Focusing On Success: Teaching Students With Attention Deficit/Hyperactivity Disorder
Focusing On Success: Teaching Students With Attention Deficit/Hyperactivity Disorder
Focusing On Success: Teaching Students With Attention Deficit/Hyperactivity Disorder
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Focusing on Success
Teaching Students with Attention Deficit/Hyperactivity Disorder
For further information, contact: Learning and Teaching Resources Branch 8th Floor, 44 Capital Boulevard 10044 108 Street NW Edmonton, Alberta T5J 5E6 Telephone: 7804272984 in Edmonton or toll-free in Alberta by dialing 3100000 Fax: 7804220576
A PDF version of this resource is available on the Alberta Education Web site at www.education.gov.ab.ca/k_12/ specialneeds/resource.asp. Copies of this resource can be purchased from the Learning Resources Centre. Order online at www.lrc.education.gov.ab.ca/ or telephone 7804272767.
The primary audience for this document is: Teachers Administrators Students Parents 9
Copyright 2006, the Crown in Right of Alberta, as represented by the Minister of Education. Alberta Education, Learning and Teaching Resources Branch, 10044 108 Street NW, Edmonton, Alberta, Canada, T5J 5E6. Every effort has been made to provide proper acknowledgement of original sources. If you identify errors or omissions, please notify Alberta Education so we can take appropriate action. Permission is given by the copyright owner to reproduce this document, or any part thereof, for educational purposes and on a nonprofit basis, with the exception of materials cited for which Alberta Education does not own copyright.
Table of Contents
PAGE Acknowledgements Chapter 1 Chapter 2 Chapter 3 Chapter 4 Chapter 5 Chapter 6 Chapter 7 Chapter 8 Appendix A Appendix B Bibliography Index Understanding AD/HD Building Home-School Partnerships Understanding Approaches to Managing AD/HD Creating Supportive Classroom Environments Choosing Instructional Strategies Building Connections and Creating Hope Moving to Independence Keeping Informed Sample Tools Recommended Books
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Acknowledgements
The development of this resource was a collaborative project between Calgary Learning Centre and Alberta Education. The contributions of the following individuals are gratefully acknowledged.
Principal writers
Calgary Learning Centre Anne Price, Ph.D., R. Psych. Shawn Crawford, Ph.D., R. Psych. Johanne Tottle, Ph.D., R. Psych. Susan Maunula, M.Sc., R. Psych.
Contributing writers
Mara Biasotto, M.Sc., R. Psych. Mary Cole, B.Ed., Dip. Ed. Psych. Marya Jarvey, B.Ed., M.Sc.
Reviewers
Paul Arnold-Schutta, M.A., R. Psych. Cameron Buchanan, M.Ed., Consultant, Edmonton Public Schools Sandra Clarren, Ph.D., Educational Psychologist, Vancouver, B.C. Lorrie Goegan, Past President, Learning Disabilities Association of Alberta Marliss Meyer, Ph.D., R. Psych. Dwaine Souveny, M.Sc., R. Psych., Dynamic Networks Psychological Services
Editor/Indexer
Judy Dunlop
Design
Shane Chen, Graphic Connections
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Acknowledgements
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Understanding AD/HD
For many people, AD[/H]D is not a disorder but a trait, a way of being in the world. When it impairs their lives, then it becomes a disorder. But once they learn to manage its disorderly aspects, they can take full advantage of the many talents and gifts embedded in this sparkling kind of mind. Hallowell and Ratey 2005, p. 4
Attention Deficit/Hyperactivity Disorder (AD/HD) is one of the most widely researched conditions of both childhood and adulthood. This research has increased awareness and understanding, but also created a media explosion of information, misinformation and conflicting opinions. The research in this area is both optimistic and hopeful. Edward M. Hallowell says that AD/HD is a misleading name for an intriguing kind of mind and that it is more useful to view it simply as a name for a collection of symptoms, some positive, some negative (Hallowell and Ratey 2005, p. 4). Inspired by Hallowell and other individuals who are both living with AD/HD and working with individuals with AD/HD, this resource offers practical information and sample strategies that teachers can use to help students with AD/HD manage learning so that school is a successful and satisfying experience for them and their families.
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1
MYTH
Understanding AD/HD
What is AD/HD?
AD/HD is not a real condition.
FACT AD/HD is a neurobiological condition characterized by differences in brain functioning that affect behaviour, thoughts and emotions.
Attention Deficit/Hyperactivity Disorder (AD/HD) is a neurobiological condition that can cause inattention, hyperactivity and/or impulsivity, along with a number of related difficulties, inappropriate for an individuals age.
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Understanding AD/HD
Characteristics of inattention, hyperactivity and impulsivity in the classroom include difficulties in: keeping track of personal belongings and school supplies getting started on tasks sitting still and focusing attention on the task at hand regulating attention to tasks and to people organizing or following through on instructions, assignments and classroom duties organizing and managing time planning for and completing written assignments (both short-term and longterm) working independently (e.g., completing paper-and-pencil tasks at desk) self-monitoring maintaining consistent quality and quantity of work from day to day, and at different times in the same day participating in classroom discussions (e.g., waiting turns, staying on topic, listening to others) dealing with change and transitions, including moving from one activity to the next during the school day and moving from grade to grade or from school to school.
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1
MYTH
Understanding AD/HD
FACT
AD/HD is found in boys and girls in all cultures around the world and is not specific to socioeconomic status.
Current statistics suggest that AD/HD is a fairly common disorder and that 4 to 12 percent3 of North American school-aged children are affected by AD/HD. Problems with AD/HD continue into adulthood. It occurs in both males and females, although according to the most recent research, there are a number of common gender differences.
Nearly 50 percent4 of all children with AD/HDmostly boystend to also be diagnosed with oppositional defiant disorder, but these disorders exist as two distinct conditions. Girls are more prone to inattentive type AD/HD, which is marked by disorganized and unfocused behaviour rather than the disruptive, impulsive conduct typically seen in boys. Girls with AD/HD tend to have higher rates of overall distress, anxiety and depression compared to boys with AD/HD.
MYTH
FACT
Boys are four to nine times more likely to be diagnosed; however, the disorder occurs in both boys and girls.4
Girls may find their AD/HD symptoms are intensified by monthly hormonal fluctuations.
3. 4.
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Understanding AD/HD
Inattention losing or forgetting things poor listening (e.g., frequently appearing to tune out) difficulty following instructions tendency to miss important details tendency to rush through tasks and make careless errors difficulty staying on task and completing assignments difficulty with short-term memory and recall organizational difficulties (e.g., keeping notebooks and supplies in order, planning for multi-step projects) problems with focusing and maintaining attention distractibility tendency to daydream (e.g., appearing lost in own world). Hyperactivity restless and always on the go (e.g., appears driven by a motor) squirming and fidgeting (e.g., finger tapping, foot tapping, knuckle cracking, rocking) difficulty staying seated or being quiet when required excessive talking. Impulsivity acting without planning or thinking first difficulty following rules and sequences of steps blurting out inappropriate remarks disturbing or interrupting others demonstrating impatience at inappropriate times (e.g., difficulty waiting in lines or taking turns) difficulty managing frustration and other emotions (e.g., getting angry or overreacting with little or no provocation) demonstrating unsafe behaviour difficulty considering consequences difficulty managing transitions from one activity to the next. Social-emotional difficulties Inattention, hyperactivity and impulsivity can also contribute to social-emotional difficulties such as: limited confidence in self as a learner limited success as a team player misinterpreting social cues emotionally overreacting difficulty managing anger.
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Understanding AD/HD
Executive functions A hallmark of AD/HD is impairment of higher level brain functions required to perform the following kinds of tasks: regulating alertness, sustaining effort, and processing information at consistent and appropriate speeds focusing and sustaining attention organizing and prioritizing tasks planning and using foresight self-monitoring and regulating actions remembering details and accessing short-term memory distinguishing essential from nonessential detail elaborating on single or basic points delaying gratification inhibiting behaviours managing frustration and other emotions evaluating information and own performances.
MYTH
FACT Currently, it appears that AD/HD may be overdiagnosed in some places but it is underdiagnosed in many others. There appears to be a few regions where an inordinate number of children are labelled as AD/HD but at the same time, there are many regions where medical doctors may not have the expertise to accurately diagnose this disorder. AD/HD is not a particular belief: it is a medical diagnosis derived from solid evidence and research.
A key to the successful management of AD/HD is a comprehensive assessment and accurate medical diagnosis. Children with AD/HD exhibit a range of behaviours and levels of severity. Individuals with AD/HD may be predominantly inattentive, predominantly hyperactive/impulsive or a combination of both. To warrant a diagnosis of AD/HD, the behaviours must: be exhibited to an abnormal degree for the childs age or developmental stage have been present to some extent prior to age seven have been present for at least six months have a negative impact on the childs ability to experience academic and/or social success be present in multiple settings.5
5.
Adapted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, (Copyright 2000), pp. 92, 93. American Psychiatric Association.
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Understanding AD/HD
The student who is brighter-than-average may be able to successfully compensate for many of the symptoms of AD/HD and may not be diagnosed until later in life when circumstances and/or expectations change. Many of the characteristics, or symptoms, of AD/HD are present for all of us at some times and under some circumstances. The diagnostic process involves gathering information to determine the intensity, duration and pervasiveness of the symptoms and their negative impact on the life of an individual. As the behavioural characteristics of AD/HD can be a result of other disorders, a thorough assessment by a qualified professional is essential in order to rule out other disorders and make a differential diagnosis. Currently, there is no valid test for AD/HD. No specific physical or neurological findings can definitively establish the diagnosis through procedures such as blood tests, brain scans or EEG (brainwave recording). The diagnosis of AD/HD is made by gathering information from the child, parents, teachers and others, combined with direct observation and information from other sources. Neuropsychological performance assessments are often used to augment information collected from interviews, behavioural checklists and observations. The Canadian Attention Deficit Hyperactivity Disorder Resource Alliance (CADDRA) strongly recommends that an assessment of AD/HD include evidence directly obtained from parents and teachers who may be able to provide information on age of onset, duration of symptoms, variation of symptoms in different settings, coexisting conditions, and degree of functional impairment.
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Understanding AD/HD
Elementary school years Teachers and parents may have concerns about a childs underachievement, poor productivity, inefficient approach to tasks and behaviour difficulties. For example, the child may seem to have sufficient skills, but has significant difficulty starting and completing assigned work. The child may socialize at inappropriate times, and be disorganized with materials and assignments. There are often concerns about peer relationships, particularly finding and keeping friends. At home, parent-child conflicts may arise over follow-through of chores such as keeping his or her room tidy. Junior and senior high school years Students referred during these years may have been able to cope with the demands of elementary school with support from home and school. There may have been some difficulties from earlier years, but the student was not disruptive and managed to keep up with school demands. Now, there are increases in the expectation for greater independence and in the need to juggle multiple demands. The volume of work, particularly of written output, increases and the student struggles. Particular difficulties include dealing with deadlines, coping with complex assignments and handling new social situations. Adult years Adults may seek an explanation for their many years of struggle. They may be experiencing challenges in their personal relationships, post-secondary education and the workplace.
Assessment process
MYTH
All children with AD/HD have behavioural problems.
FACT
Although approximately 50 percent of children with AD/HD develop behaviour difficulties, 50 percent do not demonstrate significant problems with behaviour.
Usually referrals go beyond an investigation of AD/HD and consider additional difficulties, such as underachievement or behaviour problems. There are many potential reasons why students may experience difficulties with inattention, hyperactivity and impulsivityAD/HD is not always the explanation. Coexisting conditions that can result in behaviours similar to the symptoms of AD/HD may include:
underachievement at school due to learning disabilities attention lapses caused by petit mal seizures middle ear infections that cause intermittent hearing problems disruptive or unresponsive behaviour due to anxiety or depression school work that is too hard or too easy insufficient sleep on an ongoing basis
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Understanding AD/HD
poor nutrition significant personal or family disruption situations of abuse or neglect drug and alcohol use medical, neurological or psychiatric conditions (e.g., hyperthyroid, allergies, diabetes, fetal alcohol spectrum disorder, bipolar disorder).
Physicians (including family doctors, pediatricians, neurologists and psychiatrists), psychologists and clinical social workers who have relevant training and experience in the assessment of AD/HD are qualified to make this medical diagnosis. However, a multidisciplinary team approach is preferred because of the complex nature of the disorder, the high probability of coexisting conditions and the potential for multiple causes of AD/HD symptoms. A thorough assessment of AD/HD will include interviews, observations, rating scales and psychoeducational testing. Interviews Interviews are the core of an AD/HD assessment. Parents are interviewed to develop a picture of the childs development and current functioning. Birth history, developmental history, medical history, educational history and family history are all important to determine the severity, frequency, duration and pervasiveness of the childs difficulties. Medical history is also important to rule out vision, hearing and other medical problems that may account for the difficulties. The child or teen is interviewed to obtain his or her perspective. Teachers also may be interviewed to provide a picture of past and present learning difficulties and related behaviours. Observations Observing the childs behaviour in various settings, including school, home and social situations, is very valuable for determining the range and severity of AD/HD symptoms. How the child responds and participates in classroom settings is particularly important. In addition, observations during interviews and assessments can provide valuable insight into how the child responds to certain situational demands (e.g., answering questions, engaging in conversation, sharing personal information, performing academic or other tasks requiring sustained mental effort). Teacher comments on report cards can also provide valuable observations over the years. Rating scales Rating scales provide a structured method for comparing a childs behaviour to that of same age peers. Commonly used rating scales include questionnaires for parents and teachers, and student self-reports. AD/HD-specific rating scales allow for a more in-depth analysis of specific behaviours related to problems with inattention, impulsivity and hyperactivity.
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Understanding AD/HD
Psychoeducational assessments Many other disorders frequently coexist with AD/HD. Additional assessment information can be helpful in determining whether or not AD/HD-type symptoms are the product of another disorder. Diagnostic tests such as cognitive assessments, academic achievement tests or depression inventories may be used for the assessment of other coexisting conditions such as learning disabilities, depression or anxiety. Academic achievement information is also valuable in understanding the impact of AD/HD symptoms on learning and school performance. During the assessment, psychologists also take opportunities to observe directly the students approach to tasks.
Making a diagnosis
In North America, diagnosticians are guided by the criteria for AD/HD outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). These guidelines are not intended to be used in isolation to diagnose AD/HD but to provide a common language and set of standards. Although the terms Attention Deficit Disorder (ADD) and ADD without hyperactivity are used frequently, the following DSM-IV terminology for three subtypes of AD/HD is recommended.6 AD/HDpredominantly inattentive type This subtype includes six or more symptoms of inattention (but fewer than six symptoms of hyperactivity-impulsivity) that have persisted for at least six months. AD/HDpredominantly hyperactive-impulsive type This subtype includes six or more symptoms of hyperactivity-impulsivity (but fewer than six symptoms of inattention) that have persisted for at least six months.
MYTH
FACT
A person with AD/HD may not necessarily demonstrate hyperactivity. In fact, some individuals with AD/HDpredominantly inattentive type may appear to lack energy, and seem quiet and reserved.
AD/HDcombined type The most common form of the disorder, this subtype includes six or more symptoms of inattention and six or more symptoms of hyperactivity-impulsivity that have persisted for at least six months.
6.
Adapted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, (Copyright 2000), p. 87. American Psychiatric Association.
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Understanding AD/HD
The information gathered through interviews, observations, rating scales and psychoeducational testing is reviewed to establish whether the onset, severity and pervasiveness of the symptoms meet the DSM-IV criteria for AD/HD, and to rule out other medical, psychological or environmental factors that might be primary causes of the childs current difficulties. A diagnosis also includes identification of the subtype, either predominantly inattentive, predominantly hyperactive-impulsive or combined type. Additionally, assessment information can be used to inform treatment and educational planning. FYI The Canadian Attention Deficit Hyperactivity Disorder Resource Alliance (CADDRA) has recently published Canadian ADHD Practice Guidelines (2006) for physicians. For more information, visit www.caddra.ca/english/phys_guide.html.
* 45% of adolescents with AD/HD have a conduct disorder. ** 60% of individuals with Tourettes syndrome also have AD/HD.
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Understanding AD/HD
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Understanding AD/HD
Avoid language that implies a diagnosis or labelling of the student as having AD/HD. Introduce the possibility of an assessment for AD/HD by describing the students difficulties, exploring the presence of such behaviours in the home setting. Consider the following types of statements to use in communicating with parents. We are seeing some behaviours in the classroom that seem to be interfering with your childs learning. For example Do you see similar kinds of difficulties at home? These kinds of difficulties can have a physiological cause. Have you considered sharing these concerns with your family doctor, pediatrician or a registered psychologist? When meeting with parents, refrain from recommending or discussing medication. If parents want to discuss the issue of medication, suggest they share their concerns with medical professionals. Provide parents with details about the supports and strategies that will be provided at school, regardless of the parents decision about pursuing an outside assessment and treatment options.
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1
FYI
Understanding AD/HD
For more information on Alberta Educations special education coding criteria, visit www.education.gov.ab.ca/k_12/specialneeds/. An Individualized Program Plan (IPP) is mandatory for any student with special education needs who is identified and coded using the Alberta Education special education coding criteria. The IPP must include: specialized assessment results current level of performance identification of strengths and areas of need measurable goals and objectives procedures for evaluating progress related to IPP goals identification of coordinated services medical information classroom accommodations plans for transition review of progress year-end summary parent signature.
Often, in addition to academic goals, one or more of the IPP goals for students with AD/HD will focus on such areas as applying strategies to improve organizational skills, self-monitoring and/or self-advocacy skills. All goals should involve skills or behaviours that will ultimately improve learning opportunities for that student.
FYI
For more information on the IPP process, see Alberta Educations Individualized Program Planning (2006), Book 3 of the Programming for Students with Special Needs series at www.education.gov.ab.ca/k_12/specialneeds/ipp.asp.
A-1
For a sample IPP that illustrates goals that may be appropriate for a student with AD/HD, see Appendix A-1.
