Download Attention Deficit/ Hyperactivity Disorder

ATTENTION DEFICIT
HYPERACTIVE DISORDER
(ADHD)
PRESENTER
Harry E. McCormick, Ed.D.
School Psychologist
Metropolitan Nashville Public Schools
OVERVIEW
FACTS AND MYTHS
Pre-Test
CHARACTERISTICS
DIAGNOSTIC FEATURES
DIAGNOSTIC ISSUES
TREATMENT
MEDICAL
PSYCHOSOCIAL
EDUCATIONAL
Many Names for AD/HD
Name Given to
Disorder
Time
DSM Edition
Minimal Brain
Damage
1950’S
--
Minimal Brain
Dysfunction
1960’S
--
Hyperkinetic
Reaction of
Childhood
1970’S
DSM-II
Many Names for AD/HD
(cont’d)
Attention Deficit
Disorder
With/Without
Hyperactivity
Early 1980s
Attention-Deficit
Hyperactivity
Disorder
Late 1980s
Attention Deficit /
Hyperactivity
Disorder
Present
DSM-III
DSM-III-R
DSM-IV-TR
PRIMARY CHARACTERISTICS


Inattention
Hyperactivity

Impulsivity
Inattention
Fails to pay close attention to details
Difficulty sustaining attention
Does not seem to listen
Does not follow through on instructions
Difficulty with organization
Avoids tasks that require sustained mental
effort
Inattention
(cont’d)
Often loses things
Often easily distracted
Forgetful in daily activities
Hyperactivity
Fidgets
Out of seat
Runs or climbs excessively
Difficulty playing quietly
Is often “on the go”
Talks excessively
Impulsivity
Often blurts out answers before questions
have been completed
Often has difficulty waiting turn
Often interrupts or intrudes on others
SECONDARY CHARACTERISTICS

Academic


Social
Emotional
Academic Difficulties









Poor study habits
Difficulty beginning and completing assignments
Disorganized
Poor handwriting
Inconsistent/poor recall
Difficulty generalizing
Auditory processing problems
Poor visual perception
May have additional learning problems
ADHD is not a specific developmental
disorder or learning disability as these
disorders are currently defined, but there may
be some overlap, or comorbidity, of these two
types of disorders. Approximately 20 to 25%
of ADHD children will have significant delays
in the development of math, reading, or
spelling, and 10 to 30% may have problems
with language.
Social Difficulties









Does not take responsibility for actions
Needs to be the center of attention
Difficulty relating to peers
Disturbs others who are trying to work and listen
Bullies or bosses other children
Teases peer excessively
Difficulty following rules of games
Aggressive, spiteful and vindictive
Rejected by peers
Emotional Difficulties







Low self-esteem
Irritable, low frustration tolerance
Loses temper, gets mad easily
Defiant attitude
Argumentative
Emotionally immature
Frequent, unpredictable mood swings
Major life events may cause added
stress resulting in some of the same
types
of
behaviors
that
are
characteristic of children who have
ADHD.
Where are Students with AD/HD Educated





General education
Teacher initiated accommodations in general
classroom, curriculum, and instruction
Support Team Intervention Plan
Identification of a disability under Section 504:
development of a 504 Service Plan for
accommodations in general curriculum and
modifications in instruction
Identification of need for special education and
related services - - IDEIA
Chances Are You Will Be Teaching a
Student Diagnosed with AD/HD

Occurs in 3% to 7% of school-age children

All socioeconomic, cultural, and racial
backgrounds

All intellectual levels

More prevalent in males
4:1 male to female ratio in the general population
9:1 male to female ratio in the clinical population

AD/HD can span throughout the individual’s life.
50% to 80% of AD/HD children continue to have
some degree of their symptoms in adulthood.

AD/HD is a chronic or life-long condition. As one
grows older the symptoms may become less
severe, especially in the case of hyperactivity,
but some manifestations of the condition may be
expected to be present throughout adulthood.

