Behavior Management Strategies and Resources for Students with ADD/ADHD

1. Behavior Management Strategies and Resources for Students with ADD/ADHD Presented by the Child Development Counsellors Itinerant–Elementary Student Support Services

2. CharacteristicsADHD General Information & Guidelines

3. DSM IV – TRDiagnostic Statistics Manual Diagnostic Criteria for Attention –Deficit/Hyperactivity Disorder • 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

4. 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)

5. 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)

6. 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

7. **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

8. 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

9. **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**

10. school problems STUDENTS 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)

11. DESIRABLE TRAITS COMMON IN MANY WITH ADHD AND OR LD • Resiliency • Ingenuity /Creativity • Spontaneity • Boundless energy • Risk takers • Intuitive • Inquisitive • Sensitive to the needs of others • Imaginative • Inventive • Innovative • Resourceful • Good Hearted • Gregarious • Observant

13. 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”

14. 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

15. 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

16. **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

17. Corrective Consequences • Positive practice – Do overs • Brief delay • Time owed • Fining / Response cost • Parental contact • Restitution

18. Creative, Engaging and Interactive Classroom Strategies

19. 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)

20. 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 time • Plan a response and avoid “reacting”

21. 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

22. 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 Reality • The Golden Rule = treat others as you would like to be treated.

23. WHAT SHOULD I DO ABOUT … ? • The child who is totally out of control – yelling, swearing, hiding under the desk; a danger to self / others / property • The child who can’t stay seated and who is constantly falling out of the chair • The impulsive child who blurts out in class all the time • The child who is constantly angry or upset about something • The child who is always irritating peers • See appendix 9 for some suggestions

25. 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.

26. 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 • 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). • Explain that contracts can be used in school to help motivate students to improve their performance. • 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. • 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.. • 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 … • 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. • Write down the specifics of the contract and have it signed by the student. Make a copy for the student and the teacher. • Review the contract regularly, e.g. monthly to ensure success and update rf’ment desires and continue to motivate.

27. 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

28. 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

29. 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

30. 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

31. 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

32. 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

33. 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

34. Appendix 9What Should I Do About? Some points to consider, but not the only way! • 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) • 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 • 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

35. Appendix 9 con’t • 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 • 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