Inquiry Project
on ADD/ADHD
Jacqueline
Krempl, Dipti Pidikiti, Robyn Reinmiller, Stephanie Shettel,
Jennifer
Thomas, and Anthony Tullio
· Diagnosis applied to children & adults
· Core features are displayed over a period of time & include:
1. Distractibility: Inability to maintain attention to tasks
2. Impulsivity: Impaired impulse control & delay of gratification
3. Hyperactivity: Excessive activity & physical restlessness
· Behaviors must be excessive, long-term, & pervasive
· Behaviors must appear before age 7 & continue for at least 6 months
· Behaviors must create a real handicap in at least 2 areas of a person’s life (i.e. school, home, work, or social settings)
· DSM-IV Criteria for ADD diagnosis:
1. 6 or more symptoms of inattention have persisted for at least 6 months that are maladaptive & inconsistent with developmental level or 6 or more symptoms of hyperactivity-impulsivity have persisted for at least 6 months that are maladaptive & inconsistent with developmental level.
2. Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7.
3. Some impairment from symptoms is present in 2 or more settings (school, work, home, etc.)
4. Clear evidence of significant impairment in social, academic, or occupational functioning.
· Approximately 4-6% of the US population has ADHD
· Life-long exceptionality
· Not limited to children
· Possibly genetic: if one person in a family is diagnosed with ADHD, there is a 25-35% probability that another member of the family also has ADHD
· males are 2-3 times more likely to be diagnosed than females
· Fails to give close attention to details
· Makes careless mistakes
· Has difficulty sustaining attention to tasks
· Doesn’t seem to listen when spoken to directly
· Fails to follow instructions completely & carefully
· Loses or forgets things
· Feels restless--not necessarily every person
· Talks excessively
· Blurts out answers before hearing the whole question
· Has difficulty waiting his/her turn
· Inconsistent behavior--one day he/she can perform a task, the next day he/she can’t. They may be able to remember complex issues but forget simple things
· May have poor handwriting
· Approximately 30% of individuals with ADD/ADHD have a learning disability
OBSERVATIONAL LEARNING:
Observational learning is when the observer acquires a new behavior demonstrated by the model. Students see and hear models and may adopt attitudes of their teachers, parents, or peers. By observing models, students can obtain physical skills, such as swimming or writing with a pencil, and academic skills, such as reading and doing math problems. They can also develop interpersonal skills and moral values by observing people around them. Models are often real people, like teachers, parents, and other students. Models can also be symbolic models, like fictional characters in books, movies, or video games.
There are four conditions that need to be met in order for a student to successfully model someone else’s behavior: attention, retention, motor reproduction, and motivation. To learn effectively, the learner must pay attention to the model. Students with ADD or ADHD often have a difficult time paying attention, following directions, staying seated and working independently in class. They are easily distracted and this can often impair a student’s ability to learn by observation. Teachers can help students with ADD to learn by using one-to-one instruction and increased supervision, to help them concentrate and prevent them from being distracted so easily. They can also change the classroom seating arrangement to a circle, as opposed to rows or clusters, which has been shown to increase on-task behavior. Because students with ADD/ADHD often have a short attention span, a teacher can intersperse active tasks such as arts and crafts, with passive tasks like doing math problems, to keep students interested and enable them to productively channel their energy. They can also vary presentation formats (examples, videos, models, posters) to keep students interested.
BEHAVIORAL LEARNING:
Behaviorism is a perspective that focuses on how environmental stimuli bring about changes in the behaviors that people exhibit. One of the assumptions that underlie this view of learning is that learning involves a behavior change. It cannot be assumed that a child has learned something if they do not exhibit a change in their classroom performance. Because students with ADD/ADHD may be inattentive, unfocused, hyperactive, or impulsive, it is important to reinforce good behavior, and remove any stimuli that may be causing the student to be distracted. Students with ADD/ADHD seem to “respond better to frequent feedback with immediate and highly salient consequences” (Garill, DuPaul, Kyle 89). Other behavioral interventions that have been successful in improving the on-task behavior of students with ADD/ADHD include antecedent manipulation, consequent manipulation, and cognitive-behavioral interventions.
