CHAPTER I THE PROBLEM Introduction There has been a large amount of information with varying conclusions and recommendations published about AD/HD (Attention Deficit / Hyperactivity Disorder). More and more research is being conducted in the medical and educational fields, but data among the various research groups is conflicting. The “Disorder” has become a topic of controversy among medical professionals and educators. There also has been a tremendous amount of media coverage on the medicated AD/HD child which includes one-sided accounts, hearsay, sensationalism, misconceptions, and unsubstantiated claims causing a whirlwind of rumor, speculation, and confusion about the disorder. Battle lines have been drawn, and caught in the middle of this controversial cyclone are the student with AD/HD, his parents, and the teacher (responsible for the education of the student with AD/HD and the other students of varying learning styles and differences in the classroom). The first day of a new school year signals the beginning of the teacher’s quest to uncover and identify the different student learning styles and 1 2 preferences represented in the classroom. No two students display identical learning personalities. Individuals perceive and process information in many different ways. The teacher crafts his/her lessons plans to enhance student learrning perception, feeling, creativity, imagination, critical thinking, and problem solving skills. The classroom reflects the appropriate visual stimuli to engage student learning. A variety of course delivery modes and activities are included in the curriculum mix to stimulate the various learning styles of all the students. The classroom’s instructional climate is at the proper textbook settings for nurturing and cultivating a successful learning classroom learning environment. During the first day assessment of the various learning differences and styles of the students, the teacher discovers the presence of a student diagnosed with Attention Deficits Disorder (AD/HD). Suddenly, it seems as if the bottom has fallen out of the painstakingly prepared lesson plans. The school year takes a detour down a more challenging road. There is no predicting how the student with AD/HD will react to the classroom, the course structure, and the other students in the room. There is no predicting how the other students will react to the student with AD/HD. The teacher’s responsibility in the classroom, as defined by Randy Lee Comfort (1992), is to prepare the environment for children to learn through active exploration and interaction with adults, other children, and materials. “The caring classroom is one which affords an opportunity for a child to learn with an adult who 3 provides security for every student at whatever level the child may be developmentally.” However, when faced with the reality of a classroom filled with various learning personalities and learning differences, including one or more AD/HD student(s), Comfort’s textbook statement seems rather lofty and ideal. The AD/HD student presents a unique set of challenges to the teacher. Children with attentions deficits learn best in very small, controlled settings in which there are few distractions. The ideal classroom structure and environment for the more traditional learner, with a variety of visual and auditory stimuli, is probably the worst for the AD/HD student. Colorful walls decorated with posters, maps, and charts may be stimulating to most students, but they are a distraction to the student with attention deficits. The AD/HD student does not retain course instruction delivered in a straight lecture format. Even the traditional student will struggle with lecture-style instruction. Only 15 % of the student population tend to be auditory learners; and, according to statistics, students retain only 26% of what they hear (Rief 1993). The student with AD/HD will retain far less from lecture-style delivery. He may to fidget and make sounds that distract the other students in the class. He is not doing this on purpose. He is unaware of his actions. Learning stations and centers with different activities, sounds and movements simultaneously taking place throughout the room become overwhelming for the student with AD/HD. AD/HD students tend to be concrete learners and succeed in a learning environment that is consistent and predictable. Providing a consistent learning 4 environment for the AD/HD student, without detracting from the learning environment of the others in the classroom seems an insurmountable task. Not only does the AD/HD student become overwhelmed in the classroom environment, the teacher equally becomes overwhelmed attempting to provide a stimulating learning atmosphere for all the students in the classroom. The Definition of AD/HD Since 1990, the total number of students diagnosed with AD/HD has increased from 900,000 to approximately 7 million (Jensen 2000). Sandra Rief, M.A. points out that many children with this disorder slip through the cracks. AD/HD is diagnosed between 3 to 9 times more frequently in boys than girls. It is believed that many more girls actually have AD/HD and aren’t diagnosed because of then they exhibit fewer of the disruptive behaviors associated with hyperactivity and impulsivity. Many girls have the predominantly inattentive type of the disorder and are likely not being identified and diagnosed. (Rief 1998) AD/HD affects approximately 3% to 5% of the school-aged population. These estimates rise to 6.8% - 10% when comorbid symptoms (the presence of more than one mental disorders), along with learning and behavioral differences are added to diagnosis. Other estimates put the percentage of school-aged children affected with AD/HD as high as 23% (Bender 1997). It is estimated that at least one student with AD/HD is present in today’s classroom. Through his work and research on AD/HD, Dr. Sam Goldstein, University of Utah and the University Neuropsychiatry Institute, contends, “AD/HD is a very common condition, affecting at least one out of twenty kids to 5 a significantly impairing degree.” No two students diagnosed with attention deficits interact and learn the same. Dr. Goldstein (2001) points out, “in school settings, children with AD/HD demonstrate a normal range of intellectual ability. Thus 2 % of the population of children receiving a diagnosis of AD/HD suffers from sub-borderline intellectual ability with 2 % demonstrating gifted intellect.” Many times the gifted AD/HD masks learning disabilities and other disorders such as anxiety, oppositional behavior, and depression. A student often is labeled inconsistent and lazy by the classroom teacher. One day the child performs brilliantly, the next day she is dull and unresponsive. This labeling adds to the AD/HD student’s low self-esteem and self-doubt. AD/HD is not a learning disability. It is classified as a neurological or mental disorder. To be tagged with a mental disorder further contributes to low self-esteem and self-doubt, particularly in older children and adults. Dr. Larry Silver, a Child and Adolescent Psychiatrist and Clinical Professor of Psychiatry at Georgetown University Medical Center, defines AD/HD as a neurologically- based disorder caused by a deficiency of a specific neurotransmitter in a specific set of brain circuits: AD/HD is categorized in two types, Attention Deficit Hyperactivity Disorder (AD/HD) and Undifferentiated Attention Deficit Disorder (AD/HD/WHO – Attention Deficit Disorder Without Hyperactivity). The diagnosis is determined by three behavior categories, Attention Span, Hyperactivity, and Impulse Control. Specific behavior characteristics are listed under each category. An AD/HD student might fall into one category, but it is possible for the student to display characteristics from all three. The AD/HD student might talk excessively and be disruptive, or quiet and shy. 6 It might be hard to draw the student into a class discussion or the student may be impatient, unable to wait his or her turn, and blurt out answers. (2001) Thus, it becomes more of a challenge for the teacher to define the typical AD/HD student’s learning personality. There is no such thing as a typical, textbook AD/HD student. There are some commonalities that seem to prevail among AD/HD students in general. Unimportant sights and sounds tend to be distractions, and drive the student’s mind to jump from one thought or activity to the next. How the student reacts to this tendency is different from individual to individual. Some students become restless and disruptive; other students drift off and daydream. Whatever the reaction, attention and the ability to focus and organize are requirements for success in school. Here lies the challenge for the classroom teacher. When faced with a classroom of 30 students with multiple learning differences and personalities, some difficult to identify, as is the case with the student diagnosed as AD/HD; how can learning activities and exercises be worked into lesson plans that meet the needs of each individual student? The time factor alone makes it impossible. Many educators are discovering that meeting the learning needs of the students isn’t in varying the lesson plans, but in the tools available to assist each individual student to receive, organize, process, and retain information. In the same manner many that coaches of youth sports, through the use of various motivational methods and assistive skill building devices, strive to create an equal and level playing field for the young participants of varying 7 physical abilities; classroom teachers must strive to create an equal and level learning field for their students of varying learning styles and abilities. More and more teachers and school administrators are turning to multisensory instructional methods and assistive technology devices to establish an equal and level field of learning for all the students in the classroom, including the student with AD/HD. Definition of Assistive Technology (AT) The Technology-Related Assistance for Individuals with Disabilities Act of 1988 defines an assistive technology device or tool as any item, piece of equipment, or product that is used to increase, maintain, or improve the abilities of people with disabilities. AD/HD affects the student’s ability to focus, organize, listen, process information and communicate. Assistive technology tools have been proven to greatly improve the student’s reading, writing, spelling, and math skills, and the ability to achieve success in school. Functioning as a bypass, AT helps the student work around or compensate for learning or attention deficits. From highlighting markers to mind mapping and outlining software, AT devices help the student with AD/HD rely less on others and more on themselves to successfully complete their work. Electronic devices such as computers, word processing software with spell checkers, pocket organizers, and calculators have made it possible for many AD/HD students to focus, organize, complete assignments and effectively accomplish tasks and assignments in a variety of classroom settings. Affordable and available, assistive technology tools help 8 students of all ages and learning styles to learn, practice, and use skills essential to becoming a successful learner. Assistive technology tools also serve as tremendous aides in helping the classroom teacher provide a variety of learning activities and exercises specific to the various learning personalities and differences of the student population. Not only can AT tools help the students learn, but various tools and devices help the teacher plan and organize lesson plans, delivery the course information, construct and administer assessment, calculate and organize student grades, and display course materials and resources. The use of assistive technology devices in the classroom can benefit both teacher and students; but, the use of the devices depends on how willing the teacher is to accept, learn, and include the various AT methods, formats, and tools into the general classroom curriculum. Purpose The purpose of the study is to identify relationships between the unique educational challenges presented a teacher by the presence of an AD/HD student in a traditional classroom setting, the perception/attitude the classroom teacher has toward the student with AD/HD, and the use of readily available assistive technology devices by all students in the classroom. 9 Assistive technology devices are not cures for learning problems, such as AD/HD, they are tools. The Merriam-Webster’s Collegiate Dictionary defines a tool as a “device that aids in accomplishing a task”.( 2001) Research studies have documented the effectiveness of AT devices as aids for empowering the student with learning problems. Devices and software such as electronic spell checkers and calculators, speech recognition software, word processing software, audible electronic dictionaries, book scanners, and screen readers can be used by students as a byway to accomplishing tasks in reading, writing, spelling, and math. Studies involving the use of assistive technology in the classroom generally have centered on the learner. It would be of compelling interest to look at the benefits assistive technology devices lend the classroom from the standpoint of the person responsible for creating and maintaining a successful learning environment, the teacher. The investigation into the effects of the integration of assistive technology devices with the curriculum on the teacher confronted with the challenge of meeting the unique learning needs of the AD/HD student, along with the learning needs of the other students in the classroom, would be of powerful significance in promoting the use of AT for the empowerment of both teachers and students. Studying the ways the use of assistive technology devices can enhance the ability of the teacher to create an equal and level learning venue for all students, lessens the possibility of inadvertently allowing a student with the 10 unique learning differences associated with AD/HD, to slip through the educational system’s cracks. Statement of the Problem The problem of this study is to determine the relationship between the use of assistive technology devices included in the general course curriculum and lesson plans with the unique challenges the teacher encounters when attempting to meet the learning needs of all students, including the special needs of the student with AD/HD included in the traditional classroom setting. Further, the study attempts to investigate the impact the teaching challenges created by the unique learning differences of the AD/HD student in the classroom has on the teacher’s perception of AD/HD and the teacher’s attitude towards accommodating the special learning needs of the AD/HD student. The study will determine the relationship between the use of assistive technology devices in the classroom and the teacher’s attitude towards accommodating the student with AD/HD. General Hypotheses The objective of this study is to demonstrate the correlation between the challenges the AD/HD student brings to the traditional classroom settings, teacher 11 attitudes towards the provision of special accommodations, and the inclusion of assistive technology in lesson plans. The following hypotheses were developed: 1.) There is a significant relationship between the unique teaching challenges the classroom teacher must meet due to the inclusion of the AD/HD student in the traditional classroom setting, and the use of assistive technology devices in course activities. 