Introduction

Q. Whatnames have been used to describeADD?

What are the different names that havebeen used to describe this disorder?

1902193419401957196019681980

1987

"Defectin moral daracter"-maydd~MinimalBrainSyndrome-'Hyperldnetic lmpluse Disorder""MinimalBrain DysSmccon (MBDr"Hypaidoetie Reaction ofChildhood (DSMIn""Attention DeficitDisorder(with, withau, sad residual type : DSMM""Anmtion DeficitHyperactivity Disorder-"Undifferentiated AAttention DeficitDisordrt'

INTRODUCTION

A. While diagnostic labels to describe childrenwith attention disorders have changed over theyears, all have been used to describe the same setof symptoms. Changes in labels have reflectedchanges in conceptualization of thedisorder . Cur-rent terminology, Attention-deficit HyperactivityDisorder and Undifferentiated Attention DeficitDisorder, emphasizes inattention as a key charac-teristic of the disorder.

VIEWER'S GUIDEAttention Deficit Disorder:CommonlyAsked QuestionsTo Accompany the ADD Slide Program*

Q. Howmany ADD kids are there?

Howmany ADDkids are there?

ADDis one of themost prevalentpsycizo

onai disorders of ehldhood

INT toouanoN

A. ADD is a highly prevalent disorder whichaffects from 3°k to 5% of children. Althoughboys tend to outnumber girls, girls can nonethe-less be ADD. The total number ofchildren withADD in the United States ranges from 1.35 to2.25.million.

Q. What are the signposts for identifying achild with ADD?

What are the signposts for identifyinga child with ADD?

A. Diagnosis ofADD hinges on the presence ofinattention, impulsiveness and poorly regulated

Attention Deficit Disorder Slide Program

1

Commonly Asked Questions*Pa&er, MC. and Gordon .M (1992) Teaching theADDChild.ASlidePrograntforln.Service TeacherTraining. NewYak: GSI Publicalions, Inc.IFlorida: Impact Publications,Inc.

This Viewers Guidemay be reproduced fordistribution .

motor activity, i.e . either hyperactivity orhypoactivity. Diagnostic clues come from age ofonset, chronicity, and pervasiveness. There is nosingle signpost that alone points to the diagnosis.

Q. What is the core deficit that children withADD experience?

What is the core deficit thatADD children experience?

ADD children have a thick barrierbetween themselves and life's

many consequences.

INTRODUCTION

A. Currentconceptualization ofthe disorderpointstodiminishedsensitivityto motivators as aprimaryunderpinning of symptoms. Many of the effectivetreatments for ADD are designed to create anenvironment in which the "thick barrier" betweenthe child and his environment can be more easilypierced.

Q. Are children with ADD always inattentiveand overactive in every situation?

Are ADD children always inattentive andoveractive in every situation?

M34 behavior ofADDehld:mwMvary aceordms to:

"TbedeVwto wWehmiesmattbemange&" The amotmt of sttnemro aadsnppon fortomPliarke.

"Thedegree to whichthe ehld isinte:esaed in theactivity.

A

tTOFADD

A. The behavior of children withADD will varyaccording to the degree to which the environmentis structured and compelling, Sometimes diagnos-

Attention Deficit Disorder Slide Program

tic disagreements among parents, teachers, andclinicians can be attributed to differences in thesettings in which they view the ADD child's be-havior.

Q. Are all children with ADD overly-active?

Are all ADD childrenoverly-active?

A. A diagnosis ofADD can be warranted even ifthe child is not physically overactive and impul-sive . Children who are inattentive but compliantand normally-active appear to represent a distinctsubgroup ofADDyoungsters. Children who havea diagnosis of Undifferentiated ADD, sometimesreferred to as ADD without hyperactivity, areusually very quiet, passive, daydreamy, and slowin tempo. They tend to become overfocused ontasks to a degree not found in non-ADD children .Undifferentiated-ADD makes up about one-thirdofthe group ofchildren who have attention deficitdisorder.

Causes ofAttention

Deficit Disorder

Q. Why is ADD considered a neurobiologicaldisorder?

Commonly Asked Questions

Whyis ADDconsidered

Ia neurobiological disorder?

