Quelling Hyperactivity With a Few Timely Whispers

At first, you don’t notice the whispering as a teacher with short brown hair and glasses reads a book about jazz artist Duke Ellington to a dozen children sitting on the padded floor.

The whispering is going on at the back of the group, where a blond woman sits cross-legged among the children.

“Josh is raising his hands properly.”

“Jeremy is giving good eye contact.”

“Jordan is sitting properly.”

Oops. One anxious, sandy-haired boy blurts something out. Immediately the woman whispers, “Raise your hand.”

The continual whispers are one part of an unusual program at UC Irvine to teach 45 children with attention deficit hyperactivity disorder.

Children with ADHD typically have difficulty concentrating or following directions and become easily frustrated. Sometimes, they are hyperactive. As a result, they often end up in trouble at school.

The center doesn’t discourage students from taking drugs such as Ritalin, a controversial stimulant often prescribed for children with the disorder. But the focus here is on behavior modification. The popular belief is that ADHD, which occurs in about 3% of the child population, is caused by a chemical imbalance in the brain.

“We’re also finding that in addition to the use of medication, the psychosocial intervention is extremely important,” said Stephen Simpson, an educational psychologist who designed the program at UCI. “Medication is effective in helping them increase their attention and focus but it doesn’t teach them social skills.”

The center accepts children ages 5 to 12 to the one-year program. At the end of the year, most children return to the public schools.

The Irvine Unified School District is in charge of planning the academic portion of the school. The curriculum at the center is the same as the one the pupils would receive at any other school in the district. UCI and its Child Development Center conduct the clinical portion of the program. For one hour each day, specialists trained in behavior modification techniques for children do intensive work on changing the child’s behavior.

“The idea is to have intensive interaction to get the child to go toward appropriate behavior and have them take responsibility for that,” said James Swanson, director of the child development center.

During one such session, about five adults stood in a room, monitoring children’s behavior during show and tell. Some held clipboards. Minute by minute, they marked down what types of positive and negative behavior the child exhibited.

A boy with spiky brown hair held a black glove and an orange ball in his hands. The instructor prompted him to talk about it.

“I have a ball, which is bouncing, and then I have this glove, which I have had probably for 30 years,” said the boy, who looks 7 at most. “I’ve had it since I was a baby.”

A few times, the staff told other children they were losing points for yelling or speaking out of turn; more often, they awarded points for children raising their hands, contributing to the show and tell, sitting or making proper eye contact, or saying nice things and sharing.

“Whenever they do something like that, you tell them they’re doing the right thing,” Swanson said. The goal is for the right behavior to show up 90% of the time--following directions, working patiently, raising hands.

The public education is free. But the clinical portion costs about $1,000 a month, Swanson said. Sometimes medical insurance companies cover a portion of the fee.

While the teachers conduct the lessons, behavioral specialists typically whisper to the children about acceptable or unacceptable behavior. A reward system backs up their comments.

One method has been to place a paper “pizza” in the classroom, covered with crosses. The children receive circles of paper resembling slices of pepperoni to paste on the crosses when they gather enough points from behaving well. Once the pizza is filled they have a pizza party. Another game has the children earn play money that they can use toward purchasing such rewards as computer time.

“It’s where art meets science,” teacher Dave Agler said of the program.

The center, in a portable building on Jamboree Road, has worked since 1983 with children diagnosed as having ADHD.

Much of Simpson’s interest in ADHD stems from his work years ago at Juvenile Hall in Orange County. There, he noticed that many of the youths had ADHD. Simpson hooked up with UCI, which at the time was studying ADHD.

In addition to the staff’s intensive work with the children, parental involvement is a requirement. They must attend two-hour sessions once a week for the first six weeks of the program. Then they must make a commitment to come to the school for a couple of hours each week.

Most of the children are from Orange County, but occasionally students have also come from Australia, Saudi Arabia, Israel and South Africa. Some parents from Los Angeles have also moved to Orange County so their children could attend the school.

In addition, several other universities have been examining UC Irvine’s program to study the effectiveness of behavior modification for treating ADHD. Specialists from the center have been invited to speak at ADHD seminars in England, Italy and Turkey.

Locally, Laguna Niguel resident Christine Hammond says the program has worked for her 6-year-old son Blake, who had seemed destined for trouble.

“We were always saying, ‘Blake, where are you? Blake, are you OK? Blake, are you down the laundry chute?’ ” Hammond said. “The school has made a huge difference.”

Like many children with ADHD, Blake has always been a bright little boy. He knew the alphabet by the time he was 18 months old, but he also was hyperactive. When she took him to social events, everyone knew his name by the end because he was so disruptive, Hammond said. He was diagnosed as having ADHD when he was 2.

In preschool, Hammond noticed other problems. He touched everyone else’s lunch. He grabbed toys from other children. He never completed tasks. During nap time, Blake would continue chatting and walking. She grew especially worried when he once tried to scale the school fence. He couldn’t stand next to her for more than a minute and had frequent and loud temper tantrums.

She tried a psychiatrist and other experts, with little result. She tried occupying him with computer and video games. His behavior only grew worse.

“I went through two years of sheer hell,” Hammond said.

Blake was started on the stimulant Dexedrine at age 4 1/2. That helped, but it also caused sleeping problems and lack of appetite.

Hammond signed Blake up for the Child Development Center when he was 5. A few months later, after the center showed her how it could help Blake modify his behavior, Hammond was able to take him off the afternoon doses. Blake still takes a dose of Dexedrine in the morning, but that’s all he needs, Hammond said.

The school has also taught Hammond how to reinforce the behavior Blake learns at school. Now, she said, he has fewer temper tantrums and can follow directions. The family has some peace.

“My neighbors notice,” she said. “My family notices. We can have a family holiday now.”

Because Blake entered when he was so young, the school allowed him to stay a year more than usual, but Hammond plans to send Blake to a public school next year.

* The Child Development Center can be reached at (949) 824-ADHD.