A Case Study for Adhd Students free essay sample

A Case Study for ADHD Students Peter John Bakas January 17th, 2011 As in any situation with any student that is special or gifted or that IDEA, IEP, and 504 Plans, have to be the first and foremost concern for all parties involved. â€Å"Education For All Handicapped Children Act Passed in 1975 Guaranteed and enforced the right of all children with disabilities to receive free and appropriate education Considered the foundation of special education in the United States; 1990- Law renamed to IDEA. What is an IEP? Individualized Education Plan Written plan that describes the program and special services a student requires to be successful Developed by parents and educators Individualized- plan specifically developed for a child’s special needs Modified usually each term based on the ongoing needs of a student It can cover one or more areas- academic, social, and independence needs. What is a 504 Plan? Under the provisions of the Rehabilitation Act of 1973 â€Å"The right to full participation and access to a free and appropriate public education (FAPE) to all children regardless or the nature of the disability†; Provides a â€Å"Level the playing field† for students†(collaborative modelsieps 504s, 2010). We will write a custom essay sample on A Case Study for Adhd Students or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page I have listed the following steps to a 504 (collaborative modelsieps 504s, 2010): 1. ) Student is referred by a teacher, support staff, parent, physician, or therapist. 2. ) 504 plan meeting is held Plan for student is developed Review date is set 3. Accommodations- A diabetic student may be allowed to eat in the classroom or student may be permitted to go to the office to receive medication 4. ) Assignments or testing conditions may be adjusted ( more time, less or modified test questions) Having a student such as Fred in class can be very frustrating, but we as teachers can do things to make both of your lives a little easier(Hogan, Dawn, 1997): * Consult the experts: parents, previous teachers, specialists, guidance counselors, and psychologist. * Have a sense of humor! Promote high self-esteem: be friendly, respect opinions, provide immediate feedback, and give reinforcement for any improvement. * Establish control: be consistent, follow definite rules, discipline offenses imme diately, offer explanations for what rule was violated and be willing to listen to their side of the story. * Maximize academic improvement: allow for flexibility in amount of time needed to complete a project, offer alternatives to writing (ex. typing), establish small tasks leading up to the completed project, and break it down. Schedule activities to accommodate students fluctuating energy levels: intermix high and low energy activities throughout the day, send student on errands if he or she has energy to burn, encourage active ways of answering questions during discussions. * Provide organizational tools: create checklists in order of priority, develop routine, and label anything that is to go home. * Open up communication lines with parents: engage in frequent correspondence, encourage parental monitoring of homework, provide parents with a schedule of student assignments. Reward success: use stickers, post points on a chart, shake hands, smile, and use verbal praise. * Utiliz e group work: encourage problem solving, teamwork, and cooperation. * Grab the students attention: eye contact, give short, easy-to-understand instructions, insist that students repeat back information, use non-verbal cues to quite the students such as raising a hand or blinking the lights, give private cues that student is off-task such as a hand on their shoulder. * In general: provide variety with learning centers and group projects, test material learned and not attention span, respect students input. Hogan, Dawn. ADHD: A Travel Guide to Success. Childhood Education, Spring 1997, Vol. 73, No. 3. â€Å"Attention deficit hyperactivity disorder (ADHD) is one of the most common childhood disorders and can continue through adolescence and adulthood and as Smith states, is a condition of hyperactivity, impulsivity, inattention (Smith ; Tyler, 2010, p. 196). The psychological effects associated with ADHD may last into adulthood. The main recognized psychological characteristics as recognized by educational medical professionals are (What Are the Psychological Effects Associated With ADHD? : * Low Self-Esteem-Many patients with ADHD may suffer from low self-esteem as a result of the disorders symptoms. Nicole Crawford, author of the article ADHD: A Womens Issue, points out that when women do not get their ADHD treated, they suffer from chronic low self-esteem. The low self-esteem can stem from problems in school, which can occur with all of the symptoms of ADHD. For example, with the ina ttention symptoms, the MayoClinic. com notes that patients have problems finishing work, make careless mistakes and are easily distracted. They may also have organizational problems and dislike schoolwork. With the