Attention deficit hyperactivity disorder: implications for the classroom teacher.

This article is the culmination of field observations, discussions with classroom teachers and a review of the existing research base for meeting the classroom needs of students with attention deficit hyperactive disordered needs.

Specifically the article describes strategies that classroom teachers can utilize to better meet the attention needs of their students with attention deficit hyperactive disordered needs. Every strategy is discussed in terms of how the strategy should be implemented and this discussion is followed by a heading in which current research findings that relate to the strategy are briefly discussed.

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Students labeled attention deficit hyperactive disordered (ADHD) display many characteristics that make the sustaining of attention problematic (Welton, 1999). Some of these characteristics include but are not limited to: (1) often fails to give close attention to details or makes careless mistakes in schoolwork; (2) often does not follow through on instructions and fails to finish schoolwork; (3) often does not seem to listen when spoken to directly; (4) often has difficulty organizing tasks and activities; and (5) often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort such as schoolwork or homework (Accardo, Blondis, Stein, & Whitman, 2000). However, in order to fully understand these characteristics, it is important to first understand the different parts that make-up the process of attention. For example, the process of attention demands that the learner focus that is pick or select something that needs attention. However, in order for the learner to be able to sustain or pay attention for as long as the required task demands, the learner must be able to resist or avoid things that remove his or her attention from where it needs to be. Depending upon the classroom situation, the learner may also need to shift or to move his or her attention to something else when the task demand requires slight modification.

In this article, several strategies will be described that can be used by the teacher to better engage the attention of students with ADHD in his or her classroom. These strategies were created after several periods of observing students with ADHD and after several meeting with three classroom teachers that had students labeled as having ADHD in their classrooms.

Strategy #1: To increase the use of positive reinforcement 

This strategy calls the classroom teacher' s attention to the frequency in which the student with ADHD receives negative comments or even punishments. When observing a student labeled ADHD, it was quite common to witness the teacher berating the student for his or her lack of focused attention, talking out of turn as well as participating in distracting behaviors like the clicking of a pen or the bending of a paper clip. However, once the teachers were shown the frequency in which they had delivered negative comments and we had an opportunity to discuss the replacement of these negative comments with positive verbal reinforcement (such as, "You keep improving!"; "Wow, you have completed half of the page, I know you'll get the rest done by the end of the period!"; "Sensational effort, keep up the good work!"). The teachers were truly amazed at the effort the students demonstrated in response to the positive comments was well as a decrease in the frequency in which negative behaviors occurred.

Current Research Findings

The use of positive verbal praise goes a long way toward fostering better self-esteem for learners with ADHD (McCluskey & McCluskey, 1999). A student's self-esteem or self-worth is fostered when the teacher creates a classroom environment in which the student with ADHD feels his or her efforts will be recognized. Through such recognition, the student with ADHD can perceive that they have competencies and that they will succeed at school-related tasks.

Strategy #2: To bridge from previously taught concepts to new concepts

This strategy calls attention to what it is that the classroom teacher is doing to better enable students with ADHD to process the material that is being taught. When observing the typical delivery of lessons, it was noted that although much attention was paid to the individual parts that needed to be taught in order for a concept to be learned far too little attention was paid to how this current concept fit with previously taught information. After meeting with the three classroom teachers and discussing pertinent research literature, it was decided that each lesson would incorporate eliciting from the students what it was that the class had been studying that they felt related to this "new" material. To provide the necessary support for such a discussion to take place, the students were directed to take out their notebooks and to look at the previous "Aims" that had been the focus of past lessons.

Current Research Findings

The teaching of new concepts requires that students with ADHD have time to incorporate new information into their pre-existing knowledge base and to use it as a springboard for additional abstractions and generalizations. By providing numerous opportunities for students to look for connections between what they have learned and what they are now studying, students are better able to expand on the ideas that they are learning (Howell, Fox, & Morehead, 1993).

Strategy #3: To provide opportunity for students to apply concepts they have studied to the reality of their daily lives

This strategy addresses the observation that many students with ADHD tended to be very egocentric, as if their personal reality is the only one to exist. Upon meeting with the three classroom teachers, it was noted that their students with ADHD tended not to read very much outside of school, and far too often they appeared to lack an awareness of important world events, as well as information in the arts and sciences. To address these concerns, the classroom teachers drew upon the research based technique of using focus journals as a vehicle for providing opportunity for students to apply concepts that they have studied to the reality of their daily lives. For example the technique of a focus journal would be implemented by having students write a brief comment in

response to a teacher's daily "Journal Focus" question, including support for their opinion or response. One such "Journal Focus" question might be to call attention to a modernistic work of art in their textbooks and ask them to support why they feel the piece should or should not be considered art.

Current Research Findings

When students with ADHD attach personal meaning to information, they tend to understand and recall it far better. Therefore providing opportunities for students to express their opinions and to utilize their textbook enables students to apply what they are learning to broader experiences (Fulk, 2000).

Strategy #4: To incorporate various cueing systems

This strategy addresses the observation that for many students with ADHD it was difficult to sustain attention on what the teacher was saying in the classroom. After meeting with the classroom teachers, it was decided that the three teachers would try to incorporate visual cueing through the use of ordinal words like first, second etc.. Teachers also tried to use overhead transparencies to reinforce the presentation of ideas with graphic organizers that displayed the various steps the student would later be asked to carry out on his or her own. Lastly, the teachers felt that it was important to be aware of not always standing in the same place when delivering instruction.