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Understanding AD/HD
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Building Home-School Partnerships
When parents, teachers, students and others view one another as partners in education, a caring community forms around students Epstein et al. 2002, p. 7
Parents and teachers have important roles in supporting students with AD/HD. How well a child with AD/HD does throughout life is best predicted by: parents use of effective parenting skills positive relationships with other children success in school. Research supports the importance of a collaborative approach in which parents, teachers, psychologists and medical professionals work together to address the childs AD/HD. Effective collaboration and communication promotes consistency and support across the major settings in a childs life. With consistency and support, children with AD/HD can be successful and move into adolescence and adulthood with skills and a positive sense of self.
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provide teacher assistants with directions regarding specific strategies for supporting the student with AD/HD monitor responses to various approaches and strategies communicate regularly with parents offer support and strategies to parents observe, document and report areas of strengths and behaviours of concern encourage medical investigation but refrain from offering advice or opinions on medical diagnosis or medication. Teacher assistants can: provide supportive and complementary services in the classroom to enhance the learning experiences of students provide academic and behavioural support by reinforcing appropriate skills and behaviours, consistent with the teachers expectations and directions. Psychologists can: gather information from teachers, parents, students, student records and other school staff such as family liaison workers observe the child in the classroom, when possible, to determine teachers expectations and students responses collaborate with school personnel regarding strategies and programming conduct individual assessments to determine how the student approaches tasks or to rule out other disorders or explanations make a diagnosis based on all information offer findings and recommendations to parents and school staff offer information for monitoring of medication trials and evaluation of strategies consult on an Individualized Program Plan (IPP), if needed provide parents with information about community support including referrals for treating and managing coexisting conditions.
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Physicians can: be part of a diagnostic team in a clinic setting gather information from parents and, with parent permission, from school staff rule out or take into consideration other medical factors make a diagnosis based on all information discuss potential approaches, including medications, with parents and child recommend resources for further reading provide frequent patient contact during early treatment stage and medication trials provide contact with school staff during medication trials or while evaluating effectiveness of strategies.
Home-school partnerships
Recognize that some parents may be uncomfortable meeting with teachers, particularly if this is their first meeting. In challenging or difficult situations, parents care and concern for their child might show up as tension, anxiety or frustration. Its important to remain nonjudgemental and to avoid making assumptions because the parents presenting behaviours might not necessarily reflect how they truly feel or how they are actually coping. Keep in mind that most parents do not have a background in education and some have little or no experience in working with schools. There may also be emotional barriers and other issues that get in the way of creating an atmosphere of collaboration. Factors may include: parents who struggled at school themselves. They may find it uncomfortable to work in partnership with teachers a sense of guilt that they are in some way responsible for their childs difficulties. Some families may still be struggling with feelings of loss and grief as they try to come to terms with their childs AD/HD and the resulting behaviours and learning difficulties family situations that make participating in their childs education a challenge, such as shift work, language barriers or families that are dealing with more than one child with attention difficulties cultural beliefs that school and home are separate trust issues. It takes time to develop a level of trust where parents feel comfortable talking about their child
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a lack of confidence in the schools ability to provide adequate support for students with attention difficulties denial. Some parents find it difficult to believe that their child has different needs than other children, particularly those students whose main difficulties are academic. These children may not experience the same degree of difficulty outside of the school environment. Taking time at the onset to provide information and clarify expectations will foster a sense of openness and partnership with parents. As parents become more comfortable collaborating with their childs teachers, they will more readily share information and perspectives that can be used to enhance their childs learning. As partners in supporting students with AD/HD, teachers need to collaborate with parents. These students have complex learning needs and a team approach will go a long way to addressing these needs.
SAMPLE STRATEGIES
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Are there new supports in place for the child such as a tutor or time spent with a mentor or older student? Has there been a change in medication or dosage? Encourage parents to create a list of questions they want answered during the meeting. Arrange chairs and tables to establish an atmosphere of collaboration. Use chart paper and markers to record notes and decisions made during the meeting, and review the decisions at the end of the meeting. Value the information that parents share, and allow adequate time within meetings for thoughtful reflection and discussion.
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Describe rather than label, for example: Shane tends to call out answers, sometimes before the question has been asked. He has lots of ideas and tends to interrupt the other children before they have a chance to speak. Be nonjudgemental. The behaviours that you are describing are not bad, but they interfere with learning. This is particularly important because many parents of children with AD/HD have characteristics that are similar to those of their children; i.e., they may tend to be forgetful, miss parts of conversations and interrupt when others are speaking. Clarify the reasons for your concerns. While a particular behaviour may not seem unusual or problematic outside the school, it may create a difficulty for the student or others within the school setting. This distinction is important in establishing behavioural goals.
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Communicate with parents on a regular basis to keep them informed about their childs positive and negative behaviour and progress. Discuss interventions that work well at school and can be adapted for home such as strategies for deflecting and absorbing Yes, but arguments. Some techniques can reduce the likelihood of adults becoming engaged in no-win arguments with a child who is resistant. For example: When a student tries to debate a request such as Its time to put away the math blocks, the adult can resist engaging in an argument by matter-of-factly stating, Regardless, it is time to put away the math blocks. Additional protests can be responded to with a firm Nevertheless, its time to put the blocks away. Use strategies in the classroom that parents have found to be successful at home. Encourage a consistent approach at home and at school in responding to students behaviour. Encourage parents to set up an appropriate study space at home and to equip it with essential materials. Encourage parents to establish routines for studying, for review of completed homework, and for periodic checks of notebooks and bookbags.
Communicate respect
Be sensitive to the challenges of parenting a child or teen with AD/HD and the concerns of the family. Parents of children with AD/HD often feel a range of emotions about their childs difficulties such as denial, frustration, worry, embarrassment, anger and even despair. Provide a positive perspective on individual differences and unique challenges. Develop rapport with the student to enhance the students willingness to change and develop improved work habits or more appropriate responses to situations. Acknowledge the potential for growth and improvement in addition to concerns and problems.
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Be sensitive to the possibility that a parent may have some characteristics of AD/HD and that this may cause some additional stress at home.
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encourage independence. The focus should be first on assisting children to start on homework, and then on being available to provide encouragement. Children also might need help breaking down difficult tasks or clarifying directions. If the child uses accommodations at school, encourage parents to provide them at home (e.g., use of a computer or spellchecker, help with unfamiliar words, etc.) let the teacher know if the homework is too confusing or difficult for the child to do or if it is taking too long (e.g., more than one hour a night at the grades 46 level). If homework completion becomes an issue, work with students and their parents to come up with alternate solutions.
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2
A-2
See Appendix A-2 for more information on solution-focused meetings, including a sample meeting planner.
FYI
FYI
FYI
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Understanding Approaches to Managing AD/HD
Most health professionals who treat AD/HD believe multimodal treatment is the best treatment. Multimodal treatment includes medications, behavioral therapy, school [supports], and education of children and families about the disorder
Children and Adults with Attention-Deficit/
There is no way to cure AD/HD, but with an appropriate, comprehensive approach, the symptoms can be effectively managed and individuals with AD/HD can lead successful and satisfying lives. Parents, physicians, psychologists, health-care providers and teachers all have roles to play in supporting students in the management of their AD/HD. There is no single approach that is best for all people with AD/HD. A comprehensive approach (also known as multimodal treatment) is generally the most effective. A comprehensive approach combines some or all of the following elements, tailored to the specific unique needs of each child and family: appropriate diagnosis and family understanding of the disorder medical interventions/pharmacological treatment behavioural interventions psychological interventions educational supports.
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3
MYTH
When AD/HD is left unidentified or untreated, an individual is at greater risk for difficulties in the future, including: impaired learning ability dropping out of school social problems relationship difficulties substance abuse career difficulties legal and financial problems.
FACT
In 1999, a large study compared medication, behaviour therapy and a combination of both. All groups improved but medication, when carefully monitored, was more effective than behaviour therapy alone and its effects were similar to combination therapy. The combined approach, however, allowed lower doses of medication and also improved academic performance and family relationships. In addition, it was more helpful for children who also had oppositional defiant disorder or mood disorders such as depression or anxiety.
Medication and behaviour interventions are evidence-based treatment approaches that have been subjected to rigourous research or trial and their positive effects in treating the symptoms of AD/HD have been validated. Key components of a comprehensive approach are described below, followed by a discussion of alternative treatments for AD/HD. Educational supports and strategies are discussed in Chapters 4 and 5.
Appropriate diagnosis
A comprehensive treatment plan begins with an accurate medical diagnosis that specifies the type and severity of the AD/HD. A diagnosis also rules out other conditions that have similar characteristics and clearly identifies any coexisting conditions such as learning disabilities or depression. An appropriate diagnosis will contribute to family understanding of the condition and how to better manage it.
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SAMPLE STRATEGIES
Medical interventions
Medication is one of the most common forms of treatment for individuals with AD/HD. Up-to-date and reliable research supports the effectiveness of medication in treating the symptoms of AD/HD. However, medication should not be used alone and should be part of a multimodal treatment approach. The decision to include medication as part of a treatment plan is made by the family after consultation with medical professionals. The decision is best made following a thorough discussion of various medications, how they work, possible impact and potential side effects along with the risks of not taking medication.
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Stimulants are most commonly prescribed. They have been found to be effective for 75 to 80 percent8 of children with AD/HD. Researchers believe that stimulants affect the production of neurotransmitters in the brain. The neurotransmitters are chemical agents at nerve endings that help electrical impulses travel among nerve cells. Medication stimulates the inefficient or sluggish parts of the brain making more neurotransmitters available. This stimulation helps to increase the childs capacity to pay attention, control impulses and reduce hyperactivity. Medication does not cure AD/HD; rather, medication lessens the symptoms of AD/HD so that the individual can function more effectively. One can think of the stimulants as waking a sleepy brain and helping it to function so that the individual is better able to focus. There are several stimulant medications currently available for use in Canada. A new nonstimulant medication for the treatment of AD/HD was developed recently. Stimulant medications range from short-acting (three to four hours) to long-acting (six to 12 hours). If individuals do not respond positively to one stimulant medication, they will often respond positively to another stimulant medication or to the new nonstimulant alternative.
FACT
Research indicates that individuals with untreated AD/HD are at greater risk to self-medicate with drugs and alcohol. Appropriate use of stimulant medication reduces this risk.
pay attention and stay focused initiate and complete tasks sustain mental effort and increase work production control impulses and emotions inhibit behaviours and regulate activity level. How is the optimal dosage determined? The specific dose and timing are determined on an individual basis. Dosage is not determined by height, weight or age. A trial phase should be conducted, usually beginning with a low dose that is gradually increased at three- to seven-day intervals. Observations by parents and teachers help to determine the dosage and timing that yield the greatest benefits.
8.
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MYTH
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Are there side effects? Common side effects of stimulants are reduction in appetite and difficulty sleeping. Some children experience a rebound period when the medication is wearing off. This is characterized by a brief period of negative mood, fatigue or increased activity. The side effects are usually managed by changing the dosage, timing or formulation (i.e., short-acting to long-acting medication). Will the medication have negative long-term effects? There are no known negative long-term effects. Stimulants have been studied for over 50 years and are considered safe and effective when correctly used and monitored. Are there changes in the effectiveness of medication with age? Changes are very individual. Some adolescents and adults continue to benefit from the same medication and dosage that worked for them as children while others may need higher or lower dosages. Current research indicates that the majority of children with AD/HD continue to experience symptoms in adolescence and adulthood. Medication treatment can be effective in improving the symptoms in adolescents and adults. Should medication be used outside of school hours? Families may choose to use medication outside of school to help their children be more successful in social settings, with peers, in extracurricular activities, at home and with homework. Medication may also be helpful with participation in organized sports, music lessons, summer camp, etc. The decision to use medication outside of school hours needs to be a joint decision between a childs parents and the family physician. Depending on the age of the child, he or she might also participate in this decision. What does the child need to know about his or her medication? Parents and physicians should be honest with children and provide a clear explanation of the purpose of the medication. Medication should be referred to as a tool to help the child with attention and focus difficulties, not as a vitamin or smart pill. Consider explaining medications by comparing them to eyeglasses: glasses are a tool to help people see better, medication is a tool to help people focus better. Emphasize that medication will not do the work for the child, but it can help the child be more successful in learning and using skills and strategies.
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Parents need to provide the medication in the original container with the prescription attached and the following information: written permission to administer the medication dosage intended purpose of the medication possible side effects storage information directions for administering.
Be sure that the medication is given on time. The timing is important to ensure that the student has the maximum benefit during school hours. Short-acting stimulants take about half an hour to take effect and the effects wear off in about four hours. Long-acting medications (generally administered at home) take up to one hour to take effect and the effects last for six to 12 hours. Set up a system for recording when the student takes medication. Monitor the use of medication and notify parents if the student frequently forgets or resists taking the medication on time at school. Respect the students privacy. Do not discuss medication in front of other students. Set up discreet reminders for the student to make sure that he or she goes to the designated place to take his or her medication on time. For example: Set up a consistent schedule and pair the medication time with a daily activity. Assist the student to use a beeper watch or watch alarm. Set up your own reminders, such as sticky notes in your schedule or plan book, or a watch reminder. Develop a private signal to remind the student. Monitor the childs response to medication by completing rating forms or checklists as required. Alert parents to changes in the childs behaviour and notify them of any new concerns. Discuss your observations with parents through written notes or meetings so that comprehensive feedback can be provided to the physician. Report possible side effects, such as nausea, loss of appetite, headaches or stomachaches. Information about present and past behaviour and academic performance can help physicians determine the best dosage, timing and type of medication.
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Behavioural interventions
It is more difficult to manage the behaviours of children with AD/HD compared to other children. However, research has shown that children with AD/HD generally respond to consistent behavioural intervention based on positive reinforcement. The basic approach, often referred to as behaviour modification, involves: identifying target behaviours to change identifying new skills and/or behaviours to be developed changing the antecedents (circumstances that occur before the target behaviours) consistently applying consequences (both positive and negative results that happen after the behaviours). Consistency and positive reinforcement are keys to the success of any behaviour management approach. Parents and teachers need to work together to plan: ways to prevent problem behaviours strategies for teaching new skills responses to challenging behaviours meaningful and motivating incentives and rewards.
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SAMPLE STRATEGIES
Psychological interventions
Children with AD/HD frequently experience social and emotional difficulties. Some children will benefit from ongoing contact with a psychologist or therapist for counselling or cognitive-behavioural therapy to develop social skills and self-control. They may benefit from supports that address social skills, self-monitoring skills, self-regulation strategies, anger and stress management, problem-solving strategies, and coping techniques. In addition, their family may benefit from family counselling to improve family relationships. Counselling may also be helpful for children who have co-occurring disorders such as depression or anxiety disorder. Classroom teachers can support psychological interventions by teaching and reinforcing social skills, and helping students develop strategies for managing stress and anger.
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SAMPLE STRATEGIES
Teaching social skills is a shared responsibility between home and school. Seek out community resources that provide support in social skills development. For example, clinics and specialized summer camps may offer the systematic teaching of social skills. The effectiveness of these supports is greatly increased when parents and school personnel are involved so that they can monitor, prompt and reinforce the same behaviours across settings. Explore schoolwide interventions that can increase social functioning and strengthen interpersonal relationships; for example, character and citizenship education, conflict resolution, peer mediation, cooperative learning, effective behaviour supports, and safe and caring school initiatives.
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Teach students a vocabulary for describing feelings and sensations so they are better able to verbalize and less likely to act out physically. Help students develop a Chill Out Plan (COP).9 This is a plan listing healthy actions students can take if they feel stressed or uncomfortable. Brainstorm a class list and then ask students to check off strategies they will try in different contexts. For example:
9. Adapted with permission from AD/HD: 102 Practical Strategies for Reducing the Deficit by Kim Tip Frank and Susan J. Smith-Rex (2nd Edition) (YouthLight, Inc., 2001, 1996, Chapin, SC), p. 84. www.youthlightbooks.com
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Alternative treatments
The recommended approach to the treatment of AD/HD is a comprehensive approach that includes appropriate diagnosis, family understanding of the disorder, medical interventions, psychological and behavioural interventions, and educational supports. A healthy lifestyle, including a balanced diet, sufficient sleep and daily physical activity, is beneficial for all children and teens. Many other treatments for AD/HD are being promoted through advertisements for alternative therapies in magazines, on the Internet and in stores. The advertisements often claim that these alternative treatments are safer or more effective than medication and some even claim to cure AD/HD. Currently scientific evidence is not available to support the effectiveness of the following for treating AD/HD: FYI allergy treatments biofeedback brain gym chiropractic adjustment and bone realignment eye training or vision therapy herbal remedies such as Omega 3s medicine to correct problems of the inner ear megavitamins restricted diets special coloured glasses treatment for yeast infection.
For further information about the evidence for alternative treatments, visit the Web site of the National Institute of Mental Health at www.nimh.nih.publicat/adhd.cfm and the Web site of CHADD (Children and Adults with Attention Deficit/Hyperactivity Disorder) at www.chadd.org/webpage.cfm?cat_id=24. The Canadian Paediatric Society offers the following advice about alternative therapies.10 Alternative therapies have not had the same kind of scientific review or testing as the medications that physicians prescribe to treat AD/HD.
10. Source: Canadian Paediatric Society, Alternative Treatments for Attention Deficit Hyperactivity Disorder, Paediatrics & Child Health 8, 4 (2003), pp. 243244. Adapted with permission. For more information on child and youth health, visit www.cps.ca.