Hereditary link has been suggested

One can not tell by looking at a child’s overt
behavior.
Symptoms May Change
AD/HD Is Not Outgrown

Preschool
o
o
o
o
o
o
Excessive activity
Increased talking
Resistance to routines and rules
Aggressive in play
Demanding personality
Accident prone
Symptoms May Change
AD/HD Is Not Outgrown
(cont’d)

Elementary School
o
o
o
o
o
Fidgety
Excessive talking
Erratic performance
Bossy
Constant demand for attention
Symptoms May Change
AD/HD Is Not Outgrown
(cont’d)

Adolescence
o
o
o
o
o
o
Restlessness
Talking out of turn
Problems at school
Problems with peers
Difficulty establishing independence from
parents
Poor judgment
CRITERIA FOR SYMPTOMS





Age-Inappropriate behaviors
First appeared before age 7
Persist for 6 months (or more)
Present in at least 2 settings
Significant clinical impairment
DSM-IV
Subtypes of AD/HD


Inattentive Type
Hyperactive-Impulsive Type

Combined Type
Executive Functioning
Executive functions are a collection of
inter-related
processes
that
are
responsible for goal-directed, problem
solving behavior which involves the
prefrontal lobe.
Types of Executive Functioning




Inhibit (the ability to inhibit, resist or not
act on impulse)
Shift (the ability to move freely from
one activity to another)
Initiate (beginning a task, generating
ideas or problem-solving)
Working Memory (the capacity to hold
information in mind for the purpose of
completing a task)
Types of Executive Functioning
(cont’d)



Plan/Organize (the ability to manage
current and future demands)
Organization of Materials (orderliness
of work…)
Monitor (assess work-checking habits)
Teachers, parents, psychologists,
and physicians are key to
diagnosis and successful
outcomes
AD/HD Procedures and
Best Practices
for
Metro-Nashville Public
Schools
Student is Currently on Medication

Teacher completes “Medication Effectiveness
Documentation” (MED) form

Concerns - Follow new Support Team
process

No concerns - Place MED form in cumulative
record. The process ends.
MEDICATION
EFFECTIVENESS
DOCUMENTATION
2601 Bransford Avenue, Nashville TN 37204
Phone (615) 259-8588
Fax (615) 214-8649
This form addresses the possible educational needs of a student on medication.
Student:
Teacher:
School:
Grade:____________________________
Is this student performing in the expected academic range when compared to age peers?
Yes
No (explain)
Are there significant behavioral concerns?
Yes
No (explain)
Are additional classroom modifications needed beyond expected levels?
Yes
No (explain)
If the student’s medical diagnosis is substantially interfering with educational progress,
contact the Support Team chair as soon as possible.
Teacher’s Signature
Date
Student with Academic/Behavioral Concerns
Follow the New Support Team process
o Forms and procedures have changed
o Training will occur in the very near future
Try interventions for at least one month
Reconvene Support Team to review
progress or lack of progress and make
other recommendations
Student with Academic/Behavioral Concerns
(cont’d)

The severity of the case will determine
the need to move more quickly through
the Support Team/504/IDEIA Process.
If the student has severe enough
behavioral issues, then the Support
Team can begin the AD/HD evaluation
process.
AD/HD Evaluation Process




Assessment Specialist (psychologist)
must be in attendance at Support Team
Obtain parental consent for evaluation
Global Behavior Rating Scale
(Home/School)
Specific Behavior Rating Scale for
AD/HD (Home/School)
AD/HD Evaluation Process
(cont’d)





