INTERVENTION STRATEGIES FOR EDUCATORS Copyright (C) by Ronald E. Jones, P.A. INTRODUCTION In September, 1991 the Department of Education issued guidelines clarifying that having ADD is an "other health impaired disability" and that accommodations for ADD are a right under Civil Rights Code, Section 504 and Public Law 94-142. Thus, both regular education and special education students must be provided support as needed for problems caused by their ADD. Because ADD affects the student's entire school experience, it is important to have input from the student, parents, teachers, special services staff, school counselors and administrators in order to accommodate the student's needs. Listed below are specific types of accommodations based on how the student may be affected. THE ENVIRONMENT A small class size allows fewer distractions for the student and easier supervision by the teacher and provides the teacher with more time to devote to the ADD student. The student should sit close enough to the teacher so that the teacher can easily give direct instruction. When the student sits close to the teacher it is more stimulating because he/she feels more at risk (being closer to someone who is supervising you). Being closer to the board may also be important. Nearby windows or open doors or sitting near other students who talk or try to engage in conversation is very annoying. It is more beneficial to have an ADD student sit next to a student who is good at following through, is organized, and even-tempered. Open classrooms, where there are no walls between two or more classes, set up distractions because there are two teachers (as well as other students) talking simultaneously. Unstructured, open education theory classes lack the structure the student with ADD is dependent upon. Cooperative learning classrooms work best for students who are developmentally ready, usually fourth grade or older. STIMULATION Stimulation increases a student's ability to focus by increasing the release of Dopamine. When stimulated, the student may listen better, understand more, pay attention longer, and complete more work. When unstimulated, the student may be unable to listen, organize enough to initiate work, stay on task, or be capable of completing a task. In a desperate attempt to self-stimulate, the student may make noises, talk to others, get out of his/her desk, become the class clown, start an argument, change body positions, play with something, doodle, pick at his/her skin, or ask something of the teacher. The student is more likely to be successful in completing the work if he/she is given appropriate, non-disruptive, planned choices in the ways they attain stimulation. Here are some examples of how a teacher can allow for nondisruptive stimulation. Interest If a student is interested in the subject or task, this is stimulating and creates a feeling of excitement; also how the material is presented may increase interest. When confronted with a subject which is not inherently interesting, a subtopic may be of interest. (For example, French Government might not interest the student but French architecture may. The student could do a drawing of French architecture and only memorize an outline on French Government, instead of writing an essay.) In general, students with ADD perform better on construction, drawing, performing, singing, or visual arts tasks than on writing assignments. Sometimes interest in a topic can be ignited by a conversation with the student or during a group discussion among themselves. Students with ADD are very creative at coming up with ideas, but may need some help in following through. They may need assistance in keeping the ideas relevant and organized. A teacher who varies his/her voice, walks around the room, presents material in a provocative way, and involves students in discussions that have an emotional aspect, will be more stimulating than a teacher who has a monotone voice, stays in one place when talking, avoids provocative material, and doesn't promote lively discussion. A teacher who is too authoritarian will bring out the worst sort of stimulation in the ADD student, which may include anger, argument, opposition, and defiance. Excitement for Reward Positive reinforcement systems are the most powerful motivators for students with ADD. They may be able to do some of the tasks they could not do previously when a reward system is added. The reward must be something that excites the student; thus, the student must be consulted as the reward is being defined. Definite goals that are attainable and measurable must be decided upon. A method of documenting task completion must be set up. Students who need to work on several behaviors simultaneously may need a point system chart. (What is an example of an immediate reward in the classroom? An English teacher had a basketball hoop in the classroom and he would walk around with the basketball. Every time a student would answer a question correctly, he would toss the ball to them and then he/she was allowed to attempt a basket from a free-throw line drawn on the floor.) Movement While movement is usually viewed as disruptive, it may be part of a student's expected routine. The back of the classroom could be designated as a place where the student can pace quietly while listening to a reading or lecture. A separate desk there would allow the student to squirm or shift position during seat work without bothering others. Scheduled breaks might be planned throughout the student's day. (For example, an ADD student could deliver a message to the office, run around the play field or gym, assist the custodian, lunch room staff, etc.) Usually, an ADD student needs more activity toward the afternoon if he/she has been spending the morning hours sitting. Even doodling on paper, playing with a quiet object, or chewing gum can be movement that helps a student stay on task. In deciding which methods work best for an individual student, the teacher can measure success by noting the number of completed tasks or how well the student understands the subject material. It would be misleading to judge a student as to whether they are paying attention by how they appear. The ADD student who is playing with an object at his/her desk may actually be paying closer attention to a teacher than the ADD student who is not playing with an object but is looking directly at the teacher. Risk Taking Students with ADD usually do better with tasks if they are challenged; yet, for some students who have problems with anxiety, this method may not work. Beating the clock, being on competing teams, being first to be ready or first to be done are all examples of risk taking. Presenting some