Sunday, November 17, 2013

SCHOOL COUNSELORS’ INVOLVEMENT WITH A SCHOOL-WIDE POSITIVE BEHAVIOR SUPPORT INTERVENTION: ADDRESSING STUDENT BEHAVIOR ISSUES IN A PROACTIVE AND POSITIVE MANNER

This week I read an article entitled School Counselors' Involvement with a School-Wide Positive Behavior Support Intervention: Addressing Student Behavior Issues in a Proactive and Positive Manner. As the name states, the article focused on a school-wide behavior intervention plan that targets problem behaviors before they become out of hand, costing the student valuable time that should be dedicated to learning in the classroom. School-Wide Positive Behavior Support Intervention is the behavior component of RTI, a "three-tiered systems approach that proactively addresses behavior concerns by teaching behavioral expectations and includes strategic support for students with more severe behavior issues" (Martens & Andreen, 2013, p. 313). The program, currently being used in "more than 18,000 schools," divides students into three groups, universal, targeted, and intensive, with about "80 to 85% students responding positively to the universal tier" (Martens & Andreen, 2013, p. 313-314). The universal tier is made up of five components: 
"defined school-wide behavior expectations, a process for teaching and re-teaching those expectations, an acknowledgement system, a process for preventing and addressing problem behaviors, and a system for collecting and analyzing data" (Martens & Andreen, 2013, p. 313). For the 10 to 15% of students who are unresponsive to these prevention strategies, the program introduces tier two, which includes interventions that are "readily available and require little assessment prior to implementation for students," implemented to "reduce the level of present problem behaviors and to prevent further escalation of problem behaviors" (Martens & Andreen, 2013, p. 314). Finally, for the 3 to 5% of students who are unresponsive to tier one and two, tier three, or an individualized Behavior intervention Plan, is put into place. 
The article focuses mostly on one example of a tier two intervention, the Check In/Check Out Method, or CICO. CICO "establishes a structured daily routine for identified students in order to reduce and prevent the escalation of problem behaviors," aiming to "increase the opportunities adults have for prompting students to engage in positive behavior, provide behavioral feedback to the student at predictable times throughout the day, develop a meaningful adult-student relationship through positive interaction, and communicate behavioral challenges and successes with families daily" (Martens & Andreen, 2013, p. 314). Students begin each day by checking in with an adult, receiving their daily behavior report card. The report card "defines behavior expectations and includes a Likert-type scale to evaluate the student's behavior" (Martens & Andreen, 2013, p. 314). The report card could also include "a visual schedule for students, space for written adult comments, and a reminder of the student's daily behavior goals" (Martens & Andreen, 2013, p. 314). The student carries their behavior report card with them throughout the day, using it to "allow teachers to provide behavioral feedback in the form of points and/or positive comments at designated time intervals" (Martens & Andreen, 2013, p. 314). At the end of the day, the student must check out with an adult, where they "graph the results of their day, receive praise (tangible and/or verbal), and obtain a copy of their daily behavior report card to take home" (Martens & Andreen, 2013, p. 314). The student must provide a signed copy of the behavior report card at check-in the next morning. The data that is collected from the daily behavior report cards is used to "make decisions about continuing, modifying, or discontinuing the intervention" (Martens & Andreen, 2013, p. 314).
I found this article to be a great example of tiered behavior management as described in our textbook. As McLeskey states, "tiered systems allow educators to address the behavioral needs of all students by addressing universal, inclusive management concerns typical of most students and by using a continuum of individualized planning and interventions for those students who do not readily respond to elements of the universal management system" (McLeskey, Rosenberg, & Westling, 2013, p. 365). The Check In/Check Out intervention is an example of a targeted intervention, a "powerful, focused, school-based effort designed to reduce frequent and intensive problem behaviors" (McLeskey, Rosenberg, & Westling, 2013, p. 365).
I would recommend this article to teachers, general and special education, because of the simplicity yet effectiveness of the CICO intervention. The article also includes graphic overviews of the CICO intervention, printable daily behavior report cards, and home reports. I believe this would be a great behavior management intervention to implement in a classroom, as well as a useful tool for documenting recording a student's behavior while completing a functional behavior analysis. 

