VIEWS: 137 PAGES: 29 POSTED ON: 3/9/2011
Interventions for Children with Attention Deficit Hyperactivity Disorder, Attention Deficit Disorder Information gathered and presented by Laura A. Riffel, Ph.D. Copyright © 2008 (permission to print when credit given to original author- Behavior Doctor Seminars- Laura Riffel page 1 For the purposes of this pamphlet children with Attention Deficit Disorder (ADD) and Attention Deficit Hyperactivity Disorder (ADHD) will be refered to as ADHD. The strategies which have been gathered for this book are to assist with the needs of: Behavior Academics Sensory Social Organizational Skills For two years, this researcher worked with a group of 5 children who were ADHD non- medicated within a group of typical 3 rd and 4th grade students. This began a quest for interventions with the following requirements: 1) easy to implement, 2) low cost, 3) age appropriate and 4) retains a good self-esteem image for the child. Research of literature and classroom based trials were employed to ensure a successful academic growth span. Since the 5 original children, numerous children have assisted in testing and modifying the theories turning them into practical applications of research based interventions. ADHD is frequently comorbid with Learning Disabilities. Many researchers report finding comorbidity 20-50% of the time with reading disabilities and up to 30% in math disabilities. Since many of the interventions appropriate for children with ADHD are also appropriate for children with learning disabilities and vice versa, some of the same interventions are in both booklets. Copyright © 2008 (permission to print when credit given to original author- Behavior Doctor Seminars- Laura Riffel page 2 Behavioral Interventions Code Words Secret Signals Student Teacher Rating Sheet Token Economy Copyright © 2008 (permission to print when credit given to original author- Behavior Doctor Seminars- Laura Riffel page 3 Rationale for Behavioral Interventions: The biggest predictor of off-task behavior is to point out what one student is doing incorrectly. Disbelievers can only think back to the last time traffic came to a complete slow crawl. Once traffic began moving, it became apparent the reason for the slow down was due to a police officer either reprimanding a driver for not following the rules or reprimanding two drivers for having an insurance seminar on the side of the road. Do not have a crash in your classroom. Code Words: Meet with the students once a week during lunch to discuss how things are going academically and socially. During this time, come up with a code word which the student will know is a “key in” cue to what you are saying. For example: “I spy someone who is sitting up straight and tall.” The word “spy” is a code word which lets the student with ADHD know to pay attention. The fact that you are spying someone else with an appropriate behavioral ex pectation for the classroom cues the student into the fact that they are not following those ex pectations. In many ways, this is reprimanding the student, but in a way that lets the student “save face” and get on board. Once the student is appropriately displaying the behav ioral expectations, the teacher can say, “I spy someone sitting up straight and tall” making eye contact with the ADHD student to let them know they are on track. Sav ing face is very important for all children, especially those with low self-esteem and many students with ADHD hav e low self-esteem (Clawson, 1 992); (Jaffe-Gil, Dumke, Segal, de Benedictis, Smith, & Sega, 2007 ). Secret Signals Hav ing a secret signal between the child with ADHD and the teacher is an excellent v enue for sending a message without disrupting the learning of others. This researcher used prox imity with two taps on the chair leg. If a child felt two taps on the chair leg with the teacher’s foot, this was a signal to stop the current behavior. The teacher could continue to teach without anyone else in the class knowing that the teacher was in essence saying “Stop”. Many teachers have used Carol Burnett’s ear wiggle, a coach’s time out signal, the dreaded ev il eye or a certain mark on the white board meaning stop. For instance, one teacher would draw an asterisk on the board when she wanted a particular child to stop the behav ior. She could conference priv ately with the student later by pointing out how many asterisks were on the white board. Once again, the secret signals help the student with ADHD sav e face. Copyright © 2008 (permission to print when credit given to original author- Behavior Doctor Seminars- Laura Riffel page 4 Student Teacher Rating Sheet Student-Teacher Rating Form Date: March 15, 2004 Student Rating 1 Rating 2 Rating 3 Derrick (Home Room) (Second Hour) (Third Hour) 1. Followed 1. 1. 1. Directions 2. 2. 2. 2. On Task 3. 3. 3. 3. Completed Work Totals Rating Code: 3= Great Day: No Behavioral Learning Opportunities (Negative Behaviors) 2= Pretty Good Day: A few Behavioral Learning Opportunities (Negative Behaviors) 1= Could Have Been Better: More Than A Few Behavioral Learning Opportunities (Negative Behaviors) Student Signature: _________________________________________________ Teacher Signature: _________________________________________________ Parent Signature: _________________________________________________ The teacher score is in the top half of each square and the student score is in the bottom half of each square. The teacher and student rate the hour’s behavior based on the 3-2-1 scale separate from each other. When they get together, they see if they match. If they match, the student gets a point. If they do not match, the student does not get a point. This way, the student can still have a “not so great” day, but still win points. The point here is we want the student to learn what a “3” day looks like and they won’t learn through punishment. For younger students use the following examples: