V.5 #4 - Counseling/School Psychology - Attention-Deficit Hyperactivity Disorder

Brought to you by Learning Disabilities Worldwide (LDW®) through the generosity of Saint Joseph's University.

Attention-deficit Hyperactivity Disorder (ADHD) as understood by the general population consists of difficulties with attention, poor impulse control and hyperactivity. However, learning disabilities (LD) and learning deficits that co-occur with ADHD are less known. According to Barkley (2006), prevalence rates of specific reading disability in children with ADHD occur at 21%, and for specific mathematics disorder co-occurrence reaches 28%. This article will focus on some simple interventions that are often overlooked by educators when working with children with ADHD that can also often be seen in children who have LD. Teachers’ Definition of the Problem

Before teachers can even begin to improve the behavior and learning of a child with ADHD, they need to conceptualize their definition of student success in behavior management and learning. For some teachers, success is defined by reduced classroom disruptions, more on-task behaviors with regard to classroom assignments, or mastery of academic material. The question that teachers must ask themselves is whether their definition and expectation of success is compatible with the child’s capacity for behavioral and/or academic change (Mather & Goldstein, 2008). Often teachers expect the child with ADHD and/or LD to perform at the same level as other students without disabilities within the same time frame. Unfortunately, this just may not be realistic especially when focusing on specific problems when a more comprehensive solution is clearly needed. Classroom Intervention Strategies Overview Interventions for the classroom can be divided into two categories: self-management and managed consequences (Mather & Goldstein, 2008). The first category addresses increasing self-regulatory skills in the child in order to change cognitive and emotional processes that promote better self-managed behaviors. The second category views the child as less able to self-modify their behavior and as one in need of environmental consequences by the teacher to augment classroom success. The first category was partially addressed in a previous article (see Benhar, M. (2009) Self-regulation and academic studying. Strategies for Successful Learning, Volume 3, Number 3). Mather and Goldstein (2008) created a model that combines both categories and is discussed below. Start, Stop, and Think Model Research supports the notion that students with ADHD perform better in a classroom environment that allows them ample opportunity for physical, verbal, and cognitive activity (Mather & Goldstein, 2008). Best practices dictate active engagement between students and teacher that allows for the opportunity to engage in active listening and questioning along with novel and interesting instruction to capture and keep student attention. Based on this research, educators are advised to adopt a framework in which children with ADHD are taught to start, stop, and think in a manner similar to other children in the classroom without ADHD. In other words, the child starts when the rest of the class is engaging in academic and nonacademic tasks, stops when everyone else stops the task, and to think about what the teacher is asking or telling the class (Mather & Goldstein, 2008). Interventions (adapted from Mather & Goldstein, 2008)

1) Brevity. Children with ADHD will often begin a task with less effort than their cohorts and due to this less attentional effort, they will often fall below the necessary threshold to remain focused on the task at hand. Therefore, it is incumbent upon educators to keep the academic and nonacademic activities of short duration. Moreover, a relatively fast pace that takes into consideration of the child’s capacity has been shown to reduce disruptive behaviors in the classroom and increase on-task academics.

2) Variety. Repetition of an activity that does not catch their interest is quite difficult for a child with ADHD. Often parents will report that their child with ADHD has no problems sustaining attention when playing video games or watching television, which makes them question the ADHD diagnosis. However, the truth is that sustaining of attention is quite easy for this child when they are engaging in an activity that is highly motivating for them. The same cannot be said of academic tasks that do not capture the student’s attention, especially those tasks that demand repeated trials for mastery of the academic work. A possible solution is to present choices of activities to the child with ADHD in order to reduce repetition; ideally activity choices will provide reinforcement of academic material without the repetition of task. Choice has a tendency to increase intrinsic motivation, task interest, and therefore, it results in greater effort. If choices are limited and repetition is required, the educator can also attempt to present the material in a different manner or application that presents it in a slightly different manner to increase novelty. For example, even changing a writing assignment from paper and pencil format to using the computer can go a long way.

3) Routine. Rules, procedures, schedules and a structured environment all facilitate academic and nonacademic performance in children with ADHD. The routines need to be well thought out in advance, clearly stated, taught in gradual steps of short duration, and practiced for success. Educators should keep in mind that transitioning is especially difficult for children with ADHD. Familiar routines that are broken or deviated from can greatly increase the struggles for the child.

It is important to remember that the child with a disability is quite possibly processing information in a very different way than the other children without disabilities in the classroom as evidenced by documented working memory deficits in children with ADHD and LD. Teachers should contact their school psychologist and/or special education consultant to discuss additional interventions that will facilitate better academic and behavioral performance for all students in their class. References

Barkley, R. A. (2006). Associated cognitive, developmental, and health problems. In R. Barkley (Ed.), Attention-deficit hyperactivity disorder (pp. 122-183). New York: Guilford Press.

Mather, N. & Goldstein, S. (2008). Learning disabilities and challenging behaviors. Baltimore: Paul H. Brookes Publishing Company. Michael David Benhar, Ph.D. is an Associate Professor in the Social Sciences Department at Suffolk County Community College. Dr. Michael David Benhar teaches undergraduate and graduate courses in Developmental Psychology, Exceptional Child, Classroom Management, and Assessment. He has co-authored a chapter on students with disabilities. In addition, he has worked as a school psychologist in a preschool for children with special needs. Contact Dr. Michael Benhar at benharm@sunysuffolk.edu.