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So how do medical doctors make decisions about which therapies to recommend? They read and review scientific studies published in medical journals. These studies have to meet certain standards before physicians will use them to make decisions. Many of the claims from producers of alternative therapies do not meet these standards. Despite advertising claims, there is no guarantee alternative treatments are safer than medication. There is some scientific evidence on alternative therapies and most of it suggests that parents should be careful and well-informed before they try these treatments. Many can cause side effects. Some can be dangerous. Others can be quite expensive or impact the familys daily experience in a negative way. Heres what we do know about many of the therapies that have been promoted as alternatives to drugs. Diet Changes in diet may help a small group of children who have allergy symptoms or migraine headaches. However, there is no evidence that a diet without sugar or additives will help the symptoms of AD/HD. Vitamin supplements If a child lacks a certain vitamin or mineral (such as iron, magnesium or zinc), a supplement may help, but the doses should be determined by the childs physician. Fatty acids Essential fatty acids such as fish oil and primrose oil, as well as nootropics (also known as smart drugs) such as deanol, have not been shown to help children with AD/HD. Herbs Herbs can help calm a person, and they may play a role in memory and thinking. However, because herb products are not regulated, it is essential to check with a pharmacist about the purity (how strong is it?), safety and toxicity (can it cause harm?) of any product. Valerian, which is used to help with sleep problems and anxiety, can cause headaches. Blue-green algae can cause stomach upset, weakness, numbness and tingling. Ginkgo biloba, which is said to help brain function, can cause headaches, dizziness, palpitations, stomach upset and skin rashes. It should not be used in children with clotting problems. In 2002, Health Canada issued a recall on all products containing kava because it can cause liver problems.
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3
MYTH
Food allergies, refined sugar, food additives and poor diet cause AD/HD.
FACT
The actual correlation between AD/HD and diet has not been proven. Good nutrition and general health, however, are always importantpoor diet and poor health can influence attention and functioning.
Antioxidants Also known as anti-aging remedies, antioxidants protect nerve cells. But there is no direct effect on AD/HD. There is no evidence that pycnogenol is effective, and it should not be used in children with clotting problems. Melatonin can help with sleep problems, but it can cause headaches, fatigue, irritability and sleepiness. It can also trigger convulsions (seizures) and possibly suppress puberty.
Homeopathy Homeopathy uses combinations of plant, animal or mineral extracts. No definitive studies have shown that homeopathy is effective in treating AD/HD. Biofeedback Biofeedback claims to help people control their responses. It involves a commitment from the entire family. Studies on its effectiveness were conducted with very small groups of children and were inconclusive. It is still considered an experimental treatment. Hypnotherapy Hypnotherapy may be helpful for certain symptoms of AD/HD, such as sleep problems or tics. Vision therapy, oculovestibular treatment, auditory and sound training There is no evidence to support these treatments. A-3 For parents who wish to discuss treatment options, teachers may consider providing a checklist of criteria for spotting unproven remedies. See Appendix A-3 for a sample checklist.
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Creating Supportive Classroom Environments
When you plant lettuce, if it does not grow well, you dont blame the lettuce. You look into the reasons it is not doing well. It may need fertilizer, or more water, or less sun. You never blame the lettuce. Yet if we have problems with our friends or family, we blame the other person. But if we know how to take care of them, they will grow well, like lettuce. Thich Nhat Hanh 1991, p. 78
Students with AD/HD need supportive learning environments to succeed in school. Often, students have the knowledge and skills to meet curriculum demands, but their difficulties with attention, impulsivity, activity level, organizing and planning prevent them from performing consistently. The suggestions provided in this chapter work in conjunction with the strategies offered in other chapters. The needs of students with AD/HD vary widely. No single student will need all of these strategies and supports.
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4
MYTH
FACT
AD/HD is primarily biological and genetic in its origins. It is not caused by external influences. However, environmental factors can minimize or intensify the difficulties experienced by an individual with AD/HD.
Many of the strategies and supports suggested in this chapter will also benefit other students in the classroom, not only students with diagnosed attention difficulties.
Teacher attitude
The key to a supportive classroom environment is a teacher who is willing to establish a caring relationship with each student, learn about a students individual needs and strengths, and provide the support and encouragement each student needs to be a successful learner. Students with AD/HD will benefit from teachers who are highly organized, plan for challenges ahead, and establish predictable and effective classroom routines. Because students with AD/HD often have difficulty remaining motivated and focused, they need teachers who are enthusiastic and who actively engage students in the learning process. They also need teachers who are flexible and willing to try new ways to teach and assess. Along with flexibility, these students need teachers with high expectations who believe that all students are capable of learning and doing well. Dr. Ross Greene cites these additional characteristics of teachers as likely indicators of positive learning outcomes for students with AD/HD:11 responsiveness warmth patience humour positive attitude toward inclusion knowledge of and willingness to work with students with exceptional needs knowledge of different types of effective interventions willingness to work collaboratively with other teachers (e.g., sharing information, requesting assistance as needed, participating in conferences involving students).
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Teachers with these traits provide a positive role model for all students and show how to understand and accept students with AD/HD. Teachers play a key role in helping students with AD/HD have a positive school experience.
SAMPLE STRATEGIES
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SAMPLE STRATEGIES
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Move close to the student when verbal reminders are necessary. Use a quiet, firm voice to specifically describe the behaviour that is required. Remove nuisance items. Certain objects (such as rubber bands and noisy toys) can divert the attention of students with AD/HD in the classroom. When these items are interfering with learning, make one request to put them away immediately. If the student does not do this, follow up by taking the item away from the student, placing it in a labelled envelope and returning it to the student to take home at the end of the day.
SAMPLE STRATEGIES
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Use auditory cues, such as bells or egg timers, to provide cues that signal when to take a break or return to work. Embed cues in the instructional routine to indicate when there is a shift in activity. For example, when speaking to the class, stop and indicate information that students should write down. Some transition times normally involve noise and movement, and may throw some students off task or create too much stimulation for that student. Consider sending a student who may be distracted to do an errand outside the classroom until the transition is complete and the groups are on task. Work with individual students to establish specific parameters for common transitions. For example: how they will walk (quietly and at what pace) with whom (by themselves or with an assigned partner, in the middle of the line or at the end of the line) where (on right side of the hall). Students can practise this routine ahead of time. With consistent and friendly reminders from teachers, this routine can make transitions between activities smoother and incident-free for everyone. Provide additional support during transitions to individual students as required. For example, when moving from one location to another, give students a purpose to help them focus on something positive while moving. For example, ask a student to carry the teachers clipboard to the gym or library books to the library. Review the expectations for behaviour when there is a special presentation or guest speaker. Large gatherings and performances can be difficult for students with AD/HD.
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SAMPLE STRATEGIES
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Problem Solving
1. Define the problem. Provide descriptive feedback about the students academic or social behaviour to increase his or her awareness of what he or she is doing and the impact it has on others. 2. Brainstorm possible solutions. The student may need assistance in coming up with ideas. 3. Evaluate the options. Assist the student to think about the possible outcomes or consequences of each option. 4. Select an option and make a plan. 5. Carry out the plan. 6. Evaluate the outcome. Was it successful? If not, why not? What else could be done? If yes, congratulate and celebrate!
SAMPLE STRATEGIES
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Give students substitute verbal or motor responses to make while waiting. For example, students may sing a song or say a poem quietly to themselves or use worry beads. Reward short intervals of waiting and gradually increase the length of the waiting period.
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1. Individual students keep file cards at their desks that say I need a break. 2. When a student needs a break, the student places a card on his or her desk to signal the teacher. 3. The teacher acknowledges the request, and if it is an appropriate time, the teacher exchanges the request card for a card that says something like, Lee needs a five-minute break. 4. The student then carries this card to the office or library and gives the card to an adult such as the school secretary or librarian. 5. The student spends the next five minutes engaging in a prearranged relaxing activity such as working on a puzzle or looking at a favourite book. 6. When the time is up, the supervising adult thanks the student for the visit, comments on positive behaviour, and then gives the student a card to return to the classroom teacher. The card might say something like, I enjoyed having Lee come to the office for a five-minute break. This strategy can also be expanded to help students plan their breaks throughout the day. For example, students could receive a set number of I need a break cards at the beginning of the school day and be responsible for planning how they will use them throughout the day. This strategy addresses a students need for movement and should not be linked to rewards or punishments. Ensure students go out at recess, take breaks or participate in physical activities. They may be more attentive and productive after a break because of the opportunity to run off excess energy and restlessness. If you notice that a certain student has difficulty handling the stimulation of exiting for a break with the larger group of students, you may want to delay his or her exit for a minute or two until the other students have left.
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Help students successfully manage recess or other less-structured activities by taking a few minutes each day before the activity to rehearse a positive experience. For example, just before recess a student could review a series of planning questions with a teacher or a peer, such as: 1. Who are you going to play with this recess? 2. What kind of activity are you going to do? 3. If you have difficulty, what will you do?
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Help students mediate conflicts with a structured approach such as the following five-step approach.
Resolving Conflicts
1. Identify each point of view (So youre saying that ). 2. Frame it as a common problem to reduce defensiveness (Thats a problem not You have a problem). 3. Involve students in solution (What are we going to do about it?). 4. Generate alternatives with adult help. 5. Try to reach a solution that is acceptable to each student and that encourages ownership of the solution.
SAMPLE STRATEGIES
Ask for help when needed. Enlist the support of colleagues and the school administrator.12 Look for a knowledgeable person with whom you can consult when you need advice, such as a behavioural or educational consultant, or a psychologist. Look for professionals who understand AD/HD, have worked with many children with AD/HD and are familiar with the classroom.12 Learn all you can about AD/HD. Read books, attend related professional development workshops, and talk to children and parents about how AD/HD affects learning and school success.
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relationships with adults (e.g., cooperating with requests, accepting consequences, disagreeing in an agreeable way, asking for help). As much as possible, involve students in identifying the areas that they need to work on. Ask them questions such as What kinds of things would you have to do to have a better day in school? What kinds of behaviours get in the way of having a good day? or What could you do instead?
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Evaluate target behaviours at several intervals throughout the day to provide frequent feedback to the student. Only include targets that are significant to the students improvement. See the following example of a daily report developed for a student in Grade 2.
My School Day
Date: Polite voice Me 9:00 to 10:30 10:45 to 12:00 1:00 to 2:15 2:30 to 3:00 4great! 3okay 2needs work 1not acceptable My teacher Hands and feet to myself Me My teacher Following teachers requests Me My teacher
A-4
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At home a sample menu of reinforcements could include these activities: computer games for X minutes choosing family television show or video television time for X minutes video games for X minutes listening to music for X minutes special snack talking on phone to friend or relative participating in special activity with a parent (e.g., hot chocolate, conversations, playing a board game, going on a bike ride) other rewards suggested by the child. It may sometimes be necessary to provide school-based rewards when the student is not responding to the home-based system, particularly for younger children who may require more immediate rewards. Such rewards can bridge the gap between meeting the behavioural criteria at school and earning the rewards at home. What is reinforcing to one student may not be reinforcing to another. Teachers need to work with students to make sure the consequences are motivating. At school the menu of novel rewards, those typically not part of the regular classroom routine, could include these activities: free time for X minutes talking to friend or relative listening to recorded music or stories using felt markers or other art supplies choosing a book for teacher to read to class caring for class pet using specific computer software programs choosing stickers choosing a seat for specified time playing cards or board games taking digital pictures drawing prize from grab bag other rewards suggested by the student.
Teachers may need to change the menu of rewards regularly to maintain student interest and motivation.
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Choosing Instructional Strategies
[It is] time to start to implement educational change to help youngsters with AD/HD succeed academically. Educational intervention is required at all levels; preservice and inservice education for teachers to bring them up to date with current understanding of AD/HD; implementation of teaching strategies that can be used in mainstream classes to facilitate academic success in children with AD/HD. These teaching strategies need to take into account both the cognitive and behavioural characteristics associated with AD/HD. Instructional strategies can be used that target specific academic needs (e.g., study strategies, literacy skills) in ways that reduce the cognitive load on childrens working memory (e.g., scaffolding, instructional supports, enablers) and promote high levels of cognitive engagement.
Tannock, Martinussen and Chaban, April 12, 2005
Many students with AD/HD struggle in the classroom, particularly in consistently meeting grade level curricular outcomes. Specific aspects of reading, writing and mathematics can be especially challenging for students with AD/HD, especially for the 30 to 50 percent of students with AD/HD who also have learning disabilities. These students need appropriate supports in the classroom in order to be successful learners and achieve their fullest potential. The sample suggestions provided in this chapter work in conjunction with the strategies offered in other chapters. The needs of students with AD/HD vary widely. No single student will need all of the following strategies and supports.
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Many of these strategies and supports may be of benefit to other students in the classroom, not only students with diagnosed attention difficulties.
SAMPLE STRATEGIES
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vary questioning so that it involves whole class, partner and individual responses structure partner activities so that students can read aloud to each other, question together, confirm understanding, and encourage each other to remain on task. Incorporate students interests into assignments. Create opportunities for student choice in such things as topic activity, order of tasks and materials to be used. Attention is enhanced when information is personally relevant and when it relates to students interests. Incorporate attention-getting devices into assignments. For example: vary the texture, shape and colour of materials provide students with a variety of coloured pens, pencils and markers to work with consider turning tasks into activities or games. For example, with older students, turn the review of material for a test into a Jeopardy game. Intersperse less-preferred, repetitive or passive tasks with preferred or active tasks to maintain interest and encourage perseverance. Set short time limits for task completion. A timer, such as an egg timer or stopwatch, may be helpful in motivating students to complete the task at hand. (Be careful, however, because some students may find the timer more stimulating than the task.) When possible, involve students in setting the timeframe to help develop a better sense of the amount of time particular kinds of tasks will likely take. Give feedback about the accuracy of assignments as soon as possible. Create opportunities for students to choose from a variety of ways to demonstrate understanding of learning outcomes. For example, to assess knowledge of factual information, encourage students to choose from oral presentations, audio or videotaped projects, news reports or dramatizations.
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Cue the class that instructions are about to begin and then wait until the class is mostly quiet before giving directions. If necessary, move closer to the students to get their attention. Give directions clearly, slowly and concisely, point by point. Provide both visual and printed instructions. For example, as you give directions orally, reinforce them by writing a few key words, phrases, page numbers or picture cues on the whiteboard or overhead. Use the verbal directions for prompting and the print directions for reference. Provide explicit structure and cues to emphasize relevant information such as: colour, circle, underline or rewrite such cues as directions, difficult letters in spelling or mathematics operation signs provide a graphic organizer or other structure to help students organize the task by recording the information and steps required point out the overall structure of texts; e.g., topic sentences, headings, table of contents. Model what to do. Think aloud the associated thinking process. Help students make a plan for the task by breaking it down into smaller steps and identifying where to start and where to end. State the goal clearly. Encourage students to use self-talk to apply problem-solving steps; e.g., What do I need to do first? Check for understanding with the whole class by asking for specifics. For example: Teacher: Class: Teacher: Class: Teacher: Class: What problems will we do? Numbers 1, 3, 5, 7, 9, 11. Will we do problems 8 and 12? No. Why not? We only need to do the odd numbers.
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Erase the whiteboard frequently and completely so that remnants of previous activities are not left to distract and confuse the student as the new lesson begins.
Children with AD/HD can never pay attention or complete their work.
MYTH
FACT
Inconsistency is a pervasive characteristic of AD/HD. Sometimes, and under some circumstances, individuals with AD/HD can focus and concentrate, while at other times they experience extreme difficulty. They are often able to focus on stimulating video games or creative activities such as Lego or drawing.
If only a few individuals need support, put a stop sign after a few questions so that students can let you know when they have completed these questions. Then set another goal to be completed. For the student who frequently seeks help, begin with a few items and gradually increase how much work is expected to be done independently. Use a timer to challenge students to complete a set number of questions. If the assignment is due the next day or later in the week, ask students to record it on the assignment calendar. Details of the assignment should remain posted until the due date. Make a graph for certain tasks, such as vocabulary words, and ask students to record the number of correct answers versus the number of completed answers. This strategy will encourage students to focus on quality more than quantity. Monitor frequently. Circulate. Move in closer to individual students who may need cueing to focus. Communicate a supportive attitude.
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SAMPLE STRATEGIES
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hands on desk think along. Use students names to cue them that they are about to be asked a question. For example, Bobby, this question will be for you In class discussions, try to call on students with AD/HD early in the discussion. If they are eager to participate, these students often have difficulty waiting their turn. In class discussions, provide waiting strategies to help students remember what they want to say. For example, students may write down the answer or use fingers to recall the number of points to be made. Ensure that students feel comfortable asking for repetition of information. Discuss how other people may benefit when one student takes the initiative to ask a question. Provide students with appropriate expressions to clarify meaning and to confirm comprehension, such as: Could you repeat that, please? I dont understand. What does _____ mean? Could you say that again, please? What do you mean by ? Analyze how listener friendly your teaching is by considering the following teacher checklist from Calgary Learning Centre. A-5 See Appendix A-5 for a blackline master of the checklist How Listener Friendly is My Teaching?.13
13. This checklist adapted with permission from Calgary Learning Centre (Calgary, Alberta, 1995).
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1. 2. 3.
4. 5. 6.
7. 8. 9. 10.
I reduce distractions for my students (e.g., close the door, move student near the front and away from windows). I clearly communicate my expectations of the students during the class. I provide students with an advanced organizer, outline or listening guide (e.g., highlight major concepts, provide space for notes) at the beginning of class to alert them to what will be addressed in the learning activities. My instructional plan follows the advanced organizer, outline or listening guide. I consistently review and encourage recall of previously presented information (e.g., summarize, question, provide time to review previous notes and handouts). I use cue words and phrases to signal important information (e.g., In summary , Note the following , Pay attention to , Record this important fact , This is important , Listen carefully). I use transitional phrases to cue and signal the organization of information (e.g., first, second, third; next; before/after; finally). I highlight important information by using bold, italics and different coloured text. I vary my volume, tone of voice and rate of speech to emphasize important ideas and concepts. I present information in many different ways (e.g., demonstration, lecture, discussion, videotapes, small group work, overhead projector, lectures with presentation software). I repeat important ideas and concepts by rephrasing and using multiple examples. I write important ideas, key concepts and vocabulary on the blackboard or overhead transparency. I use visual aids and objects to support the concepts and information that is presented (e.g., pictures, diagrams, maps, manipulatives, graphic organizers, overhead projector).
Need improvement
14. I provide examples and nonexamples of concepts. 15. I talk comprehension, demonstrate thinking aloud and frequently check for understanding (e.g., ask questions during the class, encourage students to ask questions during and after a presentation, encourage students to relate new information to old). 16. I provide students with opportunities to discuss concepts with a partner or small group. 17. I provide time for reflection at the end of the class (e.g., review important ideas, summarize, ask questions, self-evaluate). 18. I briefly review the important concepts at the end of an activity and preview what will be happening next class.