A.ADD is not caused by any single factor. Hered-ity seems to account for the largest portion ofchildrenwithADD. Evidenceforthe strong contri-bution of neurobiological factors comes from evi-dence of a family predisposition and recent find-ings from brain imaging studies. Recent studies atthe National Institute of Mental Health demon-strateddifferences between howhyperactive adultsmetabolize glucose in the brain as compared tonon-hyperactive adults.

Q. What is the role of diet as a cause of ADD?

A. There is no evidence that food allergies causeADD for the overwhelming majority of cases .While dietaryfactorsdo not cause ADD, they maymake matters worse for children with poor self-control.

Q. What is the role of the environment incausing ADD?

What is the role of environmentin the cause ofADD?

ADDis not caused bypoorparenting or lousy teachers

(1beeavitpnmenzmi&maleADDworseor better-but it doesn'tcause it.)

CAUSESofADD

Attention Deficit Disorder Slide Program

3

A.Childrenwith ADD arefound-eveninthe bestoffamily and school environments. Although ADDis not caused by environmental factors, such fac-tors do play an important part in affecting how achild with ADD will cope . Environments whichlack structure, clear rules, and supervision canexacerbate symptoms ofADD.

Q. What other factors could account forADD-like symptoms?

What other factors could account for ADD-like symptoms?

A. ADD is only one possibility ofmany for why achild might underachieve and misbehave. Otherproblems to look for which may explain a child'sattention problems include: medical disorders,learning or academic frustration, emotional prob-lems, stress, or environmental factors. It is impor-tant that all possible causal factors be consideredduring an evaluation.

Assessment ofAttention

Deficit Disorder

Q. Why is a comprehensive, multimodalassessment necessary?

A.AssessmentsforADD are often multidisciplinaryand may involve medical professionals, mentalhealth clinicians, and educators. Credible assess-men4 gather data in as standardized a way as

Commonly Asked Questions

possible from three realms: parents, schools, andthe child. While evaluations need to be compre-hensive, they can nonetheless be conducted in atime- and cost-efficient manner.

Q. What other problems often co-exist withADD?

What other problems oftenco-exist with ADD?

LearningDisabilities

EmotionalProblems(ar- -)Conduct Problems( y/aes-)

ASSESSMENTOFADO

A. Children with ADD are more vulnerable thannormal children to experience other learning, be-havior, and emotional problems. Because there isa high degree of comorbidity, clinicians should bewary of "either-or" diagnostic decisions and feelpomfortable with diagnoses that integrate a varietyof clinical components . A distinction should bedrawn between the general underachievement ofchildren with ADD due to poor attention, andcircumscribed academic deficits that are a conse-quence of a specific learning disability.

Q. What procedures constitute a credibleassessment of ADD?

A. There are no sure-fire markers as tests thatclearly identify ADD. Children with ADD oftenhave a matrix of symptoms which can includelearning problems, oppositional behavior, self-es-teem difficulties, etc. . A credible assessment isrequired to ensure that other explanations for thechild's behavior are not more likely . Effectivetreatmentprogramsfollowfromanaccurateunder-standing of a child's symptoms and situation .

Q. Why is a medical evaluation important?

Attention Ddficit Disorder Slide Program 4

A. All children being evaluated for ADD shouldhave had arecent physical examination to rule outmedical factors. While it is of critical importanceto establish thechild'shealth status, specificmedi-calcauses for ADD-like symptoms (such as neuro-logical or endocrine disorders) are relatively rare .Medical follow-up for children with ADD whotake medication is extremely important in order toproperly assess desired therapeutic effects andunwanted side-effects of medication.

Q. Why is a parent interview important?

A. Information gathered from the child's parents isa key component of the assessment process. Par-ents provide vital data on the child's developmen-tal history, medicalhealth, socialization, academicadjustment, family interaction, etc . . Parents alsoneed to be included as a way of encouraging theirpersonal involvement and advocacy.

Q. Why is school information important?

Why is schoolinformation important?

A=demic and social fimeaaning inmlaaon so el,cumr c

Undeammcragof seaehees effom at' maxvearioa

A55ESSUENTOFADO

A. Teachers also play a crucial role in the assess-ment process . Teachers are able to pinpoint thestudent's current classroom performance in com-parison to peers . Failure to include school infor-mation in the assessmentprocess greatly increasesthe chances of misdiagnosis .

Q. What signs should teachers look for in theidentification of ADD?

Commonly Asked Questions

What signs should teachers look forin the identification ofADD? .

