EOCCS Teaching Strategies K-4


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  • So what does this mean?Do you get this?Do you see what is happening?This is one of the main reasons the prisons are filled with men and women from minority communities.Do you get this?
  • EOCCS Teaching Strategies K-4

    3. 3. Attention Deficit Hyperactivity Disorder A Neurobiological Disorder characterized bydevelopmentally inappropriate behaviors A Neurobehavioral Disorder Inability to self-regulate  attention/focus,  activity levels/hyperactivity  impulsivity  emotions
    4. 4. ADHD – An Inside Look Cerebral Pre- frontal m k Cortex Caudate Nucleus Globus Pallidus k j Cerebellum Picture courtesy of Marlene Snyder, Ph.D., www.whitefishconsultants.com and the Cape Cod Times
    5. 5. Insufficient Levels of Dopamine Synaptic Gap i Dendritic Spine Dopamine lReceptor jStimulant h medication Dopamine floods the gap withPicture courtesy of Marlene Snyder, Ph.D. dopamineand the Cape Cod Times
    6. 6. Dopamine Produced byStimulation Physical activity Cognitive activity in an area of interest Positive Reinforcement Negative Reinforcement Argument Talking Medication
    7. 7. ADHD-Types Specified by the DSM-IV American Psychiatric Association Diagnostic and Statistical Manual, 4th EditionADHD Diagnostic Subtypes:  Primarily Inattentive -- ADHD-I  Primarily Hyperactive/Impulsive -- ADHD-H  Combined -- ADHD-C
    8. 8. Predominately Inattentive Type AD/HD- IAt least six of nine characteristics are required for diagnosis: Often fails to give close attention to details or makes careless mistakes in schoolwork, the work environment or other activities. Often has difficulty sustaining attention in tasks or play activities. Often does not seem to listen when spoken to directly. Often does not follow through on instructions and fails to finish schoolwork or other tasks. Often has difficulty organizing tasks and activities. (cont’d.)
    9. 9. Predominately Inattentive Type AD/HD- IAt least six of nine characteristics are required for diagnosis: Often avoids, dislikes or is reluctant to engage in tasks requiring sustained mental effort (school or homework). Often loses things necessary for tasks or activities (toys, assignments, tools). Often easily distracted by extraneous stimuli. Often forgetful in daily activities.
    10. 10. Predominately Hyperactive/Impulsive TypeAt least six of nine characteristics are required for diagnosis:Hyperactivity Often fidgets with hands or feet or squirms in seat Often leaves seat in classroom or other situations in which remaining seated is the expectation Often runs about or climbs excessively in situations in which it is inappropriate (in adolescents and adults, it may be limited to subjective feelings of restlessness) Often has difficulty playing or engaging in leisure activities quietly Often “on the go” or acts as if “driven by a motor” Often talks excessively
    11. 11. Predominately Hyperactive/Impulsive TypeImpulsivity Often blurts out answers before questions have been completed Often has difficulty waiting turn Often interrupts or intrudes on othersADHD Combined symptoms include all of the above
    12. 12. What are the Probable Causesof ADHD? ADHD is a Neurobiological Disorder • Strength of Evidence: Strong  Genetic – Highly Inheritable – Runs in families  High incidence rate  Strength of Evidence: Strong Environmental • Low incidence rate • Pre Birth Low birth weight Prenatal smoking and alcohol  Post Birth Environmental toxins such as lead Brain injuries
    13. 13. ADHD Prevalence Most commonly diagnosed neurobiological disorder in children  7% to 15% of all school aged children  Equal prevalence across all
    14. 14. Co-Existing Conditions ADHD alone 30% OppositionalLearning Disability Defiant Tic Disorder 50% Disorder 7% Bipolar 40% Disorder 20% Conduct Depression Disorder 10%-30% 35% Anxiety Disorder 35%
    15. 15. What does a Challenged ADHD Child look like? ● Over-stimulated easily ● Difficulty with changes in routine ● Difficulty with emotional control ● Displays aggressive behavior ● Difficult to discipline