Martens, K., & Andreen, K. (2013). SCHOOL COUNSELORS' INVOLVEMENT WITH A SCHOOL-WIDE POSITIVE BEHAVIOR SUPPORT INTERVENTION: ADDRESSING STUDENT BEHAVIOR ISSUES IN A PROACTIVE AND POSITIVE MANNER. Professional School Counseling16(5), 313-322.

McLeskey, J., Rosenberg, M.S., & Westling, D.L. (2013). Inclusion: Effective Practices for All Students. Upper Saddle River, NJ: Pearson.

Monday, November 11, 2013

The Circle of Courage in Transition Planning

This week I read an article called "The Circle of Courage in Transition Planning" by Deborah Espiner and Diane Guild, two educators in New Zealand, that have implemented and studied a new practice for transition planning, the Circle of Courage. The Circle of Courage combines philosophy and graphic facilitation to create a student-centered transition plan. "The approach is designed to ensure that the young person, the family, and whana (the Maori term for extended family) were at the centre of the planning process and were heard, so the resulting plan would represent their aspirations and goals"(Espiner & Guild, 2011, p.44). The visual and accessible format of the Circle of Courage "engages young people, capitalizes on their learning styles, and creates common understanding" (Espiner & Guild, 2011, p.45). The Circle of Courage is a large circular graphic organizer divided into four equal parts with a smaller circle in the center. Inside the small circle, the student's name is written and picture of them is attached. The four sections of the circle are labeled Belonging, Mastery, Independence, and Generosity. Below is an example of the Circle of Courage:



During the transition planning meeting, a small group, consisting of the student, their family, the teacher, and the school's transition coordinator, work together to fill out the graphic organizer, with words and graphics, by asking the student questions. First, the group works on developing the dream, what would the student and their family like to happen in this area after transitioning? Next, they work on "capturing the now" by determining "what can the young person do at the present time using skills and knowledge to work towards the Dream," and then creating a "plan for action" by asking "what do the support person and the support team need to achieve in journeying towards the Dream" (Espiner & Guild, 2011, p.46). Below are some of the prompts suggested by the authors to help facilitate the creation of the Circle of Courage:


From a case study completed on the transition process of a nineteen year old student named Andrew, Espiner and Guild found that Andrew was "highly engaged" and showed "full involvement" in the process (2011, p. 48). The participants in the meeting, Andrew's teacher, family, and transition coordinator, stated that the Circle of Courage let Andrew "see his dream" (Espiner & Guild, 2011, p.48). At the end of the meeting, pictures of the participants in front of the Circle of Courage are taken as documentation and the student is able to immediately take the Circle home as a visual reminder of their dream and the plan they will be taking to reach it. Below is a picture of Andrew's completed Circle of Courage:


I really enjoyed reading this article and found it related directly to all the readings and activities we have completed throughout this week's module. The Circle of Courage is just another example of a person centered transition plan. The Circle focuses firstly and primarily on the student and their dreams and goals, then their support group, family and staff, see what they can do to help make this dream a reality. As the textbook states, the goal of the strategy is to "involve and empower students in the development and implementation of their IEP, including goal setting, accommodation selection, and program assessment" (Smith, Gartin, & Murdick, 2012, p. 76). While the terminology in the Circle of Courage is not as technical as usually heard in IEP meetings, the four categories are able to retrieve the same important information in a way that the student can understand and that encourages them to "take ownership of their goals" (Smith, Gartin, & Murdick, 2012, p.76). 

I found this article and the Circle of Courage philosophy to be very powerful and positive. I could see this strategy being very successful in schools across the United States because of the student-centered approach and the engaging and visual process. I would definitely recommend this article to other special educators or those involved in the transition process. 

Espiner, D., & Guild, D. (2011). The Circle of Courage in Transition Planning. Reclaiming Children & Youth20(2), 44-49.

Smith, T.E.C., Gartin, B., & Murdick, N.L. (2012). Including Adolescents with Disabilities in General Education Classrooms. Upper Saddle River, NJ: Pearson. 

