Strengths and Ideas

In doing some recent observations in a variety of preschool classrooms, I developed some general feedback in regards to things that were going well for teaching and managing behavior in the classroom, and some ideas to try / areas to watch...  Here is that information which may be helpful for others to use for ideas, strategies, etc....  Many of the items are easily adaptable for classrooms beyond preschool age as well....

 Folks are welcome to add their ideas / strategies as well!


Great! Keep It Up! :


• Giving each child a small sticker for staying on their spot during circle time


• Prompting & modeling kids to ask to use an item, share, etc.


• Having the class cheer for and praise other children
    o Ex: child doesn’t want to do their job or sit for circle and, despite a protest, they comply – the other children clap, cheer, say ‘thank you,’ etc.

• Having a ‘quiet area,’ bean bag, etc for calming bodies / taking a break

• Using a visual schedule on the wall w/ pictures and reviewing


• Having a picture paired with each child’s name on their spot for circle / group time

• Having one peer help another when possible
      o Ex: Student asks for help fastening smock in the back – having a nearby peer help and / or having the student ask a nearby student for help

       o Ex: “My friend _____ is running in the classroom. Who can tell ____ what kind of feet he should be using?”



• Prompting the child to identify what they need to do differently
   o Ex: What are your hands doing? What do you hands need to be doing?


• Before structured activities, particularly following a less structured time, leading the class in taking a deep breath and counting to 3 in different languages


• While cleaning up certain activities, using songs to say where things go to the tune of Hi-ho the Dario: ex: “the books go on the shelf, the books go on the shelf, hi-ho the Dario, the books go on the shelf”





Suggestions / Areas to take note of:



• When giving a direction be clear, concise, and specific…. Avoid phrasing it as a question
    o Example: “do you want to go outside” versus “we’re going outside now”
                or “can you (will you, do you want to) help pick up” versus “ help pick up the blocks please”

     o It is confusing to the child to present something as an option / choice if it is really not an option --- only phrase as a question if the child’s possible answer is really acceptable



• Significantly increase verbal praise – should be given at a ratio of at least 6 praises for every correction / redirection
    o Use labeled praise – another way to look at it is to make sure you “answer the what”
         Ex: “Thank you for what?” “Good job doing what?” “That was nice. What was?”



• Post rules with a visual picture beside each rule in EVERY area (each classroom, hallway (the rules that apply), etc…)
       o Review rules at least 2x per week during circle time (increase after breaks and with addition of new students)



• Reserve “no” and “not safe” for situations that are truly not safe versus things you prefer a student not do
        Ex: a child lays on a swing on their stomach – tell & show the child how the swing is to be used
   o Saying ‘no’ and / or ‘not safe’ loses its impact / meaning when over used



• Be clear & concise with directions
    o Ex: Instead of “tell me when you’re ready,” use “when you are quiet, then you / we can _____”
    o Ex: Instead of “go clean up,” use “we’re cleaning up / it’s time to clean up, please put away the _____”



• Reduce hands-on redirection / management of children – this is hugely important as it puts both staff and students at risk for injury as well as increases problem behaviors and power struggles…..
       o This is not the same as hand-over-hand teaching and instruction techniques

       o “Helping” a child to a chair, location, task, etc by full bodily moving them should not be the first or     second option –unless it is a true safety issue (for example, there is a fire) – in the absence of such a safety situation , there is a rare occasion that it should be an option at all

       o Another way, another day -- what this means is that anything that is going to be accomplished or that you are trying to “teach” a child when physical management is involved can be taught in another way, at another time, and / or on another day….

ADHD and Questions of True Prevalance

http://www.medicalnewstoday.com/articles/198077.php

This is a link to a brief article regarding the possibility of ADHD being misdiagnosed in nearly 1 million US kids --- the focus is on recent research showing that a majority of children diagnosed with ADHD (another article I read recently said about 60%) are the youngest in their class. While there is surely more research to be done on this issue - for me, this information really brings to mind the need to not jump too quickly to 'what is wrong with this child' but first and foremost look at 'what are we asking of this child' and are we asking more than what is developmentally reasonable. Even more compounding to this is the idea that there are undoubtedly children who are among the youngest in their class and who legitimately have ADHD, and very well have expectations on them beyond what their developmental stage and their learning / mental health difficulties allow.


