Running Head: STUDENT PAPER ASSIGNMENT 1

Student Paper Assignment

Cora Payne
St. Clair College
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1. Background information of Cole

Cole is creative, curious, and happy. He’s eight years old, and is currently in the third

grade. I had the pleasure of working with Cole during the summer when he enrolled at

the YMCA day camp. He currently lives with his great-grandparents and has no contact

with his biological parents, nor has he since he was three years old. Cole one year ago

was diagnosed with Attention Deficit Hyperactivity Disorder. He does not currently have

any co-occurring diagnoses, but his caregiver expressed great interest in getting him

further testing.

2. Exceptionality and brief description

Attention Deficit Hyperactivity Disorder, (or as it is commonly referred to, ADHD), is

a common, neurobehavioral disorder that affects children and adults. General signs and

symptoms are easily distracted, trouble controlling impulses, and being “overly active”

(National Center on Birth Defects and Developmental Disabilities, 2016a). These

children may frequently daydream, forget/lose things, squirm or fidget, take

unnecessary risks, give into temptation, have social issues (National Center on Birth

Defects and Developmental Disabilities, 2016a). Children with ADHD have a high risk of

school failure, depression and anxiety, relational problems, substance abuse,

delinquency, job loss, and accidental injuries (Chaban, 2009a). ADHD affects five

percent of school aged children (Chaban, 2009a). This means there may be one or two

children with ADHD in every classroom. Boys typically are diagnosed more than girls.

This is not because boys have ADHD more, but because boys display ADHD symptoms

outwardly. Although ADHD is referred to as a disorder, children with it may lie on a

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spectrum. “A child may have some inattentive or hyperactive symptoms without meeting

the criteria for ADHD” (Chaban, 2009a).

Diagnosing a child with ADHD is a long and complicated process. There is no

specific test for ADHD. Typically, the process begins with a medical exam to rule out

any other causes of symptoms. Other causes include, learning problems, mood

disorders, seizure disorders, hearing or vision problems, Tourette syndrome, sleep

disorders, thyroid problems, and brain injuries (Mayo Clinic Staff, n.d.). Once other

causes are ruled out information about the child’s and family’s medical history and

school records are gathered. The child, family, and other important people (i.e.

teachers, coaches, babysitters, etc.) are then interviewed and given questionnaires. All

of this is then compared to the criteria under the DSM-5 and the child may be given a

diagnosis. This diagnosis will be classified as Predominantly Inattentive Presentation,

Predominantly Hyperactive-Impulsive Presentation, or Combined. Inattentive

Presentation is what it sounds like, it is difficult for the individual to finish a task, pay

attention, and follow instruction (National Center on Birth Defects and Developmental

Disabilities, 2016a). These children have an extremely hard time with distractions and

often forgets daily routines. Hyperactive-impulsive on the other hand is the more

stereotypical form of ADHD. The individual fidgets and talks a lot, and thus he or she

may feel restless and feel the need to jump and climb constantly. He or she experiences

impulsive acts such as, interrupting, grabbing things from others, speaking at

inappropriate times, and having accidents (National Center on Birth Defects and

Developmental Disabilities, 2016a). Combined is an equal mix between both types.

Cole has been diagnosed with combined presentation. Thus, he not only has a difficult
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time paying attention and going along with routines of the day, he experiences impulsive

behaviours and is distracted easily.

ADHD is treated usually with a combination of behavioural therapy, medication, and

school accommodations. Behavioural therapy helps the child to find skills to replace

behaviours that cause issues with appropriate behaviours. It also teaches the parent or

caregiver skills to support their child (National Center on Birth Defects and

Developmental Disabilities, 2016b). There are two kinds of medication, stimulants and

nonstimulants. Research on medication is still growing, and we do not fully understand

why these medications work (Chaban, 2009a). For children under the age of six, usually

therapy is just recommended, and children older then six, a combination of medication

and therapy is recommended (National Center on Birth Defects and Developmental

Disabilities, 2016b). Cole is currently taking a stimulant and is not in any form of

behavioural therapy.

3. Strengths and Challenges:

Cole is one of the most amazing children to talk to. His strengths surround his

curiosity and imagination. Walking around the park our camp was located, he was

constantly examining the animals and plants he would find. He has an interest in

pretend play, especially if he can be a superhero or a soldier. He also would build grand

structures with both open-ended materials and Legos. Major challenges Cole faces are

that he runs away, hits, and screams when overwhelmed. He also struggles with

following routines, especially if that routine ends free play.

4. Current Effective Strategies:

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I am unfamiliar with the strategies currently used at his school. However, I can

imagine the strategies we used at camp would be similar. We would encourage Cole to

take “breaks” when he was overwhelmed. Because Cole ran away often, we decided

together that he would try to walk away, but still be in sight of the counselor he was with.

If he was still overwhelmed, the counselor would call myself or another supervisor and

we would walk around with him. Another strategy we used was giving him fidget toys in

times where we needed all campers to listen.

