Behavior Management Strategies and Resources for Students with ADD/ADHD

Presented by the Child Development Counsellors Itinerant–Elementary Student Support Services

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Characteristics ADHD General Information & Guidelines

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DSM IV – TRDiagnostic Statistics ManualDiagnostic Criteria for Attention –Deficit/Hyperactivity Disorder

A. Either (1) or (2):

(1) six or more of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:

Inattention

(a) often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities

(b) often has difficulty sustaining attention in tasks or play activities

(c) often does not seem to listen when spoken to directly

(d) often does not follow through on instructions and fails to finish school-work, chores, or duties in the workplace (not due to ODD)

(e) often has difficulty organizing tasks and activities

(f) often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork and homework)

(g) often loses things necessary for task, activities (e.g. toys , school assignments, pencils, books, or tools)

(h) is often easily distracted by extraneous stimuli

(i) is often forgetful in daily activities

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DSM IV - TRDiagnostic Statistics Manual(2) six or more of the following symptoms of hyperactivity-impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:

Hyperactivity

(a) often fidgets with hands or feet or squirms in seat

(b) often leaves seat in classroom or in other situations in which remaining seated is expected

(c) often runs about or climbs excessively in situations in which it is inappropriate

(d) often has difficulty playing or engaging in leisure activities quietly

(e) is often “on the go” or often acts as if “driven by a motor”

(f) often talks excessively

Impulsivity

(g) often blurts out answers before questions have been completed

(h) often has difficulty awaiting turn

(i) often interrupts or intrudes on others (e.g. butts into conversations or games)

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DSM IV - TRDiagnostic Statistics Manual

B. Some hyperactive-impulsive or inattentive symptoms that cause impairment were present before age 7 years.

C. Some impairment from the symptoms is present in two or more settings (e.g.: At school, or work or home)

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WHAT ADD/ADHD LOOKS LIKE Don’t see or think of the consequences of their behavior Impulsive Some will have little empathy for other individuals involved Cannot transfer information from one situation to another May react at a later time to an incident Perception problems – see things differently Inability to recognize social cues, norms (don’t interrupt teacher – rude, not knowing when to stop, doesn’t get humor) Inability to wait Difficulty listening/ Not following directions/ Defiance Transition difficulties Fear of accomplishment – fear of failure

**What ADD/ADHD looks like… continued

Offending others i.e. Pushing, shoving

Dangerous physical risk taking

Acting out feelings (persecution – can’t see that if he was the only person acting out that was why he got into trouble)

Limited physical boundaries

Manipulating people / events

Tantrums / anxiety

Disorganization

Forgetful

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Don’t be Fooled …Is it really ADD/ADHD? or another co-existing disorder(s)

Depression

Anxiety Disorder

OCD-Obsessive Compulsive Disorder

ODD –Oppositional Defiant Disorder

* When Something’s Wrong

Conduct Disorder

Learning Disability

Tourette’s/Tic Disorder

FASD –Fetal Alcohol Spectrum Disorder

PTSD – Post Traumatic Stress Disorder

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**ASSOCIATED PROBLEMS WITH ADD/ADHD

Low self-esteem / Loss of motivation Inability to build or maintain interpersonal relationships Anxieties Obsessions / compulsions Over / under reacting (low affect) Learning Disability School Problems**

school problemsSTUDENTS WITH ADD/ADHD OFTEN …

Have average fluency and performance on “short” reading assignments

Have “spotty” comprehension

Lose their place frequently

Forget what they read

Have difficulty reading silently (needing oral input)

Avoid reading (non-choice material)

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DESIRABLE TRAITS COMMON IN MANY WITH ADHD AND OR LD

ResiliencyIngenuity /CreativitySpontaneityBoundless energyRisk takersIntuitiveInquisitive Sensitive to the needs of others

ImaginativeInventiveInnovativeResourcefulGood HeartedGregariousObservant

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STRATEGIES

Pre-made response cards Picture desk Cards/Silent Q’s Non verbal Signals Write-on response tools Team A / Team B (full class games) “Safe area (low stimulation area that is calm, relaxing, non-punitive; have props like soft pillows, music sensory toys) Catch them being “GOOD”

ORGANIZATION CLASSROOM AND HOMEWORK SUPPORT

Require 3-ring binder with pockets (from 3rd grade higher) 3-hole punch all papers given to students Consistent use of planner/agenda/assignment sheet. Provide

parents with guidelines about their role – what they can do to help. Colored folders to correspond with color coded: agenda’s,

notebooks, unit sheets, handouts… Include due dates on assignments and estimated time required to

complete

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Organization and Classroom and homework support continued

Assign study Buddies with phone number

Build cleaning/organization of notebooks and desk/locker/school bags into schedule

Provide a second set of books for home

Place copies of schedules in binders, lockers, and taped to desk

Provide more class time

Modify assignments, cutting the written work load

Limit amount of homework

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**Classroom Management

Behavioral Contracting

Remove distracting items from the classroom i.e. overhead mobiles, kites.