Sunday, October 27, 2013

Suicide and Students With High-Incidence Disabilities: What Special Educators Need to Know

As we learned in Module 9, depression and suicidal thoughts or actions are serious issues that affect thousands of adolescents each year. As the article states, "Within a typical high school classroom, it is likely that three students (one boy and two girls) have made a suicide attempt in the past year," with suicide being the "third leading cause of death in individuals ages 10 to 24 (Wachter & Bouck, 2008, p.66). About "17% to 29% of secondary school students seriously consider suicide" while "8% attempt suicide" (Wachter, et al., 2008, p.66). While these statistics are already shockingly high, they only go up for adolescents with high incidence disabilities.  Adolescents with high incidence disabilities are more likely to have a lack of social support, due to fewer school supports and social isolation, and are statistically more susceptible to depression that their peers. In fact, the article states that approximately 50% of students who are eligible for special education services could also be diagnosed as depressed" (Wachter, et al., 2008, p.66). These risk factors mean that adolescents with high incidence disabilities tend to "think more about suicide and make more suicide attempts than their peers without a disability" (Wachter, et al., p.67). Due to these alarming correlations, it is extremely important for teachers working with students with high incidence disabilities to know the warning signs and how to properly intervene. The article suggests teachers implement preventive measures, such as school-wide programs or classroom presentations by school counselors, that can educate students on how to recognize when a peer is in trouble or can teach students "coping skills for anger, sadness, and anxiety" (Wachter, et al., p.68). However, these programs will not always be enough. The article goes on to list common signs of danger, or "indicators that a student may be going through personal difficulties and should be monitored," and imminent risk, which "indicate a need for immediate intervention" (Wachter, et al., p.68). Finally, the article lists many important and practical tips on how to address students who are considering suicide, most importantly, always "taking all threats or signs seriously, even if the student seems to be attention seeking" (Wachter, et al., p.70). 

After completing the textbook reading and watching the videos in module 9 about depression and bullying, I was deeply sadden by how prevalent suicide has become for adolescents. As the textbook states, adolescence is a time of "storm and stress," when students "tend to be sensitive to criticism  easily take offense at comments made by peers and family, and display inconsistent behaviors, moodiness, and often self-consciousness" (Smith, Gartin, & Murdick, 2012, p.4). For adolescents with disabilities, "these changes may be compounded by the characteristics of the individual disability" (Smith, et al., 2012, p.5). Many students with high-incidence disabilities have "social skill deficits" that can result in "difficulty in developing friendships and successful peer relationships," as well as "low self-esteem, imperfect self-awareness, and flawed self-perception" (Smith, et al., 2012, p. 12). These overwhelming social and emotional changes can often cause "anxiety, depression, or acting-out behaviors" (Smith, et al., 2012, p. 12). As shown in the article, due to all these compounding factors, adolescents with high incidence disabilities have a greater risk for depression and suicidal thoughts and actions. Because of these alarming statistics, I felt this article was a good choice for this week's blog post. Not only does the article connect closely to the reading, but also offers practical strategies and tips for handling these issues safely and effectively. 

I found this article to be very practical and would recommend it to all teachers, not only those working with the special education population. The tips and strategies listed in the article to help identify students in the danger or imminent risk stages are something all educators should be familiar with. While students with high incidence disabilities may be at a higher risk for suicidal thoughts and actions, as the statistics in the videos and this article show, depression and suicide can sadly be a major issue for all adolescents. The strategies listed for addressing students who are considering suicide may seem like common sense, however, when put in such a high-risk and dangerous situation, they are things that must be kept in mind, especially for a special education teacher who may be more likely to encounter a depressed or even suicidal student. With adolescent depression and suicide being such a prevalent and alarming issue in society today, I believe training, preventative and intervention, or at the very least, reading an article such as this one, should be made mandatory for all teachers. 

Smith, T.E.C., Gartin, B., & Murdick, N.L. (2012). Including Adolescents with Disabilities in General Education Classrooms. Upper Saddle River, NJ: Pearson. 

Wachter, C. A., & Bouck, E. C. (2008). Suicide and Students With High-Incidence Disabilities.Teaching Exceptional Children41(1), 66-72.