Huge smiling face, medium smiling face, and straight face. Never use sad faces or zero for a rating score. Copyright © 2008 (permission to print when credit given to original author- Behavior Doctor Seminars- Laura Riffel page 5 Token Economy Token Economy does not mean M&M’s and toy s. Somewhere between behavior modification and potty training, token economy was paired with toys and candy . The pay off for the token economy should match the function of the child’s behav ior. For example, if the function of the child’s behav ior is to gain peer attention, then the pay off should be a job which gives the child peer attention. If the function is to gain adult attention, then the pay off for the token economy should be time with a preferred adult doing a preferred activity. If the function of the behav ior is to escape work, then the payoff should be earning the answers to five of the homework problems for the entire class (good public relations for the student) and what none of them know is , you added 5 problems on to what you wanted them to do in the first place. It’s a win-win situation. Here are some things you should not use for tokens and why : Poker chips o Rubbing them together makes a most obnox ious noise o Encourages gambling (only kidding) Gold Coins which are really chocolate o Tempted to eat the ev idence o You’ll be tempted to eat the token when Friday hits Marbles in a jar, Metal nuts on a bolt, rubber bands on the wrist o DUH o These can all be used as weapons (this researcher has witnessed educators using them) Here is a true ex ample of a token economy which paid off. Tay lor was a sev enth grade student with ADHD and Mild Intellectual Disabilities. Taylor’s teacher asked a behav ior specialist to sit in her room and do an observation. During this time, the behavior specialist measured Tay lor interrupting his teacher 63 times in 30 minutes. The behavior specialist asked the teacher a question, “Does Tay lor have this behav ior in his other classes?” She said, “I don’t know.” The behavior specialist went around and asked all the other teachers, “Does Tay lor interrupt your class?” All the other teachers replied : Taylor was a very quiet student and Tay lor was just barely hanging on to his grades. The behavior specialist went back and asked the teacher, “What is Tay lor’s best subject?” The teacher replied Math was probably his best subject because he made straight “A” grade s. What the behavior specialist heard, which the teacher no longer heard was specifically what Tay lor was say ing when he was interrupting. The students were supposed to be working independently so the teacher could go around the room and help those that were struggling. Tay lor was interrupting the class with comments like, “What number are you on? Be careful with that one, you have to multiply before you div ide”; “What number are you on? Be sure to invert it before you cross multiply.” Tay lor was trying to teach the other students where they would get “hung up” in the work. He was not giving out answers or taking the students off task. To the teacher though, it was just the Charlie Brown adult v oice “Wuh, wuh, wuh, wuh.” The noise had become water torture; which was wearing, but interpretable to someone who was not engaged in the war. The teacher and behav ior specialist put Tay lor on a token economy where he earned tickets for not interrupting class. Tay lor’s mother assisted by helping him prepare one lesson each night which he could teach the nex t day using old teacher’s guides prov ided to her by the school. If Tay lor earned 1 0 tickets, he got to teach the class a math lesson. Tay lor stopped interrupting the class and earned teaching time each day . It was a win-win situation for the teacher and for Taylor. The students figured out Tay lor would be a good person to call for Math homework help and Tay lor used that time to gain homework help in his other classes. Taylor’s grades began to rise and ended up graduating from high school with a 3.5 grade point average. He earned a scholarship and is now attending college to be a teacher. Here’s what this conept looks like in a competing pathway chart (O'Neill, et.al., 1 997 ) Copyright © 2008 (permission to print when credit given to original author- Behavior Doctor Seminars- Laura Riffel page 6 Competing Behavior Chart Desired Behavior: Get social approval from peers in socially Work without appropriate venues interrupting Antecedent Target Behavior Maintaining Consequence Students working Taylor interrupts Taylor gets quietly on seat the class with attention from work comments about seat work peers Antecedent and Setting Event Replacement Behaviors Consequence Modifications Modifications Taylor excited about being able to teach other students. Taylor saves talking for Teacher gives tickets for not interrupting. teaching students instead of Mom worked with Taylor to Teacher watches for signal from Taylor interrupting class during work practice and prepare a lesson that he has earned 10 tickets. time. for class. Teacher compliments Taylor’s progress. Teacher tells Taylor about new plan. This would only work if Tay lor were actually excited about teaching the class some math problems. His team determined his motiv ation and his mother’s willingness to participate in a team meeting with Taylor and his mother. If Tay lor’s mother had been unable or unwilling to help him prepare a math lesson, the team was ready to pitch in and find a teacher who would help him first thing in the morning. Copyright © 2008 (permission to print when credit given to original author- Behavior Doctor Seminars- Laura Riffel page 7 Academics Assignments Shortened Auditory Cues Kinesthetic Learning Mnemonics Visual Cues Copyright © 2008 (permission to print when credit given to original author- Behavior Doctor Seminars- Laura Riffel page 8 Assignm ents Shortened One of the recommendations frequently given for children with ADHD and