Inattention, hyperactivity, and impulsivity are the core symptoms of Attention Deficit Hyperactivity Disorder (ADHD). A child’s academic success is often dependent on his or her ability to attend to tasks and teacher and classroom expectations with minimal distraction. Such skill enables a student to acquire necessary information, complete assignments, and participate in classroom activities and discussions (Forness & Kavale, 2001). When a child exhibits behaviors associated with ADHD, consequences may include difficulties with academics and with forming relationships with his or her peers if appropriate instructional methodologies and interventions are not implemented. Show
Identifying children with ADHDThere are an estimated 1.46 to 2.46 million children with ADHD in the United States ; together these children constitute 3–5 percent of the student population (Stevens, 1997; American Psychiatric Association, 1994). More boys than girls are diagnosed with ADHD; most research suggests that the condition is diagnosed four to nine times more often in boys than in girls (Bender, 1997; Hallowell, 1994; Rief, 1997). Although for years it was assumed to be a childhood disorder that became visible as early as age 3 and then disappeared with the advent of adolescence, the condition is not limited to children. It is now known that while the symptoms of the disorders may change as a child ages, many children with ADHD do not grow out of it (Mannuzza, Klein, Bessler, Malloy, & LaPadula, 1998). The behaviors associated with ADHD change as children grow older. For example, a preschool child may show gross motor overactivity — always running or climbing and frequently shifting from one activity to another. Older children may be restless and fidget in their seats or play with their chairs and desks. They frequently fail to finish their schoolwork, or they work carelessly. Adolescents with ADHD tend to be more withdrawn and less communicative. They are often impulsive, reacting spontaneously without regard to previous plans or necessary tasks and homework. According to the fourth edition of the Diagnostic Statistical Manual of Mental Disorders (DSM-IV) of the American Psychiatric Association, ADHD can be defined by behaviors exhibited. Individuals with ADHD exhibit combinations of the following behaviors:
Children with ADHD show different combinations of these behaviors and typically exhibit behavior that is classified into two main categories: poor sustained attention and hyperactivity-impulsiveness. Three subtypes of the disorder have been described in the DSM-IV: predominantly inattentive, predominantly hyperactive-impulsive, and combined types (American Psychiatric Association [APA] as cited in Barkley, 1997). For instance, children with ADHD, without hyperactivity and impulsivity, do not show excessive activity or fidgeting but instead may daydream, act lethargic or restless, and frequently do not finish their academic work. Not all of these behaviors appear in all situations. A child with ADHD may be able to focus when he or she is receiving frequent reinforcement or is under very strict control. The ability to focus is also common in new settings or while interacting one-on-one. While other children may occasionally show some signs of these behaviors, in children with ADHD the symptoms are more frequent and more severe than in other children of the same age. Although many children have only ADHD, others have additional academic or behavioral diagnoses. For instance, it has been documented that approximately a quarter to one-third of all children with ADHD also have learning disabilities (Forness & Kavale, 2001; Robelia, 1997; Schiller, 1996), with studies finding populations where the comorbidity ranges from 7 to 92 percent (DuPaul & Stoner, 1994; Osman, 2000). Likewise, children with ADHD have coexisting psychiatric disorders at a much higher rate. Across studies, the rate of conduct or oppositional defiant disorders varied from 43 to 93 percent and anxiety or mood disorders from 13 to 51 percent (Burt, Krueger, McGue, & Iacono, 2001; Forness, Kavale, & San Miguel, 1998; Jensen, Martin, & Cantwell, 1997; Jensen, Shertvette, Zenakis, & Ritchters, 1993). National data on children who receive special education confirm this co-morbidity with other identified disabilities. Among parents of children age 6–13 years who have an emotional disturbance, 65 percent report their children also have ADHD. Parents of 28 percent of children with learning disabilities report their children also have ADHD (Wagner & Blackorby, 2002). When selecting and implementing successful instructional strategies and practices, it is imperative to understand the characteristics of the child, including those pertaining to disabilities or diagnoses. This knowledge will be useful in the evaluation and implementation of successful practices, which are often the same practices that benefit students without ADHD. An overall strategy for the successful instruction of children with ADHDTeachers who are successful in educating children with ADHD use a three-pronged strategy. They begin by identifying the unique needs of the child. For example, the teacher determines how, when, and why the child is inattentive, impulsive, and hyperactive. The teacher then selects different educational practices associated with academic instruction, behavioral interventions, and classroom accommodations that are appropriate to meet that child’s needs. Finally, the teacher combines these practices into an individualized educational program (IEP) or other individualized plan and integrates this program with educational activities provided to other children in the class. The three-pronged strategy, in summary, is as follows:
Because no two children with ADHD are alike, it is important to keep in mind that no single educational program, practice, or setting will be best for all children. How to implement the strategy: Three components of successful programs for children with ADHDSuccessful programs for children with ADHD integrate the following three components:
The remainder of this document describes how to integrate a program using these three components and provides suggestions for practices that can help children with ADHD in a classroom setting. It should be emphasized that many of the techniques suggested have the additional benefit of enhancing the learning of other children in the classroom who do not have ADHD. In addition, while they have been used most widely with children at the elementary level, the following practices are useful for older students as well. Academic instructionThe first major component of the most effective instruction for children with ADHD is effective academic instruction. Teachers can help prepare their students with ADHD to achieve by applying the principles of effective teaching when they introduce, conduct, and conclude each lesson. The discussion and techniques that follow pertain to the instructional process in general (across subject areas); strategies for specific subject areas appear in the subsequent subsection “Individualizing Instructional Practices.” Introducing lessonsStudents with ADHD learn best with a carefully structured academic lesson — one where the teacher explains what he or she wants children to learn in the current lesson and places these skills and knowledge in the context of previous lessons. Effective teachers preview their expectations about what students will learn and how they should behave during the lesson. A number of teaching-related practices have been found especially useful in facilitating this process:
Conducting lessonsIn order to conduct the most productive lessons for children with ADHD, effective teachers periodically question children’s understanding of the material, probe for correct answers before calling on other students, and identify which students need additional assistance. Teachers should keep in mind that transitions from one lesson or class to another are particularly difficult for students with ADHD. When they are prepared for transitions, these children are more likely to respond and to stay on task. The following set of strategies may assist teachers in conducting effective lessons:
Concluding lessonsEffective teachers conclude their lessons by providing advance warning that the lesson is about to end, checking the completed assignments of at least some of the students with ADHD, and instructing students how to begin preparing for the next activity.
Individualizing instructional practicesIn addition to the general strategies listed above for introducing, conducting, and concluding their lessons, effective teachers of students with ADHD also individualize their instructional practices in accordance with different academic subjects and the needs of their students within each area. This is because children with ADHD have different ways of learning and retaining information, not all of which involve traditional reading and listening. Effective teachers first identify areas in which each child requires extra assistance and then use special strategies to provide structured opportunities for the child to review and master an academic lesson that was previously presented to the entire class. Strategies that may help facilitate this goal include the following (grouped by subject area): Language Arts and Reading ComprehensionTo help children with ADHD who are poor readers improve their reading comprehension skills, try the following instructional practices:
PhonicsTo help children with ADHD master rules of phonics, the following are effective:
WritingIn composing stories or other writing assignments, children with ADHD benefit from the following practices:
SpellingTo help children with ADHD who are poor spellers, the following techniques have been found to be helpful:
HandwritingStudents with ADHD who have difficulty with manuscript or cursive writing may well benefit from their teacher’s use of the following instructional practices:
Math computationNumerous individualized instructional practices can help children with ADHD improve their basic computation skills. The following are just a few:
Solving math word problemsTo help children with ADHD improve their skill in solving word problems in mathematics, try the following:
Use of special materials in mathSome children with ADHD benefit from using special materials to help them complete their math assignments, including:
Organizational and study skills useful for academic instruction of children with ADHDMany students with ADHD are easily distracted and have difficulty focusing their attention on assigned tasks. However, the following practices can help children with ADHD improve their organization of homework and other daily assignments:
Assisting students with ADHD with time managementChildren with ADHD often have difficulty finishing their assignments on time and can thus benefit from special materials and practices that help them to improve their time management skills, including:
Helpful study skills for students with ADHDChildren with ADHD often have difficulty in learning how to study effectively on their own. The following strategies may assist ADHD students in developing the study skills necessary for academic success:
Behavioral interventionsThe second major component of effective instruction for children with ADHD involves the use of behavioral interventions. Exhibiting behavior that resembles that of younger children, children with ADHD often act immaturely and have difficulty learning how to control their impulsiveness and hyperactivity. They may have problems forming friendships with other children in the class and may have difficulty thinking through the social consequences of their actions. The purpose of behavioral interventions is to assist students in displaying the behaviors that are most conducive to their own learning and that of classmates. Well-managed classrooms prevent many disciplinary problems and provide an environment that is most favorable for learning. When a teacher’s time must be spent interacting with students whose behaviors are not focused on the lesson being presented, less time is available for assisting other students. Behavioral interventions should be viewed as an opportunity for teaching in the most effective and efficient manner, rather than as an opportunity for punishment. Effective behavioral intervention techniquesEffective teachers use a number of behavioral intervention techniques to help students learn how to control their behavior. Perhaps the most important and effective of these is verbal reinforcement of appropriate behavior. The most common form of verbal reinforcement is praise given to a student when he or she begins and completes an activity or exhibits a particular desired behavior. Simple phrases such as good job encourage a child to act appropriately. Effective teachers praise children with ADHD frequently and look for a behavior to praise before, and not after, a child gets off task. The following strategies provide some guidance regarding the use of praise:
It is important to keep in mind that the most effective teachers focus their behavioral intervention strategies on praise rather than on punishment. Negative consequences may temporarily change behavior, but they rarely change attitudes and may actually increase the frequency and intensity of inappropriate behavior by rewarding misbehaving students with attention. Moreover, punishment may only teach children what not to do; it does not provide children with the skills that they need to do what is expected. Positive reinforcement produces the changes in attitudes that will shape a student’s behavior over the long term. In addition to verbal reinforcement, the following set of generalized behavioral intervention techniques has proven helpful with students with ADHD as well:
Effective teachers also use behavioral prompts with their students. These prompts help remind students about expectations for their learning and behavior in the classroom. Three, which may be particularly helpful, are the following:
In some instances, children with ADHD benefit from instruction designed to help students learn how to manage their own behavior:
For many children with ADHD, functional behavioral assessments and positive behavioral interventions and supports, including behavioral contracts and management plans, tangible rewards, or token economy systems, are helpful in teaching them how to manage their own behavior. Because students’ individual needs are different, it is important for teachers, along with the family and other involved professionals, to evaluate whether these practices are appropriate for their classrooms. Examples of these techniques, along with steps to follow when using them, include the following:
Classroom accommodationsThe third component of a strategy for effectively educating children with ADHD involves physical classroom accommodations. Children with ADHD often have difficulty adjusting to the structured environment of a classroom, determining what is important, and focusing on their assigned work. They are easily distracted by other children or by nearby activities in the classroom. As a result, many children with ADHD benefit from accommodations that reduce distractions in the classroom environment and help them to stay on task and learn. Certain accommodations within the physical and learning environments of the classroom can benefit children with ADHD. Special classroom seating arrangements for ADHD studentsOne of the most common accommodations that can be made to the physical environment of the classroom involves determining where a child with ADHD will sit. Three special seating assignments may be especially useful:
Instructional tools and the physical learning environmentSkilled teachers use special instructional tools to modify the classroom learning environment and accommodate the special needs of their students with ADHD. They also monitor the physical environment, keeping in mind the needs of these children. The following tools and techniques may be helpful:
ConclusionThis guide has outlined a series of instructional strategies that have proven to be successful in educating children with ADHD. However, it should be emphasized again that these techniques are also highly useful for all children. The three main components of a successful strategy for educating children with ADHD are academic instruction, behavioral interventions, and classroom accommodations. By incorporating techniques from these three areas into their everyday instructional and classroom management practices, teachers will be empowered to improve both the academic performance and the behavior of their students with ADHD. In doing so, teachers will create an enhanced learning environment for all students. This guide is the second in a series of three publications that address issues related to the instruction of children with ADHD. The first is Identifying and Treating Attention Deficit Hyperactivity Disorder: A Resource for School and Home. Coming soon is A Resource Directory for ADHD. Teachers and others are encouraged to consult these publications and to use them in conjunction with Teaching Children with Attention Deficit Disorders: Instructional Strategies and Practices. As the documents become available, they will be listed on the Office of Special Education and Rehabilitative Services/Office of Special Education Programs Web site.
Liked it? Share it!Like 1 Dislike 0 U.S. Department of Education, Office of Special Education and Rehabilitative Services, Office of Special Education Programs, Teaching Children with Attention Deficit Hyperactivity Disorder: Instructional Strategies and Practices, Washington, D.C., 2004. Which of the following strategies is appropriate regarding the use of seat work?What strategy is appropriate regarding the use of seatwork? - Seatwork should be counted as part of the course grade.
Which one of the following does the textbook suggest as a strategy that teachers can use to demonstrate that they care for and respect their students?Which one of the following does the textbook suggest as a strategy teachers can use to demonstrate that their care for and respect their students? Greet each student with a smile as he or she enters the classroom at the beginning of the day or class.
Which one of the following is consistent with the module's recommendations regarding the best approach to setting limits for classroom behavior?Which one of the following is consistent with the module's recommendations regarding the best approach to setting limits for classroom behavior? Begin with a few basic rules and procedures; as the year goes on, involve students in decision making about additional issues that arise.
In what type of situation would it be most desirable for a teacher to use the lecture approach?Lecture seems well suited to situations in which objectives emphasize low-level cognitive objectives (understanding or comprehension) and affective objectives (valuing or becoming interested in material).
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