Attention-deficit Hyperactivity Disorder and Clear Consequences

Through trial, error and a positive approach, this teacher learned how to work with her student's special cognitive style

My first graders took a seat on the carpet for our first story time, and I began to read, "The Three Little Pigs. James, sit still." The children looked around. Was the book's title Three Little Pigs James Sit Still? They realized I was talking to one of their classmates, who was rolling on the floor. I continued, "The first little pig built his house of…James, stop wiggling, stop touching that." What should have been a simple task of reading the book, showing the pictures and stopping to discuss each problem the pigs faced was becoming increasingly difficult. I read on, trying to ignore the disruptions.
CRASH! The chair James had been rolling under had fallen over and knocked a crayon box off of my desk. The loud noise interrupted the story and the children complained, "James, Miss Gigout can't even finish a page. You're messing up the story. Miss Gigout, does he have to be in our class?" James pulled the chair off himself as the crayons rained down from the desk. His face burned deep red and he began to cry. He turned his back to the class, trying to pick up the mess he'd caused, and I felt his shame.
A special student. In the first hour and a half of our first day of school I saw clearly that James had the classic symptoms of Attention Deficit Hyperactivity Disorder (ADHD). He was inattentive, lacked concentration, stared into space, was impulsive and hyper. When James' mother arrived to pick him up after school, we talked about his behavior. She informed me that James had indeed been diagnosed with ADHD but was not taking any type of medication because the family just couldn't afford it. I realized that something had to be done; I couldn't ignore his behavior, hope for the best and basically let this little boy fall through the cracks for the next nine months of school.
A style versus a disorder. For the next few days I researched ADHD, trying to find a solution for our problem. I read books, searched the Internet, talked with the nurse at our school and to one of our special education teachers. No one seemed to really know how to teach a student with ADHD. They knew the symptoms and what type of medication to give, but really had no advice in the area of teaching.
Richard Restak asserts in The New Brain (Rodale Books, 2003) that "ADD/ADHD isn't so much a disorder as it is a cognitive style." With this in mind, through much trial and error, I found my way through the next nine months. Along the way I came up with these suggestions to keep in mind when one has a "James" in the classroom:
1. Set a consistent daily schedule. The most important trick I found to work was keeping James on a regular schedule. By being consistent with our class schedule, James could regulate his day. He learned to watch the clock and tell just how much longer he had to sit still while I read. He knew how much time he had left to finish his assignment and what the clear consequences were if he did not finish. I found that by setting these clear consequences and rewards for his behavior, both good and bad, there were no miscommunications and he became responsible for his actions. Any time the schedule changed, I discussed the changes with James ahead of time so he was aware some things would be different that day.
2. Limit distractions around the student's work area.
James' desk was slightly turned away from the rest of class to cut down on distractions. I didn't move his desk completely away from the other desks; I didn't want him to feel shut out or different. When it came time to work he could turn his desk away if he felt he was having trouble concentrating. On some days he had a hard time concentrating even if his desk was turned to the wall, but sitting on the floor close to my desk or in the classroom library would help him stay on task.
I also had James keep only the necessary supplies at this desk; getting up for additional supplies gave him the opportunity to take a break, walk around and get rid of a little bit of energy. Sometimes James would stand while he worked at his desk; as long as the standing wasn't distracting to anyone around him, I let him do so.
3. Explain directions at least twice and have the child repeat them.
I would tell the class the directions for an assignment, retell the directions to James one-on-one, then have him repeat the directions to me. By making sure James had three opportunities to get directions, he had a better chance of finishing the task. As the year progressed and projects got more detailed, I would explain two directions first; when those steps were complete we would discuss the rest of the task. I tried to keep the directions simple, limiting them to one or two tasks at a time.
4. Give silent cues that only you and the child know.
Story time seemed to be the hardest task for James. He had to sit still on the carpet with his classmates and try to focus on what I was reading. I found that by asking James to sit close to me while I read I could give him a signal – a small tap on the shoulder or a little cough – to get his attention and bring him back to concentration. Even while working, these subtle cues would call him back without letting the rest of the class know I was talking to him.
5. Limit the amount of work given at one time.
Instead of giving James a worksheet with 25 addition problems, I gave him five problems at a time. He'd finish those five, then take a break to get a drink of water or walk around, then come back for five more. Sometimes not all of the problems would be finished, but at least he worked without being frustrated and I didn't have to continually remind him to get busy.
6. And most importantly, be positive!
With James it was important to focus on the effort, not the end-product. Praising him for completing part of a worksheet, even though some of the answers were wrong, gave him a sense of pride and made him try even harder.
As we entered May, James had learned to read, add, subtract and even write paragraphs. He went from missing recess all week due to conduct to missing five minutes of it every few weeks for an occasional outburst. Eventually the students in my class noticed a change in James' behavior and wanted to be friends with him. He was happier in school and more eager to learn. He no longer felt the embarrassment of being in trouble or not being able to control his actions.

I did my best to embrace James' cognitive style rather than fight it. I took the time to work in a partnership with James on his concentration instead of restricting him to what works for other children, which was far more rewarding for us both.