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Tips & Tricks :: Bipolar Disorder

Bipolar Disorder

This summer, I’ve writing a blog series focusing on several different disorders that affect children at school: ADHD, Autism, Bipolar Disorder, Depression, Anxiety Disorder, and ODD. Each entry will describe the disorder, give practical strategies for improving success at school, and also a few social-emotional goals and accommodations that might be appropriate for students with special education services!

Next up is Bipolar Disorder. Although mostly diagnosed in teens or adults, many more children are now receiving diagnoses of Bipolar Disorder, so it is becoming more and more common in school settings. In bipolar disorder, people experience abnormally elevated (manic or hypomanic) mood states which interfere with the functions of ordinary life. Many people with bipolar disorder also experience periods of depressed mood, but not always. Diagnosing bipolar disorder is often difficult, even for mental health professionals. In particular, it can be difficult to distinguish depression caused by bipolar disorder from pure unipolar depression or other disorders. I’ve even had kids that actually really had Autism be given an ADHD/Bipolar Disorder combo before being correctly identified!

Symptoms:

Rear View of Boy Leaping into AirMania Episodes – 

  • Elevated or irritable mood or euphoria
  • Increased energy or decreased need for sleep
  • Distractibility
  • Fast speech
  • Thoughts appear to be “racing”
  • Impaired judgement sometimes leading to risky or impulsive behavior
  • Breaks with reality (sometimes)

Hypomania Episodes – 

  • Mild to moderate states of mania
  • Increased energy and activity levels
  • Often feels good to the person experiencing it
  • Less interference with functioning, compared to manic episodes
  • Symptoms generally last a few weeks to a few months (but can be shorter or longer)

Depressive Episodes –

  • Persistant feelings of sadness, anxiety, guilt, isolation, or hopelessness
  • Changes in sleeping patterns
  • Changes in appetite
  • Loss of interest in previously-enjoyed activities
  • Difficulty concentrating
  • Suicidal thoughts or actions
  • Symptoms usually last several weeks to months if left untreated

Suggestions:

  • Contact the child’s doctor if medication is to be given at school to make sure you have up-to-date dosage and administration instructions. However, don’t tell a parent “your child needs to be on medication.” You can encourage them to talk about concerns they may have with their child’s doctor, but put your school in a vulnerable position if you start doling out medical advice!
  • Encourage the student to get involved in extra curricular or sports activities in order to boost their confidence and self-esteem
  • Keep routines and schedules structured and predictable so the student will know what to expect
  • Feelings PosterTeach students what different emotions “feel like” to their body to help them identify when they may be entering periods of (hypo)mania or depression
  • Improve students’ vocabulary of various emotion words to express their feelings to others
  • Provide visual reminders of behavioral expectations such as pictures of rules posted on their desk, behavioral charts, etc., or have students act out rules.
  • Teach relaxation strategies or other calming techniques for students to use during times of (hypo)mania or when upset or angry.
  • Provide a “cool down” or break area with stress balls or other activities, as well as visual reminders of learned relaxation and calming skills.
  • If parents approve, teach older students facts about what Bipolar Disorder is as well as statistics about the disorder to help normalize their experiences and help them feel less “weird” or “different.”
  • Provide group or individual counseling-type services to help students combat several types of irrational thinking seen during times of depression. If you need materials, check out this Positive Thinking Pack.

Sample Goals

  • Given small group practice, Mallory will improve her classroom performance from requiring frequent redirection to independently remaining in her seat and following directions with no adult prompting.
  •  Given behavior training, James will improve his behavior in the hallway from running and bumping into others to keeping his hands to himself, maintaining appropriate personal space, and following verbal directions with minimal adult prompting.
  •  Given relaxation training, Max will improve his emotional regulation skills from yelling and becoming physically aggressive when upset to taking deep breaths, relaxing tense muscles, and moving to a quiet place when upset with no more than 1 adult prompt.
  • Given instruction regarding Bipolar Disorder, Sarah will increase her knowledge of Bipolar Disorder from not knowing any Hourglassinformation about it to listing facts regarding prevalence, symptoms, and treatment independently.

Sample Accommodations:

  • Provide a private, quiet place for calming down when irritated or over-excited
  • Allow students to use cue cards or other visual tools to express their feelings if they struggle with verbal expression
  • Give breaks or extended time if you can tell the student is struggling to focus

If you’re looking for activities for your students, check out my Dealing with Anger Activity PackAnger and Coping Skills Bingo, and Social Skills Cards: Feelings Pack Freebie! You can also check out my Pinterest Boards for Feelings, Anger Management, and Mental Health for even more ideas!

