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  • Instructor’s Notes
    Discussion Topic:
    Have students share any experiences they have had with individuals who have ADHD. Ask them to discuss the characteristics these individuals displayed. Also, explore the biases and misperceptions that others may have regarding this disorder (e.g., some think that ADHD is not a “bona fide” disorder; others just think these students are “mean”). Finally, you might want to ask students what they have learned about ADHD through the media. Many times, this disorder is presented as a controversial disorder in medial portrayals (i.e, it may be “sensationalized”).
  • Instructor’s Notes
  • Instructor’s Notes
    Discussion Topic:
    Ask your students if too many school-aged children are being diagnosed as ADHD. Point out that the American Psychiatric Association recently presented more stringent guidelines for diagnosing this disorder.
    Refer to Text:
    Refer students to Figure 5.1. This figure provides a flowchart that will help students understand the “flow of services” that characterize these two laws. Review each step in the flowchart with students.
  • Instructor’s Notes
    Refer to Text:
    Refer students to the “Rights and Responsibilities” feature in the textbook. This feature reviews parental rights under Section 504. Ask students to compare and contrast these parental rights relative to the IDEA.
  • Instructor’s Notes
    Discussion Topic:
    In the slide above, one bullet points out that ADHD typically has an onset before the age of seven. Explain to students how inattention, hyperactivity, and impulsivity are common among almost all very young children. This fact complicates the diagnostic process for preschoolers. You also might want to explain that issues related to frequency, duration, and intensity are important dimensions that need to be considered carefully when making a diagnosis of ADHD, especially in the early childhood years.
  • Instructor’s Notes
    Refer to Text:
    Refer students to Figure 5.2 and review the DSM diagnostic criteria for ADHD. Ask your students if these criteria appear to be objective or subjective.
    Discussion Topic:
    Point out to students that even though ADHD is distinguished from Conduct Disorder and Oppositional Defiant Disorder, ADHD often co-occurs with one or both of these disorders. If fact, children with ADHD are at great risk for developing one or both of these disorders. You also might want to provide students with some of the characteristics of children with Conduct Disorder and Oppositional Defiant Disorder.
  • Instructor’s Notes
  • Instructor’s Notes
    Discussion Topic:
    Explain to your students that there is extensive medical research that has been undertaken in the area of ADHD. Point out the results of this research strongly suggests that ADHD is a biologically-based disorder, even though the exact cause of the disorder is unknown in most cases.
  • Instructor’s Notes
    Discussion Topic:
    Explain to students that years ago, many professionals believed that students with ADHD were overstimulated by their environments. Current thinking in the field today is that they are understimulated by the their environments. As an analogy, explain that we may become physical understimulated while sitting through a boring lecture. This is why we do such things as doodle, fidget, talk to others, or try to create more stimulation in our environment. In many ways, this is what students with ADHD experience almost constantly. Ask your students to suggest ways that a classroom environment might be made more stimulating for students with ADHD.
    Refer to Text:
    Refer students to Figure 5.2. This figure highlights many of the characteristics of ADHD that a teacher might observe in the classroom.
  • Instructor’s Notes
  • Instructor’s Notes
  • Instructor’s Notes
    Discussion Topic:
    Ask students to project what their roles and responsibilities might be in the assessment process relative to children with ADHD.
  • Instructor’s Notes
    Discussion Topic:
    Point out to your students that prereferral interventions will be expected when initial concerns are expressed about students suspected of having ADHD.
    Refer to Text:
    Refer students to Figure 5.4. This figure provides a sample form for documenting classroom manifestations of ADHD-like behavior. Explain to students that one of their responsibilities will be to provide ongoing documentation of children’s behavior.
  • Instructor’s Notes
    Refer to Text:
    Refer students to Figure 5.5. This figure illustrates sample test items from the “Strengths and Limitations Inventory.” Explain to students that this inventory is one example of an assessment they may have to complete for a child suspected of having ADHD.