Teacher Checklist
Classroom Observations in Multiple
Settings
Social/Developmental/Medical History
Vision/Hearing Screenings (within one
year)
Psychologist writes report of the AD/HD
screening results.
2601 Bransford Avenue, Nashville TN 37204
Phone (615) 259-8588
Fax (615) 214-8649
CONSENT FOR
PSYCHOEDUCATIONAL
SCREENING
STUDENT’S FULL NAME: __________________________________________________________
DATE OF BIRTH: _______________________________ ETHNICITY: ________ SEX: _________
SOCIAL SECURITY NUMBER: __________________ SCHOOL: ____________________________
GRADE: _________ TEACHER: _____________________________________________________
PARENT(S): ____________________________________________________________________
PARENT(S) ADDRESS: ____________________________________________________________
SPECIFIC AREA OF CONCERN: _____________________________________________________
_______________________________________________________________________________
__________________________________________________
School Psychologist’s Signature
__________________________
Date
My signature below constitutes my understanding, agreement and permission:
(1)
for school psychologist to administer psychological and/or educational measures
that address the areas listed above to the above named student;
(2)
for the school psychologist to determine the specific psychological and educational
screening measures which are needed to address the areas of concern.
(3)
for the school psychologist to share the results with me and with other school
personnel.
___________________________________________________
Parent(s) Signature
_____________________________
Date
Parent(s) telephone numbers:
(Home)__________________________ (Work)_________________________
Date Received by School: _____________________ Received by: ____________________
♦Copy to be returned to Psychology Department with protocols, etc.
♦Original to be retained in Cumulative File with S-Team information
ADHD
DIAGNOSTIC
CRITERIA
2601 Bransford Avenue, Nashville TN 37204
Phone (615) 259-8588
Fax (615) 214-8649
Name: ________________________________ School: _________________________
A1. Six (or more) of the following symptoms of inattention have persisted for at least 6
months to a degree that is maladaptive and inconsistent with developmental level:
INATTENTION (Check all that apply)
____
____
____
____
____
____
____
____
____
(a) often fails to give close attention to details or makes careless mistakes in
school work, or other activities
(b) often has difficulty sustaining attention in tasks or play activities
(c) often does not seem to listen when spoken to directly
(d) often does not follow through on instructions and fails to finish schoolwork,
chores, or duties in the workplace (not due to oppositional behavior or failure to
understand instructions)
(e) often has difficulty organizing tasks and activities
(f) often avoids, dislikes, or is reluctant to engage in tasks that require sustained
mental effort (such as schoolwork or homework)
(g) often loses things necessary for tasks or activities (e.g., toys, school
assignments, pencils, books, or tools)
(h) is often easily distracted by extraneous stimuli
(i) is often forgetful in daily activities
A2. Six (or more) of the following symptoms of hyperactivity-impulsivity have persisted
for at least 6 months to a degree that is maladaptive and inconsistent with developmental
level:
HYPERACTIVITY (Check all that apply)
____
____
____
____
____
____
(a) often fidgets with hands or feet or squirms in seat
(b) often leaves seat in classroom or in other situations in which remaining seated
is expected
(c) often runs about or climbs excessively in situations in which it is
inappropriate (in adolescents or adults, may be limited to subjective feelings of
restlessness)
(d) often has difficulty playing or engaging in leisure activities quietly
(e) is often “on the go” or often acts as if “driven by motor”
(f) often talks excessively
IMPULSIVITY
____
____
____
(g) often blurts out answers before questions have been completed
(h) often has difficulty awaiting turn
(i) often interrupts or intrudes on others (e.g., butts into conversations or games)
ADHD
DIAGNOSTIC
CRITERIA
2601 Bransford Avenue, Nashville TN 37204
Phone (615) 259-8588
Fax (615) 214-8649
Check all that apply:
B. ____
C. ____
D. ____
E. ____
Some hyperactive-impulsive or inattentive symptoms that caused impairment
were present before age 7 years.
Some impairment from the symptoms is present in two or more settings (e.g.,
at school (or work) and at home).
There is clear evidence of clinically significant impairment in social,
academic, or occupational functioning.
The symptoms do not occur exclusively during the course of a Pervasive
Developmental Disorder, Schizophrenia, or other Psychotic Disorder and are
not better accounted for by another mental disorder (e.g., Mood Disorder,
Anxiety Disorder, Dissociative Disorder, or a Personality Disorder).
Code (Based on Type):
314.01 Attention-Deficit/Hyperactivity Disorder, Combined Type: if both criteria A1 and
A2 are met for the past six months.
314.00 Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type: if
criterion A1 is met but criterion A2 is not met for the past six months.
314.01 Attention-Deficit/Hyperactivity Disorder, Predominantly Hyperactive,
Impulsivepe: if criterion A2 is met but criterion A1 is not met for the past six
months.
314.9 Attention-Deficit/Hyperactivity Disorder Not Otherwise Specified
Review Support Team