Thanks to Wikipedia for contributing to this article!

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Tips & Tricks :: Non-Color-Coded Behavior Management

Screen Shot 2013-06-13 at 12.08.46 AM

Recently, I wrote a post detailing my dislike for those color-coded behavior clip charts that dominate the land of Pinterest and teacher blogs. Sure, they’re cute, they’re easy, and they change behavior, but they also undermine respect and dignity, humiliate students, and strain relationships.

I promised during my last post that I would provide some alternatives to help manage behavior while encouraging learning that doesn’t involve public reprimands, so here goes, but first I want to get a few things straight!

1. Extrinsic motivation is not the enemy. The argument a lot of people use against many different types of reward systems is that it encourages students to work for “things” rather than that “feel good feeling.” And while this can be true, I want to offer a thought. Adults are extrinsically motivated too. If you were to ask 100 adults why they work, I guarantee that one of the top reasons would be because they earn a paycheck. Sure, many adults works also primarily because they feel a sense of pride, feel like they’re making a difference, or changing the world, but if there was no paycheck attached I’m assuming that a great majority of the world would be unemployed. And when was the last time you used your own paycheck to buy “feel good feelings?” I used to hate it when my mom asked me to do something “because I would feel good about it.” So while intrinsic motivation is awesome, extrinsic motivation can be very beneficial to. It just shouldn’t be the only motivation.

2. Not every technique or strategy will work for every kid. Sure as the sun shines, there’s always going to be those 1 or 2 kids that are just going to have a rough time. For kids with lots of defiance, check out my previous post for some suggestions. For some kids, more individualized behavior plans or IEP’s may need to be developed to meet their needs. More specifically, some kids may have a much harder time developing intrinsic motivation and need exclusively tangible rewards…some students with severe Autism or cognitive impairments, for example.

All right…onto the good stuff! Here are alternatives to the rainbow rocket-ship, pirate-themed, or flower behavior clip charts.

Have Students Manage Their Own System
This gives them ownership! It can be as simple as giving them punch cards at their desk that you periodically punch throughout the day for turning in work, sitting quietly, not getting discipline referrals during the day, etc. Or, it might be a pouch of tickets they keep to earn tickets. One of the really cool things I’ve seen teachers do with the tickets is having a weekly or monthly reward time during which kids can spend their tickets or punches on various activities. More popular activities like iPods might be more expensive, whereas less “in-demand” activities are less expensive. Either way, all students participate. It’s just that the better-behaved ones during the week get more choices as to what activities they’re able to do! Really want to use color-coded? Just have the kids keep a card at their desk in a private location that you can quietly go over and trade for a different colored card. At the end of the week, each color corresponds to a point value, which determines how much “money” they have to spend on activities.

Make Your Classroom Resemble the Real World
The main purpose for education is to prepare kids for the world after school, right? So why on Earth are we having kids move clips on a chart when they’re never in their entire life going to be moving clips or being a certain color for their behavior? Hopefully, we’ll get a job and work for money and earn bonuses for good work (unless they work in schools, of course!) So the most effective way to prepare kids for this type of system is to make your classroom some type of token economy like the real world is!

Use A Variety of Reinforcers
Kids are motivated by food, others by certain activities, some by “stuff,” but everyone is motivated by CHOICE. And yes, I’m well aware about the restrictions being placed on food and school setting as well as the various dietary restrictions and needs of students. So if there issues surrounding food in your classroom don’t use it as a reinforcer! For tangible reinforcers, go spend $2 to buy a bunch of colorful pencils at a teacher discount store instead (or get them to donate – many will!)  I’ve also seen teachers allow students to wear hats Friday, earn a homework pass, be able to spend time in the classroom at the shoes off, or be allowed to use pen for the day. There’s a million different types of reinforcers, but the goal is to allow students to CHOOSE what they will be motivated by be it tangible, activity, or otherwise. In the spirit of aligning our behavior strategies with real world, when was the last time that your boss told you how you could spend your paycheck?

