View Full Version : Tutoring Undiagnosed 16 year old with ADHD


SlowAndSteady
08-11-13, 03:41 PM
I have been tutoring a student in SAT Verbal/Writing for about two weeks now. He is not diagnosed and that's not going to change - his parents are recent Chinese immigrants and don't believe in the existence of ADHD (his words). Even if he can't get a diagnosis and thereby can't get accommodations, I want to at least teach him as many strategies as I can to help him excel. He assures me he's lazy, etc, but I really don't buy it. He's a good, polite kid who just seriously can't focus. I'm probably ADHD myself (which has helped me tutor him because I bounce around a lot as I tutor and I think it helps keep his interest), so I relate...but I'm not well researched in the area, so I'm not 100% sure how to help. Here are the problems we've encountered:

1. Student is extremely distractable and has trouble focusing for long periods of time...but his mother has me doing 2 and 3 hour long tutoring sessions (trying to cram as much in before school starts back).

2. Student is not interested in the subject (harder to focus) ...and this is complicated by the fact that when I ask him what he is interested in (so I can try to work it into lessons), he can't come up with anything.

3. Student jumps on the first correct sounding answer he arrives at on multiple choice and has trouble reading the questions and answers all the way through.

4. Student zones out while taking tests - on his last practice test he literally zoned out and did nothing for 20 minutes...not trying to, just got distracted and couldn't focus and it ate away his time.

Any advice? Any and everything you have to say would be useful and appreciated, trust me.

I was also thinking that we could do a session just helping him prepare for the school year, as well. His mother seems to be open to anything that could help him academically and I think he'd really benefit from it. His grades are really bad for him right now (a bit below 3.0 unweighted) and he assures me it's because he goofs off...but I really feel, having seen the efforts he makes, that ADHD played a role. He's really bright and trying to turn it around now, but I don't know how successful he'll be without some coping strategies to help him. I can probably give his parents advice on how to deal with him as well, as long as I refer to this as distractability and not the label of ADHD - but I have to know what advice to give.

My thoughts:
1. Enforced planner use
2. Allow parental monitoring of grades (to provide accountability)
3. Having an authority figure sit next to him (doing something else) as he studies at home.

Any other ideas?

Thanks a million!

zette93
08-11-13, 08:05 PM
For the long tutoring sessions, could the two of you take a movement break (jumping jacks, push-ups, a quick run around the block) every half hour?

You might find some more ideas in the book Smart But Scattered.

Ms. Mango
08-11-13, 08:32 PM
I was going to suggest something similar to what zette said. Sometimes I have my DS walk around while learning something new, skip or even sing it back to me. Sounds silly, but it's worked for us.

Also, in addition to the impulsivity (answering quickly without giving much thought to the right answer), is it possible he is struggling a bit with English? Would he benefit from some more intense ESL coaching?

janiew
08-11-13, 08:46 PM
Take that kid outside and try to engage interest interest in the physical world.

Try to capture that kid's interest / curiosity in his/her inner the world with connections to the outside world.

RobotInDisguise
08-12-13, 12:55 AM
A lot of this rings a bell with me. Although we have a word for ADHD, it translates literally to hyperkinesis and is generally viewed more as a character trait than a disorder. My parents attempted to send me to an SAT class but realized it was a waste of money. When you're dealing with a bright person who has ADHD, you just can't coach them the way you would the average student.

I'm ambivalent on the parental monitoring of grades, as I think it's very destructive to a person's self-esteem to insinuate that their worth is based on their grades.

enforced planner use never worked on me. I'd be good at first and then fail to follow through after the first few days.

The last one worked extremely well for me. That and giving me tea during study and homework time. Nothing like getting pointed out for staring at random objects in the room, spacing out, attempting to get up out of my seat every fifteen seconds, or randomly and impulsively leaving my finished homeworks behind at various places to get me to do and turn in more of my homework. The tea seriously decreased careless mistakes.

It might be worthwhile to convince him to talk with his school counselor or teachers if he feels that he's having problems.

I would hate to see another one of us go through all of this with undiagnosed ADHD in the mix like I had. Parents with high expectations and undiagnosed learning disabilities just don't mix, especially if the said parents know what you're capable of during those hyperfocused moments.

Adduce
08-12-13, 08:03 AM
I hope you find the following links helpful and hopefully pick up some tips that you may not have come across before.

The articles are from a UK newspaper and are aimed at 16-18 year olds regarding study skills especially in the run up to exams.

Here are two of the articles, and within them you will find links (about 10 or so) linking to 'more by this author' and 'related articles'.

http://www.telegraph.co.uk/education...sion-time.html (http://www.telegraph.co.uk/education/educationadvice/9918575/5-top-tips-for-managing-revision-time.html)

http://www.telegraph.co.uk/education...n-success.html (http://www.telegraph.co.uk/education/educationadvice/9823789/Revision-techniques-The-secret-to-exam-revision-success.html)

(http://www.addforums.com/forums/newreply.php?do=newreply&p=1519967)

SlowAndSteady
08-14-13, 10:15 AM
Response to everyone:
First of all, thank you all for your great advice! It's really sad to see my student struggling when I know he's so bright and capable and how hard he tries to stay focused. We're hitting the point now where he can get every single question right - after I make him reread the question and the passage multiple times and question him when he puts the first right-looking answer he gets to. I'm convinced he could get a perfect score if he could only focus...for which, unfortunately, I'm also pretty convinced he'd need medication. (He needs a great score because his GPA's low from the effect distractability has had on his school work.)