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They will benefit from instructional approaches that support memory difficulties, particularly short-term or working memory difficulties.
SAMPLE STRATEGIES
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Use auditory and kinesthetic cues in combination. For example, combine songs with movement and dance patterns. Music and physical routines linked to learning facts can help students memorize faster and act as a cue for retrieving specific information. When presenting new information, write down the main points on an overhead or on the board. Use verbal rehearsal to practise information to be recalled. Provide regularly scheduled reviews of procedures and concepts. For example, start each day by reviewing previously learned skills and ideas. Then present new skills and ideas. Before students leave for home, review the new information. Consider using assessments more frequently and on shorter units of work. Use quick, short evaluations rather than formal, longer tests.
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Fold-overs
1. Fold a paper to make four columns.
2. 3. 4. 5.
In the first column, copy target vocabulary words in English. In the second column, write the French words for each of the vocabulary words. Check your answers in the text. Correct any answers you got wrong and fill in words you did not know. Fold back the first column so the English words are not visible. Now, practise translating the other way. Look at each of the French words you wrote in the second column and write the English translation in the third column. Check your answers against the original words in the first column. Repeat this process to translate the words back into French in the fourth column. A complete practice page might look like this:
mother father brother la mre 9 le pre 9 le frre mother 9 father 9 brother 9 la mre 9 le pre 9 le frre 9
6.
14. Adapted with permission from Murray Suid, Demonic Mnemonics: 800 Spelling Tricks for 800 Tricky Words (Carthage, IL: Fearon Teacher Aids, 1981), pp. 2, 3, 4.
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SAMPLE STRATEGIES
Choose learning activities that will help students improve the legibility of their written work
Provide models of correct letter formation for posting on each students desk.
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Encourage students to do finger warm-up exercises. (This can be a fun class activity when set to music.) Encourage appropriate posture and positioning when writing. Provide extra white space and enlarged space for written work on assignments. Provide self-monitoring checklists such as the following:
Checking My Printing
Yes 1. Are my letters the right size? on the lines? within the margins? Is there a one-finger space between words? Did I start all sentences with upper-case letters? No
2. 3.
Display particularly good samples of students work prominently in the classroom. Consider structured handwriting programs that systematically teach letter formation. Allow older students to print if they are finding cursive writing difficult. Teach keyboarding skills. Frequently schedule short practice sessions. Explore the appropriateness of word processing software programs and other assistive technology, such as speech recognition software.
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SAMPLE STRATEGIES
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Teach strategies for planning written assignments. Provide planning frameworks for different types of narrative and expository writing, such as the PENS strategy.15
PENS
P review ideas. Think about what you want to say. E xplore words. Identify the key words you will need in the sentence. N ote words in complete sentence. Write out the sentence. Be sure to capitalize the first word and punctuate the sentence. S ee if sentence is okay. Make sure it makes sense. Select verb or verbs. Ask yourself who or what is doing verb/verbs. Check to see if sentence fits a formula.
Teach strategies for proofreading and editing written work, such as the COPS strategy. Students can use this simple acronym to remind themselves of what to look for in their own writing.
COPS
C apitalization O verall appearance (e.g., legibility, neatness) P unctuation S pelling
Develop individual self-monitoring checklists focusing on the students particular areas of difficulty. Teach students how to use the editing features of word processing programs.
15. Reproduced from Donald D. Deshler, Edwin S. Ellis and B. Keith Lenz, Teaching Adolescents with Learning Disabilities: Strategies and Methods, 2nd ed. (Denver, CO: Love Publishing Company, 1996), p. 170.
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Spelling
Spelling involves memory and an understanding of the sound-letter system. It also involves the ability to self-monitor and attend to details. Many students with AD/HD struggle with inconsistency in spelling. They can often learn a list of spelling words for a test but because of short-term memory difficulties, they may not be able to spell words correctly in different writing contexts.
SAMPLE STRATEGIES
Help students identify assistive technology that will help them be more accurate spellers
Teach students how to use the spell checker feature in word processing programs. Encourage the use of hand-held electronic spell checkers.
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Reading comprehension
Reading involves a number of complex skills and many students with AD/HD struggle with one or more aspects of the reading process.
SAMPLE STRATEGIES
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Teach strategies for reading for different purposes. For example, the reading at WARF speed strategy16 encourages students to:
WARF
W iden your eye span read more than one word at a time read groups of word (e.g., the + noun). A void skip backs keep reading to try to get meaning from the context. R ead silently. F lex your reading rate read important information slowly read familiar information faster if looking for specific information, read even faster.
FYI
Investigate assistive technologies for learning to support reading, such as the text-to-speech software Read & Write Gold. For more information, see www.lrc.education.gov.ab.ca/pro/QA/q-and-a.htm?vmod=TH_ESO.
Mathematics
Mathematics can be an area of difficulty for many students with AD/HD. In order for younger students to master key concepts, it is essential that they learn how to organize their work and understand basic patterns. Some students with AD/HD have challenges completing math tasks because of memory difficulties or inability to attend to critical details such as operation signs. It is sometimes helpful for students to say aloud the steps in the math operation before beginning a task. Encourage the use of supports for math facts. For example, use math fact tables and calculators so that difficulty remembering math facts does not limit students progress in other math areas.
16. Adapted by Rosemary Tannock from Esther Minskoff et al., WARF, The Learning Toolbox, http://coe.jmu.edu/learningtoolbox/WARF.html (Accessed July 2006).
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SAMPLE STRATEGIES
Design tasks and materials that consider spatial organization and fine motor difficulties
Reduce the amount of information on a page. Provide a window box template to view one question at a time. Draw boxes around individual questions or tasks to separate them. Provide graph paper to align numbers correctly.
Provide explicit instruction in number formation. Use colour to help students focus; for example, highlight +, , x in different colours to cue the student to attend to the correct operation. Reduce the number of tasks to be completed. Reduce the amount of copying required.
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Doubles
Double17 Look Listen
The Car Fact 2 front tires, 2 back tires = 4 tires The Bug Fact 3 legs on each side = 6 legs
2+2
3+3
4+4
The Spider Fact 4 legs on each side = 8 legs The Fingers Fact 5 fingers on each hand = 10 fingers The Dice Fact 6 dots on each die = 12 dots
5+5
6+6
7+7
The Two Weeks Fact 7 days in each week = 14 days The Crayon Fact 8 crayons in each row = 16 crayons The Double-Nine Dominoes Fact 9 dots on each side = 18 dots
8+8
9+9
Doubles Plus One or Two When adding numbers that are close to a double, such as 3 + 4 or 9 + 7, think of doubles that will help. For example, to add 3 + 4, think of the double 3: 3 + 3 = 6; 6 + 1 = 7
17. Adapted from The School Survival Guide for Kids with LD (Learning Differences) (p. 89) by Rhoda Cummings, Ed.D., and Gary Fisher, Ph.D., copyright 1991. Used with permission of Free Spirit Publishing Inc., Minneapolis, MN; 8667037322; www.freespirit.com. All rights reserved.
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Counting On
When adding two numbers less than 20, start at the bigger number and count up to the smaller number. For example, to add 7 + 2, think 7 is the bigger number, so start counting on at 7. So, 7 (count up two numbers), 8, 9. So, 7 + 2 = 9.
Counting Back
To subtract 1, 2 or 3 from a number, count backwards from the bigger number. For example, to subtract 8 2, think 8 (count back two), 7, 6. So 8 2 = 6.
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Encourage students to use addition facts to help them remember related subtraction and multiplication facts
Teach strategies for turning around subtraction facts and using doubles and other strategies when multiplying. For example:
Think Addition
To find the answers to subtraction facts you do not know, turn the subtraction fact into an addition fact and find the missing part. For example, turn 11 7 into an addition fact, 7 + ? = 11. Figure out the missing part. So, because 7 + 4 = 11, then 11 7 = 4.
Multiplication Facts
Use the commutative property. If you know 2 x 9 = 18, then you also know 9 x 2 = 18. To multiply by 0 think: To multiply by 1 think: To multiply by 2 think: To multiply by 3 think: To multiply by 4 think: To multiply by 5 think: To multiply by 6 think: To multiply by 7 think: 0 x any number = 0 1 x any number = that number doubles doubles plus the number (3 x 2 think: 2 x 2 = 4; 4 + 2 = 6) doubles plus doubles count by 5s count by 5s then add the number (6 x 7 think: 5 x 7 = 35; 35 + 7 = 42) of the facts you already know if you know 3 x 7 then you know 7 x 3; memorize 7 x 7 = 49 and 7 x 8 = 56 if you know 4 x 8 = 32, then 8 x 4 = 32 memorize 8 x 8 = 64 add a 0 to the other number and then subtract that number (9 x 2 think: 20 2 = 18) add a 0 to the other number; e.g., 10 x 6 = 60
To multiply by 10 think:
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4 x 3 = 12 3 x 4 = 12 12 4 = 3 12 3 = 4
Teach strategies for practising math facts that are active and engaging
Use card games, board games and flash cards to practise facts. For example:
Addition Challenge
Two players each have a deck of cards. Remove the face cards. Both players turn over two cards at the same time and call out the sum of their two cards. The player with the largest correct answer gets one point. The game continues until one player reaches a predetermined goal, say 25. This game can also be played with 10- or 12-sided dice.
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1000
Flash Cards
Make or buy flash cards. Use them for independent practice, in races or for practice with a partner. For an added challenge, use triangular flash cards to help students become familiar with the three numbers involved in each math fact. These cards can be used for addition and subtraction or with multiplication and division facts. Use triangles with equal sides approximately 10 cm x 10 cm x 10 cm, so that when held at arms length, the student can see all three numbers in the pattern. For example: Addition
9
5 x 4 = 20 4 x 5 = 20 20 5 = 4 20 4 = 5
4
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18. Adapted from Cognitive Credit Cards: Acquiring Learning Strategies by Alan L. Edmunds, Teaching Exceptional Children, 31, 1999, pp. 69, 70, 71. Copyright 1999 by The Council for Exceptional Children. Adapted with permission.
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CCC cards will look different for different students. The content depends on the teacher talking out the cues with the student and engaging the student in discovering how he or she would best go about dealing with the topic at hand. Teachers can use questions such as: How can you remind yourself what to think about to get started? What will you have to think of next? How will you ask yourself if you have remembered to think of specific steps in the process? How will you check to see if your thinking is working? Once the student and teacher develop a set of cues for a particular topic, the cues are printed onto a piece of paper the size of a credit card. Next the CCC is laminated and attached to a binder. Whenever students need a reminder, such as during assignments, homework or tests, their personalized cognitive learning strategy is available. This strategy can be used across the subject areas.
Error analysis
Conduct an error analysis on completed assignments and tests to determine students strengths and difficulties. Encourage students to analyze their performance as well. For example, students may ask themselves these questions: Are errors related to: misreading directions mistakes with details or losing track of details not understanding concepts difficulty applying concepts test-taking issues such as anxiety difficulty studying?
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Are errors in reading words in a passage related to: meaningful substitutions skipping words or whole lines of texts? Are errors in math related to: poor recall of math facts misunderstanding of a concept forgetting part of a procedure losing track of details?
Performance assessment
Use performance assessment to help students understand the demands of a task. Provide specific criteria to help students set performance goals. Use exemplars, modelling and outlines of expectations to provide explicit stepby-step instruction. Involve students in self-evaluation and provide specific feedback about their evaluation. Provide prompt and specific feedback to allow students to set new goals for improved performances.
SAMPLE STRATEGIES
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Consider the benefits of a shortened version of a test or the test divided into several smaller parts and completed in several short writing periods over several days. Provide a distraction-free environment. Allow more time to complete the test. Consider building in a brief break for some movement during lengthier tests. If it is not feasible for students to leave their seats, teach them some techniques to use in their seats, such as chair push-ups. Explore how the student might benefit from using a word processor to complete tests. If needed, reduce the writing demands and allow a student to complete the test orally.
Learning portfolios
A collection of student work from the past year gives the receiving teacher a perspective of students personal growth and a baseline for expectations and assessment. This information can also be shared with parents to help them support their child and the teacher in the learning process.
Involve students
Whenever possible, involve students in the assessment process. Encourage them to enhance their self-advocacy skills by increasing awareness of their own strengths and needs, and of the supports they require to be successful in the classroom.
SAMPLE STRATEGIES
A-8
Discuss individual learning strengths and challenges with students. Discuss the strategies they know and use, and what works best for them. See Appendix A-8 for a sample tool to help students identify and record information about their strengths and challenges.
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A-9
Provide opportunities for students to identify what kinds of things help them learn. See Appendix A-9 for a sample tool What Works for Me Inventory. Provide ongoing feedback to students about their progress. Involve students in developing assessment and assignment rubrics. Involve students in goal setting, reflection and self-assessment (e.g., through learning logs, goal sheets, self-reflection captions on portfolio selections and self-assessment rubrics). Set up regular check-in times with individual students. Schedule five to fifteen minutes every day or once a week to informally chat with individual students about how things are going.
Team approach
Many students with AD/HD require support across the school day. Often it takes a schoolwide team approach to ensure these supports are consistently in place for those students who need them. Some students may benefit from a teacher-advisor who acts as their advocate and liaison with other school staff. Share information about specific strategies that work for individual students. For example, regularly schedule time for staff meetings to identify and discuss instructional strategies that will benefit a number of students in the school. This kind of discussion could lead to more in-depth discussions about what kinds of instructional supports might work for individual students and how these types of supports could be implemented or adapted across the subject areas. A-10 See Appendix A-10 for a sample list of strategies that can be adapted to support students in reading, writing, and completing fine and gross motor tasks. See Appendix A-11 for a sample list of learning strategies including ways to develop attention and memory skills. Identifying potential strategies is just the starting point. It is also essential that the school team review the effectiveness of different strategies so that teachers can make ongoing adjustments to their instruction and tailor their choice of strategies to specific student needs. A-12 See Appendix A-12 for a sample form for evaluating the effectiveness of a support strategy.
A-11
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Ongoing communication between team members is also crucial to creating effective academic support for students with AD/HD. If a student does not require an IPP, teachers need to develop a plan for sharing information about what supports work for this student. Consider the following example of an individual student support plan that is adapted from one used at Medicine Hat High School. This two-page informal plan identifies strategies that are helpful to an individual student and records essential information needed for instructional planning (such as reading level). Teachers can add information as they identify additional supports. A-13 See Appendix A-13 for a blackline master of this Individual Student Support Plan.
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The following is a list of strategies and supports that may assist in student learning. Only those checked pertain to this student. Please feel free to add any strategies that you have found to be helpful and to contact the teacher-advisor if you have questions or suggestions. A. Seating seat at front of class seat at back of class locate near teacher B. Instructional Presentation adapt pace of lesson highlight key points of information 5 provide examples completed by other students
5 seat away from distractions allow student to stand rather than sit provide alternate workspace
colour code print material 5 break information into smaller steps 5 photocopy notes provide regular review time in class
C. Assignment Completion allow extra time 5 allow use of calculator cover parts of worksheet provide checklist of steps to complete activity increase white space for answers 5 use computer to complete assignments reduce amount of information/questions on the page ensure student records information in homework agenda D. Attention Support reduce materials on desk 5 provide buddy to clarify missed information
provide checklist for organizational tasks 5 use nonverbal or verbal sign to cue student
E. Behaviour Support provide buddy to model appropriate behaviour use agenda to communicate with other teachers
19. This form adapted with permission from the work of January Baugh, Deb Rawlings and Carrie-Anne Bauche, Medicine Hat High School (Medicine Hat, Alberta, 2005).
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F. Reading Support allow extra time 5 buddy reading 5 use of text-to-speech software
G. Writing Support Reduce writing demands through: 5 use of word processor allowing point form to replace paragraphs
H. Assessment and Evaluation Procedures smaller chunks of information or simpler concepts use individual criteria to evaluate tasks use notes or textbook during tests 5 allow extra time on tests 5 use word processor clarify directions Medical Issues
AD/HD combined Long acting medication (taken at home) Asthma (currently under control but
does have inhaler in backpack for exercise-induced incidents)
There are no current medical issues relevant to this students learning. Individual Information
Encourage David to send e-mail questions from home re: assignments. W. Mapp Hes also using e-mail to send himself reminders of assignments/tests (with a cc to dad). Is using his personal music player for listening to novels. J.H. Word
Teacher Assistant Does this student receive the support of a Teacher Assistant? Name of Teacher Assistant Check the types of tasks required: record class notes monitor student understanding of content reteach concepts monitor progress on assignments read and explain text and handouts with student report to teacher any important information on students progress/understanding support small group work scribe for student
Yes
5 No
troubleshoot assistive technology monitor students on-task behaviour track assignment (know what is due, when it is due, that student is handing work in) monitor binders/materials deal with minor discipline issues/report larger issues to teacher Teacher assistant availability
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Building Connections and Creating Hope
Creating a connected life takes time, and it requires work to maintain it over a lifetime A balanced, connected life leads to a sturdy kind of joy that hard times cannot easily strike down.
Hallowell and Ratey 2005, p. 185
The reality is, AD/HD can create difficult challenges for students, families and teachers. But there is a bright side: these same challenges of AD/HD can actually be character-defining gifts. And for some students, AD/HD can even be a springboard to creativity, innovation and breakthrough thinking. Encouraging students and their parents to see the positive in AD/HD can go a long way in preventing patterns of negative experience. Teachers can contribute to these positive effects by providing opportunities for students and parents to: create connectedness rethink AD/HD build on strengths provide a safe and caring environment foster areas of interests increase students understanding of AD/HD.
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Create connectedness
One of the most important ways to create a positive, hopeful outlook is to help students feel a sense of connectedness. Connectedness can mean different things for different students, whether it is having friends in the classroom, belonging to a club, feeling passionate about an activity or caring for a pet. The important thing is that students feel like they are part of something positive, something larger than [themselves] (Hallowell and Ratey 2005, p. 183).