Teachers can promote learning in ADD/ADHD students by
altering their teaching strategies.
They can “present lessons in a fast-paced manner, using signals or cues
to alert the student to important information or the correct response,
providing numerous opportunities for the student to respond, and using eye
contact and teacher proximity to maintain student attention” (Garill
91). Academic tasks can be made
brief, and immediate feedback can be given to reinforce the behavior. Teachers should give frequent and
descriptive positive reinforcement immediately following a desired behavior,
and should reinforce both social behavior and academic effort and
performance. In addition, contingency
management procedures can include the use of token reinforcement systems (stickers, candy), response cost, group
contingencies, contingency contracts, and home-based contingencies.
Ø
Response-cost systems: combine
positive reinforcement with mild punishment, combines rewards for positive
behaviors and loss of priveliges for the display of negative behaviors to
control a child’s behavior in a homogenous or heterogeneous classroom setting.
Ø
Group contingency: the
presentation or loss of a reinforcer is contingent upon the behavior of an
individual in the group, a part of the group, or the entire group.
Ø
Contingency contract: an agreement
between two parties that specifies a desired behavior and a conditional reward.
PRINT-BASED
LEARNING:
1.
Give students
materials that are not cluttered and therefore distracting i.e. A few sentences
to a page that are spaced out.
2. Illustrate! This will help keep the students attention and may enable them to link the information being taught to the picture that you drew.
3.
Use colorful teaching tools such as overheads and ditto’s
to gain and keep the students attention. Try
framing the visual or printed material that you wish the students to focus on
with your hands or with a colored box.
4.
Make tool that
better enable the student to read printed materials, i.e.: an index card with a
rectangle cut out to help the student focus on the word they are reading and
not be distracted by other words on the page.
5. Provide written directions on how to do the task at hand that the student is able to reference if they get off track.
6. Have the student copy assignments down for themselves and check the student did it this ensures that the student is aware of your expectations.
7.
Use study guide
sheets that are partial outlines and have the students fill in the blanks based
on what is being taught or write it on the board and have them copy it to
ensure they are focused on the lesson at hand.
8. For homework assignments the workload should be reduced so that the student can focus at the task at hand since a “large” amount of homework could be overwhelming or stressful to the student.
9.
Break long term
assignments into manageable tasks.
10. Allow specified extended time without penalty for lateness.
11.
Offer alternative
assignments.
12. Give only one task at a time.
13. Provide extra texts for the student to have at their home.
14. Provide a reading corner, private workspace, and post classroom rules as a constant reminder to the students.
15.
When testing the
student you must format the test in a way that is not overwhelming for the
student i.e. Shorten the test, ask short questions, and allow the student to
take the test in parts. Always make sure that you are testing knowledge not
attention span or speed of test taking.
16. Allow the student to take the written test in a distraction free area.
17.
Offer the student
extended time so they do not feel rushed and in response become distracted.
LECTURE-BASED LEARNING:
1. Make academic assignments short to accommodate the students’ short
attention span.
2. Give feedback to students immediately, if they do something right
then make them aware of it FAST!
3. Teacher directions rather than seat work, this enables the student to access the teacher and be aware of how to attack the assignment at hand.
4. Schedule academic instruction in the morning since studies have proven
that as the day passes a student with AD/HD looses their ability to problem
solve. Therefore plan art, music and gym in the afternoon.
5. When preparing your lecture be sure to identify the important points clearly.
6. Verbally define rules everyday if needed
since these students need to be reminded and tasks must be reinforced often.
7. Use a token economy, or reward system to encourage student to pay attention well and reward them for doing so.
8. Give the student auditory cues, project your voice, use storytelling
9. Ask interesting, speculative questions, show pictures, or read a poem
that is related to the upcoming lecture.
10. Since it is hard for students with AD/HD to sit through and listen to long lectures, have the students assist you with the lecture, answer question that pertain to information that was just spoken about, to ensure that students are understanding.
