Doctor's office replaces principal's for pupils thought to have attention disorder Child psychiatrist Larry Silver to speak on Wednesday at Westminster High

Perhaps you had one in your class, or maybe it was you who was always being sent to the principal's office for acting up.

Now, such children are more likely to get a second look from teachers, who might suggest the child be tested by a doctor for attention-deficit disorder.


"It used to be children with attention-deficit disorder spent a lot of time in the office," said Nancy Kenehan, a special education teacher at Carrolltowne Elementary School. "It was just not understood by teachers and administrators."

That created a destructive cycle, she said. The more time these children spent outside the classroom, the further behind they fell in their schoolwork.


But in the past 10 years, she said, teacher awareness has grown. When a child has trouble paying attention, remembering directions and carrying out assignments, teachers now will suggest that parents talk to the child's doctor about it, Mrs. Kenehan said.

Because of the increasing numbers of children being identified with the disorder, nearly all the teachers in Carroll County public schools this year have had training on the disorder, said Joseph Dorsey, a special education coordinator who has provided some of that training.

Two parent support groups are sponsoring a free lecture with Georgetown University's Larry Silver, a child psychiatrist and nationally recognized expert and author on the disorder.

The Carroll County school system distributes pamphlets by Dr. Silver to parents and teachers of children with the disorder.

The lecture will be at 7:30 p.m. Wednesday at Westminster High School Auditorium. Dr. Silver will be available at 7 p.m. to sign copies of his books, including "The Misunderstood Child," which will also be on sale at the lecture.

Janice Borisevic, a parent and school nurse at Westminster Elementary School, has a son with the disorder and is president of the Carroll County-Owings Mills chapter of CHADD: Children with Attention Deficit Disorders. That group and the Learning Disabilities Association of Carroll County are sponsoring the talk by Dr. Silver.

With medication from his doctor, and modifications in the classroom, Mrs. Borisevic's son has been able to succeed in his classwork. Now a freshman at Westminster High, he plans to go to college, possibly to become a psychologist, Mrs. Borisevic said.

"When he was first diagnosed, he was 7," she said. "But I always knew."


She just didn't know exactly what was causing him to be so active, have trouble focusing on anything or be unable to relax before napping or bedtime.

"When he was 4, he broke a window at nursery school," she said.

She asked his doctors, who would respond with, "Well, he's just a boy. This is the way boys are."

When he was in first grade in Columbia, she heard from the school about a meeting where someone was going to speak about attention-deficit disorder and hyperactivity. The two conditions don't always exist together, but sometimes do, as in her son.

While Mrs. Borisevic listened to the speaker describe the disorders, "I said to myself, 'This is my child.' I remember his teacher was there, and she said to herself, 'I have this boy in my class.' We both talked and she suggested they do some testing."

IQ tests showed her son had above-average intelligence, but a doctor diagnosed him with attention-deficit and hyperactive disorders.


"They suggested he start medication," she said. "That was a hard thing, to admit he needed medication."

But she said once he began the medication, Ritalin, his behavior improved and he was able to focus and learn.

Medication alone isn't enough, she said. Her son's teachers modified his lessons and homework. If the class had to do 50 math problems, her son was given 25.

"It took him as long to do the 25 as for the others to do 50," Mrs. Borisevic said.

He used to have a daily list of homework assignments, and she would go over them with him, and he would check off things as he did them.

Rewards were important. "He got stickers, points, smiley faces," she said.


"I'm sure the kids were aware he had problems because of the teacher taking so much time with him," she said, but in general, she and his teachers tried to be discreet about his special needs. For example, he was never told the other students were getting more math problems to do.

Mr. Dorsey said he recommends several strategies for teachers to use in their classrooms when they have a student with attention-deficit disorder. Among them are:

* Seating the child with the rest of the class, but away from distractions such as doors and windows, and from things such as air conditioners, whose noise can be distracting. Also, the control panels and vents might tempt the child to fiddle with them.

* Surround the student with good role models, seating him next to the most hard-working, focused students.

* Maintain eye contact with the child, especially when giving directions. Have the child repeat the directions.

Mrs. Kenehan said teachers also can ask other children in the class to repeat directions or lessons, so that the teacher isn't always picking on the child with the disorder.


"As long as the child is hearing it a lot," Mrs. Kenehan said.

* Have daily assignment books or sheets for students. Having a written form to refer to helps children remember what they're supposed to do, he said.

* Communicate with parents through a daily notebook that the child takes from home to school and back again.

"If the student had a rough morning, the teacher can know that. If it says 'excellent evening, great morning,' then she can heap some praise on the kid when he comes in. It's important for both parents and teachers to know what's going on," Mr. Dorsey said.

"These are not only good for kids with attention deficit," Mr. Dorsey said. "They're good with all children."