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Reaching & Teaching Children with AD/HD
ADHD Association 20th Anniversary Conference
Reykjavik, Iceland
26 September, 2008
11:00 – 12:00
Sandra Rief, Presenter
www.sandrarief.com
Think of one student/child...
What strategies might I use to ...?
Common School Performance Difficulties in Students with
AD/HD
• Poor organization, time management, study skills
• Minimal/inconsistent production & output (both in-class assignments & homework)
• Some academic weaknesses – particularly in written language/writing skills
Page 1
Common School Performance Difficulties in Students with
AD/HD
• Forgetfulness/memory-related issues
• Difficulty following rules
• Behavioral & social difficulties affecting interpersonal relationships
• Unable to sustain effort for long-term goals (need short term goals/rewards)
Page 1
Things to Keep in Mind About AD/HD
• Disorder in performance, output, and production
• Approximately 30% developmental delay (in self-control, inhibition and executive functions)
Page 1
Common Misinterpretations of Behavior
• Doesn’t work independently (lazy/apathetic)– chronic memory problems, lacks
prerequisite skills, difficulty blocking internal/external distraction
• Doesn’t follow directions (noncompliance)– difficulty with recall/memory of verbal
directions & translating into action, switching gears, interrupting what they’re doing
Page 1
Common Misinterpretations of Behavior
• Repeatedly making the same mistakes (willful, deliberate)– respond too quickly to refer to past
experience
• Not sitting still (can control if tried harder)– neurologically-based need to move, difficulty
regulating motor activity
Page 1
Common Misinterpretations of Behavior
• Poor social skills/judgment (deliberate, poor parenting)
– difficulty noticing/interpreting social cues, inhibiting responses, skill/performance deficit
Page 2
Our Perception...Our Reaction
Key Elements for School Success
• Flexibility & willingness of teacher to accommodate
• Knowledge & understanding of ADHD, LD, and other neurobiological disorders
• Close home/school communication• Engaging & interactive teaching
strategies
Page 2
2 min 30
2 min 30
ATTENTION
Maintain Attention (Active) 2 min 04
Key Elements for School Success
• Effective classroom management
• Environmental adaptations & accommodations
• Positive behavioral supports & interventions
• Help & training in organization/ time management/study skills
Page 2
Key Elements for School Success
• Limiting amount of homework and reducing written workload (as needed)
Page 2
Key Elements for Success
• Respecting & accommodating learning style differences
• Adaptations and modifications according to student needs
• Differentiated instruction
Page 2
One Size Doesn’t Fit All
Key Elements for Success
• Active learning
Page 2
Kinesthetic – 53 sec
Key Elements for Success
• Developing & bringing out student strengths
• Belief in student…Doing what it takes
Page 2
~ 5% Chronic/intense
~ 15 % At-risk
~80 %Norm
Tertiary preventionIntensive interventions
Secondary preventionTargeted interventions
Primary preventionUniversal interventions
www.pbis.org
Page 3
Creating the Climate for Success of ALL Students
2 min 40
Schedule/Routines/Rules
Reverse the “praise deficit”: It takes changing the
interactions
3:1 (Minimally)
Page 3
Recognition, Acknowledgement, and
Specific Praise
“I really appreciate how you ______.”
“I appreciate the self-control you are using.”
“I noticed how hard you were working on ______.”
“I see the effort you are showing.”
“Thank you for the good choice you just made.”
Page 3
Climate Class Short – Class + Reinforcement Systems
2 min 35
Common Antecedents or Triggers
• Environmentally Based:– (e.g., poor comfort level - too noisy/crowded; lack
of structure/organization/interesting materials)
• Physically Based:– (e.g., ill, tired, hungry, thirsty, medication related)
Page 3
Common Antecedents or Triggers
• Related to Specific Activity or Event:– (e.g., unclear instructions, substitute teacher,
competitive game)
• Related to Specific Time:– (e.g., first period, before/after lunch, transitions)
Page 3
Common Antecedents or Triggers
• Performance/Skill Demand:(e.g., to remain seated, share materials, take a timed test, read independently, write in cursive, wait for a turn)
Page 3
Physical Needs 53 sec.