Hasaauble paying amennonFails to tmish things sJhesmmspa-y.daydr-nsFnxiuauly calls ant oraas bapulsirelyHastmuble completing assiped aoaicDsfti~~issmymg -snaredRcsdas. avaactive

ASSESSUENTOFADD

A. Teachers should consider the possibility ofADD when a student has significant trouble man-aging situations that require attention, persistenceand self-control. Thepossibility that ADD is attheheart ofunderachievement is greatest when achildshows problems with attention and self-controleven when he is bright, seemingly eager to pleaseand achieve, and shows no other obvious handi-caps or problems that alone could account for theunderachievement . Children with ADD can per-form well in one-to-one settings where there isample feedback and strong incentives .

Q. What can an interview with the child tellus?

A. While the ADD child's behaviorin a clinic maybe unrepresentative of behavior in other settings,youngsters are still a valuable source of informa-tion about their situation . Child interviews areparticularly important to rule out otherpsychiatricor family problems, such as obsessive compulsivedisorder, psychosis, depression, or severe familydysfunction.

Q. Why is direct observation of the child inschool important?

A. Direct observation is a very useful method bywhich to assess a child's classroom performanceand behavior. Direct observations of classroombehavior are far more likelythan other approaches

Attentiofi Deficit Disorder Slide Program 5

to generate an accurate picture of academic func-tioning . Unfortunately, direct observations are of-ten impractical for clinicians who are not school-based This is why teacher observations and rat-ings are so important.

Q. Why are behavior rating scales important?

A. Behaviorrating scales are invaluable becausethey assess the extent to which a parent or teacherfeels that the child's behavior is abnormal in lightof the youngster's age and sex . While rating scalesare an important part of the assessment process,they nonetheless are simplyquantifications ofrateropinion and need to be supplemented by otherinformation . Commonly used rating scales com-pleted by teachers include: Conners Teacher Rat-ing Scale, ACTeRS, Child Behavior Checklist,Child Attention Profile, andThe School SituationsQuestionnaire.

Q. Why is psychological testing useful?

Why is psychologicaltesting useful?

Anew spanImpulseca=lnistractliliq

r alviAnl-motorfiaxdoning

ASSESSMENTOFADD

A. Psychological testing is an important part of anassessment for ADD because it provides informa-tion based on standardized assessment of a child'sactual behavior and performance. Psychologicaltesting can efficiently characterize a child's func-tioning not only in the realm of attention and self-control, butalso regarding intellectual ability, aca-demicachievement, andemotionalstatus. Throughsuch testing the clinician can identify co-morbidconditions.

Commonly Asked Questions

Treatment ofAttention

Deficit Disorder

Q. What constitutes a comprehensive treat-ment program for ADD?

What constitutes a comprehensivetreatment program for ADD?

A. Afteracomprehensive assessmentis completedand the student's areas of strength and weaknessare delineated, atreatmentprogramcan beplanned.Treatment of ADD can be quite varied and mayinclude psychological counseling, educational in-terventions, medical management, parent educa-tion and training, behavior modification, socialskills training, etc. . Often due to the co-morbidproblems that children and adolescents with ADDhave, the treatment program is multifaceted andseveral areas are targeted for improvement.

Q. When should medication be used to treatADD?

A. TreatmentofADDwithmedication shouldonlybe considered after the child has had a thoroughassessment. Decisions about a trial of medicationhinges on many factors. Parents and child need tobe educated and comfortable about the use ofmedication. Medication is rarely used as a soletreatment for children with ADD.

Attention Deficit Disorder Slide Program

6

Q. What medications are commonly used totreat ADD?

A. There are a variety of options for medicationsalthough the stimulants have been the most thor-oughlyinvestigatedandmostfrequently prescribed.Stimulantmedicationsinclude: Rimlin, Dexedrine,and Cylert . Antidepressant medications include:Imipramine and Desipramine. Clonidine, an anti-hypertensive medication, is also used with somechildren who haveADD.

Q. How do medications help people withADD?

Howdo medicationshelp people with ADD?

