A mother duck is leading her eight ducklings across the Charles River. All fall dutifully in line behind their mother, single-file—except for one. The last little duckling lags behind, as the others dash forward. Does this scene from Robert McCloskey's Make Way for Ducklings sound familiar? In many classrooms, a similar scene plays out. Some children come to school alert and primed to learn. A few, however, seem to lag behind, distracted by the peripheral events of the classroom.
A New Student
Diana had transferred to our middle school from another school in the greater New York City area. She had dark, expressive eyes that sparkled when she talked. And love to talk, Diana did—with her teachers and with her peers. She flitted, like a butterfly, around the fringes of the classroom, pausing for brief exchanges with small groups of students huddled in conversation.
In September, Diana's parents informed the school that she had been officially diagnosed as having Attention Deficit Disorder (ADD). They also notified the school that she was under the treatment of a child psychologist and a psychopharmacologist. Her parents and the school psychologist asked us to fill out several checklists and to keep anecdotal notes of Diana's classroom behavior to assist her doctors in finding an optimal dosage of Ritalin, prescribed to improve her concentration.
Several questions weighed on my mind: How do we, as teachers, respond to Diana's needs? What other professionals must become involved and in what capacity? I have since become familiar with some of ADD's telltale signs: inability to follow directions, fidgetiness, excessive talking, disorganization, and inattentiveness (Goldstein and Goldstein 1992). But at the time, I felt unprepared to deal with Diana's learning challenges.
Meet Diana
Let's just say that Diana was not a morning person. At 8:15, she would enter the classroom and stand near the doorway or by her desk, a faraway look on her face, until I came over to greet her and to give her explicit directions: “Good morning, Diana. Please unpack and put away your things.”
Once her initial dreaminess faded, Diana gravitated toward my desk, where she would often entertain me with about 15 minutes of questions and conversation. Other mornings, she traipsed back and forth between her desk and mine. When I was noticeably busy, Diana would hover until I could attend to her. She seemed to value individual attention more than most students.
Her speech was punctuated with frequent pauses and choppy sentences. Often Diana would halt in mid-thought, forget what she was about to say, and take off on a tangent. When I reminded Diana of her initial train of thought, she would say, “Oh, yeah!” and flash a silly grin. Listening to Diana, one might say, required patience.
Diana also had some mild fidgety habits, like playing with her hair, but these behaviors were not excessive. Often, she focused her attention around her desk area, rather than on the teacher. She was also easily distracted by nearby students. Even if her neightbors were only rearranging their books, Diana would fixate on what they were doing. She was rarely a distraction to her classmates—just to herself.
My first impression of Diana academically was that she was not a very strong student, or, if she was, she was having difficulty adjusting to a new school. She often missed what had been said and needed instructions repeated. Diana's difficulty in completing homework assignments stemmed mainly from her neglect to copy the specifics from our homework board.
Socially, Diana was somewhat immature and sensitive. Once, during an overnight class trip, she became homesick and extremely distraught. On some other occasions, Diana became upset when her classmates refused her social initiatives. Though Diana spoke openly of her ADD, sometimes it would get to her. One day she burst into tears as we rearranged classroom seats: “Why do I always have to sit in the front?”
By mid-November, nearly all of Diana's major subject area teachers were concerned about her progress. Though her intelligence was average to above average, according to her records, Diana had received mostly Cs in the previous year—and this semester looked to be no different. Her parents desperately wanted Diana to achieve some degree of academic and social success in her new environment.
Getting Diana's Attention
Diana's other teachers and I spoke frequently with her parents. The school set up a team meeting with the school's psychologist, her psychologist, her psychopharmacologist, and the after-school tutor Diana's parents had hired to help with her homework. Diana was fortunate: her parents took a proactive approach toward helping her. Still, she was not achieving the level of success we had all hoped for. Her difficulties spanned the subject areas, with particular problems in math and language arts.
In math, her first-quarter scores fell significantly below those of her peers, and her errors followed no pattern. During tests, Diana's attention wandered, and even though she claimed to have checked her work, mistakes filled her papers. And there was little point in reviewing a failed exam with Diana—she didn't make the requested corrections at home.
In language arts, rather than read the assigned text, Diana would fabricate parts of the story, or invent answers with no correlation to the material at hand. She failed tests of reading comprehension and barely passed her week vocabulary quizzes. What could we do?
Though it may sound obvious, part of helping students with attention deficit disorder get on the track to success is catching their interest. I was able to accomplish this in math class through Diana's interest in Marilyn Burns's books. One day, she brought one of the texts from home. (“Aha!” I thought to myself. “She doesn't hate match after all.”) Soon, Diana and her mother were off to the bookstore to buy more books by Burns. Several times, I asked Diana to present brief mini-lessons from these texts. Having the opportunity to be the resident math expert bolstered Diana's self-confidence and gave her positive attention from her peers.
A Collaborative Quest
For Diana to succeed in mathematics, she was going to need some reinforcement outside of the classroom. Though I often observed her taking good notes and attending to discussions, she often went home and promptly forgot what she had learned.
