Reaching & Teaching
Children with AD/HD
ADHD Association 20th Anniversary Conference
Reykjavik, Iceland
26 September, 2008
11:00 – 12:00
Sandra Rief, Presenter
www.sandrarief.com
Think of one student/child...
What strategies might I use to ...?
Page 1
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
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)
Things to Keep in Mind
About AD/HD
Page 1
• Disorder in performance, output, and
production
• Approximately 30% developmental
delay (in self-control, inhibition and
executive functions)
Page 1
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
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 2
Common Misinterpretations of Behavior
• Poor social skills/judgment
(deliberate, poor parenting)
– difficulty noticing/interpreting social
cues, inhibiting responses,
skill/performance deficit
Our Perception...Our Reaction
Page 2
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
ATTENTION
2 min 30
2 min 30
Maintain Attention (Active) 2 min 04
Page 2
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
Key Elements for School Success
• Limiting amount of homework and
reducing written workload (as needed)
Key Elements for Success
Page 2
• Respecting & accommodating learning
style differences
• Adaptations and modifications according
to student needs
• Differentiated instruction
One Size Doesn’t Fit All
Page 2
Key Elements for Success
• Active learning
Kinesthetic – 53 sec
Key Elements for Success
Page 2
• Developing & bringing out student
strengths
• Belief in student…Doing what it takes
Page 3
Tertiary prevention
Intensive interventions
~ 5% Chronic/intense
Secondary prevention
Targeted interventions
~ 15 % At-risk
Primary prevention
Universal interventions
~80 %
Norm
www.pbis.org
Creating the Climate for
Success of ALL Students
Schedule/Routines/Rules
2 min 40
Page 3
Reverse the “praise deficit”: It
takes changing the interactions
3:1
(Minimally)
Page 3
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.”
Climate Class Short – Class + Reinforcement Systems
2 min 35
Page 3
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
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
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)
Physical Needs 53 sec.
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
Page 4
Environmental Accommodations
• Preferential Seating (location & alternatives to
chair)
Movin’ Sit Jr
www.theraproducts.com
Page 4
Environmental Accommodations
• Preferential Seating (location & alternatives to
chair)
• Standing work stations
• Office area/study carrel, 2-desks
• Adding structure and organization (e.g., colorcoding)
• Visual supports & prompts
Visual Cues
Page 4
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
Page 4
End of Day
Work turned in
All homework recorded in planner
Page 4
Papers in notebook
Pack all needed books and supplies
Page 5
Timer Uses
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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
Environment-beanbag (2 min 11 )
Individual Management Systems
Page 5
___________’S DAILY REPORT
handout
Page
5
GOAL__________
DATE __________
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Page 5
On time to class
Homework turned
In
Used class time
Productively
Followed class
rules (no more than
2 warnings
Page 5
With “Challenging” Kids
Page 6
• 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).
With “Challenging” Kids
Page 6
• Use “when…then” rather than “if you don’t…you
won’t.
• Use “what” questions rather than “why” questions.
•
•
•
•
What else could you try?
What would you like to happen next?
What was our agreement?
What are you risking by doing that?
With “Challenging” Kids
Page 6
• Acknowledge: “I can’t make you. But
remember your choices are either ___
or ___ . (Give 2 choices)
Go to 67 rdg or 72 org
“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.”
Page 6
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.
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
Page 6
During Reading
Comprehension Strategies
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Stopping at points to process text
Read-cover-retell
Make connections
Make predictions and inferences
Visualize
Ask questions
Stop and Process Activities
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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
Page 7
Reading Interventions
• Divide reading assignment into shorter
segments
• Use markers to block part of page
• Allow reading to self orally - whisperphone
Strategies for Organization, Time
Management, & Study Skills
Executive Function-Related
Classwork & Homework Challenges
Page 7
 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)
75 hw video or 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
Page 7
Organization & Homework Support
Required backpack and 3-ring
binder or alternative of accordion
file (pocket folder for K-2)

Homework Folder
• One colored folder in front of notebook
for all homework; or one homework
folder behind each subject tab
Page 7
Organization & Homework Support
Consistent use of planner/agenda/
calendar/assignment sheet
Page 8
Page 8
Organization & Homework Support
Color code: schedule, books,
notebooks, folders, unit sheets,
handouts
Organization & Homework Support
Page 8
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
Organization & Homework Support

Walk through recording of assignments
Recording Assignments
Page 8
Organization & Homework Support
Provide class syllabus and project
timelines
Chunking down long-range assignments
(interim due dates, monitoring, heads-up
to parents)
Page 8
Organization & Homework Support
Post all assignments, schedules,
materials needed, timelines
Page 8
Organization & Homework Support
Supervise for materials as leaving room, sign
monitoring form ticket out the room
Sign off & Long term (42 sec)
Page 8
Organization and Homework Support
School-wide supports: Supervised study
periods, homework labs, Learning
Strategies class
Page 8
Organization & Homework Support
Keep teacher copy of student planner
or assignment sheet filled out &
accessible.
Page 8
Organization & Homework Support
Teach students to use a “things to do”
list and other checklists
Page 9
Organization & Homework Support
Use a monitoring form to track and
communicate between home and
school.
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
Page 9
Organization & Homework Support
Be responsive to parent feedback
and frustration about homework
difficulties.
97 writing, 102 not fair, 103 journey
Page 9
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
Fine Motor/Handwriting
Page 9
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
100 math, 102 not fair, 103 journey
Page 9
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
Academic Interventions for
Math Weaknesses
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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
102 not fair, 103 journey
Not Fair
Page 9
• 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.
A Journey of Hope
Over the mountain Little
Train pulled...
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.
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.
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.”
Contact Sandra
www.sandrarief.com
Questions