LD is to shorten their assignments or cut up their assignment into smaller portions. Hav ing less work to do than their peers is one of the causes of low self-esteem. Therefore, this technique is much more manageable and less detrimental to self-esteem. Giv e all the students in the class a file folder to put their work inside. On the student with ADHD or LD’s file folder , make two horizontal cuts on the top half of the file folder. Teach the student to open the top third and wor k those problems. Once complete, the teacher can walk by and grade that portion and give a thumb’s up or assist. Next, the student will do the middle section and finally the last section. This makes the assignment the same, but the student approaches the task in smaller portions with check points along the way. Auditory Cues A Song is a Wish Your Heart Makes Students with ADHD frequently visit other planets and forget to come back to Earth. Playing music which ends about two minutes before a transition is a great auditory cue. Train one o f the students to say “two minute warning” when the music stops. Some great music to play is “Sixty Beats Per Minute” by Gary Lamb. Six ty beats per minute is the heart rate for a resting heart. This is excellent music to play during times of stress. For Whom the Bell Tolls Another choice is to ring a bell and say “Two minute warning” before any transition. Sometimes trainers of adults need to give a two minute warning. Reading When a child has difficulty reading, many times they will engage in a disr uptive behavior to avoid hav ing to read aloud. A technique which works well is to partner the student with a strong reader and have them each read a sentence or two and then the other read a sentence or two. Being able to follow along and hear someone else read in short spurts is a good learning tool. Copyright © 2008 (permission to print when credit given to original author- Behavior Doctor Seminars- Laura Riffel page 9 Concept Maps A concept map is used in showing relationships between two or more objects. Drawing a concept map allows children to visualize how articles are related. Stomach wall Gastric muscles glands Peristaltic Movement Gastric Tiny juice Food pieces of food Hydrochloric Medium Acid Acidic proteases proteins The representative model above indicates motion. Showing a complex set of interactions in this model allows the child to visualize the motion. Reading a complex description in a book would not allow the child to visualize the process. Copyright © 2008 (permission to print when credit given to original author- Behavior Doctor Seminars- Laura Riffel page 10 KWL Charts: Using a poster or a bulletin board ask the “K&W” questions before beginning a lesson. Use the information to develop your lesson plans. After the unit is complete, solicit answers to the “L” section. Here are just a few of the items which would be written for a unit on the state of Kansas. Kansas K= what do we already W= what do we want to L= what did we learn? know? know? (answers solicited from children) (answers solicited from children) (after teaching- solicit answers from children) Capital is Topeka. More about cowboy s in Dorothy in the Wizard of Oz Kansas. Dodge City is the town where is from Kansas. What is the state flower, bird, “boot hill” is and where Kansas is flat. mammal, and insect? Wy att Earp is buried. Kansas is shaped like a What is a Jay hawk? Wheat is a major crop. rectangle. What is the tallest spot in Kansas produced a record (with a bite out of the corner) Kansas? 492.2 million bushels of There are lots of cows in What do farmers grow in wheat in 1 997 , enough to Kansas. Kansas? make 35.9 billion loaves of There is a cowboy town there What kind of cows do they bread. where Wyatt Earp is buried. hav e in Kansas? Pizza Huts started in Kansas Farmers grow crops in What is Kansas famous for? The highest spot in Kansas is Kansas. on the campus of the University of Kansas in Lawrence. The Geodetic Center of North America is about 40 miles south of Lebanon at Meade's Ranch. It is the beginning point of reference for land surveying in North America. When a surveyor checks a property line, he or she is checking the position of property in relation to Meade's Ranch in northwest Kansas. Highlighting facts will allow the child with ADHD to know what to cue into. Ensure that the child with ADHD is allowed to add facts in all three sections. Copyright © 2008 (permission to print when credit given to original author- Behavior Doctor Seminars- Laura Riffel page 11 Kinesthetic Learning Whether you believ e in right brain/left brain or not, it is easy to understand which whole body learning is beneficial for children who require an active schedule. Here are some ideas to have motion promotion. Gatekeeper: This is a game which gets students up and moving and learning at the same time. This could be done with any activ ity but here’s an ex ample of an easy one: 1 ) Prepare sentence strips or 3 by 5 index cards with the names of animals on them. Make sure you have some which are two legged and some which are four legged. For the first few weeks, until the students understand the concept, the teacher will serve as the gatekeeper. All the students line up and the gatekeeper either lets the students through the gate or tells them they may not enter. Once the entire line has come up to the gate, the students have to guess what the common denominator was which allowed some children to pass and some to stay. In this easy ex ample, it was animals that had 4 legs. This could be done with prime numbers, American explorers, factors of four, Confederate states and so on. It’s a nice way to keep the class mov ing and learning at the same time. Have a Ball: Take a plain rubber ball from a discount store and write questions on it with a permanent marker. For example: 4 x 4 = ____ or the capital of Kansas is_____. The students then toss the ball to each other