Sunday, October 13, 2013

Different Service Delivery Models for Different Communication Disorders

The article I read this week, Different Service Delivery Models for Different Communication Disorders, focused on the impact communication disorders can have on a student and how important intensive speech and language services are on not only their education, but their social experiences and post-school opportunities. Nippold (2012) states that communication disorders, especially language disorders, can have a tremendous impact on a student's "academic, social, and vocational success" (p. 117). Nippold (2012) goes on to state that students who are diagnosed with language disorders in kindergarten "continue to lag behind their typically developing peers in spoken and written language development throughout the school-age years" causing "poorer academic outcomes, weaker social competence, and higher rates of rule-breaking behavior compared to their typically developing peers" (p. 117). Not only are these students less likely to graduate from high school with their peers, but also "less likely to attend college, and that when they do obtain employment, it is often at a substantially lower salary" (Nippold, 2012, p. 117). However, students with language disorders are not doomed to follow this path; Nippold offers possible solutions to these troubling finds. Instead of the commonly used "pull-out" model, in which students are pulled out of the room once or twice a week for usually 30 minute sessions with a speech-language pathologist, Nippold (2012) argues that effective intervention for language disorders must be "frequent and intense," promoting "children’s active attention; and that children receive corrective feedback on their responses and praise for their efforts and successes" (p. 118). Not only should intervention occur as early as possible, but should also closely include other school staff, especially the classroom teacher, a special education teacher, and a school counselor, to help with reducing the student's frustration and creating a supportive environment. Nippold states that while the "pull-out" model may be ideal for students with speech disorders, such as stuttering, it is not always the most effective option for students with language disorders. 

I found this article definitely connected with our reading this week on communication disorders. Nippold's startling facts about the impact a language disorder can have on a person's life are echoed in the textbook. The reading states that, because "communication skills are an essential part of social relations," the social behavior of a student is often affected by their communication disorder, often resulting in "withdrawn behavior" or "undesirable interactions such as aggression or disruption" (McLeskey, Rosenberg, & Westling, 2013, p. 131). Also, there is a strong correlation between communication disorders and behavioral and emotional disabilities, with "71% of students who were labeled with emotional and behavioral disabilities also having language deficits" and "57% of the students identified with language deficits also were classified as having emotional and behavioral disabilities" (McLeskey, et al., 2013, p. 131). In my classroom at Elim, all eight students use AAC devices to communicate due to a variety of language deficits. While not all of our students have behavior problems at school, those who do are often triggered by frustration due to not being understood or not being able to effectively communicate their thoughts. I believe the correlation between communication disorders and emotional or behavioral disabilities is a very evident in our room. To help remediate this issue, the students receive many of the services suggested by Nippold in the article, including speech services with our speech-language pathologist, taking part in a speech group as a class, receiving counseling services, and also receiving assistance in using their AAC devices effectively from the teacher and aides. 

I thought this article was very informative and the facts that Nippold shared about how important early language intervention is were extremely alarming. While I found her research and solutions very well done, I would have like some more concrete strategies for teachers to use in the classroom to help these students and be an effective piece of the intervention plan. Also, while I understand how important intense intervention is for students with language disorders, Nippold herself states that many speech-language pathologists in schools are already stretched thin, many working with over 60+ students, all with very different and demanding communication disorders. I agree with Nippold, that until school districts are able to fund multiple SLP's, maybe even those who focus solely on particular communication disorders, frequent and intense intervention such as she suggests may not always, unfortunately, be possible. 

McLeskey, J., Rosenberg, M.S., & Westling, D.L. (2013). Inclusion: Effective Practices for All Students. Upper Saddle River, NJ: Pearson.

Nippold, M. A. (2012). Different Service Delivery Models for Different Communication Disorders. Language, Speech & Hearing Services In Schools43(2), 117-120.


Monday, October 7, 2013

Mainstreaming v. Special School Placement for Students with ASD

This week, the article I read focused on a study completed by British psychologists on whether mainstreaming is truly the best practice for students with Autism Spectrum Disorder. As the article states, about 60 percent of students with ASD in the UK are placed in mainstreamed educational settings (Reed, Osborne, & Waddington, 2012, p.750). Many supporters of mainstreaming argue that ASD students should be placed in general education settings as frequently as possible particularly because of the social development benefits due to modeling by peers.  However, the authors of the study argue that, for students with ASD in particular, studies "have shown significant improvements in social skills for children placed in special placement" rather than general education placements and even that "several studies have shown particularly poor performance for children with ASD placed in mainstream schools" (Reed et al., 2012, p. 751). The authors of the article argue that, "for a population with ASD, it appears that social interactions may well be the domain that is most vulnerable to negative impact by mainstream placement" due to "problems with teacher training," "unrealistic teacher expectations," and "the impact of parent confidence and stress on their children’s performance" (Reed et al., 2012, p. 751). They believe that these issues, resulting from a mainstreamed placement, result in higher levels of stress and challenging behaviors for students with ASD. To test out their beliefs, the researchers administered questionnaires to students with ASD, attending both specialized and general education schools, and their parents in the beginning of the school year and then gave the same questionnaire nine months later. The questionnaire measured the students' strengths and weaknesses, as well as their adaptive behavior. The results showed that "children placed in special schools made greater improvements in their behaviour problems" and while "children with ASD can make progress in areas of adaptive behaviours when placed in mainstream schools, they do not make greater progress than children placed in special schools in socialisation" (Reed et al., 2012, p. 759). 

