More ways to help ADHD student now off meds

Discussion in 'Behavior Management' started by TemperanceFaith, Nov 6, 2008.

  1. TemperanceFaith

    TemperanceFaith Comrade

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    Nov 6, 2008

    The parents took him off his meds this past weekend because they think that his ODD tendencies and aggression are a side effect of the medications. I know this is a possibility. The admin and teachers were all prepared for this on Monday.

    The trade off is now he is doing nothing, no work, no output because he cannot sit still or stop moving at all to do it. He cannot focus at all, he cannot control any of the impulses; I took him for a walk in the hall and he did cartwheels down the hall. The behavioral point chart is not working because he no longer cares about the reward time. I feel for him because he has to be coming out of his skin. OT has given me free access to everything in the room for him, but nothing is helping.

    The aggression and defiance was bad, but at least he would focus and work output was good. Now he is so disruptive that the class is getting affected.

    Ideas would be great. Things in place already are a points/reward chart, daily ABC Chart, redirection, OT techniques such as putty, yoga moves, stress relief moves, scooters, an exercise ball for sitting, other tactile seats, stress ball, etc.
     
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  3. glitterfish

    glitterfish Comrade

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    Nov 7, 2008

    Wow, sounds like you have tried a lot. I have a little guy whose parents are not getting the subtle, polite hints that their child is completely ADHD so he is not on medication. I'm having the same difficulties. Please, everyone, share your tips! Sorry I cannot be of more help.
     
  4. stevesgirl

    stevesgirl Companion

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    Nov 7, 2008

    It sounds like you are already doing a lot to help this child. I am in a similar situation, and it really takes its toll on the rest of the class. By the end of the day they are all stressed out from trying to listen to me while listening to him. One thing that has helped is turning off half the lights and putting on some quiet classical music when they are doing seat work. I also worked it out so that I could send him to the nurse to do some activities when it gets really out of control, or just to give the rest of the class (and me) a break for 20 minutes. Hang in there!
     
  5. TemperanceFaith

    TemperanceFaith Comrade

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    Nov 7, 2008

    The removal from the room is both good and bad. Good for the other students, but bad in the sense that he is extremely bright and uses it as a work avoidance thing. He will actually get up and say he needs a walk right when it is time to work, the little stinker. :lol: He is extremely smart and as his parents told me upfront, extremely manipulative. He will work you if you let him. I don't, and he and I have a better relationship for that. But jeeze louise, was I tired by the end of every day this week.

    I am tired of hearing all the unsupportive comments from other staff members. If it was my child, I would do everything possible to help him. If there was a chance the meds could be causing the aggression, I would take him off, so I do respect what they are doing. But then you get into the trade offs and the whole inclusion aspect of school; if he cannot focus at all to do any work in the classroom, if his actions, though now no longer violent, are even more disruptive because they are constant, which is the greater evil? It is so tough. Tough on him, on his parents, on the teaching staff, on me, and on the other students.

    At this point I am hoping since the meds are just recently removed, he will get to a point and stabilize and not be so over the top. Then again, I have never seen this particular child unmedicated, so it just may be the way he presents and I will have to accept it and just keep trying my best with the behavioral modifications, the positive rewards, etc...the sad thing is, on the meds, he was earning at least one reward period a day. The last couple days off meds, he earned zeros across most of the criteria for his chart. The only good news is there was zero aggression, unless you count running through the hallway playfully growling and making monkey sounds and pretending you were an escaped monkey.

    I do love this kid, which is why I have not duct taped him to the ceiling yet. ;)
     
  6. sciencewrestler

    sciencewrestler Rookie

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    Nov 7, 2008

    The following assumes the boy is not really ADHD (most boys are naturally active) and has been on medication for a long time.

    Personally I think like any young child that has only been on this earth for a few short years, maybe the boy simply needs to learn to sit, learn to listen, learn to not do whatever he feels likes (for his own good and out of respect for others).......and since it looks like all the "hi-tech" methods of teaching him those things are not working, IMO old-skool discipline techniques need to be used.

