‘Teaching the Tornado’: Agenda…

1. ‘Teaching the Tornado’: Classroom Strategies for Working With the Disorganized, Inattentive, Overactive StudentJim Wrightwww.interventioncentral.org

2. ADHD: Key Concepts Self-Monitoring: Students as Self-Managers of Behavioral Change Teaching Students to Take Responsibility for Their Own Learning: The Art of Negotiation Review of Internet Tools to Help the Classroom Interventionist Promoting Classroom Success: Accommodations, Academic Survival Skills, Academic Interventions, & Behavioral Strategies ‘Teaching the Tornado’: Agenda…

3. Access workshop materials at:http://www.interventioncentral.org/tornado

4. ADHD: Definition • “a neurological condition that involves problems with inattention and hyperactivity-impulsivity that are developmentally inconsistent with the age of the child. [This condition] is a function of developmental failure in the brain circuitry that monitors inhibition and self-control. This loss of self-regulation impairs other important brain functions crucial for maintaining attention, including the ability to defer immediate rewards for later gain...” Source: Identifying and Treating Attention Deficit Hyperactivity Disorder: A Resource for School and Home (2003). U.S. Department of Education.

5. ADHD: 3 Sub-Types of the Disorder • ADHD: predominantly hyperactive-impulsive type • ADHD: predominantly inattentive type • ADHD: combined type Source: Strock, M. (2003) . Attention Deficit Hyperactivity Disorder. National Institute of Mental Health (NIMH)

6. ADHD: Symptoms • Inattention • Six (or more) of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level: • (a) often fails to give close attention to details or makes careless mistakes in school work, work, or other activities • (b) often has difficulty sustaining attention in tasks or play activities • (c) often does not seem to listen when spoken to directly • (d) often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions) Source: Identifying and Treating Attention Deficit Hyperactivity Disorder: A Resource for School and Home (2003). U.S. Department of Education.

7. ADHD: Symptoms • Inattention (cont.) • (e) often has difficulty organizing tasks and activities • (f) often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework) • (g) often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools) • (h) is often easily distracted by extraneous stimuli • (i) is often forgetful in daily activities Source: Identifying and Treating Attention Deficit Hyperactivity Disorder: A Resource for School and Home (2003). U.S. Department of Education.

8. ADHD: Symptoms • Hyperactivity • Six (or more) of the following symptoms of hyperactivity-impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level: • (a) often fidgets with hands or feet or squirms in seat • (b) often leaves seat in classroom or in other situations in which remaining seated is expected • (c) often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings or restlessness) • (d) often has difficulty playing or engaging in leisure activities quietly Source: Identifying and Treating Attention Deficit Hyperactivity Disorder: A Resource for School and Home (2003). U.S. Department of Education.

9. ADHD: Symptoms • Hyperactivity (cont.) • (e) is often “on the go” or often acts as if “driven by a motor” • (f) often talks excessively • (g) often blurts out answers before questions have been completed • (h) often has difficulty awaiting turn • (i) often interrupts or intrudes on others (e.g., butts into conversations or games) Source: Identifying and Treating Attention Deficit Hyperactivity Disorder: A Resource for School and Home (2003). U.S. Department of Education.

10. ADHD: Symptoms • Other Diagnostic Requirements: • Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 years. • Some impairment from the symptoms is present in two or more settings (e.g., at school [or work] and at home). • There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning. Source: Identifying and Treating Attention Deficit Hyperactivity Disorder: A Resource for School and Home (2003). U.S. Department of Education.

11. ADHD: Statistics • 3-5% of school-age population may have symptoms of ADHD • Boys are 4-9 times more likely to have disorder Source: Identifying and Treating Attention Deficit Hyperactivity Disorder: A Resource for School and Home (2003). U.S. Department of Education.

