Tutoring Students With ADHD By Kenneth Stefano, PsyD [email protected].

Tutoring Students Tutoring Students With ADHDWith ADHD

ByBy

Kenneth Stefano, PsyDKenneth Stefano, [email protected]@spodakstefano.com

What is ADHD?What is ADHD?

Attention-Deficit/Hyperactivity DisorderAttention-Deficit/Hyperactivity Disorder ATTENTIONATTENTION

• Focus, concentration, screening out/ignoring distractionsFocus, concentration, screening out/ignoring distractions DEFICITDEFICIT

• Inaccurate name – more a problem with regulating attentionInaccurate name – more a problem with regulating attention HYPERACTIVITYHYPERACTIVITY

• Restless, fidgety, impulsive, poorly controlledRestless, fidgety, impulsive, poorly controlled DISORDERDISORDER

• Causes problems in school, home, and/or communityCauses problems in school, home, and/or community

What is ADHD?What is ADHD?

ADHD is ADHD is NOTNOT the result of: the result of: LazinessLaziness Poor nutritionPoor nutrition Bad parentingBad parenting Lack of self-disciplineLack of self-discipline

ADHD is the result of:ADHD is the result of: Heredity (your genes) and biology (how your Heredity (your genes) and biology (how your

brain develops)brain develops)

What Causes ADHD?What Causes ADHD?

Top 3 genetically predisposed disordersTop 3 genetically predisposed disorders 65-75 percent of cases65-75 percent of cases

Many genes under investigationMany genes under investigation Probably a combination of genes needed Probably a combination of genes needed

to develop ADHDto develop ADHD Cause areas of brain to develop differentlyCause areas of brain to develop differently

Motor areas develop fasterMotor areas develop faster Control areas develop slowerControl areas develop slower

BiologyBiology

Some ADHD is biologicalSome ADHD is biological About 25-30 percent, due to :About 25-30 percent, due to :

Premature birthPremature birth Exposure to toxinExposure to toxin

Alcohol, cigarettes, lead, infectionAlcohol, cigarettes, lead, infection Brain injuryBrain injury Side effect of cancer chemotherapySide effect of cancer chemotherapy

3 Types of ADHD3 Types of ADHD

Hyperactive-Impulsive TypeHyperactive-Impulsive Type Fidgets and squirmsFidgets and squirms Can’t stay seatedCan’t stay seated Runs, climbs, or acts restlessRuns, climbs, or acts restless Talks excessivelyTalks excessively Blurts out answers Blurts out answers Can’t wait turnCan’t wait turn Interrupts or intrudes on othersInterrupts or intrudes on others

3 Types of ADHD3 Types of ADHD

Inattentive TypeInattentive Type Makes careless mistakes/misses detailsMakes careless mistakes/misses details Difficulty sustaining attention or listeningDifficulty sustaining attention or listening Does not follow through with or finish tasksDoes not follow through with or finish tasks Difficulty organizing tasks/activitiesDifficulty organizing tasks/activities Avoids homework, chores, other boring tasksAvoids homework, chores, other boring tasks Loses things easilyLoses things easily Easily distracted by sights, sounds, etc.Easily distracted by sights, sounds, etc. ForgetfulForgetful

3 Types of ADHD3 Types of ADHD

Combined TypeCombined Type A combination of inattentive and hyperactive-A combination of inattentive and hyperactive-

impulsive symptomsimpulsive symptoms Most common typeMost common type

What Does ADHD Look Like?What Does ADHD Look Like?

Tapping desk, shaking feet, swinging legsTapping desk, shaking feet, swinging legs Can’t stay seatedCan’t stay seated

Goes to bathroom, gets a drink, etc.Goes to bathroom, gets a drink, etc. Rushes through workRushes through work

Makes careless errorsMakes careless errors Can’t stop talkingCan’t stop talking

InterruptsInterrupts Starts conversationsStarts conversations

What Does ADHD Look Like?What Does ADHD Look Like?