subject matter in the form of a game may be stimulating to the student who might otherwise have no interest in the subject at all. The performing arts involve risk taking during the performance. (An added benefit to the student with ADD is that they learn that they don't always have to act as they feel. Often students with ADD are locked into the present, which can result in a lack of tact or an inappropriate comment, as they tend to say exactly what they feel. Learning to say one thing while feeling or thinking something else is a revelation.) Risk taking can be the source of some of the ADD student's worst behaviors; therefore, giving this tendency a more functional outlet may result in the student making better choices. Et Cetera In my years of treating students with ADD, I have learned from the students some surprising and innovative methods of self-stimulation. One student would carry an assortment of odors which he would allow himself to smell as a reward. Another carried a small wooden block which he placed on his chair, causing discomfort. Many use music for stimulation while doing homework. (the same method should work for these students in class) One high school student flipped a coin while listening to lectures, while a college student would wear multiple layers of clothing to class, taking them off or putting them on to change body temperature. In light of using movement to stimulate an increase in one's attention span, I'm sure many teachers can look back and spot a few unusual behaviors themselves. One educational study revealed that a student needs to have a repertoire of methods rather than just relying on only one. The teacher and student should decide together on a list of acceptable stimulatory behaviors and rules which are not disruptive or used as an escape from doing tasks. SOCIAL SKILLS Prospective studies of men with ADD have shown that their behavior remained socially immature into mid-adult life. This would argue against retaining a child in a grade because of social immaturity. It would be much better to provide an environment where the opportunity for success is enhanced, so that self-esteem is preserved. In general, students with ADD are dependent upon external structures or cues to know what the social rule is at any given moment. They need classroom rules that are uniform, consistent, and fair. They need a teacher, fellow student, coach or list to remind them of these rules. Given the opportunity to remind others of the rules raises their self-esteem, and helping a teacher in a classroom of much younger students would also make them feel included in the social matrix instead of always being one step out. Their self-esteem can also be enhanced by being around much older students. Their eagerness to please the older students and be accepted as part of the group results in their complying with whatever the group does. Success with the older students may help counter a life-long litany of comments from others that their behavior is immature. The highest risk setting for students with ADD is when they are with age-matched peers, without direct adult supervision. At school this would be in hallways, restrooms, the lunchroom, and on the playground. Direct supervision means having a monitoring adult standing near the student and not at a distance. Without rules to govern the social interaction, the ADD student is an easy victim for manipulation by other students. Often, other students have learned the ADD student acts on whatever he/she feels and is more likely to yell, curse, hit, or throw something when harassed. The game then is to aggravate the student with ADD until he/she acts out and is punished by the monitor. For example, this may involve surreptitiously hitting the ADD student with food, then when the ADD student throws food back in an obvious manner he/she is caught. It could involve stepping on the ADD student's foot in line, then when the ADD student yells, curses, shoves, or hits and is punished, the instigators are pleased at having so much power. When playing a game on the playground, the ADD student may be repeatedly making up new rules because they can't remember the established rules; of course, the ADD student is more likely to make up rules which would give him/her self the advantage. This may bring out anger in other students along with charges of cheating. Often, students with ADD tell me they have no friends their own age. Support can be provided to students with ADD by having an adult coach a game on the playground, by having the student play with older or younger children or by providing a separate activity away from the playground such as playing a computer game, drawing, or assisting the teacher in the classroom. The student may also need help in the hallways, restrooms, or lunchroom. A social skills group lead by a counselor might help bridge some friendships and enable other students to understand that the student with ADD may not have intended to offend them. SUMMARY The student with ADD is most likely to achieve success when taught in a classroom that is not distracting, when structure and organization systems are provided, when the teacher uses the encouraged methods of stimulation, when care is taken to provide opportunities to enhance the students self-esteem, and when a positive reinforcement system motivates the student to attempt difficult tasks (even though these tasks may not be difficult for the rest of the class). Long term prospective studies have shown that self-esteem is a predictor of adult outcome. The natural history of this disorder is that fifty percent of boys with ADD will have serious problems as adults and that half of these will be imprisoned. By putting efforts into supporting these children educationally we can change this outcome, preventing pain and suffering and saving our society an enormous cost. __________________________________________________________________________ Ron Jones, P.A. Attention Deficit Disorder Clinic 3000 Limited Ln. NW #135 Olympia, WA 98502 (206) 754-4801 This is for information purposes only and is not to be substituted for advice from the medical professional of your choice. __________________________________________________________________________ Uploaded with the permission of the author. __________________________________________________________________________ This article has been downloaded from the ADD Forum on CompuServe, and may be distributed freely as long as the contents of the file are unchanged. Because the CompuServe ADD Forum is new, we are frequently asked how to join CompuServe and get on the forum. Call 1-800-524-3388 and ask for rep #464. Outside the US/Canada call +1-614-457-0802.