Primary School

The following strategies are useful in helping children with attentional difficulties to remain focussed on their work and tp get the required amount of work completed. It is important to note that children with attentional difficulties are not merely lazy or uncooperative. They have a genuine problem and they need the assistance of relevant adults to overcome such difficulties

Children with attentional difficulties have difficulty in following instructions. Instructions should be given in a direct declarative manner rather than in the form of a question or a request. They are more likely to be followed if distractions are removed and the child has made eye contact with the person giving the instructions. However, eye contact should not be insisted upon. Instructions should be kept short and the number of steps in the instruction should be matched to the child's ability to cope. Asking the child to repeat the instruction in his/her own words can help to ensure that the instruction has been understood correctly. The child should be supervised for a short time after the instruction has been given to ensure that he/she understands what to do, and is carrying out the instruction.

Children who have difficulty in maintaining attention need to be supervised when doing independent work in order to prompt them to return to task. Prompts should not be punitive, but should serve as a gentle reminder to return to task. The aim should be to provide prompts when necessary rather than to catch the child off-task.

Some children require more frequent and more specific feedback in order to improve their performance. Initially, reinforcement should be on an almost continuous basis with intermittent reinforcement being introduced gradually and cautiously. Children respond better to small immediate reinforcers than to long-term major reinforcers.

Many children need assistance in structuring complex homework assignments. The child should be helped to break up the assignment into a sequence of sub-tasks, each of which contributes to the final assignment. A tentative timetable should also be developed to enable the child to manage time effectively and to satisfy deadlines. Until they develop competency in this task, students will need supportive supervision.

Primary school children, in most cases, have not developed the maturity and self-discipline to organise a week's homework given out on Monday to be completed by Friday. Many children need their work to be structured so that a set amount of work has to be completed in a set time. This is essential for children with ADHD.

It is better to specify particular outcomes rather than vague behaviours which are difficult to quantify. For example the child might be expected to complete a specific task by a specified time rather than being expected to stay in his/her seat. The work cannot be completed without the in-seat behaviour, but it is easier to evaluate the outcome. The preference for an academic response as the treatment target shifts the focus to a behaviour which is incompatible with inattentive behaviour.

Preferred activities are more effective than concrete rewards, and can be made available contingent on specific conditions being met. A specific target, e.g., getting a set amount of work done, is more effective than a vague goal such as working well all morning. The child may need assistance in recognising progress towards a goal. This may be done in a concrete manner with tokens, or it may be done orally. Specific rewards or reinforcers should be varied frequently to maintain their motivational value.

Reinforcers must be of value to the child. A reinforcement menu may be useful in a class so that children can choose the reinforcement which appeals to them. Such a menu may have reinforcers ranked in value so that a child who has earned the highest level of reinforcer may select any reinforcer from Bands 1, 2, or 3. The child who has achieved a medium level reinforcer may choose from Bands 2 or 3; while the child who has only earned a base level reinforcer must choose only from Band 3.

Children with ADHD often have difficulty in sitting quietly at their desks while they are working. Such physical or verbal movement may be helping the child to focus on the task. Asking the child to concentrate on sitting quietly distracts him/her from the task at hand.

Copyright Dr Stephen Dossel, and the ADD Association Queensland. This article may be reprinted but should not be modified in any way. Any such use should be acknowledged in the normal manner and must include the author's name and the source of the article.