Flamenbaum PowerPoint Presentation

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Using Clinical Interventions to
Treat Academic Problems in
Children With ADHD:
Evan Flamenbaum MA, MSW
Monday January
th
7 ,
2013
Goals of this Presentation
• Outline a general process of helping students
with ADHD with their academic struggles
• Clinically Informed Tutoring™
• Provide you will easy and ready to use
techniques
• Present the bridge between clinical and
academic interventions
First Step:
Enroll the Client
• Kids don’t go to a therapist / learning
specialist they are brought there
• Learned Helplessness
• Dissonance: I know I am smart . . . But my
intelligence doesn’t translate to success
• Give the chain a tug!!!
First Step
Enroll the Client
Motivational Interviewing
• Assess where a child is on the spectrum of
change
• Develop change talk
• Cost-benefit analysis technique
Stages of Change
• Precontemplation: “Ignorance is bliss”
• Contemplation: “On the fence”
• Preparation: “testing the waters”
• Action: “let’s do this!”
• Maintenance: “stay the course”
Cost/Benefit Analysis
“Getting paper done on time
(without all-nighter)”
_
• Letting teacher down (95)
• Making parents upset (95)
• Not getting good grade
(100)
• Being stressed about the
process (85)
+
• Rather hang out with
friends/TV/do nothing
(50)
• Would have spent less
time (40)
• Avoid caring about the
grade (60)
Second Step
Setting Goals
Solution Focused Therapy
• Miracle question
– What would be different?
– How could people tell?
– How would it feel differently?
Reaching your goals
First, think about your dreams
Think about how you would like
to be in the future.
Imagine yourself at the end of
the term/year. Write it down.
Reaching your goals
Second, set goals
1. Goals are things you want. State
them positively not negatively.
Example: I want to get an A in Spanish.
Instead of… I don’t want to fail Spanish.
Reaching your goals
Second, set goals
2. Be specific. Write down exactly what you mean.
Include numbers and times and exclude vague
words like “lots” and “more”.
Example: I want to get above an 80 in science
class.
Instead of…I want good grades.
Reaching your goals
Second, set goals
3. Check to see if your goal is
reasonable.
Example: I will run for president of my
class.
Instead of…I will run for president of the
United States.
Reaching your goals
Third, define objectives
1. Objectives are what you do to achieve
your goals.
2. Make a commitment. Use words like “I
will…” instead of “try” or “maybe.”
Reaching your goals
Objectives continued . . .
3. Make sure your objectives are
measurable and assess them regularly.
4. Every goal will have one or more
objectives.
Intrinsic Motivation
• WIFM
• What’s in it for me!
– Parents giving me a privilege or object
– Feeling happy at school
– Not being so anxious about _______
– Getting into college
– Improved grades
Reaching your goals
Objectives continued . . .
Goal: I want to get above an 80 in science class.
Objective: I will re-read my notes from class
everyday.
Objective: I will meet with my teacher once a
week after school.
Objective: I will raise my hand at least twice a
class period everyday.
Step Three
Creating a Learning Profile
Solution Focused Therapy
Three Tenets
• If it works do more of it
• If it does not work do less of it
• If it isn’t broken then don’t fix it
Scaling Questions
• On a scale of 1-10 how focused are you right
now?
• On a scale of 1-10 how motivated are you to
change how you take notes?
• Test anxiety
• Procrastination
• Worry
Your learning style
• Visual
• Auditory
• Kinesthetic
The Visual Learner
Characteristics
• Talk and move fast
• Neat, orderly, good
planners
• Use eye contact
• Strong, fast readers
• “I see what you mean.”
Suggestions
• Graphic organizers
• Give space when
speaking
• Provide big picture
• Use color
• Charts, tables
• PowerPoint, Smart Board
Tools: journaling, visualize, pictures, etc.
Auditory Learner
Characteristics
•
•
•
•
Talk in rhythm and eloquently
“Radar ears’
Great impersonators
“I hear what you are saying.”
Suggestions
• Ask clarifying
questions
• Give same directions
as written
• Repeat info
Tools: affirmations, self-talk, tape recorders, etc.
Kinesthetic Learner
Characteristics
Suggestions
• Talk slowly and
gesture.
• Move a lot
• Disorganized
• Always touching
something, can’t sit still
• Tactile
• “I feel like you…”
• Talk slower
• Use more motions when
speaking
• Give student/child
something to hold
• Give student/child tasks
involving motion.
Tools: Q-tip, squeeze ball, tactile media, take a walk, breathing,
somatic awareness, movement.
“How are you smart?”
Spatial (sculptor, pilot)
Linguistic (writer)
Interpersonal (teacher, salesman)
Musical (composer)
naturalistic (environmental scientist)
Bodily/kinesthetic (athlete, dancer)
Intrapersonal (accurate view of self)
Logical/mathematical (scientist)
What type of
thinker are you?
• Thinking styles vs. Learning styles
– Learning styles - perception
– Thinking styles – processing
• Many different types of thinkers
• Helps you relate to others better
• Helps you explain your ideas, thoughts,
and opinions better
Thinking Styles
• Structured
– Ordered, step by step, concrete
• Logical
– Concrete but less structured
• Flexible
– Feelings and emotions
• Exploratory
– Theory and thought
Thinking Styles
• How to maximize your style:
– Find someone who compliments your style
– Example: Structured pairs with flexible
Step 4
• Clinically Informed Tutoring™ in Practice
13 (1-1-1) Review Strategy
Long Term Memory
70%
Recall
3 months!
20%
Time
Recall
The Importance
of Breaks
0
1
2
Time (hr)
3
Time Quadrants
Not important
Important
Urgent
Not Urgent
“Necessity”
“Productivity and Focus”
The Procrastinator
The Prioritizer
(MANAGE)
(FOCUS)
Anxiety
Well-Being
“Deception”
“Waste & Excess”
The Yes Man
The Slacker
(MINIMIZE)
(AVOID)
Low Self-Esteem
Depression
Procrastination to Production
Counter-thought
Thought
1.
2.
“I have to.”
“I should.”
3.
4.
“I must finish.”
“This is so big.”
5.
“I must be perfect.”
6.
7.
“I don’t have time to _____.”
“I will never finish.”
1.
______________
1.
2.
3.
4.
5.
I choose to.
It would be better if…
When can I start?
I can take one small step.
I can be human.
6.
7.
I must make time to _____.
Every turn of the wheel is a step
closer.
______________
8.
Procrastination
Busters
1.
THE 5-MINUTE PLAN: Work 5 minutes at the thing you have been
putting off. After you have completed 5 minutes, schedule another 5
minutes, etc.
2.
T3 (The Tiny Task Technique): Break up a big task into smaller pieces.
Complete one piece at a time.
3.
WORST FIRST APPROACH: Jump in the deep end, get it over with!
4.
SELF-REWARD: Reward yourself with something pleasant when you’ve
finished any difficult task.
5.
COST-BENEFIT ANALYSIS: Make a list of all good things and bad things
that will happen if you stop procrastinating on an important task.
Triple Play (Study Preparation)
1.
Preview (“Recon”) - find out in advance
what is going on.
2.
Review (13)
3.
Self-Test
35
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