2.) There is a significant relationship between the attitude of the teacher forced to adjust the classroom environment and make special accommodations for the AD/HD student, and the availability and use of assistive technology devices in the classroom. Delimitations The scope of the present study is to determine the degree of teaching challenges presented by the AD/HD student as it relates to the availability and use of assistive technology in the classroom. The focus of this study is to examine the differential relationships between specific teacher attitudes when faced with the challenge of meeting the unique learning needs of the AD/HD student in the classroom and the effects the incorporation of assistive technology devices in with the course curriculum has on empowering the teacher to successfully meet the challenges and establish an equal and level learning field for all the students in the classroom. 12 1.) Data will be collected from a survey distributed randomly to teachers (Grades Pre-K – Postsecondary Grade 16) in Northeastern Ohio, Central Ohio, and Southern Ohio. 2.) The survey will be distributed in three formats: 1.) personal interview; 2.) hard copy; and, 3.) online. Participants will be encouraged to comment on each question and the survey topic in general Definitions and Operational Terms A number of frequently used terms are defined below to provide a better understanding of the study. AD/HD - Term used for Attention Deficit/Hyperactivity Disorder, can be used to describe the disorder with or without hyperactivity. Assistive Technology (AT) – any item, piece of equipment, or product that is used to increase, maintain or improve the abilities of individuals with disabilities: tools to promote independence across all areas of daily living. AT devices may be categorized as high technology and low technology. Many low-tech devices can be purchased at a hardware store, selected from a catalog, or fabricated using tools and materials found in home workshops (Franklin, 1991). Examples might be note-taking cassette recorders, pencil grips, NCR paper/copy machine, simple switches, head pointers, picture boards, taped instructions, or workbooks. High-tech devices frequently incorporate some type 13 of computer chip, such as a hand-held calculator or a "talking clock." Examples might be optical character recognition (OCR) calculators, word processors with spelling and grammar checking, word prediction, voice recognition, speech synthesizers, augmentative communication devices, alternative keyboards, or instructional software. Attention Deficit Disorder - a specific neurological difference for which there is no cure. Individuals with the disorder have decreased activity in the regions of the brain responsible for regulating their impulses, memory, and planning ability. AD/HD is not a learning disability. Comorbid - The presence of more than one disorder. Example would be an individual having both AD/HD and depression. Learning Disability (Difference) - Could be any number of disabilities that affect an individual's ability to learn. Learning Preference - A particular way or method in which an individual prefers to learn or study. Learning Style - A particular way in which an individual learns. Examples include: Physical, Mathematical, Visual, Linguistic. 14 Multimedia - The use of computers to present text, graphics, video, animation, and sound in an integrated way. Long touted as the future revolution in computing, multimedia applications were, until the mid-90s, uncommon due to the expensive hardware required. With increases in performance and decreases in price, however, multimedia is now commonplace. Nearly all PCs are capable of displaying video, though the resolution available depends on the power of the computer's video adapter and CPU. Because of the storage demands of multimedia applications, the most effective media are CD-ROMs. Summary Chapter 1 introduced a recent analysis of the goal for the classroom teacher to prepare the classroom environment for students to learn and the challenges in meeting that responsibility with the inclusion of an AD/HD student in the mix; and the impact assistive technology devices can make on successfully achieving that goal. The textbook role of the teacher is compared to the reality and challenge of creating a stimulating and productive classroom that “affords an opportunity for a child to learn with an adult who provides security for every student at whatever level the child may be developmentally.” (Comfort) Chapter 1 established the fact that Attention Deficits Disorder (AD/HD) is not a learning disability. It is classified as a mental disorder, and to be labeled 15 as having a mental disorder often time causes low self-esteem and self-doubt in older children and adults. The challenge for the teacher to define the typical AD/HD student’s learning personality is impossible in that there is no such thing as a typical AD/HD student. AD/HD falls into three behavioral categories and many times the symptoms overlap in individual cases. When comorbid symptoms or learning and behavioral problems exist along with the AD/HD, any advance curriculum planning designed to compensate for AD/HD students becomes a challenge. The purpose of this study was to identify the unique challenges a classroom teacher encounters when attempting to create a stimulating and productive learning environment for the entire classroom, and the effect assistive technology can have on easing the burden and helping the teacher achieve successful learning outcomes for all students, including the AD/HD student. The study focused on the effectiveness of incorporating assistive technology methods and devices into the course curriculum to include the entire student population, rather than specific individuals with learning differences; and the teacher’s attitude and willingness to enhance the curriculum with AT methods and devices. These factors will be investigated to conclude the use of assistive technology in the course instruction and activities can empower the teacher in the cultivation and maintenance of an equal and level learning field designed to empower all students with the means to achieve academic success. Finally, a list of operational terms and definitions has been included to aid in the understanding of the research. CHAPTER II REVIEW OF THE LITERATURE Volumes of documented research exist on how the brain work and what factors affect learning. The volumes of literature on AD/HD demonstrate and state the unresolved controversies that feed on the issue. Once called hyperkinesias or minimal brain dysfunction, AD/HD is one of the most common mental disorders among children and adults. Opinions on AD/HD/AD/HD range from complete denial to as many as 23% of all children having the disorder (Bender 1997). Eric Jensen (2000) cites estimates ranging from 2 to 10 percent of American children and 15 to 20 million Americans of all ages as being affected by the disorder. Jenson cites the following statistics: It impacts five times as many boys and girls and twice as many Caucasians as African Americans. Prescription medications are three times more likely to be used in the treatment of boys than girls, and, as children with AD/HD age, the use of medication increases. By the fifth grade, 19 to 20 percent of Caucasian boys were taking a medication for AD/HD, and some middle schools report as many as 50 percent. ( Jensen 2000) Much of the controversy surrounding the disorder centers on the methods and the validity of diagnosis, and the medications prescribed as treatment for the disorder; however, there is a large amount of educational material and available support systems for the promotion of a healthy, supportive relationship between the student with 16 17 AD/HD, her parents, and the teacher. Also, literature reveals the use of certain assistive technology devices and techniques help level the field of learning for the student with AD/HD; and enable the student to become a participating and contributing member of the traditional classroom and learning environment. Literature also indicates that when both low end and high end AT devices are incorporated in with the curriculum and made available to all students, the classroom learning environment noticeably is enhanced. The chapter is divided into five categories. The first category defines the symptoms of Attention Deficit Disorder and provides an overview of the diagnosis process. The second category examines the various challenges the student with AD/HD, the parents, and the teacher face on a daily basis. Guidelines and practical advice for teaching the student with AD/HD is included in this section. The third category looks at various assistive technology devices known to aid and empower the student with AD/HD in various subjects and learning disciplines. The fourth category examines Gardner’s Multiple Intelligence theory, multisensory instructional methods, and the AD/HD learning style. Vygotsky’s Zone of Proximal Development (ZPD) theory as applied to the use of the computer as a “more capable peer” or assistive coach for the AD/HD student is considered in the fifth category. 18 The Characteristics and Symptoms of AD/HD and the Diagnosis Today, more and more students in the United States are diagnosed with Attention Deficit Disorder as an answer to poor performance in school and classroom social and behavioral problems. As the rate of diagnosed students steadily increases, so does the controversy over the cause, diagnostic procedure, treatment, and existence of the disorder. AD/HD is not a new phenomenon. On the Suite101.com Web site, when asked by a reader where AD/HD came from, Valerie de Armas pointed out that “AD/HD symptoms were recorded in the mid 1800s in children with nervous system injuries and diseases. In 1848, a German physician wrote a children’s’ story, “Fidgety Phil”, describing hyperactive behavior.” She went on to answer: British pediatrician, George Frederic Still was probably the first to do any comprehensive observations of AD/HD children. He reported his observations in a series of lectures at the Royal College of Physicians in 1902. He described the children he observed as aggressive, defiant, lawless, overactive, attention impaired, dishonest and accident-prone. He also described them as having a “defect in moral control”. He didn’t paint a very pretty picture of the disorder for sure! His observations went on to note that the behavior was biological rather than a result of poor parenting. He theorized that the behavior was either inherited or the result of an injury at birth. (Armas 2001) The widely accepted psychiatric definition of AD/HD is from the Diagnostic and Statistical Manual of Mental disorders, DSM-IV: AD/HD: a persistent pattern of inattention and hyperactivity-impulsivity or both, occurring more frequently and severely than is typical in individuals at a comparable level of development. The illness may begin in early childhood, but may not be diagnosed until after the symptoms have been present for many years. 19 The prevalence is estimated to be 3% to 5% in children; data for adults are available. (DSM-IV)1997) The DSM-IV lists the origin as unknown; “however, the disorder may reflect a deficiency in neurochemicals that influence functions of the reticular activating system of the brain.” The cause of AD/HD is unclear. Many myths and misconceptions about the cause circulate throughout the media, the educational system, and general uninformed coffee clutch conversations. Research shows that AD/HDD is not caused by poor parenting, too much television, or too much sugar or poor diet. Genetic and environmental factors are at the center of AD/HD research. Physiology - Scientists have found an approximately 10% reduction in the size and activity of specific areas in the frontal lobe and basal ganglia of AD/HD patients. Chemical Dysregulation - Some research cites insufficient amounts or the restricted flow of the neurotransmitter dopamine to the basal ganglia and prefrontal cortex (PFC) part of the brain. Frontal-Lobe Symmetry - AD/HD research has cited over-symmetry between the left and right frontal lobes in the brain. The left frontal lobe is more involved with approach behaviors and the right frontal lobe with avoidance behaviors. The right frontal lobe is a bit larger than the left in research cases involving subjects with AD/HD. Heredity – Genetic researchers have discovered a link between the DRD4 repeater gene and AD/HD. The studies suggest that up to 80 percent of the variance in the traits or characteristics associated with AD/HD due to an inherited biochemical. Head 20 Injury – Injuries caused by falling from a bike, a car accident, a sports injury, a fight, physical abuse, etc. can cause damage to the prefrontal cortex. This area of the brain is most susceptible to injury and puts the student at risk for developing learning and conduct problems as a result. (Jensen 2000) Attention Deficit Disorder (AD/HD) typically has been categorized by three characteristic-types (Bender 1997) (Barkley, 1990; Maag & Reid, 1994): Inattentive Type (inappropriate levels of attention) Often fails to give close attention to details or makes careless mistakes in schoolwork or other activities Often has difficulty sustaining attention in tasks or play activities Often does not seem to listen when spoken to directly Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not because of oppositional behavior or failure to understand instructions) Often has difficulty organizing tasks and activities Often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork and homework) Often loses things necessary for tasks and activities (e.g., toys, school assignments, pencils, books, tools) Often is easily distracted by extraneous stimuli Often is forgetful in daily activities Hyperactive-Impulsive Type Often fidgets with hands or feet or squirms in seat Often leaves seat in classroom or in other situations in which remaining seated is expected Often runs about or climbs excessively in situations in which such behavior is inappropriate (in adolescents or adults, may be limited to feelings of restlessness) Often has difficulty playing or engaging in leisure activities quietly Often is “on the go” or often acts as if “driven by a motor” Often talks excessively Impulsivity Often blurts out answers before questions have been completed 21 Often has difficulty awaiting turn Often interrupts or intrudes on others (e.g. “butts into” conversations and games) Eric Jensen (2000) puts forth theory about AD/HD characterizing the condition into two categories, impulsiveness and time disorientation. “Current evidence suggests that AD/HD is not so much a problem of attention or skill, but of performance (i.e., impulse control).” For example, Johnny may know what 5x3 is, but when asked to complete a problem on the chalk board, he may be unable to perform on the spot. Essentially, the student may be learning but cannot always be evaluated in the traditional sense. In AD/HD subjects the prefrontal cortex, the brain’s “executive” area, is ineffective in the following functions: *Separating external (environmental) from internal (mental) states/stimulation, * Moving from other-directed to self-directed * Distinguishing the present from the future, * Delaying immediate gratification. (Jenson 2000) No