I found this article to be particularly interesting because of my current position as a paraeducator in a specialized school setting. At Elim Christian School, we have many students with Autism that, due to severe communication or behavior issues, cannot be mainstreamed into a general education setting. These students display many of the characteristics described in our textbook, such as "significant limitations in expressive and receptive language," "difficulties in social reciprocity," and " repetitive, stereotypical, and ritualistic behaviors," however many to an extreme degree (McLeskey, Rosenberg, & Westling, 2013, p. 113). Many of these students also exhibit the many of the challenging behaviors listed in the Autism Speaks toolkit, including aggressive and self-injurious behaviors. Due to my experience working with these students, I understand why the least-restrictive environment does not always mean a general education setting. Many school districts do not have the level of training, staff, or specific resources needed to educate and keep these students safe. As the Autism Speaks toolkit outlined, students with ASD can have episodes that escalate into emergency situations and it may take a team of staff to safely and successfully execute a crisis plan. Specialized school settings, such as Elim, can also adapt the environment specifically for students with ASD. At Elim Christian School, we have the ACE, or Autism Comprehensive Educational, Program that is housed in a special wing of the school where everything from the type of lightbulbs used to the playground outside are specifically tailored for students with ASD and their sensory needs. Accommodations like this are too extreme and not realistically expected in a mainstreamed setting.

While I work at a specialized school setting and think it can be a great place for some students with ASD, I believe the authors of this article are far too biased against mainstream settings. From the beginning of the article, it is evident that they do not believe students with ASD can function in a general education classroom. While they have some research to support their claim, I believe that their results, and those of similar studies, could have been caused by a variety of factors. How much training as each teacher had on working with students with ASD? What resources does the school have for students with ASD? Did the student's parents practice adaptive behavior skills at home? Do the students participate in any activities outside of school? Does the student have a supportive group of friends or family? Does the student have a history of behavior problems? Could their be other factors affecting their use of challenging behaviors? Every student with ASD is different, using behavior and language in their own way to serve a particular function. I believe the author's concept that it is merely their school placement, rather than the plethora of other possible factors, that is affecting their social and academic development is far too generalizing for all students with ASD. While I understand that a mainstreamed, general education setting may not be the best choice for every student with ASD, I do not believe it should be ruled out as viable option for all students with ASD. Instead, I believe it should be a decision made on an individual basis, taking into account all the determining factors. 

McLeskey, J., Rosenberg, M.S., & Westling, D.L. (2013). Inclusion: Effective Practices for All Students. Upper Saddle River, NJ: Pearson.

Reed, P., Osborne, L. A., & Waddington, E. M. (2012). A comparative study of the impact of mainstream and special school placement on the behaviour of children with Autism Spectrum Disorders. British Educational Research Journal38(5), 749-763. 


Sunday, September 29, 2013

Training General Educators to Increase Behavior-Specific Praise: Effects on Students with EBD

This week I read the article Training General Educators to Increase Behavior-Specific Praise: Effects on Students with EBD. The article focused on a study completed in three classrooms, two elementary and one middle school, across the country, focusing particularly on three students with EBD and four labeled as at risk for EBD. The goal of the study was "to increase the rate of BSP delivered to all students in the classroom and determine the effects of Increased BSP on students with or at risk for EBD" (Allday, Hinkson-Lee, Hudson, Nielsen-Gatti, Kleinke, & Russel, 2012, p.87). BSP, or behavior-specific praise, "provides students with praise statements that explicitly describe the behavior being praised" (Allday, et al., 2012, p. 87). For example, instead of simply saying "Great work," a teacher using BSP could say "I like how are sitting in your seat so quietly" or "Thank you for raising your hand to speak." Because working with students with challenging behaviors has been reported as the most challenging part of a teacher's professional life, this article aims to give teachers an effective and fairly simple intervention to support success and engagement in the classroom (Allday, et al., 2012, p. 87). It has been shown that "teacher attention, in the form of behavior-specific praise (BSP), is one type of attention that has shown to be effective in previous studies to increase on-task behavior, task completion, correct academic responses, and compliance" (Allday, et al., 2012, p. 87). The teachers in the study went through a brief training on implement BSP in their classroom and then were observed on about 15 to 20 separate, thirty minute sessions. During the observations, the students engagement was tracked, as well as the teacher's use of BSP. After the study was completed, it was shown that every student's level on-task behavior increased throughout the study. As Allday states (2012), "correlation analyses suggest a positive relationship between increases in rates of BSP and increases in on-task behavior, with a moderate to strong relationship for most students" (p. 95). Instead of using behavior-specific corrections, which reference an undesirable behavior, the teachers were using dramatically more BSP for all their students, resulting in a much more engaged and responsive in class.

