Disabilities
IDEA protects the rights of students with disabilities to an education. Oftentimes the terms impairment, disability, and handicap are all used synonymously, but they are not as interchangeable as often mistakenly used. The term ‘impairment’ refers to a loss of reduced ability of a body part or organ. A disability exists when an impairment reduces a person’s ability to perform a task. Finally, a handicap occurs when a person with disabilities is unable to interact with their outside environment. (Heward, 2009) Students with disabilities have some impairment that impacts their abilities to perform tasks; their disabilities may be physical, learning, and/or behavioral in nature. The characteristics of student exceptionalism and disability can fall under some of the following categories:
- Intellectual disabilities
- Learning disabilities
- Emotional or behavioral disabilities
- Autism Spectrum Disorder
- Speech/Language impairment
- Hearing or Visual impairment
- Physical/health impairment
- Traumatic brain injury
- Multiple disabilities (Heward, 2009)
Learning Disabilities
Definition: in response to an ill-fitting federal definition, the National Joint Committee on Learning Disorders generated a definition of what a learning disability is. “Learning disability is a general term that refers to a heterogeneous group of disorders manifested by significant difficulties in acquisition and use of listening, speaking, reading, writing, reasoning, or mathematical abilities. These disorders are intrinsic to the individual and presumed to be due to central nervous system dysfunction, and may appear across the lifespan.”(NJCLD, 1990/2001; Heward, 2009) This definition is important because it shows the diversity of people and types of learning disabilities; they key areas where individuals have difficulty, the potential cause for the disability, and the time life-long time span of learning disabilities.
Prevalence: “During the 2005-2006 school year, more than 2.7 million students ages 6-21 received special education under the specific learning disability category.” (U.S. Office of Special Education, 2007: Heward, 2009) Making up nearly half the student population with disabilities and about 4% of the total population, learning disabilities are the most prevalent disability. The number of students with learning disabilities has risen over the last few decades; most believe that this increase is primarily because of identification. While states have specific criteria for what constitutes a learning disability, the criterion varies across the board. Because of specific criteria Kentucky has a 1.7% population with learning disabilities while Oklahoma may be as high as 6.0%. (Heward, 2009) With the criteria different states and school districts have inaccurate reflections of their actual population. Additionally, because of over identification and misdiagnosis there has been a rise in the total number of students identified as having a learning disability.
Symptoms/Identification: There are generally three criteria to be met before an individual can be identified as having a learning disability by a school district or state. First, there must be a severe discrepancy between the individual’s intellectual ability and academic achievement. This discrepancy is measured through an IQ test and a compatible achievement test; being outside a specific range would indicate a discrepancy in an individual’s intelligence and their ability to achieve. Second, the learning disability cannot be the result of another known condition to cause learning problems. Another recognized disability can coexists with the learning disability, but the known disability to cause learning disabilities is considered the primary disability and treated as such. Third, the student needs special education services. This means that “specific and severe” learning problems occurred in a standard education setting leading to a need for specialized instruction. The responsiveness to intervention (RTI) model is designed identify students with learning disabilities and determine whether underachieving is a result of environmental or instructional factors, rather than an actual learning disability. The RTI model has three tiers of intervention where students begin with an assessment, and depending on their achievement of a benchmark, will be determined a grade level learner or a struggling learning. A struggling learning in tier two will receive a period of specialized instruction and intervention; if the student performs at the exit criteria they are considered remediated, if not, the student can have a second set of intervention with different instruction and intervention or they move to special education in tier three. (Heward, 2009) This model helps identify students, limiting the number of misidentified students, and focuses on a proactive approach to identification rather than a wait-to-fail. Students who meet the grade level standard are given the instruction they needed in the first place.
Learning: It is important to note the separation between intellectual and learning disabilities. Intellectual disabilities are identified under IDEA as “significantly subaverage[sic] general intellectual functioning existing concurrently with deficits in adaptive behavior and manifested during the developmental period that adversely affects a child’s educational performance.” (Heward 2009) The important distinction for a learning disability is the gap between a student’s achievement and an otherwise average IQ. A move away from remediation and toward modified instruction has been the focus of special education in recent years. Students with learning disabilities often a) have difficulty organizing information, b) bring limited background knowledge to current learning, and c) do not approach learning in an effective or efficient manner. (Heward, 2009) As the NJCLD definition states, an individual with a learning disability shows “significant difficulties in acquisition and use of listening, speaking, reading, writing, reasoning, or mathematical abilities.” (P.L. 108-446; Heward, 2009) Common characteristics of a learning disability are difficulties with reading (90%), writing, math (50%), social skill (15%), attention, hyperactivity, behavioral, and low self-efficacy. While these are symptoms and characteristics of most learning disabilities, the long-term impacts are the greatest. As learners fall further and further behind and the achievement gap widens the student may go unnoticed until secondary school, all the time they could have been achieving because they have the capacity and intelligence to succeed.
Attention/Hyperactivity: while there is no absolute connection between learning disabilities and attention and hyperactivity some students with learning disabilities struggle with attending to tasks and display hyperactivity. In a national study by Wagner and Blackorby, a comorbidity of learning disability and ADHD were found in 28 % of students. (Wagner, & Blackorby 2002; Heward, 2009)
Motivation: Students with learning disabilities do not lack the intelligence or the ability to succeed more or less so that students without learning disabilities. Because of the social nature of schools and students’ awareness of their achievement in contrast to their classmates, self-efficacy and self-worth are issues among some students with learning disabilities. It is unknown whether the loss of motivation lies in “a painful history of frustration and disappointment with academic and socials situations, day-to-day struggles, and/or future worries,” but a learning disability can negatively impact a student’s motivation. (Cosden, Brown, & Elliot, 2002; Lackaye Margalit, Ziv, & Suman, 2007; Heward, 2009) The importance of a positive focus on the student’s abilities and strengths is always important. (Lovitt, 2007; Heward, 2009)
Accommodations/Modifications: There are a variety of educational approaches that can enhance content for students with learning disabilities. As a teacher, breaking large tasks into smaller, manageable chunks helps students focus and achieve. Additionally, planning frequent checks for understanding allows both teacher and the student to monitor progress. Graphic organizers are words and images connected to help students better visualize concepts and connections. Graphic organizers come a in a variety of styles, but the primary purpose is to anchor new concepts using previous knowledge. Note-taking is used broadly in middle and high schools; it is important that students have concrete note-taking strategies and skills to succeed in class. Methods such as Cornell and Ferndale notes can be used to enhance notes, meaning making, and connections. Additionally, guided notes are teacher-prepared handouts that explicitly describe what to take notes on and reinforces intended learning. Mnemonic devices like acronyms, word parts, and pegwords can help assist student memory and recall. (Heward, 2009) Finally, using learning strategies to reinforce other learning methods are helpful for students with learning disabilities. Using pre-, post-, and during-strategies as well as meta-analysis reflection can help student better understand what they are learning and repeatedly practice the essential information. (Wolpow, 2006)
Prevalence: “During the 2005-2006 school year, more than 2.7 million students ages 6-21 received special education under the specific learning disability category.” (U.S. Office of Special Education, 2007: Heward, 2009) Making up nearly half the student population with disabilities and about 4% of the total population, learning disabilities are the most prevalent disability. The number of students with learning disabilities has risen over the last few decades; most believe that this increase is primarily because of identification. While states have specific criteria for what constitutes a learning disability, the criterion varies across the board. Because of specific criteria Kentucky has a 1.7% population with learning disabilities while Oklahoma may be as high as 6.0%. (Heward, 2009) With the criteria different states and school districts have inaccurate reflections of their actual population. Additionally, because of over identification and misdiagnosis there has been a rise in the total number of students identified as having a learning disability.