Review results of AD/HD Evaluation
and determine if an “educational
diagnosis” of AD/HD can be made.
If Yes - determine if 504 eligible
(follow the 504 procedures)
If not 504 - Write Support Team
Intervention Plan
After Leonard took his case to the Support Team, he
was given a 504 Service Plan which allowed him to play
his armpit in the school band.
Review S-Team (cont’d)



If No - Review/Rewrite Support Team
Intervention Plan to address other
pertinent concerns.
Both plans should be reviewed (at least
yearly).
A “medical diagnosis” is not required for
eligibility under Section 504.
IDEIA - Other Health Impairment

A student with AD/HD can qualify for special
education as Other Health Impairment (OHI)
if:
o
The student must have a current (within one year)
medical statement from a licensed health service
provider* which includes the diagnosis, prognosis,
information regarding medications (if applicable),
special health care procedures, special diet,
and/or activity restrictions.
IDEA - Other Health Impairment
(cont’d)
A
comprehensive developmental or educational
assessment which indicates the effects of the
health impairment on the student’s educational
performance, and documents deficit skills resulting
from the health impairment in pre-academics or
academic functioning, adaptive behavior,
social/emotional
development,
motor,
communication, and cognitive. If an AD/HD
evaluation has not been conducted to address the
above mentioned areas, then one should take
place using the previously outlined procedures.
IDEA - Other Health Impairment
(cont’d)
 If the student is found to be eligible under
IDEIA, then the IEP Team completes the
Eligibility Report, OHI Documentation
Form, OHI/ADHD Documentation Form,
and writes the IEP.
 If
the student is not found to be eligible
under IDEIA, then follow 504 or Support
Team procedures.
MEDICAL EVALUATION
STATEMENT
SPECIAL EDUCATION DEPARTMENT
601 Bransford Avenue, Nashville TN 37204
Phone (615) 259-8588
Fax (615) 214-8649
School:_________________________________________________
Fax No.:________________________________________________
This student has been referred to the school evaluation team in order to develop appropriate educational
interventions and determine assessment needs. As a component of this process, the team needs to determine
if any medical and/or other condition exists that may be impacting his/her educational performance. This
information may be considered in determining an educational disability. Please complete all areas.
, Date of Birth: _________________________,
(Name)
is a patient who is currently or has been under my care during the last year.
DIAGNOSIS: ___________________________________________________________________________
PROGNOSIS: (check one)  Stable
 Improving
 Declining
TREATMENT: (check all that apply)

The following medications are currently being prescribed: _______________________________
______________________________________________________________________________
______________________________________________________________________________

Other pertinent information, such as, special health care procedures, special diet, activity
restrictions, other conditions, and/or any information about the child’s physical/medical/sensory
functioning that would have implications for educational planning:_________________________
_______________________________________________________________________________
_______________________________________________________________________________

This patient is not currently being treated by medication.
I last saw :________________________________________ on _______________________________.
Patient
Name Printed:__________________________________
Medical Health Services Provider
Date
__________________________
________
Signature of MD, NP, PA
Date
Address: ___________________________________ Phone Number: __________________________
___________________________________
Please return or fax this form to the student’s school.
Metropolitan Nashville Public Schools
Eligibility Report
Name ___________________ DOB _______ Grade ______ School ____________________ School System___________________
Eligibility Date _____________ Projected Reevaluation Eligibility Date _____________
1. In accordance with the State Regulations, this student presently:
 Meets the standards to be identified as ____________________ (Primary) /__________________ (Secondary)
 Does not meet the standards for any disabilities
2. The following factors have been ruled out as the primary cause of the student’s educational difficulties:
 Lack of instruction in reading or mathematics
 Limited English proficiency
3. Educationally relevant medical findings, if any:_______________________________________________________
4. Vision Screening Results: ______________ Date: _______ Hearing Screening Results ____________ Date _______
5.
 Evaluation results are documented and the student's disability determination documentation is attached.
SIGNATURES OF ASSESSMENT TEAM
Persons involved in the assessment should sign below and indicate if they agree with the contents of this report .
(Dissenting statements should be attached)
Position
Signature
Parent
____________________ _________
Date
General Education Teacher
____________________ _________
Assessment Specialist
____________________ _________
Special Education Teacher (optional)
____________________ _________
______________________
____________________ _________
______________________
____________________ _________
Agree
Disagree












