ADHD and Behaviour

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ADHD and Behaviour
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Roadmap

• Description and Definition of Behaviour
  Exceptionality
• ADHD characteristics
• Best Practice Strategies
• Other behaviour exceptionalities (ODD, Conduct
  Disorder) characteristics

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How Do We Define Behaviour Exceptionality?

• A learning disorder characterized by specific
  behaviour problems over such a period of time,
  and to such a marked degree, and of such a
  nature, as to adversely affect educational
  performance, and that may be accompanied by one
  or more of the following

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• a) an inability to build or to maintain
  interpersonal relationships
• b) excessive fears or anxieties
• c) a tendency to compulsive reaction
• d) an inability to learn that cannot be traced to
  intellectual, sensory, or other health factors,
  or any combination thereof.

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Types of Behaviour Disorders

• ADHD
• ODD
• Conduct Disorder
• Generalized Anxiety
• Others - undefined or associated with Mental
  Health issues (e.g. PTSD)

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Think and Connect

• Personal Story
• Visualize the Students strengths and needs

• The students strengths can be used to address
  his or her weaknesses.
• Understanding and noting them is critical to
  appropriate program development

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Strengths and Needs

• Creative Thinker
• Kinesthetic Learner
• Expressive Vocabulary

• Impulsive
• Reduce physical contact
• Redirect excessive energy

• Allow for physical movement breaks
• Implement a behaviour modification reward system
• use direct instruction social stories to teach
  impulse control
• role-play appropriate behaviour (e.g. waiting
  ones turn)

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Some Characteristics

• Students who have behavioural/emotional disorders
  may demonstrate behaviours that show
• disregard for social or cultural norms and that
  deviate in a significant manner from those that
  are normally expected.

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What This May Look Like In Your Classroom

• Students who have behavioural/emotional disorders
  may demonstrate behaviours that show disregard
  for social or cultural norms and that deviate in
  a significant manner from those that are normally
  expected. They may
• destroy their own, another persons or the
  schools property
• be disobedient, defy authority, test limits,
  refuse to follow directions, or be domineering
• be uncooperative, resistive, inconsiderate, or
  disruptive
• interrupt, disturb, or cause disturbances for
  which others are blamed
• be apathetic, exhibiting a dont care attitude
• fight, hit, or assault others
• intimidate, bully, or threaten others
• be restless, boisterous, or noisy
• be untrustworthy or dishonest, lie, or steal
• use profane or abusive language and gestures
• demonstrate delinquent behaviour or vandalism
• be truant from school.

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What This May Look Like In Your Classroom

• Students who have behavioural/emotional disorders
  may demonstrate behaviours that tend to be
  impulsive or compulsive and that negatively
  affect learning. These students may
• speak out
• disrupt classroom activities
• display temper tantrums
• repetitively demonstrate the same behaviour
• have difficulty thinking before acting, or be
  impulsive
• become distracted or inattentive, or lack focus
• daydream or appear preoccupied
• demonstrate a short attention span or poor
  concentration
• demonstrate an extreme resistance to change
  (secondary consideration).

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What This May Look Like In Your Classroom

• Students who have behavioural/emotional disorders
  may demonstrate behaviours that show poor
  interpersonal relationships and low self-esteem.
  They may
• be uncooperative in groups, argumentative, or
  passively noncompliant
• seek attention
• depend on others for direction and require
  constant reassurance
• be hypersensitive, easily hurt or embarrassed, or
  easily flustered
• lack self-confidence
• demonstrate inappropriate sexual activity.

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What This May Look Like In Your Classroom

• Students who have behavioural/emotional disorders
  may demonstrate behaviours that are injurious to
  themselves, such as
• withdrawal
• nervousness
• hypersensitivity
• anorexia or bulimia
• self-abuse
• substance abuse.

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ADHD
ADHDers are great at multitasking. To a certain
extent
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What is ADHD?

• Three possible types
• Inattentive
• Hyperactive
• Impulsive

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Strict Guidelines

• DSM-V has strict guidelines to determine a
  diagnosis
• Behaviours must appear early in life
• Must be more frequent or severe than normal age
  group
• Create an obstacle or interferes with daily
  living in at least two areas of a persons life
  (e.g. school, home, work or social settings)

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Strict Guidelines Contd

• A child with some attention problems but whose
  school work or friendships are not impaired by
  these behaviors would not be diagnosed with ADHD.
  
• Nor would a child who seems overly active at
  school but functions well elsewhere.

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Typical Characteristics

• Signs of inattention include
• becoming easily distracted by irrelevant sights
  and sounds
• failing to pay attention to details and making
  careless mistakes
• rarely following instructions carefully and
  completely
• losing or forgetting things like toys, or
  pencils, books, and tools needed for a task

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Typical Characteristics

• Signs of hyperactivity and impulsivity are
• feeling restless, often fidgeting with hands or
  feet, or squirming
• running, climbing, or leaving a seat in
  situations where sitting or quiet behavior is
  expected
• blurting out answers before hearing the whole
  question
• having difficulty waiting in line or for a turn

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Lets Take a Different Perspective
All Dogs Have ADHD
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Research Continues

• Research suggests the disorder is biologically
  based
• This means that there are likely chemical and/or
  structural problems in the brains of people with
  ADHD that inhibit their ability to focus, plan
  ahead, finish tasks, and so on.

