NASET ADHD SERIES
By Roberto Roman
This issue of NASET’s ADHD series was written by Roberto Roman and highlights the use of the Daily Report Card (DRC) as a practical classroom intervention that involves monitoring behaviors and providing rewards based on goal attainment. It also discusses the need for cultural adaptations when implementing DRC for Latino families, including improving family communication, modifying rewards, considering gender roles, and acknowledging cultural values related to disciplinary practices. The publication offers routine management solutions and stresses the importance of parental involvement in promoting positive outcomes for students with ADHD.
Abstract
This work highlights the use of the Daily Report Card (DRC) as a practical classroom intervention that involves monitoring behaviors and providing rewards based on goal attainment. It also discusses the need for cultural adaptations when implementing DRC for Latino families, including improving family communication, modifying rewards, considering gender roles, and acknowledging cultural values related to disciplinary practices. The publication offers routine management solutions and stresses the importance of parental involvement in promoting positive outcomes for students with ADHD.
Key words:Behavioral Classroom Interventions, ADHD, Daily Report Card (DRC), Latino parents, cultural values, disciplinary practices.
Enhancing ADHD behavioral interventions for Latino Children through Cultural Adaptations of Daily Report Card
In the United States, Hispanic Americans make up the largest ethnic group, encompassing numerous nationalities, including Cubans, Mexicans, Puerto Ricans, Argentinians, Colombians, Dominicans, Guatemalans, Costa Ricans, Nicaraguans, Salvadorians, and individuals from South American, Central American and the Caribbean regions. Mexicans, Puerto Ricans, and Cubans represent the three largest Latino sub-groups in the United States (Chang & Liou, 2009).
These diverse cultures share similarities such as the use of the Spanish language, a common cultural background shaped by European, African, and Indigenous influences, and adherence to various religious practices (Crockett, Brown, Iturbide, Russell, & Wilkinson-Lee, 2008). Given the significant proportion of Latino students in educational institutions, it is essential to explore the values that shape Hispanic culture and their impact on disciplinary dynamics, particularly for Latino adolescents with attention deficit hyperactivity disorder (ADHD).
Attention deficit hyperactivity disorder (ADHD) is a condition that affects a significant number of children worldwide, and its symptoms can often pose challenges for both parents and teachers. The incidence of ADHD in Latinos has increased by 53% from 2003 to 2007, affecting approximately one million Latino adolescents in the United States. Recent research indicates that although both Latino and European American youth exhibit similar rates of ADHD symptoms, Latino youth are less likely to receive a diagnosis or treatment (Gerdes A. C., Kapke, Grace, & Castro, 2021).
According to Araujo, Pfiffner, and Haack (2017), some of the factors that contribute to the low likelihood of receiving diagnoses or treatments are related to the fact that a significant number of Latinos residing in the United States do not have sufficient proficiency in the English language, which limits their access to healthcare services and their knowledge about them. Other practical and cultural factors include religion, stigma associated with seeking mental services, lack of health insurance, unreliable transportation and scheduling difficulties, inability to pay for childcare, traditional gender roles, and family dynamics (Gerdes A. C., Kapke, Lawton, Grace, & Hurtado, 2015).
Some of the challenges faced by children with ADHD include the inability to complete schoolwork due to a range of cognitive and behavioral difficulties. These difficulties can lead to negative outcomes such as poor academic performance, low self-esteem, and social isolation (Kendall, 2016). Another key area of difficulty for students with ADHD is homework completion. This process requires the initiation and completion of a series of distinct behaviors, such as accurately recording information about assignments, organizing materials, managing time, and maintaining focus during task completion. Students with ADHD often struggle with one or more of these aspects, leading to incomplete work (Rosanna P. Breaux, Bourchtein, Eadeh, Molitor, & Smith, 2019)
According to Gerdes, et al., (2015), two psychosocial treatments have been found effective for treating ADHD: behavioral parent training (BPT) and behavioral classroom interventions. The BPT are focused on developing skills and covering topics such as providing effective instructions, using time-outs consistently, acknowledging and praising positive behavior, disregarding mildly negative behavior, creating a token economy, and implementing a classroom intervention that targets functional problems in the classroom. In addition, in these sessions, parents are taught how to implement evidence-based strategies such as the Daily Report Card (DRC).
The Daily Report Card (DRC) is a straightforward classroom intervention that involves teachers tracking three to five problematic behaviors in the classroom each day. The child is given the DRC at the end of the school day, and the parent provides different levels of rewards at home depending on how many DRC goals the child achieved. The DRC class aims to explain the DRC to parents and collaborate with them to develop a home-based reward system for the DRC (Gerdes A. C., Kapke, Lawton, Grace, & Hurtado, 2015).
According to Gerdes, et al., (2015) for many Latino parents, particularly those with limited English proficiency, may not feel confident enough to take over the DRC once the parent groups have ended unless more emphasis is placed on enhancing their communication and comfort level with the school and teacher. Therefore, emphasizing empowering parents and enhancing family communication could boost parental motivation in adopting this new strategy.
Another area that has required cultural adaptation is regarding the reward system. Despite research showing that children with ADHD tend to react positively to rewards and show greater improvement in their task performance after receiving smaller, immediate rewards over larger, delayed rewards (Langen, et al., 2020), some Latino parents may face a challenge when rewarding their children for engaging in expected behavior at school. This is because research suggests that as a group, Latino parents tend to favor an authoritarian parenting style that places greater emphasis on obedience and respect and less emphasis on acknowledging and rewarding expected behaviors (Gerdes, et al., 2015).
