Carrie+Stafford

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About Me
Carrie Stafford is an Upper School Learning Specialist at The Lovett School where she works primarily with 9th and 10th graders. She joined Lovett in 2011 after spending eight years living in London and working at The American School in London. Carrie earned her B.S.Ed. degree from Baldwin Wallace College (Ohio) in 1997 and her M.Ed. in Behavioral/Learning Disabilities from Georgia State University in 2000. She has worked for the past 16 years with students from third through tenth grade in both collaborative and resource settings. She lives in Acworth with her husband and young two boys. Feel free to contact her at: cstafford@lovett.org

Takeaways / Big Ideas
The environment in which I teach lends itself easily to brain-based strategies. I work with students one-on-one to support their regular classes. Because of my experiences in the EE Ford Brain Cohort, I have been much more deliberate about explaining the science behind what I do with my students. I also make sure I share this with their parents, and other teachers. I will continue to spread these ideas to as many other professionals as possible. The students with which I work face a myriad of challenges making it difficult to gauge the success of my action research. This doesn't, however, mean that it is unnecessary or unimportant.

AR Overview
Last year the majority of my students had difficulty accessing the curriculum because of concerns with language. They either lacked the relevant vocabulary or had difficulty processing auditory information. In a highly verbal environment such as Lovett, this put them at a huge disadvantage. I spent the majority of the last academic year and summer preparing ways to enhance the 9th grade curriculum so that students with language difficulties could fully engage. When I began this school year, however, I discovered that the majority of my students had attentional problems as their main area of concern. This presented a new set of challenges and prompted my action research.

AR Question
Can students with ADHD utilize brain enhancement strategies to help improve their performance in content area classes?

AR Process
To begin, I refreshed myself on the characteristics of ADHD and how it impacts the brain. Students with ADHD have difficulty with flexibility, organization, planning, memory, emotional control, and inhibition. These symptoms must significantly disrupt their daily life, have been present for more than six months, and have been observed prior to age seven. Research conducted in 2009 described three types of ADHD. The "inattentive" type has been linked with a variant of the norepinephrine transporter gene, while the "hyperactive" type has been linked to a variant in the dopamine transporter gene. Medications are currently used to regulate these deficiencies. The third "combined" type has been linked to a variation in the choline transporter gene and there is currently no specific medication to address this. The majority of the reported 3-7% of US children with ADHD have the combined type. Through the use of PET scans, ADHD brains have been found to have less activity in the frontal lobe. In my reading I found that initially medication has been found most effective at controlling symptoms, but this effect lessens over time. Many of my students are currently taking medication for ADHD and are still experiencing difficulty in maintaining focus. Many of my students complain of the side effects of their medication which can include loss of appetite, sleep problems, and mood swings. I continued researching alternative ways to increase the levels of dopamine, norepinephrine, and seratonin in the brain. I found that diet, excercise, sunlight, and stress reduction were the key.

I then began a deliberate strategy instruction phase with my students during which I showed them the research behind several brain enhancing strategies. These strategies include: sufficient sleep, adequate hydration, good nutrition, exercise level, relaxation, delayed gratification, growth/fixed mindset, and the information processing model. Through one-on-one coaching sessions, we discussed their attention level in each class paying specific attention to Biology.

While my research was going on, there was another experiment afoot in our PE department. After reading __Spark: The Revolutionary New Science of Exercise and the Brain__ by John Ratey, our PE department became interested in what might happen if we were deliberate when scheduling our 9th grade PE classes. They asked for a list of students with ADHD as their primary diagnosis and worked with the registrar to schedule these students for PE during 7th period. On four days out of seven, 7th period meets either first or second block of the day. Four of my five target students stayed in this 'specialized' PE class all year long. The hope was that getting an extended cardio workout would help improve the student's performance in classes following PE. Three of my five target students have Biology the period following PE. Because of the variability of the students in the class, it was difficult to get concrete data that the program was a success. Student self-report, however, was promising. At the end of first semester, 11 out of 13 girls and 7 out of 12 boys surveyed said they noticed a difference in their performance following a workout. Recently one of the students who has continued in 7th period PE asked to do more cardio activities on a certain day because she knew she had a big test right after. From anectdotal reports, it seems that these students have made the connection between exercise and academic performance. The PE program has gotten permission to continue this 'specialized' PE class next year.

For additional information, I administered an anonymous online survey to the students in my research group. I asked them the following questions: 1. How many mornings per week do you eat breakfast? (90% 5-7 days, 10% 3-4 days) 2. On average how many hours of sleep do you get each school night? (10% 8+, 40% 7, 40%6, 10%<5) 3. How many days per week do you exercise more than 30 minutes? (60% 5-7, 30% 3-4, 10%none) 4. Do you understand how sleep, diet, and exercise impact learning and attention? (100% yes) 5. How much non-school screen time do you get each day? (44% 3-5 hours, 33%1-3 hours, 22%<1) 6. Do you currently take ADHD meds? (80%yes, 20%no) 7. If you take ADHD medication, how often do you take it? (75% every day, 25% only school days) 8. How well are you able to maintain attention during the school day? (30% very well, 50% mostly attentive, 20% mostly inattentive) 9. How well are you able to maintain attention during homework time? (80% mostly attentive, 20% mostly inattentive) 10. List at least three strategies that help when you become inattentive. (get up and move, get a drink, block websites, get exercise, eat, listen to music)

AR Data Samples
The first graph shows five tests administered over fall semester in Biology for my group of five students. By test three, I had covered all of the listed strategies with each student in my research group. The second group shows only the test averages for all tests administered in Biology thus far.