and where their right thumb lands, is the question they are to answer. These balls can be created for any learning activity. Handwriting: To practice spelling words or handwriting, have the student use a crayon or chalk and write their words on sandpaper. The student can then trace the word with their finger. You can also hav e a kitty litter box filled with damp sand and let the student use their finger, straw, chopstick, or other utensil to write their spelling words or practice handwriting. Magic Box This is a break activity to let the children have a short recess from long drill and memorization. The teacher pretends he or she has a magic box filled with many things. (This is an invisible box with inv isible items inside.) The students are to guess what the teacher pulls out of the box based on his or her actions with that inv isible object. Once the students understand the object of the game, they can be paired in groups of 2, 3, or 4 and each have a turn at going through the box . This activ ity is very good for breaking up a long stretch of sitting. North South East West: In the corner of y our classroom put an “A” in one corner, a “B” in the opposite corner and a “C” in another and “D” in the opposite corner. Read a question and then tell the students: If y ou think the answer is “____________” go to corner “A”. If y ou think the answer is “_______________” go to corner “B” and so on until you have read all four possible answers. Make sure this is seen as a non-competitive game where no one feels bad for being in the wrong corner. Validate the answer they chose by saying, “I see how I could have fooled you because…” and offer an ex planation for the student’s choices. Mnem onics Copyright © 2008 (permission to print when credit given to original author- Behavior Doctor Seminars- Laura Riffel page 12 Mnemonics are anything used to assist memory : A string on the finger to remember to get cheese at the grocery store Every Good Boy Does Fine to remember the notes on a treble clef stave My Very Educated Mother Just Served Us Nine Pizzas for the order of the planets Spring Ahead and Fall Back for Daylight Savings Time 30 days hath September, April, June, and November… ROY GBIV for the order of the colors in a rainbow Mnemonics are very useful for everyone. There is an entire website dedicated to mnemonics for med school students to help them with anatomy and other stressful memorization tasks. Here are a few which have been helpful for students with ADHD and learning disabilities: Color Coded Reading Color coding the more difficult words will help students read them. For example: The word receipt is hard to read unless it is color coded like this: (The r,c, & t are color coded yellow for the normal letter sound. The two “e’s” are green because they are long and say their name. The i and p are color coded red because they are silent.) receipt Dot Math Teach children to v isualize dots on the numbers. The teacher can make up stories about what each number is and why they have so many dots on them. For ex ample, “7 ” is a tall man holding a baby . All the circles around smaller dots are counted twice and the number nine has a bowling ball or smiling face in the center of it. 1 2 3 4 5 6 7 8 9 Students can add or subtract using the dots. Start with the largest number and begin counting from there just as using a number line. The students can v isualize this in their heads eventually, and then no one will know they are counting to come up with the answers. This “saves face” from a sixth grader hav ing to hav e a number line on his or her desk when no one else in the room has one. Another alternative fo r a number line is to have an opaque ruler which the student can place on their math page. They can use the numbers on the ruler to count up or down without any of their neighbors know they are using a mnemonic to help them. Copyright © 2008 (permission to print when credit given to original author- Behavior Doctor Seminars- Laura Riffel page 13 Factoring Nines Hands displayed on the desk in the abov e manner. If the child is factoring 9 by 3 they would hold down the finger number three and see that the answer is 27 because there are two fingers before the finger which is held down and 7 fingers after the finger which is held down. Michenbaum’s 5-Step Cognitive Learning Theory and Spelling When this researcher taught an inclusion class every single student made an “A” on their Friday spelling test. The students did not cheat. They learned the words because Michenbaum’s Learning Theory was used to teach their spelling words. Brainstorm which words the students might have trouble with and made up a mnemonic to help them. Here are just a couple examples: muscles M-U-S-C-L-E-S, muscles make the very best….biceps (sung to the tune of Nestlé’s Chocolate) there We go here and there. It’s a place. their Prince Charles is their heir to the throne. It belongs to him. friend I have a friend to the end. sheriff She is riff and she is the sheriff (playing on this researcher’s last name) Copyright © 2008 (permission to print when credit given to original author- Behavior Doctor Seminars- Laura Riffel page 14 After mnemonics are created the students are taught in the following manner based on Michenbaum’s 5-step Cognitive Learning Theory: Day of the Week Step Procedure Example: Monday One The teacher models the way Singing M-U-S-C-L-E-S to write and spell the word while writing it. (see above) at the board with the students watching. The teacher tells what he or she is thinking out loud so the students can hear the connection between the mnemonic and the word. Tuesday Two The teacher models the way Students and Teacher sing to write and spell the word the song together while they at the board; while the both write the word : students imitate the Muscles process at their seats using paper or small dry erase boards. Wednesday Three The students model by Students sing