    Interactive Activity:
    Bring in illustrative examples of interviews, rating scales, and observations that are designed to assess students suspected of having ADHD. Have students break down into small groups and review these instruments.
  • Instructor’s Notes
  • Instructor’s Notes
  • Instructor’s Notes
    Refer to Text:
    Refer students to the Section 504 plan for Jake. Remember that Jake is the student with ADHD depicted in the opening vignette. Have students critique the appropriateness of this plan for Jake.
  • Instructor’s Notes
    Refer to Text:
    Refer students to Figure 5.6. This figure highlights a sample form for documenting the side effects of stimulant medication. Discuss with students the need for them to monitor and report side effects. This checklist is just one way they might meet this important responsibility.
  • Instructor’s Notes
  • Instructor’s Notes
    Refer to Text:
    Refer students to Table 5.1. Review these common myths about medications used to treat children and youth with ADHD.
  • Instructor’s Notes
  • Instructor’s Notes
  • Instructor’s Notes
  • Instructor’s Notes
  • Instructor’s Notes
    Refer to Text:
    The model on this slide is illustrated in Figure 5.7 in the textbook. Discuss each component in this model.
    Refer to Text/Interactive Activity
    Ask students to review the section entitled, “Personal Spotlights.” This section spotlights a child who is both gifted and has ADHD. Throughout his school year, the services he received were inappropriate for his needs. Ask students to break down into groups and design a multimodal intervention plan for this students.
  • Instructor’s Notes
    Refer to Text/Assignment:
    Refer students to the recommendations for developing classroom rules located in the narrative of the textbook. Review these rules with students and then require them to develop a set of rules and consequences for their classrooms.
    Refer to Text/Assignment:
    Refer students to the recommendations for managing large group instruction in the classroom. Ask students why these recommendations might be effective with children who have ADHD.
  • Instructor’s Notes
    Refer to Text/Assignment:
    Refer students to Figure 5.8 in the text. Ask them to develop a contingency contract, such as this one, for the student described in the “Personal Spotlight” section of the textbook.
  • Instructor’s Notes
    Refer to Text/Assignment:
    Refer students to the “Technology Today” feature in the textbook. This feature provides many online lesson plans. Ask students to download one or two of these plans and then evaluate their potential effectiveness for children with ADHD.
    Refer to Text:
    Refer students to the “Inclusion Strategies” feature in the textbook. This feature is entitled, “Time On-Task Self-Assessment for Teachers.” Ask students to review this feature and generate strategies that teachers might use to facilitate their students’ attention.
  • Instructor’s Notes
  • Instructor’s Notes
  • Instructor’s Notes
    Refer to Text:
    Refer students to the benefits of using self-regulated strategies with children with ADHD. These benefits are located in the text narrative.
  • Instructor’s Notes
  • Instructor’s Notes
  • Instructor’s Notes
  • Instructor’s Notes
    Refer to Text:
    Refer students to Figure 5.9 in the text. This figure provides an example of a direct strategy for teaching a child to manage his or her anger. Ask students to evaluate this strategy.
    Refer to Text:
    Refer students to Figure 5.10 in the text. This figure highlights a self-monitoring strategy for teaching a child to monitor his or her anger. Ask students to evaluate this strategy.
  • Instructor’s Notes
    Refer to Text:
    Refer students to Figure 5.11 in the text. This figure provides an example of a direct strategy for teaching a child to manage homework.
    Ask students to evaluate this strategy.
  • Instructor’s Notes
    Refer to Text:
    Refer students to the list of characteristics of effective teachers of students with ADHD. This list is located in the narrative in the textbook. Ask students to recall one of their excellent teachers and identify which of these characteristics this teacher exhibited. Ask them to give concrete examples for each characteristic.
  • Instructor’s Notes
  • Instructor’s Notes
    Refer to Text/Assignment:
    Refer students to the list of publications on disability awareness located in the narrative of the textbook. Ask students to locate at least one of these publications and then share them with class members.
  • Instructor’s Notes
    Assignment:
    Ask students to develop illustrative examples of home-school reporting systems and then share them with the class.