    Yep, techniques some consider "mean". But most of them sure worked well for the first few thousand years we've been here.

    As far as learning self-control, praising kids for the positive things they do has its advantages, but kids also need to learn that there are consequences for the negative things they do. And I think those consequences need to be something he/she will remember and time outs, not receiving a gold star and other such "punishments" are not something I believe most kids take seriously. Completely ignoring negative behaviors teaches a child next to nothing and I think doing this (ignoring that behavior) will only send such behavior into hibernation so to speak, and when the time is right, out it comes again! :(

    Anyone who *objectively* looks around and sees how so many kids act nowadays - e.g. selfish, pouty, constantly talk back to people more experienced than themselves, can't take constructive criticism without crying, etc - knows that using only positive reinforcement to teach kids self-control doesn't work.

    It's one thing to allow a child to be themselves, and something else entirely to allow them to create chaos for others by not teaching them there are definite rules when living/working/learning with other human beings; and chaos for themselves when they cannot learn the things in school and other similar venues that will help them grow as a person.

    IMHO.
     
  7. Samothrace

    Samothrace Cohort

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    Nov 8, 2008

    I have many students that are on medicine for add/adhd. One lil guy was horrible for me last year b/c when I saw him first thing in the morning his medicine had not kicked in. He has to take it at school b/c his mom was selling his pills for drug money.

    I can completely understand the parents taking him off that particular medicine b/c of the side effects...have they not looked into a different type that hasn't had the aggression as a side effect?
     
  8. TemperanceFaith

    TemperanceFaith Comrade

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    Nov 8, 2008

    sciencewrestler,
    While I appreciate your advice, and agree, especially having two of my own, that boys are naturally rambunctious, there is a difference between normal( I really hate to use that word, but with lack of a better one, my apologies ) "boy" behavior, and a boy with ADHD. I have seen enough of both to know the difference, and this student definitely has a legitimate diagnosis.

    He does have more serious discipline and consequences for his actions in addition to the positive reinforcement, including being suspended, suspended in school,placed in the behavioral classroom, etc. If you know anything about behavioral issues you would know that the normal discipline techniques used on any other student, like the above mentioned, increase the behavior because work evasion is the very goal. They do not want to sit still and work, in the case of ODD, and in the case of ADHD, they simply CAN'T.

    I do not know what else you are suggesting, and having grown up in the 70's and having had two students similar to this one in my classes, they used to put them in the corner facing the wall or put them out in the hallway. Psychology now tells us this is not appropriate and does nothing to aid the student whatsoever; if anything, it damages their self esteem and increases the problems. As students who have ADHD and other BD's, they already will have enough difficulty navigating the social aspects of life. Further ostracizing them from their peers and situations is not helpful, but harmful.
     
  9. TemperanceFaith

    TemperanceFaith Comrade

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    Nov 8, 2008

    They have tried all formulations, so at this point they are out of options, unfortunately.
     
  10. sciencewrestler

    sciencewrestler Rookie

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    Nov 8, 2008

    TemperanceFaith: as far as punishment is concerned, that is a very gray-area issue and the type of punishment is heavily dependent on the child and the situation he/she is involved in so I won't attempt to add anything about that here.

    As far as self-esteem goes, I would recommend checking out this site which has much information (links and summations of various articles and papers) on recent research - and usually properly carried-out research - from all kinds of sources concerning self-esteem programs and what they can actually do to a child......and it is not what one would expect. :(

    Some excerpts (BTW, self-esteem and self-respect are not the same thing):
     
  11. TemperanceFaith

    TemperanceFaith Comrade

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    Nov 9, 2008

    Thanks for the information, but I am of a different opinion and have other psychological experts I rely on for research, etc. I have read the information you provided and as with any research, it is highly opinionated and subjective. Self esteem DOES matter, especially for the student with learning and other disabilities.
     
