As a learning specialist with a cognitive psychology leaning, I was worried about how my ADHD clients would do with the shift to online learning during the COVID-19 pandemic. I was worried about transitions, tech demands, and distractibility. Gerard A. Gioia, PhD, chief of pediatric neuropsychology at Children’s National Hospital, expressed concern too in a recent conversation, noting:

“I find that kids with ADHD as well as other disorders affecting attention and learning are negatively affected by requiring students to sit and attend (stare) at a computer screen for hours at a time. It can be very challenging for anyone, but particularly students with attentional, organizational and impulse control problems to remain engaged in this form of “distance learning.”

I was worried about how stress might exacerbate their executive functioning challenges. Shields et al reported a few years ago that stress “impaired working memory, cognitive flexibility, and cognitive inhibition.”1And, I was worried about my students’ lack of peer connection.

But it turns out that despite my 30 years of experience, I was often unable to anticipate the actual problems that arose (or didn’t) during this dramatic change in instruction. Here are just a few examples.

 

The Up & Down Aspects of Remote Learning for ADHD Students

One very social young lady with ADHD was ecstatic that she didn’t have to think about how to dress or try to impress the other girls in class. She explained that she has been better able to concentrate on her studies while learning virtually, and she is doing great. I didn’t expect that – I was afraid her mild depression would increase from her lack of peer contact.

A high school student who had been failing academically due to executive functioning challenges, namely organization and work completion, started earning all A’s once his teachers were compelled by distance learning to post all assignments in one place (a win for virtual learning systems). In addition, he has enjoyed the break from having to negotiate interpersonal relationships, a shift that well suits his mild autistic tendencies. That was an unexpected but welcome surprise.

On the other side of things, a college student whom I had been less worried about, always craved solitude to study. The isolation of COVID should have provided her with some relief in that sense. However, she fell apart when she had to move back to her parents’ home and couldn’t find a quiet place to work. No coffee shops open, no libraries to escape to. She ended up dropping one class, failing one class, and barely passing the others. This client had finished high school with so many AP credits that she technically could have skipped one semester of college; she was a serious student and a hard worker. It was the combination of new conditions paired with her distractibility unexpectedly tripped her up.

There are several ways we, as educators and counselors, can put these lessons learned to use (see below), but perhaps the biggest takeaway for me as a learning specialist during these pandemic shifts in education is to expect the unexpected. In addition, I have learned to rely more heavily on communication and clinical skills to manage student needs rather than standard interventions and accommodations.

 

Tell Me, On a Scale of 1 to 10…

I now use a simple tool adapted from clinical pain rating scales to help anticipate ADHD students’ needs when assessing their education plans and progress within those plans. In our weekly sessions, I guide clients to share their learning experiences with me using a 1 to 10 scale. I have found that these informal assessments deliver powerful feedback in terms of whether instruction is adequately targeted, demands are appropriate, and accommodations are fulfilling their purpose.

Ultimately, they help me and my peer mental health professionals, social workers, and learning specialists to determine whether a particular client is “available to learn.” To illustrate a few examples, I ask the following routine questions.

On a scale of 1 to 10, how are you doing with … organization?

A simple question, it yields simple responses, such as a sheepish “5” but this question also opens the door to great discussions like, “Are you talking about organization of my folders, my desk, my laptop, or my brain?” a student may ask.

“Great questions,” I reply, “Which one(s) should we be talking about?” And then we choose the one that needs the most attention, write it in the back of a planner (or calendar, or whiteboard) and add a number (1 to 10) next to it each week. Since we’ve named it, it becomes a real priority, and we can track trends and proficiency over time.

On a scale of 1 to 10, what would you give yourself … for homework?

 We talk. And we come to a shared understanding that giving yourself a “10” for homework has to include: having it finished, on time, with good attention, and successfully received by the teacher. Those who work in the field understand just how many pitfalls and minefields there are in each of those micro-moves. If needed, you can create a supplemental 1 to 10 question to target more specific challenges. Again, by naming it we target it – and by tracking it, we can assess skills, energy use, and ultimately success.

On a scale of 1 to 10, with 10 being relaxed, what would you give yourself for stress?

Like other rating areas, a student/client might want to differentiate further, and we discuss schoolwork, friends, home, or life in general. I usually begin with life in general, but if a student queries whether we are talking about one of the other subjects, I let that lead our discussion. The student names the area to monitor, chooses a number, and records it. And I continue with a related probe…

On a scale of 1 to 10, how much stress do you like to work with?