Symptoms/Identification: There are generally three criteria to be met before an individual can be identified as having a learning disability by a school district or state. First, there must be a severe discrepancy between the individual’s intellectual ability and academic achievement. This discrepancy is measured through an IQ test and a compatible achievement test; being outside a specific range would indicate a discrepancy in an individual’s intelligence and their ability to achieve. Second, the learning disability cannot be the result of another known condition to cause learning problems. Another recognized disability can coexists with the learning disability, but the known disability to cause learning disabilities is considered the primary disability and treated as such. Third, the student needs special education services. This means that “specific and severe” learning problems occurred in a standard education setting leading to a need for specialized instruction. The responsiveness to intervention (RTI) model is designed identify students with learning disabilities and determine whether underachieving is a result of environmental or instructional factors, rather than an actual learning disability. The RTI model has three tiers of intervention where students begin with an assessment, and depending on their achievement of a benchmark, will be determined a grade level learner or a struggling learning. A struggling learning in tier two will receive a period of specialized instruction and intervention; if the student performs at the exit criteria they are considered remediated, if not, the student can have a second set of intervention with different instruction and intervention or they move to special education in tier three. (Heward, 2009) This model helps identify students, limiting the number of misidentified students, and focuses on a proactive approach to identification rather than a wait-to-fail. Students who meet the grade level standard are given the instruction they needed in the first place.
Learning: It is important to note the separation between intellectual and learning disabilities. Intellectual disabilities are identified under IDEA as “significantly subaverage[sic] general intellectual functioning existing concurrently with deficits in adaptive behavior and manifested during the developmental period that adversely affects a child’s educational performance.” (Heward 2009) The important distinction for a learning disability is the gap between a student’s achievement and an otherwise average IQ. A move away from remediation and toward modified instruction has been the focus of special education in recent years. Students with learning disabilities often a) have difficulty organizing information, b) bring limited background knowledge to current learning, and c) do not approach learning in an effective or efficient manner. (Heward, 2009) As the NJCLD definition states, an individual with a learning disability shows “significant difficulties in acquisition and use of listening, speaking, reading, writing, reasoning, or mathematical abilities.” (P.L. 108-446; Heward, 2009) Common characteristics of a learning disability are difficulties with reading (90%), writing, math (50%), social skill (15%), attention, hyperactivity, behavioral, and low self-efficacy. While these are symptoms and characteristics of most learning disabilities, the long-term impacts are the greatest. As learners fall further and further behind and the achievement gap widens the student may go unnoticed until secondary school, all the time they could have been achieving because they have the capacity and intelligence to succeed.
Attention/Hyperactivity: while there is no absolute connection between learning disabilities and attention and hyperactivity some students with learning disabilities struggle with attending to tasks and display hyperactivity. In a national study by Wagner and Blackorby, a comorbidity of learning disability and ADHD were found in 28 % of students. (Wagner, & Blackorby 2002; Heward, 2009)
Motivation: Students with learning disabilities do not lack the intelligence or the ability to succeed more or less so that students without learning disabilities. Because of the social nature of schools and students’ awareness of their achievement in contrast to their classmates, self-efficacy and self-worth are issues among some students with learning disabilities. It is unknown whether the loss of motivation lies in “a painful history of frustration and disappointment with academic and socials situations, day-to-day struggles, and/or future worries,” but a learning disability can negatively impact a student’s motivation. (Cosden, Brown, & Elliot, 2002; Lackaye Margalit, Ziv, & Suman, 2007; Heward, 2009) The importance of a positive focus on the student’s abilities and strengths is always important. (Lovitt, 2007; Heward, 2009)
Accommodations/Modifications: There are a variety of educational approaches that can enhance content for students with learning disabilities. As a teacher, breaking large tasks into smaller, manageable chunks helps students focus and achieve. Additionally, planning frequent checks for understanding allows both teacher and the student to monitor progress. Graphic organizers are words and images connected to help students better visualize concepts and connections. Graphic organizers come a in a variety of styles, but the primary purpose is to anchor new concepts using previous knowledge. Note-taking is used broadly in middle and high schools; it is important that students have concrete note-taking strategies and skills to succeed in class. Methods such as Cornell and Ferndale notes can be used to enhance notes, meaning making, and connections. Additionally, guided notes are teacher-prepared handouts that explicitly describe what to take notes on and reinforces intended learning. Mnemonic devices like acronyms, word parts, and pegwords can help assist student memory and recall. (Heward, 2009) Finally, using learning strategies to reinforce other learning methods are helpful for students with learning disabilities. Using pre-, post-, and during-strategies as well as meta-analysis reflection can help student better understand what they are learning and repeatedly practice the essential information. (Wolpow, 2006)
Emotional and Behavioral Disabilities
Definition: Two of the most prominent definitions of emotional and behavioral disturbances come from IDEA and the Council for Children with Behavioral Disorders (CCBD). IDEA defines emotional disturbance as:
“[a] condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects educational performance: a) an inability to learn which cannot be explained by intellectual, sensory, and health factors; b) an inability to build or maintain satisfactory interpersonal relationships with peers and teachers; c) inappropriate types of behavior or feelings under normal circumstances, d) a general pervasive mood of unhappiness or depression; or e) a tendency to develop physical symptoms of fear associated with personal or school problems.” (P.L. 108-446; Heward, 2009)
This definition focuses on the long-term impact of behaviors and feeling related to learning, relationship building, externalizing and internalizing behaviors, pervasive moods, and the disconnection between the disorder and other known factors. The second definition by the CCBD defines emotional or behavioral disorders as:
“a disability that is characterized by emotional or behavioral responses in school programs so different from appropriate age, cultural or ethnic norms that the responses adversely affect educational performance- in two different settings, at least one of which is school related; and unresponsive to direct intervention in general education, or the condition of the child is such that general education interventions would be insufficient.” (Heward, 2009)
This definition focuses on the impact the disability has on school and clarifies that the behavior is outside of the age, culture, and ethnic norms. The additional focus on the attempted or insufficient intervention more clearly defines highlights the possibility of identification and intervention.
