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   Modification 
    
  STRATEGIES FOR
  TEACHING STUDENTS WITH ATTENTION DEFICIT DISORDER (AD/HD) 
  Introduction
  Attention Deficit Disorders (ADD)
  are disorders characterized by serious and persistent difficulties in
  attention span, impulse control, and hyperactivity. Attention Deficit
  Disorder is a chronic disorder that can begin in infancy and extend through
  adulthood. It can have a significantly negative effect on an individual's
  life at home, in school, or in the community. There are two types of
  attention deficit disorders: undifferentiated Attention Deficit Disorder
  (ADD) and Attention Deficit Hyperactivity Disorder (ADHD). In
  undifferentiated ADD, the primary and most significant characteristic is
  inattentiveness but hyperactivity is not present. These students still
  manifest problems with organization and distractibility, even though they may
  seem quite and passive. These students also tend to be overlooked more easily
  in the classroom, and may be at a higher risk for academic failure than those
  with ADHD.  
  To be diagnosed as having ADHD a student must display, for six months or
  more, at least eight of the following characteristics prior to the age of
  seven: 
  1) fidgets, squirms, or is restless 
  2) has difficulty remaining seated 
  3) is easily distracted 
  4) has difficulty waiting for his/her turn 
  5) blurts out answers 
  6) has difficulty following instructions 
  7) has difficulty sustaining attention 
  8) shifts from one uncompleted task to another 
  9) has difficulty playing quietly 
  10) talks excessively 
  11) interrupts or is rude to others 
  12) does not appear to listen 
  13) often loses things necessary for tasks 
  14) frequently engages in dangerous actions 
  After: "Diagnostic and Statistical Manual of Mental Disorders"
  (3rd ed., rev.) (American Psychiatric Association, 1987).  
  CHICAGO, Sept. 30 (AP) - The American Academy of Pediatric Me4dcine has
  issued its first guidelines for treating attention deficit hyperactivity
  disorder, suggesting that stimulant drugs may be most effective but that behavioral
  techniques should also be used. The guidelines appear in the October issue of
  the medical journal Pediatrics, which will be released Monday. 
  As many as 3.8 million school-age children, most of them boys, are
  believed to have attention deficit disorders. Symptoms may include a short
  attention span, impulsive behavior and difficulty sitting still. The
  guidelines, which fall in line with those issued in recent
  years by the National Institute of Mental Health, were created in
  consultation with child psychiatrists and psychologists. They suggest that
  the evidence favoring medications like Ritalin is stronger than the evidence
  about behavioral therapy. 
  Symptoms improve in at least 80 percent of children on stimulants, and
  medication should be switched if it is not working, the guidelines say.
  Critics say that many doctors and teachers turn to drugs like Ritalin as an
  easy fix and that their long-term effects are uncertain. The guidelines say
  any treatment should begin only after a diagnosis is certain and doctors,
  parents and teachers have discussed appropriate treatment goals. The
  guidelines say drugs should be used with behavioral techniques, including
  time-outs for hitting. They call for rewarding children when they complete
  tasks, like homework. 
    
  General Strategies
  
   - Bring
       to the student's attention science role
       models with disabilities with a similar disability to that of the
       student. Point out that this individual got ahead by a combination of
       effort and by asking for help when needed. 
 
   - Student
       monitoring, self management, discipline, and encouragement can be a
       very important aspect for academic success. Below are the two basic
       aspects of AD/HD facilitation. 
 
   
  
   - Self-monitoring
       techniques can be very effective in the school setting.
       Self-monitoring of attention involves cueing the student so that he/she
       can determine how well he/she is attending to the task at hand. Cueing
       is often done by providing an audio tone such as a random beep, timer,
       or the teacher can give the cue. The student then notes whether he/she
       was on or off task on a simple recording sheet. Self-monitoring
       techniques are more likely to be effective when tied to rewards and
       accuracy checks. 
 
   
  
   - Behavior
       management techniques must often be used in the learning
       environment. By examining a student's specific problem behavior,
       understanding it's antecedents and
       consequences, teachers can help students with AD/HD to develop behaviors
       that lead to academic and social successes. 
 
   
  
   - Provide
       supervision and discipline: 
 
   
    - Monitor
        proper behavior frequently and immediately direct the student to an
        appropriate behavior. 
 
    - Enforce
        classroom rules consistently. 
 
    - Avoid
        ridicule and criticism. Remember that students with AD/HD have
        difficulty staying in control. 
 
    
   
  
   - Providing
       Encouragement: 
 
   
    - Reward more than punish. 
 
    - Immediately
        praise any and all good behavior and performance. 
 
    - Change
        rewards if they are not effective in motivating behavioral change. 
 
    - Find
        alternate ways to encourage the AD/HD students. 
 
    - Teach
        the student to reward himself or herself.
        Encourage positive self-talk (e.g., "You did very well remaining
        in your seat today. How do you feel about that?"). This encourages
        the student to think positively about himself
        or herself. 
 
