Haley Valero

Sister Mary Ann Jacobs

EDUC 360
April 18th, 2017

Attention Deficit Hyperactivity Disorder: Problems, Strategies, and Methods of Intervention

Anxiousness, irritability, and uneasiness are common feelings experienced by many in

intense or stressful settings or situations. Imagine experiencing these emotions at all times.
Imagine dealing with these feelings in a classroom setting and being expected to control them
when they are very much prominent in your body and on your mind. Imagine yourself in the
body of someone with Attention Deficit Hyperactivity Disorder, trying to suppress your anxieties
that weigh on you like a bridge on your shoulders, while sitting in a classroom, forced to
complete all necessary tasks demanded of you. Im sure you could imagine that this would be
extremely challenging and demand much of your effort, patience, and focus.
Attention Deficit Hyperactivity Disorder, commonly known as ADHD, is a
developmental, neurological condition defined by the presence of severe and pervasive
symptoms of inattention, hyperactivity, and impulsivity. (Daley Birchwood) To be classified as
having this disorder, one must exhibit a number of inattentive, impulsive, and hyperactive
behaviors over a period of 6 months before the age of 7. These behaviors must be exhibited in
both a classroom and in an at home setting and significantly impair ones daily functioning and
ability to achieve academic success. Some signs of ADHD are excessive talking, inability to
listen when being spoken to, a tendency to interrupt or disturb others, and frequent fidgeting.
I had always been aware of the commonality of this disorder among many children, and
now teenagers and adults, yet I have never understood why most people turn only to
pharmaceutical drugs for treatment purposes. I have been around friends and family members
with ADHD since I was young and I always couldnt help to think that there could be other ways
of managing behavior in conjunction with or without the use of pharmaceutical drugs. During
my observation hours, I spent ten hours with a young boy with ADHD who is now in the eighth
grade. Thomas is a 13 year old boy who had been diagnosed with Attention Deficit Hyperactive
Disorder at age 5 and has an IEP of OHI with ADHD, as well as ODD, which is Oppositional
Defiant Disorder. Thomas is in a general education class, despite his disability and this often
times hinders the success of other students in the classroom, as well as his own. Thomas often
times tries to talk with the peers around him, he tends to daydream and look out the window, he
has trouble focusing on what the teacher is saying, although he sometimes appears to be
listening, he refuses to take notes, and constantly tries to leave the room, asking to go to the
bathroom.
Under the IDEA, Individuals With Disabilities Education Improvement Act, I know that
every student is entitled to an appropriate education that is designed to meet each students
individual needs. Therefore, I know that there is more that can be done to aid Thomas in his
academic struggles. From what I can see, Thomas is less likely to misbehave when working in
groups, yet he struggles to complete tasks independently. Whenever attention is not on him, he
will click his pen, make noise, mutter words under his breath, or play with whatever is in front of
himripping the paper in his notebook and ripping erasers off pencils. As the day gets longer, he
tends to stop working completely or makes excuses to leave the room. From what I can see,
Thomas seems to be either bored with his work or tired, which is why he becomes uninterested,
reluctant to complete assignments, and attempts to clock out. Thomas teacher is forced to
constantly stop teaching and direct his attention to him, asking him to Please stop, or to
Please do you work. Because of his frequent misbehavior as well as the misbehavior of a few
other students in the classroom, the teacher is unable to get through his lesson without it being a
struggle. I believe that if Thomas received more attention and was encouraged to do his work
more, rather than being told what not to do, he would be more motivated to complete his
assignments.