impulsive and hyperactive symptoms, patients have problems staying still during class and may interrupt others. The problems in school can lead to failure in school, which may cause underachievement in patients. The underachievement can add to patients low self-esteem. * Depression-Some ADHD patients may develop depression, which MedlinePlus notes that parents should alert the childs doctor if they see signs. With depression, patients have a noticeable change in mood, such as persistent sadness and feeling helpless. Patients may have unusual guilt, which can make patients feel worse. Depression can also affect a patients behavior, which includes sleeping problems. Some of the symptoms of depression can worsen ADHD symptoms, such as problems concentrating. * Anxiety-The University of Illinois at Urbana-Champaign explains that some ADHD patients may develop anxiety secondary to the disorder. For example, patients can worry about specific ADHD symptoms, such as organizational problems. Performance in school may trigger anxiety in some patients. With the anxiety, patients have uncontrolled worry, which can affect their ability to think clearly. Patients may have physical symptoms of anxiety, such as a racing heart, sweating and tremors. * Substance Abuse-MedlinePlus points out that if the ADHD does not get treated, patients may develop a substance abuse problem. With substance abuse, patients turn to alcohol or drugs for either a euphoric feeling or to cover up other issues, such as depression, anxiety or low self-esteem. ADHD patients who have impulsive symptoms may use substances more, because they cannot control their behaviors. Crawford adds that in women with ADHD, they may start smoking during middle school or high school. Using drugs or alcohol can also worsen ADHD symptoms like inattention. To be diagnosed as having ADHD a student must display, for six months or more, at least eight of the following characteristics prior to the age of seven(STRATEGIES FOR TEACHING STUDENTS WITH ATTENTION DEFICIT DISORDER (AD/HD): 1. Fidgets, squirm, or are restless 2. Has difficulty remaining seated 3. Easily distracted 4. Has difficulty waiting for his/her turn 5. Blurts out answers 6. Has difficulty following instructions 7. Has difficulty sustaining attention 8. Shifts from one uncompleted task to another 9. Has difficulty playing quietly 10. Talks excessively 11. Interrupts or is rude to others 12. Does not appear to listen 13. Often loses things necessary for tasks 14. Frequently engages in dangerous actions Symptoms include difficulty staying focused and paying attention, difficulty controlling behavior, and hyperactivity (over-activity). ADHD has three subtypes: †¢ Predominantly hyperactive-impulsive †¢ Predominantly inattentive †¢ Combined hyperactive-impulsive and inattentive Children who have symptoms of inattention may: †¢ Be easily distracted, miss details, forget things, and frequently switch from one activity to another †¢ Have difficulty focusing on one thing †¢ Become bored with a task after only a few minutes, unless they are doing something enjoyable †¢ Have difficulty focusing attention on organizing and completing a task or learning something new †¢ Have trouble completing or turning in homework assignments, often losing things (e. g. pencils, toys, assignments) needed to complete tasks or activities †¢ Not seem to listen when spoken to †¢ Daydream, become easily confused, and move slowly †¢ Have difficulty processing information as quickly and accurately as others †¢ Struggle to follow instructions. Children who have symptoms of hyperactivity may: †¢ Fidget and squirm in their seats †¢ Talk nonstop †¢ Dash around, touching or playing with anything and everything in sight †¢ Have trouble sitting still during dinner, school, and story time †¢ Be constantly in motion Have difficulty doing quiet tasks or activities. Children who have symptoms of impulsivity may: †¢ Be very impatient †¢ Blurt out inappropriate comments, show their emotions without restraint, and act without regard for consequences (somewhat similar behavior) †¢ Have difficulty waiting for things they want or waiting their turns in games †¢ Often interrupt conversations or others activities† (Attention Deficit Hyperactivity Disorder (ADHD), 2008). In terms of Ken, behavioral and environment triggers apply we as teachers would have to incorporate a plan based on the IEP recommendations, and be aware of all the triggers below for ADHD and also the Asthma. In terms of the, ADHD, behavior management techniques  must often be used in the learning environment. By examining a students specific problem behavior, understanding its antecedents and consequences, teachers can help students with AD/HD to develop behaviors that lead to academic and social successes. ADHD will not occur unless the antecedents meet a second factor the triggers. Triggers are certain environmental factors that cause symptoms of hyperactivity, inattention, and impulsivity to emerge in an individual predisposed to the disorder. These triggers include poor nutrition, food allergies, physical