
 Area:    K12_SPEC_ED
 Date:    26 Nov 94  11:41:20  Public           
 From:    "Kevin Jewell"           
 To:      All                      
 Subject: Pt 1/2: ADHD, burnout tips needed!                       [1]

From: "Kevin Jewell" <kjewell@inforMNs.K12.mn.us>
Path: psgrain!usenet.eel.ufl.edu!news-feed-1.peachnet.edu!umn.edu!mr.net!InforMN
.k12.MN.us!usenet
Newsgroups: k12.ed.special
Subject: ADHD, burnout tips needed!
Organization: Internet for Minnesota Schools Project
Reply-To: <kjewell@inforMNs.K12.mn.us>
Message-ID: <55114.kjewell@inforMNs.K12.mn.us>
Date: Sat, 26 Nov 94 11:41:20 CST


Philippe, Guy,
I tried to send a document it did not appear to make it the first trie so I 
will give it another go.  This is a set of classroom tips.  I am a sch 
psych and use it frequently in consultation.
Yesterday I received a paper from Dr. Ned Hallowell, author of the 
forthcoming ADD book "Driven to Distraction."  As with several of his 
other articles, he has generously offered to make the text available 
to members of this forum.

As you'll see, from the beginning Dr. Hallowell empathizes with the 
job of a teacher with ADD students.

                 
                 50 Tips on the Classroom Management
                    of Attention Deficit Disorder
                    
      by Edward M. Hallowell, MD and John J. Ratey MD   (c) 1992
      
Teachers know what many professionals do not: that there is no one 
syndrome of ADD, but many; that ADD rarely occurs in "pure" form by 
itself, but rather it usually shows up entangled with several other 
problems such as learning disabilities or mood problems; that the face 
of ADD changes with the weather, inconstant and unpredictable; and 
that the treatment for ADD, despite what may be serenely elucidated in 
various texts, remains a task of hard work and devotion.

There is no easy solution for the management of ADD in the classroom, 
or at home for that matter.  After all is said and done, the 
effectiveness of any treatment for this disorder at school depends 
upon the knowledge and the persistence fo the school and the 
individual teacher.

Here are a few tips on the school management of the child with ADD.  
The following suggestions are intended for teachers in the classroom, 
teachers of children of all ages.  Some suggestions will be obviously 
more appropriate for younger children, others for older, but the 
unifying themes of structure, education, and encouragement pertain to 
all.

1. First of all, make sure what you are dealing with really is ADD.  
It is definitely not up to the teacher to diagnose ADD, but you can 
and should raise questions.  Specifically, make sure someone has 
tested the child's hearing and vision recently, and make sure other 
medical problems have been ruled out.  Make sure an adequate 
evaluation has been done.  Keep questioning until you are convinced.  
The responsibility for seeing to all of this is the parents', not the 
teacher's, but the teacher can support the process.

2. Second, build your support. Being a teacher in a classroom where 
there are two or three kids with ADD can be extremely tiring.  Make 
sure you have the support of the school and the parents.  Make sure 
there is a knowledgeable person with whom you can consult when youy
have a problem (learning specialist, child psychiatrist, social worker, 
school psychologist, pediatrician -- the person's degree doesn't 
really matter. What matters is that he or she knows lots about ADD, has 
seen lots of kids with ADD, knows his or her way around a classroom, 
and can speak plainly.)  Make sure the parents are working with you.  
Make sure your colleagues can help you out.

3. Third, know your limits.  Don't be afraid to ask for help.  You, as 
a teacher, cannot be expected to be an expert on ADD.  You should feel 
comfortable in asking for help when you feel you need it.

4. ASK THE CHILD WHAT WILL HELP.  These kids are often very intuitive. 
They can tell you how they can learn best if you ask them.  They are 
often too embarrassed to volunteer the information because it can be 
rather eccentric.  But try to sit down with the child individually and 
ask how he or she learns best.  By far the best "expert" on how the 
child learns is the child himself or herself.  It is amazing how often 
their opinions are ignored or not asked for.  In addition, especially 
with older kids, make sure the child understands what ADD is.  This 
will help both of you a lot.

5. Remember that ADD kids need structure.  They need their environment 
to structure externally what they can't structure internally on their 
own.  Make lists.  Children with ADD benefit greatly from having a 
table or list to refer back to when they get lost in what they're 
doing.  They need reminders.  They need previews.  They need 
repetition.  They need direction.  They need limits.  They need 
structure.

6. REMEMBER THE EMOTIONAL PART OF LEARNING.  These children need 
special help in finding enjoyment in the classroom, mastery instead of 
failure and frustration, excitement instead of boredom or fear.  It is 
essential to pay attention to the emotions involved in the learning 
process.

7. Post rules.  Have them written down and in full view.  The children 
will be reassured by knowing what is expected of them.

8. Repeat directions.  Write down directions. Speak directions. Repeat 
directions.  People with ADD need to hear things more than once.

9. Make frequent eye contact.  You can "bring back" an ADD child with 
eye contact.  Do it often.  A glance can retrieve a child from a 
daydream or give permission to ask a question of just give silent 
reassurance.

