Strategies to use with students who are diagnosed with AD/HD

The following is a list strategies teachers and parents can use to help students with AD/HD:

For Teachers:

-       Let students stand, not sit

-       Allow them time to get up and move around every 5 to 10 minutes. If this is not a possibility give the child some sort of stimulant they can use at their desk, for example a ball to squeeze.

-       Allow more time to complete assignments

-       Create an environment as distraction free as possible.

-       Routine routine routine. Students with AD/HD need a daily structured routine and plenty of notice if this routine will be broken for any reason.

-       Directions should be clarified and repeated to ensure the students know what is expected of them

-       Work should be chunked into smaller, more manageable pieces.

-       Students should also be given advanced warnings of when transitions from one class to another will be taking place (10 to 15 min)

-       Provide them with organizational tools (Checklists, Color Coded Folders, etc)

-       Dupaul and Weyndt (2006) believe a combination of proactive and reactive strategies are highly successful. Also included are adaptations for secondary level students.

o      Proactive treatment strategies involve a change in conditions (e.g. teacher behavior) before a specific behavior occurs. It is strictly a preventative measure. Proactive treatment strategies that have been used successfully for students with AD/HD include choice making, peer tutoring, and computer-assisted instruction. (p 345)

§       Choice making interventions allow student to choose from two or more concurrently presented activities. Specifically, students are provided with a menu of potential activities from which to choose in a particular academic subject area. For example, if the student is having difficulty completing independent math assignments the child would be presented with several possible math assignments to choose from. (p 345)

§       Another proactive strategy is peer tutoring wherein two students work together on an academic activity with one student providing assistance, instruction, and/or feedback to another student.

·      Class Wide Peer Tutoring(CWPT) takes this a step further. In this situation the class is a.) Divided into two teams b.) In these teams pairs are formed c.) Students take turns tutoring each other d.) The work is given to the tutors e.) Points are given to the teams where correct work is produced f.) Errors need to immediately be corrected g.) Bonus points are given by the teacher for the teams working well with each other. h.) Points are then tallied. (p 347)

·      Research has found benefits in this approach with students who have AD/HD. Active engagement in the lesson increased by 60 percent. Test scores on the subject material also increased by 18 percent. A positive change in behavior also occurred. (p 347)

§       Computer assisted instruction  (CAI) includes instructional features that allows students with AD/HD to focus their attention on academic stimuli. CAI software is specifically designed to address specific instructional objectives provides highlighting of essential material (e.g. large print, color) utilizes multiple sensory modalities divides content material into smaller bits of information and provides immediate feedback about response accuracy. (p 347)

o      Reactive strategies are interventions that involve a change in environmental conditions following a specific behavior in order to alter the frequency of that behavior in the future. Reactive strategies that have empirical support for addressing AD/HD-related behavior include prudent reprimands, token reinforcement, response cost, and self-management procedures. (p 348)

§       Reprimands and redirection statements are more successful when made in a brief, calm and quiet manner. Ideally, reprimands should be delivered privately while making eye contact with the child. (p 348)

§       Token reinforcement is a commonly used strategy in which students earn immediate reinforcers (e.g. stickers, points) for meeting behavioral expectations, and the points can be exchanged later in the day or week for back-up reinforcers (e.g. preferred home and school activities). (p 348,349)

·      Two variants of token reinforcement include the use of home-based reinforcement for school behavior (i.e. daily, school report card) and response cost. Daily report cards specify several behavioral goals (e.g. complete assigned class work) that students must achieve in school in order to earn reinforcement at home. Teachers provide written quantitative ratings for each goal that serve as the immediate contingencies. These ratings are converted to points at home and exchanged for home-based reinforcers. To make this successful: a.) goals are few in number and stated in a positive manner; b.) both academic and behavioral goals are included c.) feedback is provided by subject or class period; and d.) parents are included in the planning process. (p 349)

§       Self management interventions can include self monitoring, self-evaluating, and self-reinforcement. Although self monitoring alone may be helpful for addressing very specific behaviors displayed by children with AD/HD, several studies have indicated that the combination of self-monitoring and self-reinforcement is effective in improving a variety of behaviors including task-related attention, academic accuracy and peer interactions. (p 350)

o      Adaptations for secondary level students:

§       These students need improved interventions in organizational and study skills. Constant modeling of these skills is essential for student success. (p. 350)

§       Another adaptation is an increased reliance on self-management approaches. Self management interventions should be considered due to the fact that students have multiple teachers at this level, some of whom may be resistant to altering instructional or behavioral management practices. Specifically students were asked to keep a checklist of activities (e.g. bringing materials to class, packing correct material for home to do homework etc) (p. 351)

§       A third adaptation is to involve those students in the planning and implementation process of the IEP and/or strategies being implemented. (p. 352)

-       Humphrey (2009) states that researchers argue that pedagogic needs can be addressed in three ways; firstly, by thinking about those needs that are common to all; secondly, by thinking about those needs that are specific to a small group (such as students with AD/HD); and thirdly by thinking about those needs that are unique to individuals. (p. 21)

-       It may be better to exploit the characteristics of AD/HD rather than suppress them. For example the AD/HD students who are rather talkative could be involved in lessons that require a lot of talk. (Humphrey p. 21)

For Parents:

The National Institute of Mental Health (2010) suggests the following:

- Psychotherapy

·      Behavioral therapy aims to help a child change his or her behavior. It might involve practical assistance, such as help organizing tasks or completing schoolwork, or working through emotionally difficult events. Behavioral therapy also teaches a child how to monitor his or her own behavior. Learning to give oneself praise or rewards for acting in a desired way, such as controlling anger or thinking before acting, is another goal of behavioral therapy. Parents and teachers also can give positive or negative feedback for certain behaviors. In addition, clear rules, chore lists, and other structured routines can help a child control his or her behavior.

·      Therapists may teach children social skills, such as how to wait their turn, share toys, ask for help, or respond to teasing. Learning to read facial expressions and the tone of voice in others, and how to respond appropriately can also be part of social skills training.

-       Just like at school it is best to keep a structured routine at home (e.g. the same bedtime, homework time, dinner time etc) It’s a good idea to keep the schedule in a visible place (the fridge or a bulletin board). If there is going to be a change in this schedule be sure to give the child plenty of notice of the change.

-       Practice organization with the child. Everything should have its place (backpack, toys, clothes etc)

-       Rules at home should be clear and consistent. A rewards system for following the rules should also be enforced.

Psycho-stimulant medication, accompanied by the above strategies, is the most effective treatment for students with AD/HD. It is important to note that medication alone does not guarantee success in the child. It needs to be paired with the above strategies. Because 75% of students with AD/HD are medicated it is important for the teachers to monitor how that medication affects those students in school. The following is a chart provided by the National Institute of Mental Health listing stimulant medications used, their side effects, and the possible risks in using them:

 Side Effects And Risks:

 Side effects include loss of appetite, sleep problems. May lead to possible cardiovascular (heart and blood). Review found a slight increased risk, about 1 in 1,000, for medication-related psychiatric problems, such as hearing voices, having hallucinations, becoming suspicious for no reason, or becoming manic (an overly high mood), even in patients without a history of psychiatric problems.