inactivity, and imbalances in the immune system, inadequate rest, and lack of exposure to fresh air, sunlight, and water. More often than not, it is poor nutrition and the wrong foods which trigger ADHD in young children. In fact, renowned pediatric allergologist Dr. Feingold pointed out that ADHD only emerged when certain foods with additives and preservatives became popular among children. In terms of the Asthma triggers, we need to be aware that Asthma cant be cured, but it can be managed. â€Å"The goal of asthma management is to reduce symptoms on a day-to-day basis and to maintain normal activity levels, including the ability to exercise and participate in sports. One way to do this is by minimizing exposure to triggers. If exposure isnt controlled, triggers can cause severe flare-ups, chronic symptoms between flare-ups, and even reduced lung function. Because triggers are different for each person, youll need to work with your (school medical staff) doctor to determine your childs specific triggers. The doctor may suggest that you keep an asthma symptoms/trigger diary, using symptoms,  peak flow meter  readings, and a record of circumstances during which symptoms occurred to help you identify possible triggers. Once triggers are identified, they can be included in the overall  asthma action plan  you develop with the doctor. Your child may also need allergy skin testing if the doctor suspects that allergens are triggers. Some kids may need to take allergy medication or have allergy shots. Your doctor will determine if this is necessary. Common Triggers are allergens, include: * Mold * dust mites * cockroaches * pollen * animal dander (tiny flakes of dead skin), saliva, or urine Keep these areas as clean and dust free as possible. This means vacuuming and dusting weekly, eliminating clutter. Irritants are different from allergens — they can also affect people who dont have allergies or asthma. For most people, irritants dont create a serious problem, but for kids with asthma, they can lead to airway inflammation and flare-ups. Common irritants include: * perfumes * aerosol sprays * cleaning products wood and tobacco smoke * paint or gas fumes * air pollution Whichever of the above listed items or triggers could be avoided on the teachers part, again we as teachers need to stay in compliance with IEP and coordinate with everyone concerned. Also, we as teachers should incorporate and provide this information to the parents. In terms of what interventions, accommodations to help Fred become successful, help Fred organize his time to maximize learning, and classroom management techniques to help him perform better; I have compiled a list that I would refer to below. General Strategies (Behavior Disorders)† (Attention Deficit Hyperactivity Disorder (ADHD), 2008): * Bring to the students attention science role models with disabilities with a similar disability to that of the student. Point out that this individual got ahead by a combination of effort and by asking for help when needed. * Ask previous teachers about interactive techniques that have previously been effective with the student in the past. * Expose students with behavioral disorders to other students who demonstrate the appropriate behaviors. Direct instruction or target behaviors are often required to help students master them. * Have pre-established consequences for misbehavior. * Administer consequences immediately, and then monitor proper behavior frequently. * Determine whether the student is on medication, what the schedule is, and what the medication effects may be on his or her in class demeanor with and without medication. Then adjust teaching strategies accordingly. * Use time-out sessions to cool off disruptive behavior and as a break if the student needs one for a disability-related reason. In group activities, acknowledge the contributions of the student with a behavioral disorder. * Devise a contingency plan with the student in which inappropriate forms of response are replaced by appropriate ones. * Treat the student with the behavioral disorder as an individual who is deserving of respect and consideration. * When appropriate, seek input from the student about their strengths, weaknesses and goals. * Enforce classroom rules consistently. * Make sure the discipline fits the crime, without harshness. * Provide encouragement. * Reward more than you punish, in order to build self-esteem. Praise immediately at all good behavior and performance. * Change rewards if they are not effective for motivating behavioral change. * Develop a schedule for applying positive reinforcement in all educational environments. * Encourage others to be friendly wit h students who have emotional disorders. * Monitor the students self-esteem. Assist in modification, as needed. * Self-esteem and interpersonal skills are especially essential for all students with emotional disorders. * Do not expect students with behavioral disorders to have immediate success; work for improvement on an overall basis. As a teacher, you should be patient, sensitive, a good