the song while saying and writing the writing the word. steps to write the spelling word while the teacher watches. Thursday Four The students model by Students whisper the song whispering and writing the while writing the word. steps to write the spelling word while the teacher watches. Friday- final test Five Students think the process Students think the song while they write the word while writing the word. For spelling practice the students can have a menu of choices : 1 ) Using the words in a story, 2) writing the words in a variety of kinesthetic substances, 3) creating art designs with each word, or the usual old fashioned rote writing of each word. Copyright © 2008 (permission to print when credit given to original author- Behavior Doctor Seminars- Laura Riffel page 15 Spelling with Magnets For children who struggle with spelling, here is another idea: Purchase 5 or 6 packages of refrigerator magnets shaped as alphabet letters from one of the “dollar” type stores. Cut out pictures of the spelling words. For example: if the spelling word was tractor, find a picture of a tractor and cut it out. Then put all the letters which spell tractor in a baggie with the picture. Have the child dump the letters out and place them on a white board or their desk in the order which correctly spells the word. This is a kinesthetic activity allowing the student to touch the letters and manipulate them. If you use the same spelling lists from year to y ear, save the picture and letters in baggies and keep going back to the dollar store for more magnets. Visual Cues Many children, whether they have ADHD , LD or Autism for that matter, think in pictures. Children spend a majority of their day expected to listen without any v isual representation of the material being presented. Although it takes more time, pair ing the lecture with v isual representation is much more effective for many of our learners. This can be completed with technology, art, tangible objects, demonstrations, models, and role plays. Art Use art to teach or let students demonstrate mastery of a subject by creating their own art. o When study ing a country, bring in art work indicative of that country. Many local libraries have art available for loan. Show the art work of the country and then allow the students to create their own. o Design a flag to demonstrate math facts- assign a fact family for each group of four students and let them design flags to help others remember the facts. o Design a puppet and use the puppet to write a play to demonstrate learning mastery. Color Coding Use color to draw attention to the important facts for students with ADHD. For ex ample: o Color the math sy mbol red so the students notice the symbols o Color code the directions to a test purple so the students notice the directions Computer Programs The computer allows for interaction, movement, noise, and immediate feedback. o PowerPoint programs can be used: To study with links to appropriate website built in as hyperlinks inside the PowerPoint. To review for tests Make questions click on two answers with links to “right or try again” . The student can monitor their own progress using this program and the great thing, it can be used for many students. This website allows you to make many different interactive tests. Let some students create the tests and others take them. http://www.easytestmaker.com/default.aspx Dem onstrations Hav e community members come into the classroom and demonstrate how they use skills in their ev ery day life. Hav e community members come into the classroom to demonstrate any subject. Here are some ex amples: o Study ing Mexico: Hav e a community member who grew up in Mex ico come to talk to the students about life in Mex ico and show the students how to make tamales. o Elementary teachers do this activity frequently, howev er, the older the students become the less likely they are to have v isitors for classes. This is an excellent learning tool. Copyright © 2008 (permission to print when credit given to original author- Behavior Doctor Seminars- Laura Riffel page 16 Graph Paper Use graph paper to let the student line up math facts so they don’t make careless errors j ust from lining up problems incorrectly. Models Science: Teaching Open Circuit and Closed Circuit o Bring in two strands of Christmas lights: Strand number one will continue to shine even if one bulb is burnt out or removed from the set. Strand two will stop working if one bulb is burnt out or removed from the set. Laughing/Crying dolls Ducks which quack when you hold them in the palm of y our hand. Flashlights o This assortment and more are ex amples of open and closed circuits. There is even a doll that if you hold one hand, she does nothing and if y ou hold both hands, it completes the circuit and she laughs. o Children do not forget what they learn when they see it, touch it, hear it, and feel it. Posters KWL charts o Using a poster that will stay up the duratio n of the topic, divide the poster into three columns with three headers Header Number One: “K” What do we already know about the topic we are about to begin? Solicit answers from the class. This will give the educator a good idea of the majority of the student’s base of knowledge and allow for no wasted time in rev iewing something that is already known or allow for no presumptions which students already know something is lacking. Header Number Two: “W” What do we want to know about the topic we are about to begin? Solicit answers from the class. This will give the educator knowledge of the student’s interests Header Number three: “L” What did we learn about this topic? This is a good review before the test. This allows the students to discuss and give s the educator time to check for any misrules accidentally learned. Role Play s Role play ing is not just for teaching behavior. Real learning can take place when role plays are used to connect learning to