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ADHD in the Classroom
Transcript of ADHD in the Classroom
What is ADHD?
According to the Mayo Clinic, attention-deficit/hyperactivity disorder (ADHD) is a chronic condition that affects millions of children and often persists into adulthood. ADHD includes a combination of problems, such as difficulty sustaining attention, hyperactivity and impulsive behavior.
Children with ADHD may also struggle with low self-esteem, troubled relationships and poor performance in school. Symptoms sometimes lessen with age. However, some people never completely outgrow their ADHD symptoms. But they can learn strategies to be successful.
While treatment won't cure ADHD, it can help a great deal with symptoms. Treatment typically involves medications and behavioral interventions. Early diagnosis and treatment can make a big difference in outcome. (Mayo Clinic, 2013)
What does ADHD look like in the classroom?
Modifications & interventions for the classroom
Inattention, impulsiveness, hyperactivity, disorganization, and other difficulties can lead to unfinished assignments, careless errors, and behavior which is disruptive to one's self and others. This means that teachers must make instructional, behavioral, and environmental modifications to ensure that ALL student's are included and able to achieve success.
Accommodations for the ADHD Student
Teachers have a responsibility to provide appropriate academic accommodations for students with ADHD. Accommodations are techniques and materials that help ADHD students learn or perform schoolwork more effectively.
ADDitude editors. (2006, 08). Special education definitions, laws, glossary explaining the acronyms, abbreviations, and terms associated with special education. . Retrieved from http://www.additudemag.com/adhd/article/866.html .
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Teaching children with adhd. (n.d.). Retrieved from http://www.educationworld.com/a_curr/doe/adhd_page10.shtml
NCLD Editorial team. (n.d.). What is an iep?. Retrieved from http://www.ncld.org/students-disabilities/iep-504-plan/what-is-iep
Mayo Clinic Staff. (2013, March 5). Attention deficit/hyperactivity disorder in children (adhd) definition. Retrieved from http://www.mayoclinic.com/health/adhd/DS00275
Parker, H. (n.d.). Adapt. Retrieved from http://addwarehouse.com/shopsite_sc/store/html/article4.htm
Florida Department of Education. (2013). Exceptional Education and Student Services. Retrieved from http://www.fldoe.org/ese/ohi.asp
Teeter, P. (n.d.). Myths and misconceptions about adhd: Science over cynicism. Retrieved from http://www.ncld.org/types-learning-disabilities/adhd-related-issues/adhd/attention-deficit-myths-misconceptions?start=1
U.S. Department of Education. (2013). Identifying and Treating Attention Deficit Hyperactivity Disorder. Retrieved from http://www2.ed.gov/teachers/needs/speced/adhd/adhd-resource-pt1.pdf
Davenport, M. (2011, April 11). STOP-THINK-GO for impulsivity. Retrieved from http://flexiture4adhd.com/2011/04/11/stop-think-go-for-impulsivity/
What is a 504 plan?. (2011). Retrieved from http://www.pcdfoundation.org/pcd-at-work-and-school/what-is-a-504-plan
adhdaware. (Producer). (2011, October 16). I Have ADHD and I am.. [Web Video]. Retrieved from
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fairadventure. (2010). Adhd and the brain [Web]. Retrieved from http://www.youtube.com/watch?v
Vera, L. (Photographer). (2013, February 09). ADHD at School [Print Photo]. Retrieved from http://www.youtube.com/watch?v
Why do children have ADHD?
Unfortunately, there is no simple explanation for ADHD. Current theory suggests that although the primary cause of ADHD is a biological (neurological) one; this biological interacts with the psychosocial factors in the individual’s social, cultural and physical environment. This, in turn, leads to behavioral manifestations, which are the outward symptoms that we see from this disability.