I found this article related very closely to our reading and activities this week, as well as my personal experiences working in a special education classroom. In my current classroom, we have two students that often exhibit challenging behavior, including noncompliance and aggression, both verbal and physical. We have found that instead of using behavior-specific corrections, such as "Please stop talking" or "Sit down in your seat," the students are much more receptive to behavior-specific praise. Not only do the students enjoy being praised for behaving properly, but they understand exactly what they did that was right and know to repeat that behavior if they want to receive more praise and positive attention in class. Also, because we use BSP rather than BSC for all of our students, not just those with challenging behavior, the students with behavior issues hear their peers being praised for behaving in a positive manner and recognize that they could be receiving attention if they were to follow suit. This allows they students to learn from their peers without having to be told what to do by the teacher or support staff. As the textbook states, many students with EBD "are not fluent in social behavior because they have not had adequate exposure to models of social skills" (McLeskey, Rosenberg, & Westling, 2013, p. 105). Using BSP for all students in the classroom allows the students with EBD to find these positive models within their peers. Also, using BSP helps foster positive and authentic relationships between students and staff. Because "trusting relationships develop when teachers communicate in ways that reflect a genuine concern for students' academic performance and emotional well-being," BSP is much more effective in building these authentic connections than the constant behavior-specific corrections that many students with EBD are used to hearing at school (McLeskey, et al., 2013, p. 106). 

I found this article to be very useful and practical for all teachers. The methods used in the study are simple and it would be easy to implement BSP in the classroom. While many teachers are used to using behavior-specific corrections, with time and practice, they could easily transition to using behavior-specific praise instead. I have experienced how receptive students with challenging behavior can be to this positive attention and believe it is a very effective classroom management tool for working with all students, not just those with EBD. 

Allan Allday, R. R., Hinkson-Lee, K., Hudson, T., Neilsen-Gatti, S., Kleinke, A., & Russel, C. S. (2012). Training General Educators to Increase Behavior-Specific Praise: Effects on Students with EBD. Behavioral Disorders37(2), 87-98.

McLeskey, J., Rosenberg, M.S., & Westling, D.L. (2013). Inclusion: Effective Practices for All Students. Upper Saddle River, NJ: Pearson.

Sunday, September 22, 2013

Self-monitoring of On-task Behaviors Using the MotivAider® by a Middle School Student with a Moderate Intellectual Disability

Boswell, M., Knight, V., & Spriggs, A. D. (2013). Self-monitoring of On-task Behaviors Using the MotivAider® by a Middle School Student with a Moderate Intellectual Disability. Rural Special Education Quarterly32(2), 23-30.

This article, Self-monitoring of On-task Behaviors Using the MotivAider® by a Middle School Student with a Moderate Intellectual Disability, presents a new option for keeping students with intellectual disabilities focused during a lesson or independent work time. The article argues that, in a general education setting, a paraprofessional may not always be the best option for students with moderate intellectual disabilities. Boswell and Knight (2013) argue that students with paraprofessionals can become too dependent on this support staff and may feel separated from their peers, often expressing "feelings of embarrassment, stigmatization, rejection, and disenfranchisement" (p. 23). One alternative to paraprofessionals in the classroom is teaching students with intellectual disabilities how to self-monitor, "in which a student observes and records his or her own target behavior" (Boswell and Knight, 2013, p. 23). Boswell and Knight tested this alternative on an 11 year old, sixth grade male student with a moderate intellectual disability named Sam using a MotivAider device. The MotivAider is a low cost, small electronic device that "looks similar to a pager and can be easily programmed to vibrate on a fixed or variable time schedule" (Boswell and Knight, 2013, p. 24). Boswell and Knight set Sam's MotivAider to go off every three minutes as Sam completed math activities in the classroom. When the device would go off, Sam would fill out his self-recording form by circling yes or no to the question "Am I Working?" An instructional assistant would verify Sam's response and, if correct, give him a small edible reinforcer. Sam's responses were accurate 98 percent of the time and, after the initial session, Sam remained on-task 100 percent of the time while using the MotivAider. Once the MotivAider was removed, Sam's on-task behavior decreased significantly, falling to 33 percent (Boswell and Knight, 2013, p. 28). Boswell and Knight (2013) also found that Sam's Math fluency greatly increased while using the MotivAider, jumping from 1.5 CDM to 3.0 CDM, an 100 percent increase (p. 28). 

