ADHD : Reading and the Classroom

Contents:

• About the Author
• Jimmy Student
• Medical Information on ADHD
• Treatment in Brief
• Five Mental Systems Focusing on the Reader
• Reading Specific Practices
• Individual Accommodations
• Inclusive Classroom Modifications
• Assessing the Student with ADHD
• Conclusion
• Works Cited

About the Author

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This compilation of ADHD information and teaching strategies was prepared by me, Alan Barnicle. At the time of this site's creation I was in my third year working towards a degree in Teaching Communication Arts and Literature at the University of Minnesota – Duluth. As part of my apprenticeship I worked with a tutee who had ADHD. My work with the tutee was the inspiration for this site.

I was told before I met with my tutee that he had ADHD. I knew a little bit about ADHD but after making some observations I decided I needed to know more. Here is just a short list of the behaviors I have noticed:

• The tutee will often start out the session reading really well, and rather quickly. By the end of the session the tutee is stumbling through sentences and loosing fluency.
• When asked if he ever gets off task while reading, the tutee responded stating that he often got off task. Something in the book would remind him of something, which would remind him of something, which would remind him of something else. By the time the tutee got back to the text, all contexts and fluidity had been lost.
• A trip to the tutee’s locker showed that the tutee needed help with organizational strategies.

The following sections contain information on ADHD, classroom adaptations, individual adaptations, and inclusive practices written from the perspective of a prospective teacher as a resource for other teachers.

Any questions or suggestions appreciated. barn0290@d.umn.edu

Jimmy Student

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You are paying attention to the teacher, to the birds outside the window, to the hmmm of the computer fan, to the bight lights in the room, to the kid walking past the door in the hallway, to the girl next to you taking notes, to the guy on the other side making a paper football, to whoever is saying your name, “Jimmy”, to the kids faces, you can see them all, odd, it’s your teacher…. “JIMMY”, she is mad at you, again …. “JIMMY, are you paying attention?!” You answer. “Yea. Yes. I mean, I think so”. Your name is Jimmy Student and you have Attention Deficit Hyperactivity Disorder (ADHD). You find it hard to concentrate or focus on any one thing for long. Everything comes at you, demands your attention, and usually gets it. You mind makes connections to everything and gets off on tangents to far away places.

Teachers need to understand ADHD, as students with the condition will be in our classrooms. With a basic understanding of the condition, we as educators can identify and use procedures and adaptations that will help children with ADHD, if not all children, learn.

Medical Information on ADHD

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Attention deficit is a breakdown in attention. ADHD is a life long condition that is found in 3-7% of our population. The condition is usually found in males with ratios around three boys with ADHD to one girl or higher (Attention).

Currently, there are four recognized types of ADHD: the predominantly inattentive type, the predominantly hyper active-impulsive type, combined type, and the not otherwise specified type. The Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV), published by the American Psychiatric Association, recommends that a child have 6 or more of 18 criterions met for a period of over six months to be considered for treatment of ADHD. Among these criterion are: often does not follow through on instructions; fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions); often fidgets with hands or feet or squirms in seat; and often blurts out answers before questions have been completed. Moreover, these symptoms should not be a result of any other condition or disorder, should be present in more than one setting of the child’s life, and the student should be over the age of seven. For a complete list of types, symptoms, and considerations for the diagnosis of ADHD, refer to the ADHD page of the DSM-IV (Mayeaux).

A study at Stanford University found “decreased frontal and striatal activation in ADHD children…Other studies have also indicated decreased activity in the frontal lobe, as well as functional deficits in the basal ganglia of children with ADHD. The significance of such research is that we will soon be able to have a set of biological characteristics to diagnose ADHD rather than just behavior observation (INC Research | CNS). In practice, knowledge of what is going on inside the head of a student can be beneficial. According to Judy Bromen who is a coordinator at The University of Minnesota Duluth with the Access Center, students with ADHD tend to have lower functioning in the frontal lobe that controls executive cognition, or the ability to choose what to pay attention to and the ability organize and manage time. This set of characteristics is also known as disinhibition.

Treatment in Brief

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Treatment of ADHD is somewhat controversial, and largely out of the scope of the educator. Beyond a doubt the options available for treating ADHD are growing in number. Drugs, such as the widely recognized Ritalin, are a popular option. Drugs tend to modify the activity in the brain, enhancing the executive functions (Bromen). New drugs are being tested all the time and are being prescribed. There are also several non-drug options that are becoming increasingly popular. Such approaches include a diet that reduces intake of sugar and processed foods.