12. ADHD Mood Disorders (18%) Oppositional Defiant Disorder 30-50% Conduct Disorder 20-40% Learning Disabilities 20-30% ADHD: Common Comorbid Disorders (40-60% Affected) Sources: Strock, M. (2003) . Attention Deficit Hyperactivity Disorder. National Institute of Mental Health; American Academy of Pediatrics Website: http://www.aap.org/

13. ADHD: Impact on Students • The student’s ADHD symptoms may differ across settings and situations. On tasks or situations that demand impulse control and focused attention, ADHD symptoms are most likely to appear. Source: Strock, M. (2003) . Attention Deficit Hyperactivity Disorder. National Institute of Mental Health (NIMH)

14. ADHD: Impact on Students • Teachers may misjudge the ADHD student’s • inattention as willful ignoring of adults (inattention) or daydreaming • impulsive behavior as purposeful ‘acting out’ or attention-seeking.

15. Domains of ADHD Attention/Focus Lower Than Age-Peers Age Appropriate Impulse Control Lower Than Age-Peers Age Appropriate Level of Activity/Motor Behaviors Higher Than Age-Peers Age Appropriate

16. Example: Two Students Identified With ADHD • STUDENT A-Angela: Quiet student. Not a behavior problem. Said by her teacher to be ‘lost in a fog’ most of the time. Has low grades.(Inattentive Type) • STUDENT B-Benny: Is always the center of attention. Will blurt out answers in class without raising his hand, whether he knows the correct answer or not! Fidgets, squirms, and taps his pencil loud enough to distract students around him. When the teacher assesses Benny one-on-one, he shows that he can do grade-level work. (Hyperactive-Impulsive Type)

17. B B B A A A Domains of ADHD Attention/Focus Lower Than Age-Peers Age Appropriate Impulse Control Lower Than Age-Peers Age Appropriate Level of Activity/Motor Behaviors Higher Than Age-Peers Age Appropriate

18. ADHD & Medication • Stimulants are most widely prescribed treatment • Generally, stimulants are safe for children • The most common side effects of stimulants are loss of appetite, insomnia, increased anxiety, or irritability • About 1 in 10 children does not respond to medication for ADHD Source: Strock, M. (2003) . Attention Deficit Hyperactivity Disorder. National Institute of Mental Health (NIMH)

19. ADHD & Medication (cont.) • Stimulant medication can be very effective but does not typically result in ‘fully normal behavior’ (e.g., only 38% of children in one large stimulant study had behaviors in typical range after one year) Source: American Academy of Pediatrics (2001) Clinical Practice Guideline: Treatment of the school-age child with Attention-Deficit/Hyperactivity Disorder

20. ADHD: Myths About Its Cause… • Research offers no evidence that ADHD is caused by the following: • Eating too much sugar • Food additives • Allergies • Immunizations Source: American Academy of Pediatrics Website: http://www.aap.org/

21. ADHD: Appropriate Target Outcomes • Improvements in relationships with parents, siblings, teachers, and peers • Decreased disruptive behaviors • Improved academic performance (volume of work, efficiency, completion, accuracy) • Increased independence in self-care or homework • Enhanced safety in the community (e.g., skateboarding, bicycle-riding) Source: American Academy of Pediatrics (2001) Clinical Practice Guideline: Treatment of the school-age child with Attention-Deficit/Hyperactivity Disorder

22. ADHD: A Developmental Explanation? • “In youth with attention deficit hyperactivity disorder (ADHD), the brain matures in a normal pattern but is delayed three years in some regions, on average, compared to youth without the disorder, an imaging study by researchers at the National Institutes of Health’s (NIH) National Institute of Mental Health (NIMH) has revealed. The delay in ADHD was most prominent in regions at the front of the brain’s outer mantle (cortex), important for the ability to control thinking, attention and planning. Otherwise, both groups showed a similar back-to-front wave of brain maturation with different areas peaking in thickness at different times.” Source: National Association of Special Education Teachers. (13 November 2007). Brain Matures a Few Years Late in ADHD, But Follows Normal Pattern. Retrieved on January 15, 2008, from: http://www.naset.org/807.0.html?&tx_ttnews%5Btt_news%5D=2410&cHash=b9289c6fb9

23. Small-Group Activity: ADHD ‘Look-fors’ • As a team, create a list of ‘look-fors’ (behaviors or other evidence) that suggest that a student may have Attention-Deficit Hyperactivity Disorder. • Be prepared to share your findings with the larger group.

