Whenever I present a workshop for teachers, I ask audience members to describe Attention Deficit Hyperactivity Disorder (ADHD) in their own, non-clinical words. It’s been compared to a remote that never stops switching channels, the Energizer® bunny, loose papers in a strong wind, being lost in the fog, and electricity without a cord. Their similes capture the essence of the core symptoms of ADHD: inattention and /or impulsivity and hyperactivity. They also help us imagine what it must be like to have ADHD. They foster empathy and a desire to help.
Still, in the day-to-day grind of teaching, when problems emerge, our best intentions and sensitivities are tested. Wiggling, ﬁdgety, loud, disorganized, disruptive, hurried, careless and off-task behavior coupled with messy, incomplete, or missing work are tough challenges in the classroom, even on a good day.
The chronic nature of ADHD school-related issues has been known to frustrate more than a few teachers (and parents). This frustration may have to do with the expectation that interventions can cure ADHD. They don’t and they can’t.
Here’s the real deal: the manifestations of ADHD are seldom (if ever) ﬁxed once and for all because these problems often arise from environmental expectations, conditions, and triggers. Thus, these students are highly susceptible to the world around them and the world within them.
Most ADHD problems can be called “POP” or “point of performance” problems where students have difficulty being on point or on task.
What is on-task performance?
• Doing what you are supposed to be doing.
• When you are supposed to be doing it.
• In the way you are supposed to be doing it.
The “what” or “it” can be following a rule, working on a task, using a social skill, etc.
Some students lack the necessary skills to perform appropriately. Generally students with ADHD know what they are supposed to be doing. It’s just that where the rubber meets the road—at the point of performance—they lose traction and don’t do what they know. Distractibility, hating to wait, restlessness, losing materials, or missing pieces of the whole interfere with their best intentions to do what is expected and to do it well.
Typically, the off-task or off-rule behavior of students with ADHD is not a matter of choice. It’s a symptom of ADHD and an indicator that an intervention is needed. Here’s the good news: ADHD point of performance problems can be managed effectively (not to perfection). Most ADHD management is not a problem of knowing what to do. It’s a matter of doing what we know.
Here’s what you need to know and accept about ADHD interventions and strategies:
- They have to happen in the here and now on an as needed basis.
• They work when they are used.
• Their use often requires coaxing and coaching from an external source (teachers, parents, peers, visual cues, and/or technology).
• They may be needed throughout the school day, month, year, or lifespan.
Teachers often ask, “Shouldn’t these students learn to use these interventions on their own?” The point is this, if they didn’t have ADHD, they would be doing what they know! We can provide self-awareness and self-management strategies. Still, these students (and adults) will require coaching to do what they know.
In students with ADHD, “think ﬁrst” or “wait” do not enter into the self-control picture. So what can you do?
A POP intervention wouldn’t try to curb the need and impulse to call or blurt out. Instead, the teacher would direct the student to write down the thought. Or, if the student has difﬁculty writing or is a young learner, you might anticipate and call on this student frequently (or immediately). Or, use a silent signal as a cue to wait. Silent signals work because they are visual and thus don’t compete with the words the student is trying to keep in mind the way your verbalization does.
For the case where the student is unsure or anxious about what to do, you may assure the student that individual attention will always be given as soon as everyone else is on track.
You might also try a technique known as the two-response answer method. Let students know ahead of time that you will be asking every question twice—even if the ﬁrst answer given is correct. This method encourages students to listen to one another, signals students to wait, and allows students who might not volunteer to participate. It also allows you to call on reluctant students and gives them an opportunity to shine.
Raising a hand before speaking is a behavioral expectation. Behavioral expectations are but one type of POP problem. Off-task behavior is another. The ﬁrst type of problem may be a nuisance, but it doesn’t generally have a signiﬁcant impact on academic performance. Off-task behavior, however, is a signiﬁcant academic issue. It affects all aspects of the learner’s performance, especially the quality and quantity of task output.
The GPS (global positioning system) is a navigational system that works in the here and now. It is goal-oriented. It is problem-driven and solution-focused. When a driver needs to know how to get somewhere, the receiver calls upon every positioning satellite in the sky to devise a meta-strategy—a plan. The GPS then monitors the course as the car moves along. The “voice” gives corrective feedback whenever necessary.