    16. 16.  Symptoms occur very frequently at home, at school and in most other situations Performs poorly in groups Unpopular with peers; seen as nuisance Behavior presents significant challenges for parents and teachers
    17. 17. Prognosis With early identification and treatment, children and adults with ADHD can be successful Studies show:  Fewer problems with school, peers, substance abuse and improved overall functioning, compared to those who do not receive treatment Barkley, 1998; MTA Cooperative, 1999; Biederman, 1999; Barkley, 2003; Wilens, 2003; Barkley, 2001
    18. 18. Multimodal Treatmentof ADHD  Evaluation and diagnosis  Parent and child education about diagnosis and treatment  Behavior management techniques  Medication  School programming and supports
    19. 19. Positive Characteristics Often Associated with ADHD Energetic  Resourceful Highly verbal  Good-hearted Spontaneous  Gregarious Creative  Not boring Exciting  Highly intelligent Persistent  Humorous Innovative  Outgoing Imaginative  Willing to take chances Risk-taker  Good at improvising Tenacious  Able to find novel solutions Warm-hearted and helpful  Inventive Ingenious  Observant Compassionate  Full of ideas Accepting and forgiving  Can think on feet Resilient  Good in a crisis Fun to be around  Empathetic Sensitive to others/caring
    20. 20. Minority Children with ADHD areUnder-Diagnosed Only 20% of African American children with ADHD are diagnosed and treated Only 20% of Hispanic children are diagnosed and treated Leaving 80% of minority children with ADHD to be
    21. 21. WHY? Lack of information about ADHD Less access to health and mental health services Less likely to receive quality services Mistrust and fear of health service system Differences in language and communication
    22. 22. Likely Progression of Criminal Untreated ADHD behavior Kewley, 1999 School exclusion Challenging Substance abuse Disruptive behavior behavior Teenage Low self- Poor social ADHD Only pregnancy esteem skills Conduct disorder Learning Delay Lack of ODD motivation Complex learning difficultiesAge 6 10 14–16
    23. 23. Prevalence of Mental HealthDisorders in the JuvenileJustice System General Population Juvenile Justice• Mood Disorders 2%–8% 32%–88%• ADHD 7%–15% 50%–76%• Learning Disorders 5% 17%–53%• PTSD 1%–14% 32%–49%• Conduct Disorder 2%–16% 50%–100%• Psychotic Disorder .05%–1% 1%–16%• Borderline Disorder 2% 1%–35%
    24. 24. Research: UnitedStatesCorrectional SystemsUndiagnosedand Untreated Individuals:  50% to 75% of children in the Juvenile Justice systems have undiagnosed ADHD  65% of adults in the prison systems have undiagnosed Mental Health Disorders  50% of these inmates have undiagnosed ADHD
    25. 25. Minority Children with ADHD areUnder-Diagnosed  Only 20% of African American children with ADHD are diagnosed and treated  Only 20% of Hispanic children are diagnosed and treated  Leaving 80% of minority children with ADHD to be undiagnosed and untreated
    26. 26. For every 100 African American & Hispanic Children 100 x10% prevalence rate 10 children at-risk of ADHD 10 x20% diagnosis rate 2 children diagnosed and treated 10 x80% untreated rate 8 children undiagnosed/untreated
    27. 27. We cannot change anything unless we accept it. 27
    28. 28. The Power of the TeacherI have come to a frightening conclusion,I am the decisive element in the classroom.It is my personal approach that creates the climate.It is my daily mood that makes the weather.As a teacher, I possess tremendous power to make a child’s life miserable or joyous.I can be a tool of torture or an instrument of inspiration.I can humiliate or humor, hurt or heal.In all situations, it is my response that determines whether a crisis will be escalated or de-escalated; whether a child will be humanized or dehumanized.
    29. 29. Executive FunctioningDr. Tom Brown uses a metaphor that compares executive functioning of the brain to the function of a conductor of an orchestra. • Working Memory • Activation • Focus • Effort • Emotion • Action
    30. 30. Executive FunctioningThe impaired executive functioningskills in individuals with ADHD arerelated to abnormal dopaminelevels in the frontal lobe of thebrain.