In Julie Clarfield and Gary Stoners article, The Effects of Computerized Instruction on
the Academic Performance of Students Identified with ADHD, they identify students with
Attention Deficit Hyperactive Disorder to be at a higher risk than average for a variety of
behavioral difficulties and academic problems, with as many as 80% of students with ADHD
undergoing academic performance problems and lower work completion rates. Clarfield and
Stoner bring light to this disability because of the fact that many of students who have ADHD are
in need of effective intervention strategies to address their academic problems caused by this
disorder. These two researchers performed a study implementing the use of computer-assisted
instruction, also referred to as CAI, in which the investigation involved the examination of a
recently developed computerized reading instruction programHeadsprout and its efficacy on
assisting children with ADHD in learning.
The research involved three participants, all of whom are Caucasian and male. These
three kindergarten and first grade students were considered at risk for reading difficulties based
on teacher reports, standardized assessment scores, and referrals to the school psychologist due
to lack of progress in the area of reading. Kevin, Joe, and Tim had all been receiving aide for
literacy, with Kevin and Joe (first graders) in a Reading Recovery instruction program for 30
minutes per day and Tim (kindergartner) in Literacy Collaborative activities for 2 hours per day.
Both Tim and Joe were prescribed prescription medication, which they took daily, while Kevin's
parents refused, along with a diagnostic evaluation at the time, although they had agreed to
complete the participant screening for the study. Prior to the investigation, the researchers went
through a few assessment procedures, including rating scales from the BASC (Behavior
Assessment System for Children), which is a diagnostic rating scale that differentiates diagnosis
among behavioral and emotional disorders, an interview with the parents of each participant,
and each participants pediatric diagnosis.
The Headsprout computer reading instruction program is internet based and had been
chosen by Clarfield and Stoner as the CAI they would use in this study because of its explicit
instruction in phonemic awareness and phonics. This CAI was used particularly because of its
approach in teaching students with ADHD consistent letters and sounds, segmenting and
blending strategies, fluency building exercises, how to recognize using punctuation cues, and it
also includes explicit instruction in building sight word vocabularies. With the use of the
Headsprout program, each student would complete 40 individualized lessons, specific to the
needs of each student and are comprised of over 180 active learner interactions per lesson. The
program is designed to adapt to the students paces in order to minimize the gap between their
learning and their peers learning, as well as to increase their success rates in each lesson to a
minimum of 90%. Through each mini lesson, students are able to track their own progress, in
which their animated character will move to a new destination on their map after each completed
task. Each time a lesson is completed, the program provides the student with feedback that
includes further encouragement and constructive criticism, if necessary. When all 40 lessons are
finished, each students receives a story book encompassing all the words and sounds learned
throughout each task, so that they can refer back to their learning. By being able to learn through
fun activities that include entertainment, colors and sounds and give positive feedback, students
become more motivated to learn and participate.
The study took place in the spring of 2003 in which students were observed twice a week
during baseline conditions (independent variable) and then further observed for twice a week as
well, during the experimental condition (dependent variable) and once a week for the two
following weeks afterwards. Observation was performed by the author, Julie Clarfield and a
graduate student who recorded the observed amount of off-task and engaged behavior during
lengths of 15 second intervals across10 minute sessions while students performed independent
and group work. The instructional framework of the Literacy Collaborative is that students learn
literacy skills during authentic reading and writing experiences that include shared reading,
guided reading, independent reading, shared writing, interactive writing, and independent
writing along with phonics about 2-4 times a week.
During the experiment (dependent variable), students worked on the CAI during
nonacademic periods, 3 times a week, for 20-30 minute sessionscompleting approximately one
lesson per session. The results of the study showed that the CAI intervention produced both
higher mean levels of oral reading fluency and greater rates of growth as compared to the
baseline rates, which increased from 6 to 18, 14 to 33, and 10 24 in words read correctly for
Tim, Kevin, and Joe, respectively. Their success rates significantly outweighed the expected rates
of growth for students in special education. Each students rates of off-task behavior decreased
significantly along with the increase of reading levels, in which Tm, Kevin, and Joe were off task
3%, 6%, and 4% respectively, which is a great drop from the baseline percentages of 24%, 49%,
and 26%. These results present that a few weeks of the implementation of a computer assisted-
instruction program show immediate improvement in both academic skill development and
classroom behavior for all 3 students.