Prevalence: Studies have found a range between 8.3% of children and 30% of low-income preschoolers having emotional or behavioral disorders. Such a range can be negated by age and criteria used to identify the disabilities. More credible estimates identify between 3% and 10% needing intervention for behavioral disorders. (Heward, 2009) It is important to note that sociological criteria are what determine a behavioral or emotional disorder. In the case of gender, three fourths of children identified with emotional or behavioral disorders are boys (Wagner, Kutash, Duchnowski, Epstein, & Sumi, 2005; Heward, 2009) While boys, in Western culture, are expected to act out, the emphasis on that identity may have an impact on a child’s perceived behavioral identity. Likewise, girls, who are prescribed internalizing behaviors by society, are also more likely to be identified as having internalizing disorders. Social pressures, stereotypical assumptions about behavior, and methods of addressing behavior can all impact the identification of emotional or behavioral disorders.
Symptoms: Emotional or behavioral disorders are primarily characterized by behaviors, “so different from appropriate age, cultural or ethnic norms that the responses adversely affect educational performance,” that they negatively impact at least two realms of a child’s life, one being school. (Heward, 2009) The two types of behaviors are externalizing behaviors, which are characterized as aggressive, outwardly focused behaviors, and internalizing behaviors, which are passive, inwardly focused behaviors. Both behaviors can be measured by comparing the “five measurable dimensions of behavior:” frequency, duration, latency, topography, and magnitude. A behavior’s regularity, length, occurrence after stimuli, appearance, and degree can all be compared and measured against other age and cultural standards. Some examples of externalizing behaviors of students are:
Getting out of their seat; yelling, talking out of tern, and cursing; disturbing peers; hitting of fighting; ignoring the teacher; complaining; arguing excessively; stealing; lying; destroying property; not complying with directions; having temper tantrums (Heward, 2009)
Because these actions are observable, disturb the classroom, and present a major management issue, teachers notice the behaviors more. Some teachers also believe that these behaviors will be grown out of; H.M. Walker states that many students to not actually grow out of the behavior when not properly addressed. (Walker, Ramsey, & Gresham, 2005; Heward, 2009) Inversely, internalizing behaviors are more subtle, but still present serious implications for a student’s development. Some internalizing behaviors and conditions include.
Anxiety disorders; phobias; obsessive/compulsive disorder; anorexia and bulimia nervosa; post-traumatic stress disorder; selective mutism; depression; bipolar disorder; schizophrenia (Heward, 2009)
These conditions can have a profound impact on a student’s academic and social achievement. Disengagement from social interactions and classwork both have long-term negative impacts on a student’s success. A student exhibiting internalizing behaviors, is harder to identify and address than externalizing behaviors because they cannot be monitored and measured as easily. Additionally, students with internalizing behaviors may not be noticed because their behaviors are not as obvious as external behaviors, leading an instructor to overlook or praise the internalizing behavior of the student.
Learning: There are controversial thoughts between the correlation between emotional and behavioral disorders and intellectual achievement; statistics show some general trends across the board relating students with emotional and behavioral disorders to their achievement. Some tendencies of students with emotional or behavioral disorders include: most perform one or more years below grade level, two thirds cannot pass grade level competency exams, higher absenteeism than any other student group, and more than 60% dropout of high school. (Cullinan, 2007; Cullinan & Saborine, 2004; Heward 2009) These correlations create stigmas and stereotypes about emotional and behavioral disorders and intelligence that are unfounded. The causation of a student’s behaviors may be in response to negative academic achievement, or the student may not learn because their behavior is getting in the way of their learning.
Attention/Motivation: Some emotional and behavioral disorders can have disruptive tendencies. Most externalizing behaviors can act as a distraction to the student, their classmates, and the teacher, leading to a loss in attention by all students. Similarly, internalizing behaviors like anxiety and depression can distract a student from completing their work by stealing their attention and motivation. Limited participation, poor social interactions, and missed learning opportunities can adversely impact a student’s achievement and lead to poorer and poorer attention and motivation to engage in the future. A functional behavior assessment (FBA) can help pinpoint a student’s motivation behind their behavior. Usually behaviors are intended as positive and negative reinforcements, meant to gain something positive or remove something negative.
Accommodations/Modifications: There are a few evidence-based instructional practices that can be used by teachers or whole schools. The first set of strategic approaches for students with emotional and behavioral disorders are,
“a) teacher praise (reinforcement), b) higher rates of opportunities to respond during instruction, c) clear instruction strategies, including direct instruction, and d) positive behavior support, including school-wide, functional assessment-based individual and self-management.” (Lewis, Hudson, Ritcher, and Johnson, 2004; Heward, 2009)
A second strategy to assist in helping students with behavioral or emotional problems is teaching self-management, monitoring, and evaluation techniques. (Heward, 2009) If a student is able to reflect on their actions, the impact, and how to address or change those behaviors, students gain autonomy, responsibility for their actions, and skills for coping with their behaviors or emotions.
A final strategy is a school-wide system of positive behavior support (SWPBS). This system of support is designed as a school-wide, team-centered approach to proactively treat and reinforce behavior. The system comes in three tiers and has a set of guidelines to help students understand and learn about their behavior. A successful SWPBS is characterized by:
A SWPBS system is tiered into three levels of prevention that are associated with the guidelines above. The first step is primary intervention where the school establishes and teacher expectations, acknowledges positive behaviors, and reacts to negative behaviors. This is a universal intervention applied to all students in the school or classroom; this prevention works for about 80-90% students, the students without serious behavior problems. Secondary intervention is specialized interventions applied to the 5-15% of at-risk students where evidence is taken by the school’s team and the positive and negative behaviors are addressed. Tertiary intervention is a specialized intensive intervention applied to 1-7% of students on an individual level. These students have chronic and intense behavioral problems and a team works on specialized interventions for the student. (Heward, 2009)
“[a] condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects educational performance: a) an inability to learn which cannot be explained by intellectual, sensory, and health factors; b) an inability to build or maintain satisfactory interpersonal relationships with peers and teachers; c) inappropriate types of behavior or feelings under normal circumstances, d) a general pervasive mood of unhappiness or depression; or e) a tendency to develop physical symptoms of fear associated with personal or school problems.” (P.L. 108-446; Heward, 2009)
This definition focuses on the long-term impact of behaviors and feeling related to learning, relationship building, externalizing and internalizing behaviors, pervasive moods, and the disconnection between the disorder and other known factors. The second definition by the CCBD defines emotional or behavioral disorders as:
“a disability that is characterized by emotional or behavioral responses in school programs so different from appropriate age, cultural or ethnic norms that the responses adversely affect educational performance- in two different settings, at least one of which is school related; and unresponsive to direct intervention in general education, or the condition of the child is such that general education interventions would be insufficient.” (Heward, 2009)
This definition focuses on the impact the disability has on school and clarifies that the behavior is outside of the age, culture, and ethnic norms. The additional focus on the attempted or insufficient intervention more clearly defines highlights the possibility of identification and intervention.