    31. 31. Working Memory LimitationsMemory that holds information in your head long enough for you to act upon it; inability to quickly retrieve information ADHD is An Information Processing Disorder 31
    32. 32. Executive Function DefinitionThe higher-order cognitive processes involved in: regulation of behavior inhibition of impulses working memory sequential thinking planning organizing 32
    33. 33. Executive Function Components  Activation  Time management  Sustaining alertness and effort  Self-regulation  Emotional self-control  Self-talk  Inhibition of verbal and nonverbal response 33
    34. 34. Practical difficulties as a result of poorExecutive Skills---Generally in all areas Getting started Knowing what comes next Awareness of time Distractibility Inability to sit still 34
    35. 35. Skills Needed by Students with ADHD to Experience Success in School1. Increase Attention to Task2. Improve Listening Skills3. Increase Work Production4. Build Organization and Study Skills5. Control and Minimize Problems Caused By:  Excessive Hyperactivity  Impulsivity  Immature Social Skills 35
    36. 36. Practical Implications of Executive Function Deficits in School Performance Getting started Remembering chores and assignments Memorizing multiplication tables or other facts Writing essays Remembering what was read (reading comprehension) Controlling emotions Analyzing and problem solving Planning for the future Information from Chris A. Zeigler Dendy 36
    37. 37. Overview ofClassroom Strategies
    38. 38. General ClassroomManagement Structured and Well-Organized Class schedule Distinct routines Class rules Careful planning of seating and physical space 38
    39. 39. Class Management Tips for Challenging Children Focus on the use of positive reinforcement for appropriate behavior Maintain a calm, welcoming, inclusive and predictable environment Be flexible and accommodate the individual needs of each student 39
    40. 40. Critical Principles ofInstruction for ChallengingChildren Structure: A consistent routine, enhanced by a highly organized format of activities Variety: Novelty or the slightest change in the activity to maintain continued interest Brevity: Activities of short duration 40
    41. 41. Critical Principles ofInstruction for ChallengingChildren Positive Feedback and Reinforcement: Positive response keeps a child’s mind open Stimulation: Use of child’s interest areas and physically active breaks creates focus by increasing dopamine in the brain Transitional Preparation: Alert child to change; what is coming next, allow time for brain to refocus 41
    42. 42. Maintain a PositiveEnvironment Give positive reinforcement to child with ADHD whenever possible Overlook the little things Use positive statement about someone doing something right Biggest behavioral change occurs with the use of positive reinforcement 42
    43. 43. Teacher Proximity and Movement Seat children with ADHD in front of room; limits distractions in their line of vision and enables teacher easy eye contact and visual cueing Circulate; move around room frequently Use your physical proximity and positioning to manage disruptive behavior. 43
    44. 44. SignalsEstablish visual and auditory signals to get students to stop what they are doing and give you their attention. Use a clapping pattern Play a bar of music Call out a signal word Establish a special signal with the challenging child 44
    45. 45. Quiet Work If a room is too quiet or too noisy, it may be a problem for a child with ADHD Make accommodations for the needs of each child Have nonverbal signal to cue “I need help” so as to maintain quiet Space to be alone but moving and working at the same time; Hawaii 45
    46. 46. Classroom Strategies Designed for Specific Challenges
    47. 47. Practical DifficultiesDistraction and Movement Brain in need of dopamine  Excessively active  Trouble sitting/staying with group  Very short attention span; distractibility  Cannot listen to long stories 47
    48. 48. Strategies for Movement Define Space but Allow Movement Allow a fidget object with rules Allow doodling Sit on bean bag or ball chair Reward when child is able to sit reasonably quiet within defined space Too disruptive: “Richard, do you need to go to Hawaii?” 48
    49. 49. Strategies for Distraction Segment Projects into Small Tasks Depending on age of child, 5 to 20 minute tasks are optimum Define each segment to the child before the class begins Allow him to get up and move around for 5 minutes between tasksThis activity rejuvenates the brain and enables the child to sit and concentrate again 49
    50. 50. Practical DifficultiesListening and FollowingDirections Struggle to inhibit and control behavior Unable to readily stop and disengage from current activity Not able to quickly switch gears Attention deficits Limited working memory 50
    51. 51. Strategies Increase Listening Skills Wait until the class is quiet Do not talk over student’s voices Face the group and speak in simple, short sentences Stand next to child with ADHD and look into his eyes when speaking Provide multi-sensory instructions 51