real life. o Hav e Abraham Lincoln meet Martin Luthe r King, Jr. o Hav e an alien land in whatever country you are studying o Hav e a student teach an alien how to do the math topic the class is study ing o Hav e a person from the country you studied v isit the country you are now studying Tangible Objects Nothing teaches like the real thing. Many students with ADHD and Learning Disabilities are kinesthetic learners. Touching objects and being able to manipulate them really connects the learning Visual Schedule (individual and whole room ) Hav ing a visual schedule will help the student transition from reading to math and math to recess and recess to social studies. o Many educators respond negatively when asked to give a student a v isual schedule. They reply , “The students know what comes next.” Truthfully, we assume the students know what comes next, but many do not pay attention to those details. o Hav e you ever arrived at home when driv ing home from work and when you get there you realize you don’t even remember driv ing home? You do this task so often that it becom es Copyright © 2008 (permission to print when credit given to original author- Behavior Doctor Seminars- Laura Riffel page 17 automatic, you do not even think about it. The schedule is like that for you, but for some students it is not automatic. Work with Home Provide back-up text books. This alleviates the excuses for not doing homework. Post homework schedules on the Internet daily. This allows the parents to oversee homework. o Is it harmful to provide back-up text books for students? Is it teaching them to be dependent on other people? If you met a person in a wheelchair, would you say to that person, “You need to get up out of that chair and quit depending on wheels to get you around.” Of course, you would not. The wheelchair is a tool that is necessary for the person in the chair just as the second set of books is a necessary intervention for the student with ADHD. Remember, their brain is not wired the same way as ours. o Research from the US Department of Education (2006) indicates this is acceptable and preferred. Copyright © 2008 (permission to print when credit given to original author- Behavior Doctor Seminars- Laura Riffel page 18 Sensory Feet Fingers Tush Whole Body Copyright © 2008 (permission to print when credit given to original author- Behavior Doctor Seminars- Laura Riffel page 19 Sensory Students with ADHD require proprioceptive input. This is the reason behind their inability to seemingly sit still and their impulsive blurt outs. Educators expect children to sit on very uncomfortable chairs for long periods of time. These chairs were not purchased because they were best for children, but for cost effectiveness. Through research, trial and error, the following techniques have been helpful for many students: Sensory for the feet: Bungee cords: o Diagonally placed from the front right to the back left leg of the desk in front of the student. (or vice versa) Have the custodian come in and clamp the ends so they do not fly off. o Put across the two front legs of the student’s chair. Have the custodian come in and clamp the ends so they do not fly off. Therapy banding: o This can be put across the two legs of the student’s chair and they can stretch their feet behind it and push out- which gives them some sensory input they may need. Sensory for the Fingers o Velcro Put a strip of Velcro under the child’s desk on the lip of the lid of the desk. This is a spot where the child can self-stim by rubbing the Velcro and no one has to know it is there. The Velcro could also be put on the side of the chair if the chair were deep enough. This is right in the spot where the student’s hand will hang down. o Koosh Ball Koosh balls are great for “getting your wiggles out”. They even make pencils and pens with Koosh ball tops on them. One of this researcher’s children’s friends picks her cuticles till they bleed. This researcher purchased a Koosh ball pen and now when the friend writes, she uses the Koosh ball to pick at and not her cuticles. Koosh ball key-chains are also great for children who have impulsive behaviors. The child can keep this on their belt loop and reach for the Koosh ball when they actually feel like hitting someone or touching things they shouldn’t. Many children use them on the bus ride home. Copyright © 2008 (permission to print when credit given to original author- Behavior Doctor Seminars- Laura Riffel page 20 Sensory for the Tush: o Cushions allow for proprioceptive movement in the tushie which is helpful for students with ADHD. Air filled cushions Abilitations catalog: o https://www.schoolspecialtyonline.net/search/interm ediateDetails.jsp?catalogPartNum=121787094&catalo gCode=234820&returnURL=/search/mainSearchRes ults.jsp&catalogProductId=42729166(1) Target: o http://www.target.com/Core- Disc/dp/B000CNGKEU/sr=1- 6/qid=1205116926/ref=sr_1_6/601-4288479- 8182506?ie=UTF8&pricerange=&index=target&field- browse=1038576&rh=k%3Apilates&page=3 WalMart: o Available in Super Wal-Mart in the sporting goods department. Foam filled cushions IKEA o http://www.ikea.com/us/en/cata log/products/10054318 o Only available in the store – called IKEA PS UNDERBAR – seat pad in assorted colors. Stadium cushions: Go to your local business partner and ask them to sponsor stadium cushions for all students. These can advertise their business partnership and give a comfortable seat to each student. There are numerous companies which will imprint for very reasonable prices. Parents: Copyright © 2008 (permission to print when credit given to original author- Behavior Doctor Seminars- Laura Riffel page 21 Have the parents send in any type of seat cushion for their child’s chair. These cushions can be purchased from discount stores. There are few parents who would not be willing to send one in if it were going to help their child. Sensory for the Whole Body o Errands Keep