ADHD_Intro

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Response to Intervention
‘Teaching the Tornado’: Strategies for Working With
the Disorganized, Inattentive, Overactive Student
Jim Wright
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Response to Intervention
ADHD Students Can Provide ‘Early
Warning’ in the Classroom About
Problems With Instruction…
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Response to Intervention
ADHD: Common Comorbid
Disorders (40-60% Affected)
ADHD
Mood
Disorders
(18%)
Learning
Disabilities
20-30%
Oppositional
Defiant Disorder
30-50%
Conduct
Disorder
20-40%
Sources:
Strock, M. (2003) . Attention Deficit Hyperactivity Disorder.
National Institute of Mental Health; American Academy of Pediatrics Website: http://www.aap.org/
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Response to Intervention
ADHD: Impact on Students
• The student’s ADHD symptoms may differ across settings
and situations. On tasks or situations that demand impulse
control and focused attention, ADHD symptoms are most
likely to appear.
Source: Strock, M. (2003) . Attention Deficit Hyperactivity Disorder. National Institute of Mental
Health (NIMH)
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Response to Intervention
ADHD: Impact on Students
Teachers may misjudge the ADHD student’s
• inattention as willful ignoring of adults (inattention) or
daydreaming
• impulsive behavior as purposeful ‘acting out’ or
attention-seeking.
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Response to Intervention
Domains of ADHD
Attention/Focus
Lower Than Age-Peers
Age Appropriate
Impulse Control
Lower Than Age-Peers
Age Appropriate
Level of Activity/Motor Behaviors
Higher Than Age-Peers
Age Appropriate
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Response to Intervention
Example: Two Students Identified
With ADHD
•
STUDENT A-Angela: Quiet student. Not a behavior
problem. Said by her teacher to be ‘lost in a fog’ most
of the time. Has low grades.
(Inattentive Type)
•
STUDENT B-Benny: Is always the center of attention.
Will blurt out answers in class without raising his hand,
whether he knows the correct answer or not! Fidgets,
squirms, and taps his pencil loud enough to distract
students around him. When the teacher assesses
Kenny one-on-one, he shows that he can do gradelevel work. (Hyperactive-Impulsive Type)
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Response to Intervention
A
Domains of ADHD
Attention/Focus
Lower Than Age-Peers
B
B
Impulse Control
Lower Than Age-Peers
B
Age Appropriate
A
Age Appropriate
A
Level of Activity/Motor Behaviors
Higher Than Age-Peers
Age Appropriate
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Response to Intervention
ADHD & Medication (cont.)
• Stimulant medication can be very effective but does
not typically result in ‘fully normal behavior’ (e.g.,
only 38% of children in one large stimulant study
had behaviors in typical range after one year)
Source: American Academy of Pediatrics (2001) Clinical Practice Guideline: Treatment of the
school-age child with Attention-Deficit/Hyperactivity Disorder
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Response to Intervention
ADHD: Appropriate Target Outcomes
• Improvements in relationships with parents,
siblings, teachers, and peers
• Decreased disruptive behaviors
• Improved academic performance (volume of work,
efficiency, completion, accuracy)
• Increased independence in self-care or homework
• Enhanced safety in the community, such as riding
bicycles
Source: American Academy of Pediatrics (2001) Clinical Practice Guideline: Treatment of the
school-age child with Attention-Deficit/Hyperactivity Disorder
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Response to Intervention
ADHD: A Developmental Explanation?
“In youth with attention deficit hyperactivity disorder
(ADHD), the brain matures in a normal pattern but is delayed
three years in some regions, on average, compared to youth
without the disorder, an imaging study by researchers at the
National Institutes of Health’s (NIH) National Institute of Mental
Health (NIMH) has revealed. The delay in ADHD was most
prominent in regions at the front of the brain’s outer mantle
(cortex), important for the ability to control thinking, attention and
planning. Otherwise, both groups showed a similar back-to-front
wave of brain maturation with different areas peaking in
thickness at different times.”
