Effective Strategies When Teaching Students with ADD / ADHD

Danette Sack The American School of The Hague

Adapted from ASH Middle School Workshop

I have come to a frightening conclusion That I am the decisive element in the classroom. Its my personal approach that creates the climate. Its my daily mood that makes the weather. As a teacher, I possess a tremendous power To make a childs life miserable or joyous. I can be a tool of torture Or an instrument of inspiration. I can humiliate or humor, hurt or heal. In all situations, it is my response that decides whether a crisis will be escalated or de-escalated and a child humanized or dehumanized. --Haim Ginott

The characteristics of students with ADD/ADHD can vary greatly. A diagnosis does not dictate a specific response from educators. ADD/ADHD differs from specific learning disabilities in that its effects are not confined to a particular area. Rather, the attention difficulties and impulsivity associated with the disorder may give rise to behaviors that interfere with learning in all academic and social arenas. Regarding problem solving, the array of symptoms and behaviors associated with this disorder can make it difficult for a teacher to know where to start. A student who is inattentive, impulsive, and/or hyperactive may make a conscientious teacher feel overwhelmed. Therefore, certain problem behaviors may need to be extinguished while other constructive replacement behaviors will need to be developed. A systematic approach to behavioral intervention can lead to a greater sense of control and focus for the teacher, the student with ADD / ADHD, and the class as a whole. Isolate problem behaviors: While many behaviors may be unusual or irritating, it is necessary to prioritize the behaviors that are most problematic. Specificity is the key. Limit your problem solving to behaviors that interfere with a students academic achievement or disrupt the ability of others to do their work. Example: Jason calls out when I am giving directions to the whole class. Analyze the behavior: Effective methods of behavioral analysis consider the setting of the behavior as well as its end results. This is referred to as functional analysis of behavior or antecedent-behavior-consequence (ABC) analysis. In other words, when and where does the behavior take place and what typically happens as a result?

Example: Antecedent

Behavior

Consequence

I am giving directions to the class. Jason is fishing through his desk for his agenda and misses some of what I say. He raises his hand, but when I dont call on him immediately

he interrupts me with his question.

I ask him to wait until Im finished giving the directions. He generally persists. I know he has a hard time staying focused. Since his question is on the topic, I answer it so hell be up to speed with the rest of the class.

Determine the function of the behavior: Behavior that is repeated generally serves some function. It may not be the most socially acceptable or expedient means to an end, but it helps the student to meet some perceived need. Students may have considerable insight as to why they act in certain ways. Talk to the student! Example: Jasons questions usually come up when he misses some piece of information. I spoke to him privately and asked him why he does not wait until Im finished with my instructions to ask a question like everyone else. He said its hard for him to focus because hes worried about what he missed. He thinks that if he waits, hell forget his question. I determine that when he calls out, he is alleviating his anxiety and getting the help he needs. By examining the antecedents and consequences of the behavior, a teacher may find ways to reduce the frequency of the behavior. Changes in the environment may reduce the students need for the behavior. Changing the response to the behavior may make it less effective in meeting the perceived need. Example: After talking to Jason, I realized that I could easily record the steps to be done on the board as I give instructions. This way he wont get lost so often. When he does call out, I need to make sure that I dont answer his question immediately (delay gratification). Formulate a replacement behavior: Ideally, the replacement behavior should serve the same function as the problem behavior while allowing him/her to benefit from instruction. Be positive. Spell out what the child WILL do rather than what they wont do. Example: Jason should write down his question or a word to remind him of his question so hell be able to ask when I finish with the instructions. This doesnt meet his need as quickly as before. If he knows I will answer his question later, it may reduce his anxiety.

Punishment, or negative reinforcement, while perhaps immediately effective, is often counterproductive in the long run. It works only to suppress problem behaviors. The net result is stifling to the student rather than empowering. Teach and reinforce the replacement behavior: Many of the same strategies used to teach traditional academic subjects can be used to teach behavior. Most teachers have a great deal of expertise in shaping behavior already. Be explicit, concise, and consistent. It may be necessary to break the desired behavior into smaller, manageable pieces, building up to it in realistic increments. Example: When Jason enters class, I remind him to put a piece of scratch paper and a pencil on his desk. I remind him of the strategy we discussed. When he raises his hand and calls out, I hold up my hand signaling him to wait, make eye contact, and point to his paper. When Ive finished with instructions, I walk by his desk to make sure he understands everything hes required to do. Reflect on the progress: Exercise patience while recognizing that there is a certain degree of trial and error inherent in this process. Example: For the first week, Jason continued to call out. I no longer answered his questions right away, so he would get frustrated and sigh audibly. We had to work on getting him to write down useful words quickly, but he eventually became efficient. As we both got used to the system, I found that I could walk by his desk and read what he had written. Often, I was able to anticipate his question and answer it as I continued with the rest of the class. After a month, it was rarely necessary for me to confer with him individually to clarify directions.