Works slowlyWorks slowly Acts bored, wants to stop earlyActs bored, wants to stop early Responds to sounds, sights, etc.Responds to sounds, sights, etc. Asks off-topic questionsAsks off-topic questions Is not preparedIs not prepared

Doesn’t have materialsDoesn’t have materials Doesn’t know assignmentDoesn’t know assignment

Gets easily frustratedGets easily frustrated

What Does ADHD Look Like What Does ADHD Look Like

Inconsistent performanceInconsistent performance Some days student works well, other days Some days student works well, other days

student can’t focus at allstudent can’t focus at all Forgets previously learned proceduresForgets previously learned procedures

StrategiesStrategies

Check in with parentCheck in with parent Did student take medication today?Did student take medication today? How was student’s day at school?How was student’s day at school? Has student had a snack, play break, etc. Has student had a snack, play break, etc.

before session?before session? What strategies do parents use to help What strategies do parents use to help

student focus/behave?student focus/behave?

StrategiesStrategies

Be preparedBe prepared Have extra supplies handy (e.g., pencils, Have extra supplies handy (e.g., pencils,

erasers, calculator, etc).erasers, calculator, etc). Bring along a “fidget toy” (e.g., stress ball or Bring along a “fidget toy” (e.g., stress ball or

Koosh ball) so student can channel excess Koosh ball) so student can channel excess energy.energy.

Have clear expectations for behaviorHave clear expectations for behavior• Provide a list of “rules”Provide a list of “rules”• Make rule list visibleMake rule list visible

StrategiesStrategies

Communication skillsCommunication skills Speak softly and slowlySpeak softly and slowly Get eye-contact before speakingGet eye-contact before speaking Move closer to student when giving instructionsMove closer to student when giving instructions Have student repeat instructionsHave student repeat instructions

StrategiesStrategies

Communication skills, cont.Communication skills, cont. Provide frequent praiseProvide frequent praise Be clear and firm when student gets off taskBe clear and firm when student gets off task Tell student what you want them to DO, not Tell student what you want them to DO, not

what you want them to NOT DOwhat you want them to NOT DO• E.g., say “please sit still” instead of “stop fidgeting”E.g., say “please sit still” instead of “stop fidgeting”

StrategiesStrategies

Be organizedBe organized Have a schedule of the session’s activities.Have a schedule of the session’s activities. Make the schedule visible (allow student to Make the schedule visible (allow student to

cross off activities as session progresses)cross off activities as session progresses) Change activities often – at least every 15 Change activities often – at least every 15

minutesminutes Provide “reward” at end of session if student Provide “reward” at end of session if student

is compliant (e.g., listen to a song, play a is compliant (e.g., listen to a song, play a quick game of Uno, etc.)quick game of Uno, etc.)

StrategiesStrategies

Manage the environmentManage the environment Minimize distractions Minimize distractions

• No TV's/radios onNo TV's/radios on• Have session in low traffic areaHave session in low traffic area

Keep work area clear Keep work area clear • Only have out what you are working onOnly have out what you are working on

Present only a few problems at a timePresent only a few problems at a time• Rewrite problems from a work sheet onto several sheetsRewrite problems from a work sheet onto several sheets

Allow student to stand while working or walk around in Allow student to stand while working or walk around in between problems between problems

StrategiesStrategies

Build in breaksBuild in breaks Allow for brief movement between activitiesAllow for brief movement between activities

• Jumping jacksJumping jacks• Healthy snackHealthy snack

For younger students (5For younger students (5thth-6-6thth grade) grade) Consider using a sticker or token chart Consider using a sticker or token chart Use a clock/timer to help student stay on taskUse a clock/timer to help student stay on task

Take AwayTake Away

1.1. ADHD kids are not lazyADHD kids are not lazy

2.2. Be PreparedBe Prepared

3.3. Be creative and flexibleBe creative and flexible