    
   
  
   - Bring
       to the student's attention science role
       model who has a disability similar to that of the student with an impairment. Point out that this individual got
       ahead by a combination of effort and by asking for help when needed. 
 
   - Reduce
       the amount of materials present during activities by having the student
       put away unnecessary items. Have a special place for tools, materials,
       and books. 
 
   - Reward
       more than you punish, especially with positive reinforcers.
       
 
   - Try
       to be patient with an AD/HD student. 
 
   - Seat
       students with AD/HD in the front near the teacher with their backs to
       the rest of the class. Be sure to include them as part of the regular
       class seating. 
 
   - Place
       these students up front with their backs to the rest of the class to
       keep other students out of view. 
 
   - Surround
       students with AD/HD with good peer models, preferably students whom the
       AD/HD student views as significant peers. 
 
   - Encourage
       peer tutoring and cooperative/collaborative learning. 
 
   - A
       class that has a low student-teacher ratio will be helpful to a student
       with AD/HD. 
 
   - Avoid
       all distracting stimuli. Try not to place students with AD/HD near air
       conditioners, high traffic areas, heaters, doors, windows, etc. 
 
   - Avoid
       transitions, physical relocation, changes in schedule, and disruptions. 
 
   - Be
       creative! Produce a somewhat stimuli-reduced study area with a variety
       of science activities. Let all students have access to this area. 
 
   - Encourage
       parents to set up appropriate study space at home, with set times and
       routines established for study. Also, use this home area for parental
       review of completed homework, and periodic notebook and/or book bag
       organization. 
 
   - Educational,
       psychological, and/or neurological testing is recommended to determine
       learning style, cognitive ability, and to rule out any learning
       disability (LD is common in about 30% of students with AD/HD). 
 
   - A
       private tutor and/or peer tutoring will be helpful to a student with
       AD/HD. 
 
   - Have a pre-established consequences for misbehavior,
       remain calm, state the infraction of the rule, and avoid debating or
       arguing with the student. 
 
   - Avoid
       publicly reminding students on medication to "take their
       medicine." 
 
   
    
  Teacher Presentation
  
   - Consult
       with special education personnel to determine specific strengths and
       weaknesses of each student. 
 
   - Maintain
       eye contact during verbal instructions. 
 
   - Make
       directions clear and concise. Be consistent with all daily instructions.
       
 
   - When
       you ask an AD/HD student a question, first say the student's name and
       then pause for a few seconds as a signal for him/her to pay attention. 
 
   - To
       help with changes in assignments, provide clear and consistent
       transitions between activities and notify the student with AD/HD a few
       minutes before changing activities. 
 
   - Repeat
       instructions in a calm, positive manner. 
 
   - AD/HD
       students may need both verbal and visual directions. You can do this by
       providing the student with a model of what he/she should be doing. 
 
   - You
       can give an AD/HD student confidence by starting each assignment with a
       few questions or activities you know the student can successfully
       accomplish. 
 
   - Self-monitoring
       techniques can prove effective in the school setting. Self-monitoring of
       attention involves cueing the student so that he/she can determine how
       well he is attending to the task at hand. Cueing is often done by
       providing an audio tone. 
 
   - Behavior
       management techniques must often be used in the school. By examining a
       child's specific problem behavior, understanding it's
       antecedents and consequences, educators can help students with AD/HD
       develop behaviors that lead to academic and social success. 
 
   - Develop
       an individualized education program. By identifying each student's
       individual strengths and specific learning needs, you can design a plan
       for mobilizing those strengths to improve students
       academic and social performance. 
 
   - Gradually
       reduce the amount of assistance, but keep in mind that these students will need more help for a longer period of time than
       the student without a disability. 
 
   - Require
       a daily assignment notebook as necessary and make sure each student
       correctly writes down all assignments. If a student is not capable of
       this, the teacher should help the student. 
 
   - Initial
       the notebook daily to signify completion of homework assignments.
       (Parents should also sign.) 
 
   - Use
       the notebook for daily communication with parents. 
 
   
    
  Laboratory
  
   - Gradually
       reduce the amount of assistance, but keep in mind that these students will need more help for a longer period of time than
       the student without a disability. 
 
   - Consider
       alternative activities/exercises that can be utilized with less
       difficulty for the student, but has the same or similar learning
       objectives. 
 
   - Require
       a daily assignment notebook as necessary and make sure each student
       correctly writes down all assignments. If a student is not capable of this,
       the teacher should help the student. 
 
   - AD/HD
       students may need both verbal and visual directions. You can do this by
       providing the student with a visual model and a verbal description of
       what he/she should be doing. 
 
   - You
       can give an AD/HD student confidence by starting each lab assignment
       with a few questions or activities you know the student can successfully
       accomplish. 
 
   - To
       help with changes in assignments, provide clear and consistent
       transitions between activities and notify the student with AD/HD a few
       minutes before changing activities. 
 
   - Make
       sure all students comprehend the instructions before beginning their
       tasks (the AD/HD student will probably need extra assistance). 
 
   - Simplify
       complex directions. Avoid multiple commands. 
 