  • Transcript

    • 1. (c) Allyn & Bacon 2004Copyright © Allyn and Bacon 2004 Chapter Five Teaching Students with Attention Deficit/ Hyperactivity Disorder This multimedia product and its contents are protected under copyright law. The following are prohibited by law: •any public performance or display, including transmission of any image over a network; •preparation of any derivative work, including the extraction, in whole or in part, of any images; •any rental, lease, or lending of the program.
    • 2. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Introduction  In the past decade, public awareness about ADHD has increased.  The legal basis for services and protections against discrimination for ADHD come from the IDEA and Section 504.  Unsuccessful efforts were made in 1990 to add ADHD as a separate disability category under the IDEA.
    • 3. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Introduction  Children with ADHD may also be served in other special education categories such as:  Learning disabilities  Emotional or behavioral disorders  Mental retardation  A sizeable number of students with ADHD are not qualifying for special education services under the IDEA.  Many of these students receive accommodations under Section 504.
    • 4. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Section 504 Section 504 has been and may continue to be the primary legal basis for services to this population. Section 504 is not a special education law. It is a civil rights law. Section 504 provides for a larger group of students with disabilities and differs in many respects from the IDEA.
    • 5. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Basic Concepts About ADHD  ADHD is an invisible, hidden disability.  ADHD is not hard to spot in the classroom.  Many ADHD behaviors may be misinterpreted as lazy, unorganized, and even disrespectful.  In the majority of cases, ADHD is a developmental disability that becomes apparent before the age of seven.  ADHD continues to be problematic for most individuals during adulthood.  ADHD may have a negative impact on a student’s academic and social success.  ADHD occurs across all cultural, racial, and socioeconomic groups.  ADHD affects children and adults with all levels of intelligence.
    • 6. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 DSM-IV Criteria for ADHD Primary ADHD Symptoms:  inattention  hyperactivity  impulsivity Types of ADHD:  ADHD, Predominantly Inattentive Type  ADHD, Predominantly Hyperactive-Impulsive Type  ADHD, Combined Type  ADHD, Not Otherwise Specified ADHD is distinguished from Conduct Disorder and Oppositional Defiant Disorder.
    • 7. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Prevalence of ADHD  ADHD is the most common childhood psychiatric disorder.  Conservative estimate of prevalence is 2%; liberal estimate of prevalence is 30%.  Most commonly-accepted prevalence rate is 3% to 5%.  The wide variations in prevalence reflect problems with definition and identification.  More boys than girls are identified as having ADHD.  Girls and children from minority families may be under-identified.
    • 8. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Causes of ADHD  For most children, the precise cause of ADHD is unknown.  Some studies suggest that ADHD is inherited.  Possible causes of ADHD include:  Neuroanatomical (related to brain structure)  Neurochemical (related to chemical imbalance in the brain or a deficiency in chemicals that regulate behavior)  Neurophysiological (related to brain function)  Neuropsychological (related to dysfunction of the frontal lobes)
    • 9. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 ADHD Characteristics (Barkley, 1998) Limited sustained attention or persistence of attention to tasks Reduced impulse control or limited delay of gratification Excessive task-irrelevant activity or activity poorly-regulated to match situational demands
    • 10. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Common Difficulties Exhibited By Students with ADHD  Working Memory Difficulties  Time Estimation Problems  Difficulties Using Internal Language  Lack of Self- Discipline  Following Rules or Instructions  Situational Variability in Performance  Low Performance on Repetitive or Tedious Tasks
    • 11. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Adult Outcomes  Only 20% to 35% of children with ADHD will not be impaired as adults.  Adults with ADHD are likely:  to be fired more often.  to change jobs more frequently.  to receive more traffic citations and accidents.  Outcomes are better for adults with ADHD who receive treatment.