Let’s say you want to drive across the swamp. The GPS doesn’t wrestle with alligators it meets along the way. It doesn’t get hung up in the past and the future. The GPS lives entirely in present time and its aim is to get you to your destination (across the swamp) even if that means charting a new course.
Though I sometimes worry that one day my GPS will go “bonkers” because I’ve gotten so far off track, to date my receiver hasn’t lost its cool or showed any irritation. No yelling, no blaming, no shaming, no name calling, no idle threats, no long diatribes. When I miss a turn or get off track—it simply says, “Recalculating.”
Students with ADHD go “bonkers” when improving off-task performance requires teacher-driven “recalculations.” If you ﬁnd yourself wrestling with alligators and drowning in the swamp, there’s an easy solution. Let go of the alligator: be goal oriented, problem-driven, solution focused and ﬂexible. Be prepared to go back to the drawing board.
Remember, students with ADHD either lose sight of the goal (they fail to focus and sustain), or they’re not sure what the goal is (they have difﬁculty selecting the most important versus the most interesting information). These behaviors are not a matter of choice but rather an outcome of the neurological underpinnings of ADHD. Most students with ADHD don’t require different teachers. They require cool, calm, “recalculating” teachers who use effective and hands-on approaches.
There are three essential GPS components for all ADHD interventions:
- The scaffold—these are the structures, strategies, supports and skills you put into place that enable the student to improve performance. ADHD strategies are not so much an issue of knowing what to do but of doing what you know. ADHD scaffolds work when you use them. They belong in the here and now. Teachers often say to me, “If I do this for a student, then next year…” Or, “If I make this accommodation, what will happen when she gets to elementary school and beyond?”
Sadly, I have to report that when scaffolds are not used, student outcomes become predictably grimmer as time goes by. Furthermore, most adults with ADHD continue to need interventions and accommodations and some will seek the services of ADHD coaches.
- Ongoing monitoring—sometimes we select the wrong intervention. In general, ADHD interventions fail because their use isn’t monitored or adjustments are not made along the way. That approach is akin to ﬁxing a leaky faucet valve without adding a washer or using plumber’s thread as a sealant. Monitoring behavior guides and directs the performance along the path. Be sure that you don’t confuse monitoring with “gotcha” or “see—nothing ever works with this student!
- Positive feedback—I once asked a student, “What does ADD mean?” He replied, “It’s just another way to call a kid ‘bad.’ I think ADD should stand for Adult Deﬁcit Disorder.”
It’s no wonder that he came up with this answer. Recent research as reported by Dr. Sydney Zentall notes that 75 percent of the daily feedback received by students with ADHD is negative. Positive feedback helps them stay on the appropriate behavioral path and serves as a key performance motivator. Feedback encourages, appreciates, and supports the person.
In addition to using the global meta-strategy described above, here are some speciﬁc strategies you might try for some of the typical behaviors that interfere with performance.
For stimulation seeking—a lot of “off task” ADHD behavior has to do with stimulation seeking and the way stimulation affects the brain’s ability to focus and sustain performance.
The general principle of ADHD intervention for stimulation seeking is not to restrict it. Instead, allow stimulation seeking on terms that work for the classroom situation.
What do these students need to do?
- ADHD expert Roland Rotz suggests “ﬁdget to focus,” or allow movement through stability balls, treadmills, or frequent breaks. You can also provide manipulatives, such as stress balls, toy animals, or plastic tangles. (AKA as fidget toys or tools)
• Add or allow arousal ingredients to tasks. (Reduce arousal if it’s too high with quieting activities.)
• Use color (e.g., overlays for the last third of a reading page).
• Use manipulatives (or fidgets) for tasks—Legos®, Wikki Stix, or colored markers.
• Switch between high interest/low interest tasks.
• Create interactive lessons with games.
• Eliminate rushing by removing all external incentives to ﬁnish quickly.