two students with AD/HD display the same characteristics or identical behaviors as a result of the disorder. Not all symptoms apply to each student and symptoms vary in the degree or manner in which they affect each person. Sandra Rief points out “each child is unique and displays a different combination of behaviors, strengths, weaknesses, interests, talents, and skills.” She emphasizes: It is important to recognize that any one of these behaviors is normal in childhood to a certain degree at various developmental stages. For example, it is normal for a young child to have difficulty waiting for his/ her turn, to have a short attention span, and to be unable to sit for very long. 22 However, when a child exhibits a significantly high number of these behaviors when they are developmentally inappropriate (compared to other children their age), it is problematic. These children will need assistance and intervention. (Reif 1993) AD/HD often is confused as a learning disability. It is classified as a neurological inefficiency in the area of the brain which controls impulses and aids in screening sensory input and focusing attention (Rief 1993). The lack of dopamine, the neurological chemical with transmits neurosensory messages also is cited. Genetics is thought to be a chief cause. Studies have shown a child with AD/HD has a family member with similar learning and behavior histories. The Individuals with Disabilities Education Act (IDEA), formerly P.L. 94-142, the Education of the Handicapped Act (EHA), define a learning disability as a "disorder in one or more of the basic psychological processes involved in understanding or in using spoken or written language, which may manifest itself in an imperfect ability to listen, think, speak, read, write, spell or to do mathematical calculations." In a recent interview, Dr. Kenneth DeLuca explains, “In the case of a learning disability, the student needs the switch flicked a few times in order for the light to the psychological process involved in accomplishing a task to go on.” In the case of AD/HD, the switch won’t work, the light won’t go on. DeLuca states, “When the student with AD/HD says he can’t, it’s not because he won’t, it’s because, at the moment, he can’t.” Many times teachers have a hard time understanding this because one day 23 the student can perform and complete the task in a brilliantly creative manner, and the next day the student falters, becomes frustrated, and avoids the task altogether. Many times AD/HD also tags along with specific learning disabilities. Sandra Rief (1993) reports at least one third to one-half of her students with learning differences “display the behaviors and characteristics associated with AD/HD, even if they do not have the medical diagnosis or receive medical intervention.” According to some researchers, the presence of learning disabilities with attention deficits could be as high as 30 to 40 percent (Lisa J Bain 1991). To add to the confusion and challenge faced by the student, parents, and teacher, and can be accompanied by other mental disorders. Depression and anxiety are common companions. Eric Jensen (2000) explains, “Comorbidity (or overlapping conditions) is common in AD/HD sufferers.” In fact, some studies suggest that only 3 percent of sufferers over the course of their lifetime have AD/HD alone. Conversely, about 56 percent of AD/HD sufferers have four or more psychiatric comorbidities throughout their lifetime. About 11 percent of AD/HD sufferers experience one other psychiatric condition and 18 percent have three. Men with AD/HD experience higher rates of Conduct Disorder, Antisocial Personality Disorder, alcohol and drug dependence, and stuttering than women. But, women with AD/HD experience higher rates of depression, Bulimia Nervosa, and simple phobias. Because of this high rate of comorbidity, the risk of misdiagnosis and undiscovered problems is high. (Jenson 2000) The National Attention Deficit Disorder Association presents literature that emphasizes the concern of AD/HD not only disrupting the learning and behavior control in the school-age child, but, “as a critical neurobehavioral 24 condition, it can profoundly compromise functioning in multiple areas throughout the life span. The concern is paradoxical in that “AD/HD is both incorrectly diagnosed when it is not present and under diagnosed when it is present; and is both incorrectly treated and under treated.” Research and clinic experience suggest that AD/HD difficulties can lead to significant educational, health, social, and economic problems.” (1998) The NADDA advocates the establishment of a standard of care for the diagnosis and treatment of AD/HD, pointing out that though “controversy abounds about aspects of its diagnosis and treatment, the research and clinical experience over the past few decades have been sufficient to begin to identify certain principles regarding the evaluation and treatment of AD/HD.” (1998) The association outlines eleven Guiding Principles for the Diagnosis and Treatment of AD/HD: 1.) Evaluate and treat the whole person; 2.) AD/HD should be suspected but not presumed; 3.) AD/HD may present across the life span; 4.) A comprehensive assessment is necessary for an accurate diagnosis; 5.) The evaluation and treatment of AD/HD should be conducted by a qualified professional; 6.) Response to medication should not be used as the basis to diagnose AD/HD; 7.) Diagnosis should be based primarily upon the SDM-IV AD/HD criteria; 8.) Diagnosis and treatment of AD/HD should involve others familiar with the person undergoing the evaluation; 9.) Treatment should often involve more than one discipline working cooperatively; 10.) Stimulant 25 medications are the benchmark of treatment for most AD/HD patients; 11.) Practitioners should become familiar with current research and diagnostic tools. The diagnosis of AD/HD is a complex process done a time period of at least 6 months. Some of the criteria for diagnosing the disorder include the symptoms or behaviors appear or were present before the age of seven and last at least 6 months. Also, the levels of interference or disturbance caused by the symptoms are more severe and frequent that the norms for the person’s represented age group; and that the symptoms or behaviors caused by the symptoms create a real disability in at least two areas of the individual’s life, such as school, home, the work place, or social settings. Sandra Rief (1997) makes note that, “Just meeting the criteria in DSM-IV does not confirm a diagnosis of AD/HD. It is just the beginning of the information–gathering process.” She lists: 1.) the history of the child’s medical, developmental, school, and family; 2.) other information gathered through interview and questionnaires with parents, other family members, and teachers; 3.) behavior rating scales filled out by the parents, classroom teachers, and other adults that work frequently with the child (school counselor or special education teacher); 4.) gathering and reviewing information that must be supplied by the school such as work samples and other evidence of academic, behavioral, and social/emotional issues; 5.) a review of school records (report cards, citizenship grades, teacher comments, standardized school achievement tests, anecdotal records, etc.); 6.) an observation of the child 26 functioning in various school settings; and, 7.) assessments (academic achievement testing, intelligence testing, and a physical examination). It is the treatment of the disorder that causes the greatest controversy and misconception of AD/HD. The media has done its share in publishing and broadcasting on both useful and helpful information, along with harmful and misleading information on the cause and treatment of AD/HD. Unfortunately, the general public, teachers included, tend to listen to the media before listening to the professionals in the field of neurological disorders and special education. The Challenges of Learning with AD/HD and Assisting the Student with AD/HD to Learn To learn is to gain knowledge or understanding of a skill in by study, instruction, or experience (Merriam-Webster 2002). In order to learn, a student must be able to pay attention to the instruction and follow the steps involved in processing the information to be learned. The PBS series and Web site, Different Minds, defines “paying attention” as “the brain's ability to take all of the stimuli around us, immediately categorize and organize information as relevant or irrelevant, and focus the mind on one thing.” (2001) The site allows the visitor to experience, first hand, the challenges and frustrations a student with AD/HD faces in the classroom on a daily basis. “For a child in a classroom, paying attention to the teacher means filtering out as many as 30 other students 27 and the dynamics between them, visual or outside distractions, noises, and more.” (2001) KidSource Online describes what it is like to have Attention Deficit Disorder: Imagine living in a fast-moving kaleidoscope, where sounds, images, and thoughts are constantly shifting. Feeling easily bored, yet helpless to keep your mind on tasks you need to complete. Distracted by unimportant sights and sounds, your mind drives you from one thought or activity to the next. Perhaps you are so wrapped up in a collage of thoughts and images that you don’t notice when someone speaks to you. (2001) You became so lost in your collage of thoughts that you didn’t hear the teacher repeatedly call on you. The other students laugh. You are tagged an airhead or a space cadet. This is what a student with AD/HD encounters in the traditional classroom setting on a regular basis. Some days it isn’t as bad; some days it is worse. The longer the student is required to sit still, focus, and listen, the worse the distractions become, and the degree of stress and anxiety increase. Depending upon the characteristics and symptoms of AD/HD experienced by the student, she may drift off into a dream-like state or he may begin to fidget and distract the rest of the class. Some students with comorbid AD/HD characteristics may become angry and agitated. Others may become emotional and cry. However, the student with AD/HD reacts to the situation; it is clear, the student is overwhelmed at the moment and is not learning. 28 The student with AD/HD is at risk for experiencing low self-esteem, often times viewing herself as a failure. Teachers may describe the student with the following phrases: “Why can’t she follow directions like the other children?” “I never know what to expect from him!” “He doesn’t sit still!” “She can’t seem to concentrate.” “He doesn’t turn his papers in, even when he has them.” “He can’t stay focused on the discussion.” “She interrupts with irrelevancies in the class.” “He is like a cyclone; when he comes in, everything is disrupted.” “Sometimes I wonder how the other students concentrate at all when I constantly have to call on him to be still.” Her peers may describe her with the following remarks: “She’s just dumb.” “He can’t even do the work on the board.” “She’s mean. She doesn’t understand when she hurts other people’s feelings.” “Why do I have to be a field trip buddy with him?” “He never gets his work done.” “I don’t want her on my team.” “Why does he have to be in our group for the project?” “He never tries to get his homework in.” “Can’t we choose someone else?” And her parents may describe her with these terms: “Why can’t she get up, get dressed, and get to the breakfast table without a fuss or constant reminding, like my other two kids?” “What is it with this kid?” “How can he lose one of every pair of shoes we buy?” “Whose turn is it to help Jamie get out of bed?” “How does all the extra time she requires affect out other kids? Is this fair to them?” “I never know with this one. Sometimes it is do draining working with him.” (Bender 1997) 29 Experts advocate and encourage the teacher and parents to focus on the positive side of the child’s nature and strengths. About.com lists 10 positive characteristics of the person with AD/HD: 1.) Endless Energy; 2.) The ability to Hyperfocus; 3.) Energy and Hyperfocus combined (if the individual with AD/HD is able to focus and find an interest, there is no stopping him.); 4.) Great Imagination; 5.) Creativity; 6.) Humor; 7.) Ahead of Establishment Thinking; 8.) Creative Thinking and Problem Solving; 9.) Spontaneity; 10.) Great Passion for Interests. (2001) Eric Jensen (2000) explains that successful (experienced) educators “by virtue of necessity, have learned to accommodate the AD/HD learner.” What do they do? First and foremost, they maintain a positive attitude. (I like AD/HD learners; they have more energy and enthusiasm!) They also have learned to tweak the balance between control/direction and student empowerment, and to identify the difference between AD/HD and AD/HD combined with other more serious disorders. Lastly, when they are in over their head, they make the appropriate referral. The accommodations you learn to make for the AD/HD learner also benefit the rest of your students. Managing AD/HD effectively requires good basic teaching skills. (2000) Jensen’s statement is a recurring theme in most of the literature on including and teaching the student with AD/HD in the traditional classroom environment. Teaching the student with AD/HD requires an educator to reaffirm why he became and educator, to think and teach at times “outside of the box”, and to utilize good basic teaching skills. Jensen states, a positive attitude benefits the student with AD/HD, as well as all of the students in the classroom. 30 Assistive Technology: Empowering the student with AD/HD Statistics show that the majority of us are visual learners. Sandra Rief (1993) cites statistics that show the majority of learn best through visual and tactile/kinesthetic input. Only 15 percent of all learners tend to be auditory. She emphasizes the importance of these statistics particularly for the secondary or post-secondary teacher that tends to be more lecture-based with teaching style. She warns, “With you doing all the talking, there are a high percentage of students you’re not reaching.” Statistics show students retain: 10 percent of what they read; 26 percent of what they hear; 30 percent of what they see; 50 percent of what they see and hear; 70 percent of what they say; and 90 percent of what they say and do. (Rief 1993) Dr. Rita Dunn defines learning styles as “the way in which each learner begins to concentrate on, process, and retain new and difficult information.” Much of the literature on the subject describe learning styles as the way an individual perceives and processes information as he or she deals with daily tasks and situations. Statistics show: One third of our students do not process auditorily. Over 60 percent of our students prefer and perform better with a tactile- kinesthetic learning activity. 