Inattention, Attention-Seeking , & Defiance

1. Inattention, Attention-Seeking , & Defiance LARRY SCOTT Ken-Ton School District lscott2@kenton.k12.ny.us

2. Agenda • Bullying • Emotional & Behaviors Needs • Internalize vs. Externalizing Problems • Inattention / Hyperactivity • Attention-Seeking Behavior • Defiance / Noncompliance • Communicating with Defiant Students • Meaningful Incentives, & Tips • Homework

3. Bullying • Intentional, usually repeated acts of verbal, physical, or written aggression by a peer (or group) operating from a position of strength or power with the goal of hurting the victim physically or damaging status and/or social reputation

4. Bullying vs. Teasing vs. Conflict • Teasing: good-natured “give & take” between friends designed to get both parties to laugh • Conflict: A struggle, dispute, and/or misunderstanding between 2 opposing forces • Bullying: Based on power imbalance, taunting another with intent of harming; continues when other is distressed

5. Victims of Bullying • Have a position of relative weakness • Most are passive • Experience emotional distress- anxiety, depression, suicidal thoughts, low self-esteem • In some instances can respond with extreme violence • GLBT youth most at-risk

6. Those Who Bully • Desire power & control • Get satisfaction over others’ suffering • More exposed to physical punishment at home • Average self-esteem, BUT more likely to be depressed & feel less supported by others • Engage in other risky behaviors

7. Bully Prevention in School • Structured, Supportive, & Supervised Environments • Clear, consistent policies on harassment, including means of reporting • Immediate action with intervention not just punishment • Warmth, positive interest, adult involvement & appreciation of individual differences • Ongoing social development programs • Programs & opportunities to connect with all students

8. State Legislation and Bullying 2012- Dignity for All Students Act (DASA) • Prohibits harassment of students based on race, weight, religion, national origin, ethnic group, sexual orientation, disability, gender, & sex 2013- Amendment to DASA • Requires schools to act when cyberbullying occurs

9. Students with Emotional & Behavioral Needs • More likely to have disciplinary problems, low grades, poor attendance, & run-ins with the law • About 10% of students cause 90% of disciplinary problems • Have difficulty building & maintaining relationships- TRUST • Prone to disorganization and poor work completion • Sensitive to reprimands & being held accountable- usually leads to more resistance • Negative emotions interfere with attention & decision making. Increases impulsive actions which may relieve emotional distress temporarily • Any action that causes negative emotion in a student is more likely to increase defiance/resistance

10. Internalizing & Externalizing Problems • Internalizing Problems: high anxiety, depression, low self-esteem, poor self-identity, socially awkward • Externalizing Problems: hyperactivity, aggression, conduct problems, disruptive, defiant

11. Challenges to Changing Behavior • Poor collaboration and follow through from home. • Poor collaboration and follow through with community-based professionals. • Severe mental illness that is untreated or mistreated. • Substance abuse and illegal activity. • Resistance to trust

12. Off-task Behavior (ADHD) • ADHD effects about 2-10% of kids, more common in boys (about 10%) than girls (about 4%) • Over-diagnosed & often misdiagnosed • Neurobiological evidence that it exists • Associated with disciplinary problems, poor academic performance, substance abuse, and dropping out of school, risky sexual behavior, and future criminal behavior

13. Off-task Behavior (ADHD) • Difficulty paying attention / Short attention-span • Distractible (internal & external) • Poor self-regulation of emotion, attention, planning, and behavior • Disorganization • Usually struggle with writing

14. A Neurological Understanding of ADHD • Parts of the brain involved in attention are found to be smaller and underactive • Prefrontal cortex, amygdala, and basal ganglia are found to play a major role • Dopamine & serotonin (neurotransmitter) • Antidepressants & Cognitive Behavioral Therapy have shown to improve impulsivity and aggression

15. Prefrontal Cortex: Executive Functioning • CEO of the brain • Regulates attention/emotion, working memory, planning, organization, self-monitoring, and foreseeing/understanding consequences • Students with attention and emotional difficulty, usually have poor executive functioning • Children with a history of trauma & emotional neglect often have dysfunction in prefrontal cortex • Middle school

18. Media and ADHD • A large study found that exposure to TV (ages 1-3) is associated with attention problems and controlling impulses later in childhood For every hour watched each day, their chances of developing attention problems increased 10% • Addiction to computer / video games show similar brain functioning and behaviors as other addictions

19. ADHD Types

20. Inattention • Fails to give close attention to details / makes careless mistakes • Has difficulty keeping attention on tasks • Does not seem to listen when spoken to directly • Does not follow through on directions and fails to finish school work or other duties • Has difficulty organizing tasks/activities • Avoids or dislikes tasks that require sustained mental effort • Often loses toys, assignments, and materials needed for tasks • Is easily distracted • Is often forgetful in daily activities