5. Intervention Planning:

1.) By the end of the year, Cole will play with classmates everyday with no more than 1

physical outburst (hitting or kicking) once a week, without prompts from the teacher.

a.) With prompts from teacher, in 1 month, Cole will work with a classmate three

times a week.

b.) Within 3 months, with prompts from teacher, Cole will work with a classmate

once a day with only 3 physical outbursts a week.

c.) Within 6 months Cole will work with a classmate once a day, with only 1

physical outburst a week with prompts from teacher.

My objectives work off each other, so my strategies will begin with offering a lot of

support, and then offering less and less. I will use instrumental strategies to teach the

basic social skills and change the environment to help Cole achieve the objectives.

Specifically, I will use the teaching social skills strategy (personal communication, K.

Markham-Petro, 09/27/16). I will explain why hitting is wrong and together we will come

up with different options he has for expressing his anger (ex. Walking away, problem

solving, calm down spot, etc.). Then, I will make sure I demonstrate appropriate ways to
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express frustration (ex. “Cole, I’m feeling upset when…”). Then, I would provide

examples where Cole can practice problem solving. He will then be able to practice the

skills, first with prompting by me and then alone. When he uses the techniques we

talked about, I will praise him. I will also ensure I provide him an environment that limits

the possible frustrations. For example, I will make sure there’s enough supplies and he

is surrounded by people that I know he gets along with. Once he is skill is practice, and

when we get to the third objective, I will give him environments that allows him to

practice. This can be achieved by encouraging more and more group collaboration with

people he gets along with, and students he may not get along with. Throughout this

process, I will make sure I never yell or punish him for the physical outburst. I must

make sure I model calm behaviour and treat each outburst as a mistake that we can

move on from.

2.) By the end of the year Cole will complete an assign tasks within the period without

prompts from teacher once a day.

a.) In the next 3 months, Cole will complete an assigned task once a week with

continuous prompts by the teacher.

b.) Within 6 months, Cole will complete an assigned task three times a week with

prompts from teacher.

c.) Within 8 months, Cole will complete an assigned task once a day with prompts

from the teacher.

To begin, I must make sure the content he is instructed to focus on is interest based.

I would base an activity off an observation of his interests, then as we go through the

year, I will incorporate more of a variety of activities. For example, he has an intense
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interest in turtles. I could begin by asking him to do research on his favourite animal and

complete a mini presentation on it. I must also limit the amount of distractions during

important course work. I could do this by providing Cole with headphones to cancel out

noise and keep the room quiet. I will also give Cole agreed upon visual prompts to

remind him to stay on task, then if that does not work use verbal prompts to remind him

to stay on task. I will also provide Cole with fidget toys and a bouncy ball to sit on. This

will help him not feel so overwhelmed with sitting still. Like the last goal, I must never

yell or punish him when he gets off track, but remind him why this is important.

3.) By the end of the year, with prompts from teacher, Cole will not run out of the

classroom during class time.

a.) In the next month, with prompts from the teacher, Cole will only have 2 incidents

a week where he runs out of the classroom.

b.) In the next 3 months, with prompts from teacher, Cole will only have 2 incidents a

month where he runs out of the classroom.

c.) In the next 6 months, with prompts from teacher, Cole will only have 1 incident a

month where he runs out of the classroom.

Because Cole runs when overwhelmed or mad, I will focus my energy in finding

ways to positively express anger. I would begin by explaining to him that running away

is not safe and could put him in danger. Together, Cole and I would come up with a

signal to tell me if he feels like running away. I would also teach Cole the five-point

scale (ErinoakKids, 2012). This is a visual scale he can use to express him emotions if

he did not want to verbally tell me. A one is calm, and five is angry. That way I could

emotionally support Cole before he reached a five. I would emotionally support him by
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listening to him, empathizing with what is making him upset, and problem solving. I also

then would have a warning if he is about to run away. I could also set up the

environment where he feels free to “walk away” without literally running out of the

classroom. I could make a calm down stop with calming toys and books. I would praise

him every time he walked away instead of running away.

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References:

ErinoakKids. (2012). The Incredible 5 Point Scale [PDF]. ErinoakKids Centre for

Treatment and Development.

Chaban, P. (2009, November 30). ADHD: An Overview. Retrieved November 05, 2016,

from

http://www.aboutkidshealth.ca/En/ResourceCentres/ADHD/AboutADHD/Pages/defa

ult.aspx

Chaban, P. (2009, November 30). Brain Differences in ADHD. Retrieved November 05,

2016, from

http://www.aboutkidshealth.ca/en/resourcecentres/adhd/aboutadhd/whatcausesadhd

/pages/brain-differences-in-adhd.aspx

Mayo Clinic Staff. (n.d.). Diagnosis. Retrieved November 05, 2016, from

http://www.mayoclinic.org/diseases-conditions/adhd/diagnosis-

treatment/diagnosis/dxc-20196188

National Center on Birth Defects and Developmental Disabilities. (2016, October 4).

Facts about ADHD. Retrieved November 5, 2016, from

http://www.cdc.gov/ncbddd/adhd/index.html

National Center on Birth Defects and Developmental Disabilities. (2016, October

06).Treatment. Retrieved November 05, 2016, from

http://www.cdc.gov/ncbddd/adhd/treatment.html