One treatment option that educators regularly partake in is behavior management. By learning about the condition and what the child experiences, educators can adapt their classrooms and lessons to increase the learning potential of students with ADHD and decrease interruptions. Many of these adaptations are generally good practices that will help with classroom management and overall learning, no matter who your students are or what conditions they may be challenged with.

Clearly, ADHD can impact the student’s learning. Moreover, the student’s behavior may very likely impact the learning of other students in the classroom. The teacher is also affected. Suggestions for educators tend to fall into two broad categories: whole classroom procedures, and individual student accommodations.

Five Mental Systems Focusing on the Reader

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In addition to the SDM-IV, Levine identified 5 mental systems that may be affected by ADHD. Knowledge of how these areas break down has driven the development of individual and inclusive instruction practices (Andretti 12). A breakdown in one or more of the following systems can adversely affect reading achievement:

1. Mental Effort - For students with ADHD, paying attention can take a great deal of effort. Simply trying to pay attention takes so much effort that it may lead to exhaustion or burn out in short order. Therefore, students may appear to be daydreaming, tired or lazy in class. Students may drift off during sustained silent reading and may not be able to follow along with a reading group (12).
2. Planfulness - Like many may understand the typical structure of a story, many students also understand the typical structure of the classroom. Students know what to do when the get into a class, what procedures to follow, when to hand in thing, when to talk, when to sharpen a pencil, when to get up and move around, etc. There is a difference between understanding these structures and not following them, and not knowing them. It is suggested by Bromen that students with ADHD may not have internalized these structures. Moreover, a student with ADHD will have a hard time coming up with a plan of action for a study hall, extended seat work, or group work. While many students can come up with a plan of action during a study hall or when given time to work on a task, ADHD may end up squandering their time (Bromen).
3. Selectivity - Students with ADHD have a hard time selecting the stimulus that they are going to pay attention to. Students without ADHD tend to know that the focus of attention belongs on the teacher when she or he is talking. It is not to be taken for granted that ADHD students know what to pay attention to. They may find themselves paying attention to the bird on the windowsill, or other inappropriate stimuli for the situation (Bromen).
4. Tempo-control - When students lack tempo-control, which is the ability to know when to slow down, they may fidget or twist hair or take part in other distracting activities during instruction (Andretti 12). They may also rush through a task and make careless mistakes.
5. Self-monitoring - Making sure that one is getting the information needed from a text requires the ability to focus on one's reading to recognize when comprehension is breaking down. Students who can not self monitor may have a hard time reading aloud, following written instructions, finding and correcting errors in writing (Andretti 31).

Reading Specific Practices

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Tendencies to let the mind wander, daydream, difficulty organizing information, and the inability to maintain focus makes reading difficult for a student with ADHD. While there are many practices that will help students with ADHD learn, the following are a few that are specific to reading and comprehension:

• A goal for reading is to build fluency. Fluency is built through successful fluid reading. Therefore, if a student stumbles on a word, the word should be provided for the student as to not interrupt the flow of the text (Andretti 30).
• Trudie Hughes, who is an assistant professor at the University of Minnesota Duluth, mentions that graphic organizers are beneficial because they help with the organization of thoughts. Organized thoughts are easier to recall, therefore increasing the likelihood that the student will do well on an assessment. Graphic organizers can be used to follow the storyline, keep track of characters, organize conflicts in a text, and so on.
• When reading a text, prediction questions will increase focus on the reading (Andretti 28).
• Instead of a standard post reading test, having students draw a scene or partake in writing activities may increase comprehension (32).
• Students should be given the choice of texts whenever possible (32). Choosing texts allows students to follow interests and helps to retain attention.

Individual Accommodations

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Practices designed to help students with ADHD have been recognized as beneficial for all students as they tend to help the students organize information, increase metacognition, and know how to behave. Therefore, the list for individual accommodations is quite short.

• If standard assessment must be used, making an exception for the students with ADHD is appropriate as the student would likely be tested on his or her ability to maintain focus rather than being tested on the subject matter at hand (Bromen).
• To help with a fidgety student, the teacher may allow the students to move to a place where they will be comfortable learning such as bean bag chairs, carpet squares, or the like (Andretti 28).
• For a student who is constantly tapping or working on something with his or her hands the teacher may give the student a worry stone, a stress ball, or allow the student to draw during instruction. The last option is especially desirable because it may build more connections between the student and the content if the picture is relative to the lesson (28).

