I get many requests for information about how to deal with children with ADHD and aggressive (verbal and/or physical) behaviors. It happens so often that I thought I’d dedicate a post to this particular set of strategies.
When a child is dealing with the impulsivity of ADHD and aggressive feelings, we have to develop a multi-modal plan. This means we need three steps: (a) antecedent manipulations, (b) replacement behavior teaching, and (c) consequence modifications. Antecedent manipulations mean we set the environment up for success. The child will have no choices except to be successful. Replacement behavior teaching means we teach the child what to do instead of the targeted behavior. If a child is cussing, we cannot say “stop cussing”. We have to teach them what to do instead of cussing. Finally, we have to change consequences. What we have been using is not working so we have to change how we react to the student when they have any behavior. Remember, how we react when any behavior occurs (good or otherwise) determines whether or not it occurs again.
Most frequently, when I receive emails from viewers about children like this I ask them to list current interventions. Typically, I hear things like response cost, punishment, or other negative responses. These interventions have not worked and for good reason. These interventions work for 80% of the student population; however, they do not work for 20% of the population and these are the students whose behavior we are trying to modify. So here is what to do instead. This is a proactive multi-modal plan.
Proactive Strategies to set up the environment for success:
- air filled disk on his chair- sewn in so it can’t go flying across the room
- pool noodle cut into 1/5ths and threaded through elastic and hooked to his two front chair legs
- He needs to be taught how to use proprioceptive input with his feet to help him stay focused
- Put a strip of velcro (one side only) and a bathtub non-slip applique under his desk top and teach him how to fidget with that.
- This book has ideas for ADHD in it- http://behaviordoctor.org/wp-content/uploads/2014/01/2014nonmedicatedadhd.pdf – free download
I do not have a good one yet- I’m filming one for neuro-typical kids, ADHD kids etc. next week- but you can look it up on http://www.youtube.com and type in Siskin Institute and Video Self-Modeling. You’ll see one for a child with autism and a very young child. However, I have had huge success using this with all children as well.
Teach him (Antecedent modification) how to breathe to calm himself down in his calm down area. Here are the directions:
- Put your tongue behind your two front teeth
- Close your mouth
- Breathe in through your nose
- Breathe out through your nose
- Repeat this 10 times in and 10 times out
- I give the kids 20 pompons and an old Kleenex box and have them dump out all the pompons and put one in with each in and with each out- until all 20 are gone.
- I typically make this a poster to remind them using Boardmaker – because when a child is upset pictures are better. You can also make a video self-modeling video of this process to help him learn this. (It’s a replacement behavior teaching- – but it’s taught as an antecedent modification and this is what he will do when he is upset. He will learn how to calm himself down.
To teach Replacement Behavior:
- token economy-
o I’d use a velcro chart with 5 tokens that velcro onto the strip- when he gets 5 tokens he earns a 5 minute break
o He gets one token for each compliance to a request- no tokens= no breaks
- For behavior at home and school:
o Student/Teacher rating sheet – http://behaviordoctor.org/wp-content/uploads/2013/12/2014studentteacherratingsheet.pdf
- This is explained in the download and it ties home to school- child earns rewards based on behavior- no rewards except what is earned- nothing is given free
Spanking is not going to change his/her behavior- it doesn’t work on ADHD
What works best is to give him/her nothing and make him/her work to earn anything. (not like you are punishing- but like this is what you have to do to get: computer time, toy access, free play)
When you give him work to do- give him equal choices (not do this or lose recess)- you can do this math paper or this math paper, you can write with the red pencil or the blue pencil, you can sit in the red chair or the blue chair. Stand on his right side when you offer these choices. If he/she has a tantrum, make sure you keep your heart beat at 60bpm and talk in a sing song-y voice and say- “Do you want to walk to the calm down area with me or do you want to walk down to the calm down area with Mrs. Jones.” (Whomever could go with you to talk to him/her)
We have found with heart monitors that children who have aggressive behaviors (tantrums, aggression etc.) their heart rates tend to beat at 147 beats per minute. Music research tells us your heart will match the music you are listening to- I have on my website calming videos with 60 bpm music and 7 minutes of nature pictures. I would make a playlist of 60 bpm music and play it at conversation level all day long. I would also have a bunch of nature pictures in a calming area for him to go to – to calm himself down. I prefer a blue bean bag in this area (blue is a calming color)
I’ll try to add pictures to this tomorrow evening to help with identifying some of the strategies. You can see how this is a multi-modal plan that will help the student learn to have better control over their own behavior.