Prevent Problems: Alter the Antecedents
• Increase the structure
• Closer monitoring & supervision
• Motivating materials and assignments
• Increase opportunity for movement and active participation
• Increase cueing & prompts
• Prepare for transitions
• Adjust the environmental factors
Page 4
Environmental Accommodations
• Preferential Seating (location & alternatives to
chair)
Page 4
Movin’ Sit Jr www.theraproducts.com
Environmental Accommodations
• Preferential Seating (location & alternatives to chair)
• Standing work stations
• Office area/study carrel, 2-desks
• Adding structure and organization (e.g., color-
coding)
• Visual supports & prompts
Page 4
Visual Cues
1. May talk with teacher permission only.2. May leave seat with teacher permission only.
1. May use 12” voice.2. May leave seat when needed (e.g., to turn in work)
1. May talk quietly with other students.2. May leave seat to work with other students.
Page 4
Page 4
Page 4
Papers in notebookWork turned in
Pack all needed books and suppliesAll homework recorded in planner
End of Day Page 4
Page 5
Timer Uses
• Transitions
• Regain control message
• Motivating on-task/work completion
• X amount of time to demonstrate target behavior to earn point/token
• Time-out
Page 5
Environment-beanbag (2 min 11 )
Individual Management Systems
Page 5
GOAL__________ DATE __________
___________’S DAILY REPORT
+ - + - + -
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+ - + - + -
+ - + - + -
+ - + - + -
+ - + - + -
+ - + - + -
+ - + - + -
+ - + - + -
+ - + - + -
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TOTAL
handoutPage 5
On time to class
Homework turnedIn
Used class timeProductively
Followed class rules (no more than 2 warnings
Page 5
Page 5
With “Challenging” Kids
• Plan a response and avoid “reacting.”
• Praise, encourage, and reward increments of improvement
• Change what you can control…YOURSELF (attitude, body language, voice, strategies, expectations).
Page 6
With “Challenging” Kids
• Use “when…then” rather than “if you don’t…you won’t.
• Use “what” questions rather than “why” questions.
Page 6
• What else could you try?
• What would you like to happen next?
• What was our agreement?
• What are you risking by doing that?
With “Challenging” Kids
• Acknowledge: “I can’t make you. But remember your choices are either ___ or ___ . (Give 2 choices)
Page 6
Go to 67 rdg or 72 org
“You can stay after school to finish the class assignment or you can finish it now and not have to stay after class. It’s your choice.”
AD/HD: Reading difficulties related to…
• Inattention/distractibility
• Poor memory skills
• Application of metacognitive strategies
Rief, S. & Heimburge, J. (2006) How to Reach & Teach All Children in the Inclusive Classroom, 2nd ed.
Page 6
Students with AD/HD Often
Have average reading fluency
Have “spotty” comprehension
Lose their place frequently
Forget what they read
Fatigue easily while reading
Have difficulty reading silently
Avoid reading (non-choice material)
Page 6
During Reading Comprehension Strategies
• Stopping at points to process text • Read-cover-retell• Make connections• Make predictions and inferences• Visualize• Ask questions
Page 6
Stop and Process Activities
• Stop and re-tell in your own words…
• Stop and ask your partner a question.
• Stop and discuss…
• Stop and draw something to help you remember…
• Stop and write questions in the margins
• Stop and summarize in 1 sentence…
Page 6
Reading Interventions
• Divide reading assignment into shorter segments
• Use markers to block part of page
• Allow reading to self orally - whisperphone
Page 7
Strategies for Organization, Time Management, & Study Skills
Executive Function-Related Classwork & Homework
Challenges Memory, Forgetfulness Planning, Prioritizing, Organizing Judging and Managing Time Breaking things down into steps Activation (mobilizing, getting started) Sustaining Attention, Alertness, and Effort Self-management (including managing
frustration and emotions)
Page 7
75 hw video or 76
Homework Steps
• Know what the assignment is
• Record the assignment
• Bring the required materials home
• Do the homework
• Return the homework to their backpack
• Turn in the homework
Page 7
Organization & Homework Support
Required backpack and 3-ring binder or alternative of accordion file (pocket folder for K-2)
Page 7
Homework Folder
• One colored folder in front of notebook for all homework; or one homework folder behind each subject tab
Organization & Homework Support
Consistent use of planner/agenda/ calendar/assignment sheet
Page 7
Page 8
Organization & Homework Support
Color code: schedule, books, notebooks, folders, unit sheets, handouts
Page 8
Organization & Homework Support
Build cleaning/organization of notebooks and desks into the schedule. Provide a second set of books for home.Write due dates on assignments and estimated time required to complete.