Although the study suggest that there are benefits of CAI for improving learning and
academic performances of children with ADHD, the use of a small number of participants in
only one school, places limitations on the generalizations we can conclude from the
investigation. However, significant increases in academic performances were reached. Besides
the fact that the study is limited, the means of accessing programs similar to Headsprout are also
limited because of the fact that hardware to operate programs like these are expensive. In the
future, with growing technology and its increase in availability, more research similar to this
should be conducted with he use of CAIs in larger groups of students both with and without
ADHD.
In the article, Peer Tutoring for Children with Attention Deficit Hyperactivity Disorder:
Effects on Classroom Behavior and Academic Performance, authors DuPaul, Ervin, Hook, and
McGoey identify ADHD to be a major medical issue that causes students to exhibit higher than
average rates of off-task behavior in classroom settings, affecting students performance on
independent assignments, in group discussions, and in attending to teach instruction. These
authors find Attention Deficit Hyperactivity Disorder to be significant because of its link to
academic underachievement of students and the risks it poses to them, in regards to learning. It is
noted in this article that prescription medication used to stimulate particular areas of the brain are
proven to be effective in enhancing productivity in students with ADHD, however, it is believed
that that same enhancement in learning can be found through other means, such as immediate
feedback using individualized academic content (Piffner & Barkley, 1990).
 In order to produce a change in academic performance in students with this disorder,
positive reinforcement first, needs to be implemented through targeting scholastic behaviors,
such as in-class assignments and homeworkthis needs to be more than just the use of
pharmaceutical medications and contingency management plans within the classroom, but
possibly and preferably, the implementation of peer tutoring. Peer tutoring is an instructional
strategy in which two students work together on an academic activity, with one student providing
assistance, instruction, and feedback to another, as a means of positive reinforcement to increase
on-task behavior and decrease off-task behavior.
These four teacher-researchers conducted a study of 29 students19 with ADHD and 10
withoutwith the purpose of exploring the effects of CWPT, also known as class-wide peer
tutoring, which was implemented to achieve higher levels of the academic performance, task
engagement levels, and activity levels of students with this disorder. Out of the 19 students with
ADHD, were children in grades 1-5, in two schools (one urban and one suburban), who met the
criteria for the study which included: teacher and parent complaints of inattentive, impulsive,
and highly active behavior, clinically significant symptoms of ADHD, a presence of a8 of the 14
symptoms of ADHD to a significant degree, have an average intelligence, and a written or oral
content from both the parents and the child to participate. Teachers had referred the 10 peer
comparison children to tutor the children with ADHD because of the fact that they had never
been referred for leaning or behavior problems and they displayed appropriate behavior.
The childrens performance and behavior were monitored over a period of two school
years, within eighteen different classrooms, during academic instruction in a specific subject
area, which is usually the students weakest subjects. These observations were conducted about
3-4 times a week while students worked on a specific skill for 15-20 minutes per session. During
this time of class wide peer tutoring, the tutor was given a script of the academic material
covering the days lesson, in which the tutee would respond to orally. Each time the tutor would
receivee a correct response from the tutee, the pair would be awarded two points. Each pair of
students would then switch roles, now receiving instruction from the former tutee for an
additional 10 minutes.
The results of the study indicated that the students displayed an improvement in active
on-task behavior. The studies also demonstrated that with the removal of CWPT after the
implementation of it, had trained the students to work independently, resulting in an increase in
passive on-task behavior as well. The comparison peers that originally served as the tutors, also
exhibited higher rates off active and passive on-task behavior. Results also showed that CWPT
increased active engaged time for students with ADHD and reduced their disruptive off-task
behavior, proving the hypothesis that the tests would be successful in these areas was in fact
effective. The study proved that peer-mediated interventions can produce significant increases in
attention to academic materials, even among children with serious attention and behavioral
problems. It was found that the CWPT induced an increase in on-task behavior, similar to that
of which is produced by amphetamine drugs. If schools were to implement intervention in
general educational settings and make students more active responders to academic instruction, it
is likely that their participation, endurance, and motivation will be heightened. With long term
exposure to these types of interventions, like that of CWPT, academic success in test scores, as
well as students behavior will likely increase as well.