31 At least 50 percent of our students are frustrated by left-brain, sequential- type assignments and are global, holistic, and random in their organization and processing of information. (Sally Botroff-Hawes 1988) Research and studies show all students, regardless of learning styles or learning differences, learn best when they are engaged in their own learning. Students need hands-on experience and the change to review and talk about what they are learning throughout the school day. Rief advocates cooperative learning situations with students working together with their peers in groups. She couples the cooperative learning situations with multisensory instruction methods. Auditory techniques such as rhythm, melody, song and rap; Visual and Tactile materials, games, and computer software; Spatial designs, colored visuals and manipulatives (students with AD/HD and other learning disabilities many times have significant weakness with left brain/sequential tasks; but are gifted spatially); Verbal re-enforcement and review through group interaction, electronic devices, and computer software; and Conceptual games, software, and activities; are incorporated into the course delivery and activities, giving all students with their varied learning styles and preferences, the equal opportunity to learn effectively. Rief emphasizes that teachers must recognize that students do learn differently and multisensory techniques provide a variety of approaches to aid the teacher with the enormous task of recognizing and meeting the learning style and preferences of every student in his classroom, including the student with AD/HD. 32 Reif gives examples and suggestions of various multisensory activities using both low and high end assistive technology devices from colored markers to word processing software with spell checkers to tape recorders and calculators to computer games and other interactive learning e-devices to the World Wide Web and search engines. Rief advocates that all new information be presented to the students through multisensory instruction. “Involve all of the sense, providing auditory, visual, and tacitle-kensthetic input.” She encourages the teacher to reteach information in a variety of different ways: For visual learners, supply maps, graphs, pictures, and diagrams and write on overhead/board with colored markers, pens, or chalk. Point, highlight, model, and demonstrate. Teach through clustering, mind mapping, and other graphic organizers. For global learners who need to see the whole picture before making sense of the parts, show the end products. For auditory learners, read aloud, paraphrase, employ music, rhythm, melody, discussion, and tapes It is very helpful to have material that students need to learn on tape so they can listen to it. Allow students to bring in small tape recorders to record teacher lectures (to supplement note taking). For tactile/kinesthetic learners, provide lots of hands-on experience that promotes learning by doing. Use manipulatives for teaching math, role playing, dance and movement, acting-out. Use computers and games. Offer many choices (for example, book reports, science projects, oral reports). (1993) “Hook the students in the instruction emotionally.” Rief emphasizes the use of learning aids (assistive technology devices) to accomplish student involvement into their own instruction according to their own style of learning. Research has shown assistive technology (AT) empowers students with learning problems to work and learn. Christopher Lee (1991) emphasizes that learning 33 problems are not cured or outgrown. For instance, one of the myths about AD/HD is that the child outgrows the disorder as he enters into adulthood. Whether a learning problem or neurological disorder, research shows these conditions continue on in adulthood. It is though that the reason many people believe AD/HD disappears in an adult is because by the time the person with AD/HD has entered adulthood, she has made compensations for the effects the disorder has on her and made the proper adjustments to carry out her day- to-day tasks. Assistive technology provides a means for the person with learning problems to adjust and accomplish tasks independently. Whether it is organizing a class report, writing a letter to a friend at home with the assistance of a word processor, checking for spelling errors in a memo to a co-worker, or using a calculator to help keep score in a card game, assistive technology devices may provide the needed support to accomplish effectively tasks in a variety of contexts and settings. (Lee 1999) Lee clarifies the term assistive technology. “Tools or assistive technology are devices and equipment designed to make your life easier or to help you perform a specific task. Everyone uses tools. A dictionary is used to spell a word. Color high lighters are used to help people pick out important words in a book. If you are one of more than 49 million Americans with disabilities, matching the right tools with your disability can give more options for greater freedom in your life. These assistive devices help you become more involved at work, at school, or in everyday living. Tools are for people of all ages and with all disabilities, illnesses or impairments.” (Lee 1999) AT devices are able to empower us all People of all ages, abilities, and needs benefit from assistive technology. 34 Literature on teaching to the student with AD/HD or learning differences in the classroom emphasizes the use of color to differentiate and organize information. Lee emphasizes color-coding using both low end and high end technology. “Color- coding on files, drawers, and clothing help a person with a learning disability to remember something important.” Lee states that just by changing a computer monitor’s background color can assist greatly a students reading ability. “Workers (students) with learning disabilities can make their work (learning) more efficient by altering colors, font, or print size on a computer screen.” Using color to emphasize and organize information and material is inexpensive and effective. Many different AT devices are available to assist students with organizing their schedules and accomplishing their assignments and tasks. For instance, most students with AD/HD are inconsistent with their grammar, spelling, vocabulary, writing and reading. The degree of the abilities varies from day-to-day. Simple spell checkers included with word processing applications ease the frustration for a student that has trouble with grammar, spelling, and vocabulary. Free dictionary and thesaurus applications found on the Web, such as Atomica (http://www.atomica.com) help the student check a word just by placing the cursor it, holding down the Alt key, and clicking the left mouse button. Up pops a window with the spelling, definition, synonyms, and an audible pronunciation of the word. There also is an encyclopedia feature providing a background on the word’s definition. “This Web-based tool is so low on overhead that it doesn’t even require a browser. It’s a free, downloadable utility that resides in the Windows system tray, where it is available whenever you are connected to the Web, 35 whether you’re using, for example, an e-mail client, a word processor or a spreadsheet.” (Lee Sherman 2000) Students with AD/HD tend to display dyslexic symptoms. A convenient and practical proofing tool is the Qucktionary Reading Pen, a portable assistive reading device to help the student with reading and spelling difficulties. It can go and be used anywhere. “With the Quicktionary Reading Pen you can scan a printed word and see its definition displayed on the built-in LCD screen. It will also read out the definition. An earphone is included, so you don't disturb other people. There are devices and software, such as Voice Xpress or TYPEIT4ME, which recognize speech and enable the user to dictate to the computer, converting oral language to written text. You talk to your computer instead of typing. “You can talk to Internet Explorer e-mail chat and just about any program you normally type in. It's easy just install the program teach the program how you speak and begin to dictate.” (Dealtime 2002) Tape recorders help students review class materials and can be used in conjunction with speech recognition software that converts the audio into text. Software, such a WINN with optical character recognition capabilities allows the student to scan a book or other written material and convert the text to speech (audio). Out Spoken and JAWS are screen reading programs that allow you to use most PC programs, read what is on the screen, and provides a keyboard alternative to the mouse pointer. Write Outload is an easy-to-use word processor and screen reader for the MacIntosh. The Ultimate Reader scanner is a scanner-text-speech processing program in which text can be transferred from the scanner or other files into the reader program. “Special 36 features include the capability to change text, background color, and highlight colors. It also extends to the computerized speech, allowing a user to change pitch, frequency and modulation to whichever sounds clearest”. (Christopher Lee 2000) WebSpeak is a non- visual Web browser that provides the student with efficient and direct access to Web pages and the resources of the Internet. The program understands HTML, interprets the Web pages and then lets the student brows through the pages by reading them back to the student. The student controls the pace as which the program reads. Another program that can be downloaded for free from the Web is HELP Reader. This program helps teach students to read by reading along with the student. “Whether you’re younger or older, new to reading or have your own library, HELP Read should be able to help you read more and understand more of what you read.” The program is part of the Hawaii Education Literacy Project (HELP): Over the last eight years it has remained apparent that the need to be literate is a core ingredient in almost every pursuit of ones education and lifestyle. With the increase demands of a modern era, today’s literacy has experienced the added challenges of understanding computers, the internet, and the accompanying technically specific language added to the common terms of everyday communication. With education resources already stretched, there is no wonder that results are slipping. Still, social evolution beckons changes while education struggles to teach along its same old standards. In itself a fixed position might pose enough of a crisis were it not for the fact that so many suffering the categorization of the slow-to-learn still do not have enough in the way of adaptive and assistive learning tools. (HELP 2000) Christopher Lee points out that these tools appeal to the multi-sensory style of learning incorporating Auditory, Visual and Tactile, Spatial, Verbal Re-enforcement and Review, and Conceptual instructional techniques with electronic devices and software. 37 A device like Hewlett-Packard’s CapShare 920, the size of a CD player, allows the student and teacher to capture, store and share paper documents while away from school. Palm devices provide the same capability along with the ability to use a multitude of other learning and organizational software designed for the individual and the entire classroom. Many teachers are incorporating the devices and software into their curriculum for use by the entire class. The various software and educational programs can be found at Palm’s educational site at http://www.palm.com/education. For instance, fourth and fifth graders in Connecticut created a virtual field guide of local rivers and uncover creative ways to use Palm handhelds in all subjects. (Palm 2002) Derby High School’s, Derby Connecticut, music director, Brandt Schneider finds that handheld computers provide access to technology students who might not have access to computers at home and offer them new opportunities for learning. "Kids can have their own world on a handheld and they get more excited about school. For many students, these opportunities are helping them to be more involved in their own learning and to develop their self-esteem." (Schneider 2002) Many teachers are incorporating the use AlphaSmart 3000 boards (or like devices such as Dream Writers and eMates) in with their classroom instruction and activities. The introduction of these writing devices provides schools with a more affordable option to the PC, and allows each student the use of a word processor in their own classroom. Boston College undertook a year-long study researching the use of AlphaSmart boards in the classroom that included observations before and after the AlphaSmart ratio was increased, student interviews, teacher interviews and student 38 drawings. The study focuses on how teaching and learning changes when each student in the classroom is provided with his/her own AlphaSmart “In other words, what classroom practices change, if any, when the ratio of students to technology is increased from about 3 to 1 to 1 to 1? Specifically, what kind of changes occur in the way that students produce work, interact with each other, and interact with their teachers when they are provided full access to their own AlphaSmart.” The study cites previous research on computers and writing: The research on computers and writings suggests computers may help students produce better work. Although much of this research was performed before large numbers of computers were present in schools, formal studies report that when students write on computer they tend to produce more text and make more revisions. Studies that compare student work produced on computer with work produced on paper find that for some groups of students, writing on computer also has a positive effect on the quality of student writing. This positive effect is strongest for students with learning disabilities, early elementary-aged students and college-aged students. Additionally, when applied to meet curricular goals, education technology provides alternative approaches to sustaining student interest, developing student knowledge and skill, and provides supplementary materials that teachers can use to extend student learning. As one example, several studies have shown that writing with a computer can increase the amount of writing students produce and the extent to which students edit their writing. (Dauite, 1986, Vacc, 1987; Etchinson, 1989), and, in turn, leads to higher quality writing (Kerchner & Kistinger, 1984; Williamson & Pence, 1989; Hannafin & Dalton, 1987). (Russell, Bebell, Cowan, Corbelli 2002). Even though the research was limited to three classrooms, the research showed that even though AlphaSmarts were designed for word processing only, the use of one AlphaSmart per student led to increased use of desktop and laptop computers. “This increased use seemed to increase students comfort and skill with technology which in turn decreased the amount of time teachers spent providing students with 39 technical support. Full access and subsequent increased use of technology also led to an increase in peer conferencing and individual instruction as well as a decrease in whole group instruction.” The findings of the study suggested a positive impact on the use of technology in the upper elementary classroom when each student has individual and full access to a word processor. When each child had individual and full access to their own AlphaSmart and was able to take the machine home to do homework assignments, there was “a greater sense of student ownership, responsibility, independence and empowerment.” The participating teachers all noted in the post-study interview that the that the technology was a motivational tool for the students and that by providing each student with their own AlphaSmart to use, each student exhibited a greater sense of importance towards their work. All three teachers spoke of how the students became more responsible empowered when they had their own Alpha