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ADHD

Submitted by an LD OnLine user on

I am interested in any feedback or help with this problem. I will be student teaching elem. ed/special ed in a couple weeks. My neighbor recently asked me for help. Her son, who is in the 1st grade, was recently diagnosed with ADHD by a private psychiatrist. He was put on medication, but the mother took him off because it had no effect. In school, her son scares the other students because he invades their personal space. He also disrupts the learning process if he is not kept busy at all times. His classroom teacher has isolated him from the other students by placing his desk in the corner of the room away from everyone. I realize the other children are entitled to an education, but I feel the teacher is setting him up for social-emotional problems. I also told her a special ed teacher or school psychiatrist should be observing his behavior. My neighbor wants to take him to another doctor. I told my neighbor to contact the school and request an evaluation. I also feel the teacher needs to set up some type of self-monitoring behavioral technique with this child. Is there any other strategies that can be used in the classroom so that this child is not singled out? Any suggestions would be greatly appreciated as she is a single mother of two struggling to help her son. Thanks.

Submitted by Steve on Thu, 12/16/2004 - 9:49 PM

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It is not uncommon for first graders not to have very well developed social skills. I would put the focus on skill development, with a reward system for positive behaviors. I would pick one behavior at a time to work on, and work on it both at home and at school. I would also involve the child in devising the rewards and consequences. Sticker charts work great, with a certain number of stickers required to earn certain rewards (rather than a percentage - that would be too hard for a kid this young to get a handle on). It might be good to ask how he feels about being in the desk by himself - he might like it better there, so I wouldn’t assume it is doing any harm unless it is clearly objectionable. It shouldn’t be framed as a punishment, though, more like an accomodation so he will have an easier time concentrating. If he DOESN’T like it, earning his way back to a “normal” desk might be an incentive that can be built into the plan. Most important is to really think through what he is getting out of his misbehavior. His reward program should allow him to legitimately earn what it is he is looking for with his misbehavior, whether it is time with the teacher, time with peers, or just time to get up and walk around. If he has a legitimate way to earn the right to do these things that he wants to do, he will be much less likely to act out in order to get them by his “usual methods”.

Hope that helps!

Submitted by MarieIm on Tue, 12/21/2004 - 3:50 AM

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Dear Steve,

Thank you for your insightful and expeditious response to my question. I will pass this information along to my neighbor and I will let you the results.

Happy Holidays!

Submitted by Anonymous on Sun, 12/26/2004 - 10:31 PM

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What you’re saying is that it would be best for the child to be less obviously ‘singled out’ - we can’t meet the needs of individual children unless we do single them out in some way. I’d add let’s encourage this child to learn how to keep himself busy. My own son was like the child you describe - we found giving him a ‘squeegee ball’ helped - he could sit and furiously squeeze the ball to ground himself while he was not otherwise busy in the classroom. Having him hold a pencil also ‘grounded him’.

Good luck.

Submitted by spattoncar on Wed, 10/12/2005 - 11:24 PM

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Dear MarieIm,
I agree with Steve. Put emphasis on skill development with a reward system. Teaching over the years I have come to realize that with ADHD students isolation does not benefit the student or the teacher. Being near others seems to help. More space or individualized space for movement might be helpful. Discuss it with the child. Reward the positive, discuss the negative, and practice the positive. Daily, even hourly rewards, sometimes less than that help to reinforce the goal of positive behavior. A few busy tasks to use up energy between short term seatwork might be helpful. This could be beneficial to you and the other students too. I have found out that lots of ADHD students have lots of helpful energy to share but sometimes don’t know how to share that energy and have learned to get the attention they need negatively.

Submitted by HJW on Sat, 10/15/2005 - 11:41 PM

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I think the ideas posted here are good but I wouldn’t give up on medication after one try. As a mother of 15 year old son with ADHD and also a school counselor, it often takes many trials of medication to find something that is effective. Also, the mother may not feel like the medication is working but sometimes, the teacher can tell a difference. Over the years, I have consulted regularly with my child’s teachers whenever there has been a change in his medication or if his functioning declines. I know my son would not be the honor roll student he is without medication. His father tried to take him off medication in the 5th grade and within a matter of days, he was having MAJOR trouble at school. I see so many children who could possibly benefit from medication but whose parents are afraid and uneducated about its potential benefit.

Submitted by Steve on Mon, 10/17/2005 - 12:11 AM

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On the other hand, it is important to remember that 40 years of research have not been able to show any substantial long-term benefit in any area for the aggregate of medicated vs. unmedicated ADHD-diagnosed subjects. The kinds of intervention suggested above are essential in ANY case where ADHD is involved, and in fact, appear to be more likely to impact long-term outcomes than medication, based on the long-term research that I am familiar with (and I have studied this area extensively). My wife and I raised two (of three) ADHD boys with no resort to medication, and despite fairly severe symptoms in their early elementary years, both have been able to learn and implement self-management skills such that no one would identify them as impaired by “ADHD” today. (The oldest graduated with honors from a local high school and has been employed full-time for the last 4 years by the same organization, and has received “employee of the year” honors twice in that time.) Additionally, around 25-30% of children diagnosed ADHD (depending on the study) do NOT respond positively to medication, and some actually get worse. Add to this potential side-effect problems, and it starts to become clear that medication is not necessarily the answer for every child with this diagnosis.

I also think it is EXTREMELY important to understand that family values and preferences are essential to take into consideration before making blanket assumptions or recommendations regarding medication. I can tell you that if you, as a school counselor, had tried to persuade me (beyond simply noting it as an available option) to put my child on medication, I would have regarded your comments as inappropriate and offensive. And as you can see, we found another path that worked just as well for our family as medication did for yours.

The short-term impact of medication can be dramatic, but it’s not always positive, and by itself is not sufficient in any case. I want us to respect the fact that many people choose not to medicate, and the research suggests that this suggestion is not in any way damaging or selling their child short, as long as they are pursuing other effective solutions to the kinds of behavior described as ADHD which work for them and their families. If families who choose to medicate want to be supported and respected for their decisions, they owe it to families who don’t medicate to extend them the same support and consideration.

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