ADHD in School

1. ADHD in School Courtney Lewis, M.S. April 1, 2009

2. Kids talking about ADHD and school • http://video.google.com/videosearch?q=teachers+diagnosis+ADHD&hl=en&emb=0&aq=f#q=schools++ADHD&hl=en&emb=0 • 1:37 - 5:10 • http://uktv.co.uk/homes/item/aid/602568/displayVideo/Hi • http://video.google.com/videosearch?q=teachers+diagnosis+ADHD&hl=en&emb=0&aq=f#q=adhd+in+the+classroom&hl=en&emb=0

3. Across Settings • Imperative to gather information from teachers in order to make diagnosis of AD/HD • Helpful to gather info from teachers for treatment planning • Teacher Rating Scales • Conners Teacher Rating Scale - Revised (CTRS – R) • Sutter - Eyberg Student Behavior Inventory (SESBI-R) • Achenbach Child Behavior Checklist (CBCL) – Teacher Report Form

4. Teacher Assessment Tips • Employ parent to have rating scales completed prior to assessment • Call after school hours • Utilize email • Be brief • Recognize teacher’s expertise • Sticky Situation: • Teacher has already “diagnosed” child with ADHD • Teacher tells parents that child needs to be on medication Written Parent Consent

5. Educational Rights FAPE Free and Appropriate Education • Individuals with Disabilities Education Act (IDEA) • Of the Rehabilitation Act of 1973 : Section 504 Florida Department of Education http://www.fldoe.org/ese/pubxhome.asp

6. IDEA • Governs all special education services in the United States • If eligible can receive an Individual Educational Plan (IEP) • Modifications • March 1999 – ADHD was formally listed in the IDEA Regulations under Other Health Impairments (OHI) • Schools can no longer argue is not a ‘covered’ condition

7. To receive services under IDEA (less common) • “To receive services the child must have a diagnosis of AD/HD that results in limited alertness to academic tasks, due to heightened alertness to environmental stimuli; must be chronic (long lasting) or acute (have substantial impact); this must result in an adverse effect on educational performance; and the student must require special educational services to address the AD/HD and its impact.” • Requires evaluation by a multidisciplinary team • Routine basis • Requires parental consent

8. Section 504 • Civil Rights Statute • Requiring schools not discriminate against children with disabilities and that they provide reasonable accommodations • Eligibility • Based on the existence of an identified physical or mental condition that substantially limits a major life activity (ex. learning)

9. Our Role ????? • Pointless for health care professionals to be involved • “What starts in the school should stay in the school” (Hyimp, 2008)

10. APRIL FOOLS

11. Our Role • Empathize with parents AND teachers • Educate Parents • Include relevant language in Ax reports • Collaborate with parent and teacher / provide direction • Suggest accommodations • Reevaluate and fine tune across time

12. Empathize with Parents • Feeling… • Overwhelmed • Stressed • Embarrassed • Like a bad parent • Blamed by the school • Defensive • Angry • Defeated

13. Educate Parents ….. Provide Direction • Explain educational rights • National Resource Center on AD/HD • http://www.help4adhd.org/ • Center for Children and Families / University at Buffalo • http://ccf.buffalo.edu/resources_downloads.php

14. Collaborate !!!!!!! • Facilitate (and model) positive and effective communication between teacher, parent, and student • Empower parents and students with skills to engage in future communication independently • Sticky (but common) Situations • “He Said She Said” • “It’s their fault” • “ Don’t tell me how to do my job”

15. Accommodations • Endless possibilities  • Important to consider • Feasibility • Developmental Appropriateness • Child’s Individual Needs • Classroom Management Technique Assessment • University of Buffalo • Florida Department of Education • http://www.fldoe.org/ese/pubxhome.asp “accommodations”

16. School Home Note / Daily Report Card • GOAL • Facilitate daily positive communication between parent, teacher, AND student • Simplicity is key • Limit number of target behaviors • Feedback throughout the day • Attainable goals for … • Child • Teacher • Parent

17. Target Behaviors • Elementary • Walks in line appropriately • Raises hand to speak with X or few reminders • Middle School • Writes Legibly • Uses 1 line cross outs instead of scribbles • Writes on the lines of the paper • Writes homework in assignment planner with X or few reminders • High School • Brings completed homework to class • Accepts feedback from teacher appropriately

18. Accommodations Difficulty with Instructions • Use a prearranged signal to gain student’s attention before giving instructions • Have the student paraphrase instructions or show you what to do • Check to see if student needs any assistance getting started

19. Accommodations Difficulty Completing Assignments • Use a kitchen timer to define work times • Break long term assignments into parts with corresponding due dates • At first, give partial credit for late assignments or incomplete work until the student is able to complete the work on time

20. Accommodations Difficulty Staying Organized • Parent facilitates backpack clean-out each evening or once a week • Let student use a special folder or binder to keep materials organized. Use dividers or folders to keep subjects organized. • Give student a checklist of materials needed for each class to be kept in the student’s locker or binder

21. Accommodations Difficulty taking tests • Give verbal encouragement (keep working, answer every question) without giving clues to correct or incorrect answers • Let the student read the test items aloud to him or herself as he or she works on the test • Require fewer questions but select ones that measure all required content and skills

22. AccommodationsEasily Distracted / Short Attention Span • Let the student use an enclosed study carrel to complete independent work • Give student legitimate opportunities to get up and move in the classroom, use the restroom, or get a drink of water • Let student sit in an area away from busy parts of the classroom

23. Challenges for Parents Related to School • Feeling “blamed” by the school