Smart. (Russell, Bebell, Cowan, Corbelli 2002) Behavioral problems decreased and ease of classroom management increase. Students were free to create their own individual work spaces by taking their AlphaSmarts to corners of the classroom, out in the hallway, or to the library to write and compose, use iBooks, or complete their assignments. Students could use their “own” AlphaSmart at all times in the classroom and take their machine home in the evenings or over the weekends. The team from Boston University concluded: Given the relatively low cost of AlphaSmarts and the resulting benefits of providing each student with their own AlphaSmart found in this study, we strongly encourage technology leaders within schools as well as policy makers to consider policies and practices that promote full access to AlphaSmarts in upper elementary classrooms. While access alone will not guarantee that technology will be used, for those teachers who either 40 advocate or have actively attempted to use technology for instructional purposes, full access to word processors eliminates many of the managerial and technical issues that impeded regular use of technology in the classroom. (Russell, Bebell, Cowan, Corbelli 2002) Using a computer or an electronic device, such as an Alpha Smart, with specialized software for writing makes the writing process easier for most students, especially students with learning differences, and allows the students to visual organize their thoughts and write more in a shorter amount of time . The way to learn how to write is to do a lot of writing, and using a computer and software for writing can make the process of practicing writing easier. The same applies to any academic discipline such as math, reading, science, the acquisition of a foreign language; the way to learn is to practice. The computer and specialized software makes it faster and easier to practice and learn; and facilitate the teacher’s ability to meet all the learning styles and difference in the classroom, including the student with AD/HD. Assistive Technology devices provide various means and methods for presenting learning materials and assignments in new and different formats. AT devices incorporated in to the curriculum make it easier for the teacher to create a learning environment for ALL students, regardless of the different learning styles and differences represented in the classroom. Varying methods of course delivery and assessment has shown increased motivation on the student’s part to participate and successfully complete learning modules and assessments. 41 Students in a Denver, Colorado “alternative” high school science class for at-risk children were assigned a project of creating wetlands on the border of the school’s property. They were to design the wetlands and make observations in water quality and bio-diversity as the wetlands developed and progressed. Each student was given a hand held data grabbing device (The Trekker) for collecting data from soil analysis to the bio diversity of the developing wetlands. The project-based learning experience was designed to examine the impact this learning format had on the students’ ability to understand and explore science, and on their motivation to learn. Two versions of Colorado’s eighth grade science achievement test (pre-test/post-test) were used to evaluate learning outcomes. A control group from a “regular” high school that included high-risk students using in-classroom, simulated wetlands learning modules and labs with no hand held data grabbing devices or other assistive technology devices, was used as a comparison for the project-based group’s learning outcomes. The study found “the combination of PBL (Project-Based Learning), inquiry approaches in science, and the use of technology” resulted in students at the alternative high school becoming more motivated and engaged in their project-related work. They work on the project after classes are over, during other classes, and on holidays. This is quite unusual since the qualifications for students to come to this high school include that you have already dropped out of school at least once. (Orey, Winward, Distefano 2001) 42 The study also was conduct within the “regular” high school in the context of the general classroom. The comparison group used thermometers and stops watches for their data sampling, while the in-classroom study group used the hand held Trekkers. One class used The Trekker to record temperatures in a beaker of ice water as it was heated to boiling. This was repeated on the subsequent class using salt ice water. The comparison class used regular thermometers and a stop watch. (Orey, Winward, DiStefano 2001) Teachers found that the students using the Trekker devices were “more engaged in the experiment than their thermometer counterparts.” The teachers felt the devices motivated the students to participate, but weren’t sure if that would have an effect on their performance on the SCAP test. Christopher Lee (2000) points out that learning differences not only affect reading and writing abilities, but also affect math skills and social perception, as well. The above-mentioned devices and software aid students with math, organizational, management, and social skills in the same manner as reading and writing skills. Lee lists and gives overviews of many low and high end assistive technology devices and tools in the areas of reading, writing, math, and social difficulties. Lee concludes that assistive technology extends beyond the classroom. “Assistive technology is a lifelong process. Decide what you want to do better. Then decide if assistive technology can help you do it better.” The teacher is able to start the AT decision process in a student’s life by incorporating assistive technology devices and methods of instruction in with the 43 methods of course material delivery, activities, assignments and assessments; and allowing the student to match and adapt the tools to their own particular learning style and preferences. Multiple Intelligences, Multisensory Instruction with Assistive Technology Devices and the AD/HD Learning Style Howard Gardner, developmental psychologist, originally theorized that humans have seven intelligences, but has since included an eighth (Gardner 2000): 1) Linguistic – syntax, phonology, semantics, pragmatics; 2) Musical – pitch, rhythm, timbre; 3) Logical mathematical – number, categorization, relations; 4) Spatial – accurate mental visualization, mental transformation of images; 5) Bodily/kinesthetic – control of one’s own body, control in handling objects; 6) Interpersonal – awareness of other’ feelings, emotions, goals motivations; 7) Intrapersonal – awareness of one’s own feelings, emotions, goals, motivations; and 8) Naturalist – recognition and classification of objects in the environment. He divided them into three main groups: 1) Object- related intelligence - mathematics and logic; 2) Object-free intelligence - music and language; and 3) Personal intelligence - the psychological perception we have of our individual selves and others (Gardner 1983). Developing the classroom activities and lesson plans to include each of the eight intelligences, can assure a 44 stimulating and engaging learning environment that meets the needs of all the learners in the classroom, including the student with AD/HD. Gardner points out that our schools focus on and teach to the linguistic and logical-mathematical intelligences. He advocates equal attention and esteem be given to individuals who show gifts in the other intelligences such the artists, musicians, entrepreneurs, naturalists, designers, dancers, and others who enrich the world in which we live. (Persons with AD/HD excel and make significant contributions in the aforementioned career fields.) Unfortunately, many children who have these gifts don’t receive learning reinforcement in school, and their unique talents, skills, and ways of learning are overlooked by a heavily linguistic and logical-mathematical public school system. (Gardner 2000) Sandra Rief, educator and resource specialist in the area of learning disabilities and AD/HD, advocates the recognition of Gardner’s Multiple Intelligences in curriculum planning through the use of multisensory instruction in the classroom. Students with AD/HD learn best in a multisensory learning environment in small groups with their peers (Rief 1998). Multisensory instructional methods include: 1) Auditory techniques such as rhythm, melody, song and rap; 2) Visual and Tactile materials, games, and computer software; 3) Spatial designs, colored visuals and manipulatives; 4) Verbal re-enforcement and review through group interaction, electronic devices, and computer software; 5) Conceptual games, software, and activities (Rief 1993). Technology devices and software adds a different and engaging 45 dimension to multisensory instruction in the classroom for all learners, especially the student with AD/HD. Including assistive technology in the standard curriculum enhance the classroom learning atmosphere and “help students with cognitive disabilities achieve in a challenging curriculum” (Warger 1998) Learners with AD/HD many times are gifted spatially, but will display significant weaknesses when performing left brain/sequential tasks (linguistic and logical mathematical intelligences). However, many times the learner with AD/HD easily becomes intrinsically motivated, undertaking “an activity for its own sake, for the enjoyment it provides, the learning it permits, or the feelings of accomplishment it evokes” (Lepper 1988) in linguistic and logical mathematical subject areas through social interaction with a capable peer or adult role model. The students with AD/HD thrive, learn, and master difficult skills from positive attention and re-enforcement through social and learning relationships with capable peers, teachers, and family members. Vygotsky’s Zone of Proximal Development (ZPD) and the Use of Technology as a “More Capable Peer” Vygotsky’s Zone of Proximal Development centers on learning and the mastery of specific cognitive skills through social and intellectual partnerships and interaction. He theorizes that an individual’s cultural and cognitive development starts “on the social plane and then on the psychological 46 plane”, appearing between people as an “ interpsychological category”, then within the individual as an “interpsychological category”, especially in the areas of voluntary attention, logical memory, the formation of concepts, and the development of volition (Tharp and Gilmore 1991). These are cognitive areas in which the learner with AD/HD finds difficult to master without the help of a capable peer or adult. The term “coach” is a popular term for a “capable peer or adult” as it relates to the person with AD/HD. Vygotsky terms this social intrapsychological to individual interpsychological process as internalization. The distance between the levels of the learner’s assisted performance of a task (done with the support and guidance of capable others) and the level of the learner’s unassisted performance of the same task is the Zone of Proximal Development. “It is in the proximal zone that teaching may be defined in terms of learner development” (Tharp and Gilmore 1991). Defining and monitoring the learner with AD/HD’s ZPD in difficult subject areas, and providing assistance from a coach in the learner’s environment will help with the internalization of the skill and the ability to perform the task will become part of the learner’s “independent developmental achievement” and allow the learner to perform unassisted on a higher cognitive level (Tharp and Gilmore 1991). In a study by Globerson and Guterman (1989), computer tools (software) were used to provide assistance and guidance within the learner’s zone of proximal development as part of the internalization process in developing reading competencies and reading-related metacognitions. The study “was 47 designed to test the general hypothesis that intellectual partnership with a computer tool that provides reading-related, metacognitive-like guidance leads to the internalization of the guidance, which, in turn, facilitates better text comprehension and transfers to writing ability. The study’s hypotheses were supported, which suggests that a computer tool can serve as a “more capable peer” (Vygotsky, 1978) or assistive coach in a learner’s zone of proximal development and can thus facilitate the development of competency. (Globerson and Guterman 1989 Assistive technology (AT) empowers students with learning problems to work and learn. (Lee 2000). Technology exists that can substitute and serve as an assistive peer or coach, and meet the needs of learners having difficulties with reading, writing, math, organizational and social skills. The integration of assistive technology to meet the learning needs of all students in the classroom makes the goal of creating a stimulating and engaging classroom learning environment easily attainable for the teacher. Summary Chapter II reviewed the literature and research regarding the possible causes, characteristics, symptoms and diagnosis of AD/HD. The unique learning style and behavioral characteristics of the student with AD/HD were identified and compared with progressive course delivery methods such as 48 multisensory instruction. Assistive Technology devices were examined and related to the various student learning preferences associated with multisensory instruction. Gardner’s Multiple Intelligences theory was examined and related to the learning styles associated with the AD/HD learner. The use of assistive technology devices, particularly the computer, was further explored as research related to Vygotsky’s Zone of Proximal Development theory and the computer serving as “a more capable peer” was examined and related to the present concept of a “coach” to train and assist the person with AD/HD in learning and acquiring positive organizational, learning, and life skills. The literature review presented compelling evidence of the use of assistive to technology in the classroom to ease and facilitate the efforts of the teacher to meet the learning needs of all students, including those of the student with AD/HD. CHAPTER III PROCEDURES This chapter provide an overview of the procedure used in this study to determine if a relationship exists between the teacher’s integration of multisensory instructional methods through assistive technology devices and tools in with the course curriculum and a noticeable easing of the burden and challenge experienced by the teacher in academically stimulating and teaching the learning styles and preferences of all the students in the classroom, including the student with AD/HD and/or other learning differences; and the teacher’s perception and attitude towards the AD/HD student and the challenge of accommodating the student in the classroom. 1. Does the use of assistive technology devices incorporated into the course curriculum and lesson plans ease the burden and challenge of recognizing and meeting the needs of all learning styles and preferences in the classroom, including the student with AD/HD; making it possible for the teacher to meet the learning needs of all students? 2. Is there a significant relationship between the positive or negative nature of teacher perceptions and attitudes towards the student with AD/HD in the classroom to the frequency in which the teacher includes assistive technology devices in methods of instruction and general lessons plans in the classroom? 