TO BE COMPLETED AT THE IEP TEAM MEETING
 This student Is Eligible for Special Education (1) s/he meets the state standards, AND
(2) his/her needs cannot be met in the general education curriculum without
special education.
 This student meets state standards; however, s/he Is Not Eligible for Special Education because his/her needs can be met
in the general education curriculum without special education.
 This student Is Not Eligible for Special Education because s/he does not meet state standards for a disability.
 This student meets standards for one or more disability categories; however, the student’s parent/guardian is declining
services. This student will not receive special education or related services.
Position
Parent
Signature
Date
Agree
Disagree
____________________
________


LEA Representative
____________________
________


Special Education Teacher
____________________
________


General Education Teacher
____________________
________


Interpreter of Test Results
____________________
________


____________________
____________________
________


 I received a copy of my child’s evaluation report(s) utilized in determining eligibility and/or educational program.
____________________
____________________
________



I did not receive a copy of my child’s evaluation report (s). Explanation: _______________________________________
____________________
____________________
________


_____________________________________________________________________________________________
__________________________________________________
Parent/Guardian Signature
SPECIAL EDUCATION DEPARTMENT
OTHER HEALTH
IMPAIRMENT/ATTENTION DEFICIT
HYPERACTIVITY DISORDER
Assessment Documentation
2601 Bransford Avenue, Nashville TN 37204
Phone (615) 259-8588
Fax (615) 214-8649
Name: ________________________________________ Date of Birth: ___________ Age: _____ Ethnicity:______
Student #: ______________________ School: _______________________________________ Grade:__________
EDUCATIONAL EVALUATION INCLUDES:
1. Signed Referral/Consent for Psycho-educational Evaluation
2. Social History (to include developmental, medical, family)
3. Global Behavior Rating Scale (BASC-2, Achenbach, etc.)
4. Specific Behavior Rating Scale (Conners, Brown, BRIEF, etc.)
5. Direct Observations in multiple settings
6. Indirect Observation (Teacher Checklist, Anecdotal Information)
7. Onset of Characteristics of ADHD were noted before the age of 7
8. Documentation includes a comprehensive psycho-educational
assessment, which includes measures that document the student’s
educational performance in the following areas:
 Pre-academics or academic functioning,
 Adaptive behavior,
 Social/Emotional development,
 Motor skills,
 Communication skills, and
 Cognitive ability
MEDICAL EVALUATION INCLUDES: (required)
 Date of Medical Evaluation (within one year)
 Diagnosis and Prognosis
 Medications and/or special Care Procedures
 Special diet and/or Activity restrictions (addressed)
9. Medical Evaluation obtained by a licensed medical health services provider
Name and Address of Medical Health Services Provider (MHSP):*
10.
11.
12.
13.
*licensed physician, physician’s assistant, nurse practitioner
Diagnosis of ADHD (within one year) was made by (check one):
 Licensed Medical Health Service Provider; or
 Licensed Psychologist; or
 Licensed Senior Psychological Examiner
Name and Address of MHSP or HSP:
Information gathered in the evaluation documents a need for specially
designed instruction due to chronic or acute health problems that result in
(check all that apply; at least one must be checked yes):
 Impaired organizational or work skills;
 Inability to manage or complete tasks ;
 Excessive health related absenteeism; or
 Medications that affect cognitive functioning
There is documentation, including observation and/or assessment, of how
OHI adversely impacts the child’s educational performance in his/her
learning environment.
All above areas have been addressed and checked yes. (Exception: #10 and #11)
This student now meets the standards for OHI/ADHD.
 yes
 yes
 yes
 yes
 yes
 yes
 yes
 no
 no
 no
 no
 no
 no
 no
 yes
 yes
 yes
 yes
 yes
 yes
 no
 no
 no
 no
 no
 no
 yes
 yes
 yes
 yes
 yes
 no
 no
 no
 no
 no
 yes
 yes
 yes
 no
 no
 no
 yes
 yes
 yes
 yes
 no
 no
 no
 no
 yes
 no
 yes
 no
______________________________________________
____________________________
Signature of Assessment Personnel
Date
RE-EVALUATION FOR OHI