SAMPLE STRATEGIES
Rethink AD/HD
As teachers, our own perspective on AD/HD can make a big difference in how we interact with students and how they feel about themselves. By reframing judgements of the behaviour of students with AD/HD into more compassionate terms, we can build more positive relationships and make better instructional choices. Consider how rethinking AD/HD may be helpful for you and your students.
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Rethinking AD/HD can shift how teachers see their roles and their relationships with students. It could result in professional shifts such as the examples below.
Build on strengths
People with AD/HD can achieve great things once they learn to channel their energy in positive ways. They often become creative and resourceful learners out of necessity.
20. Adapted with permission from Diane Malbin, Paradigm Shifts and FASD (Portland, OR: Fetal Alcohol Syndrome Consultation, Education and Training Services, Inc., 1997) and from Diane Malbin, Fetal Alcohol Syndrome and AlcoholRelated Neurodevelopmental Disorders: Trying Differently Rather than Harder (Portland, OR: Fetal Alcohol Syndrome Consultation, Education and Training Services, Inc., 1999), p. 42.
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Many people with AD/HD also feel that their energetic and creative ways give them unique advantages. People with AD/HD often have traits such as divergent thinking, spontaneity, creativity, inquisitiveness, intuitiveness, resourcefulness and resilience. A good sense of humour and willingness to do things in untraditional ways can also serve them well. These individuals can experience great success by choosing career options that build on these types of unique strengths and abilities. For example, the drive for excitement and stimulation may lead to success in such areas as business, entertainment, sports and public speaking. The ability to think about many things at once can bring success in areas of art and innovation.
SAMPLE STRATEGIES
SAMPLE STRATEGIES
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Provide opportunities for students to voice their feelings, concerns and ideas through journal writing, discussions, class meetings and one-to-one meetings with the teacher.
SAMPLE STRATEGIES
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SAMPLE STRATEGIES
Doesnt have the discipline to study Never finishes things Is lost in daydreams
21. Adapted with permission from the Calgary Learning Centre (Calgary, Alberta, 2000).
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Tell positive stories about individuals and how their AD/HD affected their lives. For example: David Neelan has an interesting story. As a result of his AD/HD, David often arrived at the airport only to find he had somehow misplaced his ticket. The experience inspired him to invent the electronic ticket. The result? David is now the CEO of upstart JetBlue Airlines, and the rest of us enjoy the benefits of ticketless travel. Encourage students with AD/HD to generate a list of positive qualities associated with AD/HD. Consider the following list Calgary Learning Centre generated in their work with youth affected by AD/HD.22
Provide books on AD/HD that students can read and discuss with their families. For example: Beal, Eileen. Everything You Need to Know about ADD/AD/HD. New York, NY: The Rosen Publishing Group, Inc., 1998. Galvin, Matthew. Otto Learns about His Medicine. 3rd ed. Washington, DC: Magination Press, 2001. Kraus, Jeanne. Cory Stories: A Kids Book about Living with ADHD. Washington, DC: Magination Press, 2005. Nadeau, Kathleen G. and Ellen B. Dixon. Learning to Slow Down and Pay Attention: A Book for Kids about AD/HD. 3rd ed. Washington, DC: Magination Press, 2005.
22. Adapted with permission from the Calgary Learning Centre (Calgary, Alberta, 2000).
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Quinn, Patricia O. Putting on the Brakes: Young Peoples Guide to Understanding Attention Deficit Hyperactivity Disorder. Washington, DC: Magination Press, 2001. B-1 See Appendix B-1 for more information on these books for children and young people with AD/HD.
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7
Moving to Independence
Teachers can open doors, but students must enter by themselves.
Ancient Chinese proverb
Students with AD/HD benefit from consistent structure and supports that address their difficulties with attention, hyperactivity and impulsivity. At the same time, their success in school and in life is enhanced by increasing their independence through developing selfmonitoring, organizational and self-advocacy skills. Planning for transitions is also important to help students deal with challenges as they move into new settings.
Organization
Difficulties with attention often interfere with organization and time management. To increase independence, students with AD/HD need to develop strategies to improve organization and time management. As students get older, there is greater need for them to be on time, have a plan, prioritize and manage their belongingskeeping what is important and getting rid of the unimportant. Being organized requires attention and is a major challenge for students with AD/HD.
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Moving to Independence
Previously described strategies involved external structures and routines that assist students with organization, such as To do lists, homework agendas, schedules, planning projects, colour-coding materials. It is important to model the use of organizational strategies, to encourage students to try the strategies and to provide specific and meaningful feedback about the outcomes. Becoming independent occurs when the individual finds out what works best and becomes organized enough to reduce stress and to meet lifes daily demands.
Self-monitoring
An important component of attention is self-monitoring. This component involves checking over a task that is in progress, assessing the progress and making adjustments when necessary. It also involves reviewing a task after it has been completed and making sure that it was done correctly. In short, self-monitoring is watching ourselves doing something while we are doing it.23 The accuracy of self-monitoring is less important than the self-awareness that happens in the process.
SAMPLE STRATEGIES
Create opportunities for students to become more aware of their own behaviour and performance
Encourage students to collect information about their behaviour. Target a desired behaviour and provide the student with a method for recording the frequency of the behaviour during a specific time frame. For example, students could use sticky notes on their desks to record tally marks for each time they contribute to discussions during a language arts period. Provide checklists and criteria to help students evaluate their own work. The following checklist is an example of how a student might assess his or her approach to learning.
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Moving to Independence
Self-assessment
Working on my own
Today: 1. 2. 3. 4. 5. 6. 7. I showed good listening. I followed teachers directions. I asked myself, What do I need to do? I got started right away. I finished each task. I checked over my finished work. I told myself, Good job. Most of the day Some of the day Not at all
Provide a signal that cues the student to think about what he or she is doing. This signal may be a timer on the students wristwatch or an intermittent beep played on an audiotape as the student wears headphones. When the signal goes off, it is a cue for the student to ask self-monitoring questions: Am I doing what Im supposed to be doing? Am I on task? A card on the desk illustrating on-task behaviour may be helpful. Students may also keep a record of their own on-task behaviour to track their progress over time.
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Use the Think Aloud process to teach students to ask themselves four questions to guide problem solving.24 This helps them organize their thinking and promotes verbalization as they answer the sequence of questions. The process is most effective if students ask themselves the questions rather than respond to the teacher posing the questions.
Think Aloud
1. 2. 3. 4. Define the problem: What am I supposed to do? Consider alternatives and make a plan: What are some plans? Monitor the plan: How is my plan working? Evaluate the plan: How did I do?
Identify strategies that students can use when they are stuck, such as the following.25
6.
Encourage students to try at least three of these strategies on their own before asking for help.
24. Adapted with permission from Bonnie W. Camp and Mary Ann S. Bash, Think Aloud: Increasing Social and Cognitive Skills A Problem Solving Program for Children: Classroom Program Grades 1-2 (Champaign, IL: Research Press, 1985), pp. 41, 56. 25. Adapted with permission from Dana Antay-Moore and Catherine M. Walker, Smart Learning: Strategies for Parents, Teachers and Kids (Edmonton, AB: Smart Learning, 1996), p. 5.
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Moving to Independence
Self-advocacy
Self-advocacy refers to an individual taking action on his or her own behalf. Selfadvocacy encourages individuals to consider options and make thoughtful choices for the future. To advocate effectively for themselves, students with AD/HD need to recognize, accept and understand their attention difficulties and the impact these have on their learning and behaviour. They also need to take responsibility for themselves and learn strategies for problem solving and goal setting. The self-advocacy process needs to begin in the early grades and be practised actively in junior and senior high school. Students with AD/HD may not self-advocate effectively for a number of reasons, including the following. They may: be unable to clearly identify and describe their abilities, needs and preferred conditions for learning. These difficulties may occur because of language difficulties, poor social skills, lack of practice or lack of knowledge about themselves as learners not have been directly taught self-advocacy skills and/or do not have someone to coach them through situations where they might need to self-advocate have limited confidence in their abilities and as a result, be reluctant to ask questions in class or request extra assistance fear being thought of as stupid or as a troublemaker be passive in their approach to their own learning, feeling that their future is beyond their controlthis includes overrelying on their parents and teachers to advocate on their behalf not know who to contact for help, what to ask for or how to best use supports be discouraged because they have encountered people who do not understand AD/HD or do not believe that accommodations and assistance are appropriate. Given these barriers, students with AD/HD need support to learn and practise self-advocacy.
SAMPLE STRATEGIES
Create opportunities for students to grow in their knowledge and understanding of their own AD/HD
Demystify the disorder. Use analogies to assist students in understanding how AD/HD affects individuals. For example,
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Moving to Independence
your brain is like a turbo-charged race car, but your brakes dont work well having AD/HD is like driving a car with the windshield wipers going. Include information about the challenges and bright side of AD/HD. Provide additional resources on AD/HD such as videos, books and reliable Web sites. Provide older students with opportunities to do projects and research about AD/HD.
Create opportunities for students to identify and explore their own strengths and needs
A-14 A-15 Engage students in structured activities to explore their learning preferences, strengths and challenges. See Appendices A-14 and A-15 for two sample tools students can use: Know Your Own Strengths Inventory and Uncover Your Learning Challenges Inventory. Encourage students to talk aloud about their thinking. Help them rephrase their ideas in positive terms to highlight their learning strengths and needs. Explain assessment results so that students understand their abilities, their needs, and the implications for their schooling and future lives. Provide specific feedback to help students understand their strengths and needs, and how AD/HD affects them personally. Involve students in identifying, trying out and reflecting upon different strategies and supports so they gain a better understanding of what strategies match their own strengths and needs.
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Moving to Independence
A-17
Self-advocates need to be informed and organized in order to be effective. Help students to prepare for meetings, conversations with subject teachers and other situations in which they may be involved in planning their educational future. Model and role-play appropriate interactions and problem-solving approaches. See Appendix A-17 for a sample tip sheet for students Be Your Own Self-advocate. Provide students with alternative ways for asking for assistance such as an Asking for Help form below.26 A blackline master of this form is provided in Appendix A-18.
A-18
Student signature:
26. This form adapted with permission from Mary Cole and Anne Price, TNT: Tips N Tricks for Dynamite Learning!! (Calgary, AB: Calgary Learning Centre, 1999), p. ii (Black Line Masters).
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Moving to Independence
SAMPLE STRATEGIES
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Moving to Independence
Provide opportunities for students to develop problem-solving skills, to monitor and regulate their own performance, and to interact appropriately with peers, teachers and other adults. Help students and their parents learn about available supports and accommodations to help them deal with their attention difficulties. Transition planning is an ongoing process of helping students prepare for the future. It begins the first day of school and continues throughout life. Whenever students are faced with a significant change in their routines, environments or experiences, they will benefit from preparation and support that considers their personal needs and strengths. As students with AD/HD get closer to leaving the secondary school system, the need for transition planning becomes even more critical.
SAMPLE STRATEGIES
Support students and their parents as they prepare for upcoming transitions
Identify skills needed in the next environment and provide opportunities to develop these skills. Listen to students concerns about transitions and engage in frequent discussions about transitions. Highlight the positive aspects of a new environment. Help students understand the differences between the current environment and the new environment, including changes in routines, expectations or rules.
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Moving to Independence
Encourage independence by helping students establish consistent homework and study routines. Arrange for students to visit new classrooms or schools and meet with new teachers. Encourage parents to become advocates for their children.
SAMPLE STRATEGIES
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7
MYTH
Moving to Independence
FACT
AD/HD occurs in both children and adults. Most children with AD/HD continue to show significant signs of restlessness and distractibility into adolescence and adulthood, although often the characteristics change as an individual grows up. For instance, hyperactivity and impulsivity may decrease, and the ability to attend may increase. As well, many adolescents and adults learn strategies to help them compensate for their challenges with attention and appear to have overcome or outgrown their AD/HD. Adults may experience other symptoms, such as emotional issues (e.g., mood swings, stress intolerance) because of their attention issues.
Planning for transitions during the senior high school years generally focuses on the move to postsecondary education and/or employment and independent living. Students need to begin to narrow choices and select post-secondary and career alternatives based on their interests, preferences, needs, strengths and abilities. FYI For more information on helping students make transitions to post-secondary studies, visit the Alberta Learning Information Service (ALIS) Web site at www.alis.gov.ab.ca/main.asp and download copies of the Planning for PostSecondary Studies workbooks for students and parents.
SAMPLE STRATEGIES
Support the planning for transitions process during senior high school years
Assess students academic preparation, self-advocacy skills, technical skills, social skills and independent living skills. Help students and their families explore and think about the differences and similarities between high school, post-secondary and workplace settings. Help students and their families match career interests with postsecondary training. Encourage students to research entrance requirements for post-secondary institutions.
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Moving to Independence
Encourage students to research the types of supports, accommodations and assistive technologies available to students with AD/HD in postsecondary institutions. Provide students and their families with information about agencies or community-based programs that support young adults with AD/HD, such as Alberta Human Resources and Employment and local chapters of Children and Adults with Attention Deficit Disorder (CHADD). Discuss the benefits of volunteer experiences and paid employment in helping students explore career interests and develop marketable skills. FYI The Alberta Education resource Building on Success: Helping Students Make Transitions from Year to Year contains practical information and sample tools for creating a student profile to share information about an individual students strengths, abilities and learning needs. To download the resource at no cost, visit www.education.gov.ab.ca/k_12/specialneeds/resource.asp.
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Keeping Informed
If you do not ask the right questions, you do not get the right answers. A question asked in the right way often points to its own answer.
Edward Hodnett
Information about AD/HD is constantly changing. Research publications, popular press and Web sites present new information every day. The more information classroom teachers have about the nature, effects and treatments of AD/HD, the more able they will be to have a positive impact on students. In order to get the most out of the information, teachers need to know what questions to ask, where to look for answers, who to contact and how to assess the reliability of information sources.
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Narrow the question by first making a list of general issues or questions and then paring down the issues to the most important ones. Try to specify exactly what the key question is. For example: How do AD/HD characteristics affect the choice of instructional strategies? How might this student benefit from assistive technology for learning? What are some ways to support this students reading and writing skills? What is the relationship between the students learning disability and his or her AD/HD symptoms?
Finding information
People can be excellent resources. People to consider include colleagues, community agencies, professionals in the field and librarians. Print resources can provide a variety of information. Newspapers, magazines and periodicals are accessible and current sources for general information. Your local librarys copy of the Readers Guide to Periodical Literature or the Canadian Periodical Index will provide the names of relevant publications. Other printed materialsuch as books, pamphlets, annual reports and newsletters from relevant organizationscan provide information of a general nature that may help to direct your inquiry. For a list of books for teachers, see Appendix B-3 and the bibliography on pages 165170. Television, video and other digital resources provide information on both general and specific topics and issues related to AD/HD.
B-3
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Keeping Informed
Internet services include the World Wide Web, chat rooms, live events using video and audio, mailing lists, newsgroups, Web forums and e-mail to write to your contacts. A search engine is an index of information on the Internet. Search engines conduct searches using keywords. The best way to choose the word or words to use is to select the rarest word in the phrase. For example, instead of typing types of AD/HD medication, you would simply use AD/HD medication for the search. The following is a list of commonly-used search engines. www.google.com www.ask.com www.altavista.com www.excite.com www.beaucoup.com www.yahoo.com www.journalismnet.com www.dogpile.com (presents information taken from a number of search engines)
Different search engines access different areas of the Web, so use three or four different ones. Consider accessing media sites, such as www.cbc.ca, www.bbc.co.uk and www.cnn.com.
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What is the purpose of the source? Who is the audience? Is the information factual or propagandadoes the author use facts or emotions to get the point across? Is the purpose of the Web site to sell or promote a product or service? When was the material created? For print material, check the publication date and whether this is a first edition or a revision of the material. For a Web site, check whether links still work and look at the last time the site was updated. Older material may present information and statistics that are out-of-date. Where was the source published or created? Is the publisher or journal reputable? Is the journal reviewed? Books or periodicals that are self-published may have a hidden agenda. For Web sites, certain domain names may indicate a greater reliability. For example, the ending .edu signifies an American university and .gov is reserved for the Canadian government, both of which are reliable sources. How can I tell if the source is accurate? Double-check sources by comparing the facts and ideas presented in them to those presented in other sources. Consider whether the source might be biased or uninformed. Authors or Web sites might be speaking about something that is beyond their level of expertise. They may have used unreliable sources in the first place and passed this information on to you. Or they may have hidden agendas; for example, they may be trying to sell you a product. If the material is a book, look for a review of the book to determine how others have assessed it.
Comparing sources
The more information you have on a topic, the better your understanding of the issue will be. As a general guideline, try to gather information from at least three sources. Some of the information may be contradictory or not provide support. With controversial issues where people have taken sides, it is up to you to determine if the research is reliable and if it supports research conclusions.
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Who funded the research? Is the finding preliminary or confirmed? In addition, ask the following questions about AD/HD treatments that are reported in the media or elsewhere. Have clinical trials (scientific tests of the effectiveness and safety of a treatment using consenting human subjects) been conducted regarding the approach? What are the results? Can the public obtain information about the approach from the National Institute of Mental Healths National Center for Complementary and Alternative Medicine (NCCAM) (http://nccam.nih.gov)? Is there a national organization of practitioners? Are there licensing and accreditation requirements for practitioners of this treatment? Is the treatment reimbursed by health insurance?
Ongoing search
Teaching, like learning, is a journey that does not end. This resource provides current information classroom teachers can use to support students with AD/HD, but it is just a starting point. Ensuring students with AD/HD are successful learners requires that teachers continually increase their knowledge, share their expertise and build collaborative relationships with students, parents and professionals working with these students.