    • 12. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Identification, Assessment, and Eligibility  For years, the diagnosis of ADHD was considered the sole responsibility of psychologists, psychiatrists, and physicians.  Today, school personnel have some legal responsibilities to assess students suspected of having ADHD.  Although assessment is performed primarily by trained school personnel, teachers play an important role in the assessment process.
    • 13. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Steps in the Assessment Process Step One: Preliminary Assessment and Child Study Meeting Step Two: Formal Assessment Process: Follow-Up Meeting of the Child Study Team Step Three: Collaborative Meeting for Strategy Development Step Four: Follow-Up and Progress Review
    • 14. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Typical Components in an ADHD Assessment Battery  Observations  Interviews with child, parents, and teachers  Review of intellectual and academic assessments  Rating scales completed by teachers, parents, and student  Medical examination
    • 15. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Cultural or Linguistic Diversity (CLD) Concerns  When ADHD coexists with CLD, it presents unique challenges for the teacher.  Teachers must become familiar with students’ unique values, views, customs, interests, and behaviors.  Service-eligible behaviors cannot be the result of CLD differences.  Chaotic home environments may exacerbate ADHD-related behaviors.
    • 16. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Continuum-of- Placement Options  The U.S. Department of Education suggests that the most appropriate placement for many students with ADHD is the general education classroom, with adaptations.  This means that teachers of students with ADHD must:  understand this condition.  implement effective strategies.  collaborate with special educators to develop education plans.
    • 17. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Developing Education Plans  A Section 504 plan serves as legal documentation detailing agreed-upon services.  General educators may need to write Section 504 plans for students with ADHD.  Recommendations for writing a 504 plan:  Plan should be developed by a team.  Areas identified as causing significant limitations should be addressed in the plan.  Plan should include how school personnel will administer and monitor medication.
    • 18. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Role of Medication  Many students with ADHD are prescribed medications by physicians.  Teachers need to understand:  the types of medications used;  commonly-prescribed medication dosages;  the intended effects of medication; and  potential side effects of medication.
    • 19. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Desired Medication Outcomes  Increased Concentration  Completion of Assigned Tasks  Increased Work Productivity  Better Handwriting and Motor Skills  Improved Social Relations with Peers & Teachers  Increased Appropriate Behaviors & Emotional Control  Reduction of Inappropriate Disruptive Behaviors  Increased Self-Esteem In 70% to 80% of the cases, children respond positively to stimulants.
    • 20. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Psychostimulants Psychostimulants are the most commonly-prescribed medication for children with ADHD. Common Psychostimulants  Dexedrine (dextroamphetamine)  Ritalin (methylphenidate)  Adderall (amphetamine salts)
    • 21. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Antidepressant Medications  Prescribed less often than psychostimulants  Generally used when stimulants are ineffective OR when the individual is also depressed  Long-term use of antidepressants has not been studied extensively  Types of antidepressants commonly used to treat ADHD:  Tofranil (imipramine)  Nopramin (desipramine)  Elavil (amytriptyline)
    • 22. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Antipyschotic Medications  Much less frequently used than stimulants or antidepressants  Types of Antipsychotic Medications Used to Treat Children with ADHD:  Mellaril (thioridazine)  Thorazine (chlorpromazine)  Catapres (clonidine)  Eskalith (lithium)  Tegratol (carbamazepine)
    • 23. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Teacher Considerations Regarding ADHD Medications  Handle the dispensing of medication discreetly, but according to school policy.  Make sure the medication is given as prescribed.  Avoid placing too much blame or credit for the child’s behavior on the medication.  Monitor the behavior of the child, watching for any medication side effects.  Communicate with the school nurse, parents, and/or the physician.