  12. TemperanceFaith

    TemperanceFaith Comrade

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    Nov 9, 2008

    I also want to add that unless you have been part of the day to day experience within a Behavioral Disabled or Learning Disabled classroom, you have no idea how the little accomplishments are so important to the student. I saw a boy in the BD class, who is very close to being removed from the regular public school system, have one of his best days all year. To see that child's face at the end of the day, beaming from ear to ear, so proud of his achievement, no one can tell me that pride in one's accomplishments and self esteem and positive reinforcement conditioning does not work, particularly with these students.

    Unless you work with these students on a regular basis, while I respect you have your right to respond to my posts, you are not offering me anything that is of value or that you personally have used with a student. I am really looking for the experience of other educators in a similar situation.
     
  13. SwOcean Gal

    SwOcean Gal Devotee

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    Nov 23, 2008

    I have not read any posts yet, but typical and atypical works...I think?
     
  14. JustT

    JustT Comrade

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    Nov 23, 2008

    Each year, I have at least a handful of students who are taking ADHD meds as well as a son who is twice exceptional (ADHD/GT).

    If you look at the natural aspect of the age group you are dealing with, there is a certain amouth of time children are able to work independently before direction. The time on task for ADHD students are more difficult for them because they are distractable (either by sight, sound, touch, or thought). As we grow, we are able to block out stimulus coming into us (focus on a tv show while children play in the background) Those with adhd have difficulty blocking out stmuli and often forget what they were doing unless they manage some sort of coping skill.

    For the longest time I did not think my teen son was ADHD and when he went on meds it was lifechanging experience for him. He describes it as 5 thoughts now are quieted in his brain and he can concentrate on one. He's now able to complete lengthy projects and accelerate in school.

    There is a common misconception that ADHD medication makes children behave like zombies. If you have a normal brain and took ADHD meds, more than likely you would behave as if you were on a high dosage of caffiene (ADHD meds are often stimulants). For the ADHD child, they appear more "quiet" because the "cloud" disappears for them.

    Breaking down task into small tasks, teaching focusing skills, and minimize distractions seem to help these students keep their focus and practice skills the class is learning.
     
  15. swansong1

    swansong1 Virtuoso

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    Nov 25, 2008

    TF...I teach a group of children including two who are very similar to the one you care for. I totally agree with your evaluation of his situation. Keep plugging away...you will make a difference. I have one student who has been with me for two years. He has several disabilities (ADHD, ODD, Autism) and he is gifted. Before he came to me he had been kicked out of every program he had been enrolled in (he was 4th grade when he came to me). He had even been kicked out of a special program for children with severe behavior disorders. He was violent and his language would make a sailor blush. When he entered our class I felt we took the time to really listen to him and try to meet his specific needs. He has turned the corner and has improved tremendously. We will be placing him in a specialized autism unit for middle school next year and I am confident that he will succeed. Self esteem matters!
     
  16. Maryhf

    Maryhf Connoisseur

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    Nov 25, 2008

    I have 7 out of 17 in my class who are ADHD so I'm feeling your pain. :eek: It's frustrating for me and I know from parent conferences that they are frustrated as well. Some have tried medication and have given up on finding the "right" one for their children. Some parents are just opposed to medication on principle. In any case, self esteem can't help but suffer when you are student sitting there knowing you are intelligent enough to succeed but without the ability to concentrate enough to do so. If medicine helps a child to focus enough to be able to perform up to his capabilities, then it should be considered.
     
  17. stepka

    stepka Comrade

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    Nov 28, 2008

    As an ADD sufferer myself, I can see some factors at work here that may or may not have been addressed with this child--by the parents and doctor that is.

    First of all, as an adult who is extremely sensitive to the effects of meds, when I went on adderall, I asked for 1/2 the dose that they normally give new patients. I'm very glad I did, b/c 20 mg would have put me over the top--I don't even tolerate 15 mg very well. I'm still on 10 mg years later. I have talked to several people since then who don't tolerate the meds well, and I'm beginning to think that docs routinely overmedicate the kids and adults in their care.

    Another thing is that I have to take a sleep aid every night to get to sleep b/c if I don't I'll not get enough sleep to function well and even when I do get my sleep, I spend much of Sunday (my med day off) catching up on sleep. So sleep deprivation could be causing the ODD behaviors. Docs will tell patients to take the meds everyday, but in my own exp a day off is a big positive.