In Su-Je Cho and Kwang-Sun Cho Blairs article, Using a Multicomponent Function
Based Intervention to Support Students with Attention Deficit Hyperactivity Disorder, they
identify ADHD to be one of the most widely diagnosed disorders among public school
students. who experience a variety of issues such as overactivity, difficulty following teacher
instruction, and off-task behaviors, often times putting the child at risk for academic failure.
These authors conducted a study evaluating the effects of a multicomponent function-based
intervention on students with other health impairments for Attention Deficit Hyperactivity
Disorder. This intervention method will assist students with ADHD by providing them with a
highly structured classroom, and organized daily routine, and preference in activities and breaks
in order to reduce problem behavior and increase on task behavior.
To investigate whether this multi-component fiction-based intervention would be
effective, the researchers used more intense techniques with the focus of targeting behavioral
functions toincrease student active engagement in learning and to promote appropriate or
replacement skills. Prior study, it had been found in other research that this form of intervention
was in fact efficient in the sense that it had been used to decrease problem behavior in students
with ADHD who exhibit high intensity behavior. This study puts the hypothesis that the
intervention will produce signs of an increase in not ask behavior and a decrease in problematic
behavior to the test through the improvement of the classroom setting and with the use of fidelity
plans.
Cho and Cho Blair's study was supervised in a self-contained classroom in a special
education private elementary school, involving two students and one teacher. The usual
classrooms consist of 8-12 students with learning, language, and behavioral disabilities, one
teacher, and assist teacher, and paras where necessary. The two students involved in the study
were in the sixth grade, both with IEPs. Katrina, a female, Caucasian student had an IEP with an
OHI for ADHD as well as EBD, emotional and behavioral disorder. Her teachers had indicated
that she had a difficult time following instruction, maintaining focus, and completing tasks. She
required much assistance from the teacher and when not given attention to, would call out, blame
other for her behaviors, and had drastic mood changes. Her behavior affected her and her
classmates academic success because it prevented the teacher from being able to carry out
lessons. Sam, a 13 year old, male, Caucasian student, also had an IEP of OHI for ADHD, along
with PDD, pervasive developmental disorder. Sam was below average in regards to his level of
performance in both English and language arts, struggled with understanding and remembering
fact and details. He also had a difficult time following instruction, completing tasks, and
remaining attentive, like Katrina. Their teacher noted that he too struggled with managing their
behavior in the classroom.
The investigation aimed to target their areas of weakness in problem behavior and
academic engagement, such as aiding in the completion of tasks and creating organizational
skills for both Sam and Katrina. The researchers recognized that the students would engage in
off-task behavior when they werent receiving attention or if they were working on a task they
weren't interested in, therefore they would get out of their seat, call out, become distracted, and
daze off. The data of the study was accumulated on a recording system, indicating the number of
academic engagements and problematic behaviors carried out by each student, 3-4 times a week
during 40 minute activities.
The students were given fidelity checklists appropriated to their individual needs12
strategies for Katrina and 13 for Sam. The checklists were comprised of self monitoring tasks
such as completing a self recording sheet, review ing the sheet with the teacher, and receiving
verbal feedback for correctly using the checklist. The classroom setting was altered by
implementing a schedule board and an activity sequence chart so that students can know what to
expect, in regards to the lesson and tasks. Five minute warnings were used to let Sam and
Katrina know when the lesson would switch from preferred to non-preferred activities. They
were also allowed breaks and the opportunity to put water on their face when feeling tired. The
teacher encouraged students to raise their hand when needed, to monitor their own behavior and
control their impulses, and to set goals for themselves. The teacher then would respond to their
behavior with social praise and allowance for free time or access to preferred activities.