Prevalence: Studies have found a range between 8.3% of children and 30% of low-income preschoolers having emotional or behavioral disorders. Such a range can be negated by age and criteria used to identify the disabilities. More credible estimates identify between 3% and 10% needing intervention for behavioral disorders. (Heward, 2009) It is important to note that sociological criteria are what determine a behavioral or emotional disorder. In the case of gender, three fourths of children identified with emotional or behavioral disorders are boys (Wagner, Kutash, Duchnowski, Epstein, & Sumi, 2005; Heward, 2009) While boys, in Western culture, are expected to act out, the emphasis on that identity may have an impact on a child’s perceived behavioral identity. Likewise, girls, who are prescribed internalizing behaviors by society, are also more likely to be identified as having internalizing disorders. Social pressures, stereotypical assumptions about behavior, and methods of addressing behavior can all impact the identification of emotional or behavioral disorders.
Symptoms: Emotional or behavioral disorders are primarily characterized by behaviors, “so different from appropriate age, cultural or ethnic norms that the responses adversely affect educational performance,” that they negatively impact at least two realms of a child’s life, one being school. (Heward, 2009) The two types of behaviors are externalizing behaviors, which are characterized as aggressive, outwardly focused behaviors, and internalizing behaviors, which are passive, inwardly focused behaviors. Both behaviors can be measured by comparing the “five measurable dimensions of behavior:” frequency, duration, latency, topography, and magnitude. A behavior’s regularity, length, occurrence after stimuli, appearance, and degree can all be compared and measured against other age and cultural standards. Some examples of externalizing behaviors of students are:
Getting out of their seat; yelling, talking out of tern, and cursing; disturbing peers; hitting of fighting; ignoring the teacher; complaining; arguing excessively; stealing; lying; destroying property; not complying with directions; having temper tantrums (Heward, 2009)
Because these actions are observable, disturb the classroom, and present a major management issue, teachers notice the behaviors more. Some teachers also believe that these behaviors will be grown out of; H.M. Walker states that many students to not actually grow out of the behavior when not properly addressed. (Walker, Ramsey, & Gresham, 2005; Heward, 2009) Inversely, internalizing behaviors are more subtle, but still present serious implications for a student’s development. Some internalizing behaviors and conditions include.
Anxiety disorders; phobias; obsessive/compulsive disorder; anorexia and bulimia nervosa; post-traumatic stress disorder; selective mutism; depression; bipolar disorder; schizophrenia (Heward, 2009)
These conditions can have a profound impact on a student’s academic and social achievement. Disengagement from social interactions and classwork both have long-term negative impacts on a student’s success. A student exhibiting internalizing behaviors, is harder to identify and address than externalizing behaviors because they cannot be monitored and measured as easily. Additionally, students with internalizing behaviors may not be noticed because their behaviors are not as obvious as external behaviors, leading an instructor to overlook or praise the internalizing behavior of the student.
Learning: There are controversial thoughts between the correlation between emotional and behavioral disorders and intellectual achievement; statistics show some general trends across the board relating students with emotional and behavioral disorders to their achievement. Some tendencies of students with emotional or behavioral disorders include: most perform one or more years below grade level, two thirds cannot pass grade level competency exams, higher absenteeism than any other student group, and more than 60% dropout of high school. (Cullinan, 2007; Cullinan & Saborine, 2004; Heward 2009) These correlations create stigmas and stereotypes about emotional and behavioral disorders and intelligence that are unfounded. The causation of a student’s behaviors may be in response to negative academic achievement, or the student may not learn because their behavior is getting in the way of their learning.
Attention/Motivation: Some emotional and behavioral disorders can have disruptive tendencies. Most externalizing behaviors can act as a distraction to the student, their classmates, and the teacher, leading to a loss in attention by all students. Similarly, internalizing behaviors like anxiety and depression can distract a student from completing their work by stealing their attention and motivation. Limited participation, poor social interactions, and missed learning opportunities can adversely impact a student’s achievement and lead to poorer and poorer attention and motivation to engage in the future. A functional behavior assessment (FBA) can help pinpoint a student’s motivation behind their behavior. Usually behaviors are intended as positive and negative reinforcements, meant to gain something positive or remove something negative.
Accommodations/Modifications: There are a few evidence-based instructional practices that can be used by teachers or whole schools. The first set of strategic approaches for students with emotional and behavioral disorders are,
“a) teacher praise (reinforcement), b) higher rates of opportunities to respond during instruction, c) clear instruction strategies, including direct instruction, and d) positive behavior support, including school-wide, functional assessment-based individual and self-management.” (Lewis, Hudson, Ritcher, and Johnson, 2004; Heward, 2009)
A second strategy to assist in helping students with behavioral or emotional problems is teaching self-management, monitoring, and evaluation techniques. (Heward, 2009) If a student is able to reflect on their actions, the impact, and how to address or change those behaviors, students gain autonomy, responsibility for their actions, and skills for coping with their behaviors or emotions.
