Working Successfully with Students with Mental Health Issues

1. Working Successfully with Students with Mental Health Issues Joan Steidl, MA, PC jsteidl07@jcu.edu Or joan@becauseitsyourlife.com

2. “…high levels of (math) anxiety can devastate a student’s ability to perform, resulting in poor academic progress and high dropout rates.” - Cynthia Arem, from Conquering Math Anxiety -

3. Math: “The Critical Filter” • “If I could do math I would…” • Fear of math limits earning potential. • Fear of math hinders career choices. • Employers need employees with basic math skills

4. “The first thing people remember from failing at math is that it felt like sudden death.” -Sheila Tobias in Overcoming Math Anxiety -

5. “People don’t remember what you tell them. They remember how you made them feel.”-Anonymous-

6. “All teachers, even special education teachers, have difficulty dealing with students with mental health issues because it is not a ‘visible’ disability. “ - Sally Campbell -

7. While there certainly are children who, from a very young age, require special accommodations on the part of the school because of neurological disorders affecting their ability to learn, most mental illnesses appear subtlely; do not initially seriously disrupt learning; and when treated as close to onset as possible, have very favorable outcomes, enabling the child to recover quickly and succeed in the normal classroom.

8. What do they have in common? * Michael Jordan * Mozart * Albert Einstein * * Whoopie Goldberg * Thomas Edison * * Michael Phelps * Bill Cosby * * Walt Disney * Stevie Wonder * * Steven Spielberg * Henry Ford * *Beethoven * Terry Bradshaw * * John F. Kennedy * Babe Ruth *

9. Attention Deficit Disorder(ADHD)

10. 3%-7% of children suffer from ADHD. • ADHD is diagnosed more often in boys than in girls. • As many as 70% of those with ADHD also have other mental disorders (e.g. ODD, anxiety, depression). • AMA’s Special Council Report showed little evidence of widespread over-diagnosis of ADHD or over-prescription of medication for ADHD. (www.nichcy.org)

11. Understanding ADHD • People with ADHD have brains that work differently than most people. • Some parts of the brain that helps them think before they act, sit still and pay attention, and get organized are a little “sleepy” and work differently than people who don’t have ADHD.

12. Three Types of ADHD • ADHD, Hyperactive-Impuslive Type: student is hyperactive and impulsive. This is often the kid who can’t sit still, and gets yelled at a lot for talking in class. • ADHD, Inattentive Type: Student is inattentive and indecisive. This is the kid who has a hard time taking tests or doing homework, easily bothered by noise when studying, and daydreams a lot. • ADHD, Combined: Student is both hyperactive and inattentive. This child can be impulsive and get in trouble, and at the same time can have difficulty making decisions.

13. ADHD Kids Can Hyperfocus

14. Needed: Executive FunctionLacking: Executive Function • Organizational and planning abilities • Working memory • Inhibition and impulse control • Time management and prioritizing • Understanding complex or abstract concepts • Using new strategies

15. Executive Function Focusing, sustaining, and shifting Attention to tasks Organizing, prioritizing And activating to work Managing Frustration and Modulating emotions Accessing recall and Utilizing working memory Monitoring and Self-regulating action Regulating alertness, Sustaining effort, And processing speed 1. Activation 2. Focus 3. Effort 4. Emotion 5. Memory 6. Action Executive Functions Need to Work Together But Are Impaired

16. ADHD a Behavioral and Mental Health Issue • People with ADHD often find school difficult and often get poor grades because they have difficulty focusing. Usually a kid with ADHD wants to do well in school, but gets so easily distracted it is difficult for them to do so. • Having ADHD does not mean a person is stupid, lazy, or crazy. In fact, people with ADHD are often very talented, smart, and interested in many topics.

17. Executive Function & Math • Need good Executive Function to do math. • Word problems require the ability to ignore extraneous information, sequencing steps, and monitor one’s work.

18. Executive Function & Math • Students with weak executive function may have trouble memorizing math facts. • These students may appear to know their multiplication tables and then – POOF! – It’s as if they’ve never seen them before.

19. Effects of ADHD on Math Achievement • In mathematics attention to details is critical. Overlooking or misreading mathematical symbols, key words, or instructions leads to careless mistakes. • Poor organization skills hinder students from getting paper, pencil, book, and assignment together in one place. Source: Kay Haralson, Associate Professor of Developmental Mathematics, Austin Peay State University, The Effects of Attention Deficit Hyperactivity Disorder on Mathematics Achievement, presented atthe 2005 Annual Meeting and Exposition of the National Council of Teachers of Mathematics Anaheim, CA.

20. Effects of ADHD on Math Achievement(Haralson, 2005) • Math homework takes a lot of mental effort for a long period of time. Students with ADHD learn to avoid these types of activities. • The excessive amount of time it takes for them to complete assignments increases their frustration level. • Underestimating the time needed to complete assignments means that some go unfinished. • Students procrastinate and put off completing assignments until it is too late.