Reinforcements and rewards are a hot topic in education. I frequently hear things like, “Children should not be bribed to do the right thing.” The definition of bribery would prove this is not bribery in the true sense of the word. I think the majority of people who say these things are thinking about tangible and expensive rewards. I have been researching this topic for 10 years now and I have found that children do not want expensive rewards. This is what I have found:
I believe your rewards should come from all these areas:
1) Quality time with adults and peers
2) Escape from a task or chore
3) Earning special privileges
4) Physical touch- like high fives or special handshakes
5) Earning leadership roles
6) Social praise
7) Special assistance (help with a chore, task, etc.)
8) Tangibles (school supplies- especially in areas where children can not afford the fun school supplies like mechanical pencils, extra pencils, fun notebooks etc.)
Notice: Tangibles are last. Many reward programs focus on tangibles first and I believe children want attention and recognition much more than they truly want tangibles. For ten years now, I have been asking children from three to 18 this question: “What would mean the world to you? What could an adult give you to let you know you have done a good job, and it can’t cost any money?” The answers I get are amazingly simple. Students and children want us to notice them and give them time and attention.
Here’s my most poignant story.
I was riding a bus in a major metropolitan city. The matron on the bus walked up to me in the middle of the route and told me the boy behind me was the number one worst student on the bus (a middle school student with his hood pulled up over his head) and the student across the seat from him was the second worst student on the bus. After I thought the students had time to calm down from hearing the matron say these horrible things about them, I turned around and said, “You know, I’m not really here looking for bad kids. I’m a researcher and I’m here to train the bus drivers. But I do have a question for you, if you want to answer it. I asked the boys the question above. The first young man sat with his head down for a bit and then he took down his hood and I saw the most adorable middle school dimple faced young man looking at me. He started talking in an animated voice. He said, “Oh my gosh, I see people throw footballs and when they throw them, the footballs go straight. When I throw a football it goes all wonky. If someone could teach me how to throw a football straight. That would mean the world to me.” (This…..??????? is the worst kid on the bus) The second young man said (and I quote) “I suck at spelling. If somebody could teach me that i after e stuff (he really needed to know the rule there) that would really help because I can’t spell anything. That would mean a lot to me.”
I have heard things like, “Tell me you appreciate the fact that I got up and came to school today.” “Write a job recommendation for me.” “Play checkers with me, like my dad used to.” (from a little boy whose father had passed away unexpectedly.) It’s really pretty simple. The kids don’t really want the stickers, the candy bars, or the little toys in the McDonald’s Happy Meals. They want our eyeballs on them.
Compliments- good, bad, or ugly????
I get asked this question frequently about giving praise to children. I am a big supporter of positive behavior support and part of the philosophy is to catch students being good. My own email is “caughtyoubeinggood”, so the act of catching children being good is very important to me. However, the delivery of praise is very important. I’d like to start this discussion by telling you about two very different principals I had over the years and how they affected me with their praise.
My very first principal ever was a guy we will call George. Mr. George came into my room once a year. He would sit and watch me for 15 minutes and then write on a post-it note and leave it on my desk. The post-it note said, “Good Job”. I’m sure he thought this was high praise. It actually meant nothing to me. I did not know if I did a good job with the one math lesson he happened to observe, if my proximity standards were used well, or if my wait time was excellent. At the end of the day, I would have my daily evaluation in my box that said, “Laura does a good job.”
