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Inclusion for Students with ADHD • 3%-7% of school-age students have ADHD. • Inclusion for these students involves a high degree of classroom structure. • Teacher directed activities work best. • Functional behavioral assessments should be used to find out what triggers inappropriate behavior in students with ADHD. • Contingency-based self-management is vital for students to learn, so they can record their own behavior and make corrections as needed. • Students should be praised, given points, and tangible rewards to help with self-management skills. • (Hallahan, Kauffman, Pullen, 2009, pp. 257-258)
Pros • Teachers can be encouraged to teach with structure for everyone including those with ADHD because all students can benefit from a clear, predictable routine. • By adding modifications to traditional instructional routines, needs can be addressed without disrupting instruction for others. • (Hallahan et al, 2009, pp. 242-244) • Instructional strategies like Direct Instruction can benefit all students. Using Direct Instruction in the classroom specifically addresses positive reinforcement and lesson design that help students to focus and teachers to be intentional. • (Dell’Olio & Donk, 2007, p. 95) • Students with hyperactivity have the ability to multi-task. They can spend hours working on a variety of projects at the same time. • Students with the inability to organize are natural “out of the box” type of creative thinkers. Their characteristics of high energy and spontaneity mean that they will never get bored in the classroom. • The emotional immaturity that is consistent in students with ADHD makes it natural for them to prefer short and exciting relationships with others. They can be fun conversationalists and grab attention easily. • (Pros and Cons of ADHD, 2008, p. 2)
Cons • Students with ADHD may have behavioral inhibitions. They may not wait their turn, be aware of inappropriate responses, or ignore distractions. • Students struggle with their working memory. • Students have a deficit in time awareness. They do not see themselves in a continuum of time and find it hard to manage their own actions. • Students find it difficult to engage in goal-directed activities. • Students may have troubles with adaptive behavior. • Problems socializing with peers is consistent with students with ADHD. Students may be socially rejected and have fewer friends than others leading to social isolation that can have an effect on the classroom. • (Hallahan et al, 2009, pp. 235-240)
Pros and Cons Analyzed • ADHD is a broad category that covers many things including attention, activity, impulsivity, and behavior. It shows up differently in different people. Some signs to watch for in the classroom are: • Difficulty staying focused • Problems finishing tasks and following through • Losing papers and forgetting • Being distracted easily • Trouble organizing • Impatient • Interrupting • Restlessness • Talking excessively • Teachers can help students in a variety of ways to deal with ADHD positively. Teachers can encourage: • Students to sit in the front to limit distractions • A quiet environment to focus thoughts • Talking about ADHD with the student to find what best works for his/her learning • Smaller class size and/or tutoring sessions • More time for test-taking • Using tools for organization like a daily planner • Exercise breaks to help students stay focused and concentrate • Breathing and relaxation techniques • (Symptoms and Signs of ADHD, 2008, p. 1)
Research Findings • After examining a management program where students were responsible for managing their own behavior with a contingency established for the whole group, there was a decrease in talking out of turn for students with ADHD. Also, there were no threats from peers or negative comments (Davies & Witte, 2000). Students successfully monitored their behavior with dots on a chart. If a majority of the dots from the group were in the favorable side of the chart after the intervention period, the group received a reinforcement reward. Teachers can use this model by targeting an undesirable behavior, creating a chart for self-monitoring, communicating the procedures, then connecting the self-monitoring procedures with a group contingency. Reinforcements are then given based on the collective results of the group and each member’s behavior. • The best placement for students with ADHD should be determined individually. Full-inclusion is the most popular placement. • Over half of students with ADHD do not receive special education services. Because of this, general education teachers should be sensitive to establishing positive behavioral changes in the regular classroom. Studies have shown that these changes are more likely to happen in special education classes that students with ADHD are not being enrolled in consistently (DuPaul & Eckert, 1997). • When students can monitor their own behavior and performance positively, they may be encouraged to uphold appropriate behavior at school.