For getting and keeping their attention—students with ADHD, like all living beings, are always paying attention. The question is what’s getting their attention? The attentional problems of these students tend to rotate around three concerns: ﬁguring out what to pay attention to, determining what’s important versus what’s interesting, and staying the course until completion of the goal. These learners will find it difficult to set goals, prioritize, and say “No” to distractions. Once their minds wander, they often can’t ﬁnd their way “home”—home being where they are supposed to be focusing their attention. Home may be obvious to you, but it is not to them.
What can you do to get and hold attention?
- Add interest and novelty to all tasks.
• Talk less and do more.
• Use silent signals to redirect attention.
• Use speciﬁc directives
• Simplify visual presentations.
• Make task structures clear.
• Highlight directions and give them one at a time.
• Microsize—break all tasks down into manageable parts, monitor each phase, and provide positive feedback.
• Use self-monitoring strategies—tracking time on task, timers, graphing daily performance.
For working memory and executive function issues, imagine if you had trouble saying “No” to distractions but still had to keep certain information in your mind so you could complete a task. For instance, you’re silently reciting a new phone number you want to program into your phone and the phone rings. If you’re at all like many people, if you haven’t written that number down, you know where it goes—somewhere far and away probably never to return again.
Now imagine that you have ADHD and your attention constantly gets pulled to an internal or external distraction and needs to be redirected. Like these students, you’d probably lose a lot of information from your mental desktop—that place known as working memory. You can tell working memory (or working with memory) has been disrupted when you catch yourself saying, “Now, where was I?”
Working memory allows us to hold information in mind while we work with bits and pieces of it or with something else entirely until we are ready to come back to the info on the mental desktop and use that information to complete a task. This can be tough enough for many of us. Now, add some impulsivity—the hate to wait and rush through without thinking through—part of ADHD. Couple that with some hyperactivity and shifts in attention and focus. The effect is not surprising. Working memory affects many aspects of task performance for students with ADHD.
To my mind, working memory issues certainly make a compelling case for having a “GPS system” in the day-to-day management of ADHD issues.
What can you do?
- Externalize. If it can be held in mind, it can be written down to hold it in place—dry erase boards, cue cards, posted formulas, rules, etc.
• Use models, rubrics, timelines, planners, graphic organizers, checklists, daily action plans, and step-by-step guides.
- Use color—it attracts attention, categorizes, distinguishes objects, and helps with organization.
• Design and monitor organizational routines—and make time for them to be used.
• Post the daily schedule.
• Provide note-taking assistance to the degree necessary.
• Use peer support when appropriate.
• Train mnemonic strategies, e.g. POW—plan, organize, write.
• Make and use ﬂash cards.
ADHD is not easy to manage. Yet, it is a highly manageable condition. We can’t cure it, but we can enable students to reduce any disabling effects of this condition. We simply have to do what we know. “Doing what we know” may seem like a Herculean task. In practice, it’s using an ounce of prevention rather than a pound of cure.
In all my workshops, I invite teachers to commit to this simple intention:
I will act as though what I do makes a difference.
When we are not making the difference we want to make, we don’t change the people around us. If we change what we do, the people around us change as a result.
Share what you did with me and I’ll pay your experience forward. Write firstname.lastname@example.org
By Mary Fowler http://www.maryfowler.com – Mary trains educators and parents on ADHD, emotional challenges, and classroom management practices. An internationally recognized expert on ADHD, she is the author of four books, including the bestseller, Maybe You Know My Kid (3rd edition), Maybe you Know my Teen, the original CHADD Educators Manual, and my favorite introductory book for parents 20 Questions to Ask If Your Child has ADHD.
Reprinted with permission. Original source: How to Increase On-Task Performance for Students with ADHD? Originally published in the New Jersey Education Association’s Review in March, 2010 www.njea.org/njea-review
20 Questions to Ask If Your Child has ADHD – “Think of this book as facts with personality. Answers are written in an easy-to-read, conversational style from a parent who’s been there”. Organized into four easily manageable categories:• General/Medical Information • Social/Emotional Well-being • Home Issues • School Issues. ($10 on Kindle – $13 for paperback)
(Photo courtesy of David Castillo Dominici/freeDigitalPhoto) Modified on Canva – http://canva.com