Being a distraction
inability to pay attention to details or a tendency to make careless errors in schoolwork or other activities
difficulty with sustained attention in tasks or play activities
apparent listening problems
difficulty following instructions
problems with organization
avoidance or dislike of tasks that require mental effort
tendency to lose things like toys, notebooks, or homework
forgetfulness in daily activities
There are 3 types of ADHD
fidgeting or squirming
difficulty remaining seated
excessive running or climbing
difficulty playing quietly
always seeming to be "on the go"
blurting out answers before hearing the full question
difficulty waiting for a turn or in line
problems with interrupting or intruding
This type involves a combination of the other two types and is the most common.
There are, however, some things that "may" contribute to ADHD. Some of these factors are:
Biological - Most children who have ADHD have a relative that also has the disorder. 1/3 of parents who have ADHD have children with ADHD.
Chemical - Children who have ADHD have 5% to 10% smaller and less activity in their brains.
Environmental - Some studies have shown that mothers who smoke later in their pregnancy, are more likely to have children with ADHD. Also, studies have shown that children who watch a lot of T.V. when they are young are more likely to have attention problems later in life.
What Does NOT cause ADHD?
Unfortunately, some teachers and parents think that ADHD is just an after-effect of poor parenting. No ADHD studies have indicated that this disability occurs from a lack of proper parenting.
How Can Teachers Help Students With ADHD?
Let's look at teacher requirements through the eyes of the law:
There are actually two federal laws that address the educational needs of students with disabilities, Section 504 of the Vocational Rehabilitation Act of 1973 (or simply Section 504) and the Individuals with Disabilities Education Act (also known as IDEA). Section 504 and IDEA guarantee that students with disabilities have access to a free and appropriate public education (FAPE) that is comparable to the education available to non-disabled students. Both laws require placement of a child with disabilities in a least restrictive environment. IDEA requires an individualized educational plan (IEP) with educational goals for the student and specifically designed special education, instruction, and related services that the school is responsible for providing in order to help the student reach those goals. Section 504 does not require a written IEP, but it does require a plan of reasonable services and accommodations for the student with disabilities. (ADDitude editors, 2006)
A Teacher Talks About Accommodations for the Classroom
Who has ADHD?
What are Instructional Modifications?
When teachers make instructional modifications, they modify the way the material is presented in order for students at all levels to comprehend the materials.
What are Behavioral Modifications?
Behavior modification assumes that observable and measurable behaviors are good targets for change. Methods can be developed for defining, observing, and measuring behaviors, as well as designing effective interventions.
What are Environmental Modifications? (or physical classroom accommodations)
Effectively educating children with ADHD involves physical classroom accommodations. Children with ADHD often have difficulty adjusting to the structured environment of a classroom, determining what is important, and focusing on their assigned work. They are easily distracted by other children or by nearby activities in the classroom. As a result, many children with ADHD benefit from accommodations that reduce distractions in the classroom environment and help them to stay on task and learn.
MODIFYING THE PRESENTATION OF MATERIAL
Use concrete examples of concepts before teaching the abstract.
Provide an overview of the lesson before beginning.
Monitor the student's comprehension of language used during instruction.
Schedule frequent, short conferences with the student to check for comprehension.
Highlight important concepts to be learned in text of material.
Provide clear, concise directions and concrete examples for homework assignments.
Methods which can be used to increase positive behavior are:
praise and approval
Methods which can be used to decrease negative behavior are:
reinforcing incompatible behavior
This activity is designed to curb impulsivity, develop self control and help students develop and strengthen their "brain filter". It is beneficial to all students, but is recommended by CHADD ( Children and Adults with ADHD) and can be bought in game form as well as a child therapy tool.
Think about the situations where impulsivity can or might occur and practice weekly with students how to think before responding. This can be a competition, such as a race to the finish line, or a rewards activity where the correct responses earn no homework or student helper for a week.
The first step is to agree on a “key-word” or phrase that you can use to STOP your child and use the visual cue of the stop sign as well.
