Sunday, July 1, 2012

Using Play Therapy to Reduce ADHD Symptoms in Children

Recent Study on Helping Students with ADHD

In their study, Schottelkorb and Ray (2009) explored how students with attention deficit hyperactivity disorder (ADHD) symptoms are disruptive in class, interfering with the learning process in elementary classrooms.  Additionally, if there is no intervention early on, the symptoms continue to have negative effects into adulthood.  In the past, there have been multiple studies on the effectiveness of play therapy for children that have yielded positive results.
The belief is that “children under the age of 10 have not developed the cognitive and verbal abilities to participate fully in talk forms of counseling and instead their natural form of communication occurs through play (Landreth as cited in Schottelkorb and Ray, 2009).”  Child-Centered Play Therapy (CCPT) falls under the responsive services umbrella of the American School Counselor Association (ASCA) National Model because counselors are responsible for helping individual students’ needs and concerns in order for them to achieve academically (ASCA, 2005).  Although there have been positive results from studies in the past with the use of CCPT in schools, not many studies have focused on the direct effectiveness of CCPT with students that have ADHD symptoms.  The purpose of this study was to see if CCPT and person-centered teacher consultation (PCTC) could decrease the symptoms of ADHD that interfere with the students’ learning.
            For this study they used a single-case design in order to explain individual behavioral changes.  Four students were involved in the study that qualified through a diagnosis of ADHD and not currently on medication.  Researchers used the Direct Observation Form (DOF) three times a week to observe and rate the student’s on-task and off-task behavior, the Conners’ Teacher Rating Scale-Revised (CTRS-R:S) used by teachers to assess the problematic behaviors, and the Teacher Report Form to compare academic and behavioral performance to other classmates without ADHD symptoms.
Two students received 24 CCPT Sessions and 6 PCTC Sessions, while the other two students received only 14 CCPT Sessions and 12-14 Reading Mentoring Sessions (a substitute to prevent the observers from knowing which treatment each student is receiving).  Results showed that all of the students increased their on-task behaviors in the classroom during participation in CCPT or in CCPT and their teachers with PCTC.  The two students that received more CCPT Sessions with teachers that received PCTC Sessions showed a positive, significant change in their behaviors in the classroom.
I was very impressed by the information presented in this article.  This study has many implications for school counselors as well as teachers.  As a school counselor, it is your responsibility to ensure that all students are receiving the services necessary to be successful in the classroom.  If a student diagnosed with symptoms of ADHD is struggling to learn because of an increased amount of off-task behaviors, a counselor should provide strategies or interventions to both the student and the teacher in order to help them be successful academically.  In this article, CCPT and PCTC were found to be successful interventions for the students in the study.  However, it is important to gather all the pertinent information about a child before you try any intervention to assess if there are any other needs that should be addressed.
In the study, students that received more than twelve sessions showed significant improvement in their behaviors.  This is a very time-consuming process that is done one-on-one with the student.  According to the ASCA national model, elementary school counselors should be spending 30%-40% of their time on responsive services (ASCA, 2005).  Counselors must assess whether this intervention is appropriate and would benefit their campus’ needs for the time it requires.  I also was unaware of how helpful PCTC could be for teachers in order to improve their relationship with students.  This is an area I would like to further study because it might also be beneficial to teachers of students with other diagnoses.  I found this article very eye-opening as I did not realize there were specific treatments that school counselors have successfully used to help students with ADHD symptoms be more successful in the classroom.  I had assumed that these interventions were done outside of school as recommended by the student’s physician.  It is uplifting to know that during the school day there are opportunities to provide students with helpful sessions to improve their academic performance in the classroom.

Schottelkorb, A. A., & Ray, D. C. (2009). ADHD symptom reduction in elementary students: A single-case effectiveness design. Professional School Counseling, 13(1), 11-22.
American School Counselor Association (2005).  The ASCA National Model: A framework for school counseling programs, 2nd Ed. Alexandria, VA: Author.

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