7%"n self-0onntmi

IMP-academicpefo®_cek%n- gR% 0Wmoavatton

rnEnnaexr of ADD

A. Evidence is clear that medications can be ofsignificantbenefitifusedproperly . Approximately70% ofchildren with ADDtaking stimulant medi-cation show improvement. Any individual child'sreactions to medication cannot be predicted with-out a trial of medication. Antidepressant medica-tions are often prescribed for those children withADD who didn't benefit from the stimulant medi-

Commonly Asked Questions

cations or who have additional problems withself-esteem and depression . Even when medica-tion is effective, it is still important to implementnon-medical interventions at home and school.

Q. Whatare the most common side-effects ofstimulants?

What are the most common

side effects ofstimulants?

Loss of appetite

Later to sleep

afternoon rebound

TREATMENTOF ADD

A. Stimulant medicationsare generally safe whenproperly administered and typically do not causeserious side-effects . Nonetheless, they requireclosemonitoringandsensibleadministration. Par-ents, child, and teacher need to be aware of pos-sible side-effects so that reasonable decisionsabout medication management can be made.Common side-effects to the stimulants include :appetitereduction, problems falling asleep, head-aches, stomachaches, and irritability. Side-ef-fects such as depression, growth retardation,drowsiness, and aggression have been greatlyexaggerated and are not typically reported.

Q. What are the common side-effects ofantidepressants?

A. Antidepressants should beregardedas "secondline" options in cases where stimulants have beenineffective or contraindicated . Antidepressantsare potentially much more toxic than stimulantsand need to be monitored far more carefully forhealth effects . Common side-effects of antide-pressants include: dry mouth, constipation, andinitial fatigue.

Attentiod Deficit Disorder Slide Program

Q.What is the educator's role in monitoringmedication?

A. Teachers should play an important role in themonitoring of medication both to judge impactand also the presence of side-effects. Communi-cation between teachers and health care profes-sionals who are working with the child is impor-tant, especially in the monitoring of medicationeffectiveness .

EducationalAccommodations

Q. What are the essential educational needsof a child with ADD?

A. ChildrenwithADDlearn bestinenvironmentsthat are highly structured but also reasonablyaccommodatingto individual strengths andweak-nesses. Classrooms are typically poorly suited tothe needs of children with ADD because of highdemands for attention and self-control.

Q. What general approaches to classroommanagement interventions can be helpful forADD?

What general approaches toclassroom managementinterventions can be helpfulfor ADD?

Contingency Managements

TokeaEoonomyself-mcabMmg

Cognitive Behavior Modificationcogi,-gemsalfgsocial Skills TrAhftuse ofVohmoeesPeergPit-iefeml lmavenriam

EDUCAMONALUnERVENTUONs

A. Effective interventions are often based onvariants oftraditional behaviormodification strat-egies . Behavior modification strategies can be

7

Commonly Asked Questions

implemented in waysthatare motivating, fun, andnon-punitive to the child and teacher .

Q. What are examples of contingency man-agement programs?

What are examples ofcontingencymanagement programs?

EDUCATIONAL Axoao0Arores

A. Contingency management programs can bedesigned so that accountability over behavior isincreased in ways that are practical for teachersyet rewarding to children. Such programs mayincorporate the use of positive reinforcement toreward appropriate target behavior along withresponse costs to punish inappropriate behavior.Effective contingency management programs of-teninvolve thestudent's parentsandteacherswhoare both involved in evaluating and consequatingbehavior and classroom performance .

Q. What kinds of teacher-parent conununi-cations are necessary to assist parents?

What kinds ofcommunication are necessaryto deal with the parents ofADD children?

Frequent telephone contact

Frequentparent-teacherconferences

Daily report cards

EDUCATIONALACCOMMODATIONS

A. Ongoing communication between parents and

Attention Deficit Disorder Slide Program 8

teachers is critical to designing, monitoring, andmaintaining effectivemanagementprograms . Par-ent-teacher communication should start as soonas the teacher or parent notices the child havingproblems in school. In communicating with par-ents, teachers should be sensitive to the problemsthat the parent may also have in managing thechildwithADD. Most parents have struggledforyearsin trying to find theright help fortheirchild.Teachers appreciative of the difficulties thatpar-ents of children with ADD face, will have agreater chance of establishing a positive parent-teacher relationship.

Q. Is it fair to other students to give the ADDchild special dispensations?

Is it fair to otherstudents to givethe ADD student special dispensations?

