1. East Orange Community Charter School
TEACHING STRATEGIES
FOR CHALLENGING
CHILDREN
JUDITH CHAMPION, MSW, ACG
EDUCATOR AND COACH
ADHD ASSOCIATES

2. REVIEW
ATTENTION DEFICIT
HYPERACTIVITY DISORDER

3. Attention Deficit Hyperactivity
Disorder
A Neurobiological Disorder
characterized by
developmentally inappropriate behaviors
A Neurobehavioral Disorder
Inability to self-regulate
 attention/focus,
 activity levels/hyperactivity
 impulsivity
 emotions

4. ADHD – An Inside Look
Cerebral
Pre-
frontal
m
k
Cortex
Caudate Nucleus
Globus Pallidus
k
j
Cerebellum
Picture courtesy of Marlene Snyder, Ph.D., www.whitefishconsultants.com
and the Cape Cod Times

5. Insufficient Levels of
Dopamine
Synaptic
Gap i Dendritic
Spine
Dopamine
lReceptor
jStimulant
h medication
Dopamine floods the
gap with
Picture courtesy of Marlene Snyder, Ph.D. dopamine
and the Cape Cod Times

6. Dopamine Produced by
Stimulation
 Physical activity
 Cognitive activity in an area of interest
 Positive Reinforcement
 Negative Reinforcement
 Argument
 Talking
 Medication

7. ADHD-Types
Specified by the DSM-IV
American Psychiatric Association
Diagnostic and Statistical Manual, 4th Edition
ADHD Diagnostic Subtypes:
 Primarily Inattentive -- ADHD-I
 Primarily Hyperactive/Impulsive -- ADHD-H
 Combined -- ADHD-C

8. Predominately Inattentive Type AD/HD-
I
At least six of nine characteristics are required for
diagnosis:
 Often fails to give close attention to details or makes
careless mistakes in schoolwork, the work
environment or other activities.
 Often has difficulty sustaining attention in tasks or
play activities.
 Often does not seem to listen when spoken to
directly.
 Often does not follow through on instructions and
fails to finish schoolwork or other tasks.
 Often has difficulty organizing tasks and activities.
(cont’d.)

9. Predominately Inattentive Type AD/HD-
I
At least six of nine characteristics are required for
diagnosis:
 Often avoids, dislikes or is reluctant to engage in
tasks requiring sustained mental effort (school or
homework).
 Often loses things necessary for tasks or activities
(toys, assignments, tools).
 Often easily distracted by extraneous stimuli.
 Often forgetful in daily activities.

10. Predominately Hyperactive/Impulsive
Type
At least six of nine characteristics are required for
diagnosis:
Hyperactivity
 Often fidgets with hands or feet or squirms in seat
 Often leaves seat in classroom or other situations in which
remaining seated is the expectation
 Often runs about or climbs excessively in situations in which it
is inappropriate (in adolescents and adults, it may be limited to
subjective feelings of restlessness)
 Often has difficulty playing or engaging in leisure activities
quietly
 Often “on the go” or acts as if “driven
by a motor”
 Often talks excessively

11. Predominately Hyperactive/Impulsive
Type
Impulsivity
 Often blurts out answers before
questions have been completed
 Often has difficulty waiting turn
 Often interrupts or intrudes on
others
ADHD Combined symptoms
include all of the above

12. What are the Probable Causes
of ADHD?
ADHD is a Neurobiological
Disorder
• Strength of Evidence: Strong
 Genetic – Highly Inheritable – Runs in families
 High incidence rate
 Strength of Evidence: Strong
Environmental
• Low incidence rate
• Pre Birth
Low birth weight
Prenatal smoking and alcohol
 Post Birth
Environmental toxins such as lead
Brain injuries

13. ADHD Prevalence
Most commonly diagnosed
neurobiological disorder in
children
 7% to 15% of all school aged
children
 Equal prevalence across all

14. Co-Existing Conditions
ADHD alone
30% Oppositional
Learning Disability Defiant
Tic Disorder
50% Disorder
7% Bipolar
40%
Disorder
20%
Conduct
Depression Disorder
10%-30% 35% Anxiety Disorder
35%

15. What does a Challenged ADHD
Child look like?
● Over-stimulated easily
● Difficulty with changes in routine
● Difficulty with emotional control
● Displays aggressive behavior
● Difficult to discipline

16.  Symptoms occur very
frequently at home,
at school and in most other
situations
 Performs poorly in groups
 Unpopular with peers; seen as
nuisance
 Behavior presents significant
challenges for parents and teachers