10. Seat the ADD child near your desk or wherever you are most of the 


>> CONTINUED IN NEXT MESSAGE <<

 Area:    K12_SPEC_ED
 Date:    26 Nov 94  11:41:20  Public           
 From:    "Kevin Jewell"           
 To:      All                      
 Subject: Pt 1/2: ADHD, burnout tips needed!                       [2]

>> CONTINUED FROM PREVIOUS MESSAGE <<

time. This helps stave off the drifting away that so bedevils these 
children.

11. Set limits, boundaries.  This is containing and soothing, not 
punitive.  Do it consistently, predictably, promptly, and plainly.  
DON'T get into complicated, lawyer-like discussions of fairness.  
These long discussions are just a diversion.  Take charge.

12. Have as predictable a schedule as possible.  Post it on the 
blackboard or the child's desk.  Refer to it often.  If you are going 
to vary it, as most interesting teachers do, give lots of warning and 
preparation.  Transitions and unannounced changes are very difficult 
for these children.  They become discombobulated around them.  Take 
special care to prepare for transitions well in advance.  Announce 
what is going to happen, then give repeat warnings as the time 
approaches.

13. Try to help the kids make their own schedules for after school in 
an effort to avoid one of the hallmarks of ADD: procrastination.

14. Eliminate or reduce frequency of timed tests.  There is no great 
educational value to timed tests, and they definitely do not allow 
many children with ADD to show what they know.

15. Allow for escape valve outlets such as leaving class for a moment. 
If this can be built into the rules of the classroom, it will allow 
the child to leave the room rather than "lose it," and in so doing 
begin to learn important tools of self-observation and 
self-modulation.

16. Go for quality rather than quantity of homework.  Children with 
ADD often need a reduced load.  As long as they are learning the 
concepts, they should be allowed this.  They will put in the same 
amount of study time, just not get buried under more than they can 
handle.

17. Monitor progress often.  Children with ADD benefit greatly from 
frequent feedback.  It helps keep them on track, lets them know what 
is expected of them and if they are meeting their goals, and can be 
very encouraging.

18. Break down large tasks into small tasks.  This is one of the most 
crucial of all teaching techniques for children with ADD.  Large tasks 
quickly overwhelm the child and he recoils with an emotional 
"I'll-NEVER-be-able-to-do-THAT" kind of response.  By breaking the 
task down into manageable parts, each component looking small enough 
to be do-able, the child can sidestep the emotion of being 
overwhelmed.  In general, these kids can do a lot more than they think 
they can.  By breaking tasks down, the teacher can let the child prove 
this to himself or herself.  WIth small chidlren this can be extremely 
helpful in avoiding tantrums born of anticipatory frustration.  And 
with older children it can help them avoid the defeatist attitude that 
so often gets in their way.  And it helps in many other ways, too.  
You should do it all the time.

19.  Let yourself be playful, have fun, be unconventional, be 
flamboyant.  Introduce novelty into the day.  People with ADD love 
novelty.  They respond to it with enthusiasm.  It helps keep attention 
-- the kids' attention and yours as well.  These children are full of 
life -- they love to play.  And above all they hate being bored.  So 
much of their "treatment" involves boring stuff like structure, 
schedules, lists, and rules, you want to show them that those things 
do not have to go hand in hand with being a boring person, a boring 
teacher, or running a boring classroom.  Every once in a while, if you 
can let yourself be a little bit silly, that will help a lot.

20. Still again, watch out for overstimulation.  Like a pot on the 
fire, ADD can boil over.  You need to be able to reduce the heat in a 
hurry.  The best way of dealing with chaos in the classroom is to 
prevent it in the first place.

21. Seek out and underscore success as much as possible.  These kids 
live with so much failure, they need all the positive handling they 
can get.  This point cannot be overemphasized: these children need and 
benefit from praise.  They love encouragement.  They drink it up and 
grow from it.  And without it, they shrink and wither.  Often the most 
devastating aspect of ADD is not the ADD itself, but the secondary 
damage done to self-esteem.  So water these children well with 
encouragement and praise.

22. Memory is often a problem with these kids.  Teach them little 
trick like mnemonics, flashcards, etc.  They often have problems with 
what Mel Levine calls "active working memory," the space available on 
your mind's table, so to speak.  Any little tricks you can devise -- 
cues, rhymes, code and the like -- can help a great deal to enhance 
memory.

23. Use outlines.  Teach outlining.  Teach underlining.  These 
techniques do not come easily to children with ADD, but once they 
learn them the techniques can help a great deal in that they structure 
and shape what is being learned as it is being learned.  This helps 
give the child a sense of mastery DURING THE LEARNING PROCESS, when he 
or she needs it most, rather than the dim sense of futility that is 
so often the defining emotion of these kids' learning process.

24. Announce what you are going to say before you say it. Say it. Then 
say what you have said.  Since many ADD children learn better visually 
than by voice, if you can write what you're going to say as well as 
say it, that can be most helpful.  This kind of structuring glues the 
ideas in place.