49 50 Research Design Ex post facto research is used in this study due to the self-selected levels of independent variables involved in teacher attitudes towards the AD/HD student, the number of covarying extraneous variables, and the uncontrollable and varied scope of the area of inquiry. The variables are not manipulated. This is a correlation study designed to identify the relationship between the classroom teacher, the use of technology, and the student with AD/HD. This study will lend itself to the generation of further theory and research into the cause and effect of these relationships. Diem (2002) states “An ex post facto study is used when experimental research is not possible, such as when people have self-selected levels of an independent variable or when a treatment is naturally occurring and the researcher could not control the degree of its use.” Diem cautions, “It is important to recognize that, in a relational study, “cause-and-effect” cannot be claimed but only that there is a relationship between the variables.” Variables that are completely unrelated could vary together due to nothing more than coincidence. Newman and Newman (1994) maintain: To assume a causal relationship, one must have internal validity (all other explanations for the effect on the criterion [dependent variable] are controlled for and the only possible explanation for changes in the dependent variable must be due to the independent variable under investigation). Only with true experimental design does one have the experimental control to achieve internal validity. (p 114) 51 When investigating causation, ex post facto research is inappropriate; however, if the research deals with relationships, ex post facto procedures are acceptable. The study involved a large number of randomly selected participants. Keys points out the relationship between the subject selection and the external validity of the ex post facto study. Differential selection of the subjects determines how the findings can be generalized. Subjects selected from a small group or one with particular characteristics would limit generalizability. Randomly chosen subjects from the entire population could be generalized to the entire population. (Keys 1997) Also, the ability to generalize to the entire population increases with the number of subjects or participants. The ability to generalize lends to the external validity of the research; the larger the field of randomly selected subjects, the greater the ability to generalize findings to the entire population. This study deals with the relationship between the classroom teacher, assistive technology devices incorporated in with the curriculum, and the AD/HD student; and will be used to establish theory and further research on the cause and effect of attitudes within these relationships. 52 Participants The subjects who participated in the survey were randomly selected from three defined regions in Ohio, Northeastern (Cleveland and surrounding areas), Central (Columbus and surrounding areas), and Southern (Cincinnati and surrounding areas). Five hundred-seventy five (575) teachers varying in teaching experience, computer training and skills, grade level, areas of specialization, classroom population, and the number of computers in their classroom were surveyed. Forty-eight (48) of the surveyed subjects were interviewed and observed in the classroom. The nonprobabilistic, theoretical sampling for this study involves a large number of randomly selected participants. A probability sampling is the best method for this qualitative research, in that the study is designed to identify relationship problems linked to occurrences between the teacher and the AD/HD student, not to answer or solve them. The purpose of this qualitative, ex post facto study was to identify more theories of cause for further quantitative research. “Theoretical sampling is the process of data collection for generating theory where by the analyst jointly collects, codes, and analyzes his data and decides what data to collect next and where to find them, in order to develop his theory as it emerges.” (Merriam 2001, page 63) The theoretical method of sampling a broad base of teachers or instructors, Pre-K – 16, is used to identify general teacher attitudes towards the AD/HD student, and build a base of 53 categorized data to generate theories and further research as to the causes and occurrences that contribute to negative classroom attitudes and relationships between the teacher and the AD/HD student. The subjects for this study were randomly chosen from a large and wide spread teacher population in order to generalize the data over the entire population (the larger the field of randomly selected subjects, the greater the ability to generalize findings to the entire population). “In purposeful sampling the size of the sample is determined by informational considerations. If the purpose is to maximize information, the sampling is terminated when no new information is forthcoming from new sampled units; thus redundancy is the primary criterion.” (Merriam 2001, page 64) Redundancy in the responses to the survey questions became apparent after 500 surveys were completed. The study used 575 completed surveys for the data comparison and analysis. Instrument The survey instrument used in this study consisted of 23 questions. The survey was designed to gather information on the teacher’s attitude and perception of technology in the classroom, the student with AD/HD, and how the teacher recognized and considered the learning styles and preferences of all students in the classroom, including the student with AD/HD. The first questions established the demographics of the survey. Questions - 54 established teacher knowledge and attitude concerning AD/HD as a disorder. Questions - addressed teacher knowledge and attitude towards the various individual student learning styles and preferences represented in the classroom. The final questions surveyed the use of assistive technology devices in the classroom. Statistical Treatment Demographic data of the teachers completing the survey were examined and established. The demographic data was broken down into categories: 1.) Mode of Response (Interview, Hard Copy, and Online); 2.) Regions (Northeastern, Central, and Southern, Ohio); 3.) Degree; 4.) Grade Level (PreK- Postsecondary 16); 5.) Years Teaching (1 – 21+), 6.) Courses (Subjects) Taught; 7. ) Size of Class; and 8.) Computers in the Classroom. (See Appendix B) Data from questions 8-15 (Teacher Use of Technology), questions 16-20 (AD/HD in the Classroom), and questions 21-26 (Assistive Technology in the Classroom) were compared against the data from the established demographic data; and averages were calculated and charted on tables (see Appendix C). Additional comments from the participating teachers regarding the individual questions were considered when studying the data and forming conclusions. Comments and data averages from questions 8-15 (Teacher Use of Technology), questions 16-20 (AD/HD in the Classroom), and questions 21-26 (Assistive Technology in the Classroom) were further compared against 55 one another and charted. (See Appendix D) The averaged comparisons were used to determine the predominate teacher attitude and perception of the AD/HD student in the classroom; and to establish if a relationship existed between the teacher attitude and perception the AD/HD student and the use of assistive technology in the classroom. Limitations Although the survey specifically addresses the factors that researchers have shown to have a direct impact on the use of assistive technology in the classroom and facilitating the teacher’s a ability to meet the learning needs of students with learning differences in the traditional classroom, the study presents some limitations. Ex post facto research designs are weak due to the inability to control the variables. The subjects may not be representative of the entire teaching population. Therefore, the sample size and area sampled was large in an attempt to strengthen the study. Most teachers did not identify their school district, so the enrollment and economic status of the schools represented by the participating teachers were unknown (except for the 48 teachers interviewed and observed)’ and the exact number of schools represented could not be determined. The race, gender and age of the teachers (except for the 48 teachers interviewed and observed) also were unknown. For this reason, the actual number of students with AD/HD in the classrooms, actual AD/HD classifications, and student achievement data could not be gathered. 56 Summary Chapter III presented the questions and lay-out of the survey used in this study. The ex post facto research design was explained, and a brief definition was included to point out the weaknesses of the study. The participants were identified as a random selection of 575 teachers in Northeastern, Central, and Southern Ohio. The survey instrument used in this study was identified as a survey consisting of 26 questions that address three specific aspects affecting the education and academic experience of the student with AD/HD: 1.) teacher training and use of technology; 2.) teacher understanding of AD/HD; and, 3.) the use of assistive technology devices in the classroom. Participating teachers were encouraged to comment on any or all of the questions. The statistical treatment and presentation of the data were explained, and the limitations of this ex post facto study were identified, defining the specific weaknesses of the study. CHAPTER IV RESULTS OF THE STUDY The study attempted to identify teacher perception of the AD/HD student in the classroom. It was felt, after a review of the literature and an investigation of research findings documenting the positive impact assistive technology devices has on the AD/HD student’s ability to learn and adapt to the traditional classroom, that teachers incorporating assistive technology devices into their general classroom learning activities, events, and assessments, would have a more positive perception of the AD/HD student in the classroom. Teachers of grade levels Pre-K through Post- Secondary 16 were invited to participate. A printed survey consisting of 28 questions was distributed and returned by teachers in the Cleveland, Columbus, and Cincinnati areas. An online version of the survey also was available. Some of the respondents personally were interviewed by assistants at Cuyahoga Community College (Cleveland), Ohio State University (Columbus), and The University of Cincinnati (Cincinnati). The survey was divided up into three sections. The first 16 questions established the demographics of the population responding to the survey. The next 5 set of questions established the understanding, opinion, and perception the responding population had towards AD/HD. The remaining 7 questions established the attitude of the teacher population responding to the survey towards the 57 58 recognition of different learning styles in the classroom and the use of assistive technology devices in the general curriculum. The teachers were given the opportunity to comment on any or all of the questions and statements. They were encouraged to provide additional comments at the end of the survey. See Appendix A. Statistical Data Results The random sampling consisted of 575 subjects (48 interviewed, 282 returning hard copies of the survey, and 245 submitting the survey online). See Appendix B. The questions that evoked additional comments seemed to be the key questions in identifying the overall teacher perception of the AD/HD student in the classroom and the use of assistive technology devices in the general curriculum. They were as follows: 1. Do you feel the number of computers in your classroom is adequate to meet the needs of your students? Total Yes No 575 9% 91% 11 of the teachers in Grades 6-12, answering YES, identified themselves as resource and technology lab instructors. 5 of the schools are in partnership with local industry. 6 additional Grades 6-12 teachers commented on the use laptops in their room, 1 of which also used palm devices for science and math projects. 59 Commenting post-secondary instructors felt it's the responsibility of the students to research and complete assignments on their own computer or a tech lab computer on campus. A few commented on requesting computer labs for their classes and were unhappy with the lack of availability of open labs. The responsibility was on the student. Veteran teachers (21+ years) commented on being unsure of how the use of computers, outside of the student typing his/her own paper, would enhance their curriculum. One commented, “If it isn’t broke, why fix it.” The 9 veterans taught English on the senior high grade level. All 9 disapproved or were skeptical of the use of the World Wide Web for research. 2 General and Physical Science teachers answering YES (they had an adequate amount of computers in their classroom) took matters into their own hands and wrote grants for laptops and palm devices in their classrooms. They commented on the ease of finding and receiving the technology grants. 2. Was the use of technology included or required in your personal college curriculum towards your degree? Total Yes No 575 87% 13% Recent education graduates answering Yes mentioned the emphasis on computer software innovations on the PreK level and the emphasis on technology in their college curriculum; while post-secondary instructors answering NO, in 60 general, commented that technology was used to complete their assignments, but it wasn't emphasized in their course of study. All teachers with 1-5 years of experience felt technology was emphasized in their college education courses. All of them cited required technology courses in their college curriculum in the space provided for comments. 3. Have you attended seminars or training emphasizing technology in education since your college graduation? Total Yes No 575 96% 4% All teachers answering the online survey answered YES. Technology is interpreted as limited to computer-related equipment and software. Some instructors on the post-secondary level commented on their used technology, however their knowledge of particular software was self taught. Again, technology is perceived as computer-related. All teachers with 10 years experience and under have received some technology training after their graduation from college. In-service was cited. Most school districts require so many in-service hours of technology based training per year per year. However, many of the teachers with 21 years or more of service stated they have not attended technology training sessions. 61 4. Are you comfortable using technology to enhance your curriculum? Total Yes No 575 89% 11% Those answering the survey online had the highest percentage of “Yes” answers. Instructors on a postgraduate level were less willing to revise their curriculum to include various technology formats. One reason cited was the cumbersome curriculum review process at most colleges. Many said it wasn't worth the frustration. Others felt it was the students’ responsibility to use technology to the best of their own abilities and needs. Teachers and instructors with 10 or less years of experience (regardless of grade level) had no problem with incorporating technology (computer-based) into their curriculum. 