21. Hyperactivity • Fidgets with hands or feet or squirms in seat • Leaves seat when remaining seated is expected • Runs about or climbs in inappropriate situations • Has difficulty playing quietly • Is often “on the go”, acts as if “driven by a motor”, talks excessively

22. Impulsivity • Blurts out answers before questions have been completed • Has difficulty waiting turn • Interrupts or intrudes on others (butts into conversation or games) • Does not think before acting

23. Poor Impulse Control • More likely to act for short-term gratification than delaying for more valuable, long-term reward • Those with severe impairment fail to resist an impulsive act that may be dangerous to self or others • Present an understanding of right/wrong and seriousness of consequences, but cannot regulate impulse with the influence of emotion in the moment Worksheet 1

24. Tips for Inattention & Hyperactivity Need others & environment to help self-regulate Break tasks into chunks/separate steps, provide feedback, provide checklist… Close proximity Clear and consistent expectations/routines/consequences with reminders Structured environment with reduced distractions and limits Frequent prompts & reminders- unobtrusive, quiet, nonverbal Seat student near “action zone” Praise/recognize on-task behavior and work completion

25. Tips for Inattention & Hyperactivity Allow movement breaks Provide alternative motor behavior that will not distract others (gum chewing, stress ball, activity) Have student monitor behavior (i.e. call outs, motor behavior, leaving seat…) IGNORE low level motor behavior Seat near distraction-resistant peers Anticipate potential problems and structure appropriately Daily or Weekly Report with incentive Agenda / Organizer

26. The Selling of Attention Deficit DisorderNew York Times, December 14, 2013by Alan Schwarz CDC: 15% of high school students have a diagnosis Medication use for children has soared to 3.5 million from 600,000 in 1990 About 16 million prescriptions were written for adults (ages 20 -39) in 2012 2nd most frequent long-term diagnosis closely behind asthma

27. The Selling of Attention Deficit DisorderNew York Times, December 14, 2013by Alan Schwarz Since 2000, FDA has cited every major ADHD med for false & misleading advertising several times: Stimulants: Adderall, Concerta, Focalin, & Vyvanse Nonstimulants: Intuniv & Strattera Sales of stimulant meds were almost $9 billion in 2012

28. The Selling of Attention Deficit DisorderNew York Times, December 14, 2013by Alan Schwarz ADHD has no definitive test: symptoms are highly open to interpretation by patients, parents, and doctors American Psychiatric Association has made the diagnostic criteria more liberal in the DSM V (i.e. must show symptoms before age 12 vs. show impairment from symptoms before age 7) American Psychiatric Association receives significant funding from pharmaceutical companies.

29. The Selling of Attention Deficit DisorderNew York Times, December 14, 2013by Alan Schwarz Studies show that about ½ of diagnosed children do not show impairment as adults Long-term risks of not medically treating ADHD are often cited by big pharma & their representatives, but little is known about whether meds address and reduce these risks (FDA has cited this in many warnings) Presenters on ADHD and those that educate doctors & clinicians on ADHD, are either from pharmaceutical companies or are affiliated with and receive compensation from these companies A 2008, Senate investigation found that a prominent psychiatrist involved in many psychiatric studies, Dr. Joseph Beiderman, received $1.6 million in consulting fees from drug companies

30. The Selling of Attention Deficit DisorderNew York Times, December 14, 2013by Alan Schwarz Marketing has targeted parents Magazine ad for Concerta: “Better test scores at school, more chores done at home, an independence I try to encourage, a smile I can always count on.” In February of 2013, Shire paid $57.5 million in fines for misleading advertising and improper sales of Vyvanse, Adderall, & Daytrana. CHAD (ADHD Advocacy Group) founded in 1987 with financial backing of Ciba-Giegy Pharmaceuticals, Ritalin’s manufacturer & continues to receive about $1 million per year from big pharma.

31. Attention-Seeking Behavior • Children value attention, some desire any attention- positive and negative. • Negative adult response (reprimand) can serve the function of attention and negatively reinforce problem behavior.

32. Attention-Seeking Cycle Worksheet 1

33. Break Attention-Seeking Cycle • Make eye contact & smile • Check-in with student • Pat student on shoulder • Call on student • Praise student (verbal, nonverbal, written) • Converse with student • Give student a desired task Recognize Positive Behavior

34. Break Attention-Seeking Cycle • Positive attention should be provided as frequently as negative attention seeking behavior occurs • May only be required in particular settings and times • Ignore negative attention-seeking behavior or in discrete manner redirect student back on-task • Fade positive attention as negative behavior reduces or discontinues

35. Brain and Perception • Slight differences in brain function translate into different ways of experiencing the world • Each of us believes what we perceive is reality • The reality we perceive influences how we behave and interact with others • Our perceptions are greatly influenced by our social experiences • There are many thoughts/functions of the brain that we are unaware of Worksheet 2

