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Helping the Student with ADHD in the Classroom

General behaviour intervention suggestions for TEACHERS

Classroom interventions for students with ADHD should be based upon a solid foundation of general behaviour intervention principles. While students with ADHD have a core of common problems, this group is fairly heterogeneous. Thus, instead of focusing on ADHD symptoms, management should target specific problem behaviour directly. Next, an alternative behaviour, incompatible with the problem behaviour, should be selected. It is essential to keep both behaviours in mind. We want to clarify to students what behaviour is unacceptable (what we do not want them to do), but we also want to clarify what behaviour is acceptable (what we want them to do). These behaviours should be carefully defined so the teacher can monitor them accurately.

Antecedents and consequences of both the problem and replacement behaviours must be studied. Antecedents will suggest environmental changes that prepare the student for success or failure. On the other hand, analysis of consequences will identify those environmental contingencies that reinforce both desired and undesired behaviour. It is also vital to ensure that the behaviour intervention plan is based upon a careful functional assessment of behaviour. The function of the problem behaviour should guide intervention plans. For example, if the behaviour is maintained by negative reinforcement (e.g., avoidance of an undesired task), then the intervention should ensure that the problem behaviour does not obtain this goal. At the same time, the intervention should teach the student that the desired behaviour is a more effective way of obtaining the behavioural goal.

Environmental and instructional considerations

Task duration

To accommodate the student’s short attention span, academic assignments should be brief and feedback regarding accuracy immediate. Longer projects should be broken up into manageable parts. Short time limits for task completion should be specified and can be enforced with timers.

Direct instruction

Attention to the task is improved when the student with ADHD engages in teacher-directed activities instead of independent seat-work activities. Also, the teaching of note-taking strategies increases the benefits of direct instruction. Both comprehension and on-task behaviour improve with the development of these skills.

Peer tutoring

Class-wide peer tutoring provides many important instructional variables in setting up students with ADHD for success. For example, it provides frequent and immediate feedback. Peer tutoring has been found to yield dramatic academic gains when combined with a token economy.

Scheduling

Based on evidence that the on-task behaviour of students with ADHD progressively worsens over the day, it is suggested that academic instruction is provided in the morning. When problem-solving skills are mainly poor in the afternoon, more active, non-academic activities should be scheduled.

Novelty

Presentation of novel, enjoyable, highly motivating material will improve attention. For example, increasing tasks’ novelty and interest level through increased stimulation (e.g., colour, shape, texture) reduces activity level, enhances attention and improves overall performance.

Structure and organization

Lessons should be carefully structured, and important points should be identified. For example, providing a lecture outline is a helpful note-taking aid that increases the memory of main ideas. Students with ADHD perform better on memory tasks when a material is meaningfully structured.

Rule reminders and visual cues

The rules given to students with ADHD must be well-defined, specific and frequently reinforced through visible modes of presentation. Well-defined rules with clear consequences are essential. Relying on the student’s memory of rules is not sufficient. Visual rule reminders or cues should be placed throughout the classroom. It is also helpful to review rules before activity transitions and to follow school breaks. For example, token economy systems are especially effective when the rules for these programs are reviewed daily.

Auditory Cues

Providing students with ADHD auditory cues that prompt appropriate classroom behaviour is helpful. For example, using tape with tones placed at irregular intervals to remind students to monitor their on-task behaviour has improved arithmetic productivity.

Pacing of work

It is helpful to allow students with ADHD to set their own pace for task completion when possible. The intensity of problematic ADHD behaviours is less when work is self-paced compared to situations where others pace work.

Instructions

Because students with ADHD have difficulty following multi-step directions, instruction needs to be short, specific and direct. Additionally, teachers must be prepared to repeat directions frequently and recognize that students often may not have paid attention to what was said. Further, to ensure understanding, it is helpful if these students are asked to rephrase directions in their own words.

Productive physical movement

The student with ADHD may have difficulty sitting still. Thus, productive physical movement should be planned. It is appropriate to allow the student with ADHD opportunities for controlled movement and to develop a repertoire of physical activities for the entire class, such as stretch breaks. Other examples might include a trip to the office, a chance to sharpen a pencil, taking a note to another teacher, watering the plants, feeding classroom pets, or simply standing at a desk while completing classwork. Alternating seatwork activities with other activities that allow for movement is essential. It is also important to remember that on some days, it will be more difficult for the student to sit still than on others. Thus, teachers need to be flexible and modify instructional demands accordingly.