A final strategy is a school-wide system of positive behavior support (SWPBS). This system of support is designed as a school-wide, team-centered approach to proactively treat and reinforce behavior. The system comes in three tiers and has a set of guidelines to help students understand and learn about their behavior. A successful SWPBS is characterized by:
- “behavioral expectation are stated
- behavioral expectations are defined and taught
- appropriate behaviors are acknowledged
- behavioral errors are corrected proactively
- program evaluations and adaptations are data driven and made by a team
- individual student supports are integrated with school-wide discipline systems.” (Center for Positive Behavioral Interventions and Support, 2007; Heward, 2009)
A SWPBS system is tiered into three levels of prevention that are associated with the guidelines above. The first step is primary intervention where the school establishes and teacher expectations, acknowledges positive behaviors, and reacts to negative behaviors. This is a universal intervention applied to all students in the school or classroom; this prevention works for about 80-90% students, the students without serious behavior problems. Secondary intervention is specialized interventions applied to the 5-15% of at-risk students where evidence is taken by the school’s team and the positive and negative behaviors are addressed. Tertiary intervention is a specialized intensive intervention applied to 1-7% of students on an individual level. These students have chronic and intense behavioral problems and a team works on specialized interventions for the student. (Heward, 2009)
Autism Spectrum Disorder (ASD)
Definition: There are two active definitions for Autism Spectrum Disorder (ASD). The first, under IDEA, defines the disability as: “Autism means a developmental disability affecting verbal and nonverbal communication and social integration.. that adversely affects a child’s educational performance. Other characteristics often associated with autism are engagement in repetitive activities and stereotyped movements, resistance to environmental change or change in daily routines, and unusual response to sensory experiences.” (Heward, 2009) The second definition, taken from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) defines autism spectrum disorder as:
“A. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive, see text): 1) deficits in social-emotional reciprocity... 2) deficits in nonverbal communicative behaviors used for social interaction..., 3) deficits in developing, maintaining, and understanding relationships...
B) Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive; see text): 1) stereotyped or repetitive motor movements... 2) insistence on sameness, inflexible adherence to routines, or ritualized patterns or verbal nonverbal behavior... 3) highly restricted, fixated interests that are abnormal in intensity or focus... 4) hyper- or hyporeactivity to sensory input...“ (American Psychiatric Association, 2013)
Both definitions focus on the stereotypical social and communication deficits and the restrictive and repetitive behaviors. As the DSM-V stated, the list of behaviors are illustrative rather than exhaustive; being a spectrum and a heterogeneous group, individuals with autism spectrum disorder exhibit a wide array of symptoms within the definitions on a scale of severity.
Prevalence: The identification and diagnosis of autism spectrum disorder has been on the rise; once thought to be 6.5 in 10,000 children, and now estimated at 1 in 68, it is the fastest-growing disability category in special education. (Heward, 2009; Facts about Autism, 2012) While there are theories about the genetic, environmental, or other causes of ASD, the main theory about the rise in numbers is because of awareness and improvements in federal and state assessment procedures. (Heward, 2009) About 1 in 42 boy, five times more than girls, are more likely to be autistic. (Facts about Autism, 2012)
Symptoms: These lists of symptoms are illustrative rather than exhaustive; the different symptoms of ASD range in severity and degree depending on the individual. Most symptoms can be categorized into two main groups, social and communication deficits and behavioral. A social symptom of ASD is impaired social relationships. This symptom can occur as a lack of empathy, ability to think about others abstractly, recognition of gestures or expressions, or recognition of another individual’s presence. Young children with ASD do not exhibit joint attention where a child mimics the attention of an adult. Secondly, individuals with ASD can have communication and language deficits. About half of children with autism are mute, but they may hum or utter simple sounds; speech may occur in the form of echolalia and repetition of heard phrases. Children with ASD may best communicate through concrete concepts rather than abstract. (Heward, 2009) More other symptoms of ASD can be categorized as behavioral. First, children with ASD may be hyper responsive or under responsive to sensory stimuli; auditory and tactile sensations are most common. A second behavioral symptom is sameness and preservation where individuals exhibit patterned, predictable daily schedules, ritualistic routines, and repetitive behaviors. Additionally, a child may have a special interest area in minimal topics. Finally, stereotypical behaviors such as flapping hands, rocking back and forth, or repeating an action for long periods of time are often seen. (Heward, 2009)
Learning: Individuals with autism display varying levels of academic and intellectual ability. Some individuals diagnosed with autism may display severe or profound intellectual disabilities; while intellectual disabilities are on a spectrum of abilities, 40-80% of individuals with autism are considered to have mental retardation. (Heward, 2009) It is common for individuals with autism to have splinter skills where they perform significantly better in some areas rather than others; a very small percentage of individuals function with the realm of savant. Intellectual disabilities aside, there are several methods proven effective for instructing individuals with ASD. Early intensive programs with applied behavior analysis (ABA) can effectively decrease the impact ASD symptoms have on an individual. Both systems are scientific approach to designing, conducting, and evaluating instruction based on empirically verified principles describing functional relations between events in the environment and learning. The programs can improve IQ by 20 points, promote a familiarity with an academic setting, and prepare students for social/communication interactions. Many students in the intensive programs can merge with general education classrooms by kindergarten. The programs give them the equitable education and abilities needed to succeed in a general education/population setting. (Heward, 2009) Secondly, teaching the individual, not the disability, is an important practice with autism. Individualized and differentiated approaches to teaching can have a profound impact on the student’s self-efficacy, learning, and general achievement.
Strengths: A stereotypical behavior of autism spectrum disorder is a child’s special interest area (SIA). Considered a “dominant characteristic of over 90% of children and adults with Aspergers syndrome,” SIA can be used to great effect when teaching students with autism. (Heward, 2009) The process of using special interest areas in teaching is:
With a special interest area drawing a student’s attention they are more likely to engage with the material, gain the skills they need to advance academically, and maintain their involvement with the class socially and academically.
Motivation/Attention: Because many students with autism have a strong focus on routines and repetitive behaviors, schedules and a predictable routine are important tools for motivating students with autism. Patterned and predictable behaviors can be used to a teacher’s advantage; knowing when a student is more active in their work can help a teacher better plan work time. However, students with autism can be prone to outburst and fits; some fits can last for hours. Teachers need to be proactive and predict where troubles may occur. If a change in the schedule will happen, giving the student advanced notice, or if a new topic is being introduced provide work with a connection to the student’s SIA. (Heward, 2009) Finally, building a student’s social, communication, sensory, motor, and emotional skills can better prepare a student with autism to be more flexible and in control of their actions.