5. What would prevent you from pursuing further training in technology formats designed for the classroom? Total Time Equipment Funds Administration Other 575 100% 91% 98% 0% 2% 9 teachers cited they had no need for further technology training. All 14 teachers answering in the "others" category felt it wasn't necessary for their particular area of study or that it suited their teaching methods and style. 283 teachers (Grades 4-12) made mention of the government's emphasis on the 62 proficiency tests as a contributing to the "lack of time" factor. Many faulted the pressures caused by the proficiency tests requirements and rankings as monopolizing the teachers' time and efforts. Out of 575 survey participants, 0 answered Lack of Administration Support. Those who commented felt the administration encouraged them to further their training in the area of technology. Most of the K-12 districts required 3-6 hours (average) of in-service training in technology for their faculty and staff. However, comments were made on sport activities, such as football, that seemed to be the administration’s budget priority. Those that commented felt the sports programs were top priority in the allocation of funds for equipment and staffing. Technology came second and the arts were at the bottom of the list. One comment stated, "They'll (the school board) will approve a state of the art Stairmaster in the state of the art weight room before they'll approve a laptop to be shared by the 30 students in my classroom." 6. Have you taken a course or attended a seminar in which AD/HD Learning Styles have been studied or discussed? Total Yes No 575 38% 62% Teachers (Grades K-12) commented that they have attended in-service seminars on learning disabilities, but there wasn't an emphasis on AD/HD in the 63 material. The disorder was discussed in work groups, but it was mostly supported by teachers’ experiences, hearsay, and opinions. Many commented on broadcast and print media as a major influence on their opinion regarding the AD/HD student’s ability to learn and participate in the normal classroom setting. PreK had a high percentage of NO answers. Levels of education and degrees weren’t a factor. Post-secondary instructors commented that by the time the students entered college, they should be responsible for dealing and adjusting with their individual learning difficulties on their own. 4 of the post-secondary instructors answering YES taught child development courses and units on AD/HD were included in their course text and supplemental materials. 7. In your opinion, is AD/HD over diagnosed? Total Yes No 575 100% 0% This question was answered YES by all respondents. Most everyone had a comment or opinion. Those interviewed displayed negative movements or expressions when asked the question (rolled their eyes, shook their head, breathed a deep sigh, etc.). The hard copy comments reflected the same frustration only in phrases such as "confusing to parent, teachers and students", "used as an excuse for bad behavior", "latest psych ed fad", etc. The online responses were brutal. Some respondents used more earthy vocabulary to express their frustration. One 64 named a local Northeastern Ohio doctor and called him a quack “making money off of parents who don't know how to parent”. Very few of the respondents to this survey knew enough about AD/HD to distinguish the three diagnostic categories of the disorder. Most described the hyperactive and impulsive characteristics when referring to and decribing the student with AD/HD. 38% of the respondents to this survey felt the problem was not a disorder, but poor parenting skills. Other comments included too much sugar and poor dietary habits. A few comments were made regarding too much television and not enough family interaction. One comment was made on obsessive use of hand held video game devices. 8. Is AD/HD a learning disability, mental disorder, or both? Total LD MD BOTH 575 93% 6% 1% Most teachers thought AD/HD was a learning disability. A few commented that they didn’t believe the disorder existed citing poor parenting, poor diet, and excessive viewing of television. Again, the hyperactive and impulsive characteristics associated with the disorder were given as examples of typical AD/HD behavior. Most of the teachers and instructors knowing that AD/HD is a neurological/ mental disorder were in special education and psychology. 2 65 teachers mentioned they were diagnosed AD/HD and knew it was a neurological/mental disorder. Some teachers, knowing that AD/HD is a neurological/mental disorder, preferred to use neurological and omit the mental tag. They felt the term "mental" gave a negative connotation and AD/HDed to the misconceptions most people have of AD/HD, since most people have misconceptions on mental disorders. 9. Does it make a difference to understand and recognize how AD/HD/AD/HD is classified (LD or MD) when teaching a student with attention deficits? Total Yes No 575 7% 93% All Special Education and Psychology educators answered YES. Many emphasized the danger in recognizing and treating AD/HD as a learning disability. One commented, “Treating AD/HD aggravates the problem for the student with AD/HD. AD/HD is not a learning disability.” In personal observations and interviews with teachers, I noticed a “stubborn resistance” to facts and medical information about AD/HD. It didn't matter what medical or educational research has discovered and documented about AD/HD. Many had formed their own opinion regarding AD/HD from their personal experiences and the opinions of other educators. Media misconceptions 66 played a factor, also. Many cited and trusted media reports over medical findings. The broadcast news anchor was more credible in this area than the neurologist or psychiatrist. When asked if a student with AD/HD told them she can't do the task; many replied she could if she tried, she just doesn't want to try hard enough. Many commented that the students with AD/HD were over-medicated. Some commented on the medication prescribed for the student with AD/HD student using terms such as "doped up" or "out of it" to describe the condition of the medicated AD/HD student. A few of the teachers interviewed refused to believe the medication prescribed to a student with AD/HD was a stimulant. Medical information was shown to the teachers stating that the stimulant has nothing to do with sedating a student. “The stimulant acts on the area of the brain that causes a person to focus on a task.” The medication causes the student to focus. So if the student was hyper and fidgety prior to the medication and after taking the medication becomes quiet and calm, that is because the student has become focused on his/her task. The medical information was refuted and rejected by some of the teachers. 23 of the interviewed teachers cited negative and misleading information heard on media magazine shows, such as 20/20, to refute the medical information and research on AD/HD. 16 of the 48 interviewed teachers, when asked which source was more credible, the AMA (American Medical Association) or 20/20, choose 20/20 as the more reliable source for accurate information regarding AD/HD. 67 10. Do you find it challenging to accommodate the AD/HD/AD/HD student? Total Yes No 575 86% 14% Comments in the YES column were mixed. Most were negative in nature. Most were frustrated with the impulsive, hyperactive AD/HD student. A majority of the teachers stereotyped the student with AD/HD with the impulsive and hyperactive characteristics of the AD/HD diagnosis. They didn't recognize the AD/HD student with attentive disorders as AD/HD. AD/HD students with attention problems were termed daydreamers, inconsistent, and lazy. Students with attention problems weren’t considered by some of the teachers as being AD/HD. Many commented that those students “just didn’t want to try hard enough.” The positive YES comments came from the Special Education teachers. Once commented, "It is challenging because on-going assessment is needed in order to figure out what works for the child. Finding and accentuating the AD/HD student’s strength and accommodating for the weakness and learning differences are essential." Many answering NO were post-secondary instructors. Again, many felt that by the time the student enters college, the students should be aware of their learning differences and make their own accommodations. 68 Others in the NO column commented that their areas of study (such as Art, Music, Information Technology, Vocational Ed) were engaging to the students with AD/HD. No accommodations were necessary. Again, in personal observations and interviews with teachers, I noticed a stubborn resistance to learning and receiving the facts and information from the medical and educational research on AD/HD. Most teachers commenting on AD/HD have formed their own opinion as to the cause and effects of AD/HD. As stated above, poor parenting was cited as the chief cause behind the behavioral problems associated with the student with impulsive and hyperactive AD/HD characteristics. 12 of the interviewed teachers commented that the AD/HD diagnosis was used as an excuse for behavioral problems and poor academic performance. The medication controversy was brought out again with this question. One online respondent commented that it was “impossible to accommodate "doped up" or "drugged out" students whose parents don’t give a damn about them”. One of the interviewed teachers, after being shown AMA (American Medical Association) and APA (American Psychology Association) literature on medication (stimulants) prescribed to persons with AD/HD commented, “I see what the medication does to students in my class, and nobody can tell me the medication doesn't act as a sedative. Those kids act as if they were in a drug induced stupor, like they were smoking pot or something." 69 It was interesting to note, that teachers being interviewed and asked the survey questions (in person) were guarded and professional when expressing their frustration with the concept of AD/HD. They were not as frustrated with the students as they were with the AD/HD diagnosis and medication. Teachers returning their responses in the hard copy format were a bit more expressive and less reserved when describing their experiences and frustrations with the students diagnosed with AD/HD. Many of the comments from those responding online were uninhibited and unprofessional. Some of the comments could be considered free and expressive venting of teacher frustration and disgust towards the AD/HD issue. As with the interviewed and hard copy respondents, the online respondents’ anger was more towards the medical professionals and their diagnosis and treatment of the disorder than towards the students. However, the online respondents displayed less decorum when expressing their thoughts on the AD/HD diagnosis and treatment. Some of the online comments were offensive and crude. 11. Do you use assistive technology devices or multimedia formats in any area of your course curriculum and classroom activities (course planning, organization, instruction, activities, assignments, presentations, student interaction, or assessments?) Total Yes No 575 85% 15% 70 All teachers in grades PreK-8 used assistive technology devices and formats in their planning, instruction, activities, and assessments. Most considered assistive technology devices as computer-related hardware or software. One hard copy comment questioned "highlighters" as being considered an AT device. An assistive technology device was considered electronic. Most post-secondary instructors welcomed the use of assistive technology devices in their classroom, but that was a student option. One instructor acknowledged the use of Microsoft Word and Excel software as a requirement for completing assignments, but was hesitant to say he was incorporating assistive technology into his curriculum. The Information Technology instructors were hesitant to use the term assistive technology when referring to the use of the computer and the Internet in their courses. The IT instructors didn't feel the use of the computer and Internet as falling into the category of assistive technology. Assistive technology devices in the IT classroom were considered software such a JAWS (audible screen readers) and WYNN (scanning and reading literacy software). A professor of math at a Northeastern Ohio community college commented on his redesigned algebra course centered on the use of Microsoft Excel spreadsheets for calculating problems. Students did their assignments and assessments using Excel software. He hesitated to say that this was assistive technology, but he did note that students seemed to have an easier time understanding and successfully completing his course after he redesign the 71 instruction to include Microsoft Excel software. He noticed the percentage of students successfully completing his course rose from 58% to 80%. The terms technology and assistive technology were thought to be electronic by most educators. The Smart Board and laptops were on "The Most Wanted" list by teachers K-12. Teachers and instructors with 5 or less years of teaching experience were more willing to acknowledge the use of assistive technology devices in their curriculum. A majority of the teachers that answered NO to the use of assistive technology had computers in their classroom and used a personal computer to plan and keep records, but didn’t consider them assistive devices. One teacher commented that when she thought of assistive technology, she thought of devices used by the severely mentally or physically challenged. Teachers with 16 or more years of experience were less likely to use the term assistive technology when referring to devices used in the classroom that enhanced the instruction and learning environment of the classroom. Many of the teachers with computers in their classroom commented that they used technology to enhance their curriculum, but not assistive technology devices. 12. Do you use forms of assistive technology in your own (personal) curriculum and lesson plan development, building student assessments, record keeping, and organization of your course? 72 Total Yes No 575 94% 6% When the term technology was used in conversation, the interviewed teachers were open about the ways the devices and software they used to plan and organize their course or classroom. When assistive was added, they became confused. Many commented that assistive technology were devices for those with disabilities, and not related to the general student population. Again, many of the teachers with computers in their classroom commented that they use technology to plan and organize their curriculum, but they would not consider the computers or software assistive technology. Some commented that they changed their answer from NO to YES after they reviewed the operational definitions at the beginning of the survey. Most commented that when they think of technology, they think of something that has to do with a computer. 13. It is important to recognize the learning styles and preferences of all the students in the classroom, including those with nontraditional learning differences, and adjust my lesson plans and assessments accordingly. Total St. Agree Agree Disagree St. Disagree Unsure 575 30% 41% 22% 4% 3% 73 Instructors in higher education disagreed or strongly disagreed with this statement. It was felt that by the time students enter into post-secondary education, it was their own responsibility to recognize their own learning styles and preferences, and adjust to the course delivery style and assessment procedures of the professor. 