Page 8
Organization & Homework Support
Walk through recording of assignments
Page 8
Recording Assignments
Organization & Homework Support
Provide class syllabus and project timelines
Chunking down long-range assignments (interim due dates, monitoring, heads-up to parents)
Page 8
Organization & Homework Support
Post all assignments, schedules, materials needed, timelines
Page 8
Organization & Homework Support
Supervise for materials as leaving room, sign monitoring form ticket out the room
Page 8
Sign off & Long term (42 sec)
Organization and Homework Support
School-wide supports: Supervised study periods, homework labs, Learning Strategies class
Page 8
Organization & Homework Support
Keep teacher copy of student planner or assignment sheet filled out & accessible.
Page 8
Organization & Homework Support
Teach students to use a “things to do” list and other checklists
Page 8
Organization & Homework Support
Use a monitoring form to track and communicate between home and school.
Page 9
5 – Excellent: Worked all or most of class and was not disruptive
4 – Good
3 – Satisfactory: Did acceptable work, but needed some prompts to stay on-task
2 – Poor
1 – Unacceptable: Did not do any or very little work and was a distraction to others
Organization & Homework Support
Be responsive to parent feedback and frustration about homework difficulties.
Page 9
97 writing, 102 not fair, 103 journey
Why is Writing is Such a Struggle?
Planning & Organization (topic, ideas, sequence, structure of genre)
Memory (working & long term)
Language (logical, coherent, vocabulary usage)
Spelling
Grapho-Motor Skills (physical task)
Editing (revision, proofreading)
Self-Monitoring (make sense? enough detail?)
Speed of Written Output & Production
Page 9
Fine Motor/Handwriting
Some Writing Accommodations
• Pre-Writing and Organizational Supports (e.g., use of graphic organizers, checklist or rubric of required components, talk through ideas first)
• Editing Assistance (teacher/peer, spell-check)• Bypass Strategies (e.g., permission to dictate
portions, print instead of cursive, access to computer/assistive technology)
• Shortened/modified written assignments• Use of scribe, note-taking assistance• Alternatives/Options to Writing Assignments
Page 9
100 math, 102 not fair, 103 journey
Math Difficulties Due to Weaknesses in..
Working memory
Long term memory retrieval (steps, rules, vocabulary, processes, math facts)
Attention
Sequencing (multi-step procedures, counting)
Perceptual-motor/Spatial organization
Language (abstract terms, word problems)
Self-monitoring (estimating, pacing)
Page 9
Academic Interventions for Math Weaknesses
• Allow use of calculator & multiplication chart• Use graph paper to space numbers• Provide immediate correctness feedback• Give clues to the process needed to solve problem• Color-code processing signs• Provide time to let students work with each other
(partners/groups) solving problems, checking and reteaching
Page 9
102 not fair, 103 journey
Not Fair
• Fairness is giving everyone what they need, not equal treatment.
• Fairness does not mean sameness, it means everyone treated with equal respect & equal opportunity to succeed.
• Accommodations provide = footing; not unfair advantages; based on need.
Page 9
A Journey of Hope
Over the mountain Little Train pulled...
A Journey of Hope
Over the mountain Little Train pulled.Family & friends pushed on, hoping he would.An obstacle in life…this mountain was school,The side-line cheered on with love as the tool.Harder and harder the Little Train tried.Often he slipped and sometimes he cried,“I can’t, I can’t”…”Oh yes you will!”…Cries of support came from over the hill.
A Journey of Hope
At times on his journey, he became derailed;Totally feeling as though he had failed.“Get back on track, we know you can!”Came the shouts from the side line,Believing in him.
Sure enough, Little Train came through,Accomplishing the goal he set out to do.Knowing that life is meant to be shared, heCouldn’t have made it without those who cared.
A Journey of Hope
The question is asked, “How will I repayAll those on the side line who cheered all the
way?”“By helping others”, the answer came…”We show that with love our journey is
changed.”
Questions