Later in my career I moved to North Carolina. I had a principal that I will call Wilford. Mr. Wilford was in my room the first week of school an hour a day. He would be sitting in the back smiling and watching me and writing, writing, writing on his clipboard. I was a nervous wreck. I must be terrible. Why is he in here? Am I doing a good job? He just smiled and left each day before the end of the day. At the end of the first week, I went into Mr. Wilford’s office. He said, “Laura, I’m so glad you came in. I wanted to talk to you. I love the way you use wait time in your class. Did you take a class on that? Also, the way you move around the room while you are teaching is phenomenal. I really like that.” I said, “Oh Mr. Wilford, I’m so happy to hear this. I am not used to a principal staying in my room for so long each day and I thought I must be horrible.” He laughed and said, “I come into your room to do my reports. I could listen to you talk all day. Why the way you talk to those kids, I bet you could teach them how to build a nuclear reactor and they’d do it.” He said, “I think it’s your accent, but they hang on your every word.” (I don’t have an accent- people in North Carolina have an accent J ).
Mr. Wilford and I had a great relationship. He told me when he saw me do something good and he also told me when he saw me do something he didn’t like and how to fix it. In North Carolina, we had to teach our own Physical Education and our own Music. These are not my two best subjects. Mr. Wilford helped me become better at all the things by giving me behavior specific praise and behavior specific critiques. I believe Mr. Wilford helped me become a better teacher and Mr. George did nothing to improve my teaching abilities.
So what does this mean for kids? Does it hurt kids to get a compliment? I do not believe compliments hinder a child’s growth, as long as the praise or compliment is behavior specific. I want adults to say things like, “The way you held the door open for someone with their arms full is a great way to show respect to others.” This is teaching a child and all those within earshot of the praise what is important. However, if a child had held the door open and I smiled and said, “Good job.” That comment would have meant very little to help the child and those around become better learners.
I believe compliments about academics are the same. I don’t think writing “good job” on a paper means anything and is actually not helpful at all. However, if you write three things you did well on this paper and one thing I wish you would work on, that would immensely help a child. “The spacing of your cursive handwriting made it easy for me to read.” “The way you used personification in this story made it easy for me to visualize the setting.” “The action words you chose to put in the climax of the story made it a pivotal piece to the ending.” “I wish you would add some more detail to the main characters.” “Can’t wait to read this paper again.” These kinds of compliments or praise would be quite helpful to children.
Whenever I train universal supports for behavior in a systemic change within the school, I always have someone who does not like the part about giving out little slips of paper denoting what it was the child did correctly. We call these slips “gotchas”. If they are given properly with verbal behavior specific praise, the child and all those around will learn what is of value. It is very difficult to be intrinsically motivated if we do not know what is of value. I believe that behavior specific praise teaches us what is of value.
For instance, when a child is first learning to walk parents do not just sit back and watch the child stumble and fall and say nothing about their efforts. The first time they stand up on their own the parents clap and smile and say, “Look at you standing up.” As the child begins to take their first few steps, the parents get more and more involved and encouraging. “That’s it. You have it, move that foot.” “Look at you walking!” Although it took some cheering to get us going in the first place, we all walk around now without anyone cheering us on. We were externally motivated to figure it out and then we now are intrinsically motivated to walk from here to there because we know the value of the behavior.
This has become a rather long post, so I will stop today. There are times that even behavior specific praise, if given in front of peers is not good. Children with low self-esteem cannot accept praise given in front of others or sometimes even in private because it does not match how they feel on the inside. In these cases, we need to set the child up to earn social capital by setting them up for success in front of their peers without giving oral behavior specific praise. I’ll post about this at a later time.