listener, fair and consistent in our treatment of students with behavioral disorders. * Present a sense of high degree of possessiveness in the classroom environment. Teacher Presentation for Behavior Disorders (Attention Deficit Hyperactivity Disorder (ADHD), 2008): * After a week, or so, of observation, try to anticipate classroom situations where the students emotional state will be vulnerable and be prepared to apply the appropriate mitigative strategies. By using examples, encourage students to learn science so they can emulate adult behaviors. * Check on the students basic capacity to commu nicate and adjust your communications efforts accordingly. * Use a wide variety of instructional equipment which can be displayed for the students to look at and handle. * When an interest in a particular piece has been kindled, the instructor can talk to the student about it and show him or her how to use it. * Instructions should be simple and very structured. * Group participation in activities is highly desirable because it makes social contacts possible. Monitor the student carefully to ensure that students without disabilities do not dominate the activity or detract in any way from the successful performance of the student with the behavioral disorder. * Teachers should reward students for good behavior and withhold reinforcement for inappropriate behavior. * Some aggressive students act as they do because of a subconscious desire for attention, and it is possible to modify their behavior by giving them recognition. * Have the individual with the behavioral disorder be in char ge of an activity which can often reduce the aggressiveness. Special efforts should be made to encourage and easily facilitate students with behavioral disorders to interact. * Show confidence in the students’ ability and set goals that realistically can be achieved. * Plan for successful participation in the activities by the students. Success is extremely important to them. * The environment must be structured but sensitive to the needs of these youth with behavioral disorders. * Expose students with behavioral disorders to other students who demonstrate the appropriate behaviors. Direct instruction or target behaviors are often required to help students master them. * Consultation with other specialists, including the special education teacher, school psychologist, and others may prove helpful in devising effective strategies. * Keep an organized classroom learning environment. * Devise a structured behavioral management program. * As an educator you serve a model for the students who are behaviorally disturbed. Your actions therefore, must be consistent, mature, and controlled. Behavioral outbursts and/or angry shouting at students inhibit rather than enhance a classroom. Provide a carefully structured learning environment with regard to physical features of the room, scheduling, routines, and rules of conduct. * If unstructured activities must occur, you must clearly distinguish them from structured activities in terms of time, place, and expectations. * Let your students know the expectations you have, the objectives that have been established for the activity, and the help you will give them in achieving objectives. * When appropriate, seek input from the students about their strengths, weaknesses and goals. Do not expect students with behavioral disorders to have immediate success; work for improvement on an overall basis. * Be fair and consistent, but temper your consistency with flexibility. * You should refer the students to visual aids and r eading materials that may be used to learn more about the techniques of skill performance. * Present a sense of costiveness in the learning environment. * Remain calm, state the infraction of the rule, and avoid debating or arguing with the student with a behavioral disorder. * Have pre-established consequences for misbehavior. Administer consequences immediately, and then monitor proper behavior frequently. * Enforce classroom rules consistently. * Make sure the discipline fits the crime, without harshness. * Provide encouragement. * Reward more than you punish, in order to build self-esteem. * Praise immediately and all good behavior and performance. * Change rewards if they are not effective for motivating behavioral change. * Find ways to encourage the student. * Be positive and supportive. * Develop a schedule for applying positive reinforcement in all educational environments. Encourage others to be friendly with students who have emotional disorders. * Monitor the students se lf-esteem. Assist in modification, as needed. * Self-esteem and interpersonal skills are especially essential for all students with emotional disorders. What physical changes can the student make at home to improve the learning environment? In terms of home life where we as teachers do not have much control, but we can influence and educate the parents I would take an approach of education the parents on how to communicate with Fred, and other children in similar situations. I would supply a number of websites and invite