Source: National Association of Special Education Teachers. (13 November 2007). Brain Matures a Few Years Late in
ADHD, But Follows Normal Pattern. Retrieved on January 15, 2008, from:
http://www.naset.org/807.0.html?&tx_ttnews%5Btt_news%5D=2410&cHash=b9289c6fb9
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Response to Intervention
‘Extinguishing the Blaze’: Avoiding
Power Struggles and Helping
Students to Keep Their Cool
Jim Wright
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Response to Intervention
‘Extinguishing the Blaze’: Teacher Tips…
While you can never predict what behaviors your students
might bring into your classroom, you will usually achieve
the best outcomes by remaining calm, following preplanned intervention strategies for misbehavior, and acting
with consistency and fairness when intervening with or
disciplining students.
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Response to Intervention
‘Extinguishing the Blaze’: Selected Ideas…
Allow the Student a 'Cool-Down' Break (Long, Morse, &
Newman, 1980). Select a corner of the room (or area outside the
classroom with adult supervision) where the target student can
take a brief 'respite break' whenever he or she feels angry or
upset. Be sure to make cool-down breaks available to all students
in the classroom, to avoid singling out only those children with
anger-control issues. Whenever a student becomes upset and
defiant, offer to talk the situation over with that student once he or
she has calmed down and then direct the student to the cooldown corner. (E.g., "Thomas, I want to talk with you about what is
upsetting you, but first you need to calm down. Take five minutes
in the cool-down corner and then come over to my desk so we
can talk.")
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Response to Intervention
‘Extinguishing the Blaze’: Selected Ideas…
Ask Open-Ended Questions (Lanceley, 2001). If a teacher who
is faced with a confrontational student does not know what
triggered that student’s defiant response, the instructor can ask
neutral, open-ended questions to collect more information before
responding. You can pose ‘who’, ‘what’, ‘where’, ‘when’, and ‘how’
questions to more fully understand the problem situation and
identify possible solutions. Some sample questions are "What do
you think made you angry when you were talking with Billy?" and
"Where were you when you realized that you had misplaced your
science book?" One caution: Avoid asking ‘why"’questions (e.g.,
"Why did you get into that fight with Jerry?") because they can
imply that you are blaming the student.
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Response to Intervention
‘Extinguishing the Blaze’: Selected Ideas…
Have the Student Participate in Creating a Behavior Plan
(Walker, Colvin, & Ramsey, 1995). Students can feel a greater
sense of ownership when they are invited to contribute to their
behavior management plan. Students also tend to know better
than anyone else what triggers will set off their problem behaviors
and what strategies they find most effective in calming
themselves and avoiding conflicts or other behavioral problems.
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Response to Intervention
‘Extinguishing the Blaze’: Selected Ideas…
Keep Responses Calm, Brief, and Businesslike (Mayer, 2000;
Sprick, Borgmeier, & Nolet, 2002). Because teacher sarcasm or
lengthy negative reprimands can trigger defiant student behavior,
instructors should respond to the student in a 'neutral', businesslike, calm voice. Also, keep responses brief when addressing the
non-compliant student. Short teacher responses give the defiant
student less control over the interaction and can also prevent
instructors from inadvertently 'rewarding' misbehaving students
with lots of negative adult attention.
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Response to Intervention
‘Extinguishing the Blaze’: Selected Ideas…
Listen Actively (Lanceley, 1999; Long, Morse, & Newman,
1980). The teacher demonstrates a sincere desire to understand
a student’s concerns when he or she actively listens to and then
summarizes those concerns--that is, summing up the crucial
points of that concern (paraphrasing) in his or her own words.
Examples of paraphrase comments include 'Let me be sure that I
understand you correctly…', 'Are you telling me that…?', 'It
sounds to me like these are your concerns:…' When teachers
engage in 'active listening' by using paraphrasing, they
demonstrate a respect for the student's point of view and can also
improve their own understanding of the student's problem.