25. 'Teaching the Tornado' in Grades 3-12 Self-Monitoring: What benefits can be gained by having the ADHD student track her or his own behavior?

26. Student Self-Monitoring • Self-monitoring: a student's measurement of his or her own behavior and comparison of that behavior to a pre-determined standard. • Self-monitoring is based on a fundamental behavioral principle: the act of measuring one's target behavior and comparing it to an external standard or goal can result in lasting improvements to that behavior. • Self-monitoring is sometimes described as having 'reactive' effects, because students who measure and pay close attention to selected behaviors often react to this monitoring information by changing those target behaviors in the desired direction.

27. Student Self-Monitoring: Advantages • Self-monitoring requires the student to take an active role in measuring and evaluating his or her behaviors. • Student self-monitoring data is also typically economical to collect, even in a busy classroom, and can often be used as one data source to track the success of a behavioral intervention.

29. Steps to Set Up Student Self-Monitoring • Teach behavioral expectations. • Select a method for self-monitoring. • Choose a schedule for monitoring. • [Optional] Choose suitable rewards for successful behavior change. • Conduct periodic accuracy checks.

30. STEP 1: Teach Behavioral Expectations When working with an individual student, the teacher: • identifies the behavioral target(s) that the student will self-monitor (e.g., study or work skills, classroom behaviors). • Meets with the student to discuss the behaviors that the student will monitor. • Writes (ideally with the student) a behavioral definition, or rubric, that provides observable evidence, or 'look-fors', to indicate when the behavior is successfully accomplished, partially accomplished, and not accomplished at all.

31. STEP 1: Teach Behavioral Expectations (Cont.) • Figure 1: Behavioral Rubric Example • Behavioral Goal: The student will come to class with all work materials. • Rubric: • Fully accomplished: The student comes to class with all required work items (1.pen and paper; 2. all required handouts; 3. all completed homework; 4. all cumulative notes; and 5. course text). • Partially accomplished: The student comes to class missing no more than one significant item. • Not accomplished: The student comes to class missing more than one significant work item.

32. STEP 2. Select Method for Self-Monitoring There are three main methods for student self-monitoring: • Checklists • Rating Scales (e.g., Behavior Report Cards) • Academic Performance Measures

33. Methods for Self-Monitoring: A Review • Checklists. The checklist is a useful format for recording student follow-through on multi-step directions. Checklists also can be helpful in translating more comprehensive skills (e.g., 'organization') into more manageable sub-skills. The checklist format is quite versatile: it can be used to verify that a student has materials necessary to begin classwork, for example, or to measure a student's level of attention and participation during lecture, or to review homework for common errors before handing that work in to the teacher.

34. Methods for Self-Monitoring: A Review • Checklist: Samples. Packet 2: p. 5

35. Methods for Self-Monitoring: A Review • Checklist: Example. To help his student, Alicia, with classroom organization, her middle school math instructor, Mr. Haverneck, develops—with student input– a checklist of 5 observable organization subskills: • arriving to class on time; • bringing work materials to class; • following teacher directions in a timely manner; • knowing how to request teacher assistance when needed; • having an uncluttered desk with only essential work materials. • Alicia previews the checklist at the start of the school day. At the end of math class, she completes the checklist and charts her score for that day.

36. Checklist: Example. Y Y N Y N

37. Skills Checklists and the Standards Checklists are well-suited for: • evaluating whether a student has the essential foundation skills necessary to attain success on a given Standard. • breaking a complex Standard down into component skills that can be verified through direct observation, review of work products, student interview, or other means.