11. Model excitement and enthusiasm for an upcoming lesson.
12. Use eye contact, be sure that students are facing you and use body language.
13. Incorporate demonstrations and hands on presentations in your teaching
whenever you can.
14. Move around the classroom to maintain visibility.
15. Teach thematically whenever possible.
16. Use direct instruction techniques and other methods of questioning that allow for high response from the students.
18.
Alter the way that
students are called on, have students respond to their neighbor, or tell them
to write down their response.
COOPERATIVE-BASED
LEARNING:
Cooperative-based
learning is a method of teaching that allows students in the class to work
together in-groups and help each other learn to attain goals. Students with
ADD/ADHD have a hard time concentrating on a subject for a prolonged period of
time. The teacher needs to implement in the curriculum activities that teach
interaction and interdependence. Cooperative learning can be split into five
elements:
|
Positive interdependence |
Establishes and includes mutual goals, joint rewards, shared materials, and assigned roles. |
|
Face-to-face interaction |
Three or four children (maximum) are grouped together, arranged “eyeball to eyeball.” |
|
Individual accountability |
Structure this in the group by giving each group member an individual exam or randomly selecting one member to give an answer for the whole group. |
|
Interpersonal & small group skills |
Students do not come to school with all the social skills they need to collaborate effectively. Teachers need to teach the skills. |
Group processing
|
Give time and procedures to students to evaluate how well their group is functioning. |
(How to Reach and Teach ADD/ADHD Children. Pg. 95-96. See References)
For cooperative-based
learning to be successful, the teacher needs to implement the activities
throughout the curriculum. The teacher should make small groups and eventually
increase the number of students in the group but not exceed four. The seating
should be close so the students have eye-to-eye contact. A student can focus if
given a role in a group such as the reader, recorder, or the material handler.
The teacher should give clear instructions and ask that one answer be given by
the group so all the students have an input. When there is positive behavior,
the teacher should award the groups. Another way to reinforce students with
ADD/ADHD is show positive reinforcement for their behavior by taking photos.
The photos can be of the student sitting still and doing the work or the
student working with the group. A teacher should see that there is a problem
with the structure of the cirrocumuli if there are students that act
impulsively in the group by leaving, working on their own, not collaborating
answers, or not sharing materials, discussing other subjects.
INQUIRY OR
DISCOVERY LEARNING:
Another method that is used is inquiry or discovery learning. This method uses a hands-on method to develop understanding of a topic. A teacher can use the hands-on technique in several ways. There could be a use of “manipulatives for teaching math, role playing, dance and movement, acting-out” (Teif, 111). For example, a math teacher could use graphs, flash cards, charts, and math computer programs. The teacher could assign oral reports, science projects, and can use games and computers. Inquiry learning has a limit to its use and manipulation to make teaching hands-on. Research has shown that inquiry based learning has positive results however cooperative-based learning is the best method but is used less frequently (Tief, 112).