Fairness isn't every childgetting the same,

but every child gettingwhat be needs

EDUCATIONALACCOMMODATIONS

A. ChildrenwithoutADDcanbe helped to under-stand that those with ADD have special needs.Children without ADD may well benefit fromlearningin an atmosphere that acknowledges andadjusts to individual differences.

Q. Should a teacher talk to the class aboutADD?

A. Most children with ADD want others tounderstand their problem. Clearly, classroomdiscussions need to be handled in ways the childwho has ADDwon't interpret as suggesting s/heis somehow damaged orinadequate. Anumberofbooks for children and teens have been writtenwhich explain ADD and ways in which help canbe provided. Consult the reference section fortitles .

Commonly Asked Questions

Q. What are the elements of effective parenttraining programs?

What are the elements ofeffective parent training programs?

l. Education aboutADDbasic concepts. assessment process, neatmeat options.

.2 Review essentials of effective child management

atteadmg dolls. home token sysoems~ punishmentsedmiqua.

gproblems. ammunieatioa skills .poblem solving dolls. and ignoring strategies

3. Management of special problemscomes .: . enoopesis, stcalin& school diffrcuhies, etc .

4. Homeworkassigrmx=

5. Group therapy and social support

,

ti.Booster sessions

A. It is essential that parents be educated aboutADD so as to gain afull andthoroughunderstand-ing of the causes of the disorder, its course, andmethods of treatment. Even the most competentof parents will probably need an opportunity tolearn strategies forchild/adolescent managementto handle the special types of challenges thatchildren with ADD present. Parents of childrenwith ADD often feel alone in their parentingexperiences . Their children are frequentlyshunnedby others andpositive socialcontactandacceptance may be hard to come by. Supportgroup meetings such as CH-A.D.D. can offervitally important understanding andrespectfromother parents who have been in their shoes.

For more information aboutattention deficit disorders

call or write to:

CH.A.D.D.*Children With

Attention Deficit Disorders499 Northwest 70thAvenuePlantation, Florida 33317

(305) 587-3700

*CH.A.D.D. maintains over 350chapters nationwide .

Attention Deficit Disorder Slide Program

The Ideal Teacher (and Parent)ForA Child With ADD

1 . Thoroughly knowledgeable about ADD andaccepts legitimacy of the disorder.2 . Tough as nails about rules but always calmand positive.3. Ingenious about modifying teaching strate-

gies and materials in order to match child'slearning style.4 . Tailors academic material to suit child's

abilities and skills.5 . Creates assignments that require as muchactivity on child's part as possible. Hatesdittos and endless seatwork .6 . Mixes high and low interest tasks in tune

with child's predilections .7 . Isn't into homework in a major way.8 . Knows to back off when student's level of

frustration begins to peak.9. Knows to back off when teacher's level of

frustration begins to peak.10 . Speaks clearly in brief, understandablesentences.11 . Looks the . child straight in the eye whencommunicating .12. Runs an absolutely predictable and orga-nized classroom.13 . Controls the classroom without beingcontrolling.14. Provides immediate and consistent feed-back regarding behavior.15. Develops a private signal system with childto gently notify him when he's off task oracting inappropriately .16. Maintains close physical proximity withoutbeing intrusive.17 . Ignores minor disruptions. Knows how tochoose battles.

From M. Gordon (1991)

9

Commonly Asked Questions

Teaching the ADD ChildPresentation Test Questions

Circle the correct choice in each of the questions below.1 . Which of the following has n9t been identified as a possible cause of attention deficit disorder?

a. Heredityb . Brain injuryc . Environmental toxinsd . Poor parentinge. Birth-related problems

2. Dietary factors are responsible for causing attention deficit disorder in:a. Nearly all casesb. About three quarters of casesc. At least half of casesd. About a quarter of casese . Less than 10% of cases

3. The behavior ofADD children will vary according to all but which of the following factors?a. The amount of sugar in the dietb. The extent to which adherence is requiredc. The amount of supervision and redirectiond. The extent to which consequences are meaningful an d consistente. The novelty of the situation

4. Which of the following is =t typically a part of the ADD evaluation?a. Interview with parentsb. Contact with teachersc. Psychological testingd. Psychiatric interview with childe. allergy testing

5 . Which of the follwing is not a typical component of a multimodal treatment for ADD?a. Behavior modificationb. Medical managementc. Psychological counselingd. Sensory integration therapye. School programming

