Emily was diagnosed with ADHD in the third grade. When she entered my class in the fourth grade, I found her bright and creative, but she had difficulty managing her behavior. While she enjoyed writing and reading, she didn't like math and couldn't work cooperatively with other students. One day Emily, frustrated during a math lesson, hit her partner over the head with a textbook. At that point, I knew we needed a plan.
The next day, Emily, her mom, and I sat down in the classroom and put one together. Within two weeks, Emily was finishing her math assignments in class and working in harmony with her classroom partners. A miracle? Not exactly.
It was the use of a daily report card that we created for her. After a rocky year in third grade, Emily had a good year in the fourth.
Research indicates that the combination of medication and behavioral treatments, such as a daily report card, are more effective in treating ADHD than is medication alone. The daily report card is an effective tool for shaping a child's attitudes about school and friendships. In fact, many ADHD summer camps use it to teach children how to succeed in the classroom and with peers. Here's how it works.
A collaborative process
Teacher and parent set up the goals they want a student to achieve and determine, along with the child, what kind of rewards he can earn. As a teacher, I have found that limiting the goals to no more than four each week is the key to success. And the goals should be clear and specific. Each day the teacher records whether the goals were met, and the child takes the report card home and shares it with his parents. Based on his degree of success, the child earns different rewards. If he achieves four out of four goals during the week, he earns his No. 1 privilege; three out of four garners him his second favorite. If no goals are met, he receives, well, nothing. When a child has underperformed, it's important that a parent deliver the news in a neutral tone, along with the reminder that tomorrow is another day. This is the hardest part, but you should remember that you are in this for the long haul and that change is possible.
TRY THIS: To make the daily report card even more effective, sit down with your child and draw up a simple contract on a piece of paper. Use language like "I, Johnny, agree to work at studying for a test a week before the test rather than the night before. If I do that, I will earn at the end of the week $10 toward a new mountain bike." Everyone signs the contract, including the teacher. This ensures that all involved understand the rewards system and accept the consequences agreed upon.
"The good thing about a daily report card is that it doesn't punish a child for negative behavior," says Michael Manos, Ph.D. director of ADHD Center at the Cleveland Clinic. "He is simply not rewarded when the goals aren't met. In addition, the report card focuses a parent's and a teacher's attention on the child's behavior twice a day. This constant and specific feedback can teach the child to recognize and practice positive behavior herself."
Focusing on faulty behavior
With Emily, we figured out specific goals - finish her daily classroom math assignment at school and finish her homework assignments at home. Emily knew exactly what to do. Comments like "be good" or "work hard" are too vague to be helpful. If Emily did her math assignment with 90 percent accuracy, she earned a hot fudge sundae. If she received between 75 and 90 percent, she had to settle for an ice cream cone. If she didn't concentrate on her assignment and received between 60 and 75 percent accuracy, she got a popsicle.
At home, the reward system was based on privileges. If she did her homework five out of five days without complaining, she had a special outing with Mom and Dad; four days earned her horseback lessons on the weekend. If she was managed homework completion only one or two days, she didn't earn any privileges.
TRY THIS: Because children with ADHD are naturally attracted to novelty, be creative with your rewards program. As Emily got older, we added a points system, in which the teacher determined how many points she earned toward achieving her goal. Emily's mom input those goals into a computer and graphed how many points she was earning as the school year went along.
The biggest problem for most ADHD children is getting the report card from school to home. They tend to lose things. The solution? Explain to your child that you can't dispense privileges unless you know how many goals he achieved that day. If he wants the rewards, you must see the report card. Once you explain the rules, you'll be amazed how closely he will keep track of it.
TRY THIS: You can cue your child to take home the report card by taping a sticker or note to his desk or in his locker.