Once your student stops, he/she needs to THINK about the options. Use the visual cue for thinking. For each option, they should answer some questions:
“Is it going to hurt anyone?”
“Is it going to hurt me?”
“Is it going to help me?”
*Make sure the student understands that “hurt” can include physical, emotional, and social problems*
Next, the student should GO with the best choice! Here we would use the visual cue for GO.
If the student didn’t make a good decision, he/she should ask someone, “How could I make a better choice next time?”
You will need to role-play this process a number of times using real-life situations in the classroom. Examples could be: "How would you respond if someone took your pencil?" and could be used for even simpler situations such as "What would you do if you needed to use the bathroom and the teacher was talking?"
On a weekly basis, it may be helpful to role-play any upcoming challenges that could cause your child to become impulsive.
What is an IEP?
What is a 504 Plan?
Each student who receives special education services must have an Individualized Education Program (IEP). This is an especially individualized program that creates an opportunity for teachers, parents, school administrators, related services personnel and students to work together to improve educational results for children with disabilities.
A 504 Plan helps a child with special health care needs to fully participate in school. Usually, a 504 Plan is used by a general education student who is not eligible for special education services. A 504 Plan lists accommodations related to the child’s disability and required by the child so that he or she may participate in the general classroom setting and educational programs. For example, a 504 Plan may include:
Plans to make a school wheelchair-accessible.
Your child’s assistive technology needs during the school day.
Permission for your child to type assignments instead of writing them by hand.
Permission for your child to hand in assignments late due to illness or a hospital stay.
("What is a," 2011)
Accommodations are necessary for many issues that may arise in the classroom. Let's look at a few:
seat student in quiet area
seat student near good role model
seat student near "study buddy"
increase distance between desks
allow extra time to complete assigned work
shorten assignments or work periods to coincide with span of attention; use timer
break long assignments into smaller parts so student can see end to work
assist student in setting short term goals
give assignments one at a time to avoid work overload
require fewer correct responses for grade
reduce amount of homework
instruct student in self-monitoring using cueing
pair written instructions with oral instructions
provide peer assistance in note taking
give clear, concise instructions
seek to involve student in lesson presentation
cue student to stay on task, i.e. private sign
ignore minor, inappropriate behavior increase immediacy of rewards and consequences
use time-out procedure for misbehavior
supervise closely during transition times
use "prudent" reprimands for misbehavior (i.e. avoid lecturing or criticism)
attend to positive behavior with compliments etc..
acknowledge positive behavior of nearby students
seat student near role model or near teacher
set up behavior contract
instruct student in self monitoring of behavior, i.e. hand raising, calling out
call on only when hand is raised in appropriate manner
praise when hand raised to answer question
Organization and Planning
ask for parental help in encouraging organization,
provide organization rules
encourage student to have notebook with dividers and folders for work
provide student with homework assignment book
supervise writing down of homework assignments
send daily/weekly progress reports home
regularly check desk and notebook for neatness, encourage neatness rather than penalize sloppiness
allow student to have extra set of books at home
give assignments one at a time
assist student in setting short term goals
do not penalize for poor handwriting if visual-motor defects are present
encourage learning of keyboarding skills
allow student to tape record assignments or homework
Other health impairment means having limited strength, vitality or alertness, including a heightened alertness to environmental stimuli, that results in limited alertness with respect to the educational environment, that is due to chronic or acute health problems. This includes, but is not limited to, asthma, attention deficit disorder or attention deficit hyperactivity disorder, Tourette syndrome, diabetes, epilepsy, a heart condition, hemophilia, lead poisoning, leukemia, nephritis, rheumatic fever, sickle cell anemia, and acquired brain injury. This definition is found in State Board of Education Rule, Florida Administrative Code (F.A.C.).
According to the Florida Department of Education, ADHD is classified under "Other Health Impairment" or "OHI".