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Whether or not Diagnosed

• Observe students in the following areas
• Mental Energy
• Processing
• Production

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Mental Energy

• The first attention control system, mental
  energy, regulates and distributes the energy
  supply needed for the brain to take in and
  interpret information and regulate behavior.
  Children whose mental energy is not working
  effectively may become mentally fatigued when
  they try to concentrate, or have other problems
  related to maintaining the brain energy needed
  for optimal learning and behavior.

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Four Mental Energy Controls

• The first is alertness, a state of mind in which
  a child can effectively listen to and watch
  information being presented. Children who
  experience difficulty with alertness can appear
  to be daydreaming.

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Four Mental Energy Controls

• The second mental energy control is sleep and
  arousal balance. This control affects the ability
  to sleep well enough at night to be sufficiently
  alert during the day. Children who are
  experiencing trouble with sleep and arousal may
  find it difficult to get to sleep at night, or
  they may sleep poorly. They then have trouble
  getting up in the morning and may appear tired in
  class.

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Four Mental Energy Controls

• The third mental energy control is mental effort.
  This control initiates and maintains the flow of
  energy required for a child to start, work on,
  and complete a task. Mental effort is
  particularly important when children are faced
  with tasks that may not be especially interesting
  or personally motivating. Children who have
  difficulty with mental effort can benefit from
  having tasks broken down into smaller, more
  manageable parts.

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Four Mental Energy Controls

• The fourth mental energy control is performance
  consistency. It works to ensure a reliable,
  predictable flow of energy from moment to moment
  and day to day. Children who have trouble with
  performance consistency don't have problems all
  of the time. Sometimes they can concentrate and
  perform well, while other times they cannot.
  Their work output and behavior may be impossible
  to predict.

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What Does it Mean?

• A student
• has difficulty concentrating may complain of
  feeling tired or bored
• does not seem to be well rested and fully awake
  during the day
• has inconsistent work patterns that negatively
  impact quality and quantity of work
• shows overactivity and fidgets -- especially
  pronounced when sitting and listening

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Whether or not Diagnosed

• Observe students in the following areas
• Mental Energy
• Processing
• Production

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Processing

• The second attention control system is called
  processing. This system helps a child select,
  prepare, and begin to interpret incoming
  information. Children who have difficulty with
  processing may have a range of problems related
  to regulating the use of incoming information.
  There are five processing controls.

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Five Processing Controls

• The first is saliency determination. It involves
  selecting which incoming information is the most
  important. Children who have difficulty with this
  control may be distracted by things that aren't
  relevant and miss important information being
  presented.

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Five Processing Controls

• The second processing control is depth and detail
  of processing. It controls how intensely children
  can concentrate on highly specific data. It
  enables them to focus deeply enough to recognize
  and remember necessary details.

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Five Processing Controls

• The third processing control is cognitive
  activation. This active processing connects new
  information to what has already been learned
  through prior knowledge and experience. Children
  who are inactive processors are unable to connect
  to prior knowledge to assist their understanding
  of new information. In contrast, overactive
  processors are reminded of too much prior
  knowledge, making it difficult for them to
  maintain focus.

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Five Processing Controls

• The fourth processing control is focal
  maintenance. This allows a child to focus on
  important information for the appropriate period
  of time. As Dr. Levine explains, "It isn't so
  much how long your attention span is, as it is
  how well-matched the duration of your attention
  is to the target at hand." Some children who
  don't concentrate long enough on certain things
  may concentrate too long on others.

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Five Processing Controls

• The fifth and final processing control is
  satisfaction control. This control involves a
  child's ability to allocate enough attention to
  activities or topics of moderate or low levels of
  interest. "Insatiable" is a term used for
  children with poor satisfaction control who may
  be unable to concentrate on activities that are
  not exciting enough.

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What Does it Mean?

• A student
• processes too little or too much information
  can't distinguish between what is important and
  what isn't
• focuses too superficially or too deeply on
  information presented
• has difficulty connecting new information with
  information already known
• only pays attention to exciting information or
  highly stimulating activities
• focuses for too brief a period
• has problems shifting focus from one subject or
  activity to another

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Whether or not Diagnosed

• Observe students in the following areas
• Mental Energy
• Processing
• Production

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Production Output

• The third attention control system is production.
  This area governs output -- including what
  children generate academically, behaviorally, and
  socially. Children with production control
  problems have a range of difficulties related to
  regulating academic and behavioral output. They
  may do things too quickly without thinking,
  planning, or previewing outcomes.
• There are five production controls.

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Five Production Controls

• The first is previewing. It involves considering
  more than one action or response and anticipating
  the likely outcome of a particular choice.
  Children who have difficulty with previewing may
  plunge into activities instantly and react too
  quickly.