    Also, to boost the effect of the meds, I take a vitamin B tablet every morning. It calms the nerves and boosts the effects of the meds. Eating too much sugar in my diet almost cancels the positive effects of the meds, and brings out the negative ones.

    I realize that as the teacher, you can control almost none of this, but if you have a good rapport with the parents, you may be able to speak with them about this--these things are always very important when a child is on ADD meds, but the docs almost never point them out to you--I had to figure it out on my own, and with the help of a great forum I went on in the beginning of my dx.
     
  18. NewTeacher79

    NewTeacher79 New Member

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    Dec 14, 2008

    Hello,

    I was just reading the OG post that describes a boy in my class as well. His mother expressed her concerns over medication and I completely understand.

    I wonder if anyone has seen research on treating ADHD/ADD and other similar issues using Fish Oil?
     
  19. Kate Change

    Kate Change Companion

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    Dec 20, 2008

    This sounds a lot like a boy I work with in one of my pull outs (a group of 5). I try to work with him one on one while he gets the main lesson, he shows me a few exercises and then I have him work on a game or activity that reinforces the lesson. Then I work with the other four students. This is not a great long term solution, but it makes that hour pass and he does learn something. The sponsor teacher for this student is refering him to a very small self contained class. I think they are considering an ED environment because he is no longer able to maintain himself in his inclusion classes. He was doing OK before, not great, but OK. Now he is always in trouble. Though the parents did not tell the school when they took him off his medication, after several days, we could all tell that something major had happened.

    It sounds like you are trying everything imaginable. Sometimes, the only thing to do is to change the setting. It feels awful, but it can help.
     
  20. stepka

    stepka Comrade

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    Dec 20, 2008

    Here's what drives me crazy about (some) parents--I certainly can understand why they may not want their kids on the meds, but they should at least be trying to help their child in another way, rather just dumping them on the school system. We can't give these kids vitamins or feed them right or make sure they get enough sleep or any of those things that parents rightfully control. There are many supplements that can help these kids and all they'd have to do is get on the internet and do their research, but almost none of them do and if they did, they would probably communicate that to you, so if you don't hear from them you can be sure that nothing is being done. Sigh. Rant over. (And yes, new teacher, many with ADD swear by fish oil.)

    Also, I wanted to let you know that once I had great success working with a kid on an exercise ball--as long as he could roll around, he'd do anything for me--even read, which he hated. I used it as a bargaining tool.
     
  21. CanukTeacher

    CanukTeacher Comrade

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    Dec 20, 2008

    TemperanceFaith - I know every day is different but could you tell us a bit more about what a morning or afternoon looks like? It sounds like you are doing great things, but maybe with a bit more information we could brainstorm some more ideas. I work with some ADHD students who are integrated into regular classrooms and I would love to learn some more about this with you as it is something I struggle with too!
     
  22. Marci07

    Marci07 Devotee

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    I agree that breaking down tasks into small tasks helps greatly. I am an adult with ADD (not hyperactive) and I have also had my share of students with ADHD and I can tell you that when a task seems huge panic sets in and we freeze.

    Last year I had a middle school student who was ADHD, who was extremely defiant and wouldn't do much work. By this time, he had had so many bad experiences with teachers that he wasn't willing to cooperate at first. No teacher could get him to do any work and the interruptions in the classroom were out of control.

    Having an attitude of a coach is better than an authoritarian role when dealing with ADHD. They are very sensitive to criticism and will not cooperate if they feel that they won't be able to meet your expectations. A behavior plan that they can successfully follow, even if it means small steps at first, gives them a sense of accomplishment. For example, I would have a weekly behavior plan for my student that at the beginning included expectations such as: having no more than 5 interruptions in the classroom, complete 70% percent of the work, special signals to let him know he was off task or disruptive, etc.