The U.S. Department of Education provides a definition for ADHD
Attention Deficit Hyperactivity Disorder (ADHD) is a neurological condition that involves problems with inattention and hyperactivity-impulsivity that are developmentally inconsistent with the age of the child.
Seat the student near the teacher
Seat the student near a student role model
Provide ow-distraction work areas
Allow the student to choose a favorite spot to sit
Dim the classroom lights for a calming affect
Use a timer so the student is more aware of time frame
Limit traffic in and out of the classroom
Use and stick to routines
ADHD at School
Learning Theories and Teaching Students with ADHD
Students with ADHD are at higher risk for having academic achievement problems and are less likely to complete post-secondary education. Students with ADHD don’t lack intellectual ability when compared to their non-ADHD counterparts; however their hyperactivity, impulsivity, and/or inattention make concentration difficult and this negatively impacts their performance. Thus it is important for teachers to know about the specific learning needs of students with ADHD and how to more effectively engage ADHD students in the learning process.
It is vitally important to engage ADHD students because they often exhibit inattention, impulsivity, hyperactivity and lack of concentration to a greater extent. Frequently, students with ADHD are kinesthetic learners that need to engage in gross motor activity to learn most effectively.
Other learning styles associated with ADHD students are visual and auditory styles. Visual learners learn by seeing and responding to pictures, illustrations, written lessons, outlines, diagrams, charts, maps, and educational videos.3 Teachers can include a lot of these visual activities in their lesson plan which would make it easier for the ADHD students to learn. Auditory learners retain information best when they have an opportunity to hear it.
(adhdaware, I Have ADHD and I am...)
Resources for Teachers
National Cenetr for Learning Disabilities
Education World http://www.educationworld.com/a_issues/issues148c.shtml
Misconceptions and Preconceptions about students with ADHD
Because there is no blood test or X-ray that gives solid proof of its existence, some people may have a hard time believing that ADHD is a real disorder, or that there is a medical cause for many of the disorder's symptoms.
"Myth #1: ADHD Is Not a Real DisorderAccording to the National Institutes of Health, the Surgeon General of the United States, and an international community of clinical researchers, psychiatrists and physicians, there is general consensus that ADHD is a valid disorder with severe, lifelong consequences. Studies over the past 100 years demonstrate that ADHD is a chronic disorder that has a negative impact on virtually every aspect of daily social, emotional, academic and work functioning. It is a real disorder with serious consequences.
Myth #2: ADHD Is a Disorder of ChildhoodLong-term studies show that anywhere from 70-80 percent of children with ADHD exhibit significant signs of restlessness and distractibility into adolescence and young adulthood. Research estimates that 1.5 to 2 percent of adults have ADHD, and between two and six percent of adolescents have ADHD. ADHD is a lifelong disorder that requires a developmental framework for appropriate diagnosis and treatment.
Myth #3: ADHD Is Over-DiagnosedIt is difficult to find evidence that ADHD is over-diagnosed or that stimulant medications are over-prescribed. Moreover, in some cases ADHD may be undiagnosed and/or untreated. Rates vary depending on the rating scales employed, the criteria used to make a diagnosis, the use of cut-off scores, and changes in diagnostic criteria.
Changes in special education legislation in the early 1990s increased general awareness of ADHD as a handicapping condition and provided the legal basis for the diagnosis and treatment of ADHD in the school setting. These legal mandates have increased the number of school-based services available to children with ADHD and may have inadvertently led some to conclude that ADHD is a new disorder that is over-diagnosed.