Also, it turns out I was wrong - he's 15. He's so bright he skipped a grade and is still in a high school you have to test into and is really rigorous (IB) - he's just that smart.

I don't think I can take him on outside walks or have him sing. The latter because as a 15 year old boy I'm pretty sure I'd offend his teenage sensibilities. The former because I tutor him in his parents' restaurant and I seriously doubt they'd approve of that. In addition, in response to another suggestion, his English is flawless. I think he basically grew up in the States.

Thanks for the links! I checked them out and will try to incorporate the advice. I'll also try and read the book that was mentioned. I've already been working my way through another book about ADHD (an old edition of Driven to Distraction) so I'll pick up your book after I finish this one.

I decided to put my progress with the tutoring and the student below for feedback.

Adapting my tutoring method to his ADHD:
What I've been doing is using the Pomodoro method with him - 25 minutes of work, followed by a three minute break, and just looping that. I also let him stand up and walk around during our sessions. The other thing I've been working with him on is physically marking off right and wrong multiple choice answers - like scratching off A, B, C, etc as he figures out they're wrong until he eliminates as many as he can and just chooses from the ones that are left. I've also been having him physically mark up passages. My hope is that doing this will keep him more focused.

I'm trying to come up with a ritual - just something he has to do every single time before he moves on to another question. Something like, "read the question, reread the section of the passage (if applicable), reread the question, read the answers, mark off wrong answers, reread the answers, and then choose an answer." He finishes and reads so quickly that I think he can go through these

Talking to his parents about a diagnosis:
I'm really scared to do this, because from what it sounds like, it seems as though he's talked to them before. But I really want to because it'd really be so beneficial if he could get help. They also don't know that he's told me they don't believe in ADHD, so I could probably hopefully maybe get one free pass.
Another consideration here, of course, is that his parents are the ones that are paying me...so it may be unwise of me to aggravate them.

I did mention this situation to my Dad. He has ADHD himself which he takes medication for, is highly successful in life, and is also an immigrant (albeit Latin American, not Chinese). He offered to go eat at the restaurant with his girlfriend and just mention his diagnosis and how helpful medication has been for him in passing. Planting a seed? Don't know how effective that would be, but thought it was worth mentioning.

RobotInDisguise, I would especially appreciate your thoughts here. For your reference, I do know a fair amount about Chinese culture (went twice) and speak Chinese myself (although I hadn't known the word for ADHD), which is how I ended up tutoring the student in the first place. Parents have been here for a long time - mother speaks good English, but the father seems shy even about his 普通话 (Mandarin, which is all I speak).

His mother seems to realize there's a problem. For example, I wanted him to do some practice tests at home and bring them in for me, but she didn't want him to do that because she knew he wouldn't focus on the questions and didn't want to waste a test - she wants me to sit next to him while he takes them. Again, though, she seems to just think it's a character trait.


Thanks again to everyone for the suggestions - please keep them coming!

zette93
08-14-13, 03:13 PM
I wonder if it would help to mention that if he had an ADHD dx he could get more time to take the tests, which would give him time to implement all the strategies you've been teaching him -- some parents are interested in getting a perceived edge for their child. You might want to wait until tutoring is over, then disclose that you have ADHD and how much treatment helped you.

Ms. Mango
08-14-13, 05:58 PM
Well, there's no sense in killing the goose that laid the golden egg and losing your tutoring gig. Only you can assess the situation and determine if his parents will be receptive to an outsider's view.

He's like a lot of very smart ADHD kids. The work has been easy for him up to this point but now he's hit a wall and his parents probably don't believe he's really struggling.

Yeah, singing is silly. What I was thinking about was giving him some ideas about mnemonic devices that will aid in learning and retention. Some ADHD kids are kinetic learners.

However, even if singing is silly, I'm going to show my DS this when he needs to learn the periodic table:

http://www.youtube.com/watch?v=DYW50F42ss8

SlowAndSteady
08-14-13, 10:29 PM
Good news!

I was talking to my student's mother at the end of the session, letting her know how we were doing as always. I told her that distractability had really emerged as his greatest problem and what was really holding the student back, and told her what we were doing to try to address that. (I've been trying to come up with a formula that he applies to every question - lots more underlining and active participation with the text, scratching off wrong answers, rereading questions, etc.) She asked me what more we could do to help him with his distraction and I told her my honest opinion, which is that he would benefit from medication. She asked me if I thought he had ADHD...and we were off from there. (Here I was, nervous about bringing it up, and she asked me herself! What a relief!)