I also believe we should be very careful about giving praise for the way a child is dressed. First, how a young child is dressed is a reflection on the parent and not the child. Second, for those children who cannot dress in fashionable clothing, it is an insult that someone near them is praised for something that has nothing to do with their character. I believe praising for things that are not actions are harmful. When I teach students how to give compliments to each other, I always teach them to compliment someone’s behavior and not how they look.
So these are my thoughts on praise. Inflated praise, non-specific praise, and praise on things that are not actions do little to help children become quality adults. However, behavior specific praise helps children learn proper behavior. At school, we always know when the child has moved to intrinsic motivation on their own. We will walk over to give them a gotcha for a behavior and they will say, “That’s okay. I don’t need a gotcha. It was just the right thing to do.” At this point, you know your behavior specific praise has paid off and the child is well on their way to becoming an adult that will do well in the world.
How we give a compliment is important
Why we remember negative more than positive
Terry Scott article on response to behavior and academics
Haydon, T., Conroy, M., Sindelar, P., Scott, T. M., Brian, & Marie, A. (2010). Comparison of Three Types of Opportunities to Respond on Student Academic and Social Behaviors, Journal of Emotional and Behavioral.
Why a Positive Approach to Education?
RTI- squared, cubed, and quartered by Dr. Terry Scott
Are we bribing kids too much?
Booklet of mine that has some of the research for teacher to student interactions:
inflated praise for kids with low self-esteem is harmful
This is why I like my 4 P’s for raising self-esteem. You can’t give compliments to kids with low self-esteem because they don’t believe it. It doesn’t match how they feel about themselves on the inside. The 4Ps are :
- Proficiency- help them make up for academic and social deficits by teaching them specific skills
- Public Relations- help them look good in front of their peers without calling them out- set them up for success in front of others (social capital)
- Power- teach them how to have power over their emotions- (breathing techniques etc.)
- Philanthropy- put them in charge of some philanthropy at school and home. It’s hard to feel bad about yourself when you are helping someone else.
(Please forgive the fact that this post jumps around a bit. I just had major surgery this week so my writing ability is a little marred.)
April is Autism Awareness Month; however, I think I agree with many of my friends that there are few people who aren’t aware of autism- so why are we still focusing on awareness. Let’s focus on building quality lives for all our children. One of my friends is trying to change April to Autism Actions and True Friendships Month. Check out this facebook page: https://www.facebook.com/NaturalTies This was one of Jay’s favorite activities- going out with the guys. It helped build friendships in the community that lasted a lifetime.
One of the best decisions my husband and I ever made in our lives was to choose to live with our friend Jay who happened to have autism. We learned so much from him and hopefully we enriched his life as much as he enriched ours. Every year at Christmas I share a story about Jay and this year I decided to save it for April. In 2009, we lost Jay to a sudden heart attack and this story comes from his last Christmas on Earth.
Jay did not clearly understand money for if you asked him what his house cost he would say, “One dollar”. Jay worked 20 hours a week as a mailman at the University of Kansas and he was paid the same wages as anyone else at the University. Hundreds of dollars meant nothing to Jay. So his check was deposited into his bank account and each day he was given eight one dollar bills if he did a good job at work.
Jay only liked one dollar bills and if you gave him a five, ten, or twenty it would promptly go into the trash because it didn’t belong in his billfold (lesson learned). This gave him enough money throughout the week to pay for his meals when he went out with the fraternity gentlemen on Wednesday night, dinner with his girlfriend and music therapist on Monday night, lunches out with friends throughout the week and dancing on Friday night at one of the local clubs. It also allowed him to go down and purchase a soda from the machine each day during his work break. These eight dollars meant everything to him. Jay loved opening up his billfold and pulling out his own money to pay for his meals.