Research Findings Continued • Using functional behavioral assessment and contingency-based self-management strategies has proven to be successful by increasing appropriate behavior in students with ADHD. In one study, a student was interviewed and observed by the teacher to determine that his poor behavior was due to gaining peer attention negatively. The student started to evaluate his on-task behavior each class period on a 0-5 rating scale. He would compare his evaluation with the teacher’s identical evaluation. Reward points were given for positive behavior. Positive behavior was increased (Ervin, DuPaul, Kern, & Friman, 1998). These are samples of self-management recordings, by students with ADHD, from my personal 5th grade classroom in 2008.
Research Findings Continued • Direct Instruction is a teaching technique that can be used as an effective intervention for students with ADHD. It promotes positive self-esteem and social skills. • Students with anxiety also benefit from a Direct Instruction model. • General education teachers who participate in inclusion programs or modify instruction should be interested in the effectiveness of Direct Instruction. When paired with cooperative learning, and other experiential learning methods, it has positive effects on students. • Teachers respond immediately to correct answers of questions which promotes positive participation by students. Lessons are fast-paced allowing for few distractions and more time on-task. • Routines and procedures are reoccurring, so students become fluent and comfortable with learning in a safe environment. • Relating to the information process theory, Direct Instruction maximizes the use of students’ short term memory and allows them to repeat information immediately with feedback. Students are able to focus on the task at hand and have many opportunities for practice. • When compared with behaviorism, Direct Instruction fits students with ADHD perfectly. • (Dell’Olio & Donk, 2007, pp. 95-96)
Possible Accommodations • Testing accommodations can include small-group or individual administration of a test in a quiet setting. • Extended time can be given to students to complete tasks, homework, and assignments. • Frequent breaks may be given to students to reenergize themselves, exercise their muscles, and refocus their thoughts. • (Hallahan et al, 2009, p. 258) • Teachers can shorten the amount of required reading and teach previewing strategies for better comprehension. • Typed reports can replace hand written work if writing is weak. • Teachers can change the delivery of instruction by using colorful charts to focus attention and a timeline for daily activities. • Students can be given a different type of performance task such as an oral test instead of a written test, or to make a model of the solar system instead of a poster about the planets. • Reading text independently can be replaced with reading aloud with students to ensure their focus on a selection. • Answers to questions can be completed with a multiple choice format instead of a written, short answer format. • (Parker, 2008, p. 2)
Possible Modifications • Structuring the environment for a student with ADHD can make a difference that counts. • Establish rules, routines, and schedules. • Give positive and negative consequences for acceptable and inacceptable behavior consistently. • Organize the room with ease for locating supplies, using materials, and cleaning up. • Seat students with ADHD front and center in the classroom away from distractions. • Modifications in instruction and assessments can also be made. • Teachers can provide a written schedule with check boxes. • A “study buddy” can be assigned to help with needing one-on-one attention and completing assignments. • An additional set of textbooks can be stored at a student’s home. • Appointing an instructional aid may help students to keep organized and on top of traveling from class to class with a variety of materials. • Medication for ADHD is another way to help students regain their focus while attending school. “This medical strategy, coupled with environmental controls and solid teaching practices, often yields compelling results (Fowler, 2000-2008).”