She's still not nearly convinced. Thankfully I happened to be reading (unrelated to my student, actually) Driven to Distraction at the time and was able to pull it out and give it to her, which should hopefully help. I'm not actually diagnosed with ADHD myself, nor am I on medication (I've asked elsewhere in the forum whether I would benefit from that) so I couldn't use myself as an example. However, my dad and sister both have ADHD, and I was able to use them as examples - she herself pointed out that she could tell my sister had ADHD but not my dad, and I mentioned that my sister doesn't take medication, while my dad does. I told her my dad would be happy to talk to her about ADHD and medication (and academics - he's an educator himself), so he'll hopefully be stopping by the restaurant. She seems like she can go either way at this point with her belief - I just don't know which way that is.

Here are her concerns that she said are holding her back. If you have anything to add to them, whether it's to say that they're justified or to myth bust, please add your comments!!!

1. Side effects of medication emerging later on.
She told me a lot of people in China are concerned that medication will develop side effects that are shown later on. I told her my sister took it for years with no ill effects popping up later, and my dad has had nothing either. Don't know if it'll help - if anyone has any other information about this concern, I'd appreciate it.

2. Going to a doctor to get a diagnosis/medication.
She didn't say anything, but she seemed leery of this. I told her I wasn't sure that you had to have a diagnosis in order to receive meds - my doctor handed me a script for Straterra without any diagnosis or test whatsoever (I can't testify to effectiveness, though, because I was so skeptical of the manner she went about prescribing it that I took it for maybe a month. Maybe.).

3. Her son is still functioning at a high level - he wouldn't be labeled as having a problem in China, just a personality that can't stay focused.
I talked to her about the differences I'd seen between the treatment of high functioning autism here and in China. In China it seems like so long as you function well, you're not perceived as possibly having a mental difference. The label used is simply "weird" and it's dismissed at that. Here, kids get diagnosed and get help even if they function decently well (by function here, I mean can get a job, etc, even if they're distressed by symptoms), which explains part of the difference in frequency of these diagnoses. It's not that the kids don't exist in China (which is what she said) - it's just that they don't get diagnosed. But I truly believe that with help people that can simply function can go from functioning to achieving their potential, so I'd have to go with the American method of also diagnosing high functioning people here.

4. Her son's teachers never mentioned this.
My mom's a teacher and mentioned that teachers really aren't able to bring this up as easily as in the past...I could ask her to elaborate on that. I personally think his brightness is what's led teachers not to notice something's astray, but in high school he's starting to hit the point where brightness can't simply carry him any more which is showing in his grades.


She really seems like a great mom who just wants the best for her son, and I feel for her situation right now. Anyways, hopefully she reads the book, which can do a lot better explaining than I can. As always, any thoughts you have to give are greatly appreciated!!!! :)

Ms. Mango
08-14-13, 11:36 PM
There aren't any medical tests that are approved for diagnosing ADHD; diagnosis is done by observation, interviewing parents and child and having parents and teachers fill out questionnaires. He should absolutely go though the process and get a diagnosis, if warranted.

I would also recommend the mom talk to the doctor so she can get those questions answered. I spent about an hour talking to my son's doctor so he could go over all the types of medications and their potential side effects.

My mother was a teacher (now retired). Sometimes she would bring up a problem she saw in the classroom and suggest the parent take a child to the doctor, but she never shared what she thought the problem might be. Teachers aren't qualified to diagnose.

Your doctor has me scratching my head. Part of me wonders if she thought you were engaging in drug seeking behavior and just gave you a prescription for a non-stimulant to get you out of her office. First line treatment for ADHD is stimulant medication unless contraindicated for some reason.

I would just (gently) emphasize that there are cultural differences here that make it much easier to seek out and get treatment.

SlowAndSteady
08-15-13, 07:31 AM
My doctor, it is agreed upon by all (she was my sister's doctor, too), was a bit strange. The reason she chose Strattera, according to her, is because of my anxiety issues I was experiencing - the idea was to kill two birds with one stone. In fact, I got the impression that she was trying to fix the anxiety more the the distraction element. It still felt really weird to me at the time, though - we'd talked for maybe 10-15 minutes (just the two of us, she didn't talk to my parents) and I left with a script. It was disconcerting. I'm thinking about going back to a psychiatrist myself (I still have both problems), but this time around I would definitely not go to her.

Sorry about the tangent. Still really excited about my student - going back there today for more tutoring, though, and I'm really nervous that the mother will change her mind. (Or, rather, unfavorably make up her mind.) Hopefully all goes well. :)

Adduce
08-15-13, 09:42 AM
Some links which may be helpful.

Study skills for adhd students.
http://www.addforums.com/forums/showthread.php?t=145691

I'd recommend researching study skills such as cornell notetaking, visual mnemonics (such as method of loci), sq3r/sq4r, mind maps etc.

Here's another link regarding memory improvement skills by two UK academics.
http://www.thepsychologist.org.uk/ar...5C1006morr.pdf (http://www.thepsychologist.org.uk/archive/archive_home.cfm/volumeID_19-editionID_140-ArticleID_1093-getfile_getPDF/thepsychologist%5C1006morr.pdf)