Of course, the answer is not as easy as having them just stay back a year or delay starting school, as there is also conflicting research on the those benefits. In reality, I don't believe there is a clear-cut easy answer. Undoubtedly, how children are evaluated for and diagnosed with ADHD is often of concern. It is imperative that diagnoses are made by qualified professionals who use multi-informant and multi-process methods of evaluation versus an 'eye ball' evaluation or medication trial and error without assessment or other intervention. Additionally, I believe it essential that we continuously look at and build upon how we teach children, what we ask of them, where they are at developmentally, and how we can make classrooms work for kids just as much as we expect kids to work for their classrooms.

Effectiveness of PBIS

While difficult to measure objectively and statistically due to the lifelong time element and multidimensional aspects of PBIS, there is some evidence available from schools related to its effectiveness.
Olson Park Elementary School in Loves Park reports a 40% decrease in its Office Behavior Reports from September, 2001 to September, 2002 due to implementing PBIS (FY03 PBIS 1st Quarter 2002).

Kentucky Schools indicate a 66% decline in office referrals due to implementation of a PBIS program, and a 64% decrease in school suspensions and expulsions. During the 1997-98 school year, one Kentucky school did not have a PBIS program in place. After implementing it the following year, the school showed a 65% decrease in the number of students suspended, a 76% decrease in the number of days of suspension school-wide. They also experienced an increase in reading scores attributed to a greater number of instructional hours (Positive Behavior Support and Delinquency Prevention, 2004)

The state of Maryland is a national model for effective use of PBIS. With state mandates to utilize the program, and routine training of teachers and school administrators by the state board of education, Maryland schools benefit from a proven track record of decreased numbers of school suspensions, and less class time lost to handle behavior situations. Nancy S. Grasmick, State Superintendent of Schools claims, "PBIS is so successful because it focuses on changing behavioral expectations within schools, not just individual student behaviors. As a result, school cultures and environments have changed, making way for the kind of academic learning that we want for all Maryland’s children." (MSDE to Train Educators. . . 2004)
(http://wik.ed.uiuc.edu/index.php/PBIS_(Positive_Behavioral_Interventions_and_Supports)

Cool Tools!

In Carbondale Elementary School, in Illinois, Cool Tools help them to work with tier 2 students.  These are suggestions for teaching or role playing with a different focus for each week.  Here is an example:

"Target Area For the Week
Be Kind to one another

Monday: Try saying something nice to someone in your room or on the playground every day this week. You will be amazed at the results.

Tuesday: First, take pride in who you are. Then, treat others, as you would want to be treated. To have a friend you must be a friend.

Wednesday: Calling a person a name can often hurt as much as being hit. If you are mad at someone walk away form them. Don't stand there and call them names. That is a sure way to cause trouble for both of you.

Thursday: Making fun of another person isn't cool. If you don't like the way a person looks, acts, or what he is saying, leave the person alone. Making fun of a person will almost always make for hurt feelings. Only a small person makes fun of others.

Friday: We don't use racial slurs or make fun of another person's heritage. We all need to be proud of who we are. Feel good about yourself. Only a small person puts another person down to make himself feel good."
They have many more examples on their web site below. 


http://www.ces95.jacksn.k12.il.us/education/components/docmgr/default.php?sectiondetailid=88438&catfilter=3039&PHPSESSID=5f95bfea912c57fd308058decb9d1f62#showDoc

ADHD as a Journey

Students learn that even though their ADHD symptoms can make their school experience different from that of other students, it is possible to be successful. Each of the six sessions presents a different social skill and includes opportunities for guided practice:
1. Our journey. This session introduces the notion that students with ADHD must learn to be a different kind of traveler and must learn new ways to demonstrate socially appropriate behavior at school.
2. Pack it up. The need to learn effective organizational skills is emphasized and students are exposed to assorted organizational strategies that facilitate classroom learning.
3. Stop lights and traffic cops. Students learn various strategies designed to help them pay close attention when faced with distractions.
4. Using road signs as a guide. This session helps students identify personal cues that lead to socially appropriate classroom behavior.
5. Road holes and detours. Students are instructed on selected cognitive behavioral techniques intended to help identify and maneuver around obstacles that interfere with classroom learning.
6. Roadside help and being your own mechanic. This session emphasizes social skills with the expectation that students use the skills to self-manage their behavior.
The Journey is most effective when combined with teacher reinforcement in the classroom of social skills acquired during the group intervention.
(http://www.lyceumbooks.com/pdf/Sclsocwk7_Chapter_35.pdf)