6. Which of the following is a common side effect of stimulant therapy?a . Academic underachievementb. Loss of appetitec . Suicidal thoughts or actionsd. Zombie-like staringe . Moodiness

7. Which of the following is an example of a contingency management classroom strategy?a. Beep tapesb. Self-monitoring schedulesc. Response cost strategiesd. Self-report formse. Academic tutorial programs

8 . Which of the following is an example of a cognitive behavior modification technique?a. Self-recording formsb. Attention trainersc. Token economiesd. Sticker programse. Time-out

9. Which of the following statements aboutADD in adults is true?a. ADD symptoms tend to disappear by pubertyb. Adults may still have signs of ADD but it rarely is seriousc. ADD symptoms tend to persist into adulthood and can seriously affect adjustmentd. ADD adults are at risk for schizophreniae. Children who took medication for their ADD as children are more likely to abuse

drugs than other ADD children10 . Which of the following information is important to include in anADD parent training

program?a. Conflict negotiation strategiesb. Behavior modificationc. General information about ADDd Inforniation about medical managemente. All of the above

Use the space below to comment on the presentation :

nostir: CriIPria for 314.01 -.Attention-deficit NypetactiyitV Disorderk �I

Note: Consider :a criterion

ing are present :

13 .

Onset before the age of seven .

onl ;

if- l `e :~eliawior is conste same``mental age.

7t disturbance of-at-least - six months during which °at -leas 7ei l t of the follow

(1) often fidgets with .-ltands or feet or squirms i

seat (i_ri 4dolescents, mwbe limited to .subjective feelings of restlessness)-"

(2) has difficulty re.mair ing seated when required - to - do so(3)

is easily distracted 'b'y;~extraneous stimuli

.(4) has difficulty awaiting turn in games or group situations(S) often blurts out;answers to questions before they have been complete((6) has difficulty following through on instructions from others (not due t(

oppositional behavior or failure of comprehension), e .g ., fails to finislchores

,.(7)

has difficulty sustaining attention in tasks or play activities(B) often shifts from one uncompleted activity to another(9)

has. difficulty playing quietly

-

-(10) often talks excessively(1 1) often interrupts or intrudes on. others, e .g ., butts into other children'

games

-(12) often does not seem to listen to what is being said to him or her(13) often loses things necessary for tasks or activities at school or at horn

(e .g ., toys, pencils, books, assignments)

-

(14) often engages in physically dangerous activities without considerinpossible consequences (not for the purpose of thrill-seeking), e .g ., rurinto street without looking

Note: The above items are listed in descending order of discriminating pow(based on data from a- national field trial of the DSM-III-R criteria for Disrupti%-Behavior Disorders .

C.

Does not meet the criteria for a Pervasive Developmental Disorder.

Criteria for severity of Attention-deficit Hyperactivity Disorder :

- -

Mild: Few, if any, symptoms in excess of those required to make the diagnosis aronly minimal or no impairment in school and social functioning . .

Moderatle : Symptoms or functional impairment intermediate between "mild" a(-severe .."

-

- '

Severe : Many symptoms in excess of - those required to make the diagnosis arsignificant and pervasive impairment in functioning at home and school and wipeers .

Difficultyorganising work

* .Does .not complete. tasks:

* Appears not tolisten .

* Work i . messy* Appears careless

* Failure to followthrough withrequests

* Shifts from oneincompleted taskto another"

* Failure to listen..to other children

* Failure to followrules ofstructured game .

IMPULSIVE

directionbefor"e beginningto work

* Interrupts teacher* Disturbs other

children

* Interrupts others* Accident prone

* Failure to waitone's turn ingames

* Interrupts* Grabs objects,

toys* Engages inpotentiallydangerousactivities

THERE WILL ALSO BE AGE-SPECIFIC FEATURES

HYPERACTIVE

* Difficultyremaining .seated

* Runs in classroom* Fidgets in -seat . .'

Plays with objects`

Inability toremain seatedwhen expected todo soExcessively noisyactivities

* Excessive talking* Inability to playquietly

* Inability toregulatebehaviour toconform to therules of the game

* Blurts out answers* Fails to wait

one's turn* Fails to heed

In Classroom

*

Sit near teacher.

