Why Can’t Johnny Sit Still? ADHD and How it Affects Your Child’s Classroom Behavior

 

A parent asked me this the other day:  She and the teachers were so frustrated with her son’s behavior.  It turns out that “Johnny”, as he is known in this blog, is a bright child with Attention Deficit Hyperactivity Disorder (ADHD).  Luckily for him, his parents, and his teachers, he is not alone and there are many well-validated interventions to get him to “sit still”. Johnny is just one of the estimated 8-10% of school aged children who have a diagnosis of ADHD.  The DSM-IV, which is the diagnostic manual for all mental health disorders, indicates that there are several symptoms of ADHD including:  inattention, impulsivity, and hyperactivity.

Once the diagnosis of ADHD has been made by a pediatrician, psychiatrist, or psychologist, the next step is to develop the most efficacious and lasting intervention plan.  Typically, the intervention plan should be applied across multiple settings, including:  home, school, and the child’s social environment.

The American Academy of Pediatrics published a best practice paper for the intervention of ADHD in 2001.  In a nutshell, the paper states that the two primary interventions for ADHD include the use of stimulant medication and behavioral therapy.  Donna Palumbo, a neuropsychologist from New York, wrote a chapter in a Pediatric Neuropsychology Textbook in 2007 that updated the AAP practice guidelines to include parent training and social skills training in addition to the already mentioned stimulant medication and behavior therapy.  The one area that was left off of everything is the child’s school performance.  Children with ADHD frequently exhibit deficits with their performance in the classroom setting.  They have trouble focusing on the teacher’s lectures, and often exhibit co-existing learning disorders.   Previous blogs of ours have described the Individual Education Plan (IEP) and 504 Plan process two extremely important aspects of the child’s plan for school success.  However, the child’s academic performance and behavior within the classroom must be an area that is addressed.  Children with ADHD do need help receiving behavior strategies in school.  It is imperative that the behavior therapist working with the child provide support for the academic team to ensure that he or she progresses to potential.

What behavior strategies have or have not worked for your child with ADHD at school?


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11 replies
  1. maureen evans
    maureen evans says:

    My youngest son Matthew was involved in a study during third grade. His teacher noticed that a high percentage of boys ( and some girls) could not sit still or focus during the reading period. She had read that if kids have some small physical release while reading, comprehension went way up. She bought 8 large exercise balls and set very strict rules for their use. The students could sit and roll “gently” but if they bounced, they were not allowed to participate! This mini-experiment was a huge success!! The students involved experienced a definite improvement in their reading scores by simply channeling that extra energy! That same teacher used peppermint to revive sleepy students at 2:oo pm!! Matthew loved that classroom!

    Reply
    • Greg Stasi
      Greg Stasi says:

      Maureen,
      Thank you for sharing your story. It is great to hear about teachers who “get it” and will go out of their way to help the children.

      Reply
  2. Dana Nadel
    Dana Nadel says:

    The American Journal of Occupational Therapy published a 2003 research article written by Denise Lynn Schilling, Kathleen Washington, Felix F. Billingsley and Jean Deitz that identified therapy balls versus chairs in the classroom increased positive seated behavior and handwriting legibility of students with ADHD. Some of the behaviors that were recognized while the subjects were seated in chairs during school included sleeping, disruptive out-of-seat activities and constant motion. However, use of therapy balls instead of chairs diminished these behaviors and increased the subjects’ attention. There are a number of different classroom strategies that work for children with ADHD and therapy balls as chairs is an example of one of these great tools!

    Schilling, D.L., Washinton, K., Billingsley, F.F., & Deitz, J. (2003). Classroom seating for children with attention deficit hyperactivity disorder: Therapy balls versus chairs. American Journal of Occupational Therapy, 57, 534-541.

    Reply
  3. Lyndsay Sarra
    Lyndsay Sarra says:

    In regards to behavior therapy, I have found that children with ADHD need to be involved in consistently self-monitoring their own behavior with adult support. In the past, I have used vibrating watches to remind them to “check their behavior”. Allowing them to set their own goals and visually displaying their acheivements is also helpful. Rewards have to be VERY motivating and they need to be able to receive them quickly. These kiddos can’t wait a month or sometimes even a week for their “pay off” of demonstrating positive behavior.

    Reply
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