17. Prognosis
 With early identification and
treatment, children and
adults with ADHD can be
successful
 Studies show:
 Fewer problems with school, peers,
substance abuse and improved overall
functioning, compared to those who do
not receive treatment
Barkley, 1998; MTA Cooperative, 1999; Biederman, 1999; Barkley, 2003; Wilens, 2003;
Barkley, 2001

18. Multimodal Treatment
of ADHD
 Evaluation and diagnosis
 Parent and child education about
diagnosis and treatment
 Behavior management techniques
 Medication
 School programming and supports

19. Positive Characteristics Often
Associated with ADHD
 Energetic  Resourceful
 Highly verbal  Good-hearted
 Spontaneous  Gregarious
 Creative  Not boring
 Exciting  Highly intelligent
 Persistent  Humorous
 Innovative  Outgoing
 Imaginative  Willing to take chances
 Risk-taker  Good at improvising
 Tenacious  Able to find novel solutions
 Warm-hearted and helpful  Inventive
 Ingenious  Observant
 Compassionate  Full of ideas
 Accepting and forgiving  Can think on feet
 Resilient  Good in a crisis
 Fun to be around  Empathetic
 Sensitive to others/caring

20. Minority Children with ADHD are
Under-Diagnosed
 Only 20% of African
American children with
ADHD are diagnosed
and treated
 Only 20% of Hispanic
children are diagnosed and
treated
 Leaving 80% of minority
children with ADHD to be

21. WHY?
 Lack of information
about ADHD
 Less access to health and mental
health services
 Less likely to receive quality
services
 Mistrust and fear of health service
system
 Differences in language and
communication

22. Likely Progression of
Criminal
Untreated ADHD behavior
Kewley, 1999 School exclusion
Challenging Substance abuse
Disruptive
behavior
behavior Teenage
Low self- Poor social
ADHD Only pregnancy
esteem skills
Conduct disorder
Learning
Delay Lack of
ODD motivation
Complex learning
difficulties
Age 6 10 14–16

23. Prevalence of Mental Health
Disorders in the Juvenile
Justice System
General Population Juvenile Justice
• Mood Disorders 2%–8% 32%–88%
• ADHD 7%–15% 50%–76%
• Learning Disorders 5% 17%–53%
• PTSD 1%–14% 32%–49%
• Conduct Disorder 2%–16% 50%–100%
• Psychotic Disorder .05%–1% 1%–16%
• Borderline Disorder 2% 1%–35%

24. Research: United
States
Correctional Systems
Undiagnosed
and Untreated Individuals:
 50% to 75% of children in the Juvenile
Justice systems have undiagnosed
ADHD
 65% of adults in the prison systems
have undiagnosed Mental Health
Disorders
 50% of these inmates have
undiagnosed ADHD

25. Minority Children with ADHD are
Under-Diagnosed
 Only 20% of African American
children with ADHD are diagnosed
and treated
 Only 20% of Hispanic children are
diagnosed and treated
 Leaving 80% of minority children
with ADHD to be undiagnosed and
untreated

26. For every 100 African American
& Hispanic Children
100
x10% prevalence rate
10 children at-risk of ADHD
10
x20% diagnosis rate
2 children diagnosed and treated
10
x80% untreated rate
8 children undiagnosed/untreated

27. We cannot change anything
unless we accept it.
27

28. The Power of the Teacher
I have come to a frightening conclusion,
I am the decisive element in the classroom.
It is my personal approach that creates the
climate.
It is my daily mood that makes the weather.
As a teacher, I possess tremendous power to
make a child’s life miserable or joyous.
I can be a tool of torture or an instrument of
inspiration.
I can humiliate or humor, hurt or heal.
In all situations, it is my response that
determines whether a crisis will be escalated or
de-escalated; whether a child will be
humanized or dehumanized.

29. Executive Functioning
Dr. Tom Brown uses a metaphor that
compares executive functioning of the
brain to the function of a conductor of an
orchestra.
• Working Memory
• Activation
• Focus
• Effort
• Emotion
• Action

30. Executive Functioning
The impaired executive functioning
skills in individuals with ADHD are
related to abnormal dopamine
levels in the frontal lobe of the
brain.