21. Effects of ADHD on Math Achievement(Haralson, 2005) • Students show inconsistent performance. Information learned one day, seemingly mastered, may be missing the next day. • Performance is worse under pressure. • Students have difficulty retrieving information on demand, even when thoroughly studied. • Students become angry with themselves and their teachers when they are criticized or when they do not do well.

22. Oppositional Defiant Disorder

23. ODD: What it Looks Like • Consistently negative, hostile and defiant behavior for at least six months, at least four of the following symptoms. • The behavior symptoms significantly interfere with social, academic, or occupational functioning. • Comorbidity between ODD and ADHD ranges from 20 to 57%. • Behaviors usually begin in preschool.

24. At least 4 of these symptoms • Losing temper • Arguing with adults • Defying rules, refusing to comply iwht requests from adults. • Deliberately annoying people • Blaming others for personal mistakes and misbehavior • Being touchy or reactive • Being angry and resentful • Being spiteful and vindictive

25. Conduct Disorder

26. Conduct Disorder: What It Looks Like • Children or adolescents who consistently violate the rights of others. • Three or more of the following present within the last year, and one within the past 6 months. • Aggression towards people and animals. • Destruction of property • Deceitfulness or theft • Serious violation of rules

27. Anxiety

28. Anxiety • An unpleasant emotion characterized by a general sense of danger, dread and physiological arousal. • Experience of anxiety is not just emotional – involves cognitive, behavioral and physical components.

29. Anxiety: Different Types • Separation Anxiety Disorder • General Anxiety Disorder • Panic Disorder • Phobias (e.g. Social Phobia) • Obsessive Compulsive Disorder • Posttraumatic Stress Disorder

30. Anxiety and How It Impacts School Performance • Negative self-talk • Test Anxiety • Gives up • Excessive Absences • Avoidance • Failure • Low Self-Efficacy • Low Self-Esteem

31. Mood Disorders

32. Mood Disorders • Major Depressive Disorder • Mood Disorder Due to General Medical Condition • Dysthymic Disorder • Bipolar I Disorder • Bipolar II Disorder • Cyclothymic Disorder

33. Children Exhibit Depression in Different Ways • Young children who are depressed may lose their appetites, become excessively sleepy, develop nightmares, or be clingy or apathetic. • Aren’t playful and often look sad. - From Abnormal Psychology by Hansell & Damour -

34. Children Exhibit Depression in Different Ways • School-aged children share common symptoms with depressed adults (e.g. sadness, self-criticism, loss of motivation), but also complain of headaches, be more negative and aggressive with peers, and disruptive in school. - From Abnormal Psychology by Hansell & Damour -

35. Adolescents Exhibit Depression in Different Ways • Depressed adolescents often have trouble at school – grades typcially drop, they may skip school or stop going all together. • Teens become irritable, argumentative, and sometimes aggressive. • Withdraw from friends, pay little attention to looks, become overly sensitive. • Can become engaged in dangerous behaviors like drug and alcohol abuse, sexual promiscuity, and extreme risk taking. - From Abnormal Psychology by Hansell & Damour -

36. Autism Spectrum Disorders

37. Autism • Autism - significant impairment in communication and socialization • Restricted interests • Stereotypic behaviors (e.g., rocking, spinning, finger or hand flapping) • Characteristics appear prior to age 3 • Four times more common in boys than in girls

38. Asperger • Less severe impairment in socialization and communication than autism • Typically language development at normal age (or earlier). • Typically normal self-help skills and normal (or above) IQ.

39. Autism In the Classroom “…please try to realize that instinctively knowing where to go and who to talk to and what do next just isn’t possible for a kid on the autistic spectrum. If a teacher says ‘now get out your book and turn to page 10’ and doesn’t say ‘and now start answering those questions’ the kid is not likely to know; so to tell them off for not doing no work on that lesson is unfair.” - Luke Jackson, adolescent student and author in Freaks, Geeks & Asperger Syndrome

40. Autism in the Classroom “Many older AS people that I have talked to tell me that school memories range from being best forgotten to impossible to forget because they were so traumatic.” - Luke Jackson, adolescent student and author in Freaks, Geeks & Asperger Syndrome -

41. “The problem for children with Asperger’s syndrome who are able to solve complex mathematical problems can be in explaining in words how they achieved the answer…”I can’t do this orally, only headily.”- from The Complete Guide to Asperger’s Syndrome -

42. If you have a toothache, all you can think about is that toothache.

43. Effective Interventions

44. “Fairness is not every student getting the same but every student getting what he or she needs.” - quote found hanging in Special Education Teacher Sally Campbell’s classroom -

45. "If students can't learn the way we teach them, then we need to teach them the way they learn.”-quote found hanging in Special Education Teacher Sally Campbell’s classroom -

46. “ADHD children do something right once and we hold it against them for the rest of their lives.” - Dr. Russell Barkley -

47. Overcoming Math Anxiety Using the ABCDs

48. Managing Self-Talk

49. “Promise me you’ll always remember you’re braver than you believe, and stronger than you seem, and smarter than you think.” - Christopher Robin to Pooh -