Every once in awhile, Jay would have a not so great day at work. Whenever he chose to not be compliant at work, he was told he might not earn his eight dollars. This was usually enough to get him on the right track . One day, Jay was in the hallway without his job coach and I saw him focusing on a door. Jay had obsessive compulsive disorder and one of his major obsessions was that “things” were at a 90 degree angle. He did not like “catty wampus”. All of the furniture in our home was flat up against the wall and all of our towels hung at precise 90 degree angles. As you might imagine at a university with tons of busy professors and doctoral students, post-it notes are left on doors to send messages to each other. Jay did not like post-it notes that were not placed at 90 degree angles. He would fuss and fuss with them until they were perfectly placed. Unfortunately, as is with post-it note stickiness- it wears off.
I saw Jay messing with a post-it note on a doc student’s door. He kept straightening and straightening and then it happened. The post-it note started falling off the door and onto the floor. This would not do. Nothing belonged on the floor so I knew where the post-it note was headed. It was headed for the great toilet bowl in the sky. The other thing Jay loved was watching things swirl in the toilet bowl as they disappeared from sight. I saw Jay look around and start heading toward the restroom with the post-it note. I happened to know the post-it note was very important and the doc student needed to see it. I followed Jay. As he headed for the restroom door, I said, “Jay, it will be such a bummer if you flush that post-it note down the toilet. You wouldn’t be able to get your eight dollars today. Denise really needs that note.”
Jay stood still in his tracks and looked over his shoulder at me. I could see the wheels spinning in his head. “Oh yeah, she’s the one that means what she says. Crumb.” He stood there for a minute and then marched quickly past the bathroom door and straight for the trash can at the end of the hall. He placed the post-it note in the trash can and turned around and smiled at me. He said, “I’m getting my eight dollars today.” All I had said was, “If you flush it you won’t get your eight dollars.” He was so smart. He did get his eight dollars.
I did dig out the note from the trash and slid it under Denise’s door. (That would have bothered him to know because he would have asked all day, “When is she going to pick that up?”) He loved to pick up things off the floor. A trip to Wal-Mart was quite a coup for the Wal-Mart employees because Jay did their work that day.
So Jay’s eight dollars meant a lot to him. You might say it was one of the ways he felt as if he was the same as everyone else because he paid his own way with his own money that he earned. Jay never left work without earning his eight dollars.
My husband has a big heart and he cannot walk past a homeless person without giving them money. He can’t walk past the kettles at Christmas time and not add something to the pot. Jay witnessed this time and time again when we were out and about. He never said anything, but he was watching. Our last Christmas together was extremely icy in Kansas. One day, his job coach Shelby took him with her to the grocery store to run some errands for the Beach Center. Since it was icy and Jay was uneasy on his feet in normal circumstances, she decided to drop him off at the door and then go park the car. She told him to stand still and she’d be right back for him. As she parked the car and was walking up to the door, she witnessed Jay’s generous soul.
The Salvation Army Kettle Ringer was standing at the door with his big red pot. Jay opened up his billfold, pulled out all eight, one dollar bills and placed them carefully into the bellringer’s pot. The Salvation Army Employee had tears in his eyes because he knew Jay and he knew how much this had to mean to him. He gave away his last one dollar bill to help someone else.
As I reflect again on Jay’s life and what living with him meant to our family, I think about how much he gave us in friendship, his loving heart, and the kindness he generated in others. Almost 700 people came to Jay’s funeral and open house. I believe it is because his loving heart touched so many and he taught us what it means to give dignity to each person’s soul. Despite having his own issues to deal with, Jay had compassion in his heart for everyone. He loved everyone. He didn’t see race, religion, sex, or disabilities. He just loved you for being you.
So in honor of autism awareness month and in honor of Jay Turnbull, I ask you to take eight dollars this month and pay it forward. I usually ask people to do this at Christmas time; however, everyone is asking for help at Christmas. I thought a better way to spread Jay’s spirit is to ask now during Autism Awareness Month. So, if you can: give eight dollars to your favorite charity, put an extra eight dollars in the plate at your worship service, or pay it forward at Starbucks. If you can’t spare eight dollars, go to Wal-Mart and pick up eight items off the floor that don’t belong there in Jay’s honor.