the parent to review these sites and for the parent to also do research on the subject and share that research with me. The parents and teachers have to be on the same page. I would provide this site initially to the parents, and print the article out for the parents to read. In dealing with Fred in school and in any environment, we need to pay close attention to triggers as mentioned above. Here is the first website that I would recommend, http://www. education. om/reference/article/quick-guidelines-parenting-teaching-kids/, and here are the recommendations for parents with children with ADHD: â€Å"When there is a child with an attention deficit disorder, reducing stress within the home is a primary concern. Whatever the school can do to assist in this matter will be beneficial, not only to the child, but to the teaching staff as well. Parents need to be taught effective strategies for managing their child. Since all children with   ADHD  are different, the management strategies for each will also be different. A child with ADD/ADHD literally sees the world differently than other kids. Though each child is unique, special  parenting  methods should be used to bring out these kids strengths in intellect and creativity and to compensate for problems with short term memory, oppositional behavior, and obsessive compulsive tendencies†( Quick Guidelines for Parenting (or Teaching) Kids with Attention Deficit Disorders, 2011). Here are the following recommendations listed in the article (Quick Guidelines for Parenting (or Teaching) Kids with Attention Deficit Disorders, 2011): * Create positive alternative choices based on your childs purposes and  encourage him/her to make a choice. Rather than you statements, use I statements that move him toward positive  outcomes. * Keep your cool. * Make consequences specific to the problem  and dole them out in small  increments. * Dont get hooked into oppositional arguments. Keep rewards visible and immediate to desired action. * Reward for work completed. Do not punish for incomplete work. * Remember, the best mo tivators are rewards  that help him achieve his purposes. * Dont push them past what they are capable of doing. * Assist with sequencing and transitions and train him to do it himself. * Get on problems early. Encourage pretend play, read to them, and make up stories. The full article gives examples on how each of the above bullet points can be incorporated into everyday life. As I stated I would print this article, run it past the administration for legal considerations and proceed to provide a copy and the source website. I would incorporate this into my classroom management and parental plans also, and any handbooks or literature provided to the parents. In terms of what study skills would we as teachers recommend to Fred, I listed following (Educational Approaches for ADHD, 2011): * Cognitive Behavior Modification (CBM). The objective of CBM is to teach students problem-solving strategies and self-control techniques. Students are instructed in a step-by-step procedure to monit or and direct their behavior. For example, students are taught to deal with conflict by (1) calming down before reacting impulsively; (2) identifying feelings and expressing feelings in an appropriate manner; (3) setting positive goals for themselves; (4) thinking of alternative solutions to problems; (5) trying a plan and evaluating results (Greenberg, 1998). The overall goal is for students to spontaneously think through situations in which they feel the impulse to act quickly† (Educational Approaches for ADHD, 2011). * Social Skills Training-  Ã¢â‚¬Å"Students with ADHD develop impulsive habits that interfere with their ability to manage interactions with peers and adults. The purpose of social skills training is to rectify social skills deficits through direct and indirect instruction. This proactive approach seeks to change students disruptive behavior by focusing on teaching new skills rather than the reactive approach of trying to eliminate bothersome behaviors. For example, a student who acts out impulsively might benefit from learning to verbalize his or her feelings (i. e. , proactive), rather than being sent to timeout each time the offending behavior occurs (i. e. , reactive). Social skills curriculums employ a variety of instructional techniques including modeling, step-by-step scripts, classroom meetings, reinforcement, and emphasizing social skills embedded in the regular curriculum; for example, using science to teach how to anticipate consequences or using children’s  to teach conflict resolution† (Educational Approaches for ADHD, 2011). Contingency Management-  Ã¢â‚¬Å"Based on principles of behaviorism, students are rewarded when they demonstrate socially appropriate behavior. Contingencies also can include negative consequences for inappropriate behavior. Positive consequences can include praise or tangible rewards. Reprimands or ignoring the behavior are examples of frequently used negative consequences. Teacher s must be vigilant to ensure that negative consequences are logical