Cognitive
Teach the student to THINK differently, therefore, they BEHAVE differently. These are effective and long lasting. Students may not respond immediately, so be patient! Memory strategies Self-monitoring strategies (checklists, behavior plans)

Environmental management
These manipulate the environment to promote success. These are effective and temporary. Teachers can judge the effectiveness immediately. Establishing consistent routines Allowing movement Using special signals It is important to use a combination of the two types! Simple interventions are usually the best! You should seek student input and approval! Interventions are necessary to make up for weak Executive Functioning skills: Working Memory and Recall Activation, Alertness and Effort Internal Dialogue Controlling Emotions Complex Problem Solving Planning Organizing

Cognitive
Behavior contracts Teach memory skills: mnemonics, acronyms, memory shortcuts, roleplaying, chaining Cooperative learning: assign roles, provide input regarding interaction within the group Social skills training: use teachable moments Teach study & organizational skills

Environmental management
Use positive reinforcement Teach your rules: rules are few, clear and comprehensive; explain the rationale for your rules; they are visible in classroom Impose clear consequences for not following the rules Employ time outs - these are often needed to help students re-gain selfcontrol

Provide computer / keyboarding instructions Provide student insight into their learning style and teach to their strengths Teach time management strategies: use calendars, reminder techniques

Monitor homework carefully: communicate with parents, give consistent feedback Reduce workload Utilize non-verbal signals agreed upon by you and the student in advance Use proximity Provide different seating arrangements Allow for appropriate movement

Structured routines are in place Organized classroom environment Positive feedback is frequent and immediate Immediate consequences for non-compliant behavior Teacher proximity is used Minor disruptions are ignored Materials are appropriately leveled Assignments are brief or chunked Tasks are mixed interest and level Multisensory teaching methods are used Transitions are supervised Problems are anticipated Communication with parents is frequent Study skills teaching is part of daily curriculum Movement is allowed

Dont assume the student is lazy. Dont be fooled by inconsistency. Students with ADD / ADHD can do the work one day. The next day they may not. Dont give up on a student. These children need your persistence and belief in their ability in order to succeed. Dont give up on behavior modification techniques. They take time! Dont forget to talk to others. Networking with other professionals eases your load. Dont forget to involve parents. Be sensitive to their frustrations and fears. Dont be afraid to adapt, provide accommodations, and alter assignments for students as needed. It is okay and fair to provide accommodations for students with special needs.

Adapted from How to Reach and Teach ADD/ADHD Children Rief, Sandra F. 1993

Give directions only when the class is completely quiet. Wait until you have everyones attention. You may need to physically cue certain students. Explain instructions clearly, slowly and concisely. Use multisensory instructions. For example, write key words, phrases, page numbers, and picture cues on the whiteboard / Smartboard. Model what to do. Show the class. Students will be overwhelmed with too many instructions at once. Give them one at a time or in small chunks. Have individual students repeat or rephrase directions to check for understanding. Make sure to give complete directions, including what you expect students to do once a task is finished.

Students with ADD / ADHD need direct assistance and training in how to: Organize their material Organize their work place Record their assignments Make lists Prioritize activities Plan for short-term assignments Break down long-term assignments Know standards of acceptable work Read and use a calendar Follow a schedule Know what to take home and leave home Know when and where to turn assignments in Know what materials are needed and expected

Adapted from How to Reach and Teach ADD/ADHD Children Rief, Sandra F. 1993

According to research, people retain: 10 % of what they read 26 % of what they hear 30 % of what they see 50 % of what they see and hear 70 % of what they say 90 % of what they say and do

So it is necessary to teach in a variety of methods, especially for students with attention difficulties.
Learning Style Adaptations Alter the instructional groupings Allow students to use assistive technology calculators, word processors, voice text, etc.

Use meaning-making activities Teach metacognition, reciprocal teaching, think-alouds Teach visualization strategies Guide students in making detailed mental pictures Encourage students to look for and identify patterns in math, literature, poetry, nature, music, and dance

Use a discovery approach as often as possible Teach students to explain their reasoning and describe their thinking processes in writing Bring humor to your classroom Use emotion to hook students into the lesson
Adapted from How to Reach and Teach ADD/ADHD Children Rief, Sandra F. 1993

Attention Deficit Disorder Association www.add.org National Institutes of Health www.nih.gov In-depth education & healthcare information www.kidsource.com A parents guide to helping kids with learning difficulties www.schwablearning.org Explores the other side of ADD www.borntoexplore.org The leading website on learning disabilities for parents, teachers and other professionals www.ldonline.com Children and Adults with Attention Deficit Disorder www.chadd.org Presents classroom interventions to help students with ADHD www.addinschool.com