Here’s hoping everyone finds the friendship of someone like Jay before they leave this earth. The best thing you can do to help others with autism is to understand them, to see their soul shining through and help them shine.
To read the memorial page for Jay click this link Jay’s Memorial Blog- the picture above is my daughter Jessica with Jay. Jay’s favorite song was “Kryptonite” by Three Doors Down. He loved it when she wore this shirt. The first blog post on the previous link is from my youngest son. Jay made a huge impact on our family.
My daughter is just beginning her career as a teacher. She is changing careers and I couldn’t be more proud. She finished her student teaching in December and is currently teaching a long term substitute position for a fourth grade class. This morning she got up at 2 a.m. because she was so excited. Her students have been on spring break for a week. She went out every day to work on bulletin boards and lessons. She has something really exciting planned for her anticipatory set on the Southwest Unit they start today. She is going to dress up like a cowgirl and rope a little wooden horse. Her cowboy hat belonged to her Uncle Jim who was a proud farmer and she comes from a long line of Texans. The wooden horse was hand carved by her grandfather who was born and raised in Texas. He grew up on a dairy farm. It will be a fun way to kick off the unit and make it real for the kids.
She couldn’t wait to get back to school to see those 25 smiling faces bound into the room. I thought I’d take a moment on the blog to ask you to share what excites you the most about teaching? What do you do to make it real for the kids?
Please write in and let us know. I think people would love to read about the excitement we get from sharing knowledge with the students. What do you get excited about?
You might not know what hyperacusis is, but you do know that some of your students are extremely reactive to sounds. We have all had students who put their hands over their ears when they entered the gymnasium, or the fire alarm sounded. For some of our students, this might be hyperacusis. Here is a great page discussing hyperacusis- http://www.hyperacusisresearch.org/
Here are some suggestions to help in school and at home:
Since most people do not use the drawstrings on their hoodie sweatshirts, a great solution is a hooded sweatshirt that has earbuds instead of drawstrings. You can check out what these look like at gizmag. The Hoodie Buddie would be a great solution for students to wear in school. When the noise becomes more than they can take, they can pick up the ear buds and put them in their ears. I have witnessed some not so great solutions that made the student stand out and look different from their peers: lime green earplugs sticking out of the student’s ears, giant headphones like the airport employees wear, and the old giant headphones from listening labs. I like for the student to look as typical as possible and no one else is walking around with giant headphones. If a school really wanted to integrate and make all the students love being at school, the school could make it a rule that students were allowed to listen to music during class changing period. the school could put a limit on this. “We will allow headphone use for all students during class changing periods as long as tardies remain below 1%.” The students would be motivated to police each other to retain this privilege. This would make all the students happy and the students with special needs would not stand out at all during class changing period.
In my Building Behavioral Expertise Class in Morton, PA, one of the participants came up with the idea to take a girls stretchy wide headband and put earbuds running through the headband. The young lady could wear the headband and when the noise go to be too loud, she could pull the earbuds and place them into her ears to block out some of the noise.
- Of course, tennis balls on the bottoms of chairs to alleviate the screeching of chair tips on the tile floors is a solution
- Allow the student to eat lunch with a group of friends in an empty classroom- don’t isolate the student
- Seating the student away from air vents and overhead projectors for the SmartBoard
- Seating the student away from the door
- Use a pool noodle and a pillowcase. Put one outside the door inside the pillowcase and then slide the other pool noodle inside the pool noodle and slide the middle of the pillowcase under the door (You will need to make the pillow case thinner so that it is just about 3 inches larger than 2 pool noodles side by side
- Put a decorated piece of foam over the loudspeaker in the room – you will still be able to hear the announcement- but it will lessen the severity of it
Please share your ideas
Any other ideas you have to share would be appreciated. I’m really hoping to come up with more viable solutions than Shrek colored ear plugs sticking out of a student’s ears, or cotton balls, or giant foam headphones.