Published By Division of Innovation and Development Office of Special Education Programs Office of Special Education and Rehabilitative Services U.S. Department of Education This document was developed by the Chesapeake Institute, Washington, D.C., with The Widmeyer Group, Washington, D.C., as part of contract #HS92017001 from the Office of Special Education Programs, Office of Special Education and Rehabilitative Services, United States Department of Education. The points of view expressed in this publication are those of the authors and do not necessarily reflect the position or policy of the U.S. Department of Education.
What Teachers Should Know
The child who repeatedly disrupts your class and who seldom completes assignments may not be deliberately troublesome, but could be showing signs of Attention Deficit Disorder (ADD). Similarly, a student who constantly stares out of the window might not be intentionally ignoring you, but instead could be demonstrating behavior caused by ADD. This disorder causes impulsive behavior, difficulties in focusing attention, and sometimes hyperactivity. Fortunately, when ADD is identified correctly, a program that combines supervised medication and teaching strategies designed to modify behavior can lead to success in the classroom.
Like other children with disabilities, students with ADD are helped best when the teacher understands the students' special problems and makes some modifications to the instructional program. However, you do not have to face these challenges alone; teachers work as part of a team that includes administrators, special educators, school psychologists, healthcare professionals, and the parents.
Identifying ADD in Your Students
Many children with ADD are not identified until they enter school. A child's impulsiveness, inattention, and hyperactivity are most visible in the classroom because they interfere with learning. While teachers are not required to make the final diagnosis of ADD, you can help these children by recommending that a child who frequently demonstrates these behaviors be checked for ADD or other learning problems. Specialized teaching strategies can also work even before formal identification of the child's problem.
The students who should be referred to specialists are those who persistently do not listen and those who give the impression of not knowing what is happening in class. Such children may have difficulty determining what is important and focusing on it. While other children occasionally may become bored with a topic and stop paying attention for a time, children with ADD appear distracted frequently and for long periods of time, regardless of the tasks assigned. Children with ADD have difficulty concentrating on a task and often move from one assignment to another without finishing any work. They behave impulsively, without pausing to think about the consequences of their actions. In general, a child with ADD seems immature, his or her behavior resembles that of a younger child.
Many children with ADD are hyperactive, fidget when seated, and constantly run around in the classroom. Overexcited, they cannot wait their turn and blurt out answers to questions without waiting for the teacher to call on them. These characteristics are persistent, present in different settings and with different activities, and severely interfere with the child's learning.
If you suspect a student's behavior is caused by ADD or another learning disorder, it is helpful to keep a diary of the child's behavior for documentation, noting how much work the student completes and how often the student leaves his seat. Write down the time of each disturbance and the activity the child was supposed to be doing.
Other factors may cause student behavior that resembles symptoms of ADD; they include child abuse, drug use, prolonged deprivation, disorganized or limited home or school environments, and other developmental problems and psychological disorders. Therefore, consult with the school's special education staff and psychologist to see if they know of other circumstances that explain the behavior. Show them your notes on the child's behavior and how those notes show possible signs of ADD. Explain how you attempted to resolve the problems and how the student responded.
Contact parents early in the process to describe the problems with the child. They may have already investigated their child's behavior or have concerns of their own. They may have information that can help explain other factors influencing the behavior.
If the child behavior specialist or the parents decide that the child should be systematically checked for ADD, the administration will call a conference with a team of parents, teachers, administrators, health care professionals, school psychologists, and other specialists. Your role at this conference is to describe the behavior you observed and how that behavior is interfering with the child's learning.
During the evaluation process, you may be asked to complete a standardized rating form and answer questions about the child and his or her behavior. You may also be asked to try other classroom accommodations and evaluate their effects on the progress of the child. A specialist in ADD will come to the classroom to observe the student's behavior. In addition, if the team decides the child has ADD, you will play a major role in designing a specialized plan to improve the child's academic performance.
Medication in the Classroom
Between 60 and 90 percent of students with ADD are treated with some form of medication. Due to legal issues, a teacher should not recommend medication; however, you may suggest the parent take the child to a doctor for examination.
If medication is prescribed by a doctor, ask parents about the type of medication prescribed, when the medication is to be taken, and what side-effects might develop. A proper dose of medication should not make the child sleepy or lifeless, but should enable the child to focus on his or her work without being easily distracted.
While medication can reduce children's hyperactive behavior temporarily, it does not solve the academic problems experienced by children with ADD, and most studies show that medication has few long-term benefits on academic achievement and social adjustment. Instead, medication is a tool that facilitates the use of other methods for helping students with ADD. For example, a child will complete more work when the child's academic schedule is coordinated with the medication so that most of his or her schoolwork can be finished while the medication is calming the child's behavior.
The child should not take the medication without an adult present, and your school's policy may require the school nurse to administer the medicine. The school or the parents should inform all of the child's teachers about the medication so they can be alert for side-effects and medical problems.
Secrets of Successful Schools
The schools that are most successful in helping students with ADD make certain that individual student differences are reflected in the design of their education plans. The teachers and administrators demonstrate a common commitment to working with students with ADD, understand the complexity of the disorder, and believe strongly in the services they are providing to all children. Such schools work as a team to deal effectively with students with ADD by matching techniques and modifications to students' individual potential and methods of learning. Since students with ADD often are rejected by their fellow students, successful schools train students with ADD in social skills and pair them with non-ADD peers. These schools serve as partners for parents and develop a common understanding of goals and objectives, as well as a common plan to carry out those objectives and communicate any progress or problems.