    At the end of the week we would review the plan together and set up a new plan for the following week. I would give him a grade based on his ability to follow the plan emphasizing and celebrating his accomplishments and when he received a bad grade, he was more open for suggestions on how to improve it. It is important to also include some strategies just in case they are having a bad day.

    This plan helped us greatly. Sometimes he would set up higher goals for himself. There were a lot less interruptions in the classroom and my ADHD student was learning some behavioral management strategies that he could use on his own later in life. Of course, it didn't change from one day to the next, and even at the end of the school year, he still had his bad days but now we had a plan.

    I hope this helps. I believe that teaching behavior management to ADD/ADHD students without the negative helps tremendously.
     
  23. stepka

    stepka Comrade

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    That is absolutely right. I had so much negativity from my teachers, even though I didn't have the hyperactivity, that I ended up very angry and disillusioned in high school, and dropped out in 10th grade. Breaking up tasks is important like you said, and setting a time limit to get something done helps a lot. Like if they have a whole page to do and are poking thru it b/c it looks so overwhelming, you can set a timer to 1 minute and ask them to do as much as possible w/in that 1 minute and they are often amazed at what they can get done in that time. After you show them this, they can set their own goals like you said, and that will give a tremendous sense of power and ownership of the work. One thing that many teachers don't know about ADD people is that when we are faced with a boring task, the processing center of our brain will literally go to sleep, so we need the extra stimulus of goals, time limits, or rolling around on a ball to keep it awake. This is true even of the kids with the hyperactivity. Their body will be bouncing off the wall and their brain will be asleep.

    One thing I've noticed with some kids is that sometimes when they have a big worksheet--say one with 50 math problems--for the sake of example it is one with math facts like 6+1, etc. Some kids will sit there and do all of the problems in order, 1st to last and be dying of boredom, but I have showed some of the ADD kids that it is better for them and their learning to skip around--go thru and pick out all of the problems that say 6+1, or 1+6, and just do those, and so on. This really works for some of them, b/c it helps them to internalize that 6+1=1+6 every time, and adds some interest. As an adult, I still skip around when I am faced with a similar task. You should see a room when I am painting a wall. Blotches here there and everywhere.:D
     
  24. shouldbeasleep

    shouldbeasleep Enthusiast

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    Dec 21, 2008

    Read as much as your palm can cover. Then talk or respond to it.

    Why do 50 math problems when 10-15 will show whether the student knows how to do it?

    Allow to stand while working.

    Power teach with gestures.

    Allow a snack break about mid-morning. (Also time to get up and wander around the room)

    Chew sugar-free gum.

    Your finger on the problem in the book so as to let his eye go back to it easily.

    Peanut butter cracker in the morning. (Protein seems to calm some kids down. It did with my son.)

    Frequent water breaks.

    Our principal, who is ADHD, takes my wild child (who is not medicated) for 15-20 minutes and sends him on errands just before lunch.

    I don't think mine is anywhere as severe as yours sounds. But maybe some of this will help.


    And to sciencewrestler: Surely you don't think Temperence Faith hasn't been teaching long enough to know the difference between boy behavior and ADHD behavior? Your argument sort of reminds me of Tom Cruise's comments about post-partum depression being a myth.
     
  25. tracykaliski

    tracykaliski Connoisseur

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    Dec 22, 2008

    Do a search on Russell Barkley and you'll come up with lots of good info. He's got a fantastic book for parents out about adhd and I've read it and use some of it in my classroom. He's amazing.

    Russell BArkley did a ton of research with adhd kids and has some great suggestions.
     
  26. Missy99

    Missy99 Connoisseur

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    Dec 23, 2008

    Drives me crazy, too!

    One of my brightest students has excellent analytical skills, an fantastic vocabulary and a photographic memory.

    But the student also has trouble focusing. The student has to have certain fetishes on the desk -- a certain pencil or a small stuffed animal -- in order to be able to work. The student also requires complete silence in the room in order to take reading tests on the computer.