I found this article and the use of the MotivAider to be very interesting as a strategy for helping students with intellectual disabilities be more independent in a general education classroom. In my classroom, we have used similar methods to help our students gain independence from staff. Some of our ambulatory students carry small alarms with them that go off when the students have to leave for different activities, such as lunch or a therapy. When the alarm goes off, the students know to get a hall pass and leave for said activity. The alarm is small and discrete, not interrupting the rest of the class but still acts as cue or reminder for the student. While I haven't seen the alarms used during lessons as a way of self-monitoring, I have seen how successful they can be in giving students with intellectual disabilities independence from their paraprofessionals and other staff. Although it is a tactile cue instead of visual, I found the use of the alarm to be very similar in concept to many of the visual supports that were demonstrated in our autism module. 

I thought this article was extremely practical and useful and I could definitely see the MotivAider, or a similar device, being used in a general education classroom to help students with intellectual disabilities stay focused while also teaching important self-monitoring skills. As a paraprofessional myself, I believe that some students can greatly benefit from having a one on one aide and that extra support throughout their day. However, if the student is becoming too dependent on their support staff and becoming ostracized from their peers, looking into other options for at least part of the day may be beneficial. I believe this MotivAider could be a viable option for many students with mild or moderate intellectual disabilities during class time or, if the student needs more support, possibly just during a homeroom or resource period. After the initial training and some practice, the student would not need a paraprofessional standing near them, reminding them to stay on-task, with the alarm would act as the reminder. The MotivAider is fairly affordable, about 40 dollars, and could be a great investment for the classroom. Habit Change, the company that created MotivAider, has also come out with a MotivAider app for the iPhone and Androids which only costs $1.99, making it much less expensive if the student already has a smartphone or the classroom already has a tablet or iPad. The article suggests many other uses for the MotivAider that could be beneficial in the classroom, such as using it to "signal break time for a student who is easily frustrated by a difficult task," "as a prompt for a student on a toileting schedule," or even as "a prompt for a teacher who wants to deliver verbal praise orcheck on a student at regular intervals" (Boswell and Knight, 2013, p. 29). 

I would be very interested in seeing future studies using the MotivAider, or a similar device, with a larger group of students or testing the variety of different uses that the device could have in the classroom. 

Sunday, September 15, 2013

Brain Games as a Potential Nonpharmaceutical Alternative for the Treatment of ADHD

Wegrzyn, S. C. (2012). Brain Games as a Potential Nonpharmaceutical Alternative for the Treatment of ADHD. Journal Of Research On Technology In Education45(2), 107-130.

According to Wegrzyn (2012), "Attention deficit hyperactivity disorder (ADHD) is the most commonly diagnosed childhood neurobehavioral disorder, affecting approximately 5.5 million children between the ages of 4 and 17." However, of these 5.5 million, 20% do not respond to the commonly prescribed stimulate medications (p. 107). Due to this fact, Wegryzn and her team decided to research and test a new alternative for students with ADHD: brain games. One of the believed causes of ADHD is a lack of activity in the prefrontal cortex. Recent research states that activities such as "rapid mathematical calculations and reading aloud" can greatly increase activity in this section of the brain and have proven beneficial for patients with dementia (Wegrzyn, 2012, p. 108). In this article, Wegrzyn had students, ages 10 to 17, that were previously diagnosed with Combined or Inattentive ADHD play at least twenty minutes of BrainAge, a Nintendo DS video game, everyday before going to school. Through student and parent journals, as well as EEG testing, Wegrzyn was able to test the effectiveness of this alternative treatment option for students with ADHD. After five weeks of treatment, the students returned to their normal routine, not playing any brain games for three weeks. When this post-treatment period ended, Wegrzyn began to analyze all the compiled data. According to Wegrzyn (2012), the participant journals revealed that "six of the nine participants who kept journals showed patterns of increased engagement during the treatment period." The students saw "a positive difference in their ability to focus, pay attention, concentrate, or engage in class" (p. 118). The parents also witnessed similar changes, stating that "9 out of 10 parents saw an improvement in one or more symptoms of their child's ADHD" (p. 118). During the post-treatment period, both students and parents noticed a "decreased engagement" and "a negative change in one or more of the symptoms of ADHD" (p. 118). 