To reinforce her daily schoolwork, Diana's father agreed to work with her every night, using a duplicate math text. This extra attention from her father led to a dramatic change in both Diana's homework and her classroom performance. Along with these improvements, her test scores became As, with one test skyrocketing to 102. After I phoned to tell her of this success, Diana sent me this note: Dear Miss Shima,I never thought I would get a nicest teacher as you.With Love, DianaP.S. It was very nice of you to call me and tell me the good news about my Math test than waiting for the next day. THANKS!
These grades were not just flukes. Evidence of Diana's thorough work, advanced logical thinking, and abstract reasoning skills was present in these much-improved test scores. As Diana's written math work improved, so did her classroom performance. And this success spilled over into other subject areas.
More Strategies for Success
Just as Diana's father helped reinforce her math skills, a new, at-home tutor helped Diana strengthen specific language arts skills. She worked on strategies such as reading for the main idea, summarizing selected passages, and completing vocabulary drill exercises. Again, her work improved from failing levels to passing scores.
Meanwhile, I was struggling to help Diana organize her homework assignments. In addition to forgetting to copy down the assignments and bring her work in the next day, Diana's mother told me that she wandered throughout her home while trying to complete her assignments. Clearly, she could not keep track of materials in such a peripatetic study environment. I reemphasized to her parents the need for a quiet place where Diana could concentrate and complete her assignments in an organized fashion.
The school's assignment pad, I discovered, was disorienting for Diana. It contained too many lines in too little space, and the subject order often did not correspond to Diana's daily schedule. I developed a simple spreadsheet of her weekly classes. I told Diana that she would be responsible for copying assignments onto the spreadsheet and then asking her teachers to initial them. She had to note the entire assignment, receive the appropriate signature, and provide a daily record for her parents and teachers.
Diana found some subjects easy to learn. Social studies was an early favorite. Her fascination may have stemmed from a classroom discussion about a famous family whose surname was similar to her own. The intense, personal interest enticed Diana, and she was captivated. In science class, hands-on, experimental classroom activities grabbed her attention. In addition to becoming more focused, Diana proved herself a leader in carrying out group lab experiments.
A Trio of Techniques
- Evaluation and remediation. Although she scored in the average range on standardized tests, Diana's academic performance was below her tested ability. We approached evaluation and remediation as a team. We felt that Diana was capable of changing her classroom performance, based on prior evaluations done by checklists (McCarney 1989) and assessments of anecdotal transcripts by her teachers.
- Behavioral therapy. Regular meetings with her psychologist helped Diana deal with both direct and indirect issues of ADD—for example, picking up on social cues in conversation, maintaining focus and attention in the classroom, and becoming more responsible as a student. With several years of poor academic and social standing behind her, Diana's self-esteem was also suffering. The meetings with her psychologist gave Diana an outlet for feelings and frustrations stemming from ADD. Overall, Diana gained a stronger sense of herself, her needs, and her emotions.
- Medication. Though many parents and educators are hesitant to involve children in a regular course of drug therapy, Ritalin—when properly regulated—is often beneficial to ADD sufferers. It was to Diana. The theory is that stimulant drugs, such as Ritalin, affect behavior by activating the attention center of the brain stem. Thus, initial, mild side effects can include poor appetite, insomnia, and mild irritability. Most physicians begin with the lwest dosage of Ritalin possible and adjust the levels of medication until the child's outward behavior becomes more appropriate and side effects lessen or cease. The importance of close physician supervision of the drug cannot be overemphasized, as Ritalin, like all similar drugs, can have serious side effects.A challenge throughout the school year was ensuring that Diana received her noontime dose of Ritalin from the school nurse. Often Diana would forget to visit her nurse, at which point I would remind her or the nurse would track her down. Other times, she remembered to go, but the nurse would be away from her office. It was a daily cat-and-mouse game, but checking to make sure that Diana received her daily dosage became part of my routine.
Diana's Way
- Create interactive, hands-on lessons. Whether through a cooperative learning activity, lab work, or role-play, the more we engaged Diana, the more focused she became.
- Restate directions often. We became extremely explicit in our directions (often to the benefit of the whole class). By restating instructions and asking Diana to paraphrase what we wsaid, we did our best to ensure that she understood what was expected of her.
- Create graphic organizers. Diana's use of a homework spreadsheet helped her organize and monitor her work, thus becoming a more responsible learner.
- Actively solicit student participation. We called on Diana often to provoke high levels of participation. Doing this during classroom discussions focused her attention and gave us a good idea of her immediate comprehension.
Throughout the year, Diana's improved performance across subject areas gave her a sense of ownership for her academic progress. Working closely together, Diana's teachers, parents, and in- and out-of-school specialists provided a learner-centered, focused, and individualized attention that was crucial to Diana's metamorphosis. Her father reinforced this fact in a recent letter in which he wrote, “I can never remember a time when Diana's confidence has been so high and she has felt so good about herself.”
My graduate training hadn't prepared me to have Diana in my classroom. In retrospect, what I needed was a list of best practices to guide me in structuring her day-to-day learning. Along the way, Diana's other teachers and I discovered that best practices can often be found within the boundaries of good teaching. I hope these suggestions will help others who are struggling to make their classrooms a better place for students with ADD.