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Appendices
Appendix A: Sample Tools
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. Sample Individualized Program Plan (IPP) Solution-focused Meetings and Sample Planner Checklist for Spotting Unproven Remedies Daily Report How Listener Friendly is My Teaching? Reading Strategies Survey Preview Your Textbook Knowing My Strengths and Challenges What Works for Me Inventory Strategies to Support Reading and Writing Strategies to Support Attention and Memory Difficulties Reviewing the Effectiveness of a Support Strategy Individual Student Support Plan Know Your Own Strengths Inventory Uncover Your Learning Challenges Inventory KWL+ About AD/HD Be Your Own Self-advocate Asking for Help Ticket Goal-setting Organizer
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Appendices
A-1
Background Information: Classroom context School: Anyschool Elementary I.P.P. Coordinator and Classroom Teacher: Mrs. Anyteacher Additional IPP Team Members: Ms. Anyresource, Special Education Coordinator
Lee is in a Grade 5 program in his neighbourhood school. There are currently 22 students in his grade 4/5 classroom; three have been identified as having special education needs. A special education coordinator in the school provides consultation to the classroom teacher, on an as-needed basis.
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Appendices
Strengths
Enjoys working and socializing with other students, has many friends Likes to build things, especially in science Comfortable with the computer, can find all kinds of interesting sites on the Internet Excels in sportsswimming and mountain-biking Enjoys soccer at recess but occasionally loses his cool with other players
Areas of Need
Strategies to improve reading comprehension across the subject areas, but especially for social studies Planning, writing and proofreading strategies to increase quality and quantity of written expression Support to return to task and complete in-class assignments (using low-key teacher cueing) Lees accommodations need to be in place across the school day and with all teachers, including substitute teachers
Test
WISC-IV
Results
Full score: average (slightly below average on working memory index) Reading: borderline Mathematics: average Written language: borderline Oral language: average Moderate learning disability in the areas of reading and written expression
WIAT-II
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A-1
Year-end Summary
June Continues to work at grade level in math and science, with minimal support. Although Lees reading fluency is still below grade level, his comprehension has improved and he is using self-questioning strategies, especially when reading high-interest scientific information. He will need additional strategies for more complex narrative material in Grade 6. Using his new reading strategies have helped Lee maintain a C average in social studies. He is receiving occasional support with note taking, test taking and completing written longer assignments. Although longer writing assignments remain a challenge for Lee, output has increased (e.g., Junes sample was 80 words in 30 minutes), hes using planning tools when prompted, writing vocabulary is more specific and hes attempting to provide more detail, and spelling accuracy has increased to about 70%. Now that several other students in the class are using a spell check, he is more willing to use his. With systematic teacher prompting, Lee is returning to task and completing 75% of inclass assignments.
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A-1
Appendices
Goal #1
Long-term Goal: Lee will independently read and demonstrate understanding of selected Grade 4
level reading passages.
Short-term Objectives
By November 15 Lee will read and understand selected mid-Grade 3 level reading passages.
Assessment Procedures
Two selected reading passages at mid-Grade 3 level and five comprehension questions
Progress Review
November 10 Achieved. Lee is independently reading material at the midGrade 3 level.
By March 15 Lee will read and understand selected end-of-Grade 3 level reading passages.
Two selected reading passages at end-of-Grade 3 level and five comprehension questions
March 12 Achieved. Lee is doing even better than his objective; he is independently reading material at the early-Grade 4 level, especially factual material.
By June 30 Lee will read and understand selected early-Grade 4 level reading passages.
June 15 Achieved. Lee is reading independently at the earlyGrade 4 level (and even higher if the material is especially interesting to him).
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A-1
Goal #2
Long-term Goal: Lee will generate at least 20 sentences at Grade 5-level expectations within allotted time for written assignments.
Short-term Objectives
By November 15 Lee will complete a Splashdown or list of key words of at least 15 items as a plan for at least two monthly writing samples.
Assessment Procedures
Collect three monthly writing samples and evaluate with grade-level rubric.
Progress Review
November 12 Achieved. Lee prefers to use key words and he completed plans for monthly writing samples.
By March 15 Lee will use a planning tool to generate at least 15 ideas and use these ideas to write at least 12 sentences within allotted class time for at least three monthly writing samples.
Collect three monthly writing samples and evaluate with grade-level rubric.
March 10 Progressing. Completed writing samples indicate that Lee prefers working with facts and information, and has more difficulties working with opinions and personal responses. June 15 Achieved. Monthly writing samples are at least 20 sentences long and completed within allotted time.
By June 30 Lee will independently generate at least 15 ideas and use these ideas to write at least 20 sentences within allotted class time for at least three monthly writing samples.
Collect three monthly writing samples and evaluate with grade-level rubric.
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Appendices
Goal #3
Long-term Goal: Lee will complete 80% of in-class assignments by responding quickly and
positively to teacher prompts to return to task.
Short-term Objectives
By November 15 Lee will return to task 80% of the time within one minute when cued by teacher using: sentence gesture; e.g., hand on head proximity; e.g., near Lees desk plus one verbal reminder (if needed). This increase in on-task behaviour will result in him completing 60% of in-class assignments. By March 15 Lee will return to task 80% of the time within one minute when cued by teacher using: gesture proximity. This increase in on-task behaviour will result in him completing 70% of in-class assignments. By June 15 Lee will return to task 80% of the time within one minute when cued by teacher using low-key gesture. This increase in on-task behaviour will result in him completing 80% of in-class assignments.
Assessment Procedures
Use checklist on desk to track successful return to task. Teacher will prompt Lee Give yourself a check Criteria: 3 consecutive days of 80% of returning to task within one minute Teacher to record and share data with Lee and parents on % of weekly in-class assignments completed
Progress Review
November 12 Achieved. Lee is returning to task approximately 90% of prompts. Is completing approximately 70% of in-class assignments.
March 10 Achieved. Lee is returning to task approximately 90% of prompts. Is completing approximately 70% of in-class assignments.
June 15 Achieved. Lee is returning to task almost 100% of the time, with minimal prompting. In-class assignment completion is about 75%.
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A-1
Signatures
I understand and agree with the information contained in this Individualized Program Plan.
Parents
Date
IPP Coordinator/Teacher
Date
Principal
Date
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Appendices
Solution-focused Meetings
Solution-focused meetings can be an effective way to resolve particularly difficult situations, or when it is important to promote communication among all learning team members. Ensuring input from all members of the learning team in an open, honest and respectful manner will contribute to increased commitment to the IPP process by teaching staff, parents and the student. A solution-focused meeting uses a process such as the following. 1. One member of the learning team agrees to act as the facilitator for the meeting. This individual needs to be positive, attentive, task-oriented, and have the ability to clarify issues and summarize. It is also important that the facilitator help each team member stay on topic and work toward appropriate, practical solutions. The facilitator begins the meeting by inviting the learning team member who initiated the meeting to state clearly and concisely what the concern is. It is important to find out specifically what the team member wants to happen as a result of this meeting. The team members ask questions to clear up any uncertainties they may have as to exactly what the issue is or what the related circumstances are. The facilitator may need to encourage team members to look for factors that appear to trigger or contribute to the problem, and to identify and analyze conditions that seem to alleviate the problem. As part of this analysis, team members may also identify the strengths of the student and available resources. Once the problem or issue is clearly defined, the learning team uses a round table brainstorming session to generate suggestions for how the problem may be solved. All ideas are recorded on chart paper. It is important at this stage of the process to let ideas flow freely and not to comment directly on any one idea. The facilitator and the referring teacher review the strategies together and then rate each suggestion by assigning a number value to it. For example: 1 = an idea or strategy that the teacher and/or parent wants to try 2 = an idea or strategy that has merit, but is not a priority 3 = an idea or strategy that has already been tried and didnt seem to resolve the issue 4 = an idea or strategy not immediately practical at this time. 6. 7. The learning team develops an action plan for each strategy selected, including materials and resources required, persons responsible, and dates for follow-up and review. The facilitator closes the meeting by thanking everyone and asking for feedback on the process. The team generally agrees to meet for a progress review in four to six weeks.
2.
3.
4.
5.
Adapted with permission from Gordon L. Porter et al., Problem Solving Teams: A Thirty-Minute Peer-Helping Model, in Gordon L. Porter and Diane Richler (eds.), Changing Canadian Schools: Perspectives on Disability and Inclusion (North York, ON: The Roeher Institute, 1991), pp. 224, 225, 226, 227, 228.
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A-2
C. Description of students strengths and priority areas of need Strengths Areas of need Other resources
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A-3
Appendices
Adapted from Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD), Complementary and Alternative Treatments, What We Know Information Sheet #6, National Resource Center on AD/HD, October 2003, www.help4adhd.org/documents/WWK6.pdf (Accessed April 2006).
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A-4
Daily Report
Name: Date:
Circle the numbers that best describe how the student demonstrates this behaviour today.
Wonderful! Satisfactory Needs improvement
Brings all needed supplies and books to class Follows directions Starts to work with minimal prompting Interacts positively with peers Responds positively to teacher requests
3 3 3 3 3
2 2 2 2 2
1 1 1 1 1
Student signature:
Teacher signature:
Parent signature:
Comments:
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A-5
Appendices
2.
3.
4.
5.
6.
7.
8.
9.
This appendix adapted with permission from Calgary Learning Centre (Calgary, Alberta, 1995).
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A-5
I do this 10. I present information in many different ways (e.g., demonstration, lecture, discussion, videotapes, small group work, overhead projector, lectures with presentation software). 11. I repeat important ideas and concepts by rephrasing and using multiple examples. 12. I write important ideas, key concepts and vocabulary on the blackboard or overhead transparency. 13. I use visual aids and objects to support the concepts and information that is presented (e.g., pictures, diagrams, maps, manipulatives, graphic organizers, overhead projector). 14. I provide examples and nonexamples of concepts. 15. I talk comprehension, demonstrate thinking aloud and frequently check for understanding (e.g., ask questions during the class, encourage students to ask questions during and after a presentation, encourage students to relate new information to old). 16. I provide students with opportunities to discuss concepts with a partner or small group. 17. I provide time for reflection at the end of the class (e.g., review important ideas, summarize, ask questions, self-evaluate). 18. I briefly review the important concepts at the end of an activity and preview what will be happening next class.
Need improvement
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Appendices
Usually
1. I study the title and pictures or photographs, and try to predict what the selection is about. I try to predict what is going to happen next in the selection. I break new words into familiar chunks in order to pronounce words properly. I think about movies, TV shows or books that might be similar in some way. I study the illustrations, photographs or diagrams for information. I reread when I dont understand. I imagine myself right in the story. I conference with others to clear up confusing parts. I think about how the story is like something I have experienced.
Sometimes
Never
2. 3.
4.
5.
6. 7. 8. 9.
10. I try to figure out the main idea of the selection. 11. I try retelling the story in my head. 12. I look up new words in the dictionary. 13. I self-correct when I mispronounce a word. 14. I ask questions about what I read. 15. I change my reading rate to adjust for the task or text.
This appendix reproduced with permission from Edmonton Public Schools, AISI Middle Literacy Project (Edmonton, Alberta, 2001).
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A-6
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A-7
Appendices
Look over the table of contents and write six questions that this book will explore. 1. 2. 3. 4. 5. 6.
Adapted with permission from Edmonton Public Schools, Think Again: Thinking Tools for Grades 610 (Edmonton, AB: Resource Development Services, Edmonton Public Schools, 2003), p. 168.
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A-8
Learning Strengths
Learning Challenges
List five things you are good at doing outside of school and draw a picture in the box of one of these strengths. 1. 2. 3. 4. 5.
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Appendices
C. In the classroom
y What seat in the classroom works best for me? y What do I read best from? ___ chalkboard ___ overhead ___ projector ___ chart paper ___ my own copy y Does the colour of ink (or chalk) make a difference? y Does the type of printing (printed, handwritten or typed) make a difference? y Does the size and spacing of print make a difference?
This appendix adapted from Alberta Learning, Make School Work for You: A Resource for Junior and Senior High Students Who Want to be More Successful Learners (Edmonton, AB: Alberta Learning, 2001), pp. 8586.
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A-9
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A-10
Appendices
Adapted with permission from Calgary Learning Centre (Calgary, Alberta, 2002).
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A-11
Adapted with permission from Calgary Learning Centre (Calgary, Alberta, 2002).
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Appendices
3. 4. 5. 6.
How often does the student access the strategy? Can the student use the strategy independently? Does the student require monitoring while using the strategy? Does the strategy seem to be facilitating independence? How?
7. 8. 9.
Is the strategy transferable to other classes/grades? Is it improving the students quality of learning? Are there barriers to the use of the strategy? Specify.
Students comments
Parents comments
Teachers comments
Reproduced with permission from Calgary Learning Centre (Calgary, Alberta, 2004).
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A-13
The following is a list of strategies and supports that may assist in student learning. Only those checked pertain to this student. Please feel free to add any strategies that you have found to be helpful and to contact the teacher-advisor if you have questions or suggestions.
A. Seating seat at front of class seat at back of class locate near teacher
seat away from distractions allow student to stand rather than sit provide alternate workspace colour code print material break information into smaller steps photocopy notes
B. Instructional Presentation adapt pace of lesson highlight key points of information provide examples completed by other students provide regular review time in class
C. Assignment Completion allow extra time allow use of calculator cover parts of worksheet provide checklist of steps to complete activity increase white space for answers use computer to complete assignments reduce amount of information/questions on the page ensure student records information in homework agenda D. Attention Support reduce materials on desk provide buddy to clarify missed information E. Behaviour Support provide buddy to model appropriate behaviour use agenda to communicate with other teachers provide positive reinforcement such as
provide checklist for organizational tasks use nonverbal or verbal sign to cue student
This appendix adapted with permission from the work of January Baugh, Deb Rawlings and Carrie-Anne Bauche, Medicine Hat High School (Medicine Hat, Alberta, 2005).
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Appendices
F. Reading Support allow extra time buddy reading use of text-to-speech software
G. Writing Support
Reduce writing demands through: use of word processor allowing point form to replace paragraphs
H. Assessment and Evaluation Procedures smaller chunks of information or simpler concepts use individual criteria to evaluate tasks use notes or textbook during tests allow extra time on tests use word processor clarify directions Medical Issues
Individual Information
Teacher Assistant
Does this student receive the support of a Teacher Assistant? Name of Teacher Assistant Check the types of tasks required:
Yes
No
record class notes monitor student understanding of content reteach concepts monitor progress on assignments read and explain text and handouts with student report to teacher any important information on
students progress/understanding
troubleshoot assistive technology monitor students on-task behaviour track assignment (know what is due, when it is due,
that student is handing work in)
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A-14
A. List four successful experiences you have had in the last 12 months:
y y
B. List four everyday things you do well:
y y
y y
C. List two things you could teach someone else:
y y
y
D. List 10 positive words to describe yourself:
y y y y y
E. List two things that really matter to you:
y y y y y
y
F.
List two things you can do for yourself that will always make you feel good:
G. List two people who you can count on for help and support:
Adapted from Alberta Learning, Make School Work for You: A Resource for Junior and Senior High Students Who Want to be More Successful Learners (Edmonton, AB: Alberta Learning, 2001), p. 84.
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Appendices
Always 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. I come to school every day. I come to class on time. I come to class with the materials I need. I come to class prepared; e.g., textbook read, assignments complete. I leave my worries outside the classroom door. I can follow written directions. I can follow spoken directions. I understand the new ideas the teacher presents. I can focus my attention in class. I contribute to class discussions. I take accurate and detailed notes. My notebooks are organized and complete. I am clear and concise when writing. My written work is accurate, legible and organized. I finish assignments within time limits. I know when and who to ask for help. I can sit still for long periods of time. I do not distract or chat with others. I remain calm and focused during tests. I do well on tests.
Usually
Sometimes
Not yet
This appendix adapted from Alberta Learning, Make School Work for You: A Resource for Junior and Senior High Students Who Want to be More Successful Learners (Edmonton, AB: Alberta Learning, 2001), pp. 8283.
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A-15
B. Do teachers ever mention a specific in-class behaviour to you? For example, do they say, Dont chat with your neighbours or You need to bring a pencil every day. Write these comments down even if you dont like them or agree with themthere may be helpful information in this feedback.
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A-16
Appendices
K
What I Know about my AD/HD
W
What I Want to know about my AD/HD
L
What I Learned about my AD/HD
+
Why is it important to find out more about my AD/HD? How can I use this information?
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A-17
Ask
I am working hard to improve my reading skills but I often misread exam questions. My understanding greatly improves when someone else reads the questions to me. One of the peer tutors would be willing to tape the test questions for me. Would you be willing to give this a try?
Adapted from Alberta Learning, Make School Work for You: A Resource for Junior and Senior High Students Who Want to be More Successful Learners (Edmonton, AB: Alberta Learning, 2001), pp. 5, 70.
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A-18
Appendices
Date:
Dear (teachers name) These are the things that I am having difficulty with: understanding my textbook knowing what my homework is getting my homework done listening in class taking notes passing tests completing assignments other Could we please meet to discuss possible strategies? Two meeting times that work for me:
Student signature:
Adapted with permission from Mary Cole and Anne Price, TNT: Tips n Tricks for Dynamite Learning!! (Calgary, AB: Calgary Learning Centre, 1999), p. ii (Black Line Masters).
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A-19
Goal-setting Organizer
Name: Date:
Goal
My goal is to
Rationale
Action plan
Measurement
Evaluation
Adapted from Alberta Learning, Make School Work for You: A Resource for Junior and Senior High Students Who Want to be More Successful Learners (Edmonton, AB: Alberta Learning, 2001), p. 87.
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Appendices
B-1
Galvin, Matthew. Otto Learns about His Medicine. 3rd ed. Washington, DC: Magination Press, 2001. Interest level: Preschool to Grade 4 Reading level: Grades 34
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Appendices
Kraus, Jeanne. Cory Stories: A Kids Book about Living with AD/HD. Washington, DC: Magination Press, 2005. Interest level: Grades 16 Reading level: Grade 4
In this illustrated book for elementary school-aged children, Cory, a child with AD/HD, talks about what it is like to live with AD/HD. In language that children can relate to, he describes his symptoms and his experiences with medication and doctors. He sums up with a statement of acceptance of himself, a focus upon his strengths, and an optimistic outlook on life. The book also includes an informative note to parents describing symptoms and offering specific suggestions about parenting, developing social skills, managing schoolwork and addressing attention span difficulties. This informative book provides elementary schoolaged children with a realistic and constructive way to understand AD/HD. It includes a self-assessment checklist, what others can do to help, what a child can do for himself or herself, and special projects for children and parents. The authors suggest that the book be read together by parents and children, reading one section at a time and then taking time for discussion and reflection. Also included is a section addressed to parents with information about rewards, the importance of special time together, and a list of Web sites and books for further reading. This book is an informative and reassuring guide to AD/HD for older children. The authors compare having AD/HD to driving a powerful and fast sports car that lacks braking power. The book has two sections: understanding AD/HD and strategies for gaining control. The book explains the types of AD/HD, medical terminology and typical symptoms, and discusses prevalence, diagnosis and medication. Also included is a basic explanation of AD/HD and brain activity. The book discusses possible negative feelings associated with AD/HD, as well as highlights the importance of positive feelings and identification of strengths.
