More, More, More!

1. More, More, More!

2. Steve • First grade student • Attends a typical public school • Middle- aged female teacher with 27 classmates • Is not currently diagnosed with any kind of disorder or disability

3. Steve’s Strengths • Very happy • Upbeat • Loves to talk and share his knowledge with his peers • Expressive • Creative • Competitive

4. Steve’s Weaknesses Steve can be seen…. • excessively talking to his peers • often times out of his seat • making disruptive or disturbing noises • as a “know-it-all” • bothering his peers

6. Observation • Two Problematic setting: • Direct Instruction • Transitions

7. Overall Setting

8. Direct Instruction • Behaviors • Shouting out • Disrupting classmates- kicking, talking, tapping his pencil • Making loud animal noises • Moving inappropriately • Behaviors are aimed at: • Getting Stimulation 59% • Avoiding boredom 24% • Gets Self-determination 18%

9. Payoffs in Direct Instruction Avoids Boredom, 24% Gets Stimulation Gets Self-determination Avoids Boredom Gets Stimulation, 59% Gets Self-determination, 18% Payoffs of Direct Instruction

10. Specific Examples • Getting stimulation • collecting garbage off the floor during math lesson • playing with his shoes for an entire Reading lesson • throwing his pencil at another student • rocking on his knees for 10 minutes- during a word stretching activity • Avoids • Making loud animal noises at the beginning a repetitive lesson on writing the letter “Q” • Shouting “O” loudly several times during an activity “What sound do you hear”

11. Transitions • Description of Behaviors • Shouting out • Disrupting classmates- kicking & talking • Making loud disrupting noises • Moving inappropriately • These Behaviors are aimed at • Getting Stimulation 86%

12. Payoffs during Transition

13. Specific Examples Getting Stimulation • Jumping on students • Collecting garbage and throwing it up like confetti • Continuing falling down while walking in line • Making disruptive noises while washing his hands • Disrupting the teacher by making loud gagging noises

14. Getting Stimulation • Largest ‘get’ • Steve is attempting to stimulate himself through his misbehavior • He is obviously not receiving enough stimulation

15. Consequences of Misbehavior • He is constantly redirected • He has been since into the hall • His desk has been separated from his peers

16. ADHD • 4% to 12% of school aged children have been diagnosed with ADHD (Barson, 2004) • Most common symptoms • Inattentiveness • Hyperactivity • Impulsivity • Which include • Fidgeting • Leaving seat • Talking excessively • Blurting out answers • Interrupting or intruding

17. ADHD & Tourette Syndrome • Tourette’s is an disorder characterized by involuntary motor and vocal tics (Munson, 2005) • Males are more often affected with Tourette’s (Leckman, 2002) • Most people with this syndrome have normal IQs (Munson, 2005) • 60% of children diagnosed with tourette's also have ADHD (Denckla, 2006)

18. Tourette Syndrome • Examples • Making loud animal noises at the beginning a repetitive lesson on writing the letter “Q” • Shouting “O” loudly several times during a “What sound do you hear activity” • Disrupting the teacher by making loud gagging noises

19. Tests • Steve should be tested for ADHD • Steve should have a MRI to test for Tourette syndrome

20. Interventions • Give Steve more stimulation by… • Peer tutoring • Assigning him special chores (organizing the library area, sharpening pencils, or picking up garbage) • Add fun and exciting surprises to lessons • Praising him when he is behaving properly • Give him more small group activity time

21. References • Barzman, D.H., Fieler, L., & Floyd, F.R. (2004). Attention-Deficit Hyperactivity Disorder and Treatment. The Journal of Legal Medicine, 25, 23-38. • Denckla, M.B. (2006). Attention-Deficit Hyperactivity Disorder (ADHD) Comorbidity: A Case for “Pure” Tourette Syndrome? Journal of Child Neurology,21, 701-703. • DuPaul, G.J., & Hoff, K.E. (1998). Reducing disruptive behavior in general education classrooms: The use of self-management strategies. School Psychology Review, 27, 290-304. • Egger, H.L., Kondo, D., & Angold, A. (2006). The Epidemiology and Diagnostic Issues in Preschool Attention-Deficit/Hyperactivity Disorder. Infants & Young Children, 19, 109-122. • Furman, L. (2005). What is Attention-Deficit Hyperactivity Disorder. Journal of Child Neurology, 20, 994-1002. • Leckman, J.F. (2002). Tourette’s syndrome. The Lancet,360, 1577-1586. • Munson, B.L. (2005). About Tourette’s syndrome. Nursing, 35, 29-29. • Zentall, S.S. (2006). ADHD and Education- Foundations, Characteristics, Methods, and Collaboration. New Jersey: Pearson Educational, Inc.