Active vs passive involvement

In line with the idea of providing for productive physical movement, tasks that require active (as opposed to passive) responses may help hyperactive students channel their disruptive behaviours into constructive responses. While it may be problematic for these children to sit and listen to a long lecture, teachers might find that students with ADHD can be successful participants in the same lecture when asked to help (e.g., help with audio-visual aids, write important points on the chalkboard, etc.).

Distractions

Generally, research has not supported the effectiveness of the complete elimination of all irrelevant stimuli from the student’s environment. However, as these students have difficulty paying attention, to begin with, attractive alternatives to the task at hand must be minimized. For example, activity centres, mobiles, aquariums and terrariums should not be placed within the student’s visual field.

Anticipation

Knowledge of ADHD and its primary symptoms helps anticipate difficult situations. It is essential to remember that some situations will be more difficult than others. For example, effortful problem-solving tasks are especially problematic. These situations should be anticipated and appropriate accommodations made. When presenting a task that the teacher suspects might exceed the student’s attentional capacity, reducing assignment length and emphasizing quality instead of quantity is appropriate.

Contingency management: Encouraging appropriate behaviour

Although classroom environment changes can help reduce problematic behaviours and learning difficulties, they are typically insufficient. Thus, contingencies that reinforce appropriate or desired behaviours and discourage inappropriate or undesired behaviours need to be available.

Powerful external reinforcement

First, it is important to remember that the contingencies or consequences used with these students must be delivered more immediately and frequently than is typically the case. Additionally, the consequences used need to be more powerful and of a higher magnitude than is required for students without ADHD. Students with ADHD need external criteria for success and a pay-off for increased performance. Relying on intangible rewards is not enough.

Using negative and positive consequences is essential when working with ADHD students. However, before negative consequences can be implemented, appropriate and rich incentives should first be developed to reinforce the desired behaviour. When negative consequences are administered, they should be given in a fashion that does not embarrass or put down students. Giving much encouragement, praise and affection are important as these students are easily discouraged. Also, it is essential to remember that the rewards used with these students lose their reinforcing power quickly and must be changed or rotated frequently.

Token economy systems

These systems are an example of a behavioural strategy proven to help improve the academic and behavioural functioning of students with ADHD. These systems typically give students tokens (e.g., poker chips) when they display appropriate behaviour. These tokens are exchanged for tangible rewards or privileges at specified times.

Response-cost programs

While verbal reprimands are sufficient for some students, more powerful negative consequences, such as response-cost programs, are needed for others. These programs provide mild punishment when problem behaviour is displayed. For example, a student may lose earned points or privileges when previously specified rules are broken. There is evidence that such programming decreases ADHD symptoms such as impulsivity. A specific response-cost program found to be effective with ADHD students involves giving a specific number of points at the start of each day. When a rule is broken (a problem behaviour is displayed), points are taken away. Thus, to maintain their points, students must avoid breaking the rule. At the end of the period or day, students are typically allowed to exchange their earned points for a tangible reward or privilege.

Time-out

Removing the student from positive reinforcement or time-out typically involves removing the student from classroom activities. Time-out can be useful in reducing aggressive and disruptive actions in the classroom, especially when these behaviours are strengthened by peer attention. They are not helpful; however, problem behaviour results from the student’s desire to avoid school work. The time-out area should be a pleasant environment, and a student should be placed in it for only a short time. Time-out is ended based on the student’s attitude. At its conclusion, a discussion of what went wrong and how to prevent future problems occurs. While these procedures are effective with ADHD students, it is recommended that they are used only with the most disruptive classroom behaviours and only when there is a trained staff.

Summary

As students with ADHD are a heterogeneous group, there is no one intervention (or set of interventions) that will improve the classroom functioning of all of these students. Thus, it is suggested that classroom modifications be tailored to each student’s unique needs. In developing these modifications, it is perhaps best to examine how the classroom environment might be changed to set up the student with ADHD for success. The next step is to consider implementing a contingency management system to provide external incentives for appropriate classroom behaviours. In doing so, it is important to remember that behaviour management programs must be consistently applied.

In all cost programs, avoiding unrealistic standards that result in excessive point or privilege loss is crucial. Further, it is essential to avoid excessive use of negative consequences (such as reprimands and time-out). Students must experience success. In other words, caregivers must reinforce frequently wanted behaviour rather than merely punish them for misbehaving.

Source: LD online