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ADHD:School-Based

Interventions

Overview

What do teachers see in the classroom? Can we base interventions on subtype alone? The role of Functional Behaviour Assessments

in intervention The role of the teacher Evidence-based approaches to behaviour and

academic interventions/ classroom principles

School Problems: What do teachers see in the classroom?

Academic Underachievement Disorganization Frequent distraction Less attention to rules governing a task Decreased ability of shift attention Poor test performance and study skills Inconsistent completion of independent

work/decreased productivity/more errors Frequent shifting of activities Forgetting/Losing assignments(DuPaul, Stoner & O’Reilly, 2002; Silverman, Iseman & Jeweler, 2009;

School Problems: What do teachers see in the classroom?

Disruptive &/or off-task classroom behaviour Failure to listen to instructions High rates of Noncompliance/Aggression Disrupts learning of others Difficulties with peer relations Easily angered when encountering challenging tasks Calling out/frequent talking

(DuPaul, Stoner & O’Reilly,2002; Silverman, Iseman & Jeweler, 2009)

As a result....

Higher rate of High School dropouts

25-36% of students with ADHD do not complete High School (Silverman, Iseman & Jeweler, 2009)

Higher risk for grade retention

30-50% of student with ADHD are retained at least once (Silverman, Iseman & Jeweler, 2009)

Example of Subtype & intervention

ADHD-I Characterized by:

slow cognitive processing

low levels of curiosity & enjoyment of learning

Prefer less challenging tasks

Prefer cooperative work environments

Greater reliance on external criteria for success

(Pfiffner, DuPaul & Barkley, 1998)

Intervention: emphasize non-

competitive external incentives for meeting goals

Plan assignments that address slow work style and incorporate preference for cooperative groups

“ ...the most effective behavior interventions must go beyond the diagnosis and identify specific behaviours for change as

well as the function that these behaviours serve for the student.” (Pfiffner, DuPaul & Barkley, 1998)

Functional Behaviour Assessment

Behaviour interventions in the classroom are most effective when they are based on the information gathered through a functional behaviour assessment (DuPaul & Weyandt, 2006).

Observation of the student in the classroom setting: What are the target behaviours? What are the antecedents? What are the consequences?

Design intervention Implement Review progress

(DuPaul & Weyandt, 2006; Pfiffner, DuPaul & Barkley, 1998; Iseman, Silverman & Jeweler, 2010)

Example: (DuPaul & Weyandt, 2006 )

Behaviour Function Antecedent Based Intervention

Consequence Based Intervention

Obtain teachers attention Remind class of classroom rules & the connection between student behaviour and teacher attention

Provide attention for appropriate behaviour; ignore disruptive behaviour

Task avoidance Increase stimulus value of task; reduce amount of work required

Provide “attention breaks” upon completion of selected portions of work

The Role of Teachers

When working with students with ADHD, teachers must:

Develop a positive working relationship with the student, based on understanding of the student and knowledge of the disorder.

Work collaboratively with school psychologist/behaviour specialist; on-going consultation

Facilitate effective and consistent communication between home and school

(Pfiffner, L., DuPaul, G., & Barkley, R.,1998, Silverman, Iseman & Jeweler, 2009).

Evidence-Based Approaches

Stimulant medication

Behavioural Interventions: Target on-task & disruptive behaviour

Academic Interventions: manipulation of antecedents (type of instruction, materials, outcomes...)

(Raggi & Chronis, 2006)

General Principles of Classroom Interventions (Pfiffner, DuPaul & Barkley, 1998)

1. Swift, frequent & significant consequences “Parallel Teaching”

Reprimand

Token Reinforcement

Response Cost

General Principles of Classroom Interventions (Pfiffner, DuPaul & Barkley, 1998)

2. “Positives before Negatives”

3. Frequently change/rotate rewards

4. Anticipate! “Think Aloud, Think Ahead”

(Antecedent based strategies)

5. Hold students accountable

6. Continued monitoring & modification for maximum effect

Academic Interventions Strengths-Based Approach

Boosts self-confidence

Adaptations/Accomodations Examples: Modify pace of instruction, allow extended time for task completion, allow frequent breaks, allow ‘fidget toys’...

Computer-Assisted Instruction Improves sustained attention and work performance

Self-Monitoring Improve social and academic behaviour in classroom

Strategy Training

Places responsibility on the student to improve performance

Peer Tutoring Allows for instruction that is tailored to academic ability & pace

(DuPaul, Stoner & O’Reilly, 2002; Iseman, Silverman & Jeweler, 2010; Raggi & Chronis, 2006; Silverman, Iseman & Jewelwe, 2009)

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ConclusionSchool-based interventions can be quite powerful while they are being administered, particularly when they:• are administered consistently by teachers who are actively engaged in working with students

•are based on FBA, tailored to the specific student

•Include active engagement on the part of the student

•Include effective communication between home and school

References

DuPaul, G., & Stoner, G. (2003). ADHD in the Schools: Assessment and Intervention Strategies. New York, New

York:The Guilford Press.

DuPaul, G., Stoner, G., & O’Reilly, M.J. (2002). Best Practices in Classroom Interventions for Attention Problems. In

A. Thomas & J. Grimes (Eds.), Best Practices in School Psychology: Volume 2 (4th ed., pp. 1115-1127).

Bethesda, MD: National Association of School Psychologists.

DuPaul, G., & Weyandt,L. ( 2006). School-Based Interventions for Children with Attention Deficit Hyperactivity

Disorder: Effects on Academic, Social, and Behavioural Functioning. International Journal of Disabilities,

Development and Education, 53, 2, 161-176. doi: 10.1080/10349120600716141

Iseman, J., Silverman, S., & Jeweler, S. (2010). 101 School Success Tools for Students With ADHD. Waco, Texas:

Prufrock Press Inc.

Pfiffner, L., DuPaul, G., & Barkley, R. (1998). Treatment of ADHD in School Settings . A Handbook for Diagnosis and

Treatment. New York: Guilford Press.

Raggi, V., & Chronis, A. (2006). Interventions to Address the Academic Impairment of Children and Adolescents with ADHD. Clinical Child and Family Psychology Review, 9, 2. doi: 10.1007/s10567-006-0006-0

Silverman, S., Iseman, J., & Jeweler, S. (2009). School Success for Kids With ADHD. Waco, Texas: Prufrock Press Inc.