Nadeau, Kathleen G. and Ellen B. Dixon. Learning to Slow Down and Pay Attention: A Book for Kids about AD/HD. 3rd ed. Washington DC: Magination Press, 2005. Interest level: Grades 16 Reading level: Grades 34
Quinn, Patricia O. Putting on the Brakes: Young Peoples Guide to Understanding Attention Deficit Hyperactivity Disorder. Washington, DC: Magination Press, 2001. Interest level: Grades 38 Reading level: Grade 6
Please note: This list of titles is provided through the courtesy of Calgary Learning Centre. It is provided as a service only and does not imply ministerial approval. It is intended to assist local school authorities in identifying potentially useful resources for students, parents and teachers. The responsibility for evaluating the materials prior to use rests with the user, in accordance with local and provincial policy.
158
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APPENDIX
Appendices
B-2
Jones, Clare (ed.), Russell Searight (co-ed.) and Magda Urban (co-ed.). Parent Articles About AD/HD. San Antonio, TX: Communication Skill Builders, 1999.
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APPENDIX
B-2
Appendices
Levine, Mel. A Mind at a Time. New York, NY: Simon & Schuster, 2002.
Although Levines book goes beyond AD/HD issues, it is a valuable reference for both parents and teachers in understanding attentional difficulties. Levine encourages readers to understand the ways in which young minds differ, to respect this amazing diversity and to commit to helping those minds develop to their fullest. Different brains, Levine believes, are wired differently. He explains that eight fundamental neurodevelopmental systems influence learning and one of these systems deals especially with attention. Levine dedicates a chapter to this attentional control system, explaining that it includes three types of controls: mental energy controls, intake controls and output controls. Each system is explained in detail. Levine makes a strong case for developing self-understanding about ones own kind of mind and offers strategies to strengthen childrens abilities to learn and live well. In this warm and engaging book, the McCluskeys share their personal account as parents of a daughter with AD/HD. Vivid details from everyday life create a vibrant picture of what it means to parent and teach a child with AD/HD. The McCluskeys recount their daughters struggles to fit in with expectations of peers and teachers. Embedded in their stories are practical tips and strategies, such as the use of logical consequences, choice within limits and reflective listening. Because these tips are set within stories, a reader can see how they play out in daily life. References are provided for more information. The McCluskeys published an earlier version of this book, entitled Butterfly Kisses. This new edition continues the story of their daughter into her early adulthood.
McCluskey, Ken and Andrea McCluskey. Understanding AD/HD: Our Personal Journey. Winnipeg, MB: Portage & Main Press, 2001. (Formerly published as Butterfly Kisses)
160
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APPENDIX
Appendices
B-2
Moghadam, H. Attention Deficit-Hyperactivity Disorder. Calgary, AB: Detselig Enterprises Ltd., 2006.
Written by practitioners from Calgary, Alberta, this practical resource provides a Canadian perspective and draws upon the expertise of a range of professionsmedicine, psychiatry, psychology, education and social work. The multidisciplinary approach is helpful in addressing the complex nature of AD/HD, and addresses concerns and questions frequently raised by parents of children with AD/HD. Topics include a brief historical review, prevalence, causes, diagnosis, management (drug therapy, behaviour management, classroom management, other approaches), parenting and family life, and AD/HD in adolescents. The writers tackle controversial topics head-on and provide information based upon currently available evidence in a way that is accessible to a lay audience and provides parents with a basic understanding of key issues. In a straightforward manner, Morris discusses concerns of parents of children with AD/HD and provides a sensible discussion of diagnosis and treatment. Aware of how AD/HD contributes to stress in the family, she offers strategies for minimizing difficulties, including suggestions for home organization. Her chapter on managing misbehaviour examines the underlying causes and provides a practical explanation of behaviour management. Her strategies include conflict management and techniques for avoiding power struggles, such as giving a voice and a choice. She also addresses school-related concerns by offering tips for building relationships with teachers and managing homework. This is an accessible, well-organized book that is thorough without being overwhelming. It maintains a positive, compassionate approach to AD/HD without minimizing the seriousness of its impact.
Morris, Janet. A Survival Guide for Parents of Children with AttentionDeficit/Hyperactivity Disorder. Champaign, IL: Research Press, 1998.
Please note: This list of titles is provided through the courtesy of Calgary Learning Centre. It is provided as a service only and does not imply ministerial approval. It is intended to assist local school authorities in identifying potentially useful resources for students, parents and teachers. The responsibility for evaluating the materials prior to use rests with the user, in accordance with local and provincial policy.
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161
APPENDIX
B-3
Appendices
McConnell, Kathleen, Gail Ryser and Judith Higgins. Practical Ideas that Really Work for Students with AD/HD. Austin, TX: ProEd, 2000.
162
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APPENDIX
Appendices
B-3
Rief, Sandra. The AD/HD Book of Lists: Practical Guide for Helping Children and Teens with Attention Deficit Disorders. San Francisco, CA: JosseyBass, 2003.
In this easy-to-read book directed at teachers and parents, Rief offers accessible, current and reliable information on AD/HD. The author discusses understanding and diagnosis of AD/HD and promotes use of collaborative care and multimodal approaches for treatment. In addition to offering strategies for preventing and managing behaviour problems, she addresses common academic difficulties and offers practical study skills, learning strategies, organizational skills and homework tips. The final section addresses general topics such as improving outcomes for students, dos and donts for teachers, tips on communicating with parents, and AD/HD across the life span. Teachers will appreciate the collection of reproducible charts and forms for managing classroom routines, rating behaviour, selfmonitoring and using contracts. Teachers and parents are cautioned that information included on laws in the United States does not apply to Canada. This book provides 75 summaries of key issues related to school success for teens. The summaries discuss symptoms of AD/HD and their impact upon students school performance and behaviour. Based on classroom experience and research, the discussions present specific interventions to manage symptoms and enhance success. Topics include diagnostic criteria, myths about AD/HD, learning issues, executive functions, organizational skills, medication issues, classroom management, challenging behaviours and what it means to go the extra mile for students. Appendices include blank forms and additional information. The books overall tone is positive and encouraging, and its sensible and practical approach will appeal to teachers. Readers are cautioned that information included on laws in the United States does not apply to Canada.
Ziegler Dendy, Chris A. Teaching Teens with ADD and AD/HD: A Quick Reference Guide for Teachers and Parents. Bethesda, MD: Woodbine House, 2000.
Please note: This list of titles is provided through the courtesy of Calgary Learning Centre. It is provided as a service only and does not imply ministerial approval. It is intended to assist local school authorities in identifying potentially useful resources for students, parents and teachers. The responsibility for evaluating the materials prior to use rests with the user, in accordance with local and provincial policy.
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163
164
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Biederman, J. et al. Influence of Gender on Attention Deficit Hyperactivity Disorder in Children Referred to a Psychiatry Clinic. American Journal of Psychiatry 159 (2002), pp. 3942. Brown, Dale S. Learning a Living: A Guide to Planning Your Career and Finding a Job for People with Learning Disabilities, Attention Deficit Disorder, and Dyslexia. Bethesda, MD: Woodbine House, 2000. Brown, R. T., W. S. Freeman and J. M. Perin. Prevalence and Assessment of Attention Deficit Hyperactivity Disorder in Primary Care Settings. Pediatrics 107, 3 (2001), pp. 111. Brown, Thomas E. (ed.). Attention-deficit Disorders and Comorbidities in Children, Adolescents, and Adults. Washington, DC: American Psychiatric Press, 2000. Camp, Bonnie W. and Mary Ann S. Bash. Think Aloud: Increasing Social and Cognitive Skills A Problem Solving Program for Children: Classroom Program Grades 12. Champaign, IL: Research Press, 1985. Canadian Attention Deficit Hyperactivity Disorder Resource Alliance (CADDRA). Canadian ADHD Practice Guidelines, First Edition. Toronto, ON: CADDRA, 2006. Canadian Paediatric Society (CPS). The Use of Stimulant Medication in the Treatment of Attention Deficit Hyperactivity Disorder. Paediatrics & Child Health 7, 10 (2002), pp. 693696. Canadian Paediatric Society (CPS). The Use of Alternative Therapies in Treating Children with Attention Deficit Hyperactivity Disorder. Paediatrics & Child Health 7, 10 (2002), pp. 710718. Canadian Paediatric Society (CPS). Alternative Treatments for Attention Deficit Hyperactivity Disorder. Paediatrics & Child Health 8, 4 (2003), pp. 243244. Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD). Complementary and Alternative Treatments. What We Know Information Sheet #6. National Resource Center on AD/HD. October 2003. www.help4adhd.org/documents/WWK6.pdf (Accessed April 2006). Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD). Deciding on a Treatment for AD/HD. What We Know Information Sheet #6S. National Resource Center on AD/HD. 2004. www.help4adhd.org/documents/ WWK6s.pdf (Accessed April 2006).
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Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD). The New CHADD Information and Resource Guide to AD/HD. Landover, MD: CHADD, 2006. Cole, Mary and Anne Price. TNT: Tips N Tricks for Dynamite Learning!! Calgary, AB: Calgary Learning Centre, 1999. Cummings, Rhoda and Gary Fisher. The School Survival Guide for Kids with LD (Learning Differences). Minneapolis, MN: Free Spirit Publishing, Inc., 1991. Deshler, Donald D., Edwin S. Ellis and B. Keith Lenz. Teaching Adolescents with Learning Disabilities: Strategies and Methods. 2nd ed. Denver, CO: Love Publishing Company, 1996. Eaton, Howard. Self-Advocacy: How Students with Learning Disabilities Can Make the Transition from High School to College. Santa Barbara, CA: Excel Publishing, 1996. Edmonton Public Schools. AISI Middle Literacy Project. Edmonton, AB: Edmonton Public Schools, 2001. Edmonton Public Schools. Think Again: Thinking Tools for Grades 610. Edmonton, AB: Resource Development Services, Edmonton Public Schools, 2003. Edmunds, Alan L. Cognitive Credit Cards: Acquiring Learning Strategies. Teaching Exceptional Children 31, 4 (1999), pp. 6873. Epstein, Joyce L. et al. School, Family, and Community Partnerships: Your Handbook for Action. 2nd ed. Thousand Oaks, CA: Corwin Press, Inc., 2002. Farrelly, Geraldine A. ADHD: A Diagnostic Dilemma. The Canadian Journal of Continuing Medical Education 13, 10 (2001), pp. 249260. Flick, Grad L. ADD/ADHD Behavior-Change Resource Kit: Ready-to-Use Strategies and Activities for Helping Children with Attention Deficit Disorder. San Francisco, CA: Jossey-Bass, 1998. Fowler, Mary. CH.A.D.D. Educators Manual: An In-Depth Look at Attention Deficit Disorders from an Educational Perspective. Plantation, FL: Children and Adults with Attention Deficit Disorders (CHADD), 1992. Frank, Kim Tip and Susan J. Smith-Rex. ADHD: 102 Practical Strategies for Reducing the Deficit. 2nd ed. Chapin, SC: YouthLight, Inc., 2001, 1996.
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Greenhill, Laurence L. et al. Practice Parameter for the Use of Stimulant Medications in the Treatment of Children, Adolescents, and Adults. Journal of the American Academy of Child and Adolescent Psychiatry 41, 2 (February 2002 Supplement), pp. 26S49S. Hallowell, Edward M. and John J. Ratey. Driven to Distraction: Recognizing and Coping with Attention Deficit Disorder from Childhood through Adulthood. New York, NY: Simon and Schuster, 1994. Hallowell, Edward M. and John J. Ratey. Delivered from Distraction: Getting the Most out of Life with Attention Deficit Disorder. New York, NY: Ballantine Books, 2005. Jones, Clare B., H. Russell Searight and Magda A. Urban (eds.). Parent Articles About ADHD. San Antonio, TX: Communication Skill Builders, 1999. Levine, Mel. A Mind at a Time. New York, NY: Simon & Schuster, 2002. Levy, Florence and David A. Hay (eds.). Attention, Genes, and ADHD. Philadelphia, PA: Brunner-Routledge, 2001. Malbin, Diane. Paradigm Shifts and FAS/FAE. Portland, OR: Fetal Alcohol Syndrome Consultation, Education and Training Services (FASCETS), Inc., 1994. Malbin, Diane. Fetal Alcohol Syndrome and Alcohol-Related Neurodevelopmental Disorders: Trying Differently Rather Than Harder. Portland, OR: Fetal Alcohol Syndrome Consultation, Education and Training Services (FASCETS), Inc., 1999. McCluskey, Ken and Andrea McCluskey. Understanding ADHD: Our Personal Journey. Winnipeg, MB: Portage & Main Press, 2001. McConnell, Kathleen, Gail Ryser and Judith Higgins. Practical Ideas That Really Work for Students with ADHD. Austin, TX: Pro-Ed, Inc., 2000. Morris, Janet. Facing AD/HD: A Survival Guide for Parents of Children with AttentionDeficit/Hyperactivity Disorder. Champaign, IL: Research Press, 1998. MTA Cooperative Group. A 14 Month Randomized Clinical Trial of Treatment Strategies for Attention-Deficit/Hyperactivity Disorder. Archives of General Psychiatry 56, 12 (1999), pp. 10731086. Minskoff, Esther et al. WARF. The Learning Toolbox. http://coe.jmu.edu/learningtoolbox (Accessed July 2006).
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Nadeau, Kathleen G. Help4ADD@HighSchool. Silver Spring, MD: Advantage Books, 1998. Nadeau, Kathleen G., Ellen B. Littman and Patricia O. Quinn. Understanding Girls with Attention Deficit Hyperactivity Disorder. Silver Spring, MD: Advantage Books, 1999. Nhat Hanh, Thich. Peace is Every Step: The Path of Mindfulness in Everyday Life. New York, NY: Bantam Books, 1991. Porter, Gordon L. et. al. Problem Solving Teams: A Thirty-Minute Peer-Helping Model. In Gordon L. Porter and Diane Richler (eds.), Changing Canadian Schools: Perspectives on Disability and Inclusion (North York, ON: The Roeher Institute, 1991), pp. 219237. Rief, Sandra F. The ADHD Book of Lists: A Practical Guide for Helping Children and Teens with Attention Deficit Disorders. San Francisco, CA: Jossey-Bass, 2003. Sommers-Flanagan, Rita and John Sommers-Flanagan. Problem Child or Quirky Kid? A Commonsense Guide. Minneapolis, MN: Free Spirit Publishing Inc., 2002. Souveny, Dwaine M. and Dianna L. Souveny. ABCs for Success: Attention Deficit Disorders. Rev. ed. Red Deer, AB: Dynamic Networks Publication, 1996. Suid, Murray. Demonic Mnemonics: 800 Spelling Tricks for 800 Tricky Words. Carthage, IL: Fearon Teacher Aids, 1981. Tannock, Rosemary. Understanding, Teaching, and Supporting Students with ADHD, presentation at 2003 Conference on ADHD. The Association of Chief Psychologists with Ontario School Boards. November 27, 2003. www.acposb.on.ca/HSC%20Part%202%20supporting%20&%20teaching%20ADH D.ppt (Accessed June 2006). Tannock, Rosemary, Rhonda Martinussen and Peter Chaban. Beyond Behavior: Rethinking ADHD as a Type of Learning DisabilityCommentary. The Hospital for Sick Children, Toronto, Ontario, Canada, April 12, 2005. Thorne, Glenda C. and Alice Thomas. What is Attention? Center for Development & Learning. January 1, 2003. www.cdl.org/resource-library/articles/attention2.php? type=subject&id=1 (Accessed June 2006).
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Zeigler Dendy, Chris A. Teenagers with ADD: A Parents Guide. Bethesda, MD: Woodbine House, 1995. Zeigler Dendy, Chris A. Teaching Teens with ADD and ADHD: A Quick Reference Guide for Teachers and Parents. Bethesda, MD: Woodbine House, 2000.