Accommodations/Modifications: The first and most important modification for a student with autism is the individualized lessons and attention. Treating the student as an individual and catering to their needs is essential rather than teaching the disability. Also, because there is a wide range of severity and ability for students with autism, the following list of accommodation and modifications are illustrative and by no means absolute or comprehensive strategies for all students with ASD. First, some students with autism spectrum disorder would be best suited in a general education classroom. The social environment is considered by some to be an essential element in the development of important social skills, but as McConnell (2002) notes, “the data strongly suggests that inclusion is a necessary, but not likely sufficient, condition for social interaction interventions for young children with autism. (McConnell, 2002; Heward, 2009). Schwartz, Billingsley, and McBride note five strategies for teaching student with autism in a general education classroom:
These strategies are great for students with autism who are in a general education classroom. The focus of the strategies is to develop social, communication, and essential skills. For other students with ASD, not in a general education classroom, there are other accommodations that may work better for their needs. Social stories can be a method of developing a student’s social and communication skills. Heward describes social stories as, “social stories explain social situations and concepts, including expected behaviors of the persons involved, in a format understandable to an individual with ASD.” (Heward, 2009) These are tools for helping individuals with ASD prepare for social encounters. They are stories told at the comprehension level of the individual wherein a series of basic sentence formats are presented as:
Finally, the use of assistive technology can greatly help students with autism. Because some students with autism have social deficits that can impact their interactions with others, the use of digital calendars, prompts, and activities can promote an individual’s independence and self-determination.
“A. Persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following, currently or by history (examples are illustrative, not exhaustive, see text): 1) deficits in social-emotional reciprocity... 2) deficits in nonverbal communicative behaviors used for social interaction..., 3) deficits in developing, maintaining, and understanding relationships...
B) Restricted, repetitive patterns of behavior, interests, or activities, as manifested by at least two of the following, currently or by history (examples are illustrative, not exhaustive; see text): 1) stereotyped or repetitive motor movements... 2) insistence on sameness, inflexible adherence to routines, or ritualized patterns or verbal nonverbal behavior... 3) highly restricted, fixated interests that are abnormal in intensity or focus... 4) hyper- or hyporeactivity to sensory input...“ (American Psychiatric Association, 2013)
Both definitions focus on the stereotypical social and communication deficits and the restrictive and repetitive behaviors. As the DSM-V stated, the list of behaviors are illustrative rather than exhaustive; being a spectrum and a heterogeneous group, individuals with autism spectrum disorder exhibit a wide array of symptoms within the definitions on a scale of severity.
Prevalence: The identification and diagnosis of autism spectrum disorder has been on the rise; once thought to be 6.5 in 10,000 children, and now estimated at 1 in 68, it is the fastest-growing disability category in special education. (Heward, 2009; Facts about Autism, 2012) While there are theories about the genetic, environmental, or other causes of ASD, the main theory about the rise in numbers is because of awareness and improvements in federal and state assessment procedures. (Heward, 2009) About 1 in 42 boy, five times more than girls, are more likely to be autistic. (Facts about Autism, 2012)
Symptoms: These lists of symptoms are illustrative rather than exhaustive; the different symptoms of ASD range in severity and degree depending on the individual. Most symptoms can be categorized into two main groups, social and communication deficits and behavioral. A social symptom of ASD is impaired social relationships. This symptom can occur as a lack of empathy, ability to think about others abstractly, recognition of gestures or expressions, or recognition of another individual’s presence. Young children with ASD do not exhibit joint attention where a child mimics the attention of an adult. Secondly, individuals with ASD can have communication and language deficits. About half of children with autism are mute, but they may hum or utter simple sounds; speech may occur in the form of echolalia and repetition of heard phrases. Children with ASD may best communicate through concrete concepts rather than abstract. (Heward, 2009) More other symptoms of ASD can be categorized as behavioral. First, children with ASD may be hyper responsive or under responsive to sensory stimuli; auditory and tactile sensations are most common. A second behavioral symptom is sameness and preservation where individuals exhibit patterned, predictable daily schedules, ritualistic routines, and repetitive behaviors. Additionally, a child may have a special interest area in minimal topics. Finally, stereotypical behaviors such as flapping hands, rocking back and forth, or repeating an action for long periods of time are often seen. (Heward, 2009)
Learning: Individuals with autism display varying levels of academic and intellectual ability. Some individuals diagnosed with autism may display severe or profound intellectual disabilities; while intellectual disabilities are on a spectrum of abilities, 40-80% of individuals with autism are considered to have mental retardation. (Heward, 2009) It is common for individuals with autism to have splinter skills where they perform significantly better in some areas rather than others; a very small percentage of individuals function with the realm of savant. Intellectual disabilities aside, there are several methods proven effective for instructing individuals with ASD. Early intensive programs with applied behavior analysis (ABA) can effectively decrease the impact ASD symptoms have on an individual. Both systems are scientific approach to designing, conducting, and evaluating instruction based on empirically verified principles describing functional relations between events in the environment and learning. The programs can improve IQ by 20 points, promote a familiarity with an academic setting, and prepare students for social/communication interactions. Many students in the intensive programs can merge with general education classrooms by kindergarten. The programs give them the equitable education and abilities needed to succeed in a general education/population setting. (Heward, 2009) Secondly, teaching the individual, not the disability, is an important practice with autism. Individualized and differentiated approaches to teaching can have a profound impact on the student’s self-efficacy, learning, and general achievement.
Strengths: A stereotypical behavior of autism spectrum disorder is a child’s special interest area (SIA). Considered a “dominant characteristic of over 90% of children and adults with Aspergers syndrome,” SIA can be used to great effect when teaching students with autism. (Heward, 2009) The process of using special interest areas in teaching is:
- identify a student’s interest area
- incorporate the SIAs into academics, curriculum, and social activities
- generate a behavior trap, a) baited with interest, b) only low-effort initial response, c) outside reinforcements to curriculum, d) SIAs remain effective over long time
- use bait judiciously
- don’t eliminate SIAs too early
- involve peers
- make small changes/add-ons
- evaluate SIA motivation over time (Heward. 2009)
With a special interest area drawing a student’s attention they are more likely to engage with the material, gain the skills they need to advance academically, and maintain their involvement with the class socially and academically.
Motivation/Attention: Because many students with autism have a strong focus on routines and repetitive behaviors, schedules and a predictable routine are important tools for motivating students with autism. Patterned and predictable behaviors can be used to a teacher’s advantage; knowing when a student is more active in their work can help a teacher better plan work time. However, students with autism can be prone to outburst and fits; some fits can last for hours. Teachers need to be proactive and predict where troubles may occur. If a change in the schedule will happen, giving the student advanced notice, or if a new topic is being introduced provide work with a connection to the student’s SIA. (Heward, 2009) Finally, building a student’s social, communication, sensory, motor, and emotional skills can better prepare a student with autism to be more flexible and in control of their actions.