something handy which could become an instant job for a child to do. For example: Extra library books Notes that need to go to the office, nurse, counselor etc. When it appears the child is about to “lose it” meaning they are really needing to get up and walk around- then send them on an errand. The biggest predictor of off task behavior is reprimanding someone. If this child “loses it”, and you have to reprimand, then the whole class is losing learning time. If you send this child on a walking errand and they come back and sit down and begin to work, then only that child lost learning time for a few minutes. o Two Desks Have two desks in the room and give the child permission to move from desk A to Desk B, then they get to get up and walk, giving them proprioceptive input. Set up the parameters under which you will allow them to move for example: “You may move to the other desk if I am not standing in front of the class teaching.” o Rent the teacher’s chair: Use a token economy and let the student earn points to use the teacher’s chair: Wheels which allow for some movement A little padding For more tokens, rent the teacher’s chair and desk and even more tokens, rent the teacher’s chair and the reading table. Copyright © 2008 (permission to print when credit given to original author- Behavior Doctor Seminars- Laura Riffel page 22 Social Interventions Secret Soldier Secret Word Social Groups PowerPoint Relationship Narratives Copyright © 2008 (permission to print when credit given to original author- Behavior Doctor Seminars- Laura Riffel page 23 Intervening for Social Situations for Children with ADHD Children with ADHD need public relation’s agents. Their impulsive behavior and possible lack of social appropriateness causes them to feel as social outcasts. Here are some of the techniques employed by others to assist with promoting a positive self- image for all the students with ADHD: Secret Soldier: Do this daily: Choose one student to be the secret soldier. Tell the students the selection of secret soldier is random and you will be watching one student per day to discern if their behavior warrants a reward for the whole class. Go over the behavioral expectations. As you do this daily, watch for a day when the child with ADHD has a great day and secretly make them the “secret soldier”. Tell the class that “Johnny or Susie” was the secret soldier that day and their wonderful behavior has earned the whole class 5 free answers on the homework that night. This will do wonders for the child’s self-esteem and how the other students view that child. Review privately with the student what behaviors were extremely appropriate. During this private session, try very hard not to mention any of the negative behaviors from the past. Secret Word: Groucho Marx had a secret word on “You Bet Your Life”. Have a private conversation with the child (I recommend during lunch) and tell the child, “You and I are going to have a secret word. If I say the word “spy”, it means I want you to cue in to what I’m saying after that.” If you are teaching and the child with ADHD is about to rev up and lose composure, look the opposite direction and say to a large group of students, “I spy someone sitting up straight and tall.”(Eight children will think you were talking about them.) This code word “spy” is a secret message between the teacher and the student. The biggest predictor of off task behavior is reprimanding a student. It is best to try to control the behavior with secret codes. Once the student with ADHD has caught on and is sitting up straight and tall, then look at that child, smile, and say, “I spy someone sitting up straight and tall over here.” (Make sure you look directly at the student with ADHD. This will be good PR for the student.) Social Groups Invite 3 or 4 students to eat lunch in the classroom with the teacher instead of in the cafeteria. Invite the child with ADHD with the most understanding students in the class. Talk about ways to be a friend with all the students. “What are some ways you all make friends on the playground, in your neighborhood, on the bus?” Talk about the really great answers and highlight them. This is great peer teaching. Copyright © 2008 (permission to print when credit given to original author- Behavior Doctor Seminars- Laura Riffel page 24 PowerPoint Use PowerPoint to create relationship narratives using the child as the star. Develop the story depicting appropriate behavior in whatever social situation the child is struggling. For example, if the child is struggling during lunchtime in starting conversations with friends, create a PPT about appropriate topics which could be brought up for discussion at lunch. Model reciprocal conversation and have the child with ADHD watch the video in a private screening area right before lunch. Transitions are also difficult for children with ADHD, such as the transition from grade school to middle school. Make a PPT movie about the new school and have the child watch the movie once a day during the summer. The child should be the star of this movie. Make sure to denote schedule, teachers, social situations and potential settings which might require intervention. Copyright © 2008 (permission to print when credit given to original author- Behavior Doctor Seminars- Laura Riffel page 25 Organizational Interventions Follow through Inattention Latency Poor handwriting Prioritizing Sequencing Study skills Transition skills Written directions Copyright © 2008 (permission to print when credit given to original author- Behavior Doctor Seminars- Laura Riffel page 26 Organizational Skills for Children with ADHD Follow Through: Instead of saying “Do this now.” Ask Questions like, “Where should you be right now? What should you do first to get started?” Keep asking questions until the child has attained. Help the student’s set realistic goals and time allotment. List task analysis steps with pictures showing the