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Response to Intervention
‘Extinguishing the Blaze’: Selected Ideas…
Offer the Student a Face-Saving Out (Thompson & Jenkins,
1993). Try this face-saving de-escalation tactic: Ask the defiant
student, “What can we work out together so that you can stay in
the classroom and be successful?" Such a statement treats the
student with dignity, models negotiation as a positive means for
resolving conflict, and demonstrates that the instructor wants to
keep the student in the classroom.
NOTE: Be prepared for the possibility that the student will initially
give a sarcastic or unrealistic response (e.g., "Yeah, you can
leave me alone and stop trying to get me to do classwork!").
Ignore such attempts to hook you into a power struggle and
simply repeat the question.
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Response to Intervention
‘Extinguishing the Blaze’: Selected Ideas…
Proactively Interrupt the Student’s Anger Early in the
Escalation Cycle (Long, Morse, & Newman, 1980; Walker,
Colvin, & Ramsey, 1995). The teacher may be able to ‘interrupt’ a
student’s escalating behaviors by redirecting that student's
attention or temporarily removing the student from the setting. For
low-level defiant or non-compliant behaviors, you might try
engaging the student in a high-interest activity such as playing
play an educational computer game or acting as a classroom
helper. Or you may want to briefly remove the student from the
room ('antiseptic bounce') to calm the student. For example, you
might send the student to the main office on an errand, with the
expectation that-by the time the child returns to the classroom-he
or she will have calmed down.
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Response to Intervention
‘Extinguishing the Blaze’: Selected Ideas…
Relax Before Responding (Braithwaite, 2001). Educators can
maintain self-control during a tense classroom situation by using
a brief, simple stress-reduction technique before responding to a
student’s provocative remark or behavior. When provoked, for
example, take a deeper-than-normal breath and release it slowly,
or mentally count to 10. As an added benefit, this strategy of
conscious relaxation allows the educator an additional moment to
think through an appropriate response--rather than simply
reacting to the student's behavior.
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Response to Intervention
Response-Cost Lottery
(Witt & Elliott, 1982)
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Response to Intervention
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Response to Intervention
Response-Cost Lottery:Ideal for…
teachers seeking an affordable, motivating
student reward system that can be used
with individuals or groups of students
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Response to Intervention
Response-Cost Lottery: Steps
1.
2.
3.
4.
5.
Develop reward menu
Select 1-3 target behaviors
Decide on time period for Lottery
Introduce student(s) to game
Assign students tickets at the outset of
each period
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Response to Intervention
Response-Cost Lottery: Steps
6. Deduct a ticket for each negative student
behaviors
7. At the end of the period, toss all tickets
the student retains into the lottery jar
8. Hold periodic drawings for prizes or
reward menu choices
9. After each drawing, start over with ticket
collection
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Response to Intervention
Response-Cost Lottery
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Response to Intervention
Response-Cost Lottery
Tommy
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Response to Intervention
Mystery Motivator
(Rhode, Jenson, & Reavis, 1992)
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Response to Intervention
Mystery Motivator: Steps
1.
2.
3.
4.
Develop reward menu
Select 1-3 target behaviors
Decide on time period for MM
Decide on level of student compliance
needed to access chart
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Response to Intervention
Mystery Motivator: Steps (Cont.)
1. Prepare MM chart
A. Determine how frequently the student will
find the ‘secret’ sign (e.g., starting at 3 times
per week)
B. Randomly assign secret sign to days on
chart with ‘invisible’ ink
C. Decide on number of bonus points to write
into bonus box
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Response to Intervention
9/23-9/30
Frank Smith
Complete classwork
Follow teacher requests promptly
Speak with permission
M
MM 4
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Response to Intervention
Mystery Motivator: Troubleshooting
The student cheats
•
Suspend temporarily from ‘game’
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