EXPERIENCE BASED LEARNING:
Experience based education refers to the active participation of students in the course of the lesson. This is a hands on approach to learning in contrast with the lecture format of classroom instruction. When considering students with ADD and AD/HD, experience based learning can help the student stay focused on task by increasing their roll in the lesson plan (Cantwell, 96). Science experiments and fieldwork give students specific tasks to do. However there are certain considerations a teacher must make before implementing this type of instruction in the classroom. The number one priority of teachers is the safety of their students. As mentioned earlier, students with ADD and AD/HD require added supervision. This goes double when attempting experience-based education with a class. The science lab, probably the most common setting for experience-based education, contains hazards for all students. Accidents are more likely to happen when students are not paying attention. Since attention is a problem with ADD and AD/HD students, precautions must be made prior to lab work. Does the experiment involve dangerous materials? If so these students will require direct supervision while using them. Is the experiment lengthy; are there a number of steps involved? By walking through an experiment prior to it execution and then conduction the experiment in stages, i.e. insuring that the entire class has completed each step before moving on to the next, the risk of injury is reduced. This also gives ADD and AD/HD students less material to focus on at a given time thus increasing their attention. Fieldwork also poses problems for ADD and AD/HD students. While it does promote active participation, teacher supervision is reduced. Hence, if a student is uninterested or has an attitude of indifference toward the assignment, the benefits of hands on learning are extinguished. There are several ways to remedy this situation. First, direct supervision of fieldwork, as with any type of instruction, can increase the attention of ADD and AD/HD students. However, constant supervision of this type can stigmatize students; lower their self-reliance and cause resentment (Goldman, 98). No one likes having someone constantly looking over his or her shoulder. Pairing ADD and AD/HD students with their piers who are more enthusiastic about the given assignment can reduce these feelings as well as increase attention and learning. From another prospective, giving students more control over the subject matter also increases learning. ADD and AD/HD students are more inclined to focus on material, which interests them (Cantwell, 96). Thus, allowing students to pick their own topics at least insures that they have an interest in what they are studying. In short, experience based learning increases the ADD and AD/HD students’ attention by making them active participants in the lesson. However, as with all methods, this does not nullify the disorder or in itself insure that the student will benefit. The extent that the student is interested in the material plays an important roll. The more relevant the material is to the individual can greatly increase the chances of actual learning. This leads us to our next method: Technology based learning. TECHNOLOGY BASED LEARNING:
Technology based learning refers to the use of computers and the internet in classroom instruction. As with experience based learning there are benefits as well as drawbacks when implementing this type of instruction. Unlike experience based learning, technology based learning gives teachers a head start, familiarity of the computer. Research suggests that today school-aged children have greater ease working with computers when compared to students of previous generations (Goldman, 98). This inclination towards computers can make it easier for students with ADD and AD/HD to focus on tasks by incorporating their interest with computer work into classroom lessons. A student may become distracted while sitting through a lecture but find it easier to focus on a computer assignment covering the same material (Goldman, 98). Mentioned above is the fact that students today are more computer savvy than those of previous generations. Teachers being members of those previous generations causes the first problem with technology based learning. To be effective, teachers must be experts in the technology used in the classroom. A teacher's lack of computer skills can be detrimental to the lesson. Students regardless of any disabilities can loose attention while their teacher fumbles on the keyboard. Also, computer skills, although more widespread than ever before, are not universal. Thus an ADD or AD/HD student without these skills has more information to focus on, the lesson and how to work the computer, and thus can become even more distracted. In addition to these problems are inherent distracters while using the internet. Pop up windows, advertisements and slow downloads can divert a students attention or break their concentration.In response to these problems, teachers must follow guidelines when using technologies in the classroom. First and foremost, never use any technologies that are not familiar to you. In addition to the problems that are mentioned above, a teacher runs the risk of loosing creditability while trying to learn these technologies on the spot. Next, careful selection of software is essential. Complicated programs will loose the ADD and AD/HD students if they are unaccustomed to them. Be sure the class is familiar with the programs operations before using them to teach. As for the internet, ADD and AD/HD students, as well as others, may need added supervision while on the net (Mannuzza, 98). With the multitude of information out there it is best to suggest specific pages to access rather than allowing students to search on their own. A final word of caution on technologies, computers and the internet can greatly enhance instruction but they are not suitable for every lesson. Again, by carefully selecting which lessons will benefit by technology based education; many of the pitfalls associated with it will be avoided.
· Preferential seating--sit at the front of the room
· Help with organizational & social skills training
· Reduce workload if necessary
· Provide more time for certain tasks
· Provide opportunity for untimed tests
· Provide a notetaker
· Provide one-to-one help when necessary
· Make rules specific & clear--post them in writing
· Help them anticipate & plan for what’s ahead
· Place student by other students that are quiet & focused
· Encourage using an assignment book & insist the student write in it as soon as an assignment is given
· Allow the student to move around--run an errand, clean the board, get a drink, go to the bathroom
· Allow the student to keep a small object at his/her desk to use when distracted (ex: soft squeeze ball)
· Go over a list of items the student needs to bring home to complete the assignment
· Avoid stressful situations--an ADD brain works less efficiently if under stress
· Provide a quiet, distraction-free study area
· Use earphones on computers & audio equipment to minimize distractions
· Plan supervision during transition between subjects, classes, recess, lunchtime, etc.
