Attention Deficit Disorder
Mark is a 10-year-old Latino boy in a general education fifth-grade classroom. Mark’s class includes a special education teacher who conducts small group reading and math classes within the general classroom and a primary general education teacher who led most class activities. He is disorganized, uncoordinated, clumsy and chaotic. Mark has problems organizing his equipment and books and settling down to tasks at classroom. His difficulties in fine motor skills demonstrate in his laborious and sluggish handwriting and his inability to copy letters at an average pace. Mark has a poor visual and auditory memory resulting in complexities remembering along with a lack of concentration, planning ahead and following instructions. Mark avoids sport at all cost as his lack of balance, co-ordination and insensitivity to spatial awareness makes him feel inadequate in front of his peer group.
Mark’s elementary public school ranged from kindergarten to 5th grade. 30 percent of the kids in the school were eligible for free school dinner. Mark’s teacher uses a conventional classroom format and arranges classes by combining whole-class, small-group activities and independent work. In the morning, kids are required to independently complete 3 to 4 small projects listed on the chalkboard and then change to math groups or small reading. The day activities usually consisted of science projects or social studies conducted in a large group format. Usual day activities involve fifteen minutes of large-group teaching and forty-five minutes of individual or small-group work.
Mark is an only child. His parents had a strong marriage and regularly engaged Mark in family activities. Parents both work full-time; his mother teaches English language, and his father works as engineer. His mother finished college, though she recalled struggling with mathematics. Mark’s mother described herself as a “worrier” and approved fears about meeting novel people, flying and taking holidays. Mark’s father finished high school but recalled struggling with reading. He took individual reading classes beginning in elementary school, but as an adult, he rarely read a newspaper or a novel. He reminded that teachers told his parents that he was “hyperactive” and that his poor attention and overactivity in class weakened his education.
Mark’s pediatrician diagnosed him with Attention Deficit Disorder (ADD) during the first half of the school year using an interview with close relatives and teacher and parent rating scales (Achenbach, 1991). Mark is not medicated with stimulants. Owing to his classroom problems with behavior and poor academic development, the commission on special education classified Mark as “Other Health Impaired”. This paper will describe the pre-referral, referral and evaluation processes and develop an Individualized Education Program for the reason that his learning problems and behavior affected his academic development.
The present intervention is a daily behavior sheet that targeted 5 posted classroom rules: “work silently”, “finish work in the time provided,” “follow instructions,” “keep on task” and “cooperate with adults and peers.” Following each activity, Mark and his teacher met for a short time and discussed whether he thought he met each target on his sheet. If both of them reached consent that he met his behavioral objectives, he could color in a four-sided figure on a sheet of graph paper. Once he colored in a prearranged number of quadrangles, he could receive a reward (e.g., credits). The typical latency to receiving a reward was planned to be approximately 2 weeks. Although teachers offered even better rewards (e.g., trading cards), nothing else motivated Mark.
Additionally, Mark prioritized his classroom occupations according to significance based upon ascribed meaning. For example, Mark was on probation and needed community service hours. On occasion, his classroom occupations in his art class consisted of cleaning, which was a means of satisfying his need for hours. This took precedence over his need for earning credits at the start of the study. Yet, his goal of earning credits was a factor that contributed to how he constructed his classroom occupations. He was aware of his current credit status and was tracking his progress to the 0,5-degree of accuracy. He did not see electives as a necessary part of his learning experience and the curriculum, given his need to earn credits for graduation. Despite his steady progress toward maximizing credits earned he perceives his situation in accurate terms, …”I am still behind” but fails to see the validity of earning credits in electives, and asserts that he has no voice in the decision of selecting his classes.
Traditionally, electives tend to be less demanding courses and more geared toward students’ specific interests, such as art, woodshop, or printing. Mark did not identify any benefits in taking elective classes. This consistent theme of contrasts continued throughout the study. Art class is where Mark feels connected with a teacher that cares for him, and the course was the only one he asserted could be worked at his own pace, a preferred work mode for Mark. As was the case in his English class he made decisions to work independent of the class, or copy someone else’s work in order to earn credits as quickly as possible.
Referral and evaluation process
After the initial meeting Mark’s primary general education teacher and the special education teacher (who educated Mark’s small math and reading groups in the morning), baseline procedures were collected. The educators in this meeting were presented with information that specified Mark’s current levels of on-task behavior and disruptive and the group norm for on-task and disruptive behavior. Given that Mark’s behavior was outside the class standard for both categories, the counselor suggested some adjustments to the present behavioral intervention. These propositions aimed to adjust probable consequences and antecedents of Mark’s harmful behavior.
The counselor suggested diminishing the latency to reward for Mark. While he had yet to experience a reinforcer for his actions, consistent and frequent rewards might develop his behavior. Mark’s educators were unwilling to provide big, tangible rewards on a daily basis but agreed to make a daily activity dependent on suitable behavior. Mark got pleasure from playing his hand-held computer game, and, when asked, Mark reported that he would like to obtain computer game time during a dinner and prior to dismissal.
Therefore, it was decided that access to his hand-held computer game would be made dependent on meeting three fourths of his daily behavior targets. The intervention firstly aimed only Mark’s afternoon behavior, but because of the accomplishment of this afternoon intervention, it was ultimately modified to give an opportunity to play his computer game in the afternoon and morning. The objective of this adjustment was to augment the frequency of affirmative effects earned for proper behavior.