31. Working Memory Limitations
Memory that holds information in your
head long enough for you to act
upon it; inability to quickly retrieve
information
ADHD is
An Information Processing Disorder
31

32. Executive Function Definition
The higher-order cognitive processes
involved in:
 regulation of behavior
 inhibition of impulses
 working memory
 sequential thinking
 planning
 organizing
32

33. Executive Function Components
 Activation
 Time management
 Sustaining alertness and effort
 Self-regulation
 Emotional self-control
 Self-talk
 Inhibition of verbal and nonverbal
response
33

34. Practical difficulties as a result of poor
Executive Skills---Generally in all areas
 Getting started
 Knowing what comes next
 Awareness of time
 Distractibility
 Inability to sit still
34

35. Skills Needed by Students with ADHD
to Experience Success in School
1. Increase Attention to Task
2. Improve Listening Skills
3. Increase Work Production
4. Build Organization and Study Skills
5. Control and Minimize Problems Caused By:
 Excessive Hyperactivity
 Impulsivity
 Immature Social Skills
35

36. Practical Implications
of Executive Function Deficits
in School Performance
 Getting started
 Remembering chores and assignments
 Memorizing multiplication tables or other facts
 Writing essays
 Remembering what was read (reading
comprehension)
 Controlling emotions
 Analyzing and problem solving
 Planning for the future
Information from Chris A. Zeigler Dendy
36

37. Overview of
Classroom Strategies

38. General Classroom
Management
Structured and Well-Organized
 Class schedule
 Distinct routines
 Class rules
 Careful planning of seating and
physical space
38

39. Class Management Tips for
Challenging Children
 Focus on the use of positive
reinforcement for appropriate behavior
 Maintain a calm, welcoming, inclusive
and predictable environment
 Be flexible and accommodate the
individual needs of each student
39

40. Critical Principles of
Instruction for Challenging
Children
 Structure: A consistent routine,
enhanced by a highly organized
format of activities
 Variety: Novelty or the slightest
change in the activity to maintain
continued interest
 Brevity: Activities of short duration
40

41. Critical Principles of
Instruction for Challenging
Children
 Positive Feedback and Reinforcement:
Positive response keeps a child’s mind open
 Stimulation: Use of child’s interest areas and
physically active breaks creates focus by
increasing dopamine in the brain
 Transitional Preparation: Alert child to
change; what is coming next, allow time for
brain to refocus
41

42. Maintain a Positive
Environment
 Give positive reinforcement to child with
ADHD whenever possible
 Overlook the little things
 Use positive statement about someone doing
something right
Biggest behavioral change occurs
with the use of positive
reinforcement
42

43. Teacher Proximity and
Movement
 Seat children with ADHD in front of
room; limits distractions in their line
of vision and enables teacher easy eye
contact and visual cueing
 Circulate; move around room
frequently
Use your physical proximity and
positioning to manage disruptive
behavior.
43

44. Signals
Establish visual and auditory signals
to get students to stop what they are
doing and give you their attention.
 Use a clapping pattern
 Play a bar of music
 Call out a signal word
 Establish a special signal with the
challenging child
44

45. Quiet Work
If a room is too quiet or too noisy, it may
be a problem for a child with ADHD
 Make accommodations for the needs
of each child
 Have nonverbal signal to cue “I need
help” so as to maintain quiet
 Space to be alone but moving and
working at the same time; Hawaii
45

46. Classroom Strategies
Designed for
Specific Challenges

47. Practical Difficulties
Distraction and Movement
Brain in need of dopamine
 Excessively active
 Trouble sitting/staying with group
 Very short attention span;
distractibility
 Cannot listen to long stories
47

48. Strategies for Movement
Define Space but Allow
Movement
 Allow a fidget object with rules
 Allow doodling
 Sit on bean bag or ball chair
 Reward when child is able to sit
reasonably quiet within defined
space
 Too disruptive: “Richard, do you
need to go to Hawaii?”
48

49. Strategies for Distraction
Segment Projects into Small
Tasks
 Depending on age of child, 5 to 20
minute tasks are optimum
 Define each segment to the child
before the class begins
 Allow him to get up and move around
for 5 minutes between tasks
This activity rejuvenates the brain and
enables the child to sit and
concentrate again
49

50. Practical Difficulties
Listening and Following
Directions
 Struggle to inhibit and control
behavior
 Unable to readily stop and
disengage from current activity
 Not able to quickly switch gears
 Attention deficits
 Limited working memory
50

51. Strategies
Increase Listening Skills
 Wait until the class is quiet
 Do not talk over student’s voices
 Face the group and speak in
simple, short sentences
 Stand next to child with ADHD and
look into his eyes when speaking
 Provide multi-sensory instructions 51