· Always provide opportunity for physical activities--do not take away recess as a punishment & don’t use recess as a make-up period
· Provide a consistent, predictable schedule & hang it up
· Provide the student with a legible outline before the lesson/lecture, including teacher’s notes
· Provide a note-taker at all times to record classroom discussions/lectures
· Provide instruction & information in writing
· Provide student with a weekly syllabus
· Break instructions into short sequential steps
· Divide work into “mini assignments”
· Schedule shorter work periods
· Provide guidance & supervision on longer assignments & projects
· Help the student plan their project schedule
· Give the student cues to stay on track
· Give the student cues before an important point is to be made
· Allow time for students to formulate an answer
· Use visual aids with oral presentations
· Avoid sarcasm, continual criticism, or bringing attention to student’s needs in front of his peers
· Ask to see student’s work after he has done a few problems to confirm his correctness
· Encourage using books-on-tape
· Provide the student with published book summaries (i.e., Cliff Notes) to read before reading a novel
· Modify/shorten assignments as necessary
· Make a second set of books & materials to keep at home
· Provide tips on study skills, test-taking skills, organizational skills, & time-management skills
· Help the student organize materials by color-coding each subject
· Teach the student how to identify key words, phrases, operation signs in math & key sentences, words, & phrases in reading
· Teach the student how to scan a chapter for info & how to highlight important sections
· Teach the student to efficiently proofread his work
· Encourage mnemonics to aid memory formation & retrieval
· Support alternative methods of outlining like mind-mapping or clustering
· Match the student with faculty that can best support his needs
· Recognize the difference between skill deficits & non-compliance
· Provide a safe learning environment
· Praise in public, reprimand in private
· Use rewards that are powerful & meaningful to the child
· Give feedback often
· Use positives & praise more than negatives or punishments
· Act--don’t talk too much. Respond with behavior.
· Keep daily/weekly progress report of the student.
· Give tests & quizzes in a quiet area
· Provide the student with specific information on test material, in writing
· Provide practice quizzes/tests
· Allow more time to complete quizzes/exams
· Ask the student to write on the test to arrange for more time
· Provide alternative opportunities to express what the student knows
· Consider allowing the student to use a calculator if he understands math calculation concepts
· Allow calculator use to check work
· Type test, rather than write by hand
· Make sure tests are clear, dark & easy to read
· Remove questions from the test that are not to be answered
· Place test instructions next to the appropriate questions
· Review the test to assure the questions are ordered in a logical, sequential manner
Appendix for Attention Deficit (Hyperactivity) Disorder
Appendix
I: Most Useful Journal Articles (Copies
Attached)
Gardill, M. Cathleen; DuPaul, George J.; and Kyle, Kara E. “Classroom Strategies for Managing Students with Attention-Deficit/Hyperactivity Disorder”. Intervention in School and Clinic. Vol. 32, Number 2. November 1996. 89-94.
Marshall, Richard M.; Hynd, George W.; Handwerk, Michael J.; and Hall, Josh. “Academic Underachievement in ADHD Subtypes”. Journal of Learning Disabilities. Vol. 30, Number 6. November/December 1997. 635-642.
Shimabukuro, Serena M.; Prater, Mary Anne; Jenkins, Amelia A. “The effects of Self-Monitoring of Academic Performance on Students with Learning Disabilities and ADD/ADHD”. Education and Treatment of Children. Vol. 22, Number 4. November 1999. 397-414.
Appendix
II: Additional Journal Articles
Barkley, R.A. (1981). Hyperactive Children: A Handbook for Diagnosis and Treatment. New York: The Guilford Press.