student the steps to follow to complete each task. Inattention: Many students look as though they are not paying attention. However, there are many adults and children who actually listen better if they are actively engaged in an act ivity or motion. Telling a child to “pay attention” means nothing, if they have no idea what those words mean. Teach the children what it means to pay attention. Head leaning slightly forward with eyes on speaker, nodding head when in agreement with spe aker, asking questions appropriately when not understanding speaker, and taking notes on important concepts. With that in mind, it is important to note this researcher frequently has participants in the audience who knit or crochet because it helps them pay attention. If it is true for adults, then it is true for children. Sitting still for some children is impossible. Expecting the child to sit for 45 minutes while “Ben Stein” drones on about the Revolutionary War, is ludicrous. Latency: Many times it appears the child with ADHD is being latent, however, they possibly are running the entire scenario through their mind before they begin. Use “alerting cues” when giving directions. “Everyone will need to pay attention to this next piece of information to do the work correctly.” Poor Handwriting: Rushing is one of the reasons for poor handwriting. Providing a rubric of acceptable papers is a good idea for all the students. Purchasing a special pen or pencil for the student for easy grip is another great idea. Wal-Mart sells a pen which looks like a little rocket ship. It is called PenAgain and sells for about $5.00, in the writing section. There are also websites selling buckets of these pencils. Prioritizing: Color code the student’s work in the order it is to be done. Use file folders in the following colors: red, yellow, orange, green, blue, purple. A small file box could be set up on the floor under the desk and the student puts work in the folders in the order they are to be completed. This keeps the child from jumping from one activity to another. Copyright © 2008 (permission to print when credit given to original author- Behavior Doctor Seminars- Laura Riffel page 27 Sequencing: Develop a laminated card with two squares drawn on it. The first box should be labeled “now” and the second box should be labeled “then”. The student can either write tasks with a non permanent marker or use a representative picture. Have a daily schedule labeled with tasks for the day and laminate the sheet. The child will use a non-permanent marker to check off as tasks are completed. This can be for daily schedules, or task analysis of smaller tasks throughout the day. Study Skills: Many students with ADHD sit down to study, but have no idea how to go about that. Teach what it means to study. Develop a note taking strategy which will assist with good study habits. An old reliable note taking strategy is to divide a piece of notebook paper in half with a vertical line from top to bottom. Have the student take notes from class on the left side. In the beginning it would be a good idea to set up the outline format for them on the computer, overhead, or whiteboard. When the student goes home to study, the student will fill in the right side of the paper with the information they find in the book. This will allow the student with ADHD to connect learning from class to b ook and provide a good note taking strategy will take them through college. Transition Skills: Many children with ADHD have difficulty with transitions due to their poor organizational skills. One technique which has proven successful is to have the student with ADHD keep all their materials in a tub on a shelf in the classroom instead of in their desk. The student then has to get up and go to the tub (giving proprioceptive input on the trip there) retrieve the items the teacher instructed the child to get, and bring them back to their desk. This alleviates a distracting mess at the desk, gives opportunity for movement, and gives the teacher an opportunity to compliment their appropriate completion of the task. Written Directions: Many students with ADHD are confused by written materials and have difficulty discerning the main idea from the paragraph etc. Provide the student with a copy which has the main ideas underlined or highlighted. Provide the student with outlines of important points from the reading materials. Laminate these and save them from year to year for all the students. Provide your notes to the child prior to the lesson. This researcher used to send home lesson plans for the next week every Friday. This allowed the parents, specialists and the student to prepare for the next week. Copyright © 2008 (permission to print when credit given to original author- Behavior Doctor Seminars- Laura Riffel page 28 For further information: Websites of interest: http://www.additudemag.com/ http://add.about.com/ http://www.adhdnews.com/ http://www.help4adhd.org/ http://www.chadd.org/ Books: The Gift Of ADHD: How To Transform Your Child's Problems Into Strengths (Paperback) by Lara Honos-Webb (Author) The Gift of ADHD Activity Book: 101 Ways to Turn Your Child's Problems into Strengths (Companion) (Paperback) by Lara, Ph.D. Honos-Webb (Author) The Edison Gene: ADHD and the Gift of the Hunter Child (Paperback) by Thom Hartmann (Author), Lucy Jo Palladino (Author) US Government: http://www.ed.gov/teachers/needs/speced/adhd/adhd-resource-pt1.pdf This is a 23 page booklet produced by the Department of Education on ADHD. Dr. Riffel does not represent or affiliate with any of the above authors or websites. They are simply websites and books used in research. Dr. Riffel can be reached at www.behaviordoctor.org website and caughtyoubeinggood @gmail.com email. Copyright © 2008 (permission to print when credit given to original author- Behavior Doctor Seminars- Laura Riffel page 29
"Interventions for Children with ADHD-ADD - article"