Inclusive Classroom Modifications

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While special consideration for students with ADHD is appropriate, many techniques that may come from such situation would be suitable for the whole class. Here are several great examples:

• Signals that let the student know that the instructor had noticed a student’s behavior, but does not draw the class’s attention to the situation are desirable. Such signals may be a hand on the shoulder or simply teaching near a student’s desk (26).
• It is helpful to move about the room and teach near the places where students with ADHD are. This private reinforcement avoids public humiliation (26).
• Breaking large tasks down into smaller ones will help the student that has trouble coming up with a game plan, a student whose disinibition keeps him or her back. For example, if the students are working on completing a packet of sheets, handing those sheets out in intervals would be helpful (26).
• A teacher may allow her or his students to move between activities. Allowing students to move in the classroom is an appropriate practice as it allows students a break between activities. If the class seems to be wandering, taking time for a stretch break may help the students to gain back some focus (ADHD).
• Teachers should pay attention and record what triggers students’ inattention. For example, talking to the class while the class is intent on a task may break attention that will not be regained (Andretti 27).
• Use prediction questions to tap prior knowledge of the class before starting a class (ADHD).
• Visual aids will help a student know where to look and will increase focus (ADHD).
• Use of peers can be quite helpful. Grouping students together will allow students to ask their buddy to answer questions first, before the student asks the teacher and interrupts the class. Buddies can keep each other on task, monitor each other's comprehension, and offer clarification (ADHD).
• When told to consider a certain problem, have the students check their answers with their buddy and then give the answer to the teacher (ADHD).
• Use of buddies helps students with their interpersonal skills. Often, students with ADHD have poor interpersonal skills due to the inability to remember and keep promises, dates, or carry on a conversation (ADHD).
• When having students work on a problem, use of whiteboards will be helpful in that each student can participate and quickly show the teacher the answer generated. This will allow the teacher to take a quick assessment of the students’ comprehension of the instruction (ADHD).
• Having set routines and clear transitions that repeat daily will help the students know and predict what is happening and what will be happening next (ADHD).
• Inviting specialists in the classroom for collaborative teaching can be very helpful. The specialist will be able to give valuable insight for the classroom and will identify possible solutions for any problems the student may be having (ADHD).

Setting clear expectations for behavior and reviewing them often will ensure the students know what is expected of them (ADHD).

Assessing the Student with ADHD

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Standardized testing doesn’t measure students’ learning, especially if the students have ADHD. Students with attention difficulties may not do well on standardized or timed tests because of the needed degree of focused attention to the questions, careful recording of answers, and lack of student-teacher interaction (Andretti 24). Therefore, there is a need for a more authentic measure of learning. Teachers should consider the following:

• Assessment should be fair. Testing must give the opportunity for the best possible performance (Andretti 25).
• Assessment should be authentic. Assessing the student’s portfolios will provide opportunity for evaluation and positive feedback (25).
• Assessment should include self-evaluation. Students with attention problems often lack metacognitive skills to succeed in school. With guided practice in self-evaluation, these students cam be helped by this element of assessment (25).
• Assessment should be stated in positive terms such as +15 instead of -5. Letter grades can be accompanied by encouraging statements (27).
• Assessment should be based on work samples. Standardized testing does not measure how well a student with ADHD knows the content; it measures how well the student can keep his or her concentration. As Judy Bromen mentioned, students with ADHD may often over-think each answer in a multiple choice test and eventually justify each option as a plausible solution, leading to frustration and exhaustion. Using a miscue analysis, or a project, may be appropriate options in lieu of a multiple choice test.
• Assessment should be collaborative. When students are part of evaluating their own work, they do not feel victimized by the teacher’s grade (Andretti 27).

While these assessment practices work well with students with ADHD, they are also quite appropriate for all students.

Conclusion

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Knowing what ADHD is and expecting it in your classroom is the first step to students’ success. I am confident that if teachers use these inclusive tools, not only will their students with ADHD learn more effectively, but all students will benefit.

Works Cited

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ADHD Inclusive Instruction and Collaborative Practices. Perf. Sandra Rief. Videocassette. National Professional Resources, Inc.

Andretti, Ann P., and Micheal P. French. Attention Deficit and Reading Instruction. 382nd ed. Bloomington: Phi Delta Kappa Educational Foundation, 1995. 17-32.

"Attention Deficit Hyperactivity Disorder." The Encyclopedia of Learning Dissabilities. N.p.: Checkmark Books, 2002.

Bromen , Judy. Personal interview. 28 Apr. 2004.

Hughes, Trudie. Personal interview. 15 Apr. 2004.

INC Research | CNS. Aug. 2001. Apr. 2004 http://public.incresearch.com/core_synapse.php3?Sec=0801.

Mayeaux Jr., E j. DSM-IV Diagnostic. 2000. Louisiana State University Medical Center. 28 Apr. 2004 http://lib-sh.lsumc.edu/fammed/intern/adhd.html.