    • 24. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Alternative Therapies for ADHD  These therapies are offered as “quick fixes” and have not been validated scientifically.  These therapies include:  Megavitamins  Diet Restrictions (e.g., sugar or additives)  Caffeine  Massage Therapy  Chiropractic Skull Manipulations  Biofeedback  Play Therapy  Herbs
    • 25. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Model for ADHD Interventions  Any approach to addressing the needs of students with ADD must be comprehensive in nature. Assessment Procedures Environmental Management Medical Management Program Planning and Collaboration Student-Regulated Strategies Instructional AccommodationsModel of Educational Interventions
    • 26. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Group Management  Classroom Rules  Time Management  Effective Grouping
    • 27. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Behavioral Supports  Positive Reinforcement for Desired Behavior  Premack Principle (“Grandma’s law”)  Contingency Contracting  Cueing or Signaling
    • 28. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Modifying Teacher Behavior  Students will ADHD need novelty and excitement in their learning environment because they are not stimulated very easily.  Students with ADHD have particular difficulty with nonstimulating, repetitive activities.  Therefore, teachers should:  Vary activities.  Allow and encourage movement that is purposeful and not disruptive.  Give frequent breaks.  Let students stand as they listen, take notes, or perform other academic tasks.
    • 29. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Modifying the Curriculum  Students with ADHD need a curriculum adapted to “focusing on doing” and one that avoids long periods of sitting and listening.  Examples:  Experience-Based Learning  Problem-Based Learning  Varied Assessment Techniques
    • 30. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Test Adaptations Extra Time Frequent Breaks Taking Exams in a Distraction-Reduced Environment
    • 31. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Self-Regulated Strategies  Self-regulated strategies are interventions, initially taught by the teacher, that the student will eventually implement independently.  Self-regulated strategies address the core problems of ADHD (e.g., impulsivity, problem-solving, and self-regulation).
    • 32. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Organizational Tactics  Students with ADHD often have difficulty organizing their work and developing effective study skills.  Organizational strategies include:  Designating space for materials  Establishing a routine for writing down assignments (e.g., assignment notebook)  Providing notebooks in different colors for each subject area.
    • 33. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Teaching Study Skills  Teachers may need to teach study skills such as:  Listening  Outlining  Notetaking  Teachers may need to teach students how to break a complex task into smaller components.  Teachers may need to teach students time management skills.
    • 34. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Self-Management Primary Goal is to Help Children:  Be aware of their own thinking processes  Use task-approach strategies  Take responsibility for their own reinforcement Advantages of Teaching Self-Control  Saves teacher’s time  Increases the effectiveness of an intervention  Increases maintenance of skills over time  Increases student’s ability to use the skill in a variety of settings
    • 35. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Types of Self-Regulation Self-Assessment Student determines the need for change and monitors personal behavior. Self-Monitoring Student attends to specific aspects of behavior Self-Instruction Student cues self to inhibit inappropriate behaviors or to express appropriate ones. Self-Reinforcement Student administers reinforcement for appropriate behaviors.
    • 36. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Learning Strategies  A learning strategy is an “individual approach to a task.”  A learning strategy includes how an individual thinks and acts when planning, executing, and evaluating performance.  The learning strategy approach combines cognition (what is going on in one’s head) with behavior (what one is actually doing).
    • 37. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Recommendations for Social Skills Training  Implement training throughout the year  Use groups of 4-8 classmates  Make sure to include a well-liked child in each group  Use the following:  Practice  Modeling  Reinforcement of appropriate behavior during real-life problem situations
    • 38. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Promoting Inclusive Practices School-Wide Support Should Include:  Disability Awareness Activities  Use of Positive Discipline  Use of Adult Volunteers Critical Features of Successful Inclusion  Skills and Behaviors of Teachers  Understanding and Acceptance by General Education Peers
    • 39. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Resources for Developing Awareness in Peers  Teachers need to be a positive role model for general education students in helping them to understand and accept children with ADHD.  Teachers should confer with parents and the child with ADHD to obtain advice on explaining ADHD to other students in the classroom.
    • 40. (c) Allyn & Bacon 2004 Copyright © Allyn and Bacon 2004 Collaboration with Parents  Teachers can often promote success with student with ADHD by working closely with parents.  Parent-centered activities include:  Practicing and reinforcing school behaviors  Posting and reviewing home and school rules frequently  Using the same signal at both home and school  Developing a home-school reporting system

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