This is where things get really interesting. I usually begin by explaining that in the US, we hear a lot about stress being a “bad” thing and something to be avoided but, in fact, we can use stress as a motivator. With students, I discuss examples like the stress we feel before an athletic competition, which can either get us on our toes and ready to run or makes us want to throw up. One is useful, the other –not so much. Or we talk about the adrenalin of a due date coming at us. Sometimes that stress energizes us, and sometimes it overwhelms us. So, I ask my clients, how much stress do you like to work with?

Combining these two stress questions can reveal an awful lot about our young friends. I have one young man who gave himself a “9” for being pretty relaxed, but when asked where he’d like to be in order to be most productive, he replied, “a 10! And I can’t seem to work at all unless I’m completely relaxed.”

Another student gave herself a “9” for relaxed, but a “6” for how relaxed she likes to be in order to get things done. “So you really like a bit of stress in order to get going?” I asked. “Oh yeah,” she assured me.

These 1-to-10 scale questions can be used to target student performance, assignments, or the online platform itself. I believe it is always important to include a measure of stress. This simple qualitative tool engages students in self-reflection and encourages them to become reporters of their own conditions – an essential element for success.

More on kids with ADHD on our Psycom consumer site.

Can I Use the 1 to 10 Scale for Myself?

 Of course. What are your goals? What are your obstacles? Try to get some clarity on what these entail in your school system or your practice, and then name them, rate them, pursue them, and track them.

If you have trouble getting clarity or application in your professional setting, consider using a Planning and Reflection Guide like the one outlined in Chapter 7 of Boosting Executive Skills in the Classroom, which I co-authored with Joyce Cooper-Kahn.2  There is one guide for clarifying goals/dreams and another for turning them into an action plan.

Distance Learning Lessons: How Can We Apply Them to Future Accommodations?

As demonstrated with the brief student case scenarios above, we are learning new things about our ADHD students and how they may thrive – or not thrive – when instructional patterns change.  Looking ahead, I am hopeful that standard accommodations will evolve to meet emerging student needs – whether students remain remote or return to school facilities. A few suggestions to start:

  • One-on-one online time with a teacher or an adult who can review content and expectations has been consistently satisfying based on feedback received from clients and teachers in the field – it helps students to stay on track and build confidence. Some remote teachers provide weekly check-ins while others report leaving their platform open all day so students can drop in as needed.
  • Rather than priority seating, which has taken on a whole new meaning with virtual classrooms, consider whether required screen time is appropriate for the individual student, or whether an accommodation can be made for reduced time online. In some cases, allow students to participate in virtual school sessions time on a stationary bike.
  • Allow students, when appropriate, to use asynchronous accredited independent sites for certain classes.
  • Students report a weird sense of disconnection when math instruction is presented using a stylus pad with no human hand showing. They seem to prefer to see the teacher’s hand drawing on a board or pad. These are things we’re finding when we ask targeted questions – the answers can lead us to more effective instruction.
  • Reflect on mid-day breaks. Some students may need this time for movement and outdoor play; some prefer to get work done to avoid their afternoon dregs. Your 1-to-10 questions can help to assess such needs.
  • Always have students use a planner to track assignments unless you’re certain that there’s a more effective strategy for that student. Remember, they may need instruction, guidance, and practice in order to use a planner successfully.

 

What ADHD and Learning Specialists Can Do Now

Overall, I like to remind myself that we are building life lessons in learning and competence right now. State standards, while important, do not define our students’ greatest needs this year. In fact, publishers of standardized tests remind us that even our normed test results will be askew because they are based on school year/months of instruction.

Rather, our role as school-based therapists, learning specialists, and clinicians guiding students outside of the school setting, is to attend to the internal workings of our clients, assess their availability to learn, and monitor their educational demands during this transitory time in education.

Instruction will continue to change state by state, and district by district, based on COVID’s prevalence. Teachers will adapt, internet connections will vary, and everything will remain in flux for the foreseeable future. For students with ADHD who crave novelty, this can be exciting! For those who require routine, it can be devastating. The only way to know for sure whether the instructional environment is effective for a student with special needs, is to test these waters regularly. There are no guidebooks or quantitative studies to lead us, although I’m sure we’ll write some great ones soon.

For now, to best support students, we must be willing to ask good questions and be flexible in our thinking, our consulting, and our advocation.

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Last Updated: Nov 17, 2020