1. Reaching & Teaching Children with AD/HD ADHD Association 20 th Anniversary Conference Reykjavik, Iceland 26 September, 2008 11:00 – 12:00 Sandra Rief, Presenter www.sandrarief.com

2. Think of one student/child...

3. What strategies might I use to...?

9. Common School Performance Difficulties in Students with AD/HD Poor organization, time management, study skills Minimal/inconsistent production & output (both in-class assignments & homework) Some academic weaknesses – particularly in written language/writing skills Page 1

10. Common School Performance Difficulties in Students with AD/HD Forgetfulness/memory-related issues Difficulty following rules Behavioral & social difficulties affecting interpersonal relationships Unable to sustain effort for long-term goals (need short term goals/rewards) Page 1

11. Things to Keep in Mind About AD/HD Disorder in performance, output, and production Approximately 30% developmental delay (in self-control, inhibition and executive functions) Page 1

12. Common Misinterpretations of Behavior Doesn’t work independently (lazy/apathetic) –chronic memory problems, lacks prerequisite skills, difficulty blocking internal/external distraction Doesn’t follow directions (noncompliance) –difficulty with recall/memory of verbal directions & translating into action, switching gears, interrupting what they’re doing Page 1

13. Common Misinterpretations of Behavior Repeatedly making the same mistakes (willful, deliberate) –respond too quickly to refer to past experience Not sitting still (can control if tried harder) –neurologically-based need to move, difficulty regulating motor activity Page 1

14. Common Misinterpretations of Behavior Poor social skills/judgment (deliberate, poor parenting) –difficulty noticing/interpreting social cues, inhibiting responses, skill/performance deficit Page 2

15. Our Perception...Our Reaction

16. Key Elements for School Success Flexibility & willingness of teacher to accommodate Knowledge & understanding of ADHD, LD, and other neurobiological disorders Close home/school communication Engaging & interactive teaching strategies Page 2

17. 2 min 30 ATTENTION

20. Maintain Attention (Active) 2 min 04

21. Key Elements for School Success Effective classroom management Environmental adaptations & accommodations Positive behavioral supports & interventions Help & training in organization/ time management/study skills Page 2

22. Key Elements for School Success Limiting amount of homework and reducing written workload (as needed) Page 2

23. Key Elements for Success Respecting & accommodating learning style differences Adaptations and modifications according to student needs Differentiated instruction Page 2

24. One Size Doesn’t Fit All

25. Key Elements for Success Active learning Page 2

26. Kinesthetic – 53 sec

27. Key Elements for Success Developing & bringing out student strengths Belief in student…Doing what it takes Page 2

28. ~ 5% Chronic/intense ~ 15 % At-risk ~80 % Norm Tertiary prevention Intensive interventions Secondary prevention Targeted interventions Primary prevention Universal interventions www.pbis.org Page 3

29. Creating the Climate for Success of ALL Students

30. 2 min 40 Schedule/Routines/Rules

31. Reverse the “praise deficit”: It takes changing the interactions 3:1 (Minimally) Page 3

32. Recognition, Acknowledgement, and Specific Praise “I really appreciate how you ______.” “I appreciate the self-control you are using.” “I noticed how hard you were working on ______.” “I see the effort you are showing.” “Thank you for the good choice you just made.” Page 3

33. Climate Class Short – Class + Reinforcement Systems 2 min 35

34. Common Antecedents or Triggers Environmentally Based: –(e.g., poor comfort level - too noisy/crowded; lack of structure/organization/interesting materials) Physically Based: –(e.g., ill, tired, hungry, thirsty, medication related) Page 3

35. Common Antecedents or Triggers Related to Specific Activity or Event: –(e.g., unclear instructions, substitute teacher, competitive game) Related to Specific Time: –(e.g., first period, before/after lunch, transitions) Page 3

36. Common Antecedents or Triggers Performance/Skill Demand: (e.g., to remain seated, share materials, take a timed test, read independently, write in cursive, wait for a turn) Page 3