Correctly place the ADHD child

Increase the distance between desks

See Appendices for additional information

Adapted from Harvey Parker, Ph.D

Self Monitoring

Teach listening skills

Establish eye contact

Vary voice tone and inflection

NB Do not use timers they only exacerbate the pressure and distractions

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Corrective Consequences

Positive practice – Do overs

Brief delay

Time owed

Fining / Response cost

Parental contact

Restitution

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Creative, Engaging and Interactive Classroom Strategies

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Creative, Engaging and Interactive Classroom Strategies

Get their attention before giving directions

Tell the students when and where to look

Keep directions short and clear

Have the child(ren) repeat

Provide clarity and structure for the students

Increase praise, encourage and reward increments of improvement and interaction (frequency, duration, intensity)

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We Can Make a Difference

Change what you can control…YOURSELF(attitude, body language, voice, strategies, expectations)

Be fair, firm and consistent Remain calm Disengage from power struggles Role model appropriate behavior Give extra praise for a job well done Choose issues carefully Allow the child to vent before dealing with issues Try to get an understanding of how the child “perceives”

the situation first before trying to work through it Deal with one situation at a timePlan a response and avoid “reacting”

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We Can Make a Difference

Affirm and acknowledge their feelings and your confidence in their ability to make good choices. Use “what” questions rather than “why” questions Use “when …then” rather than “If you don’t…you won’t” Training and knowledge about Add/ADHD Close communication between home and school Team work / Administrative support Respecting student privacy and confidentiality while being sensitive about not embarrassing or humiliating BELIEVE IN THE STUDENT – do not give up when the plan(s) A, B, and C don’t work

Pearls

Rules without Relationship = Rebellion

The more out of control one feels, the more in-control they need you to be.

F.E.A.R = Finding Evidence Against RealityThe Golden Rule = treat others as you would like to be treated.

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WHAT SHOULD I DO ABOUT … ?

1.The child who is totally out of control – yelling, swearing, hiding under the desk; a danger to self / others / property2.The child who can’t stay seated and who is constantly falling out of the chair3.The impulsive child who blurts out in class all the time4.The child who is constantly angry or upset about something5.The child who is always irritating peers

See appendix 9 for some suggestions

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About the Presenters and their Resources

Leah Ferron, Kelly Lajeunesse and Lee Pedersen are Child Development Counsellors with the Near North District School Board. All participated in compiling this presentation based on personal experiences, previous workshops attended and some written resources purchased over the years.

The counsellors wish to acknowledge the invaluable insights and strategies they have gathered from the following books regarding the subject

of ADD/ADHD:

When Something’s Wrong - Canadian Psychiatric Research Foundation

HOW TO REACH AND TEACH ADD/ADHD CHILDREN – Sandra F. Rief

The ADD Hyperactivity Handbook for Schools – Harvey C. Parker, Ph.D.

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Appendix 1Behavioral Contracting

Beh. Contracting = an agreement between two or more parties (teacher, student, caregiver). The student agrees to behave in a specified manner for some reciprocal behavior from the teacher/caregiver

Young students may not understand the idea of a contract so “deal” is an optional word.

For the young and ADD/ADHD students “impulse control” is to large and an unrealistic goal; therefore setting the child up for failure – so very small obtainable steps are recommended to assure success and larger steps can evolve until you get to your ultimate goals – eventually. Many ADD/HD students will need shorter times between rf’ment i.e.: end of each period or some may succeed at the end of the morning or afternoon, others my make the whole day (I would not reco. this initially)

How to use Beh. Contracts

i. Explain, for young children the contract can be described as a “game” with the opportunity to win things from the teacher. For older children, explain contracts are used throughout society in business, in social relationships and between countries. Equate the idea of a contract to the notion of a promise or an agreement between two people who give their word to exchange on thing (behavior) for another (reward).

ii. Explain that contracts can be used in school to help motivate students to improve their performance.

iii. For younger students select one or two “target” behaviors you would like them to focus on. Demonstrate (role-play) the behavior so the child clearly understands what your expectations are to obtain the ‘prize’ reward. For older students encourage input in defining the ‘target’ behaviors.

iv. Write down one or two target behaviors for younger students, while older students may be able to handle four or five such target behaviors. E.g. raises hand before asking question or giving an answer, copies homework assignments from the board each day, pays attention for 15 minutes at the start of every math lesson etc..

v. Specify how each target behavior will be measured and when e.g. whenever I see you raise your hand before asking a question or giving an answer I will mark it down; when you get 5 marks I will let you know and …

vi. With student input, decide on an appropriate reward (or penalty) to be given for performing (or not performing) the target behavior(s). Specify when the reward is to be given. Remember children with ADD/HD may need more frequent rewards.**Be sure to change the reward frequently to maintain motivation and interest.

vii. Write down the specifics of the contract and have it signed by the student. Make a copy for the student and the teacher.

viii. Review the contract regularly, e.g. monthly to ensure success and update rf’ment desires and continue to motivate.