Throughout baseline, Mark’s teachers continued to utilize the scheme of weekly rewards, and he received no rewards throughout this phase. The use of his hand-held computer game throughout this time was non-contingent. During the intervention conditions, Mark’s teacher placed a checkmark on his daily behavior sheet if he received his daily reinforcer(s), and Mark was not consented to access to the computer unless he met the operationalized behavior prospects. To make certain Mark did not have right to play with his computer unless he earned it, his instructor kept it in his school desk except for the times Mark received his reward.
The augmented chance to earn rewards together with specific behavioral objectives and direct feedback would advance the efficiency and success of the classroom behavior modification program. In this case a various baseline design through activities is used (afternoon and morning activities; Kazdin, 1998). Following conducting a baseline evaluation, the intervention began in the morning and finally included the afternoon in addition.
Additionally, though Mark’s parents gave their consent to make access to the computer game dependent on his behavior in classroom and were informed of Mark’s advancement by his teacher, they was not straightly involved in the intervention. Mark’s parents were very busy on their work, and they could not be present at meetings throughout the school day. Parental involvement is a significant predictor of long-term academic result (Jimerson et al., 2000), and lack of parent participation in this case is an additional limitation.
Mark’s history points to a reading inability, one that damages his comprehension and fluency. Inclusive testing in this area is crucial to identify while he needs assistance. If he is doing well in spelling, his word-recognition/ memory /phonics skills may be dishonestly standard and could disguise this weaknesses. Depending on the outcomes of these tests, a reading expert at school may be able to provide assistance or the family may be able to organize a reading program after school. Preferably, Mark’s parents will be able to work with him and may be able to immediately work on comprehension through reading aloud to them at home, followed by discussing stories and asking questions. If Mark has a considerable problem in reading, he will also need support in these subjects if he is falling behind. An in-school tutor or homework tutor may be supportive.
Mark needs an evaluation for learning deficits and strengths and the symptoms that imply nervousness and ADD. The focus of the assessment should be on the impact they have on his success and efficiency in socialization and learning. Making clear of Mark’s condition directed at both the child and his parents can initiate the progression of success. Behavioral and environmental changes, with classroom accommodations, can bring advances in quality of being and self-esteem.
Individual Education Plan (IEP)
Mark is a lively, impulsive, sensitive, verbally versed ten-year-old of high cleverness with a wide common knowledge and comprehension that would put many adults to shame. Mark’s parents noticed that he memorizes “everything” in detail. Mark is very garrulous, and has a great sense of humor. Mark loves to speak in groups. He enjoys crafts of all types and playing on computer. He is fond of music. His beloved television programs are educational ones, from which he seems to discover a lot of info straightforwardly. He has made a number of extensive presentations to his peers based on what he has studied from such programs. Among all family members relationships are considered to be tremendous. He takes part in classroom and family activities.
Mark was firstly referred to the behavioral counselor because of troublesome behavior in classroom. Teachers described his impairing activities as producing poor academic work, getting out of his seat without consent, interrupting teachers, talking back to teachers when corrected, being disobedient and teasing peers. These actions resulted in academic and social impairment. Mark’s teachers conveyed that other peers did not want to work with or sit near Mark, and the teachers frequently became annoyed with his classroom distraction. Academically, he was competent in many actions, but because he was often off task, he failed to follow instructions on assignments or did not complete his work.
Mark’s academic work is measured normal by his teacher in most areas, although weakest in reading and spelling. Mark is mainly tough in verbal expression and noted to have outstanding knowledge and vocabulary. He was uncertain to take part in-group activities and often needed substantial encouragement. In contrast, Mark was noticed to be liked by his classmates despite he was a bit troublesome. His major weak points were considered to be in attentional and organization skills. Handwriting is slow and difficult, and therefore written work is a special challenge.
The inclusion or pullout services needed should include small group teaching in reading and mathematics with an individual education instructor. Then, speech class once a week, and the provision of a behavior sheet on a daily basis (O’Leary et al., 1976) with a chance to receive weekly or biweekly classroom-based rewards. Mark would benefit from personal therapy, and this should be started without medication. He may also obtain benefits from resource-room services. The psychotherapy will help Mark understand his learning divergences.
Within 1 year Mark will recognize words at the next grade level with only 6 mistakes per 100 word reading passage. He should be assessed on a weekly basis by oral reading tests, observation and charting of words.
Kazdin, A. E. (1998). Research design in clinical psychology. (3rd ed.). Boston: Allyn ; Bacon.
Jimerson, S. A., Egeland, B., Sroufe, L. A., ; Carlson, B. (2000). A prospective longitudinal study of high school dropouts: Examining multiple predictors across development. Journal of School Psychology, 38, 525–549.
O’Leary, K. D., Pelham, W. E., Rosenbaum, A., ; Price, G. (1976). Behavioral treatment of hyperkinetic children: An experimental evaluation of its usefulness. Clinical Pediatrics, 15, 510–514.
Achenbach, T. M. (1991). Manual for Teacher Report Form and 1991 profile. Burlington: University of Vermont, Department of Psychiatry.