38. Skills Checklists and the Standards • breaking a complex Standard down into component skills that can be verified through direct observation, review of work products, student interview, or other means. Language Standards: K-5: Production & Distribution of Writing Source: New York State P-12 Common Core Learning Standards for English Language Arts & Literacy. (2010). Retrieved from http://www.p12.nysed.gov/ciai/common_core_standards/pdfdocs/p12_common_core_learning_standards_ela.pdf p. 39

39. Methods for Self-Monitoring: A Review • Rating Scales (e.g., Behavior Report Cards). Rating scales are behavior items with a quantitative (e.g. 1-9) or qualitative (e.g., 'poor-fair-good') behavior rating format. One version of rating scales is the Behavior Report Card (BRC)—useful for students to evaluate behavior after a fixed period (e.g., morning; class period; independent seatwork). • The Behavior Report Card can be a goal-setting tool: The student previews items and sets a performance goal for each item (e.g., 'Today I plan to earn a rating of 'good/3' on 'Came to class with necessary work materials')—then uses the Report Card to evaluate the actual behavior and judge whether the original performance goal was attained.

40. Methods for Self-Monitoring: A Review • Rating Scales (e.g., Behavior Report Cards): SamplePacket 2: p. 7

41. Behavior Report Card Maker www.interventioncentral.org

42. Methods for Self-Monitoring: A Review • Rating Scales: Example. Teachers on a 7th-grade instructional team select a Behavior Report as a self-monitoring tool for their student Brian--with the following items: Brian focused his attention on teacher instructions, classroom lessons and assigned work. Brian completed and turned in his assigned class work on time. Brian spoke respectfully and complied with adult requests without argument or complaint. • Each rating items is rated using a 1-9 scale: • Brian self-monitors his performance on all items and shows the ratings to the teacher at the end of each class period. • His goal is to attain ratings of 7 or higher on each item.

43. Rating Scales: Example (Cont.) 7 3 5

44. Rating Scales (Behavior Report Cards) and the Standards Behavior Report Cards and similar rating scales are ideal for: • monitoring observable student behaviors and interactions that support or are directly cited as part of Common Core Standards.

45. Rating Scales (Behavior Report Cards) and the Standards Speaking & Listening Standards: 6-12: Comprehension & Collaboration Source: New York State P-12 Common Core Learning Standards for English Language Arts & Literacy. (2010). Retrieved from http://www.p12.nysed.gov/ciai/common_core_standards/pdfdocs/p12_common_core_learning_standards_ela.pdf p. 62

46. Methods for Self-Monitoring: A Review • Academic Performance Measures. Student self-monitoring of academic performance has the advantage of tracking relevant school skills; this is an important consideration for students with ADHD who may also struggle to complete assigned work. • Additionally, academic performance can be a helpful self-monitoring target for the ADHD student because engagement in academics is largely incompatible with off-task behaviors such as looking out the window or joking with peers.

47. Methods for Self-Monitoring: A Review • Academic Performance Measures. Student self-monitoring of academic performance can track a range of different measureable outcomes, such as: • Percentage of problems correct on math computation worksheet • Number of paragraphs read during independent reading time • Total words written in writing journal entries • Number of correctly spelled words in writing journal entries • Percentage of items attempted on a daily math homework assignment • Words read correctly from a passage in 1 minute

48. Methods for Self-Monitoring: A Review • Academic Performance Measures: Sample Packet 2: pp. 9-10

49. Methods for Self-Monitoring: A Review • Academic Performance Measures: Example. A 5th-grade student, Rodney, is often off-task during a daily 10-minute in-class journal-writing activity. His teacher selects academic-performance monitoring as a way to increase his on-task time and work production: • Academic Performance Measure: His teacher has Rodney count and track the total number of words that he produces during each journaling session. • Goal-Setting: Prior to each journaling session, Rodney increases his most recent previous total-words score by 2 to set the current day’s goal.

50. Rodney 5th Gr 2012-13 • Academic Performance Measures: Example (Cont.). Length of entries during daily10-min in-class journaling activity Total words written 10/31/12 28 words 31 words 11/01/12 33 words 34 words 11/02/12 36 words 35 words 11/05/12 37 words 37 words