AR Data Analysis
In February, I analyzed grade data from Biology hoping to see a positive improvement. What I found was difficult to interpret as you can see with the graph on the left. The overall test average had increased from 68% on the first test to 70% on the fifth test, but looking at individual students showed great variability. The best results by far were on the fall exam with an average of 75%. Student 4, who has started quite strong, had stopped taking his ADHD medication because of heart palpitations and his scores steadily declined. Another student (5) started wrestling season and had to cut nearly 20 pounds. He arrived each day looking pale and sickly and his averages on test 4 and 5 suffered greatly (56% and 67% respectively). When I put the graph on the right together I was pleasantly surprised by the results. My students had remained concerned throughout spring semester. They had a different teacher than in the fall and worried that they didn't take adequate notes. They found it more difficult to remain focused, but the results showed an upward trend.

I decided to create an attention strategy sheet and ask students to monitor their attention throughout a two-week period. The hope was that this would reveal patterns in my students' attentional profiles. Were they less attentive during a specific class, at a specific time of day, or during a specific activity? Unfortunately, student participation was very poor. Of the five I asked to complete the ratings, only two submitted them when asked. One of these students found that he is mostly inattentive in the classes before and after lunch unless they are doing something particularly active. The other student found Friday afternoon to be the worst class no matter what was going on, but all afternoon classes were worse than mornings. We discussed how they could spend their lunch time to help with this problem. They could run after eating or at least take the longest route to their last class going up and down different stairwells. While they both recognized that being more active would help them, they were reluctant to isolate themselves socially in order to do it.

AR Conclusions
Overall I found that my students are really difficult to conduct research with. They have so many variations that it is impossible to determine if the effect is significant. This doesn't mean that I wouldn't do it again though. I think that they appreciated the explicit instruction. They are able to articulate an understanding of how their brains work, but they are still teenagers and need constant reminders. Next year I will continue to use my attention strategy sheet. I plan to make several poster sized versions to hang in upper school classes. I'd like to work more within the Upper School classes to find ways to incorporate movement into lessons. Out of everything we did, my students overwhelmingly agreed that movement helps them learn better. I want our teachers to be aware of this.

Lit Review & Resources
Eide, Brock, and Fernette Eide. The Dyslexic Advantage: Unlocking the Hidden Potential of the Dyslexic Brain. New York: Hudson Street, 2011.

Hallowell, Edward M., and John J. Ratey. Driven to Distraction. New York: Pantheon, 1994.

Hallowell, Edward M., and John J. Ratey. Delivered from Distraction: Getting the Most out of Life with Attention Deficit Disorder. New York: Ballantine, 2005.

Ratey, John J., and Eric Hagerman. Spark. New York: Hachette Book Group, 2008.

Silverman, Stephan, Jacqueline S. Iseman, and Sue Jeweler. School Success for Kids with ADHD. Waco, TX: Prufrock, 2009.

Sousa, David A. How the Brain Learns. 4th edition. Thousand Oaks, CA: Corwin. 2011.

"Dr. Hallowell: Discusses What It Is like to Have ADHD with Ty Pennigton on ABC's The Revolution." Vimeo. N.p., n.d. Web. 30 Apr. 2013.

"Clinical Evidence for Yoga and ADHD." YouTube. YouTube, 17 Dec. 2008. Web. 30 Apr. 2013.

"Data & Statistics." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 12 Dec. 2011. Web. 30 Apr. 2013.

"ADHD: In-Depth Report." ADHD. N.p., n.d. Web. 30 Apr. 2013.

"EHP – Attention Deficit/Hyperactivity Disorder: A Focused Overview for Children's Environmental Health Researchers." EHP. N.p., n.d. Web. 30 Apr. 2013.

"ADD/ADHD Simulation Software - Adders.org." ADD/ADHD Simulation Software. N.p., n.d. Web. 30 Apr. 2013. "Free Toolkit We Love to See Our Clients Succeed and Their Leaders and Managers Perform Better." GoodPractice. N.p., n.d. Web. 30 Apr. 2013. [|ADHD and your brain] [|What's it like to have ADHD?] [|Clinical Evidence for Yoga and ADHD] [|CDC information on ADHD] [|NY Times-In Depth Report on ADHD] [|EPH: A Focused Overview of ADHD] [|Experience what it's like to have ADHD] [|Huffington Post: Your Brain on ADHD] [|David Sousa's Information Processing Model] [|Dr. Hallowell and Ty Pennington discuss ADHD] [|Secrets of Self-Control: The Marshmallow Test] [|Guided Imagery Relaxation Script] [|A full l] [|ist of ADHD medications]

Reflections
I think it is important to be a life long learner. I am always looking for ways to improve myself and my teaching. It is hard to expect students to learn if I just sit back and do what I've always done. I have thoroughly enjoyed being part of the EE Ford Brain cohort and I feel it has improved the work I do with students. I want to thank those who have helped me through this process especially my family who made it possible to devote so much time to such a worthy endeavor.