37. Physical Needs 53 sec.

38. Prevent Problems: Alter the Antecedents Increase the structure Closer monitoring & supervision Motivating materials and assignments Increase opportunity for movement and active participation Increase cueing & prompts Prepare for transitions Adjust the environmental factors Page 4

39. Environmental Accommodations Preferential Seating (location & alternatives to chair) Page 4

40. Movin’ Sit Jr www.theraproducts.com

41. Environmental Accommodations Preferential Seating (location & alternatives to chair) Standing work stations Office area/study carrel, 2-desks Adding structure and organization (e.g., color- coding) Visual supports & prompts Page 4

45. Visual Cues 1.May talk with teacher permission only. 2.May leave seat with teacher permission only. 1.May use 12” voice. 2.May leave seat when needed (e.g., to turn in work) 1.May talk quietly with other students. 2.May leave seat to work with other students. Page 4

51. Papers in notebook Work turned in Pack all needed books and supplies All homework recorded in planner End of Day Page 4

52. Page 5

54. Timer Uses Transitions Regain control message Motivating on-task/work completion X amount of time to demonstrate target behavior to earn point/token Time-out Page 5

55. Environment-beanbag (2 min 11 )

57. Individual Management Systems

58. Page 5

59. GOAL__________ DATE __________ ___________ ’S DAILY REPORT + - TOTAL handout Page 5

60. On time to class Homework turned In Used class time Productively Followed class rules (no more than 2 warnings Page 5

62. With “Challenging” Kids Plan a response and avoid “reacting.” Praise, encourage, and reward increments of improvement Change what you can control…YOURSELF (attitude, body language, voice, strategies, expectations). Page 6

63. With “Challenging” Kids Use “when…then” rather than “if you don’t…you won’t. Use “what” questions rather than “why” questions. Page 6

64. What else could you try? What would you like to happen next? What was our agreement? What are you risking by doing that?

65. With “Challenging” Kids Acknowledge: “I can’t make you. But remember your choices are either ___ or ___. (Give 2 choices) Page 6 Go to 67 rdg or 72 org

66. “You can stay after school to finish the class assignment or you can finish it now and not have to stay after class. It’s your choice.”

67. AD/HD: Reading difficulties related to… Inattention/distractibility Poor memory skills Application of metacognitive strategies Rief, S. & Heimburge, J. (2006) How to Reach & Teach All Children in the Inclusive Classroom, 2nd ed. Page 6

68. Students with AD/HD Often  Have average reading fluency  Have “spotty” comprehension  Lose their place frequently  Forget what they read  Fatigue easily while reading  Have difficulty reading silently  Avoid reading (non-choice material) Page 6

69. During Reading Comprehension Strategies Stopping at points to process text Read-cover-retell Make connections Make predictions and inferences Visualize Ask questions Page 6

70. Stop and Process Activities Stop and re-tell in your own words… Stop and ask your partner a question. Stop and discuss… Stop and draw something to help you remember… Stop and write questions in the margins Stop and summarize in 1 sentence… Page 6

71. Reading Interventions Divide reading assignment into shorter segments Use markers to block part of page Allow reading to self orally - whisperphone Page 7

72. Strategies for Organization, Time Management, & Study Skills

74. Executive Function-Related Classwork & Homework Challenges  Memory, Forgetfulness  Planning, Prioritizing, Organizing  Judging and Managing Time  Breaking things down into steps  Activation (mobilizing, getting started)  Sustaining Attention, Alertness, and Effort  Self-management (including managing frustration and emotions) Page 7 75 hw video or 76

76. Homework Steps Know what the assignment is Record the assignment Bring the required materials home Do the homework Return the homework to their backpack Turn in the homework Page 7

77. Organization & Homework Support  Required backpack and 3-ring binder or alternative of accordion file (pocket folder for K-2) Page 7

78. Homework Folder One colored folder in front of notebook for all homework; or one homework folder behind each subject tab

79. Organization & Homework Support  Consistent use of planner/agenda/ calendar/assignment sheet Page 7

80. Page 8

82. Organization & Homework Support  Color code: schedule, books, notebooks, folders, unit sheets, handouts Page 8

83. Organization & Homework Support  Build cleaning/organization of notebooks and desks into the schedule.  Provide a second set of books for home.  Write due dates on assignments and estimated time required to complete. Page 8

