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Interventions: Counseling, Consultation, and Support

The counselor's role in enhancing the academic performance of students with ADD or ADHD often involves consultation with teachers around classroom interventions, as well as providing support and education to parents. In addition to basic behavioral interventions, coping skills, social skills, and self-monitoring skills are important tools that can be reviewed through various modalities, including individual counseling, group sessions, or classroom guidance modules. Providing workshops in the evening with separate sessions for parents and children can be a resource welcomed by parents. Such efforts may be jointly offered with community support groups.

Parents often need information about appropriate expectations for behavior and school work, positive parenting techniques, and support groups at the school or in the community, such as CHADD (a support group for children and adults with attention deficit disorder). For example, a counseling newsletter to parents can provide descriptions of ADD, such as the fact that disruptive behaviors observed at school may not be observed at home, or that behavior can be inconsistent - at times under the child's control, and impulsive at others. Information and support can help parents in making the decision to seek an evaluation.

Typical challenges for students with ADD or ADHD include: 1) organizational problems; 2) problems with transitions; 3) acting as if rules don't apply to them; 4) adopting a negative attitude out of frustration in academic tasks, social interactions, or as a defense against low self esteem; 5) experiencing isolation or exclusion from peers; 6) poor grades as a result of rushing through assignments, incomplete work, or distractibility in class; 7) impulsive behavior; 8) difficulty sustaining attention; 9) different learning styles; or 10) disruption of sleep or appetite, as a result of ADD or medication. These students often describe feeling bored at school, and may appear oppositional (APA, 2000). Motivation around academic tasks or conforming to rules can be a challenge for these students.

A simple intervention that has proven successful includes "chunking" or organizing assignments into smaller sections. This makes successful completion a more likely outcome, and if applied to in-class assignments, allows the student a legitimate reason to get up and walk to the teacher's desk. Even such a small amount of movement can help discharge energy that is so critical for these students. It is for this reason that a common consequence for not completing homework (i.e., losing recess) is actually counter-productive with overactive children.

It is also important to remember the lack of self-monitoring ability as being central for many of these individuals. Teachers and parents can help children and adolescents develop this skill. Mechanisms to increase self-awareness include external monitoring systems such as checklists in the classroom. Additionally, the teacher can provide verbal cues such as asking the class to, "Stop and check - where is your mind?" Or the teacher can use physical monitoring cues for particular students, e.g., a simple tap on the shoulder to help them self-monitor. These cues are general enough to ensure that students don't feel ostracized by their use.

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