ADHD RPG LARP Example Case Study Plan 20160309c

Student is female in 8^th grade. Until 5^th grade she performed adequately academically, but began to “hit a wall” in 6^th grade, end of this year's first semester has F's in Math, English, & History, with C's & D's in the rest of her classes. Teachers have reported she regularly “zones out” or falls asleep in class, has a complete lack of interest in her Math, History, and English classes, all 3 taught by the same instructor. She has had an increasingly negative affect and verbal responses to this instructor, leading to her recently being sent to principal's office. She is quiet and non-participatory in class projects, tries to sit in back of class by window. She never finishes her in-class math assignments, and now often does not even begin them, instead doodling on the handouts. Handwritten assignments and essay tests are illegible and incomplete.

The family therapist interviewed and assessed for depression, but ruled that out. Substance use/abuse was ruled out. Student has indicated significant frustration, embarrassment, and anger when talking about school, especially with math, history, and English courses, and that though she at first liked the instructor, she now “can't stand him, he's a jerk”.

After 3 different medication trials, and the teachers participation in the use of the Medication Effectiveness A9 & A10 assessments (357-358), her behavior and attentiveness have noticeably improved and she is now doing very well in other classes, but she still isn't passing the 3 problem classes. The instructor is older, nearing retirement, indicates he likes the student, despite her struggles, and is open to trying different approaches even though he has generally used “old school” approaches through lecture, memorization by rote, and significant essay writing.

Since medication began working, she is now doing well with other classes: interactive geology science labs (which include frequent outdoor classes), choir, theater, Spanish, and PE. Spanish class is highly interactive, very little writing, with interactive computers, videos, and games, focusing more on verbal interaction, word recognition, and interaction with objects and games. The therapist did notice she was easily distracted and had difficulty keeping focus on low-stimulus/interest tasks. Upon further assessment, she tested very high in verbal skills, but average in other areas that required motor skills, and very slow processing speed (index 75). Memory tested with motor component, scored 25^th percentile, using Rey-Osterrieth. When tested on memory without motor component, scored 84^th percentile, using WRAML. Indicates she has very good visual memory skills, but when required to produce information by writing or drawing (including math), problems with integrating visual information with fine motor output interferes in ability to remember the visual information.” The BASC observations indicated notable likelihood of “Attention Problems”. Diagnosis: moderate AD/HD predominately Inattentive type (314.00 (F90.0)), with co-morbid severe Dysgraphia (784.69 (R27.8)), and moderate Dyscalculia (315.1 (F81.2)).

To compensate for the significant motor skills and math impairments, recommend adaptive options to writing, and be able to utilize her very strong verbal skills whenever possible. The following specific recommendations are made (364): Allowed calculator (86) and computer-based math testing computer software labs rather than hand-written. Allow to use Sylvan Prometric-style math learning interactive computer programs to track math learning, with instructor supervision available during study hall period. For math tests that must be written in class (or filling circles), allow her more time to complete the tests. For all written assignments she should be allowed to use a keyboard instead of hand-written essays (82-84).

While medication has improved her focus, it is further recommended she be seated closer to the front row, away from the windows, pencil sharpener, door, or teacher's desk, to help optimize her focus. She should be assigned a “study buddy” that can help her stay on top of assignments.

Since there is no reading impairment indicated, also make use of her very strong verbal skills, to provide opportunities to talk about topics, with this student as speaker for the teams, include some days with game-based learning, such as Math Bingo (115), History Jeopardy, or English Hangman games to increase interest, engagement & retention. Winning team members gets a “homework pass”. Also consider a cross-curriculum Edu-LARP program for Math, English, & History, adding a kinesthetic memory aspect to help increase retention and increase level of stimulation and interest. (Educade.com)

May also want to plan ahead for an IEP (213-220) transition plan from Junior High to High School, since it will be a new location and a different batch of peers and instructors, to help her have a smoother transition, also planning later for an ITP by the time she is 16. (188,226-229)

References

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Educade.com. Educational Live-Action Role-Playing (Edu-LARP), Cross-curricular, 3 Lesson Plans. Retrieved March 7^th, 2016 from http://educade.org/teaching_tools/educational-live-action-role-play- edu-larp

(2000). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Zeigler, Chris (2011). Teaching Teens with ADD, ADHD, & Executive Function Deficits. 2^nd Edition.

Woodbine House.