84. Organization & Homework Support  Walk through recording of assignments Page 8

85. Recording Assignments

86. Organization & Homework Support  Provide class syllabus and project timelines  Chunking down long-range assignments (interim due dates, monitoring, heads-up to parents) Page 8

87. Organization & Homework Support  Post all assignments, schedules, materials needed, timelines Page 8

88. Organization & Homework Support  Supervise for materials as leaving room, sign monitoring form ticket out the room Page 8

89. Sign off & Long term (42 sec)

90. Organization and Homework Support  School-wide supports: Supervised study periods, homework labs, Learning Strategies class Page 8

91. Organization & Homework Support  Keep teacher copy of student planner or assignment sheet filled out & accessible. Page 8

92. Organization & Homework Support  Teach students to use a “things to do” list and other checklists Page 8

94. Organization & Homework Support  Use a monitoring form to track and communicate between home and school. Page 9

95. 5 – Excellent: Worked all or most of class and was not disruptive 4 – Good 3 – Satisfactory: Did acceptable work, but needed some prompts to stay on-task 2 – Poor 1 – Unacceptable: Did not do any or very little work and was a distraction to others

96. Organization & Homework Support  Be responsive to parent feedback and frustration about homework difficulties. Page 9 97 writing, 102 not fair, 103 journey

97. Why is Writing is Such a Struggle?  Planning & Organization (topic, ideas, sequence, structure of genre)  Memory (working & long term)  Language (logical, coherent, vocabulary usage)  Spelling  Grapho-Motor Skills (physical task)  Editing (revision, proofreading)  Self-Monitoring (make sense? enough detail?)  Speed of Written Output & Production Page 9

98. Fine Motor/Handwriting

99. Some Writing Accommodations Pre-Writing and Organizational Supports (e.g., use of graphic organizers, checklist or rubric of required components, talk through ideas first) Editing Assistance (teacher/peer, spell-check) Bypass Strategies (e.g., permission to dictate portions, print instead of cursive, access to computer/assistive technology) Shortened/modified written assignments Use of scribe, note-taking assistance Alternatives/Options to Writing Assignments Page 9 100 math, 102 not fair, 103 journey

100. Math Difficulties Due to Weaknesses in..  Working memory  Long term memory retrieval (steps, rules, vocabulary, processes, math facts)  Attention  Sequencing (multi-step procedures, counting)  Perceptual-motor/Spatial organization  Language (abstract terms, word problems)  Self-monitoring (estimating, pacing) Page 9

101. Academic Interventions for Math Weaknesses Allow use of calculator & multiplication chart Use graph paper to space numbers Provide immediate correctness feedback Give clues to the process needed to solve problem Color-code processing signs Provide time to let students work with each other (partners/groups) solving problems, checking and reteaching Page 9 102 not fair, 103 journey

102. Not Fair Fairness is giving everyone what they need, not equal treatment. Fairness does not mean sameness, it means everyone treated with equal respect & equal opportunity to succeed. Accommodations provide = footing; not unfair advantages; based on need. Page 9

103. A Journey of Hope Over the mountain Little Train pulled...

104. A Journey of Hope Over the mountain Little Train pulled. Family & friends pushed on, hoping he would. An obstacle in life…this mountain was school, The side-line cheered on with love as the tool. Harder and harder the Little Train tried. Often he slipped and sometimes he cried, “I can’t, I can’t”…”Oh yes you will!”… Cries of support came from over the hill.

105. A Journey of Hope At times on his journey, he became derailed; Totally feeling as though he had failed. “Get back on track, we know you can!” Came the shouts from the side line, Believing in him. Sure enough, Little Train came through, Accomplishing the goal he set out to do. Knowing that life is meant to be shared, he Couldn’t have made it without those who cared.

106. A Journey of Hope The question is asked, “How will I repay All those on the side line who cheered all the way?” “By helping others”, the answer came… ”We show that with love our journey is changed.”

107. Contact Sandra www.sandrarief.com

108. Questions