25. Simplify instructions.  Simplify choices.  Simplify scheduling.  
The simpler the verbiage the more likely it will be comprehended.  And 
use colorful language.  Like color coding, colorful language keeps 
attention.

26. Use feedback that helps the child become self-observant.  Children 
with ADD tend to be poor self-observers.  They often have no idea how 


>> CONTINUED IN NEXT MESSAGE <<

 Area:    K12_SPEC_ED
 Date:    26 Nov 94  11:41:20  Public           
 From:    "Kevin Jewell"           
 To:      All                      
 Subject: Pt 1/2: ADHD, burnout tips needed!                       [3]

>> CONTINUED FROM PREVIOUS MESSAGE <<

they come across or how they have been behaving.  Try to give them 
this information in a constructive way.  Ask questions like, "Do you 
know what you just did?" or "How do you think you might have said that 
differently?" or "Why do you think that other girl looked sad when 
you said what you said?"  Ask questions that promote self-observation.

27. Make expectations explicit.

28. A point system is a possibility as part of a behavioral 
modification or reward system for younger children.  Children with ADD 
respond well to rewards and incentives.  Many are little 
entrepreneurs.

29. If the child seems to have trouble reading social cues -- body 
language, tone of voice, timing and the like -- try discreetly to 
offer specific and explicit advice as a sort of social coaching.  For 
example, say "Before you tell your story, ask to hear the other 
person's first," or, "Look at the other person when he's talking." 
Many children with ADD are viewed as indifferent or selfish, when in 
fact they just haven't learned how to interact.  This skill does not 
come naturally to all children, but it can be taught or coached.

30. Teach test-taking skills.

31. Make a game out of things.  Motivation improves ADD.

32. Separate pairs and trios, whole clusters even, that don't do well 
together.  You might have to try many arrangements.

33. Pay attention to connectedness.  These kids need to feel engaged, 
connected.  As long as they are engaged, they will feel motivated and 
be less likely to tune out.

34. Give responsibility when possible back to the child.


35. Try a home-to-school-to-home notebook.  This can really help with 
the day-to-day parent-teacher communication and avoid the crisis 
meetings.  It also helps with the frequent feedback these kids need.

36. Try to use daily progress reports.

37. Encourage a structure for self-reporting, self-monitoring.  Brief 
exchanges at the end of class can help with this.  Consider also 
timers, buzzers, etc.

38. Prepare for unstructured time.  These kids need to know in advance 
what is going to happen so they can prepare for it internally.  If 
they suddenly are given unstructured time, it can be over-stimulating.

39. Praise, stroke, approve, encourage, nourish.

40. With older kids, have them write little notes to themselves to 
remind them of their questions.  In essence, they take notes not only 
on what is being said to them, but what they are thinking as well.  
This will help them listen better.

41. Handwriting is difficult for many of these children.  Consider 
developing alternatives.  Learn how to use a keyboard.  Dictate.  Give 
tests orally.

42. Be like the conductor of a symphony.  Get the orchestra's 
attention before beginning.  (You may use silence, or the tapping of 
your baton, to do this.)  Keep the class "in time," pointing to 
different parts of the room as you need their help.

43. When possible, arrange for each student to have a "study buddy" in 
each subject, with phone number. (Adapted from Gary Smith.)

44. Explain and normalize the treatment the child receives to avoid 
stigma.

45. Meet with parents often.  Avoid the pattern of just meeting around 
problems or crises.

46. Encourage reading aloud at home. Read aloud in class as much as 
possible.  Use story-telling. Help the child build the skill of 
staying on one topic.

47. Repeat, repeat, repeat.

48. Exercise.  One of the best treatments for ADD, in both children 
and adults, is exercise, preferably vigorous exercise.  Exercise helps 

---
 * Origin: Bink of an Aye, Portland Oregon (1:105/42.0)

 Area:    K12_SPEC_ED
 Date:    26 Nov 94  11:41:20  Public           
 From:    "Kevin Jewell"           
 To:      All                      
 Subject: Pt 2/2: ADHD, burnout tips needed!                          

work off excess energy, it helps focus attention, it stimulates 
certain hormones and neurochemicals that are beneficial, and it is 
fun.  Make sure the exercise IS fun, so the child will continue to do 
it for the rest of his or her life.

49. With older children, stress preparation prior to coming into 
class.  The better idea the child has of what will be discussed on any 
given day, the more likely the material will be mastered in class.

50. Always be on the lookout for sparkling moments.  These kids are 
far more talented and gifted than they often seem.  They are full of 
creativity, play, spontaneity and good cheer.  They tend to be 
resilient, always bouncing back.  They tend to be generous of spirit, 
and glad to help out.  They usually have a "special something" that 
enhances whatever setting they're in.  Remember, there is a melody 
inside that cacophony, a symphony yet to be written.


Kevin Jewell
kjewell@inforMNs.K12.mn.us

---
 * Origin: Bink of an Aye, Portland Oregon (1:105/42.0)