Peer Pairing

Mervis (1998) reported that peer-pairing is an effective model for children with poor impulse control, hyperactivity, or high levels of aggression.  Peer-pairing is a good option to consider when traditional small-group, individual, or classroom interventions have been ineffective. The model is well suited for students who become overstimulated in a group setting. Peer pairing provides ongoing social skills instruction and coaching to two students who are matched based on similar levels and types of problem behaviors. Students who have acquired an emerging level of social skills acquisition can invite a guest student to the peer-pairing sessions. The guest student is someone whom both students agree to invite. A guest student does not have to have social skills deficits. Peer-pairings with guest students are another way to provide the student pairs an opportunity to rehearse what they have learned. By providing targeted training and coaching in peer paired arrangements, students with poor impulse control or highly aggressive behaviors can develop the skills necessary to be successful in school.
(http://www.lyceumbooks.com/pdf/Sclsocwk7_Chapter_35.pdf)

Kids Together

Kids Together is an effective group play-therapy intervention for studentswho exhibit impulsive, disruptive behaviors, and poor communication skills(Hansen, Meissler, & Owens, 2000). The fifteen-week program targets students age 5–17 and aims to increase socially appropriate peer and adult interactions. The group curriculum includes skill topics such as listening, organization, self-monitoring, impulse control, and problem solving. Students receive step-by-step instructions on how to seek and maintain positive social relationships. Once students demonstrate skill competencies, they identify cues and prompts to help them generalize the new behaviors to classrooms, hallways, and lunchrooms. Using a combination of play, art, and recreational therapeutic activities, Kids Together has been shown to reduce problem behaviors while increasing socially appropriate ones.
(http://www.lyceumbooks.com/pdf/Sclsocwk7_Chapter_35.pdf)

Cueing and Group Social Skills Instruction

Children and adolescents with poor impulse control frequently talk out of turn, fail to listen to directions, blurt out answers before being called upon, and have difficulty waiting their turn. Posavac, Sheridan and Posavac(1999) described an effective behavior intervention for students that demonstrate disruptive classroom behaviors. These students received social skills instruction as part of a small group counseling intervention that focused one enhancing listening and anger management skills. In addition, students were assigned a target goal behavior to focus on for the duration of the intervention. The goals were stated in positive terms such as “keep hands to myself.” A critical component of the intervention involved a cueing procedure that required students to evaluate themselves as well as their fellow group members at five minute timed intervals during social skills instruction periods as to whether they had met their goal. The cueing procedure culminated with the group leader making the final determination regarding goal attainment. Students were recognized and positively reinforced for performing the identified behavior. The cueing procedure provided in conjunction with small group social skills instruction for children that displayed disruptive classroom behaviors resulted in a decrease in impulsive behaviors.
(http://www.lyceumbooks.com/pdf/Sclsocwk7_Chapter_35.pdf)

Pygmalion effect

The Pygmalion effect is a form of self-fulfilling prophecy, and, in this respect, people with poor expectations internalize their negative label, and those with positive labels succeed accordingly.  This is very important to keep in mind when working with students in the classroom with mental health/behavioral issues.  If a student is expected to act out or be disruptive in the classroom chances are greater that he or she will do so.  Studies with students have found that reality can be changed by the expectations of others.  This is important to keep in mind on a daily basis in the classroom. 

Response to Intervention (RTI)

RTI is designed to monitor all students to identify those at risk for behavioral and/or academic difficulties. There are three tiers of instruction or intervention used. Tier one (80-90% of students) is instruction given to all students in the general curriculum. Tier two (5-10% of students) provides additional instruction and intervention in addition to the general curriculum. Student evaluation will determine which students require Tier two interventions. This will include small group work along with weekly or monthly progress monitoring. Specific interventions will depend upon the needs of the students in this group. Tier three (1-5% of students) is for students who have been placed in Tier two but continue to be unable to meet appropriate benchmarks. Tier three involves more intensive instruction and interventions in addition to the general curriculum with focus on increasing the student’s rate of progress. Students in Tiers two and three require ongoing monitoring, setting goals, data gathering, and making changes in instruction according to data.

This blog is designed to assist you with students that fall into Tier two. If you have students who need additional assistance in the classroom due to mental illness or behavioral issues and are looking for help with interventions that might be helpful please post your questions here.

