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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.
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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."
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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.
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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.
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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
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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.
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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.
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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.
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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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