Current Research Practice

Awareness of the importance of using a cueing system when working with students with ADHD needs is just one important way of motivating students to learn. The cueing system speaks to the importance of personally involving students in the learning process (Klumb, 1992).Teachers who take the opportunity to actively involve learners through the use of prepared transparencies are attempting to actively involve the learner beyond listening and reading to the actual articulation of ideas based on the material that is being presented. In addition the transparency serves as a visual organizer that the student can refer to at a later point when they are asked to complete some assignment or task based on this learning.

Strategy #5: To use contingency-based self-management techniques

This strategy usually involves having individuals keep track of their own behavior and then receive consequences, usually in the form of rewards based on their own behavior. It was decided to try this strategy because the teachers felt that too much of their time was being devoted to being "police sergeants". They also began to wonder if the teacher continued to play this role how would it be possible for students with ADHD to become more aware of the many parameters that made-up their behavior. The contingency-based self-management phase involved the student evaluating his or her behavior on a 5-point scale (0=unacceptable to 5=excellent) at the end of an agreed time period. The teacher also rated the behavior, and the student was awarded points based on how closely the ratings matched. In another time-period or class, the teacher awarded negative or positive points to members of the class depending on whether or not they responded to attention-seeking behaviors from any member of the class. In both time periods or classes, the points could be used for privileges.

Current Research Based Findings

The research literature has pointed to the critical role that contingency plays in contingency-based self-management. Specifically, it has been shown that reinforcement of some kind, such as social praise or points that can be traded for privileges, is especially important in order for self-management techniques to be effective in leading to positive behavioral changes in students with ADHD (DuPaul & Eckert, 1997).

Strategy #6: To use self-monitoring of attention to increase on-task behavior

This strategy addresses the observation that students with ADHD had difficulty displaying on-task behaviors for extended periods of time. As a result of our discussions, the teachers decided to apply a self-monitoring strategy for these students. Self-monitoring of attention involves having students ask themselves "Was I paying attention?" and recording a "Yes" or a "No" on a score sheet every time they hear a tone on a tape recorder. The time between tones varies randomly from thirty seconds to one and a half minutes. Once the student is able to use the self-monitoring program successfully and consistently, the teacher weans the student off the tape recorder and the self-recording sheet.

Current Research Findings

The use of self-monitoring strategies are effective at increasing the on-task behaviors of inattentive students in both elementary and secondary schools (Lloyd, Hallahan, Kaufman & Keller, 1998). As students learn to monitor their own on-task behavior, they learn to be more conscious about what triggers their off task behavior and they can use this information to better enable themselves to return to on-task behaviors (Shapiro, DuPaul, & Bradley-Klug, 1998).

Conclusion

This article has focused on the role that attention plays for students with ADHD. Throughout the article some six strategies have been described. Each of these strategies was the result of field-based observation by the author. All field based observations were shared with the three classroom teachers that had students labeled ADHD in their classrooms. In addition to sharing these observations, pertinent research literature was also shared at scheduled meetings. At a subsequent meeting, both the teachers and I agreed on a plan of action that would be tried to better engage the attentive behaviors of the students in their classrooms. It is suggested that other teachers and districts working to better meet the needs of students with ADHD might try such a model of collaboration.

References

Accardo, P., Blondis, T., Stein, M., Whitman, B. (2000). Attention deficits and hyperactivity in children and adults. New York: Marcel Dekker, Inc.

DuPaul, G.J., & Eckert, T.L. (1997). The effects of school-based interventions for attention deficit hyperactivity disorder. A meta-analysis. School Psychology Review, 26, 369-381.

Fulk, B. (2000). Twenty ways to make instruction more memorable. Intervention in School and Clinic, 35(6), 183-184.

Howell, K. W., Fox, S. L., & Morehead, M. K. (1993). Curriculum-based evaluation. Pacific Grove, CA: Brooks/Cole Publishing Company.

Lloyd, J. W., Hallahan, D. P., Kauffman, J.M., & Keller, C. E. (1998). Academic problems. In R. J. Morris & T. R. Kratochwill (Eds.), The practice of child therapy (pp. 167-198). Boston: Allyn & Bacon.

McCluskey, K. & McCluskey, A. (1999).. The agony and the empathy: A hyperactive child's journey from despair to achievement. Reclaiming Children and Youth, 7, 205-212

Shapiro, E. S., DuPaul, G. J., & Bradley-Klug, K.L. (1998). Self-management as a strategy to improve classroom behavior of adolescents with ADHD. Journal of Learning Disabilities, 31,545-555.

Welton, E. (1999). How to help inattentive students find success in school: Getting the homework back from the dog. Teaching Exceptional Children, 31(6), 12-18.

Elizabeth M. Reis, Ph.D, Associate Professor of Psychology, The Bernard M. Baruch College/ C.U.N.Y.

Correspondence concerning this article should be addressed to Dr. Elizabeth M. Reis, One Baruch Way, Box B-8215 New York, NY 10010.