try not to place students with AD/HD near air conditioners, high traffic areas, heaters, doors, windows, etc.
  • Avoid transitions, physical relocation, changes in schedule, and disruptions.
  • Be creative! Produce a somewhat stimuli-reduced study area with a variety of science activities. Let all students have access to this area.
  • Encourage parents to set up appropriate study space at home, with set times and routines established for study. Also, use this home area for parental review of completed homework, and periodic notebook and/or book bag organization.
  • Educational, psychological, and/or neurological testing is recommended to determine learning style, cognitive ability, and to rule out any learning disability (LD is common in about 30% of students with AD/HD).
  • A private tutor and/or peer tutoring will be helpful to a student with AD/HD.
  • Have a pre-established consequences for misbehavior, remain calm, state the infraction of the rule, and avoid debating or arguing with the student.
  • Avoid publicly reminding students on medication to "take their medicine."

Source:  http://www.as.wvu.edu/~scidis/add.html

 

 

 

STRATEGIES FOR TEACHING STUDENTS WITH

BEHAVIORAL DISORDERS

Behavioral disorders also known as conduct disorders are one of the most common forms of psycho pathology among children and young adults and is the most frequently cited reason for referral to mental health services. The appearance of behavioral disorders is increasing dramatically in our K-12 classrooms. As a result their presence severely constrains the ability of the school systems to educate students effectively. The prevalence of behavioral problems among children and young adults is substantial. Many surveys indicate that behavioral disorders vary among young adults, ranging from 2 and 6% in K-12 students. This percentage translates into 1.3 to 3.8 million cases of behavioral disorders among the school and pre-college population.

Behavioral disorders become apparent when the student displays a repetitive and impact persistent pattern of behavior that results in the significant disruption in other students. Such disturbances may cause significant impairments in academic, social, and or occupational functioning. Such a behavior pattern is consistent throughout the individuals life. Among the characteristics of a behavioral disorder among children and adolescents are:

  • Initiation of aggressive behavior and reacting aggressively towards others.
  • A display of bullying, threatening, or intimidating behavior.
  • Being physically abusive of others.
  • Deliberate destruction of other's property.
  • Showing little empathy and concern for the feelings, wishes, and well being of others.
  • Showing callous behavior towards others and lack of feelings of guilt or remorse.
  • They may readily inform on their companions and tend to blame others for their own misdeeds.

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General Strategies

  • Bring to the student's attention science role models with disabilities with a similar disability to that of the student. Point out that this individual got ahead by a combination of effort and by asking for help when needed.
  • Ask previous teachers about interactive techniques that have previously been effective with the student in the past.
  • Expose students with behavioral disorders to other students who demonstrate the appropriate behaviors.
  • Direct instruction or target behaviors is often required to help students master them.
  • Have preestablished consequences for misbehavior.
  • Administer consequences immediately, then monitor proper behavior frequently.
  • Determine whether the student is on medication, what the schedule is, and what the medication effects may be on his or her in class demeanor with and without medication. Then adjust teaching strategies accordingly.
  • Use time-out sessions to cool off disruptive behavior and as a break if the student needs one for a disability-related reason.
  • In group activities, acknowledge the contributions of the student with a behavioral disorder.
  • Devise a contingency plan with the student in which inappropriate forms of response are replaced by appropriate ones.
  • Treat the student with the behavioral disorder as an individual who is deserving of respect and consideration.
  • When appropriate, seek input from the student about their strengths, weaknesses and goals.
  • Enforce classroom rules consistently.
  • Make sure the discipline fits the "crime," without harshness.
  • Provide encouragement.
  • Reward more than you punish, in order to build self-esteem.
  • Praise immediately at all good behavior and performance.
  • Change rewards if they are not effective for motivating behavioral change.
  • Develop a schedule for applying positive reinforcement in all educational environments.
  • Encourage others to be friendly with students who have emotional disorders.
  • Monitor the student's self-esteem. Assist in modification, as needed.
  • Self-esteem and interpersonal skills are especially essential for all students with emotional disorders.
  • Do not expect students with behavioral disorders to have immediate success; work for improvement on a overall basis.
  • As a teacher, you should be patient, sensitive, a good listener, fair and consistent in your treatment of students with behavioral disorders.
  • Present a sense of high degree of possessiveness in the classroom environment.