After four weeks of the implementation of these intervention strategies, the results
showed that problem behavior by the two students decreased while their academic engagement
increased in each academic period when multicomponent function-based interventions were
implemented. The teacher was also able to carry out these functions effectively, by promoting
the students engagement and getting them to complete their tasks without his assistance. The
rearrangement of the classroom environment and the use of self monitoring techniques were also
effective in that students exhibited an immediate decrease and almost extinction in problematic
and off-task behavior. Although this study was successful in this particular case, there are
limitations, in regards to the fact that there is a likelihood that supervisors may fail to effectively
use these methods of intervention to manage students' behavior in schools that lack appropriate
funding, time, supervision and training.
After conducting my research on strategies to aid students with ADHD, I devised a plan
for Thomas, the student I observed, based on some of the methods and techniques I found to be
useful within these articles. Because Thomas has a hard time listening and responding to
instruction, is very impulsive and has a hard time sitting still, carrying out academic tasks and
monitoring his impulsivity, I figured that the techniques used with Sam and Katrina in the
multicomponent function-based intervention study would also be useful if applied to Thomas.
With the permission of Thomas teachers, I came up with a checklist for him to use in each class,
which would help him to monitor his behavior. The checklist was comprised of a series of
questions, in which Thomas could circle yes or no to answer. The questions were: (1) was I
paying attention to my assigned work? (2) was I following the classroom rules? (3) did I use
appropriate classroom language? (4) did I follow the teachers directions? (5) did I ask for help if
I did not understand something? (6) did I become distracted or distract others? (7) did I copy my
notes? (8) did I click my pen or make noises? Since I was only with Thomas for two days, I was
only able to implement the use of the checklist on my second day with him, however, he
completed what Cho and Cho Blair would call a fidelity checklist, and his behavior did seem
to improve from the prior day. Since Thomas had been seated in the first row next to the window,
I suggested to the teacher that he be seated in another row, away from the window, but in the
front still, with he purpose of preventing him from dazing off and daydreaming and motivating
him to remain focused and on task. With the completion of the checklist, I provided Thomas with
positive feedback, reminding him that he was doing very well with following directions, and
received permission to allow him to take a break to walk throughout the halls before his fifth
period class, so that he could refresh and have an outlet from a non-classroom setting.
When it came time for group work, Thomas was more inclined to participate, therefore I
suggested that the teacher implements peer tutoring by means of helping Thomas to stay on task
with the assistance of one of his peers, who dont exhibit problematic behavior. I took this idea
from the article I researched on peer wide tutoring because off its efficacy on students with
ADHD in the study they conducted. I dont know whether or not the teacher did or did not
attempt to use this strategy, but it did not happen over the course of my time there. I also thought
that the implementation of a CAI, similar to Headsprout, would be effective in his case because
of the fact that it was proven to be useful in Clarefield and Stoners study in the improvement of
on-task behavior and the reduction of off-task behavior. The use of a CAI would also be a fun
way for Thomas to become engaged in learning as an alternative means of instruction.
Although I think that the plan I came up with for Thomas would be extremely useful to
him and would most likely increase his performance levels in the classroom and hopefully
decrease his problematic behavior, I wonder if the teacher would take these strategies into
consideration and apply them to her classroom and all her classes, for not just Thomas, but for
any other students with academic and behavioral issues. I also wish I had the opportunity to
spend more time in Thomas class room so that I could see if the teacher would adopt any of
these techniques and incorporate them to her own lesson. I would also like to know if the
strategies were effective, if they were in fact used. I can only take my new knowledge, strategies
and techniques under my belt and implement them into my own classroom in the future in order
to assure that I am attending to the needs of all my students.