170
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Index
A
A-B-Cs (Antecedent-Behaviour-Consequence) in behaviour supports, 56 active listening skills instructional strategies for, 6870, 136137 AD/HD causes of, 3, 44 coexisting conditions with, 11 gender differences, 4 incidence of, 4, 11, 114 positive aspects of, 1, 22, 9698, 100101 symptoms of, 26, 67, 114 types of, 1011 See also diagnosis of AD/HD; researching AD/HD issues; treatments for AD/HD AD/HD Book of Lists: Practical Guide for Helping Children and Teens with Attention Deficit Disorders, The (Rief), 163 AD/HD Companion: Attention Deficit Hyperactivity Disorder, The (Brown), 162 adolescents with AD/HD symptoms in, 8, 11, 114 transition planning for, 113115 See also students with AD/HD; transition planning adults with AD/HD symptoms in, 8, 114 treatment of, 33 undiagnosed and untreated AD/HD in, 30, 32 Alberta Education special education requirements, 14 alcohol abuse. See substance abuse allergy treatments as treatment for AD/HD, 40 alternative treatments for AD/HD about alternative treatments, 4042 how to evaluate information on, 4042, 119121, 134 See also treatments for AD/HD anger management psychological interventions for, 36 strategies for, 3839
FOCUSING ON SUCCESS
171 171
Index
antioxidants as alternative treatment for AD/HD, 42 anxiety disorders as coexisting condition, 4, 8, 11, 114 treatment of, 30, 36 arithmetic skills. See math skills asking for help ticket for self-advocacy, 109, 154 assessment of AD/HD. See diagnosis of AD/HD assessment of learning in individual student support plan, 94 in IPP sample, 126130 strategies for, 8891 assignment completion goals and objectives in IPP sample, 130 monitoring for, 67 Attention Deficit/Hyperactivity Disorder. See AD/HD Attention Deficit/Hyperactivity Disorder (Moghadam), 161 attention difficulties impact of AD/HD on, 46 self-assessment of, 142143 self-monitoring strategies for, 104106 strategies to support, 145 See also behaviour supports and interventions; instructional strategies; selfassessment inventories for students auditory and sound training as alternative treatment for AD/HD, 42
B
Beal, Eileen, 157 behaviour supports and interventions about supports and interventions, 3536 at school, 3536, 4755 in comprehensive treatment approach, 2931 home-school consistency, 2324, 31, 3536 individual behavioural support plans, 5661, 135 low-key cues as, 4950 monitoring and review of, 23, 146 positive feedback in, 48 self-monitoring strategies as, 104106 See also transition planning
172
FOCUSING ON SUCCESS
Index
behavioural disorders as coexisting conditions, 8, 11 psychological intervention for, 36 biofeedback as alternative treatment for AD/HD, 40, 42 bipolar disorder as coexisting condition, 11 psychological intervention for, 36 blue-green algae as alternative treatment for AD/HD, 41 brain gym as alternative treatment for AD/HD, 40 Brown, Molly Lyle, 162 Building on Success: Helping Students Make Transitions from Year to Year (Alberta Education), 115
C
CADDRA. See Canadian Attention Deficit Hyperactivity Disorder Resource Alliance Canadian ADHD Practice Guidelines (2006) (CADDRA) for physicians, 11 Canadian Attention Deficit Hyperactivity Disorder Resource Alliance (CADDRA) on diagnosis of AD/HD, 7, 11 Canadian Paediatric Society on alternative treatments, 4042 CCCs (cognitive credit cards) as math strategy, 8788 Chaban, Peter, 63 CHADD. See Children and Adults with Attention Deficit/Hyperactivity Disorder character and citizenship education as schoolwide interventions, 37 Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD) on comprehensive treatment approach, 29 Web site for evaluation of alternative treatments, 40 children with AD/HD. See students with AD/HD Chill Out Plan (COP) for stress management, 3839 chiropractic adjustments as alternative treatment for AD/HD, 40 classroom environment basic rules in, 47 reduction of distractions in, 4546 reward systems in, 5960
FOCUSING ON SUCCESS
173 173
Index
safe and caring atmosphere in, 37, 9899 self-assessment by student of, 142143 See also behaviour supports and interventions coexisting conditions as complex type of AD/HD, 11 cognitive credit cards (CCC) as math strategy, 8788 combined type of AD/HD criteria for diagnosis of, 1011 communication skills strategies for, 108109 See also social skills complex and simple AD/HD differences between, 11 conduct disorders as coexisting condition, 11 psychological interventions for, 36 conflict management as schoolwide intervention, 37 strategies for, 55 connectedness creating with students, 9599 COP (Chill Out Plan) for stress management, 3839 COPS for editing writing, 77 Cory Stories: A Kid's Book about Living with AD/HD (Kraus), 158 cues strategies for low-key cues, 4950 See also attention difficulties; memory difficulties
D
daily reports for home-school communication, 5661, 135 deanol as alternative treatment for AD/HD, 41 Delivered from Distraction: Getting the Most Out of Life with Attention Deficit Disorder (Hallowell and Ratey), 159 depression as coexisting condition, 4, 8, 11 psychological intervention for, 36 treatment of, 30
174
FOCUSING ON SUCCESS
Index
diagnosis of AD/HD procedures for, 611, 30 what to do for students with undiagnosed AD/HD, 1213 Diagnostic and Statistical Manual for Mental Disorders (DSM-IV) criteria for diagnosis of AD/HD, 1011 diet as alternative treatment for AD/HD, 4042 directions for assignments student self-assessment of preferred methods, 142143 teacher strategies for giving directions, 6567 Dixon, Ellen B., 158 drug abuse. See substance abuse DSM-IV. See Diagnostic and Statistical Manual for Mental Disorders (DSM-IV)
E
ear conditions infections as coexisting condition, 8 inner ear treatments as alternative treatments, 40 elementary students with AD/HD symptoms in, 8 transition planning for, 112113 See also students with AD/HD; transition planning epilepsy as coexisting condition, 8 error analysis for assessment of learning, 8889 Everything You Need to Know about ADD/AD/HD (Beal), 157 executive functions impairment as AD/HD symptom, 6 eye training and eyeglasses as alternative treatments for AD/HD, 40
F
families. See parents of children with AD/HD; students with AD/HD fatty acids as alternative treatment for AD/HD, 41 fetal alcohol spectrum disorder as coexisting condition, 11 fine motor skills strategies in math, 81 See also handwriting and printing skills
FOCUSING ON SUCCESS
175
Index
fish oil as alternative treatment for AD/HD, 41 focusing skills. See attention difficulties food and nutrition as alternative treatment for AD/HD, 4042
G
Galvin, Matthew, 157 gender differences in symptoms of AD/HD, 4 ginkgo biloba as alternative treatment for AD/HD, 41 goal setting goals and objectives in sample IPP, 128130 for individual behaviour supports, 57 in organizer for planning, 110, 155 in transition planning, 110115 Greene, Ross, 44
H
Hallowell, Edward, 1, 95, 96, 100, 159 handwriting and printing skills instructional strategies for, 7476, 144 herbs as alternative treatment for AD/HD, 4042 heredity causes of AD/HD and, 3 Higgins, Judith, 162 high school students with AD/HD. See senior high students with AD/HD homeopathy as alternative treatment for AD/HD, 42 home-school partnerships about strategies for, 2028 for behaviour support plans, 4752 for daily reports on behaviour, 5661, 135 for homework routines, 2627, 46 for reward systems, 5960 See also parents of children with AD/HD; teachers of students with AD/HD homework routines for, 2627, 46
176
FOCUSING ON SUCCESS
Index
hyperactive-impulsive type of AD/HD criteria for diagnosis of, 1011 metaphors for, 100, 107108 strategies to manage, 5054 symptoms of hyperactivity and impulsivity, 5, 114 testing-taking skills and, 89 hypnotherapy as alternative treatment for AD/HD, 42
I
impulsivity. See hyperactive-impulsive type of AD/HD inattentive type of AD/HD criteria for diagnosis, 1011 symptoms of inattention, 5 inconsistency as symptom of AD/HD, 67 Individualized Program Plan (IPP) required for students with special education needs, 1314 sample IPP, 125131 information on AD/HD issues. See researching AD/HD issues instructional strategies, 6394 appealing to student interests, 6465, 9899 error analysis, 8889 giving directions, 6567 individual instructional support plans, 9394, 147148 listening skills, 6870, 136137 memory prompts, 7174 monitoring and review of strategies, 23, 146 monitoring for assignment completion, 67, 130 self-assessment of effectiveness of, 142143 self-monitoring strategies, 104106 team approach, 55, 9192 See also assessment of learning; and specific subjects Internet how to research issues on, 118121 interviews for assessment of AD/HD, 9
J
Jones, Clare, 159 The Journey: A Handbook for Parents of Children Who are Gifted and Talented (Alberta Education), 28
FOCUSING ON SUCCESS
177
Index
junior high/middle school students with AD/HD symptoms in, 8, 11, 114 transition planning for, 113 See also students with AD/HD; transition planning
K
kava as alternative treatment for AD/HD, 41 Kraus, Jeanne, 158 K-W-L+ (chart) for researching issues, 152
L
language arts. See printing and handwriting skills; reading skills; spelling skills; writing skills learning disabilities association for, 121 as coexisting condition, 2, 8, 11 Learning Team: A Handbook for Parents of Children with Special Needs, The (Alberta Education), 28 Learning to Slow Down and Pay Attention: A Book for Kids about AD/HD (Nadeau and Dixon), 158 Levine, Mel, 160 listening skills strategies for teaching, 6870, 136137
M
Martinussen, Rhonda, 63 math skills impact of AD/HD on, 2, 80 instructional strategies for, 8088 McCluskey, Ken and Andrea, 160 McConnell, Kathleen, 162 medication for AD/HD about stimulant medications, 3135 administration to student at school, 3335 in comprehensive treatment approach, 2931 evaluation of treatments, 4042, 120121, 134 substance abuse and, 32 talking with parents about, 13, 3536, 159161 talking with students about, 33, 101102, 157158 See also researching AD/HD issues
178
FOCUSING ON SUCCESS
Index
meetings, parent and teacher sample planner for, 132133 strategies for, 2122, 35 See also parents of children with AD/HD; teachers of students with AD/HD melatonin as alternative treatment for AD/HD, 42 memory difficulties strategies for math facts, 8086 strategies to support, 7174, 145 mental illnesses as coexisting condition, 11 psychological intervention for, 36 metaphors for AD/HD use of, 100, 107108 middle school students with AD/HD. See junior high/middle school students with AD/HD Mind at a Time, A (Levine), 160 mineral supplements as alternative treatment for AD/HD, 41 mnemonics for memory difficulties, 7374 Moghadam, H., 161 monitoring academic progress. See assessment of learning monitoring behaviour daily reports for, 5661, 135 strategies for, 5661 monitoring medication effects strategies for, 34 mood disorders. See anxiety disorders; depression Morris, Janet, 161 motor skills. See fine motor skills movement needs strategies for, 5254 multimodal treatments as comprehensive treatment approach, 2931 See also behaviour supports and interventions; medication for AD/HD muscle relaxation for stress management, 38
N
Nadeau, Kathleen G., 158 National Institute of Mental Health evaluation of alternative treatments, 40, 121
FOCUSING ON SUCCESS
179
Index
Neelan, David, 101 Nhat Hanh, Thich, 43 nootropics as alternative treatments for AD/HD, 41 nutrition as alternative treatment for AD/HD, 4042 poor nutrition as coexisting condition, 9
O
observations for assessment of AD/HD, 9 oculovestibular treatment as alternative treatment for AD/HD, 42 oppositional defiant disorders as coexisting condition, 4, 11 psychological interventions for, 36 treatment of, 30 organizational skills impact of AD/HD on executive functions, 6 self-assessment of, 142143 strategies for organizing materials, 46 for transitions, 103104, 110115 organizations, AD/HD as resources, 11, 121 Otto Learns about his Medicine (Galvin), 157
P
Parent Advantage: Helping Children Become More Successful Learners at Home and School, Grades 19, The (Alberta Education), 28 Parent Articles about AD/HD (Jones), 159 parents of children with AD/HD causes of AD/HD and, 3, 44 daily reports to, 5661, 135 home-school communication, 2526 home-school partnerships, 2028 homework strategies, 2627, 46 meetings with teachers, 2125, 35, 132133 parent education initiatives, 25, 3031 reframing and rethinking AD/HD, 1, 9698 reward systems for children, 5960 roles for, 1718 what to do for children with undiagnosed AD/HD, 1213 See also resources for parents
180
FOCUSING ON SUCCESS
Index
peer mediation programs as schoolwide interventions, 37 PENS strategy for planning writing, 77 physical education support for social skills during, 54 physicians prescribing medications for AD/HD, 3235 resources for, 11 roles for, 17, 20 planning skills impact of AD/HD on executive functions, 6 strategies for teaching, 68 See also transition planning portfolios for assessment, 90 Practical Ideas that Really Work for Students with AD/HD, 162 preschool children AD/HD symptoms in, 7 primrose oil as alternative treatment for AD/HD, 41 printing and handwriting skills instructional strategies for, 7476, 144 problem-solving approaches goal-setting organizer for, 110, 155 impact of AD/HD on executive functions, 6 planning skills in, 68 self-monitoring strategies as, 104106 six-step plan, 51 See also transition planning progressive muscle relaxation for stress management, 38 psychological interventions in comprehensive treatment approach, 2931, 36 psychologists roles for, 17, 19, 36 Putting on the Brakes: Young People's Guide to Understanding Attention Deficit Hyperactivity Disorder (Quinn), 158 pycnogenol as alternative treatment for AD/HD, 42
FOCUSING ON SUCCESS
181
Index
Q
Quinn, Patricia O., 158
R
Ratey, John, 1, 95, 96, 100, 159 rating scales for assessment of AD/HD, 9 reading skills error analysis, 8889 impact of AD/HD on, 2 individual student support plan for, 94, 147148 instructional strategies for, 7980, 138139, 144 IPP sample goals and objectives for, 128 self-assessment by student of, 138139 textbook preview checklist, 79, 140 reframing and rethinking AD/HD for parents and teachers, 1, 9698, 100101 relaxation exercises for stress management, 3839 researching AD/HD issues about research strategies, 117121 evaluation of alternative treatments, 40, 119121, 134 K-W-L+ (chart), 152 resources for parents organizations, 11, 121 print materials, 25, 28, 101102, 159161 role of school in provision of, 25 on transitions, 115 resources for students print materials, 101102, 157158 resources for teachers organizations, 11, 121 print materials, 115, 162163 See also Web sites reward systems in support plans, 5960 Rief, Sandra, 163 Ryser, Gail, 162
182
FOCUSING ON SUCCESS
Index
S
school environment safe and caring atmosphere in, 37, 9899 schoolwide interventions, 37 See also classroom environment Searight, Russell, 159 second languages strategies for learning vocabulary, 73 self-advocacy skills asking for help ticket, 109, 154 strategies for, 107109, 153154 self-assessment inventories for students of general strategies, 142143, 145 of reading and writing strategies, 138139, 144 of strengths and challenges, 141, 149151 self-assessment inventories for teachers of listener friendly strategies, 123 self-monitoring skills impact of AD/HD on executive functions, 6 strategies for, 104106 senior high students with AD/HD symptoms in, 8, 11, 114 transition planning for, 114115 See also students with AD/HD; transition planning simple and complex AD/HD differences between, 11 sleep difficulties as coexisting condition, 8 smart drugs as alternative treatment for AD/HD, 41 social skills anger management, 3839 communication skills, 108109 conflict management, 55 how to teach a specific social skill, 37 impact of AD/HD on, 5 psychological interventions to teach, 36 self-advocacy skills, 107109, 153154 self-monitoring skills, 104106 strategies for improving, 3739, 55 sound training as alternative treatment for AD/HD, 42
FOCUSING ON SUCCESS
183
Index
special needs, students with sample IPP for, 125131 students with AD/HD as potential, 1314 Web site for coding criteria, 14 speed reading skills (WARF), 80 spelling skills instructional strategies for, 7374, 78 stimulant medications. See medication for AD/HD strengths of students with AD/HD about strengths, 1, 22, 9698, 100101 inventories, 108, 149 stress management strategies for, 3839 students with AD/HD creating connectedness with, 9596 discussing medication with, 33, 101102, 157158 gender differences in students with AD/HD, 4 instructional support plan, 9394, 147148 learning about AD/HD, 33, 9698, 100102, 107108, 157158 positive side of AD/HD in, 1, 22, 9698, 100101 safe and caring environment for, 37, 9899 self-advocacy skills, 107109, 153154 self-assessment of strategies used by, 142143 self-assessment of strengths and needs, 108, 141, 149151 self-monitoring by, 104106 transition planning strategies for, 4849, 110115 undiagnosed and untreated AD/HD in, 30, 32 See also assessment of learning; instructional strategies; treatments for AD/HD substance abuse as coexisting condition, 9 medication for AD/HD and, 32 undiagnosed and untreated AD/HD and, 30, 32 supplements, dietary as alternative treatment for AD/HD, 4042 Survival Guide for Parents of Children with Attention-Deficit/Hyperactivity Disorder, A (Morris), 161
T
Tannock, Rosemary, 63 teachers of students with AD/HD administering medication at school, 3334 home-school partnerships, 2028 listener friendly instruction (checklist), 6870
184
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Index
meetings with parents, 2125, 35, 132133 qualities of effective teachers, 4445 reframing AD/HD for positives, 1, 22, 9698, 100101 roles for teachers, 1719, 9698 roles for teacher advisors, 91 safe and caring atmosphere, 37, 9899 strategies for connectedness with students, 9598 support for learning about AD/HD, 100102, 107108 team approaches, 55, 9192 what to do for students with undiagnosed AD/HD, 1213 See also behaviour supports and interventions; home-school partnerships; instructional strategies; resources for teachers teacher assistants roles for, 19, 94, 148 team approaches, 55, 9192 Teaching Teens with ADD and AD/HD: A Quick Reference Guide for Teachers and Parents (Dendy), 163 teens with AD/HD. See adolescents with AD/HD Ten Good Things about People with AD/HD, 101 test-taking skills strategies for, 89 See also assessment of learning textbook preview checklist for, 79, 140 Tourette's syndrome as coexisting condition, 11 psychological interventions for, 36 transition planning IPP sample plan, 131 resources for, 115 strategies for, 4849, 110115 treatments for AD/HD in comprehensive approach, 2931 See also alternative treatments for AD/HD; behaviour supports and interventions; medication for AD/HD types of AD/HD, 1011 See also hyperactive-impulsive type of AD/HD; inattentive type of AD/HD
FOCUSING ON SUCCESS
185
Index
U
Understanding AD/HD: Our Personal Journey (McCluskey), 160 undiagnosed and untreated AD/HD, students with difficulties from, 30, 32 what to do for, 1213 See also diagnosis of AD/HD Urban, Magda, 159
V
valerian as alternative treatment for AD/HD, 41 vision therapy as alternative treatment for AD/HD, 40 visualizations for stress management, 38 vitamin supplements as alternative treatment for AD/HD, 4041
W
WARF speed reading skills, 80 Web sites for assistive technologies for reading, 80 on behavioural interventions, 61 on evaluating alternative treatments, 41 using search engines for, 118119 writing skills impact of AD/HD on, 2 in individual support plan, 94 IPP sample goals and objectives for, 129 printing and handwriting skills, 7476, 144 spelling, 7374, 78 strategies for improving, 7677, 144
Y
yeast infections treatments as alternative treatments for AD/HD, 40 youth with AD/HD. See adolescents with AD/HD
Z
Zeigler Dendy, Chris A., 163
186
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