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Five Production Controls

• The second production control is facilitation and
  inhibition. This is the ability to exercise
  restraint and not act immediately, to consider
  multiple options, and to choose the best one
  before acting or starting on a task. Children who
  have trouble with facilitation and inhibition
  frequently act impulsively and may appear to be
  doing only the first thing that comes to mind.
  These children may blurt out answers before being
  called upon in class.

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Five Production Controls

• The third production control is pacing, which
  means doing tasks or activities at the most
  appropriate speed. Pacing difficulties often show
  up in children's reading. Their reading pace may
  be so fast that they skip over words, have
  difficulty with multisyllable words, and show
  little reading comprehension.

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Five Production Controls

• The fourth production control is self-monitoring.
  It allows children to evaluate how they are doing
  while performing and after completing a task.
  This control allows children to regulate their
  attention and take corrective action.

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Five Production Controls

• The fifth production control is
  reinforceability. It allows children to use
  previous experience to guide current behavior and
  approaches to current tasks. Often called
  hindsight, this ability enables children to make
  use of precedent, experience, and prior knowledge
  to guide their decision making and actions.

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What Does it Mean?

• A student
• fails to preview the effects of statements or
  actions or to predict the outcomes of tasks or
  activities
• has difficulty coming up with the right strategy
  or technique to accomplish a task
• does not monitor quality of work or the
  effectiveness of strategies
• does not use past successes and failures to guide
  current behavior, actions, or strategies
• is apt to do too many things too quickly and some
  other things too slowly
• has a poor sense of how time and how to manage it

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Remember

• It is important to note that students who have
  attention difficulties (e.g., attention deficit
  disorder or attention deficit hyperactivity
  disorder) are not willfully inattentive. It takes
  inordinate effort for some of these students to
  keep themselves on task.

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What You Can Do In Your Classroom

• seat the student in an area of the classroom that
  will minimize distractions
• locate the student to maximize the positive
  effect of role models in the class
• establish a private cueing system to remind the
  student to attend
• provide immediate, specific feedback on learning
  and behavioural progress whenever possible
• break instructional learning periods into smaller
  units of time with the intention of increasing
  on-task behaviour
• allow the restless student opportunities to
  change focus or tasks
• judiciously assign a job that requires the
  student to move away from the problem situation
  (e.g., ask the student to run an errand).

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Strategies and Suggestions Related to Lesson
Presentation

• teach the student the skills necessary to manage
  instructional materials
• pre-teach important vocabulary
• provide a structured overview of the lesson
  before beginning instruction
• use visual aids, demonstrations, simulations, and
  manipulative materials to ensure that the student
  understands the concepts presented
• include a variety of activities for the student
  in each lesson
• help the student enhance his or her memory by
  teaching specific learning strategies such as
  mnemonics (e.g., cues, rhymes, codes)
• review with the student the process required to
  complete the task.

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Strategies and Suggestions Related to Assessment

• make expectations explicit
• break down large tasks, which can quickly
  overwhelm the student, into small tasks, and
  provide reinforcement as each part is completed
• simplify instructions, choices, and schedules
• provide models of completed tasks, so that the
  student can visualize a completed project
• provide instructions visually and verbally
• pair students to check each others work
• provide checklists, outlines, and advance
  organizers, to help the student complete
  assignments
• permit student to demonstrate his or her
  understanding in various ways (e.g. oral
  presentations, displays, dramatizations, and
  demonstrations)
• Reduce workload

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Conduct Disorder (CD)

• a persistent pattern of conduct in which the
  basic rights of others and major age-appropriate
  societal norms or rules are violated.

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Oppositional Defiant Disorder

• ...a pattern of negativistic, hostile, and
  defiant behaviour without the more serious
  violations of the basic rights of others that are
  seen in conduct disorder.

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General Features of ODD

• Persists over time (at least 6 months)
• Characterized by at least four of the following
  behaviours
• Losing temper
• Arguing with adults
• Actively defying or refusing to comply with the
  requests or rules of adults
• Deliberately doing things that will annoy other
  people
• Blaming others for his or her own mistakes or
  misbehavior
• Being touchy or easily annoyed by others
• Being angry and resentful
• Being spiteful or vindictive
• Significantly impairs normal functioning socially
  or academically

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Classroom Strategies
1) Recognizing the stages of anger irritation
agitation loss of control
resolution

• Does and Don'ts
  Student
• DO use the student's name
• DO remove the audience (if possible)
• DO use humour to de-escalate the situation
• DO double your distance
• DO minimize the discussion (this is not a
  teachable moment)

• with an Angry
• DON'T place your hands on the child (unless there
  is a safety concern)
• DON'T raise your voice
• DON'T threaten consequences (talk about it when
  the student is more relaxed
• DON'T point your finger
• DON'T crowd the student

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• 2) Careful Communication
• Body
• Personal Space
• Posture
• Eye contact
• Facial expression
• Gestures

• Mind
• Listen for the student's point of view
• Limit your verbiage and avoid over reacting
• Mouth
• Calm voice
• Slow cadence

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END