Special Education Teacher’s
Responsibilities:
List all students due for re-evaluation
o Give a copy to appropriate assessment
specialist
o Complete or collect observations, checklist
parent information, current vision and
hearing, and current academic information
o Schedule IEP Re-evaluation Team Meeting
o
RE-EVALUATION FOR OHI
(cont’d)

Psychologist’s Responsibilities:
Complete the Re-evaluation Summary
Report
o Collect any additional information that the
IEP Team deems necessary (e.g.
comprehensive
assessment,
current
medical)
o Complete Eligibility Report, OHI Evaluation
Review, and OHI Documentation Form
o
A Multi-Modal Treatment for
AD/HD Is Optimal



Medical
Psychosocial
Educational
Medical Management


Psychostimulants
Antidepressants


50 years of research has shown that
stimulants are therapeutic and do not
cause drug addiction when used
appropriately
Proper treatment of ADHD with
stimulants can lead to a lower risk of the
student abusing alcohol and other drugs
Stimulant
Medication
Stimulant Medication
Clinical benefits of stimulant medication
 Reduces core symptoms of the disorder
o
o

Inattention
Impulsivity/Hyperactivity
Improves associated features
Academic performance
o Interactions with parents and teachers
o Improves social behavior with peers
o Improves aggressive behavior
o
Stimulant Medication –
Sustained Release








Concerta
Ritalin SR
Ritalin LA
Metadate ERl
Methylin ER
Metadate CD
Adderall XR
Dexedrine Spansule
Stimulant Medication
Stimulant
Medication––
Immediate Release
Immediate
Release






Ritalin
Methylin
Focalin
Adderall
Dexedrine
Dextrostat
Antidepressants






Norpramin
Tofranil
Elavil
Pamelor
Prozac
Zoloft
Other
Other Medications
Medications



Clonidine
Risperdal
Wellbutrin
Dietary Treatments for ADHD*




Caffeine
Herbs
Limiting intake of food additives and red
color dye
Removal of sugar
*Are not clinically proven to be effective
Psychosocial Interventions






Self-Monitoring Training
Self-Control Training
Social Skills Training
Teacher Training for Classroom
Management
Group and Individual Counseling
Parent Counseling
Psychosocial
Interventions
Behavioral Therapy
(cont’d)

Broad set of specific interventions
o
Change physical and social environment to
change behavior
• Be consistent
• Use positive reinforcement
• Teach problem-solving skills

Ongoing consistent communication with
parents
o
Notes, Phone Calls, E-Mail
Classroom Management
Strategies
Classroom Management
Strategies

Behavioral Strategies
o
o

Management Strategies
o
o


Structural
Physical
Organizational skills
Time management
Teaching Strategies
Cultural Competence
Classroom Management Strategies
Structure





A structured, positive classroom that is
welcoming, inclusive, and well managed
Establish a clear routine
Post the rules and review frequently
Review your expectations with established
visual/auditory prompts
Prepare for and provide structure and
supervision during transition times, changes
of routine, and unstructured situations
Classroom Management Strategies
Behavioral Strategies



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Implement
a
classroom
behaviormanagement plan
Use praise significantly more than
reprimands
Role play appropriate behavior
Give praise, a small privilege, or token to
students who are engaged in appropriate
behaviors
Increase the immediacy and frequency of
positive feedback and reinforcements
Communicate with parents frequently
Functional Behavioral Assessment
(FBA)


.
Useful for those students with ADHD
whose behaviors are affecting school
performance
Assesses why a student behaves as
he/she does, given the nature of the
student and what is happening in the
environment
Functional Behavioral Assessment
(FBA)