HELP FORTWACHERS

*

Away from distractions .*

Eliminate extraneous material from work area.*

Compile lists ofwhat to do.*

Establish routine.*

Notify changes in advance.*

Close communication with parents regarding school and homework.*

Make eye contact.*

Make physical contact.*

kelp develop listening skill, practice in class.*

Give clear, simple direction*

Give warning re endings.*

Have specific zules ('stay in seat").*

Follow rules consistently.*

Consequences to follow immediately

.*

Respond without anger/ridicule .*

Ensure child knows which rule was. broken,*

Use non-verbal cues or signals for indicating to childwhen rule broken.

*

Use reward system ofpoints/stars/etc.*

Manipulation ofpeer attention.*

Soil personalised reprinmds.*

Avoid suspensions (parental anger).*

Focus on behaviour and learning for reinforcement,* Ignoring .* Over-correction.*

Response-cast (loss of expected positive event) .*

Immediate (+) reinforcement.*

Use all ofabove.Use warning signals.

*

Time-out as a last resort.

Mvelop Self-Esteem bX:

Set attainable goals and feedback,Ackowledge achievements.Use highlighter to emphasise positives.Start a "Pride" folder.Initiate conversation.Ask child to think ofgood thing that happened,Recognise positives,Encourage classroom jobs .Encourage "internal praise" .

Strategy withParents :

Establish an alliance by communicating regularly.Meet regularly.Be sensitive to parents' feelings.Help parents feel proud oftheir child.During meetings avoid moralizing, preaching, blaming.

HELPING ADD STUDENTS MAKE SCHOOLING A SUCCESS

HOW CAN WE STRUCTURE SCHOOL FOR SUCCESS?

Be a firm, flexible, encouraging teacher .

Seat near the front of the class away from distraction .

Communicate with enthusiasm, clarity and cue words. Be succinct.

Instruct in short, simple steps .

Give brief bursts of full-on learning followed by rest - reward .

Apply the opportunity to replay and revise .

Encourage self monitoring and cognitive questioning .

Focus on structure, headings, planning, seeing salient points .

Homework on a strict contract basis. Reward effort .

Encourage self-esteem by giving responsibility, privileges and showing interest .

Let them know the day's programme and stick to it.

Ignore trivial, unimportant irritations .

Tasks for the A . D./H .D . child should be formulated with a reduced degree ofpersistence required rather than a reduced level of difficulty .

Traditional classrooms suit more than open plan .

addstuadoc(Flelprg A00 snxknls make schoohrg a succeWJ Greendsk(

consistent consequences ." consistent routines in classroom activity ." close proximity to child while giving directions ." write directions on board as well as verbally ." give a responsible peer as partner ." ask to repeat directions to you.

give special responsibilities ." respond well to praise ." regular parent/teacher communication as in our experience many parents need

reminding of what their role is .strategic seating (away from distractions - windows, doors etc) and closeproximity to teacher .

" *FM system* (similar to one used by hearing impaired students) which block outdistractions and teacher's voice feeds directly into A.D .D. students' ears!! (worksgreat!)structured classroom - clear, concise instructions diet control .not too many sweets.

+I

short term rewards and tasks .immediate rewards - eg . lolly rewards .consistent .

* fair expectations - be realistic .

SUGGESTIONS FOR ASSISTING A.D./H.D. STUDENTS TO LEARN

encouragement .individual work programme.technology - use computers etc .carefully sitting them in a good seat .limited instructions - 1 or 2 at a time .seat close to teacher - tap on shoulder when instructions given.behaviour modification programme - instant rewards .involve remaining students in same system to avoid isolation .clearly defined outcome - focus on one aspect of behaviour at a time .reinforce and clearly define the goals/task in visual form .must involve parent/teacher child conference - communication essential .in extreme cases/peer involvement vital .short instructions .child verbalise instructions .partner/group work.physical/eye contact .isolation .strict routine, consistent procedures .routine desk/wall charts .quiet approach .frequent checks on desks, materials, tools.close to teacher.doors, windows out of view (reduce stimuli) .direct instruction .behaviour modification - immediate reward eg . green/red cardrewards/punishment .peer tutoring - pair up with another child .written list of instructions instead of repeating .Pre Primary : teacher to physically "help" eg. steer child in right direction .giving ADD child a specific responsibility - good for self-esteem .bland environment - reduce stimuli ie . noise, " posters, signs .use headphones.use computers .