I found this article and Wegrzyn's research to be very interesting and enlightening. I was previously unaware that such a large percentage of children with ADHD do not respond to the commonly prescribed medication. From the ADHD: Fact or Fiction video, I learned that medication is only part of a treatment program for someone with ADHD, also including aspects such as diet, stress-control, therapy, and coaching. I believe that for some students, brain games could be another effective component. During my student teaching, I worked with one such student, a high school junior with inattentive ADHD. I regularly witnessed this student, like many other students, on his phone and iPod sneakily trying to play games during downtime or passing periods. I found these transition times between classes challenging because this student, and others without ADHD, often lost focus from one class to the next and it could be difficult to get everyone quickly back on track during in the beginning of the class period. Because of this previous interest in video games and the lack of focus after a transition, I believe using brain games either before school or during breaks could have been a viable option. Not only do I believe this student could have benefitted from this activity, but I believe many of my students without ADHD could have benefitted from brain games. I could also see brain games being beneficial in my current classroom at Elim. While our students are not diagnosed with ADHD, many of them struggle with focusing during class due to a variety of learning disabilities. Some effective strategies we use to promote attentiveness and to help the students concentrate include incorporating technology into lessons as well as breaking up our day into short blocks of time for each activity. Since many of students use the computers at school and already enjoy playing video games, adding brain games as one of our activities during centers, individual work, or free time could be a beneficial in the classroom and enjoyable for the students.

I found Wegrzyn's research and her conclusions to be a very practical and useful, not only for teachers but also for parents. I have heard many parents state that they worry about putting their children on medication for ADHD because of the myth that it causes children to become zombie-like. While the video, ADHD: Fact or Fiction, puts these rumors to rest, for parents that are still worried, brain games could be a possible non-pharmaceutical treatment option or component in their treatment plan. For the classroom, brain games could be an inexpensive and interesting way to promote engagement. Wegrzyn's study used Brain Age for the Nintendo DS. A used Nintendo DS and the Brain Age game together costs about 80 dollars. While I don't believe it is a practical idea that schools would provide such equipment for each student, it possible that they may be willing to purchase a few sets for a classroom. If not, many students may already own a Nintendo DS, significantly cutting down the cost. Other ideas such as donations or fundraising could also help in the acquiring the games. The article suggests that teachers could allow students to play the Nintendo DS during homeroom, lunch, recess, or other breaks during the day and then monitor any changes in the student's ability to focus. As Wegrzyn (2012) states, "liability is not an issue, considering that, even if the games did not help the child's engagement, they would at least provide the educational benefit of practicing basic math facts, memorization, and reading skills" (p. 125). Even if it were impossible to afford the video game, there are countless websites, including cnn.com, aarp.com, and many others, that host similar and free brain games. 

I believe the biggest weakness point of the article was limiting size and span of the study. Wegrzyn's study only included ten students with ADHD, ages 10 to 17, and lasted only eight weeks, five of which were for the actual treatment. While study was significantly helpful for these students, I would like to see a similar experiment done on a larger scale with various groups. Would brain games be as successful for students with ADHD that also have other disabilities? The article also states that even though the students felt an improvement, because the treatment only lasted 5 weeks, it was "just not enough time for the improvement to carry over into the classroom (Wegrzyn, 2012, p. 126). A longer study would allow the actual classroom impact to be monitored through grades and teacher observations. 

Overall, I found the article to be very interesting and useful in providing alternative methods to help students with ADHD focus and become in engaged in the classroom. I could see myself and other teachers I know easily incorporating brain game activities, with or without the actual Nintendo DS game used in the study, into the daily classroom routine. I believe that these brain game activities would help not only the students with ADHD, but other students as well due to their quick and fun approach.