Myth #4: Children with ADHD Are Over-MedicatedAlthough there has been an increase in the rate of prescriptions for stimulants and an increase in the production of methylphenidate, "most researchers believe that much of the increased use of stimulants reflects better diagnosis and more effective treatment of a prevalent disorder." Others suggest that the changes may be a function of increased prescription rates for girls and teens with ADHD. The percentage of children who receive medication of any kind is small. So while there has been an increase in the number of prescriptions, a relatively low overall rate of stimulant use is reported in school-aged children. (Teeter)
Myth #5: Poor Parenting Causes ADHDThis misconception may be the most difficult to dispel because parenting characteristics (i.e., being critical, commanding, negative) and poor management do exacerbate ADHD. Studies exploring the contribution of environmental factors (e.g., parenting practices, parental psychopathology) find that genetic factors and not a shared environment account for the greatest variance in ADHD symptoms — about 80 percent. While management difficulties influence parent-child conflicts and the maintenance of hyperactivity and oppositional problems in young children, "theories of causation of ADHD can no longer be based solely or even primarily on social factors, such as parental characteristics, caregiving abilities, child management, or other family environmental factors."
Other factors may play a causal role, including exposure to environmental toxins (e.g., elevated blood lead, prenatal exposure to alcohol and tobacco smoke), but not all children exposed to these risk factors have high rates of hyperactivity, nor do all children with ADHD have these risk factors. Although other factors (e.g., family adversity, poverty, educational/occupational status, home environment, poor nutrition, environmental toxins, ineffective childrearing practices) do not appear to have a significant contribution to the development of ADHD symptoms these factors contribute to comorbid disorders and complicate treatment effectiveness.
Researchers identified a number of inaccurate or non-scientifically based parent beliefs about the causes of ADHD including: allergic reactions or sensitivity to foods, family problems like alcoholism or marital discord, high sugar consumption, ineffective discipline, lazy learning habits, a lack of motivation, etc. Inaccurate or "false beliefs" were associated with parental attributions that children were responsible for their ADHD symptoms (symptoms are intentional and children can control their symptoms), and with the use of less effective treatment (e.g., diet control).
Myth #6: Minority Children Are Over-Diagnosed with ADHD and Are Over-Medicated Access to diagnosis and treatment of mental health illnesses varies depending on gender, race and social economic status, but not in the way one might predict. Research investigating ADHD in African American youths is sparse. A study of public school children and youths in Florida found that service delivery to African American children was deficient even though there was no evidence that the incidence rate of ADHD was lower than those reported in whites. Researchers found that: (1) only 50 percent of children with ADHD were receiving treatment, (2) girls were underserved at a rate three times lower than boys, and (3) whites were three times more likely to be referred compared to African American children. In the few studies exploring medication rates across races, ethnic minority children are 2 to 2.5 times less likely to be medicated for ADHD compared to white children.
Access to treatment is affected by: (1) a lack of perceived need; (2) system barriers including availability, cost and language; (3) concerns that their children would be taken from the home if parents seek services; (4) stigma associated with seeking help for mental illnesses; and, (5) cost of treatment, lack of adequate reimbursement, length of treatment and cost of medication. Furthermore, African Americans are more likely to leave mental health treatment prematurely, and are less likely to receive care. Evidence suggests that minority children are not over medicated and may be underserved for ADHD.
Myth #7: Girls Have Lower Rates and Less Severe ADHD than BoysAccording to the Surgeon General's Report on Mental Health (2001) girls are less likely to receive a diagnosis of and treatment for ADHD compared to boys despite need. Girls with ADHD have greater intellectual impairment, but lower rates of hyperactivity and externalizing disorders compared to boys. Girls with ADHD have more severe internalizing disorders than boys. Girls with ADHD were more likely to have conduct problems, mood and anxiety disorders, lower IQ, and more impairment on social, family and school functioning than non-referred girls. However, conduct problems were lower in girls than in males with ADHD, which may account for lower referral rates in community and school samples.
Compared to boys with ADHD, girls with ADHD reported higher rates of overall distress, anxiety and depression, and demonstrated more hyperactivity, conduct and cognitive deficits. Parents and teachers noted higher rates of inattention, hyperactivity, oppositional defiance, conduct problems, social difficulties, depression and anxiety. Girls may report more distress than boys, and they "may be more affected by environmental factors than males with ADHD." (Teeter)