Teacher’s input
Context of behavior
o Contributing factors (triggers)
o Function of behavior
o Teacher response/student reaction
o Previous interventions
o Is behavior continuing? Why?
o Potential rewards for change
o
Positive Behavior Intervention Plan
(+BIP)

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+BIP is based on results of the FBA
Development of the +BIP
Prevention
o Teaching new skills
o Prevent reinforcement of problem behavior
o Increase reinforcement of desired and
replacement behaviors
o
• Positive reinforcement
• Negative reinforcement
Classroom Management Strategies
Creative Positive Reinforcers
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Work on board
Choice of seat
Messenger carrier
Pass to library
Pet or plant caretaker
Decorating room
Listen to music
Reduced homework
Puzzles
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Monitor lines/computer
Special pens, paper
Pop bubble wrap
Jokes
Puzzles
Cartoons/drawing
Talking periods
Arts and crafts
Board games
Classroom Management Strategies
Physical Environment
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Create a U-shaped seating arrangement
Seat student near you – Source of instruction
to cue and prompt
Seat student near well-focused students –
good role models
Seat student away from high-traffic areas,
windows, doors, and other distractions
Provide students with quiet, distraction free
area for study and test-taking
Classroom Management Strategies
Organization
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Require the use of a 3ring binder/notebook
(starting in 3rd grade)
Require the use of
subject dividers and a
pencil pouch
Require the use of a
monthly assignment
calendar (use
consistently with regular
teacher monitoring)
Handouts 3-hole
punched

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Teach how to organize
papers and desk
Have periodic desk and
notebook checks
Provide time and
assistance for cleaning
desk and notebook
Encourage organization
first thing in the morning
Color code materials
Classroom Management Strategies
Time Management
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Teach how to tell time
Teach how to read
calendars
Establish a daily routine
Direct all assignments
to be recorded in
calendar
Call close attention to
due dates
Assist with prioritization
of activities
Utilize “to do” lists
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Break down longer
assignments into smaller,
manageable increments
Check in on long-term
projects (book reports etc)
Provide advanced notice
about upcoming projects
Assign study buddies
Use frequent praise and
rewards
Visual timer
Classroom Management Strategies
Teaching Strategies
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Instructional activities versus didactic lectures
Encourage “cooperative learning”
Ensure high interest and novelty are an
integral part of the lesson
High-impact visual aids
Display and support mnemonic strategies to
aid memory
Call on students by random method
Classroom Management Strategies
Teaching Strategies

Adaptations for students with ADHD
Adjust for hyperactivity by providing opportunities
for the student to move
o Clarify and simplify instructions
o Provide guidance with time management
o Allow extra time
o Utilize reading aids
o Alter testing
o Address homework strategies
o
Classroom Management Strategies
Cultural Competence

Developing a classroom that is culturally
competent – suggestions for teachers
o
o
o
o
o
Take note of your own personal and cultural
biases
Engage and establish rapport with students
and their families whenever possible
Provide interventions for home
Learn to listen effectively across cultures
Parents of children with ADHD can teach
school personnel about ADHD and effective
techiques they use at home
Classroom Management Strategies
Summary
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Direct, focused instruction
Consistency
Structure
Brevity, variety, choices
Effective classroom management and
positive discipline
Bringing out student strengths
Respect for differences and feelings
Communicate, communicate, communicate!
Summary
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ADHD has many faces
The role of the teacher is to recognize and
report behaviors that look like ADHD
Cultural competence is key to successful
communication
Teachers play an integral role in the ADHD
Process
Effective classroom strategies are the key to
overall success of the student
Please take a moment to share one
take-away that you could begin
implementing as a result of this
presentation.
References
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Barkley, R. A. (1990). Attention-deficit hyperactivity
disorder: A handbook for diagnosis and treatment.
New York: Guilford Press.
Barkley, R. A. (1991). Attention-deficit hyperactivity
disorder: A clinical workbook. New York: Guilford
Press.
DuPaul, G. J., & Stoner, G. (1994). ADHD in the
schools: Assessment and intervention strategies.
New York: Guilford Press.
www.interventioncentral.org
Questions and Answers