    52. 52. StrategiesImprove Following of Directions Model what to do; show the class Avoid multi-step directions Use Classroom Cue Cards Read written directions and have students highlight/circle/underline key words Check for understanding by having an individual student rephrase the instruction 52
    53. 53. Strategy Classroom Cue Card Writing ____Name ____Read Directions ____Answer ALL questions that areColor CIRCLED ____Color (if needed) ____Cut (if needed)Scissors ____Glue (if needed) ____Turn into black basket 53
    54. 54. FindCircleWrite 54
    55. 55. Practical DifficultiesChange/TransitionsChange is difficult; Transitions can cause behavior problems: Change in routine Change of instructional situation Change of teacher In classroom to out of classroom Inside school to outside of school 55
    56. 56. Strategies Prepare and Provide Structure for Transitions Weekly/Monthly calendars with stickers indicating activities Activity Story Boards-done in small groups/individually and then discussed; final Story Board put together by class. Practice the steps involved; lining up for the bus, sitting on the bus without disruption, waiting on line at the museum, moving about in small 56
    57. 57. Strategies Extra Supervision for Transitions Smaller groups with only one challenging child per group Child gets special attention, perhaps walking with teacher Provide a lot of positive praise for appropriate behavior 57
    58. 58. Practical DifficultiesSocial Skills Difficulty playing with other children Cannot read unspoken social cues Poor self-control when frustrated or angry Emotions interfere with activities Poor self-awareness - does not know what behaviors other people find annoying or intrusive 58
    59. 59. StrategiesProvide Social Learning Social-Emotional Learning Programs Cooperative Learning Structures; team child with tolerant, supportive, positive role models Facilitate friendships for students who tend to be socially isolated; pairing with positive role model Teachers model and teach pro-social behaviors 59
    60. 60. Practical DifficultiesOrganization Working memory limitations and Distraction  Loses things  Forgets to record assignments  Not bringing home all materials needed for assignments  Forgets to turn in completed work  Clutter in desk and in backpack 60
    61. 61. StrategiesOrganizational Structure Well organized notebook system Extra supplies due to frequent lose Assignment book checked and signed by teacher and parent Review materials needed for assignments Have a folder for Completed Work Have an easy access box for handing in work Parent works with child to keep
    62. 62. StrategiesHomework Organization Notebook • Include a monthly calendar in front of folder • Designate different colored pockets for: 1. Papers to bring home: HOME 2. Homework to be completed: DO 3. Homework in process: DOING 4. Homework completed, give to teacher: TURN IN • Check notebook at the end of each day and reinforce how papers should be ordered • Work with parents to understand the system and work with child at home 62
    63. 63. Practical DifficultiesTime ManagementLack of awareness of time Judging and managing time Forgets deadlines and due dates Difficulty in estimating time needed to complete a task; underestimates Self-regulation issues and the ability to work to task completion without distraction Difficulty prioritizing work based on due dates or importance 63
    64. 64. StrategiesTime Management Structures Practice time estimating Use of timers to learn the passing of time Due dates included in assignment book Assignments and due dates written on board and given verbally Weekly calendars in classroom Chunk up large assignments into
    65. 65. Practical DifficultiesStudy Skills Memory/forgetfulness: Assignments, materials, and handing in homework Judging and managing time Mobilizing and getting started on tasks Sustaining alertness, attention and effort General self-management and the ability to work toward a goal 65
    66. 66. StrategiesImproving Study Skills Distraction free environment All supplies available Chunk up large projects Note taking, highlighting, and mind maps Timer to stay on task Breaks to rejuvenate brain Worry pad for stray thoughts
    67. 67. General Strategy Evaluate and Re-Evaluate Evaluate the frequency of the problem behavior at the start of intervention. Re-Evaluate at the end of each week. Important to know if what you are doing is working. One strategy may work for one child and not for the other. 67
    68. 68. By Kathy Chislom, M.Ed 68
    69. 69. Parent Training is VeryImportant Must be aware of challenges of child Manifest differently at home and school Communication between Parent and Teacher is essential If challenged child does have ADHD, parent’s permission needed for evaluation ADHD Parent Training provided through school is very successful when teachers are involved.
    70. 70. JUDITH CHAMPION, MSW, ACG ADHD ASSOCIATES 609-468-0819 Judith@judithchampion.com www.ADHDAssociates.com