Monday, December 13, 2010

For the Teacher: How to Teach the Child with ADHD to Join Ongoing Activities

It is very important for you, the teacher, to judge if the child with ADHD in your classroom has acquired the social skill of joining ongoing activities. Children with ADHD typically do not know how to behave or what to do when they want to join in with children who are already playing. Children with ADHD do not know what to do when they want to ask another child if they can join in their play. They do not know that they should wait until there is a quiet time before they ask to join in other children’s activities. These children have been known to barge in on the two children who are already playing. Being able to discriminate between people’s various facial expressions and their associated body language is a major strength when a child approaches another and has to decide whether to ask if he can play in their group.

A child has more of a probability of social failure and rejection when he does not understand other children’s facial expressions and body language. When children with ADHD fail to pick up cues from other children as to whether they will ask them to join in their active play, they do not understand that the particular time that they enter the social interaction may not be an acceptable time to play with these children. It is very important to teach children with ADHD to recognize and to understand body language so they can judge when is an appropriate time to try to join in activities.

Here are some ways to teach children with ADHD to appropriately join in with another’s activities. The following activity is for children with ADHD who like taking on roles and who do not have social anxiety related to being in front of people.

Charades: We all remember the game charades. It is a great game for helping a child with ADHD to recognize facial expressions as well as body language. If the child does not really understand what the facial expressions mean, read himToday I Feel Silly & Other Moods That Make My Day by Jamie Lee Curtis (1998). They can manipulate the facial expressions at the end of the book themselves. One child can model one facial expression, such as angry, while the other guesses that facial expression. The teacher can make up two teams and the team that guesses the most facial expressions wins. The teams should be mixed randomly with children who have ADHD and those who do not have ADHD. All children, those who do and do not have social anxiety, can try the next exercise.

Mirror, Mirror on the Wall: Mirrors are great tools for showing children who might not otherwise realize what a certain facial expression means to learn to understand their meaning. Either a teacher or another child can make a facial expression in the mirror. Ask the child with ADHD to name the facial expression (i.e., happy, angry, nervous, afraid, etc.). Then, ask the child with ADHD to make the same expression in the mirror that the other child did. If the child with ADHD did not pay attention to the other child’s facial expression, have the child make the facial expression again.

Candid Camera: The teacher can gain permission from the child’s parents to take pictures of the children themselves making the various facial expressions. The teacher should write in an informed consent letter that the pictures will only be used for the teacher’s educational purposes. It may be easier to teach facial expressions to children with ADHD if they see pictures of themselves making the various expressions. They typically laugh and seem to remember the facial expressions because they become personally relevant. Children with ADHD learn and remember when they are engaged in the learning process.

When teachers make learning experiences meaningful and relevant to children, they are more likely to remember what they have learned. Digital photography offers another lesson as well. After you take the pictures, look at them with the child with ADHD and agree that he has made a particular expression. If not, you can delete it until the child makes the facial expression that was discussed.

Candid Camera Video: Children with ADHD and other disabilities, for that matter, often do not see other people’s viewpoints as to how they are behaving. A great way for these children to see themselves from what I call a worldview is to videotape their behavior in situations where they are trying to interact with other children. Make sure that you gain the parents’ permission before you videotape. Do not be concerned that your presence will affect the quality of the social interaction, because it will not. During my field research, I had that same concern. However, I quickly learned that not only do I become invisible, but more interestingly, the children cannot and do not alter their behavior in any way. Children with ADHD do not perform for anyone. They exhibit the same behavior no matter who is in the room.

Children with ADHD behave as they behave; that is it. I would recommend viewing the videotape first yourself, just to make sure that in your opinion, nothing about the tape embarrasses the child. As I said before, most children with ADHD do not see themselves from other people’s viewpoint, so in most cases the videotape will be fine for the child to view. I would, however, view the videotape privately with the child, as you should be certain to state precisely on the informed consent. Once the teacher has decided that the video footage is a good representation of what she wants to teach, then do not delete either the tapes or the pictures. You might want to go back and refer to them later on. The following are cues that teachers can help children with ADHD to look for when they want to join in with children who are already playing.

Explain what body language means:

Are the children’s bodies facing in the same direction?
Are the children’s heads and faces close together?
Are the children engaged in an animated conversation
with each other?
Are the children playing in a corner of the room away
from others?
Do the children look at the approaching child when he
moves toward them?

One book that might help young children to understand the basics of joining in with another’s play is Join In and Play by Cheri J. Meiners (2004). Now that the teacher/parent has taught the child with ADHD to join in on activities, it is also crucial that the child learn about volunteering to help peers.

The social skill of volunteering to help peers is one for teachers to think about before they begin to teach it. This is really a thinking social skill. You will remember that I discussed making each social skill you teach meaningful to the child with ADHD as a way to help him learn it. Well, let us explore how to do that. First, try to encourage the child to think about the last time he observed that one of the children in their class needed
help of any kind. Did someone have to pick up blocks quickly to get to the next activity? Was a child holding many things in his hands while trying to open a door? Did someone have too much to carry when he held his lunch tray? Did someone lose something important to him? Additionally, just to make sure that the child really understands what you mean by helping another child, you could read a book to the child, such as The Berenstain Bears Lend a Helping Hand by Stan and Jan Berenstain (1998) and Helping Mom by Mercer Mayer (2002).

Another great idea that would make this social skill lesson meaningful is for both the teacher
and the student to write a social skills story based on a time when a child needed help and another child came to his assistance. A peer support or a peer buddy system is a very useful tool for teaching social skills to children with ADHD. In this example, the teacher speaks to a typical child and asks him to help a specific child when he needs assistance. Bob has been building a large block structure for an hour. The teacher says, “Okay, everybody, we have to clean up because lunch is in five minutes.” Bob looks around and looks worried and says aloud, “How will I ever put all of these blocks away in five minutes?” Before he becomes very upset, Bill, another child in the class, goes over to him and says, “Bob, would you like me to help? Two of us can put the blocks away faster than one!” Bob says, “Great. Thanks, Bill!” They put the blocks away so fast that Bob and Bill are the first in line for lunch!

Be sure to include pictures along with the social stories to make the meaning very clear for the child reading it. The child can draw the pictures, the teacher and the child can draw the pictures together, or the teacher can take digital pictures (with informed consent, of course) of one child helping another as a real example.

The teacher might want to include the reasons why is it important to help another child in a social story. The teacher and the child with ADHD, therefore, can collaborate and write a social story that describes a situation when a child wants help from another child. Perhaps the child with ADHD can offer assistance to a typical child. The child with ADHD will feel good about himself, because he is helping someone else. Most important, helping another child might be the first step in making a friend.

Speaking of steps, here are some steps to teach a child for when he decides to help another child. Notice what the child has to do in the first step. We have discussed this social skill previously. The steps can be written on a task card, which we will see examples of later.

Maintain eye contact with the child.
Smile and use a kind voice.
Say, “It looks like you might need some help putting away
the blocks.”
Ask, “Would you like me to help you?”
Help the child. (adapted from Hensley, Dillon, Pratt, Ford, & Burke, 2005, p. 162)

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