Social Skills Group  9th Grade Boys with Attention Disorders

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Project Implementation: School Characteristics. Suburban Public High School, Grades 9-122500 Students80% Caucasian, 12% Latino, 8% Other Minorities30% Free Lunch Eligible. Need Determination. Large number of 8th graders in feeder schools on daily medicationsFew requests for high school medication administration or follow upWhere are these missing kids? How well do they transition and self manage?Curiosity and personal interest.

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Social Skills Group 9th Grade Boys with Attention Disorders

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1. Social Skills Group 9th Grade Boys with Attention Disorders Ann Vrabel, RN, BSN Multnomah Education Service District

2. Project Implementation: School Characteristics Suburban Public High School, Grades 9-12 2500 Students 80% Caucasian, 12% Latino, 8% Other Minorities 30% Free Lunch Eligible

3. Need Determination Large number of 8th graders in feeder schools on daily medications Few requests for high school medication administration or follow up Where are these missing kids? How well do they transition and self manage? Curiosity and personal interest

4. School Receptiveness “Medical” Arena School Counselors School Administrators Teachers Students and Parents Response

5. Recruitment of Members Search of school records Feedback from middle school teachers, counselors, nurses Student questionnaire Individual interviews

6. Findings 15 of 21 students interviewed currently on medication School numbers similar to literature reports: 9:1 male to female ratio Strong level of interest in participation Limited understanding of diagnosis and implications

7. Parent Consent Mailing: Parent Survey Student Progress Report Permission Form Telephone Follow Up

8. Plan for Measurement of Outcomes Pre & Post Conners-Wells Self Report (1997) (ADHD, Hyperactivity, Inattention, Conduct) Statistical analysis School Progress Reports, Report Cards Teacher & parent input Behavioral/ Discipline Referrals One student had dx of post traumatic stress disorder Became aware after a few weeks that all girls had experienced a break in relationship with their biological mother either through abandonment from drug use, incarceration, child abuse or serious illness. Implications for screening students with a history of parental loss Grief education?One student had dx of post traumatic stress disorder Became aware after a few weeks that all girls had experienced a break in relationship with their biological mother either through abandonment from drug use, incarceration, child abuse or serious illness. Implications for screening students with a history of parental loss Grief education?

9. Group Format 8 boys, all 9th graders 1 hour per week for 10 weeks Rotating group times Started after 1st Report Cards

10. Group Activities Snacks Manipulatives: e.g. Stressballs, Koosh* Balls, Silly Putty* Problem Solver Game Communicator Game Skill Streaming Activities -snacks= good diversion & ice breaker; opportunity to work on social skills -manipulatives -had to be earned through simple rules, ie. not throwing. Silly putty quieter than paper rustling -Problem Solver & Communicator: board games, dice, cards are drawn, questions answered correctly to advance. Input from all group members re appropriate responses -Skiull Streaming: Beginning skills level used; group facilitators demonstrated skills like "Listening," Asking a question," "Starting a conversation," that group members then demonstrated in pairs. Group feedback given. - Ground Rules: determined by group 1st meeting; reviewed each session -Agenda: open to particular concerns but predetermined weekly -snacks= good diversion & ice breaker; opportunity to work on social skills -manipulatives -had to be earned through simple rules, ie. not throwing. Silly putty quieter than paper rustling -Problem Solver & Communicator: board games, dice, cards are drawn, questions answered correctly to advance. Input from all group members re appropriate responses -Skiull Streaming: Beginning skills level used; group facilitators demonstrated skills like "Listening," Asking a question," "Starting a conversation," that group members then demonstrated in pairs. Group feedback given. - Ground Rules: determined by group 1st meeting; reviewed each session -Agenda: open to particular concerns but predetermined weekly

11. Student Evaluation Fun and Supportive Break in Routine Camaraderie Increased understanding

12. Staff and Parent Evaluations Increased social maturity Improved self-responsibility Improved coping abilities Positive impact on school success -"the gnat:" school counselor who had known him since grade 2 commented that student came to her office with a question, waited his turn, asked question in an appropriate manner said thank you and then left. Was the first time ever! -members learned appropriate ways to approach teachers for help, also had nurses as advocates -all those on meds had improved daily medication compliance while involved with the group -all had an improvement in understanding purpose of medication & life long implications-"the gnat:" school counselor who had known him since grade 2 commented that student came to her office with a question, waited his turn, asked question in an appropriate manner said thank you and then left. Was the first time ever! -members learned appropriate ways to approach teachers for help, also had nurses as advocates -all those on meds had improved daily medication compliance while involved with the group -all had an improvement in understanding purpose of medication & life long implications

13. Lessons Learned Personal & professional satisfaction Value of co-facilitation Need for structure & flexibility Need for school & professional consultation & collaboration -important to have co-facilitators, also satisfying professionally with 2 to bounce ideas off of -high energy group of kids, never a dull moment -this is often overlooked/ignored group of kids -important to have core focus for group session but to read energy level & interest of group -update schools counselors/involved teachers of skills taught, lessons emphasized, ask for observations & behavior changes -use available professional consultants-important to have co-facilitators, also satisfying professionally with 2 to bounce ideas off of -high energy group of kids, never a dull moment -this is often overlooked/ignored group of kids -important to have core focus for group session but to read energy level & interest of group -update schools counselors/involved teachers of skills taught, lessons emphasized, ask for observations & behavior changes -use available professional consultants

14. Positive Outcomes Medication compliance Connectedness, normalcy New skills- coping, strategies Improved understanding: ongoing implications -medication compliance improved due to students feeling of connectedness to nurses, better understanding of purpose of meds, desire for regular "check-ins" -students felt improved connection to staff (nurse), & peers; thus improving school success -better understanding of disease process, long term implications, purpose of medication -change in last 2 years to most kids on sustained action meds so less stigma re. taking meds at school -medication compliance improved due to students feeling of connectedness to nurses, better understanding of purpose of meds, desire for regular "check-ins" -students felt improved connection to staff (nurse), & peers; thus improving school success -better understanding of disease process, long term implications, purpose of medication -change in last 2 years to most kids on sustained action meds so less stigma re. taking meds at school

15. Recommendations Tap into the School Nurse Energizing, Fun Group of Kids Go For It!

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