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ADHD:

SchoolBased
Interventions

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Overview
What do teachers see in the classroom?
Can we base interventions on subtype alone?
The role of Functional Behaviour Assessments
in intervention
The role of the teacher
Evidence-based approaches to behaviour and
academic interventions/ classroom principles

School Problems:
What do teachers see in the classroom?

Academic Underachievement
Disorganization
Frequent distraction
Less attention to rules governing a task
Decreased ability of shift attention
Poor test performance and study skills
Inconsistent completion of independent
work/decreased productivity/more errors
Frequent shifting of activities
Forgetting/Losing assignments

(DuPaul, Stoner & OReilly, 2002; Silverman, Iseman & Jeweler, 2009;

School Problems:
What do teachers see in the classroom?
Disruptive &/or off-task classroom behaviour
Failure to listen to instructions
High rates of Noncompliance/Aggression
Disrupts learning of others
Difficulties with peer relations
Easily angered when encountering challenging tasks
Calling out/frequent talking
(DuPaul, Stoner & OReilly,2002; Silverman, Iseman & Jeweler, 2009)

As a result....
Higher risk for grade
retention
30-50% of student with ADHD
are retained at least once
(Silverman, Iseman & Jeweler, 2009)

Higher rate of High


School dropouts
25-36% of students with ADHD
do not complete High School
(Silverman, Iseman & Jeweler, 2009)

Example of Subtype & intervention


ADHD-I
Characterized by:
slow cognitive
processing
low levels of curiosity &
enjoyment of learning
Prefer less challenging
tasks
Prefer cooperative work
environments
Greater reliance on
external criteria for
success
(Pfiffner, DuPaul & Barkley, 1998)

Intervention:
emphasize non-competitive
external incentives for
meeting goals
Plan assignments that
address slow work style
and incorporate preference
for cooperative groups

...the most effective behavior interventions must go beyond


the diagnosis and identify specific behaviours for change as
well as the function that these behaviours serve for the
student. (Pfiffner, DuPaul & Barkley, 1998)

Functional Behaviour Assessment


Behaviour interventions in the classroom are
most effective when they are based on the
information gathered through a functional
behaviour assessment (DuPaul & Weyandt, 2006).
Observation of the student in the classroom setting:
What are the target behaviours?
What are the antecedents?
What are the consequences?

Design intervention
Implement
Review progress
(DuPaul & Weyandt, 2006; Pfiffner, DuPaul & Barkley, 1998; Iseman, Silverman & Jeweler, 2010)

Example:
Behaviour Function

(DuPaul & Weyandt, 2006 )

Antecedent Based
Intervention

Consequence Based
Intervention

Obtain teachers attention Remind class of


classroom rules & the
connection between
student behaviour and
teacher attention

Provide attention for


appropriate behaviour;
ignore disruptive
behaviour

Task avoidance

Provide attention
breaks upon completion
of selected portions of
work

Increase stimulus value


of task; reduce amount
of work required

The Role of Teachers


When working with students with ADHD, teachers must:
Develop a positive working relationship with the student, based on
understanding of the student and knowledge of the disorder.
Work collaboratively with school psychologist/behaviour specialist; on-going
consultation
Facilitate effective and consistent communication between home and school

(Pfiffner, L., DuPaul, G., & Barkley, R.,1998, Silverman, Iseman & Jeweler, 2009).

Evidence-Based Approaches
Stimulant medication
Behavioural Interventions: Target on-task &
disruptive behaviour
Academic Interventions: manipulation of
antecedents (type of instruction, materials,
outcomes...)
(Raggi & Chronis, 2006)

General Principles of Classroom


Interventions
(Pfiffner, DuPaul & Barkley, 1998)

1. Swift, frequent & significant consequences

Parallel Teaching

Reprimand

Token Reinforcement

Response Cost

General Principles of Classroom


Interventions
(Pfiffner, DuPaul & Barkley, 1998)

2. Positives before Negatives


3. Frequently change/rotate rewards
4. Anticipate! Think Aloud, Think Ahead
(Antecedent based strategies)
5. Hold students accountable
6. Continued monitoring & modification for maximum effect

Academic Interventions
Strengths-Based Approach

Boosts self-confidence

Adaptations/Accomodations

Examples: Modify pace of instruction, allow extended time for task completion, allow frequent breaks, allow fidget toys...

Computer-Assisted Instruction

Improves sustained attention and work performance

Self-Monitoring
Improve social and academic behaviour in classroom

Strategy Training
Places responsibility on the student to improve performance

Peer Tutoring

Allows for instruction that is tailored to academic ability & pace

(DuPaul, Stoner & OReilly, 2002; Iseman, Silverman & Jeweler, 2010; Raggi & Chronis, 2006; Silverman, Iseman & Jewelwe, 2009)

Conclusion
School-based interventions can be
quite powerful while they are being
administered, particularly when
they:
are administered consistently by
teachers who are actively engaged
in working with students
are based on FBA, tailored to the
specific student
Include active engagement on the
part of the student
Include effective communication
between home and school

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References
DuPaul, G., & Stoner, G. (2003). ADHD in the Schools: Assessment and Intervention Strategies. New York, New
York:The Guilford Press.
DuPaul, G., Stoner, G., & OReilly, M.J. (2002). Best Practices in Classroom Interventions for Attention Problems. In
A. Thomas & J. Grimes (Eds.), Best Practices in School Psychology: Volume 2 (4th ed., pp. 1115-1127).
Bethesda, MD: National Association of School Psychologists.
DuPaul, G., & Weyandt,L. ( 2006). School-Based Interventions for Children with Attention Deficit Hyperactivity
Disorder: Effects on Academic, Social, and Behavioural Functioning. International Journal of Disabilities,
Development and Education, 53, 2, 161-176. doi: 10.1080/10349120600716141
Iseman, J., Silverman, S., & Jeweler, S. (2010). 101 School Success Tools for Students With ADHD. Waco, Texas:
Prufrock Press Inc.
Pfiffner, L., DuPaul, G., & Barkley, R. (1998). Treatment of ADHD in School Settings. A Handbook for Diagnosis and
Treatment. New York: Guilford Press.

Raggi, V., & Chronis, A. (2006). Interventions to Address the Academic Impairment of Children and Adolescents with ADHD.
Clinical Child and Family Psychology Review, 9, 2. doi: 10.1007/s10567-006-0006-0
Silverman, S., Iseman, J., & Jeweler, S. (2009). School Success for Kids With ADHD. Waco, Texas: Prufrock Press Inc.