14. Do you believe Assistive Technology tools and techniques are useful for supplementing your course delivery and enhancing individual student learning capabilities? Total St. Agree Agree Disagree St. Disagree Unsure 575 30% 41% 14% 4% 10% Instructors in higher education disagreed or strongly disagreed with this statement only because they felt it was the student’s responsibility to use whatever tools or devices necessary to enhance their own learning capabilities. 15. I believe Assistive Technology formats and techniques incorporated into my curriculum help me meet the learning styles and preferences of all my students, and support classroom management. Total St. Agree Agree Disagree St. Disagree Unsure 575 30% 41% 14% 4% 10% 74 Instructors in higher education disagreed or strongly disagreed with this statement. It was felt that it was the student’s responsibility to understand the syllabus and follow the syllabus. At the post secondary level, there should be no need for classroom management methods or devices. 16. What assistive technology devices do you use in your classroom? All 575 respondents to the survey check at least 4 devices. The top 10, overall, AT devices used by teachers in their classroom were 1.) Computers - 533, 2.) Videos (Cams, Tapes, and VCR) - 507, 3.) Educational Software - 479, 4.) Electronic Games - 578, 5.) WWW Search Engines (Portals) - 472, 6.) Highlighters - 448, 7.) Overheads and Transparencies – 407, 8.) Calculators – 397, 9.) PowerPoint Presentations – 393, 10.) Class Web site – 370. The technology device found most on teachers’ "Wish Lists" (mentioned in many of the comments), were the Smart Boards and projectors. For a breakdown of assistive technology use in the classroom by grade level and academic specialization see Appendix C. 75 Implications The teacher’s knowledge and use of technology in the classroom seemed to have no effect or influence on their perception of the AD/HD student in the classroom. Those teachers using assistive technology and multisensory instruction in their classroom admitted the AD/HD student wasn’t disruptive; but their perception of the disorder was still negative. When comparing questions 4 (Are you comfortable using technology to enhance your curriculum?), and 12. (Do you use forms of assistive technology in your own (personal) curriculum and lesson plan development, building student assessments, record keeping, and organization of your course?) with question 10. (Do you find it challenging to accommodate the AD/HD/AD/HD student?); 89% of the teachers were comfortable using technology to enhance their curriculum, and 94% of the teachers used forms of assistive technology in their classroom; 86% found it a challenge to accommodate the AD/HD student in the classroom. Though 81% of the teachers strongly agreed or agreed (question 13) that it is important to recognize the learning styles and preferences of all the students in the classroom, including those with nontraditional learning differences, and adjust lesson plans and assessments accordingly; 93% of the responding teachers (question 9) felt it didn’t make a difference, when dealing with the AD/HD student in the classroom, to understand and recognize how AD/HD/AD/HD is classified (LD or MD) when teaching a student with attention deficit disorders? 38% percent of the teachers 76 commenting on the over diagnosis of AD/HD strongly believed the disorder didn’t exist and was attributed to poor parenting. See Appendix D for comparison. A majority of the Pre-K – Grade 5 teachers surveyed found the AD/HD student to be a challenge. A high percentage of teachers specializing in Math, English, Social Science, History, Political Science, and General/Physical Science found the AD/HD student difficult to accommodate in the classroom; while teachers specializing in Visual Art, Music, Philosophy, and Psychology had the least amount of trouble accommodating the AD/HD learning style. At larger percentage of teachers with the least amount of teaching experience found the AD/HD student more difficult in the classroom that the veteran teacher with 21 years or more experience. . Though teachers recognized the importance of recognizing and accommodating all learning styles and preferences represented in the classroom, the AD/HD learning style seemed to be excluded. Negative comments focused on the over diagnosis of the disorder and the medication controversy. The use of assistive technology and multisensory instructional methods incorporated into the curriculum didn’t seem to influence or positively impact the teacher’s perception of the AD/HD student in the classroom. Conclusion A teacher may teach, but that does not ensure that the child will learn. - Weiss and Weiss 77 The student diagnosed with AD/HD (Attention Deficit/Hyperactive Disorder) is perceived as a challenge to the typical traditional classroom teacher at all grade levels. The random survey revealed there is more to the negative perception of the AD/HD students, then the every day classroom challenges teacher’s experience with these learners. There is an underlying misconception as to what causes AD/HD. The additional teacher comments to this survey, for the most part, were negative and conveyed tones of resentment. The use of assistive technology devices and multisensory instructional methods in the classroom did not lessen the negative perception of the disorder. It seemed the negative perception was fueled by hearsay and the media’s focus on the medication prescribed to the person with AD/HD. The key to reaching and teaching the student with AD/HD is the same for reaching and teaching any style learner in the classroom. The student with AD/HD is a disruptive force in the classroom due to the fact the teacher’s focus is on that disruptive force. As with any student, the student with AD/HD has a unique learning personality. The challenge for the classroom teacher is to see past the labeled AD/HD peculiarities and characteristics, and recognize the unique individual learning styles and preferences of the student. Instead of focusing on the negative characteristic, it makes a tremendous difference in the teacher/student relationship to focus on the AD/HD student’s ability to put forth endless energy and to hyperfocus on a subject or project when motivated. AD/HD students are driven by intrinsic motivation factors. They are 78 critical thinkers and problem solvers, usually thinking ahead of the establishment. Their imagination, creativity, humor, and spontaneity is noted as boundless. They are the future artist, politicians, inventors, journalists, novelists, industrialist, athletes, musicians, and scientists of the world. The AD/HD/LD Institute posts on their One AD/HD Place Web site a list of famous people "officially diagnosed" with AD/HD; along with others not "officially diagnosed," but exhibiting the life style characteristics of AD/HD. Albert Einstein Thomas Edison Gen. Westmoreland Galileo Gen. George Patton Eddie Rickenbacker Mozart Agatha Christie Gregory Boyington Wright Brothers John F. Kennedy Harry Belafonte Leonardo da Vinci Whoopi Goldberg F. Scott Fitzgerald Cher Rodin Mariel Hemingway Bruce Jenner Thomas Thoreau Steve McQueen Tom Cruise David H. Murdock George C. Scott Charles Schwab Dustin Hoffman Tom Smothers Henry Winkler Pete Rose Suzanne Somers Danny Glover Russell White Lindsay Wagner Walt Disney Jason Kidd George Bernard Shaw John Lennon Russell Varian Beethoven Greg Louganis Robin Williams Carl Lewis Winston Churchill Louis Pasteur Jackie Stewart Henry Ford Werner von Braun "Magic" Johnson Stephen Hawkings Dwight D. Eisenhower Weyerhauser family Jules Verne Robert Kennedy Wrigley Alexander Graham Bell Luci Baines Johnson Nugent John Corcoran Woodrow Wilson George Bush's children Sylvester Stallone Hans Christian Anderson Prince Charles Nelson Rockefeller (Petty 1998) As with any learner, no two students with AD/HD learn the same. There are general characteristics of the learner with AD/HD that can help the classroom teacher recognize the individual learning personality of the student. 79 When mapping the learning personality of an individual student with AD/HD, the attention factor is the focus. Motivating and stimulating the attention of the student with AD/HD does not have to be a negative challenge. Understanding the neuropsychological factors of AD/HD is important, but teaching to the cognitive and metacognitive characteristics of the learner with AD/HD is vital for the learning success of individual students with AD/HD. For instance, taking into consideration the general characteristics of AD/HD and applying Gardner’s Multiple Intelligence Theory; and/or recognizing Vygotsky’s Zone of Proximal Development and his theory on internalization is a start for turning the negative into the positive challenge. Research and theory on intrinsic motivation concepts related to the students innate preference to learn and absorb or assimilate information (Ryan and Deci 1999) when considered in relation to the general psychological characteristics of AD/HD can eliminate that disruptive behavioral factor attributed to the student with AD/HD in the traditional classroom. The inclusion of the student with AD/HD should not be a frustrating challenge or negative experience for the teacher or the student. By integrating multisensory methods of instruction and assistive technology devices and software into the general classroom curriculum to meet the needs of all learners, including those with unique learning differences, such as the student with AD/HD, an engaging atmosphere of learning and social interaction can be maintained easily by the teacher in the classroom. Classroom activities and assessments that include and accommodate Gardner’s eight multiple intelligences; 80 and using assistive technology devices to aid in teaching within the zone of proximal development of each student assures a positive learning experience for all students, and promotes the achievement of unassisted student performance in all subject areas to progress to higher cognitive levels. The key is knowledge and understanding of the disorder. This study warrants more research on educating the classroom teacher on the positive characteristics of AD/HD student. The study points to a need to redirect the classroom teacher’s focus on the overdiagnosis and overmedication issues associated with AD/HD to the positive and unique learning style and preferences of the student with AD/HD. If the use of multisensory instructional methods and assistive technology devices were incorporated in with lesson plans and classroom activities that include all of Gardner’s multiple intelligences and taught within Vygotsky’s Zone of Proximal Development for each student, would medication be necessary? The original hypotheses of this study, 1.) There is a significant relationship between the unique teaching challenges the classroom teacher must meet due to the inclusion of the AD/HD student in the traditional classroom setting, and the use of assistive technology devices in course activities; and 2.) There is a significant relationship between the attitude of the teacher forced to adjust the classroom environment and make special 81 accommodations for the AD/HD student, and the availability and use of assistive technology devices in the classroom; must be rejected at this time. The results of the random survey warrant more specific qualitative and quantitative research in the area of educating the classroom teacher on the positive characteristics and unique learning styles of the student with AD/HD. Summary This study investigated teacher attitudes and perceptions of the student with AD/HD in the classroom, and attempted to identify the relationship of those attitudes and perceptions with the use of assistive technology devices in the classroom. Prior research and studies have proven the incorporation of assistive technology devices in with the general curriculum, course delivery, lesson plans and classroom activities facilitates the teacher’s ability to meet the learning styles and preferences of all students, eases classroom management, and improves overall student academic outcome. Assistive technology devices have been proven to empower student with learning differences and AD/HD, and improve their ability to organize, control negative behavior, and complete tasks and assignments. With this in mind, the study attempted to establish a positive relationship between readily-available assistive technology devices for teacher and all students in the classroom, and a positive teacher attitude and perception of the student with AD/HD included in the classroom. 82 The study consisted of an ex post facto research design and participants were a random selection of 575 teachers in Northeastern, Central, and Southern Ohio. The survey instrument used in this study was a questionnaire consisting of 26 questions (see Appendix A) that addressed three specific aspects affecting the education and academic experience of the student with AD/HD: 1.) teacher training and use of technology; 2.) teacher understanding of AD/HD; and, 3.) the use of assistive technology devices in the classroom. Participating teachers were encouraged to comment on any or all of the questions. The questionnaire was distributed and collected in three formats: 1.) personal interview and observation; 2.) hard copy (printed); and, 3.) online. A difference in the formats regarding the tone and professionalism was noticed concerning the comments. The tone and professionalism of the comments deteriorated as the anonymity of the participant increased. Comments by the responding online participants tended to be less reserved than the hard copy and interviewed respondents, and voice of decorum and political correctness. The demographic data was identified and categorized, and the data from the three categories of questions were compared and charted. The data suggests there exists a lack of understanding by the teachers regarding the disorder and the AD/HD learning style, and that the overall teacher attitude and perception of the student with AD/HD is negative. There is no relationship between the use of assistive technology in the classroom and the teacher’s attitude and perception of the student with AD/HD. The data also suggest confusion over the definition of assistive technology and the use of readily-available assistive technology devices for all students in the classroom. 83 Finally, the original hypothesis was rejected and implications for further research should be focused on teacher education on AD/HD and the positive attributes and learning styles of the student with AD/HD. The conclusion implied that beyond the use of assistive technology devices in the classroom, there is a need for members of the academic community to see past the controversies and misconceptions surrounding AD/HD, and develop a greater understanding of the disorder and the unique learning style and positive attributes of the students with AD/HD. Further theories regarding the relationship between the teacher and the student with AD/HD will be developed and more qualitative and quantitative research pursued on the causes and effects of the negative perceptions and attitudes of teachers towards the student with AD/HD .