Accommodations/Modifications: The first and most important modification for a student with autism is the individualized lessons and attention. Treating the student as an individual and catering to their needs is essential rather than teaching the disability. Also, because there is a wide range of severity and ability for students with autism, the following list of accommodation and modifications are illustrative and by no means absolute or comprehensive strategies for all students with ASD. First, some students with autism spectrum disorder would be best suited in a general education classroom. The social environment is considered by some to be an essential element in the development of important social skills, but as McConnell (2002) notes, “the data strongly suggests that inclusion is a necessary, but not likely sufficient, condition for social interaction interventions for young children with autism. (McConnell, 2002; Heward, 2009). Schwartz, Billingsley, and McBride note five strategies for teaching student with autism in a general education classroom:
- teach communication and social competence
- use instructional strategies that maintain the class’s natural flow
- teach and provide opportunities for independence
- build a classroom community that include all children
- promote generalization and maintenance of skills, (Schwartz, et el. 1998; Heward, 2009)
These strategies are great for students with autism who are in a general education classroom. The focus of the strategies is to develop social, communication, and essential skills. For other students with ASD, not in a general education classroom, there are other accommodations that may work better for their needs. Social stories can be a method of developing a student’s social and communication skills. Heward describes social stories as, “social stories explain social situations and concepts, including expected behaviors of the persons involved, in a format understandable to an individual with ASD.” (Heward, 2009) These are tools for helping individuals with ASD prepare for social encounters. They are stories told at the comprehension level of the individual wherein a series of basic sentence formats are presented as:
- descriptive sentences identify the contextual variables of the target situation
- directive sentences describe the desired behavior with respect to a specific social cue or situation
- perspective sentences describe the reactions and feelings of others about the situation
- affirmative sentences express shared beliefs or reference a rule or law about the situation. (Heward, 2009)
Finally, the use of assistive technology can greatly help students with autism. Because some students with autism have social deficits that can impact their interactions with others, the use of digital calendars, prompts, and activities can promote an individual’s independence and self-determination.
Attention Deficit/Hyperactivity Disorder (ADHD)
Definition: The DSM-V updated attention deficit disorder and attention deficit hyperactivity disorder to fall all under the title of attention deficit/hyperactivity disorder (AD/HD). (American Psychiatric Association, 2013) The definition now states:
“AD/HD is characterized by a pattern of behavior, present in multiple settings (e.g., school and home), that can result in performance issues in social, educational, or work settings. ...symptoms will be divided into two categories of inattention and hyperactivity and impulsivity that include behaviors like failure to pay close attention to details, difficulty organizing tasks and activities, excessive talking, fidgeting, or an inability to remain seated in appropriate situations. ...Children must have at least six symptoms from either (or both) the inattention group of criteria and the hyperactivity and impulsivity criteria, while older adolescents and adults (over age 17 years) must present with five.” (American Psychiatric Association, 2013)
Prevalence: The American Psychiatric Association estimates that between 3% and 5% of school age children are diagnosed with as AD/HD or presenting problems similar to that of AD/HD. Boys are four times more likely to be diagnosed with AD/HD than girls and younger children are diagnosed more often.
Symptoms: DSM-V states that children must present six traits and individuals over 17 must exhibit five to be diagnosed with AD/HD by a physician. The updated DSM-V lists the different symptoms and criteria for a diagnosis:
“People with ADHD show a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development: 1) Inattention: ...symptoms of inattention have been present for at least 6 months, and they are inappropriate for developmental level: fails to give close attention; trouble holding attention; does not seem to listen when spoken to directly; does not follow through on instructions; trouble organizing tasks and activities; reluctant to do tasks that require mental effort over a long period of time; loses things necessary for tasks and activities; easily distracted; forgetful in daily activities. [and/or] 2) Hyperactivity and Impulsivity: ...symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for the person’s developmental level: fidgets with or taps hands or feet, or squirms in seat; leaves seat in situations when remaining seated is expected; runs about or climbs in situations where it is not appropriate; unable to play or take part in leisure activities quietly; "on the go" acting as if "driven by a motor”; talks excessively; blurts out an answer; has trouble waiting his/her turn; interrupts or intrudes on others. ...In addition, the following conditions must be met: several inattentive or hyperactive-impulsive symptoms were present before age 12 years; several symptoms are present in two or more setting, (e.g., at home, school or work; with friends or relatives; in other activities); clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning; the symptoms do not happen only during the course of schizophrenia or another psychotic disorder. The symptoms are not better explained by another mental disorder.” (American Psychiatric Association, 2013)
The DSM-V also lists the different kinds/presentations AD/HD can take. “1) combined presentation: if enough symptoms of both criteria inattention and hyperactivity-impulsivity were present...; 2) predominantly inattentive presentation: if enough symptoms of inattention, but not hyperactivity-impulsivity...; 3) predominantly hyperactive-impulsive presentation: if enough symptoms of hyperactivity-impulsivity but not inattention... Because symptoms can change over time, the presentation may change over time as well.” (American Psychiatric Association, 2013) The inclusion and differentiation between attention deficits and/or hyperactivity over the course of a half year makes the diagnosis of AD/HD updated and hopefully more accurate with the new DSM.
A common treatment for hyperactivity and behavioral problems is stimulant medication. Drugs like Ritalin and other Schedule II stimulants are prescribed to increasing numbers of children over the past few decades; as Schedule II drugs, there is potential for abuse. First, the prescription of such stimulants is because children demonstrate impulsivity and behaviors that are troublesome to parents and teachers; second, many children with AD/HD show improved behavior while on the medication. Professionals are concerned about the long-term impact of such medications; research is still being done in the area. (Heward, 2009)
Attention/Learning: Students with attention deficit/hyperactivity disorder have a notoriously difficult time staying on task. The primary symptoms of AD/HD fall under the two categories of attention deficits and hyperactivity; both categories represent huge roadblocks for the student’s ability to pay attention in class. If symptoms are extreme, students can not only distract themselves, but their classmates, and the teacher on a regular basis. A non-medication treatment for behavioral troubles is applied behavior analysis (ABA), a scientific approach to designing, conducting, and evaluating instruction based on empirically verified principles describing functional relations between events in the environment and learning. ABA uses behavioral principles such as positive reinforcement to teach children skills in a planned, systematic manner. (Heward, 2009) Because the behavioral problems for AD/HD children appears to be in decision making, Barkley (2005) theorizes that a deficit in the child’s executive function, the ability to think through or control one’s actions causes the typical inattention and hyperactivity. (Heward, 2009) Neef, Bicard, and Endo have demonstrated how students with AD/HD can learn through behavioral training by reinforcing a “do-say” strategy of acting and describing the action verbally and a “say-do” strategy where a student states their intent and then acts. (Heward, 2009) A second activity to help students develop their self-monitoring skills is by using a timer and a track card where a student tracks their behavior at specific time intervals. By monitoring their actions the students become aware of when they are on- and off-task. These self-monitoring activities have shown to hold potential in helping students with AD/HD manage their inattention or hyperactivity.