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Teacher Presentation

  • After a week, or so, of observation, try to anticipate classroom situations where the student's emotional state will be vulnerable and be prepared to apply the appropriate mitigative strategies.
  • By using examples, encourage students to learn science so they can emulate adult behaviors.
  • Check on the student's basic capacity to communicate and adjust your communications efforts accordingly.
  • Use a wide variety of instructional equipment which can be displayed for the students to look at and handle.
  • When an interest in a particular piece has been kindled, the instructor can talk to the student about it and show him or her how to use it.
  • Instructions should be simple and very structured.
  • Group participation in activities is highly desirable because it makes social contacts possible.
  • Monitor the student carefully to ensure that students without disabilities do not dominate the activity or detract in any way from the successful performance of the student with the behavioral disorder.
  • Teachers should reward students for good behavior and withhold reinforcement for inappropriate behavior.
  • Some aggressive students act as they do because of a subconscious desire for attention, and it is possible to modify their behavior by giving them recognition.
  • Have the individual with the behavioral disorder be in charge of an activity which can often reduce the aggressiveness.
  • Special efforts should be made to encourage and easily facilitate students with behavioral disorders to interact.
  • Show confidence in the students ability and set goals that realistically can be achieved.
  • Plan for successful participation in the activities by the students. Success is extremely important to them.
  • The environment must be structured but sensitive to the needs of these youth with behavioral disorders.
  • Expose students with behavioral disorders to other students who demonstrate the appropriate behaviors.
  • Direct instruction or target behaviors is often required to help students master them.
  • Consultation with other specialists, including the special education teacher, school psychologist, and others may prove helpful in devising effective strategies.
  • Keep an organized classroom learning environment.
  • Devise a structured behavioral management program.
  • As an educator you serve a model for the students who are behaviorally disturbed. Your actions therefore, must be consistent, mature, and controlled. Behavioral outbursts and/or angry shouting at students inhibit rather than enhance a classroom.
  • Provide a carefully structured learning environment with regard to physical features of the room, scheduling, routines, and rules of conduct.
  • If unstructured activities must occur, you must clearly distinguish them from structured activities in terms of time, place, and expectations.
  • Let your students know the expectations you have, the objectives that have been established for the activity, and the help you will give them in achieving objectives.
  • When appropriate, seek input from the students about their strengths, weaknesses and goals.
  • Do not expect students with behavioral disorders to have immediate success; work for improvement on a overall basis.
  • Be fair and consistent, but temper your consistency with flexibility.
  • You should refer the students to visual aids and reading materials that may be used to learn more about the techniques of skill performance.
  • Present a sense of positiveness in the learning environment.
  • Remain calm, state the infraction of the rule, and avoid debating or arguing with the student with a behavioral disorder.
  • Have preestablished consequences for misbehavior.
  • Administer consequences immediately, then monitor proper behavior frequently.
  • Enforce classroom rules consistently.
  • Make sure the discipline fits the "crime," without harshness.
  • Provide encouragement.
  • Reward more than you punish, in order to build self-esteem.
  • Praise immediately and all good behavior and performance.
  • Change rewards if they are not effective for motivating behaviral change.
  • Find ways to encourage the student.
  • Be positive and supportive.
  • Develop a schedule for applying positive reinforcement in all educational environments.
  • Encourage others to be friendly with students who have emotional disorders.
  • Monitor the student's self-esteem. Assist in modification, as needed.
  • Self-esteem and interpersonal skills are especially essential for all students with emotional disorders.

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Laboratory

1.   Use the appropriate general strategies, given above.

2.   Consider alternate activities/exercises that can be utilized with less difficulty for the student, but has the same or similar learning objectives.

3.   If unstructured activities must occur, you must clearly distinguish them from structured activated in terms of time, place, and expectations.

4.   Be sensitive when making team pairings for activities so that the student with an emotional disorder is supported.

5.   Use a wide variety of instructional equipment which can be displayed for the students to look at and handle.

6.   When an interest in a particular piece has been kindled, the instructor can talk to the student about it and show him or her how to use it.

7.   Activity instructions should be simple but structured.

8.   Monitor carefully to ensure that the students without disabilities do not dominate the activity or detract in any way from the successful performance of the student with the behavioral disorder.