When it comes to teaching Latino parents how to increase child compliance through effective instructions, it is important to consider gender role conceptions. Research suggests that traditional Latino gender roles may not align with both parents administering consequences for noncompliance. Gerdes,et al. (2015) explains that in sessions with parents, it is common for some Latino mothers to defer to their husbands instead of implementing an immediate consequence for repeated noncompliance. The authors also suggests as a way of adaptation when implementing DRC with Latino parents is removing the requirement for parents to keep graphs for each target and making the DRC a collaborative effort between the parent and teacher. This approach helps alleviate the parent’s sole responsibility for decision-making regarding changes in DRC criteria and targets.
Additionally, Gerdes, et al., (2015), noted that “time out”, a commonly used technique in parent training, may not be suitable for many Latino parents. Concerns were raised about the severity of the punishment for repeated noncompliance and how it contradicts the importance of family values in Latino culture. Instead, it is more effective to focus on using consistent consequences in the form of natural consequences, removing privileges and possessions. Regarding “token economy” Gerdes, et al., (2015), concluded that this strategy may not be appropriate for many Latino families due to difficulties in consistent implementation and cultural differences related to household structure.
In the case of routine management, it has been found that homework hour and morning and bedtime routines are commonly identified as problematic times by parents of ADHD-diagnosed youth (Gerdes et al., 2015). The origin of these behaviors is due to homes lacking structure, and some parents may not be able to provide homework assistance due to language barriers and busy schedules. Some solutions proposed by the authors are to find a community-based program that offers tutoring and homework help or establish a family routine for homework hour.
When considering disciplinary practices for Latino students with ADHD, it is important to recognize how cultural values and beliefs can shape disciplinary decision-making. It is also crucial to acknowledge the importance of parental involvement and support in promoting positive outcomes for students, especially those with disabilities or at risk of academic failure. Parents of students with special needs possess a wealth of information about their child and can play a vital role in advocating for their educational needs (Strassfeld, 2019, p. 284).
Conclusion/Recommendations
The Daily Report Card (DRC) is an evidence-based strategy that has been shown to be effective in reducing ADHD symptoms in children. Providing training and support to Latino parents can help them to feel empowered to adopt the DRC and other evidence-based strategies. This can include providing them with detailed instructions and modeling, as well as offering ongoing support and feedback.
Parents who feel that they are working collaboratively with their child’s teacher may be more motivated to adopt new strategies and interventions. Teachers can play a critical role in facilitating this collaboration by providing regular updates on the child’s progress and offering suggestions for how parents can support their child’s learning and behavior.
Encourage both parents to participate in the DRC intervention, emphasizing the importance of shared responsibility and decision-making. It can help to promote better communication and cooperation between parents, which can lead to a more harmonious home environment.
Work collaboratively with Latino parents to identify and implement effective consequences that are consistent with their cultural values and beliefs. By adapting the reward system to align with Latino cultural values, parents may be more motivated to use the system and children may be more responsive to it.
References
Araujo, E. A., Pfiffner, L., & Haack, L. M. (2017). Emotional, Social and Cultural Experiences of Latino Children with ADHD Symptoms and their Families. Springer, 3512-3524.
Cen, S., & Aytac, a. B. (2016). Ecocultural Perspective in Learning Disability: Family Support Resources, Values, Child Problem Behaviors. Hammill Institute on Disabilities , 114–127.
Chang, N.-Y., & Liou, T.-Y. (2009). A study of Latino Parenting Culture and Practices: Listening to the Voices of Latino Parents. HSIUPING JOURNAL OF HUMANITIES AND SOCIAL SCIENCES, 1-36.
Crockett, L. J., Brown, J. R., Iturbide, M. I., Russell, S. T., & Wilkinson-Lee, A. M. (2008). Conceptions of Good Parent–Adolescent Relationships among Cuban American Teenagers. Springer Science + Business Media, 575–587.
Gerdes, A. C., Kapke, T. L., Grace, M., & Castro, A. (2021). Feasibility, Acceptability, and Preliminary Outcomes of a Culturally Adapted Evidence-Based Treatment for Latino Youth With ADHD. Journal of Attention Disorders, 432–447.
Gerdes, A. C., Kapke, T. L., Lawton, K. E., Grace, M., & Hurtado, G. D. (2015). Culturally Adapting Parent Training for Latino Youth With ADHD: Development and Pilot. Journal of Latina/o Psychology, 71-87.
Kendall, L. (2016). The teacher said I’m thick!’ Experiences of children with Attention Deficit Hyperactivity Disorder within a school setting. NASEN, 123-137.
Langen, M. J., Hulst, B. M., Douma, M., Steffers, M., Wiel, N. M., Ban, E. v., . . . Zeeuw, a. P. (2020). Which Child Will Benefit From a Behavioral Intervention for ADHD? A Pilot Study to Predict Intervention Efficacy From Individual Reward Sensitivity. Journal of Attention Disorders, 1–11.
Rosanna P. Breaux, J. M., Bourchtein, E., Eadeh, H.-M., Molitor, S. J., & Smith, Z. R. (2019). dx.doi.org/10.1037/spq0000287 Brief Homework Intervention for Adolescents with ADHD: Trajectories and Predictors of Response. School Psychology, 201–211.
Strassfeld, N. M. (2019). Preparing Pre-Service Special Education Teachers to Facilitate Parent Involvement, Knowledge, and Advocacy: Considerations for Curriculum. Teacher Education and Special Education, 283–296.