Bussing, Regina; Zima, B.T.; and Perwien, A.R. (2000). Self-esteem in special education children with ADHD: relationship to disorder characteristics and medication use. Journal of the American Academy of Child and Adolescent Psychiatry, 39 (10), 1260-1269.
Griffin, M.W. & Prior, M.R. (1985). Hyperactivity: Diagnosis and Management. London: W. Heinemann Medical Books.
Jones, E.D.; Wilson, R.; and Bhojwani, S. (1997). Mathematics instruction for secondary students with learning disabilities. Journal of Learning Disabilities, 30 (2), 151-163.
Okolo, C.M.; Bahr, C.M.; and Reith, H.J. (1993). A retrospective view of computer-based instruction. Journal of Special Education Technology, 12 (1), 1-27.
Reetz, Linda; Ring, M.M.; and Jacobs, G.M. (1999). 20 ways to examine test modifications. Intervention in School and Clinic, 35 (2), 117-118.
Renshaw, D.C. (1974). The Hyperactive Child. Chicago: Nelson-Hall.
Silver, L.B. (1993). Dr. Larry Silver’s Advice to Parents on: Attention Deficit Hyperactivity Disorder. London: American Psychiatric Press, Inc.
Trites, R.L. (1979). Hyperactivity in Children: Etiology, Measurement, and Treatment Implications. Baltimore: University Park Press.
Weiss, G. and Hechtman, L.T. (1993). Hyperactive Children Grown Up: ADHD in Children, Adolescents, and Adults. New York: The Guilford Press.
Wood, J.W. and Miederhoff, J.W. (1988). A model for adapting the teacher-made test. The Pointer, 33(1), 7-11.
Zeigler-Dendy, C.A. (1995). Teenagers with ADD: A Parents’ Guide. Bethesda: Woodbine House.
Appendix III: Organizational Resources (Copies of
Correspondence Attached)
Attention Deficit Information Network (Ad-IN)
475 Hillside Avenue
Needham, MA 02194
617-455-9895
Children and Adults with Attention Deficit Disorders (CHADD)
499 NW 70th Avenue Suite 109
Plantation, FL 33317
305-587-3700
National Attention Deficit Disorder Association (National ADDA)
1788 2nd St. Suite 200
Highland Park, IL 60035
847-432-ADDA
National Information Center for Children and Youth (NICHCY) with Disabilities
PO Box 1492
Washington, DC 20013
800-695-0285
Linda Anderson, Coach & Professional Organizer
161 Mechanics St.
Doylestown, PA 18901
215-230-7315
Specialty in ADD organizational coaching for adults & young adults
Appendix
IV: Most Useful Internet Resources
(Copies Attached)
Children and Adults with Attention-Deficit/Hyperactivity Disorder
LD OnLine
National Attention Deficit Disorder Association
Appendix
V: Additional Websites
The ADD Action Group
The ADD/ADHD Online Newsletter
ADD/ADHD Toronto
ADD/ADHD: What Does It Mean for Parents and Families When Their Child Is Diagnosed with This Condition?
http://www.kidsource.com/kidsource/content4/ADHD.pn.html
ADD Focus—About Attention Deficit Disorder
ADD Medical Treatment Center of Santa Clara
ADD Warehouse
AD/HD Outreach
Attention Deficit Disorder
http://www.stanford.edu/group/dss/Info.by.disability/Attention.Deficit.Disorder/
Attention Deficit Hyperactivity Disorder
http://www.mentalhealth.com/dis/p20-ch01.html
Office of Special Education—Attention Deficit Disorder
http://teis.virginia.edu/go/cise/ose/categories/add.html#defin
What is AD(H)D?
http://www.wpi.edu/~driel/add.html
Appendix
VI: Contacts for Technology Resources
ADD Warehouse
300 NW 70th Avenue
Plantation, FL 33317
800-233-9273
Individuals with Disabilities Education Act Amendments of 1997, 20 U.S.C. § 1400.
Rief, Sandra F. How to Reach and Teach ADD/ADHD Children. Prentice-Hall Canada Inc.: Toronto, 1993. (p. 1-236).