Recommendations • Cruickshank recommends reducing irrelevant stimuli and enhancing relevant learning materials in a structured environment with strong teacher direction. Activities should be scheduled for each child for the entire day (Cruickshank, 1961). • Planning for students with ADHD can be done with Responsive Instruction (Hallahan et al, 2009, p. 244). • Praise students often. • Reward students regularly. • Provide structure in a predictable environment. • Modify the curriculum. • Give ADHD students a job to do instead of waiting. Jobs like paper passer, board eraser, or pencil sharpener are encouraged. • Use games in the learning environment. • (Fowler, 2000-2008, p. 1)
Recommendations Continued • Simplify complex directions and avoid multiple commands. One word directions can be helpful. “Stop, look, listen” is one example that works well with primary elementary students. “Read, write, review” is an example that can work with intermediate elementary students. • To avoid distraction, teachers can write tests using large type on clean paper with no pictures or other ink marks. • Use timers to help students monitor their time on-task and daily schedule. • To help with organization, provide graph paper, lattice charts, circle maps, and other diagram templates for students to finish math assignments easily. This will also allow for ease in studying later. • Supervise students during transitions to reinforce positive behavior and keep focus. • (Parker, 2008)
Recommendations Continued • Provide organization rules. • Provide a folder for homework assignments and a daily planner. • Supervise the use of a daily planner and check it for completion. • Send progress reports home frequently. • Regularly check a student’s desk, locker, and folder for neatness. Reward neatness immediately. • Set short-term goals with students. • Give assignments one at a time and allow time for using a tape recorder, computer device, or typing program. • Compliment positive behavior and strong work ethic. • Overall, provide reassurance and encouragement. • (Parker, 2008)
Summary • Inclusion for students with ADHD can be successful for both students and teachers with minor modifications made to the classroom environment, instructional strategies, and behavior management system. • Although students with ADHD may not be able to follow through, organize, or focus on tasks as well as others, they can learn when distractions are limited. Students with ADHD need constant reminders as they struggle with their working memory. Socializing and adapting behaviorally to situations can be difficult. An effective, intentional teacher can make a true difference. • The five most integral tips for teachers to remember are: • Keep the classroom structured and organized. • Maintain a clear, predictable routine. • Make adjustments to the curriculum as needed. • Reinforce consequences while students monitor their own behavior frequently. • Reward positive behavior. • Overall, students with ADHD are lovable kids who have difficulties learning because they cannot focus as well as others. A full-inclusion model can work if students are given the proper conditions for success. Teachers should remember to praise students for progress both academically and behaviorally. Encouraging positive behavior can lead a student down the path less traveled as they embark on their journey of success.
Resources • Cruickshank, W.M., Bentzen, F.A., Ratzeburg, F.H., & Tannhauser, M.T. (1961). A teaching method of brain-injured and hyperactive children. Syracuse, NY: Syracuse University Press. • Davies, S., & Witte, R. (2000). Self-management and peer-monitoring within a group contingency to decrease uncontrolled verbalizations of children with attention- deficit/hyperactivity disorder. Psychology in the Schools, 37, 135-147. • Dell’Olio, Jeanine M., & Donk, Tony (2007). Models of Teaching: Connecting Student Learning With Standards. California: Sage Publications, Inc. • DuPaul, G.J., & Eckert, T.L. (1997). The effects of school-based interventions for attention deficit hyperactivity disorder: A meta-analysis, School Psychology Review, 26, 5-27. • Ervin, R.A., DuPaul, G.J., Kern, L., & Friman, P.C. (1998). Classroom-based functional and adjunctive assessments: Proactive approaches to intervention selection for adolescents with attention deficit hyperactivity disorder. Journal of Applied Behavior Analysis, 31, 65- 78. • Fowler, Mary (2000-2008). Five Tips for Teachers. Retrieved November 25, 2008, from Family Education Web site: http://school.familyeducation.com/learning- disabilities/treatments/37773.html?detoured=1&fo • Hallahan, Daniel P., Kauffman, James M., & Pullen, Paige C. (2009). Exceptional Learners: An Introduction to Special Education (11th ed.). Boston, Massachusetts: Pearson Education, Inc. • Parker, Harvey C. (2008). ADAPT: Accommodations for Students with ADHD. Retrieved November 25, 2008, from NACE National Association for Continuing Education Web site: http://www.naceonline.com/article-accommodations-for-adhd.php • Pros and Cons of ADHD (2008). Retrieved November 25, 2008, from Sushi and Seduction.com Web site: http://sushiandseduction.wordpress.com/2008/01/28/pros-and-cons-of-adhd/ • Symptoms and Signs of ADHD (2008). Retrieved November 25, 2008, from Kids Health Web site: http://kidshealth.org/teen/school_jobs/school/adhd.html