Teens and Suicide

Suicide is the third-leading cause of death for 15- to 24-year-olds, according to the Centers for Disease Control and Prevention (CDC).  Girls think about suicide twice as often as boys.  Girls tend to attempt suicide by overdosing or cutting.  Boys die by suicide four times as often, as they attempt suicide by hanging, firearms, or jumping from heights. 

Factors that increase the risk of teen suicide:
•a psychological disorder, especially depression, bipolar disorder, and alcohol and drug use (in fact, approximately 95% of people who die by suicide have a psychological disorder at the time of death)

•feelings of distress, irritability, or agitation
•feelings of hopelessness and worthlessness that often accompany depression (a teen, for example, who experiences repeated failures at school, who is overwhelmed by violence at home, or who is isolated from peers is likely to experience such feelings)
•a previous suicide attempt
•a family history of depression or suicide (depressive illnesses may have a genetic component, so some teens may be predisposed to suffer major depression)
•physical or sexual abuse
•lack of a support network, poor relationships with parents or peers, and feelings of social isolation
•dealing with homosexuality in an unsupportive family or community or hostile school environment

A teen who is thinking about suicide might:

•talk about suicide or death in general
•talk about "going away"
•talk about feeling hopeless or feeling guilty
•pull away from friends or family
•lose the desire to take part in favorite things or activities
•have trouble concentrating or thinking clearly
•experience changes in eating or sleeping habits
•self-destructive behavior (drinking alcohol, taking drugs, or driving too fast, for example)
(http://kidshealth.org/parent/emotions/behavior/suicide.html#)

Maine Crisis Hotline:
1-888-568-1112
National Suicide Prevention Lifeline:
1-800-273-TALK (8255)

School Phobia

QUESTION:

I have a student with school phobia. What is the prognosis that he will "recover" after he leaves school? Is he more likely to develop other phobias?

ANSWER:
Students who have school phobia with early onset, ages 5-7, have the best chance of recovery as this may be a form of separation anxiety from parents. However, onset after age 11 may be due to depression, anxiety, or other issues going on at home or school, i.e. bullying. Adolescents in this scenario have more chance of developing other mental health issues later in life. It is best to talk with the child/adolescent, find out what the cause of the school phobia is, and help him or her with those underlying issues, referring to a counselor as needed.
(http://www.phobics-awareness.org/schoolphobia.htm)

Positive Psychology

Positive Psychology states that fostering positive qualities in an individual is more effective in behavior change than remediation of problem behavior.


…“Research has shown that teaching optimism (Jaycox et al., 1994; Seligman et al., 1995) can be effective in preventing at-risk children from developing depressive symptomology. By using cognitive training and social problem solving, elementary school aged children at risk for depression were taught optimistic ways to view events. Following the training, a significant difference was noted with the treatment groups reporting less depression than the
control group with this effect increasing over a two-year follow-up. Roberts, Brown, Johnson, and Reinke (2002) described work by Snyder and colleagues that demonstrated modest positive changes in children who were taught cognitive beliefs in one’s own ability to produce workable paths to goals….”
“…In addition, developing Individual Education Plan (IEP) goals is another area that school psychologists might use positive psychology. As research has shown, the more clear the goals, the more likely participants are to meet them (Melton, 1978). This may hold implications for school psychologists as they focus on developing IEP goals. By developing goals directed toward the students strengths and increasing them, it will force the clinician to “think outside the box.” When writing goals that directly assess remediation of areas of deficiency, school psychologists can think of addressing and reinforcing the student’s strengths so that they may indirectly affect the areas of deficiency.
In summary, instead of a traditional assessment question that asks, “Why might some students experience greater difficulty than others?” perhaps a better question is, “Why might some students succeed in spite of their difficulties?” That is, although a myriad of factors affect learning, one of those factors could be the coping strategies and cognitive approach that a student takes. In our educational assessment and planning, perhaps we should be writing about a student’s strengths along with goals that reinforce and enhance those strengths rather than solely remediate weaknesses.”
Full article at: (http://74.125.155.132/scholarq=cache:KWq7vmQrM0QJ:scholar.google.com/+integrating+the+classroom+with+children+with+mental+illness&hl=en&as_sdt=2000)


How does this work in a practical classroom situation? If a child is having trouble attending school regularly could it be helpful to identify why others are not having this problem and relate it to the individual? Or would reinforcing the child’s strengths while he/she is in school help him/her to attend more often?