and match the inappropriate behavior. For example, a logical consequence for throwing food in the cafeteria is eating lunch alone in the classroom for 3 days rather than doing additional homework. Other applications of behavior theory to  ADHD  include token economy, response cost, and contingency contracting† (Educational Approaches for ADHD, 2011). * Structured Activity and Movement-  Ã¢â‚¬Å"Planned classroom activities that allow students to move about, converse with others, and interact with concrete materials help students with ADHD sustain attention and reduces the stress of trying to constantly restrain motor activity. Some frequently used techniques are learning centers, planned student interactions, art, music, kinesthetic activity,  games, and authentic learning experiences such as teaching ratios by making orange juice from concentrate (Reif, 1998)† (Educational Approaches for ADHD, 2011). * Self-Management Strategies-  Ã¢â‚¬Å"Students with ADHD lack organizational skills for sustaining attention and completing projects. Direct instruction in time management helps students learn to divide a task into subunits. By monitoring due dates incrementally, teacher’s help students set realistic time lines and avoid procrastination. Helping students learn how to organize materials is another key self-management strategy. Filing papers, scheduling, keeping notes in binders and periodical inventory of materials are frequent self-management organizational objectives. Teaching study skills such as active  reading  (i. e. , writing down questions and comments rather than simply highlighting), webbing of chapters, reviewing key topics and subtopics, and developing test taking skills are helpful strategies† (Educational Approaches for ADHD, 2011). Classroom Accommodations- â€Å"The physical layout of a classroom is the single most important element in focusing attention. Textbooks with shiny paper particularly are problematic under fluorescent lights. Also, the hum and the flickering of fluorescent lights is a distraction and they should be replaced with incandescent lights. Soft, classical  music  in the background can be soothing. Natural sound recordings can have a similar effect. Student seating sho uld be adjusted to cut down distractions from high-traffic areas. Sitting at tables may present a problem for some students. Canels with side panels help eliminate visual distractions. Some teachers report that overhead projectors help cut down on visual distractions by reducing the clutter that sometimes fills up chalkboards (Flick, 1998). Directions should be given slowly with frequent requests for the student to provide restatements. When worksheets are used, students benefit from fewer problems to complete, lined paper helps with handwriting, and computer software offers myriad possibilities from  word processing  to games that reinforce academic skills† (Educational Approaches for ADHD, 2011). In terms of the 504 sample provided for Fred I felt this was best addressed in my conclusion. All the factors, triggers, strategies, legal considerations, all parties involved, and effort to educate Fred have to coordinate to put a plan together that is within IDEA guidelines and incorporated into the IEP. My responsibilities as a teacher first and foremost is the safety of all the children, and then to educate them. Because of Fred’s combination of ADHD and Asthma, which have common triggers, and can trigger each other, I have to consider that ADHD can trigger an Asthma attack or vice versa. I would have to be work closely with the medical personnel at the school, and pay close attention to the family doctors recommendations. Knowing what I know about each condition and also what I have learned through my journey in this course, I feel confident that all considerations would be met, and that Fred would be given the best environment to prosper health wise and also as a student. References: collaborative modelsieps 504s, 2010, Retrieved January 17, 2011, http://www. authorstream. om/Presentation/naija14-573965-collaborative-models-ieps-504-s/ STRATEGIES FOR TEACHING STUDENTS WITH ATTENTION DEFICIT DISORDER (AD/HD), http://www. as. wvu. edu/~scidis/add. html What Are the Psychological Effects Associated With ADHD? , Retrieved January 15th, 2011, http://www. livestrong. com/article/155678-what-are-the-psychological-effects-associated-with-adhd/#ixzz1B4MEchLD Quick Guidelines for Parenting (or Teaching) Kids with Attention Deficit Disorders, 2011, Retrieved January 15, 2011, http://www. education. om/reference/article/quick-guidelines-parenting-teaching-kids/ M. Henley|R. S. Ramsey|R. F. Algozzine, Pearson Allyn Bacon Prentice Hall, Educational Approaches for ADHD, 2011, Retrieved January 15th, 2011, http://www. education. com/reference/article/educational-approaches-ADHD-disorders/ Smith, D. D. Tyler, N. C. (2010). Introduction to special education: making a difference. New Jersey: Merrill. Teaching Tips for Those Working with ADHD Kids, 2010, Retrieved, December, 10th, 2010, http://user. cybrzn. com/kenyonck/add/teaching_tips. html