36. Noncompliance / Defiance • Defiant students usually have a painful history of rejection in personal relationships • Often perceive rejection and view adults as threatening • Defiant students often lack effective communication & negotiation skills • May act out to mask poor skills and/or insecurities • Often choose to defy to avoid/escape tasks and/or to gain control of situations/others

37. Noncompliance / Defiance Emotional reactions to misbehavior: • Risk being reinforcing to some students • Risk making timid students afraid of you • Provide a terrible model of leadership

38. Noncompliance / Defiance • Conflicts / Power Struggles / Arguments involve at least two parties • Be aware of preconceptions- trivial behavior may produce angry / aggressive response and trigger resistance from student • Angry reactions (raising voice, appearing angry, or attempting to intimidate) to behavior is negative reinforcement & worsens defiance • Defiance can become deliberate strategy • Defiant students gain control with each and every angry response from adult Worksheet 1

39. Nonverbal Communication with Defiant Students • Relax and reflect on how you are feeling and will respond • Model that you will not be pulled into power struggle • Stay outwardly calm, professional, & business-like • Low tone of voice • Establish eye contact and call student by name • Move toward student slowly, respect student’s space, speak privately, & sit nearby student at their level • Be aware of nonverbal communication- avoid mismatch with words

40. Verbal Communication with Defiant Students • State directive in positive manner • Use clear and specific terms, but keep it brief • Ask open ended questions (avoid WHY questions) • Active Listening: summarize a person’s ideas, opinion, or point of view • Emotional Labeling: validate student emotion • I-Centered Statements • Strategic Pauses

41. Communication with Defiant Students • Provide choice with logical consequences • Offer student a Face-Saving Out • Focus on behavior, while acknowledging that you value student • Do not attempt to force a student to comply • Avoid demands when student is upset • HUMOR

42. Strategies for Defiance / Noncompliance • Allow student a “cool down” break when upset / angry • Assign reflective essay or apology after misbehavior and student is calm • Consequences- predetermined, fair, consistent • Behavior Contract • Redirect / Distract student when showing signs of frustration

43. My Tips to Avoid Conflict • Establish relationship • Random problem-solving • Acknowledge student prior to stating expectation • Remove student from audience • Simple nonverbal communication • Time-away techniques

44. Meaningful Incentives • Choose music for class to hear • Eat lunch with a friend in the classroom (with teacher) • Eat lunch outside with entire class • Enjoy time outside with entire class • Shoot baskets with an adult and/or with peer • Computer time • Assist a custodian or other staff • Be first in lunch line • Eat lunch with teacher, counselor, and/or principal

45. Meaningful Incentives • Eat lunch with an invited adult (grandparent, parent, etc…) • Positive note, email, or phone call home • Be helper for lower grade level • Make deliveries in school • Receive a note of recognition from teacher or principal • Receive private praise from teacher or principal • Receive silent thumbs up or other sign indicating praise and approval

46. Homework Tips 2 methods to increase homework completion: • Establish a consistent weekly schedule for homework • Physically collect homework from each student

47. References • Doidge, N. (2007), The Brain that Changes Itself. • Gresham, F. M. (1992). Conceptualizing behavior disorders in terms of resistance to intervention. School Psychology Review, 20, 23-37. • Eagleman, D. (2011), Incognito: The Secret Lives of the Brain. • Individuals with Disabilities Education Improvement Act – Amendments to Rules of the Board of Regents and Regulations of the Commissioner of Education (NYS), Part 200.1 (r), June 23, 2006. • Nickerson, A., Director of Alberti Center for the Prevention of Bullying Abuse & School Violence, University of Buffalo • Ratey J. (2008), Spark: The Revolutionary New Science of Exercise & the Brain • Sprick, R. Safe & Civil Schools. http://www.safeandcivilschools.com/index.php • Willingham, D. (2011). Can Teachers Increase Students’ Self-Control?American Educator. • Willingham, D. (2004-05). Understanding ADHD. American Educator. • Wright, J. (2006). www.jimwrightonline.com, www.interventioncentral.org • Schwarz, A. (2013). The Selling of Attention Deficit Disorder. New York Times • Costenbader, V. & Markson, S. (1998) School Suspension: A Study with Secondary School Students, Journal of School Psychology, Vol. 36, Issue 1 Spring 1998, p. 59-82. • Raffaele Mendez, L. (2003) Predictors of suspension and negative school outcomes: A longitudinal investigation. • Skiba, R. (2002) Special Education and School Discipline: A Precarious Balance, Behavioral Disorders, Vol. 27, No. 2 (February 2002), pp. 81-97 • Fenning, P., Raffaele Mendez, L., Sharkey, J., Sullivan, A., & Mcloughlin, C. (2013) Disproportionality: Understanding the Issues and Creating Equitable Schools, February 14, 2013, NASP Convention, Seattle, WA