Accommodations/Modifications: There are many different accommodations and modifications that a general education teacher can make to positively impact the behavior of students with AD/HD. Teachers can use behavioral interventions as well as strategies to help students with their, focus, social interactions, behavioral problems, and personal strategies. Some behavior strategies include: give clear guidelines and rules, promote and ignore positive and negative behaviors respectively, teach coping and self-management, proactively plan flexibility into lessons, break large concepts into smaller chunks, changing pace and activities regularly, giving intermittent breaks, remain present or close by, and hold students to high expectations. (Heward, 2009) To help students focus, teachers can utilizes strategies such as to-do lists, check-lists, schedules, timers and task sheets, and regular feedback on behavior. Finally, some social accommodations include: modeling positive behavior, providing clear expectations in group work, teaching self-monitoring skills, teaching proper reactions for activities, and behavioral training using applied behavioral analysis.
“AD/HD is characterized by a pattern of behavior, present in multiple settings (e.g., school and home), that can result in performance issues in social, educational, or work settings. ...symptoms will be divided into two categories of inattention and hyperactivity and impulsivity that include behaviors like failure to pay close attention to details, difficulty organizing tasks and activities, excessive talking, fidgeting, or an inability to remain seated in appropriate situations. ...Children must have at least six symptoms from either (or both) the inattention group of criteria and the hyperactivity and impulsivity criteria, while older adolescents and adults (over age 17 years) must present with five.” (American Psychiatric Association, 2013)
Prevalence: The American Psychiatric Association estimates that between 3% and 5% of school age children are diagnosed with as AD/HD or presenting problems similar to that of AD/HD. Boys are four times more likely to be diagnosed with AD/HD than girls and younger children are diagnosed more often.
Symptoms: DSM-V states that children must present six traits and individuals over 17 must exhibit five to be diagnosed with AD/HD by a physician. The updated DSM-V lists the different symptoms and criteria for a diagnosis:
“People with ADHD show a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development: 1) Inattention: ...symptoms of inattention have been present for at least 6 months, and they are inappropriate for developmental level: fails to give close attention; trouble holding attention; does not seem to listen when spoken to directly; does not follow through on instructions; trouble organizing tasks and activities; reluctant to do tasks that require mental effort over a long period of time; loses things necessary for tasks and activities; easily distracted; forgetful in daily activities. [and/or] 2) Hyperactivity and Impulsivity: ...symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for the person’s developmental level: fidgets with or taps hands or feet, or squirms in seat; leaves seat in situations when remaining seated is expected; runs about or climbs in situations where it is not appropriate; unable to play or take part in leisure activities quietly; "on the go" acting as if "driven by a motor”; talks excessively; blurts out an answer; has trouble waiting his/her turn; interrupts or intrudes on others. ...In addition, the following conditions must be met: several inattentive or hyperactive-impulsive symptoms were present before age 12 years; several symptoms are present in two or more setting, (e.g., at home, school or work; with friends or relatives; in other activities); clear evidence that the symptoms interfere with, or reduce the quality of, social, school, or work functioning; the symptoms do not happen only during the course of schizophrenia or another psychotic disorder. The symptoms are not better explained by another mental disorder.” (American Psychiatric Association, 2013)
The DSM-V also lists the different kinds/presentations AD/HD can take. “1) combined presentation: if enough symptoms of both criteria inattention and hyperactivity-impulsivity were present...; 2) predominantly inattentive presentation: if enough symptoms of inattention, but not hyperactivity-impulsivity...; 3) predominantly hyperactive-impulsive presentation: if enough symptoms of hyperactivity-impulsivity but not inattention... Because symptoms can change over time, the presentation may change over time as well.” (American Psychiatric Association, 2013) The inclusion and differentiation between attention deficits and/or hyperactivity over the course of a half year makes the diagnosis of AD/HD updated and hopefully more accurate with the new DSM.
A common treatment for hyperactivity and behavioral problems is stimulant medication. Drugs like Ritalin and other Schedule II stimulants are prescribed to increasing numbers of children over the past few decades; as Schedule II drugs, there is potential for abuse. First, the prescription of such stimulants is because children demonstrate impulsivity and behaviors that are troublesome to parents and teachers; second, many children with AD/HD show improved behavior while on the medication. Professionals are concerned about the long-term impact of such medications; research is still being done in the area. (Heward, 2009)
Attention/Learning: Students with attention deficit/hyperactivity disorder have a notoriously difficult time staying on task. The primary symptoms of AD/HD fall under the two categories of attention deficits and hyperactivity; both categories represent huge roadblocks for the student’s ability to pay attention in class. If symptoms are extreme, students can not only distract themselves, but their classmates, and the teacher on a regular basis. A non-medication treatment for behavioral troubles is applied behavior analysis (ABA), a scientific approach to designing, conducting, and evaluating instruction based on empirically verified principles describing functional relations between events in the environment and learning. ABA uses behavioral principles such as positive reinforcement to teach children skills in a planned, systematic manner. (Heward, 2009) Because the behavioral problems for AD/HD children appears to be in decision making, Barkley (2005) theorizes that a deficit in the child’s executive function, the ability to think through or control one’s actions causes the typical inattention and hyperactivity. (Heward, 2009) Neef, Bicard, and Endo have demonstrated how students with AD/HD can learn through behavioral training by reinforcing a “do-say” strategy of acting and describing the action verbally and a “say-do” strategy where a student states their intent and then acts. (Heward, 2009) A second activity to help students develop their self-monitoring skills is by using a timer and a track card where a student tracks their behavior at specific time intervals. By monitoring their actions the students become aware of when they are on- and off-task. These self-monitoring activities have shown to hold potential in helping students with AD/HD manage their inattention or hyperactivity.
Accommodations/Modifications: There are many different accommodations and modifications that a general education teacher can make to positively impact the behavior of students with AD/HD. Teachers can use behavioral interventions as well as strategies to help students with their, focus, social interactions, behavioral problems, and personal strategies. Some behavior strategies include: give clear guidelines and rules, promote and ignore positive and negative behaviors respectively, teach coping and self-management, proactively plan flexibility into lessons, break large concepts into smaller chunks, changing pace and activities regularly, giving intermittent breaks, remain present or close by, and hold students to high expectations. (Heward, 2009) To help students focus, teachers can utilizes strategies such as to-do lists, check-lists, schedules, timers and task sheets, and regular feedback on behavior. Finally, some social accommodations include: modeling positive behavior, providing clear expectations in group work, teaching self-monitoring skills, teaching proper reactions for activities, and behavioral training using applied behavioral analysis.