Keep It Private
Ultimately, the goal of any system should be to keep it as private as possible. No other student in the classroom should know how many points or how many tokens or how many punches a student has earned unless that student wants to tell others. The purpose of discipline should never be to humiliate or torment. Along with that, avoid disappointing in groups as much as possible. I love how in schools we send the worst behaving kids to the principal’s office or keep them out of recess all together, so they sit outside the office or on the side of the playground for hours each year commiserating together and forming an army against the adults in their lives. There’s a reason that in counseling school we are told not to put all of the people with behavior kinds of problems in a group together. Unless two students wronged each other and are mediating a conflict, disciplined students should not be put altogether. Have them each go “help a teacher” or do something productive somewhere in the school when possible. It makes them feel like they have a purpose, and keeps them from forming a coalition with other kids who have difficulty behaving.

Encourage Intrinsic Motivation Too
So far, I’ve talked a lot about strategies that encourage extrinsic motivation so here are some thoughts about developing intrinsic motivation because that is also crucial in the adult world:

  • Keep all educational material relevant to students lives. One technique I saw recently was to have a “fact of the day” board in the classroom where students could submit interesting facts from some nonfiction source they found. Then, their fact and their name would be written on the board. What a great way to encourage students to read nonfiction while gaining peer and adult attention as a motivator!
  • Provide choice – let students choose between different ways of demonstrating Mother and Son Reading Bible Together nowledge (a worksheet vs. “create your own” test vs. “tell your partner”). Choice helps students cater their own learning toward their interests while discovering and developing their own strengths. If doing this is too overwhelming for every assignment, just pick 1 day each week. After a year, you’ll have 36 days of differentiated instruction. After 3 years, you’ll have 108! Or…find a friend to each pick a day each week and you can get a differentiated year 2 or 3 times as fast!
  • Focus on Relationships – authoritative teaching styles work best to increase student interest, enjoyment, and performance, just as authoritative leadership styles work best to improve employee productivity and happiness.  Listen, give encouragement, and show empathy for students. You’d be surprised how much better behavior gets when students feel like you are their ally rather than their dictator. They WANT to work to impress you if they feel loved and cared for.

Fair is Not Equal
We educational people live and breathe this fact almost every moment of every day. We differentiate, flex group, and we try to give every student exactly what they need. This is why we all look like post-apocalyptic zombies come the beginning of June! But what I mean by this is that the students have to know it too! I often use the Band-Aid analogy in that if a student came in with a broken arm, I wouldn’t give them a Band-Aid just because their classmate got a Band-Aid for a paper cut that morning. There are tons of visual lessons  and demonstrations that can be used to teach this fact to kids and I highly recommend weaving it into every aspect of what you do in the classroom. Reminding kids that “I give every student what they need even though it’s not the same thing” is so important because as you and I know, when they get to the real world things are not the same for everyone. People earn giant promotions or get laid off, live in trailer parks or giant mansions, have 5 kids or suffer through infertility. Students will have so much more respect and trust for you if they know that they’re going to get what they need from you even if it’s not every other kid in the class needs.

Unfortunately, there’s no magic wand. There’s no “easy button.” There’s just a lot of hard work, long days, and undead-looking teachers by June. But in the end, it’s worth it. These kids are going to be running the world pretty soon and even though there are 7 or 8 now, they are just as important as you or I. And they have just as much dignity, worth, and value as any other person. I absolutely love the following quote: “Each child in your class is someone else’s whole world.” We need to always remember that.

“Yes, behavior charts can create a classroom full of raised hands, quiet voices, walking feet, please-and-thank-you’s. But a child’s dignity is too high a price to pay for criss-cross-applesauce.” Thank you for the reminder, Amy!

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Pinterest Find :: Colorful Behavior Management Charts

Waiting in Line

Ok…so the title of this post is probably misleading…but please don’t throw anything. Hear me out!

Really, I should call it “Why A Little Part of me Wants to Die Every Time I See One of Those Colored Behavior Clip Charts.” When I was finding additional material for this blog post, I came across an amazing one that said 90% of what I wanted to say, so I’ll start with part of it. The entry is from Amy of Miss Night’s Marbles. I changed a few details, but she tells it so well so there’s really no other reason to re-invent the wheel.

Imagine that you have a new job. You’re VERY excited about this new job, and a little bit nervous. You know there are parts of it that you will be very good at, but there are some things that you are still working on, or that you might need support from your boss to master. It’s okay, though, because you’re pretty sure that your boss is really nice, and will help you work on those things.

