ADHD in the Classroom

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ADHD in the Classroom What Educators Need and How to Make it Happen Sam Goldstein, Ph.D. Assistant Clinical Professor University of Utah School of Medicine Clinical Director Neurology, Learning and Behavior Center www.samgoldstein.com Through the Eyes of Innocence How Will They Feel in Five Years?

Do Children Care What We Think? Part I Do Children Care What We Think? Part II Drew as a Teen

Caregivers are the architects of the way in which experience influences genetically preprogrammed but experience dependent brain development. Daniel Siegel The Developing Mind What is the overarching ability necessary for classroom success? Todd

We fail to appreciate that children are genetically endowed with certain patterns of behavior and thought. What Are These Traits? The drive to help. The drive to mastery. Intrinsic motivation. Altruism. Problem solving. Social connection. The drive to acquire knowledge. The drive to become self-disciplined.

Students will work in order to earn extrinsic rewards, avoid punishments, win competitions or to nurture their intrinsic motivation. Intrinsic motivation driven by instinctual optimism explains the drive of young children. Learning is greatest when prompted by intrinsic motivation rather than external controls.

Intrinsic not external motivation is at the center of creativity, responsibility, healthy behavior and lasting change. Motivation isn t something that gets done to children but rather something that children must do for themselves. Self-discipline can be understood as a vital component of a sense of ownership and responsibility for one s behavior.

The need to develop and effectively harness selfdiscipline at an early age, while critical in any culture, may take on greater importance in a society filled with complex demands, challenges, and stresses. The possession and ability to effectively utilize self-discipline paves a successful road into adulthood. It is not surprising that in our fast paced, seemingly chaotic world, children capable of implementing self-discipline at young ages appear to negotiate the maze of family, school, friends, and community more successfully than those who struggle with this ability. Effective self-discipline implies that a child has internalized a set of rules so that even without the presence of a parent or other caregiver, the child will act in a thoughtful, reflective manner.

Todd The ability to inhibit The ability to delay Self-discipline The ability to separate thought from feeling The ability to separate experience from response The ability to consider an experience and change perspective The ability to consider alternative responses

Self-discipline The ability to choose a response and act successfully towards a goal The ability to change the response when confronted wi new data The ability to negotiate life automatically The ability to track cues Children with poor self-discipline aren't clue-less They are unfortunately often cue-less! Poor Self-discipline is synonymous with... Poor Self-control

Poor self-discipline leads to Impulsive behavior Poor self-discipline leads to: Knowing what to do is not the same as doing what you know Inconsistent behavior Unpredictable behavior The illusion of competence Riding an emotional roller coaster Problems with automatic behavior Conditions under which inattention is observed Repetitive Effortful Uninteresting Not chosen

Conditions under which problems with consequences are observed Delayed Infrequent Unpredictable Lacking saliency ADHD is a condition resulting from poor self-regulation. It reflects exaggeration of normal behavior. The Symptoms of ADHD Lead to a Nearly Infinite Number of Consequences

ADHD acts as a catalyst fueling other developmental and environmental risk factors. To understand why children fail we must first understand how they succeed. The consequence is worse than the symptom NEGATIVE REINFORCEMENT

Todd Treatment Plan For ADHD Education Thorough assessment Medication Behavior management Educational support Long term perspective Build success Focus on resilience

Adopt a learning to swim mindset! Five keys to successful management of ADHD Make tasks interesting Make payoffs valuable Adjust expectations for change Allow more trials to mastery Allow more time for change Pills will not substitute for skills But they will relieve symptoms

The Ideal Mindset of Children Taking Medication For ADHD Pills won t substitute for skills Active participation in treatment I am a person with ADHD not an ADHD person A mixed locus of control I am important I can make a contribution Psychosocial Interventions for ADHD Environmental manipulation of the physical plant Environmental manipulation of consequences Modification of cognitive function Test Your Psychosocial Intervention Skill

Symptom relief is not synonymous with changing long term outcome. What Qualities Define the Best School for Students With ADHD? What Qualities Define the Best Teacher For Students With ADHD? Qualities That Define the Best Teacher For All Students!

Some Qualities of Good Teachers Empathic Communicate Well Seek the best in every student Focus on strengths not weaknesses Make children feel welcome in the classroom Educate enthusiastically Seek to understand before being understood Change methods not students Make the work interesting and the discipline will take care of itself E. B. White The Power of Education?

What teachers want from children with ADHD TO THINK TO START TO STOP in concert with all students Keys for the Education of Children With ADHD MAKE TASKS INTERESTING MAKE PAYOFFS VALUABLE ALLOW MORE TRIALS OVER LONGER TIME PERIODS FOCUS ON ASSETS ADOPT A LONG TERM PERSPECTIVE Cognitive Strategies For the Classroom Monitoring Evaluation Cuing Problem solving Communication Attribution

Management Strategies For the Classroom Adjust expectations Everyone succeeds every day Prepare for changes Seating in rows Incompetence versus non-compliance Mix high and low interest tasks Simple, single directions The Art of Educational Commands START STOP ALPHA Place your feet on the floor. (Best) Take your feet off the desk. BETA Do it! Don t do it! (Least effective) Management Strategies For the Classroom Transitions Consequences Consistent routine Allow non-disruptive movement Teacher contact Ignore minor disruptions An efficient system for homework

Management Strategies For the Classroom Manage negative reinforcement Use response cost Use differential attention State and review rules Predictable schedule Maintain home-school communication Don t be a martyr Stress Hardiness Committed to finding a meaningful purpose in life. A belief that you can influence your surroundings and outcome of events, A belief that you can learn and grow from both positive and negative life experiences. Focus on Well Being! COMPETENCE in academic, social and vocational areas CONFIDENCE or a positive identity CONNECTIONS or healthy relations CHARACTER or positive values, integrity, and values CARING and compassion (Lerner et al, 2000)

The secret of education lies in respecting the student Ralph Waldo Emerson Todd

Goldstein s Axiom Through intelligent and ethical educational practices develop self-discipline and build educational proficiency in all children without stealing away their dignity and hope. Or This! www.samgoldstein.com info@samgoldstein.com twitter - @drsamgoldstein Facebook - Doctorsamgoldstein