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This guide focuses on Steve, a first-grade student who exhibits both strengths and weaknesses in a public school setting. Despite being an expressive and creative child, he often disrupts the class through excessive talking and impulsive behaviors. Highlighting the need for stimulation and engagement in learning, we will explore potential interventions, including peer tutoring and structured activities, to support children like Steve. Additionally, consideration for testing ADHD and Tourette syndrome may provide further insights for effective management.
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Steve • First grade student • Attends a typical public school • Middle- aged female teacher with 27 classmates • Is not currently diagnosed with any kind of disorder or disability
Steve’s Strengths • Very happy • Upbeat • Loves to talk and share his knowledge with his peers • Expressive • Creative • Competitive
Steve’s Weaknesses Steve can be seen…. • excessively talking to his peers • often times out of his seat • making disruptive or disturbing noises • as a “know-it-all” • bothering his peers
Observation • Two Problematic setting: • Direct Instruction • Transitions
Direct Instruction • Behaviors • Shouting out • Disrupting classmates- kicking, talking, tapping his pencil • Making loud animal noises • Moving inappropriately • Behaviors are aimed at: • Getting Stimulation 59% • Avoiding boredom 24% • Gets Self-determination 18%
Payoffs in Direct Instruction Avoids Boredom, 24% Gets Stimulation Gets Self-determination Avoids Boredom Gets Stimulation, 59% Gets Self-determination, 18% Payoffs of Direct Instruction
Specific Examples • Getting stimulation • collecting garbage off the floor during math lesson • playing with his shoes for an entire Reading lesson • throwing his pencil at another student • rocking on his knees for 10 minutes- during a word stretching activity • Avoids • Making loud animal noises at the beginning a repetitive lesson on writing the letter “Q” • Shouting “O” loudly several times during an activity “What sound do you hear”
Transitions • Description of Behaviors • Shouting out • Disrupting classmates- kicking & talking • Making loud disrupting noises • Moving inappropriately • These Behaviors are aimed at • Getting Stimulation 86%
Specific Examples Getting Stimulation • Jumping on students • Collecting garbage and throwing it up like confetti • Continuing falling down while walking in line • Making disruptive noises while washing his hands • Disrupting the teacher by making loud gagging noises
Getting Stimulation • Largest ‘get’ • Steve is attempting to stimulate himself through his misbehavior • He is obviously not receiving enough stimulation
Consequences of Misbehavior • He is constantly redirected • He has been since into the hall • His desk has been separated from his peers
ADHD • 4% to 12% of school aged children have been diagnosed with ADHD (Barson, 2004) • Most common symptoms • Inattentiveness • Hyperactivity • Impulsivity • Which include • Fidgeting • Leaving seat • Talking excessively • Blurting out answers • Interrupting or intruding
ADHD & Tourette Syndrome • Tourette’s is an disorder characterized by involuntary motor and vocal tics (Munson, 2005) • Males are more often affected with Tourette’s (Leckman, 2002) • Most people with this syndrome have normal IQs (Munson, 2005) • 60% of children diagnosed with tourette's also have ADHD (Denckla, 2006)
Tourette Syndrome • Examples • Making loud animal noises at the beginning a repetitive lesson on writing the letter “Q” • Shouting “O” loudly several times during a “What sound do you hear activity” • Disrupting the teacher by making loud gagging noises
Tests • Steve should be tested for ADHD • Steve should have a MRI to test for Tourette syndrome
Interventions • Give Steve more stimulation by… • Peer tutoring • Assigning him special chores (organizing the library area, sharpening pencils, or picking up garbage) • Add fun and exciting surprises to lessons • Praising him when he is behaving properly • Give him more small group activity time
References • Barzman, D.H., Fieler, L., & Floyd, F.R. (2004). Attention-Deficit Hyperactivity Disorder and Treatment. The Journal of Legal Medicine, 25, 23-38. • Denckla, M.B. (2006). Attention-Deficit Hyperactivity Disorder (ADHD) Comorbidity: A Case for “Pure” Tourette Syndrome? Journal of Child Neurology,21, 701-703. • DuPaul, G.J., & Hoff, K.E. (1998). Reducing disruptive behavior in general education classrooms: The use of self-management strategies. School Psychology Review, 27, 290-304. • Egger, H.L., Kondo, D., & Angold, A. (2006). The Epidemiology and Diagnostic Issues in Preschool Attention-Deficit/Hyperactivity Disorder. Infants & Young Children, 19, 109-122. • Furman, L. (2005). What is Attention-Deficit Hyperactivity Disorder. Journal of Child Neurology, 20, 994-1002. • Leckman, J.F. (2002). Tourette’s syndrome. The Lancet,360, 1577-1586. • Munson, B.L. (2005). About Tourette’s syndrome. Nursing, 35, 29-29. • Zentall, S.S. (2006). ADHD and Education- Foundations, Characteristics, Methods, and Collaboration. New Jersey: Pearson Educational, Inc.