   - Repeat
       instructions in a calm, positive manner. 
 
   - Help
       the students feel comfortable with seeking assistance (most students
       with AD/HD will not ask for help). 
 
   - Assign
       only one task at a time. 
 
   - Modify
       assignments as needed for the AD/HD student. 
 
   - Keep
       in mind that students with AD/HD are easily frustrated and they need
       assurance of things that are common in science, e.g., when an experiment
       does not turn out as expected. Stress, pressure, and fatigue can help
       reduce their self-control and can lead to poor behavior. 
 
   
    
  Group Interaction and Discussion 
  
   - Help
       the students feel comfortable in seeking assistance (most students with
       AD/HD will not ask for help, especially in a group activity). 
 
   - Gradually
       integrate the AD/HD student into the interactive system 
 
   
    
  Reading
  
   - Provide
       additional reading time. 
 
   - Use
       "previewing" strategies by being aware of the following
       reading problems: 
 
   
    - Reversals
        when reading (i.e., "was" for "saw", "on"
        for "no", etc.) 
 
    - Reversals
        when writing (b for d, p for q, etc.) 
 
    - Transposition
        of letters and numbers (12 for 21, etc.) 
 
    - Loss
        of place when reading, line to line and word to word. 
 
    
   - Shorten
       the amount of required reading. 
 
   - Avoid
       oral reading *. 
 
   - For
       all assignments, clearly identify expectations in writing. 
 
   - Make
       required book lists available prior to the first day of class to allow
       students to begin their reading early or to have texts put on tape*.
       
 
   - Encourage
       the use of books-on-tape* to support students reading assignments. 
 
   - Provide
       students with chapter outlines, or handouts, that
       highlight key points in their readings. 
 
   - Read
       aloud material written on the chalkboard or that is presented in
       handouts or transparencies. 
 
   - Provide
       the student with published book summaries, synopses, or digests of major
       reading assignments to review beforehand, and also downloads for Cliff
       notes are available for computer use (and for transformation to tape
       output)*. 
 
   
              
              
              
                
  *Although seemingly contradictory, it really means that some
  individuals find one or the other more helpful.  
    
  Research
  
   - Review
       and discuss with the student the steps involved in a research activity.
       Think about which step(s) may be difficult for the specific functional
       limitations of the student and with the student devise accommodations
       for that student. 
 
   - Consider
       alternative activities/exercises that can be utilized with less
       difficulty for the student, but has the same or similar learning
       objectives. 
 
   - Monitor
       the AD/HD students closely on field trips. 
 
   - Help
       the students feel comfortable with seeking assistance (most students with
       ADD will not ask for help). 
 
   - Give
       extra time for certain tasks. Students with AD/HD may work slowly. 
 
   - Use
       appropriate laboratory and field strategies. 
 
   
    
  Field Experiences
  
   - Gradually
       reduce the amount of assistance, but keep in mind that these students will need more help for a longer period of time than
       the student without a disability. 
 
   - Repeat
       instructions in a calm, positive manner. 
 
   - Require
       a daily assignment notebook as necessary and make sure each student
       correctly writes down all assignments. If a student is not capable of
       this, the teacher should help the student. 
 
   - AD/HD
       students may need both verbal and visual directions. You can do this by
       providing the student with a visual model and a verbal description of
       what he/she should be doing. 
 
   - You
       can give an AD/HD student confidence by starting each lab assignment
       with a few questions or activities you know the student can successfully
       accomplish. 
 
   - To
       help with changes in assignments, provide clear and consistent
       transitions between activities and notify the student with AD/HD a few
       minutes before changing activities. 
 
   - Make
       sure all students comprehend the instructions before beginning their
       tasks (the AD/HD student will probably need assistance). 
 
   - Simplify
       complex directions. Avoid multiple commands. 
 
   - Repeat
       instructions in a calm, positive manner. 
 
   - Help
       the students feel comfortable with seeking assistance (most students
       with AD/HD will not ask for help). 
 
   - Assign
       only one task at a time. 
 
   - Keep
       in mind that students with AD/HD are easily frustrated and they need
       assurance of things that are common in science, e.g., when an experiment
       does not turn out as expected. Stress, pressure, and fatigue can help
       reduce their self-control and can lead to poor behavior. 
 
   - Monitor
       the AD/HD students closely on field trips. 
 
   
    
  Testing
  
   - Make
       sure you are testing knowledge and not attention span. 
 
   - Give
       extra time and frequent breaks for certain of the examination tasks
       (e.g., math related). Students with AD/HD may work slowly. 
 
   - Keep
       in mind that students with AD/HD are easily frustrated. Stress,
       pressure, and fatigue can result in reduction of self-control and lead to
       poor behavior. 
 
   - Use
       especially some of the general strategies related to stress, i.e.,
       management (see first part of General Strategies). 
 
   - Testing
       accommodations such as: (1) Use of a highlighter; (2) computer
       with/without spell check/grammar/cut & paste features; and (3)
       suitable setting such as private room and preferential seating. 
 
   
    
    
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