- reduce verbal

1 .7 . UP C/

rats aren't bornthey're created

Y OU'D probably haveyour own theories asto what makes a

delinquent . Certainly thepolice department in Hous-ton, Texas, seem prettyclear.Some years ago, in an effort

to t:ombat juvenile crime, theymade up billboards to attractcommunity attention to theproblem.one that caught the eye of

m~Fst observerswasthis:1S I1ULES FORRAISING

UELINQUEN'P CHILDREN1. Beginning in infancy, givechildren .everything they want .In this way they will grow up tobelieve that the world owesthem a Living.

When they pick up badwards, laugh at them. This willmake them think they are cute .3. Never give them any spiritualtraining.4. Avoid the use of the word'a , rong'. They may, .develop agailt complex.5. Do everything for them sothat they will be experienced inthrowing all responsibility ontoothers.G, Let them read any printedmatter they can get their handson . Be careful that the silver-ware and glasses are sterilisedbut let their minds feast ongarbage.1. Quarrel frequently in thepresence of your children . Inthis way they will learn to dothe same .:4 . Calve children all the spend-mg money they want . Never letthem earn their own money.11 . Satisfy their curving for food,_.,_ _-.,, --.6 ..a R.... that

sUulH LAKE PRIMARY SCHOOL

CopingwithkidsDr JohnIrvine

their every sensory desire isgratified.10. Take their part againstneighbours, teacher andpoliceman. They are all preju-diced against your children,anyway.11. When they get Into trouble,apologise for yourself by say-ing, "I could never do anythingwith them, anyway."12. Prepare for a life of grieGYou will be likely to leave it.Maurice Balson, author of

the very successful Acer bookBecoming Better Parents,argues that many middle-classparents, in their efforts notjustto become good parents butblameless parents, take awaychildren's responsibility andleave them powerless to dealwith life's problems.The pampering parent, he

says, steals initiativj3 and self-confidence from young people,and limits their opportunitiesfor developing strategies 1.0

ID=61 9 4172223

Cope with problems such asschoolwork, mendships and re-lationships with the oppositesex.Ralson suggests that in this

situation the young people failto learn howthe control of theirlives is in their own hands.Thus, when the teenager

strikes orie of life's little prob-lems and the doting parentfails to solve It, the adolescentbecomes very angry. In otherwords, the teenager feels help-less and powerless to copealone, and that little problemlooms; bigger than life itself.At this point, says Balson,

the teenagers are so angry thatthey choose suicide, orthey areso hurt they choose to rebel.Many times in my clinic, each

week, I see families where thechildren have become ex-tremely hostile towards theirparents because, in deprivingthe children of coping skills,parents have set up what istermed a"conflict-dependencyrelationship" ; the childrendepend on their parents andcome to hate dependency .According to Raison, you are

a pampering parent if you:* Routinely

call

teenagersmore than once to get them outofbedin the morning.Drive teenagers to school

when they could easily walk ortake public transport.0 Help them with most of theirhomework .0 Cook special meals just forfussy teenagers.0 Put out their clothes to wearfor school or social functions.*Provide money handouts freeof any effort on their part .

0 Ask them to do jobs but endup doing ityourself.0 Tend not to say 'no', nor todisagree with teenagers.*Tolerate them interruptingyour conversation .0 Ask them if they have anyhomework .9 Allow them to eat in front ofTV instead of with the family .sAllow them use of the familytelephone in ways that Infringeon the rights of others,When I speak with parents I

discover their reasons for parn-pering.are often basedon somedeep-seated fear - that theirchildren won't be successfuland will blame their parents forit. Or, worse, that other par-ents will blame them . Or, evenmore destructive, a belief that"if I don't do everything per-fectly I am not acceptable tomyself". .When parents replace that

tormenting tyranny with somesimple, old-fashioned self-acceptance, then the fear offailure recedes. The fear ofbeing found out as a fake hasno hold and they can enjoybeing themselves, warts andall, maybe for the first time intheir lives:Coddling kids Is not security .

It gives kids the clear messagethat life is threatening and theycan't cope alone. It breedsinsecurity, not security .Maybewe all need to remem-

ber, as some cynic once said,that when it's all boiled downit's no use worrying about lifeall the time. Because no onegets out alive.Dr John Irvine can be heard

Monday to Friday at 11.h0amon Radio (JIX .

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