9.   If unstructured activities must occur, you must clearly distinguish them from structured activated in terms of time, place, and expectations.

10.               Special efforts should be made to get students with behavioral disorders to interact in laboratory activities.

11.               If a student must be denied permission to use the equipment, this should be done on an impersonal basis so the student will not feel hurt or discriminated against.

12.               Plan for successful participation in the laboratory activities by the students with behavioral disorder. Success is extremely important to them.

13.               To ensure success consider the special needs and interests of each person; give friendly, patient instruction in the laboratory skills; and continually encourage a wider interest in activities.

14.               When a student displays a reaction of dislike to the activities this dislike usually stems from fear or lack of experience for the activity or factors inherent within the situation itself.

15.               Some students with behavioral disorders may go to great lengths to avoid class participation. To feign their disorder is the method most frequently used, in hope of being excused from participation.

16.               Every effort should be made to arouse the interest of such students in laboratory activities, so they will learn to perform the activities with success and pleasure.

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Group Interaction and Discussion

  • Acknowledge the contributions of the student with an emotional disorder.
  • Call for responses and participation commensurate with the student's socialization skills.
  • As the student's comfort level rises and when a safe topic is available, encourage the student to be a group spokesperson.
  • Along with the student, devise a contingency plan in which inappropriate forms of response are replaced by appropriate ones.
  • Gradually increase the challenges in the student's participation in group exercises while providing increased positive reinforcement.
  • Help the student to feel as though he or she has something worthwhile to contribute to the discussion.
  • Some students may experience considerable strain in social adjustment in a group context. It may be necessary to work gradually toward group activities. One can devise a strategy of progressing from spectatorship to one-to-one instruction and eventually to small group discussion.
  • Should monitor carefully to ensure that the nondisabled students do not dominate the discussion or detract in any way from the successful performance of the student with the behavioral disorder.

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Reading

  • It is necessary to target specific prosocial behaviors for appropriate instruction and assessment to occur such as:

1.   Taking turns, working with partner, following directions.

2.   Reading in group or with others.

3.   Increasing positive relationships by means of awards when they read appropriately.

4.   Demonstrating appropriate reading

  • Instructional strategies involving self-control, self-reinforcement, self-monitoring, self-management, problem solving, cognitive behavior modification, and metacognitive skills should be focused on teaching students reading skills

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Research

  • Review and discuss with the student the steps involved in a research activity. Think about which step(s) may be difficult for the specific functional limitations of the student and jointly devise accommodations for that student.
  • Use appropriate laboratory and field strategies.
  • Depending on the site of the research check the previous two sections.
  • Show clear examples of what the students should expect as an outcome of their research.

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Field Experiences

  • Use appropriate general strategies.
  • Consider alternate activities/exercises that can be utilized with less difficulty for the student, but has the same or similar learning objectives.
  • In field activities acknowledge the contributions and assistance of the student with an emotional disorder.
  • Help the student to feel as though he or she has something worthwhile to contribute to the field trip.
  • Use a buddy system.
  • Gradually increase the challenges in the student's participation in field exercises while providing increased positive reinforcement.
  • Group participation in field activities is highly desirable because it enhances social contacts.
  • Make the student with the behavioral disorder become one of the field trip leader of an activity which can often reduce their disorder.
  • Special efforts should be made to get students with behavioral disorders to interact with other students.
  • You should encourage students to practice field skills during their free hours.
  • Every effort should be made to arouse the interest of such students in activities, so they will learn to perform the activities with success and pleasure with appropriate behaviors.

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Testing

  • Be sensitive to the student's reactions to the various aspects of assessment.
  • For each student, accumulate in his or her portfolio several examples of work (quizzes, assignments, projects) that demonstrate knowledge of the subject matter or the unit of study.
  • Make special arrangements for the student with an emotional disorder according to what their special needs are and that they do not compromise the integrity of the testing situation.
  • Stay on top of student progress through informal assessment, don't wait until it's too late to discover that there is a problem.
  • Provide private room/smaller group setting/alternative test site (with proctor present); alternatively screens to block out distractions.

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Reference:

http://www.as.wvu.edu/~scidis/behavior.html