Selective Mutism

I recently had contact from a teacher with a student recently diagnosed with Selective Mutism. Here is some general information that may be helpful:

According to the DSM-IV-TR Selective Mutism is when a child continually (for at least one month, not including the 1st week of school) fails to speak in specific social situations while still speaking in other situations. For example the child will speak to parents at home, but won’t speak at school. (This diagnosis would not be appropriate for a child diagnosed with PDD, a communication disorder, or a psychotic disorder).
Children with Selective Mutism often have severe impairment in school and social functioning. They may be teased by peers in school. Children with this diagnosis are often also diagnosed with an Anxiety Disorder.
This diagnosis is fairly rare, affecting less than 1% of people seen in mental health settings. Usually Selective Mutism has an onset before age 5, but may not be noted until the child starts school. It could last a few weeks to a few years.
As with presentation of other mental health issues a child presenting with these symptoms should be referred to professional services.

ADD and Marajuana Use

QUESTION:
I had a student who was diagnosed with ADD. As he progressed through his high school years there were indications that he was using pot. I confronted him but I could not get him to understand that his use of medications for ADD and his use of marijuana would make a difference in his behavior. What arguments could I have used to make it more clear to him? Are there statistics or research that would have been easy for him to understand?

ANSWER:
In my research I am coming up short on information specific to the use of marijuana and ADD medications. However, there is no shortage of information about the ill effects of marijuana use for adolescents. Side effects of marijuana use include trouble remembering things, slowed reaction time, difficulty concentrating, sleepiness, anxiety, paranoia, altered time perception, tremors, nausea, headache, decreased coordination, breathing problems, increased appetite, reduced blood flow to the brain, and changes in reproductive organs.(http://familydoctor.org/online/famdocen/home/common/addictions/drugs/485.html)

Research also finds adolescents using alcohol have lower achievement in school than non-users; they exhibit more delinquent behavior, aggression, and rebelliousness; have poorer relationships with parents; and, in general, will get into more trouble. (http://parentingteens.about.com/gi/o.htm?i=1/XJ&zTi=1&sdn=parentingteens&cdn=parenting&tm=108&gps=413_338_1520_639&f=20&su=p284.9.336.ip_p504.3.336.ip_&tt=2&bt=1&bts=1&zu=http%3A//www.theantidrug.com/drug_info/marijuana-mental-health-connection.asp)

Adolescents with ADD often have issues with anger, and turn to marijuana to reduce that anger. The marijuana then gets in the way of the teen developing appropriate coping skills. (http://www.tools4families.com/adhd-add/why-kids-with-adhd-self-medicate-with-marijuana.htm)

Combining marijuana with the symptoms of ADD makes for a teen who is going to have an even harder time concentrating and getting necessary tasks completed. A person diagnosed with ADD often fails to give close attention to details, or makes careless mistakes in schoolwork, work, or other activities; often has difficulty sustaining attention in tasks or play activities; often does not seem to listen when spoken to directly; often does not follow through on instructions, and fails to finish schoolwork or chores; often has difficulty organizing tasks and activities; often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework); often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools; is often easily distracted by extraneous stimuli; and is often forgetful in daily activities. (DSM IV-TR)

Teenagers, however, will often not respond to a lecture, or someone trying to be an authority on something the teen thinks they have figured out. He may even find his own statistics to counter your own. It may be more beneficial to find the underlying cause for the marijuana use. Is he using to cope with ADD symptoms? If so, maybe a different medication is needed. Are there new stressors in his social life or at home?

What is your goal with the teen? Is it making him understand the possible interaction of his prescribed medication and marijuana,  or is it to help him stop his drug use? Working together you can come up with a better picture of what is really going on with this teen. You could have a great argument about how marijuana is bad for the teen, and how it is affecting his health and social emotional growth. But the teen must be getting something out of his use of it; that is what needs to be identified. Then work with the teen on how to better address his need.

Dr. Ross Greene has a method of working with children/teens called Collaborative Problem Solving. His "Plan B" technique would work well in this situation, and many others. The "Plan B" technique has three main steps:
1. The Empathy Step. In this step the goal is to find out the teen's concern. This step may take a bit of time since the teen may not immediately be able to identify what the concern or problem is. Drilling, asking additional, non-judgmental, questions will help you to clarify the teen's concern/problem.

2. Identify the teen's problem, along with what your goal is. Get both problems on the table.

3.Finally, brainstorm solutions and try to come up with a collaborative solution that meets both the teen's needs and yours.

See the website listed for a video of how to complete each step. (http://www.livesinthebalance.org/)