Responsive schools organize their programs and instruction to meet the special needs of all students, including those with ADD. In redesigned programs, the entire class participates in a management system that does not separate the child with ADD from the rest of the group. Programs range from a simple "target behavior of the day" with an immediate reward system to an elaborate system of "levels," in which each level has specific rules and privileges. Schools vary their activities, use cooperative learning and games as part of their strategy, and provide additional training for teachers who need it.
Many schools use a checklist to help classroom teachers, special education teachers, and parents communicate. One school developed a system in which parents reward at home their child's behavior in school. Parents in that school meet with teachers and come to a mutual agreement about targeting certain specific behaviors. During class, the teacher monitors and evaluates students' behavior. The children are given feedback and notes on their behavior, and they gain or lose privileges at home based on their behavior at school.
Successful schools realize that students with ADD are not "problem children," but children with a problem. They encourage the school, parents, and teachers to work together with the child with ADD in order to help that child develop skills and work habits that he or she will need to be successful in school and in life.
Classroom Strategies for a Class with Students with ADD
You do not have to wait for a formal decision to evaluate the child for ADD before starting these strategies. Many of these will be effective even if the student does not have ADD but has other problems causing inattention, distractibility, and/or hyperactivity.
Teachers work with a team of parents, administrators, special educators, school psychologists, health care professionals, and other child professionals to support their efforts. This team will help you develop accommodation plans that may modify the physical arrangement of the classroom, lesson presentation, work assignment, test-taking methods, or classroom management as necessary. The plan will specify what accommodations will be made and how the team will work together.
Students with ADD, and other attention or behavior problems, do best in a structured classroom -- one where expectations and rules are clearly communicated to them, and where academic tasks are carefully designed for manageability and clarity.
In addition, teachers can break down assignments into smaller, less complex units, and build in reinforcement as the student finishes each part. Students with ADD may need more time (especially on tests) than other students. You can give a student confidence by starting each assignment with a few questions or activities you know the student can successfully accomplish.
Some teachers have found that pairing a student with ADD with another student or dividing the class into cooperative groups can be an effective way to encourage the student to concentrate on the work.
Individual Strategies for Helping Students with ADD Learn
Because no two children with ADD are alike, no single educational setting, practice or plan will be best for all children. Instead, teachers can help all students by identifying students' individual strengths and special learning needs and designing a plan for mobilizing those strengths to improve students' academic and social performance.
Although students with ADD are easily distracted, simple methods can help them focus their attention. These include: placing students near your desk or in the front row; maintaining eye contact with the students; using gestures to emphasize points; and providing a work area away from distractions. Reduce the amount of materials present during work time by having the student put away unnecessary items. Have a special place for tools, materials, and books.
Students may need both verbal and visual directions. Provide the child with a model of what he or she should be doing. Periodically remind the student of the assignment.
You can help students shift from one task to another by providing clear and consistent transitions between activities or warning students a few minutes before changing activities. Similarly, when you ask a student with ADD a question, begin the question with the child's name and then pause for a few seconds as a signal to the child to pay close attention.
Recent research suggests that providing more stimulation and variety can improve the performance and behavior of students with ADD. You can alter the type of assignment, the activities involved, or even the color of the paper used.
Communication with parents is essential when working with ADD. A simple way to improve communication is to use a checklist system for parents that records when a student achieves a goal or objective, such as arriving on time, being prepared, and completing classroom work. For each subject, the child should write down the homework and then show it to the teacher so that it can be checked for correctness. At the end of the class, repeat the homework assignment out loud as a reminder. Parents will then use the checklist to ensure the child completes the homework.
Students with ADD may need more help than their peers in learning strategies to help them study and organize their work more efficiently. Help in these areas may include focusing on listening skills, outlining structure, task structuring, and notebook organization. Teach students techniques for taking notes from both lectures and textbooks. Some teachers have found it helpful to give their students an outline for their notes and to list the main ideas or concepts in advance.
How to Manage ADD Behavior
Children with ADD respond well to a behavior management system in which rewards are given for good behavior. Reward systems encourage students to work toward earning privileges or rewards by gaining points for desired behavior and losing points for undesirable behavior. If you use this system with younger children, you may want to make charts or use tokens or stickers to show students the consequences and positive results of their behavior.
An effective management system concentrates on a few behaviors at a time, with additional behavior patterns added when the first ones are mastered. The reinforcement is something the student is willing to work for (or to avoid). The teacher gives or removes points immediately, according to the behavior, so the child understands why he or she is being rewarded or punished. While older children may be willing to work toward a deferred reward, younger children may need immediate reinforcement.
You can help children with ADD behave in a disciplined manner in the classroom by establishing a few rules which result in immediate consequences when they are broken. Give the child specific rules that are phrased positively in terms of what the child should do. When you praise and reward the student for good behavior and punish for inappropriate behavior, the child can see you apply the rules fairly and consistently.
Another proven strategy used by teachers is to provide a specified time-out location to which the student can go when he or she is not in control. This should not be seen as a punishment but as a place for the student to go for a few minutes to calm down. Older students can be taught to sense when they are getting out of control and go to the time-out area on their own.
For hyperactive children, you may want to establish active tasks such as cleaning the blackboard or leading the class to the lunchroom as rewards for good behavior.
Since children with ADD have difficulty understanding different rules for different places, parents and teachers benefit from working together to develop a consistent set of rules and a similar management system. When teachers and parents communicate with each other about a child with ADD, they increase the likelihood that he or she will be able to learn effectively.
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