You arrive at work and start meeting your new co-workers, who are just as excited and nervous as you. You notice that some of them seem to be VERY good at nearly everything, and others seem to struggle with even more things than you, but altogether they are a nice enough group and you feel like you will be a good team. You start to make some work friends. It feels good.

Then, at some point – maybe right away, maybe after a few days or weeks or months, your boss sits you ALL down together and explains a new performance management system. On the wall of your communal work area, Boss has posted a list of all the employees, by name. Next to each name is a rainbow of color-coded cards. Boss explains that every employee will start each day on the same color, but depending on your performance, your name can be moved up the rainbow, or down the rainbow. People who move up the rainbow will get special extras: a small bonus, or an extra long lunch, or a half-day off. People who move down the rainbow will face consequences: a shorter break, a docked paycheck, a note in their file.

The next day starts out badly before you even get to work. There’s no hot water left for your shower, you’re out of coffee, your cat has peed on your favorite shoes, your car isn’t starting AND it’s raining. You get to work about 5 minutes late and within an hour, your name has been moved down to yellow. You get a warning from your boss. Then, your favorite work friend doesn’t want to work next to you because you just got in trouble and she doesn’t want to get in trouble by association. Your hurt feelings make you distracted, and you make a few careless errors in your tasks. Your name gets moved to orange and now you only get 20 minutes for lunch, which is really upsetting because the sun is finally shining and you had been confident that a nice walk in the fresh air with your buddies would help turn your day around.


The end of the day approaches. A few of your colleagues get to leave 30 minutes early because their names got moved “up” to blue. Thileaves you with extra work that has to be done before you can leave. Among these colleagues, one of them had his name moved up to purple, so he is buying a round of drinks for everyone… Everyone who can leave early, that is. It’s always the same people who can leave early, and really, they’ve become quite clique-y. You convince yourself you wouldn’t really WANT to have drinks with them, 

anyway. You really fit in better with the red and orange card crowd.On your abbreviated lunch break, you try to get online to order some new shoes. Impatient and frustrated, you curse under your breath when the site won’t load properly. In front of everyone, your boss moves your name to red. There goes 50 bucks off your pay. Apparently you won’t be buying new shoes, after all. You approach your boss privately, trying to explain and apologize. Boss tells you, kindly-but-firmly, that “No cussing” is an ironclad rule, and that because other employees heard you cuss, she has to give you the same consequence she would give anyone else. Later, you take a bit too long in the bathroom, and your name gets moved off the rainbow altogether. A note is placed in your file, documenting a reprimand for inappropriate language in the 

workplace.

UGH…right? I mean, if it were me, I’d probably put my big girl pants on, pack up my bags, and find another job. Really, ANYWHERE would be better than this. Unfortunately, our kids don’t have this luxury. They’re trapped. Whether we maintain their dignity and privacy or announce to the whole class when they’re not living up to our expectations for them, they’re required by you, the truancy officer, or their parent to be there the next day…and for the next 180 or so of them.

Sure, I’ve seen teachers “adjust” these systems to use numbers instead of names, hiding the clothespins on chalk ledges so they don’t face the class, etc, but let’s be honest, all kids know who the “purple and blue” kids are and who the “red and orange” kids are.

So why on this earth have we decided that it’s ok to do this to kids? Nearly all research point to public discipline as ineffective or counterproductive. Because it’s easy – that’s why. Unfortunately, we’re not in this business to make things easier for us. We’re in it to do what’s best for kids. We owe it to them to find another way to balance order and dignity.

little girl and teddy bear

Amy ends her post with these absolutely perfect words:

“There are many many reasons not to use publicly-displayed, one-size-fits-all behavior “systems” in a classroom: they undermine a sense of community; they prevent kids from generalizing good behaviors;  but this is the biggest one, to me:

A child’s dignity, privacy, self-respect are no less real or important or valid, than mine. When I undermine a children’s privacy and dignity, I do damage to their relationships: with their peers, with me, and with themselves.

Yes, behavior charts can create a classroom full of raised hands, quiet voices, walking feet, please-and-thank-yous.

But a child’s dignity is too high a price to pay for criss-cross-applesauce.”

Here’s a few other blog posts others have written regarding the downsides to public behavior clip charts as well as what they use instead:

Teaching in Progress
A Teeny Tiny Teacher
Teaching Ace

Update: Head over here for follow ups on behavior strategies that WORK to encourage intrinsic motivation and community while maintaining dignity!