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Appendix 2Self monitoring

Is a method of teaching students self-control over their beh.

They have to observe their own beh. And record their observations

The goal is that they’ll gain better self control

This method can be used with children of varying ages and ability

The students have to stop what they’re doing, evaluate their behavior and record whether a specific target beh. Has occurred or is occurring

For ADD/ADHD students – we’d usually be targeting attention to task

One method would be to have tape recorded tones beeping at irregular intervals (no less than 45 seconds)

Each tone would prompt the student to evaulate “am I paying attention to any work” and record data on a data sheet

Self monitoring can also be used for improving attention, self-control, organization and making friends

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Appendix 3Remove Distracting Items from the Classroom

The visual distractions are not as obvious as the auditory distractions

An “enriched” classroom cn be highly distractable to a student with attentional difficulties i.e.: busy bulletain boards, twirling mobiles, project displays, aquariums

Basic rule of thumb… try to avoid visual distractions in the students line of sight between them and you when you give instructions

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Appendix 4Teach Listening Skills

Most ADD/ADHD students have developed poor listening habits

Research has shown that listening skills can be learned

With junior and senior high school students you can instruct them to listen to a taped recording of the AM news and then complete worksheets on the material heard. The students then construct the broadcast from memory as one student takes notes on the blackboard

Students will quickly show an improvement in their ability to listen effectively

Ask students to look at you before giving instructions – make sure they have a direct view of your face, especially your mouth

In elementary grades, have an entire class repeat oral instructions sentence by sentence verbatim – this is time consuming but beneficial

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Appendix 5Correctly Place the ADD/ADHD Child Physically

Try to avoid

• Moving the ADD/ADHD students desk closer to your desk IF you often have other students often come to your desk for assisitance or corrections – highly distracting

• A location near the pencil sharpener• A window view• A location close to the classroom door / hallway

• Do• Try the middle of the classroom where the primary objects in their visual or auditory fields are other

children working• Set up an office / study carrel which is available to any student who needs a quieter space to work in

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Appendix 6Establish Eye Contact

Children with ADD/ADHD have brains that are oversensitive to external and internal stimuli

Establishing eye contact makes it easier for them to pay attention

Avoid giving directions while facing away form the students i.e.: facing the blackboard, looking sown at your desk or other objects.

Remember to smile

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Appendix 7Increase the Distance Between Desks

With large numbers of students and small classrooms, it can be difficult but try to avoid having students with ADD/ADHD too close to their peers that they can touch them without leaving their seats or moving their desks

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Appendix 8Vary voice tone and inflection

Louder or softer tones do not help to increase attention but varying the tones is critical

Give oral instructions twice, varying the volume between presentations

Emphasize the most important parts of the instructions by using louder tones

Ask students to listen carefully and then softly give instructions

Move around the room

Use body gestures

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Appendix 9What Should I Do About?

Some points to consider, but not the only way!

1) The child who is totally out of control… Be proactive, if possible – have a game plan pre-established Remove the child from the classroom ASAP or remove classmates from the student Alert the office – get help. Decide beforehand who has the best relationship with the student to mediate with him/her Offer cool down time Spend more time telling student what he is doing right Talk softer and slower Remain physically relaxed (no crossed arem fists clenched) Watch your words (no put downs) Use statements of empathy, understanding and concern Know your child (you may need to something different)

2) The child who can’t stay seated… In private time with the student – explain your concern and expectation that they try to stay seated Ask student what would help to stay seated – is there a physical problem? Remember they have a physical need for mobility ‘Masking tape boundaries’ on floor may help Be tolerant and willing to ignore some of this behavior Contract with rf’ment

3) The impulsive child… Try a contract with the rf’ment for raising his /her hand (a token system may work – reward at end) Proximity control – gentle touch – auditory (soft whisper)

Negative rf’ment token Program – give student a set number of tokens in the morning, each time he blurts out, he/she loses a token – don’t acknowledge students response when blurting out – if he/she has tokens left at the end of the day reward follows – if there are not tokens left a consequence might follow

If he/she raises his/her hand to answer, quickly call upon them to answer

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Appendix 9 con’t

4) The child who is always angry…

Find time to listen to the student

Provide for release of physical tension

Teach relaxation techniques

Increase self awareness – deep breathing “Chill out” “take 5”

Social skills training – teachable moments – broaden their insights shape their understanding of the effect of their beh. on others

5) The child who is always irritating peers…

Lack of self awareness – help them gain some personal insights – bottom line is they desperately want friends

If an adult embarrasses a student by confronting the student often dislikes the teacher and will not listen to anything they have to say – Rules without relationship = Rebellion

Never humiliate them in front of their peers

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