The Daily School Note: A proven intervention for children with ADHD.

In my last post I mentioned Daily School Notes. These are little feedback forms that let you know how your child is doing in school. That sounds simple enough, but often they are misused and abused, causing more harm than good. Here are some really simple rules:

1. This note is designed to emphasize what went right, not what went wrong. It's a means of measuring progress, not failure!

2. The goal of every day at school is a "good day at school," it's as simple as that.

3. Point systems and other reinforcement programs should ALWAYS be used in a manner that point to success. NEVER to deny something, or to punish. (I don't get NEGATIVE pay checks, do you?)

Look at the research on behaviour management of children in schools. The most successful method of teaching new behaviours and getting them to happen more frequently is a positive reward / token system. For the past 30 plus years school/home notes have been a component of nearly every successful behaviour intervention program written about. If you hear "I've tried that, it doesn't work," it's most likely because it wasn't done properly. Regretfully teacher education programs no longer seem to require any training in classroom management. So, we need to make these changes back to what we know works "one classroom at a time."

So what does a daily school note look like? Usually it's a SHORT series of questions relating to behaviour, on-task behaviour, academic completion (should be effort!) and so on. Usually it has no more than 5 issues, and a line about homework. Every day the note goes home and in the morning comes back. Some schools do these on line now.

A problem with many of these is that they are used to punish children, to inform parents of bad behaviour, and to get parents to "do something" at home about what went on at school. These are all really bad ideas. By 6 pm it's too late to have much of an influence on a child's behaviour from 10 am that morning. Punishing and criticism won't make a change. If they would, it would have happened by now.

Instead a good school note should offer some feedback on the day that is on a scale, say 1-5, and not a scale of success or failure. Here is an example:

1. On-Task behaviour (focusing on your work for 5 mins at a time)
(Circle) Had difficulty 1-2-3-4-5 Great day!

So the child gets a score of 1-5. Now often these scores are then taken to be an opportunity to punish a child. You got a 2! What was wrong? And the child loses some privilege or reward. This is not a good idea. Soon the home note becomes something to avoid, and school becomes a negative, also to be avoided.

Instead the reinforcement and correction happens WHEN THE SCORE IS GIVEN, and that should be right when the behaviour happens. The immediacy of the feedback and reinforcement is what makes it work. You can't wait 25 minutes to give feedback and reinforcement to a child with ADHD. It just doesn't work. So the feedback should be immediate, corrective, specific and emphasizing the positive whenever possible. Home notes used to punish, where the feedback occurs a long time after the behaviour don't work.

So give the feedback right away. Writing on the note helps reinforce it. THAT is the reinforcer. Later when the child takes it home the points should be totalled up and are always, ALWAYS, leading to some greater reinforcer.

So a note that had five threes gets 15 points, and Tommy needs 100 to get to go to the movie. Rather than saying "Well, you didn't earn your reward today..." and ending up with crying and hating the school note you should say, "Fifteen points today, well, your getting closer, just 70 more to go! What gave you trouble? Anything we can do to help?" The response to the note should be specific and positive. Now the teacher has had an opportunity to correct inappropriate and reinforce appropriate behaviour, a method to give the reinforcement has been provided (the note), the child is learning to put off rewards (it might take several days to earn enough points) and don't we all want our children to learn that they need to wait for good stuff and earn it over time? And finally, the parent has feedback that whatever is going on needs some improvement. There are simply too many 2 and 3 point days. So you need to ask ourself "What can we change to support Tommy better so he is getting 4's and 5's?"

That's basically how a positive support system is used. And as you probably know that's often NOT how home notes re used. We end up with kids crying, parents yelling, kids hating school and teachers expecting parents to fix their kids behaviour after it happened.

I often provide training and consultation on setting up feedback systems with schools, and moving from the punishment mentality to the support, model, reinforce model isn't easy. But it's the only way to go with a child with ADHD (Attention Deficit Hyperactivity Disorder).

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The ADHD blog is not offered as medical advice or as a means of diagnosing or treating ADHD or any other disorder. My recommendations: Don't go on-line and take an ADHD "test." The diagnosis of ADHD is complex and involves not just looking for symptoms of ADHD, which is all that those “tests” do, but also involves ruling out other disorders that might look just like ADHD. Often individuals who think they have ADHD have other disorders, and may have co-morbid disorders such as depression, anxiety or OCD. A simple check off sheet of “symptoms” doesn’t differentiate these. So avoid these on-line "tests" which are nothing more than a collection of symptoms. You need to see a licensed or registered professional for a real diagnosis. Medical doctors can diagnose ADHD, but the diagnosis is complex and often they will make a referral to a Registered Psychologist for a full understanding of a patient’s symptoms. You can obtain a referral for a psychologist with expertise in ADHD from the British Columbia Psychological Association (BCPA).

In my practice I offer Attention Deficit Hyperactivity Disorder (ADHD) assessment and treatment services for individuals, couples, families, children and adolescents in the Burnaby, Vancouver, Coquitlam, Port Moody, New Westminster and Maple Ridge areas of the lower mainland. This includes neuro-developmental assessments, psycho-education, cognitive rehabilitation for problems with memory and concentration and cognitive behaviour therapy. I also provide diagnostic assessments for autism and Asperger's Disorder in my Burnaby office.

My web page lists a number of resources you can make use of yourself in dealing with Attention Deficit Hyperactivity Disorder (ADHD). Please visit it at www.adhdhelp.ca or one of my other sites at either Psychology Today, AAMFT, PSYRIS or my professional site. Please feel free to call if you have questions about ADHD or other cognitive issues.


Dr. Jim Roche
Registered Psychologist, British Columbia 01610
778.998-7975
www.relatedminds.com
www.adhdhelp.ca