52. Strategies
Improve Following of Directions
 Model what to do; show the class
 Avoid multi-step directions
 Use Classroom Cue Cards
 Read written directions and have
students highlight/circle/underline key
words
 Check for understanding by having an
individual student rephrase the
instruction
52

53. Strategy
Classroom Cue Card
Writing ____Name
____Read Directions
____Answer ALL
questions that are
Color CIRCLED
____Color (if needed)
____Cut (if needed)
Scissors
____Glue (if needed)
____Turn into black basket
53

54. Find
Circle
Write
54

55. Practical Difficulties
Change/Transitions
Change is difficult; Transitions can
cause behavior problems:
 Change in routine
 Change of instructional situation
 Change of teacher
 In classroom to out of classroom
 Inside school to outside of school
55

56. Strategies
Prepare and Provide
Structure for Transitions
 Weekly/Monthly calendars with
stickers indicating activities
 Activity Story Boards-done in small
groups/individually and then
discussed; final Story Board put
together by class.
 Practice the steps involved; lining up
for the bus, sitting on the bus without
disruption, waiting on line at the
museum, moving about in small 56

57. Strategies
Extra Supervision for Transitions
 Smaller groups with only one
challenging child per group
 Child gets special attention,
perhaps walking with teacher
 Provide a lot of positive praise for
appropriate behavior
57

58. Practical Difficulties
Social Skills
 Difficulty playing with other children
 Cannot read unspoken social cues
 Poor self-control when frustrated or
angry
 Emotions interfere with activities
 Poor self-awareness - does not know
what behaviors other people find
annoying or intrusive
58

59. Strategies
Provide Social Learning
 Social-Emotional Learning Programs
 Cooperative Learning Structures; team
child with tolerant, supportive, positive
role models

 Facilitate friendships for students who
tend to be socially isolated; pairing with
positive role model
 Teachers model and teach pro-social
behaviors
59

60. Practical Difficulties
Organization
Working memory limitations and Distraction
 Loses things
 Forgets to record assignments
 Not bringing home all materials needed for
assignments
 Forgets to turn in completed work
 Clutter in desk and in backpack
60

61. Strategies
Organizational Structure
 Well organized notebook system
 Extra supplies due to frequent lose
 Assignment book checked and signed
by teacher and parent
 Review materials needed for
assignments
 Have a folder for Completed Work
 Have an easy access box for handing
in work
 Parent works with child to keep

62. Strategies
Homework Organization Notebook
• Include a monthly calendar in front of
folder
• Designate different colored pockets for:
1. Papers to bring home: HOME
2. Homework to be completed: DO
3. Homework in process: DOING
4. Homework completed, give to teacher:
TURN IN
• Check notebook at the end of each day and
reinforce how papers should be ordered
• Work with parents to understand the
system and work with child at home 62

63. Practical Difficulties
Time Management
Lack of awareness of time
 Judging and managing time
 Forgets deadlines and due dates
 Difficulty in estimating time needed to
complete a task; underestimates
 Self-regulation issues and the ability to
work to task completion without
distraction
 Difficulty prioritizing work based on
due dates or importance
63

64. Strategies
Time Management Structures
 Practice time estimating
 Use of timers to learn the passing of
time
 Due dates included in assignment
book
 Assignments and due dates written on
board and given verbally
 Weekly calendars in classroom
 Chunk up large assignments into

65. Practical Difficulties
Study Skills
 Memory/forgetfulness: Assignments,
materials, and handing in homework
 Judging and managing time
 Mobilizing and getting started on tasks
 Sustaining alertness, attention and effort
 General self-management and the ability
to work toward a goal
65

66. Strategies
Improving Study Skills
 Distraction free environment
 All supplies available
 Chunk up large projects
 Note taking, highlighting, and mind
maps
 Timer to stay on task
 Breaks to rejuvenate brain
 Worry pad for stray thoughts

67. General Strategy
Evaluate and Re-Evaluate
 Evaluate the frequency of the
problem behavior at the start of
intervention.
 Re-Evaluate at the end of each
week.
 Important to know if what you are
doing is working.
 One strategy may work for one
child and not for the other.
67

68. By Kathy Chislom, M.Ed
68

69. Parent Training is Very
Important
 Must be aware of challenges of child
 Manifest differently at home and
school
 Communication between Parent and
Teacher is essential
 If challenged child does have ADHD,
parent’s permission needed for
evaluation
 ADHD Parent Training provided
through school is very successful
when teachers are involved.

70. JUDITH CHAMPION, MSW, ACG
ADHD ASSOCIATES
609-468-0819
Judith@judithchampion.com
www.ADHDAssociates.com