    The student was on medication prior to 4th grade, but no more. When I have communicated my concerns about how we can work together to ensure the child performs well, the father puts the ball back in my corner and say I should do what I need to do, period. He offers no support whatsoever. I will be taking the appropriate steps to help this child, but the lack of parental concern is irritating and heartbreaking.
     
  27. stepka

    stepka Comrade

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    Dec 23, 2008

    And the crazymaking thing about this is that B vitamins are so cheap and they help so much! Like, 50%. Or 25% on a high sugar day.
     
  28. UVAgrl928

    UVAgrl928 Habitué

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    Dec 26, 2008

    My little guy went off meds right around the time that I started at the school (end of October). So I never worked with him on meds... and apparently he was fine while he was on them. Mom has excuse after excuse about why she is giving him his medicine... at first I thought she was on the same page, saying that no one will watch him (he has been kicked out of our afterschool program, and babysitters refuse to watch him). The poor kid is my sweetest child, but has absolutely no control over himself... it's so sad to see, because he realizes it. I had talked with his whole IEP team, the guidance counselor, and my P and AP, and after they all took turns sitting in on my classroom, I was told that when he was behaving like that, I cannot keep him in my classroom.

    The biggest problem for him is his wild outbursts and tantrums. He is eight years old, and has full on tantrums (it's so embarrassing because our wing echoes so much, and he's so loud). One day when he totally lost it, the guidance counselor came down to help out... I had to remove the rest of the class and go on a walk around the school with them as she physically removed him from the classroom (she had to literally pick him up and carry him over her shoulder). When I returned to the room, everything on my desk was on the floor (apparently he kicked my desk as hard as he could). That time, he was finally suspended, and I was told that anytime he began acting like that again, he would be suspended... maybe mom would get the picture of how often it was happening. Only problem was, we were later told that since he has an IEP, we were limited on the number of times he can be suspended (plus I just hate having a child being forced out of my room).

    There have been two things I have found work really well for this child. One is that his SPED teacher has worked with him on when he is starting to feel out of control, to clench his hands together in his lap. I notice him doing it while we are doing a whole group lesson on the carpet, and I feel like it has really helped. Was it an automatic improvement? No, we had to work with it, but it has definitely helped. One other thing that he absolutely loves is partner work. I have him buddied with a very mature girl, that is very motherly. He really enjoys working with her, and she helps keep him on task. She knows that they have permission to help him or work with him on almost every assignment (except tests). It really helps since I am the only adult in a room of 22 kids... otherwise I am spending every second with him, and the other students are losing out on instructional time. With the neglect situations at home, he really needs people to show that they care about him. Him and I call mom together on his good days, he gets to go around to his favorite teachers on good days (and they will write him a "great job" note, or give him a high-five or hug).

    What works for him though, obviously may not work for your student. That's the thing that's so difficult... figuring out what works for that child. Try a few things and stick them out. I tend to try something for a day or two and then give up... but most of the time it takes much longer.

    Also, I have ADHD, but my parents always refused to medicate me. I don't know how many doctors told them I would be much better off with the meds, but they always said no. I have always regretted their decision, because it has made everything I do soooo difficult. Even throughout college, everything took me so much longer than my peers. It is a lot to ask of a small child to control themselves when they have something like that going on.
     
  29. WorkingTitles08

    WorkingTitles08 New Member

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    Jan 7, 2009

    Isn't expressing overly "high" self-esteem a symptom of low self-esteem anyway? Children (and adults too!) will act conceited and arrogant as a defense mechanism for feeling as if they must defend themselves constantly. If you're talking about defiance as an indicator of "over confidence" for example, its true motivator is usually that children feel out of of control (weak/helpless...the opposite of confident) and are struggling for power. I'm interested to know how they were able to get an accurate measurement of self-worth in children.
     
  30. coffee crazy

    coffee crazy Rookie

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    Apr 19, 2009

    I have a student like this... do you have any ideas for independent paractice. When it is time to do workbook practice and I have small group...he will NOT do his work...
     

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  1. miss-m,
  2. Backroads,
  3. MrsC,
  4. Jeremy Provost
Total: 388 (members: 4, guests: 351, robots: 33)
test