BACKGROUND
It is important to understand what ADHD is. ADHD stands for Attention Deficit Hyperactivity Disorder and was originally thought to be a form of "minimal brain dysfunction (MBD) (D’Alonzo 88)." However, it is no longer recognized as a form of MBD. Along with these changes in classification, researchers identified behaviors related to ADHD. These behaviors are; hyperactivity, restlessness, impulsivity, aggression, distractibility, and short attention span. These symptoms formed the three behavioral constructs inattention, impulsivity, and hyperactivity, as described by the American Psychiatric Association (D’Alonzo 88)." In both the professional and lay media, ADHD is routinely referred to as a neurological disorder. While most experts agree that genetic-biochemical factors influence behavior somewhat, the general public tends to view this as biologically unconditional, where in brain chemistry and heredity explain behavior as opposed to environmental interaction (Diller 13). As well as being a neurological disorder, most parents and teachers seem to believe that ADHD impairs learning. It is important to stress that ADHD is not the same as a learning disability. Although some children with learning disabilities are hyperactive and inattentive, many are calm and work hard at learning tasks. While many students without learning disabilities also have trouble paying attention and sitting still. Likewise, numerous students who display impulsivity, inattention, or hyperactivity do well in school (D'Alonzo 90). It is unfortunate to note as well that the mass media has also played a large role in the general encroachment of Ritalin and other psychotropic medication to cope with one’s problems.
This is a picture of a comparing the brain of an ADHD child and a non- (PET scan).
From al. (1990)
Currently the American Psychiatric Association uses the term Attention-Deficit/Hyperactivity Disorder (AD/HD) with three different categories of symptoms: Combined Type, Predominantly Inattentive Type, and Predominantly Hyperactive-Impulsive Type. The behaviors grouped under inattention, hyperactivity, and impulsivity is listed as follows.
Inattention - This classification results from behaviors such as inattention to detail, careless mistakes in life activities such as schoolwork, a difficulty in sustaining attention and listening, incompletion of assigned tasks, organizational skill deficits, losing and misplacing materials, being easily requiring sustained effort, and forgetfulness (D'Alonzo 88).
Hyperactivity - This classification results from behaviors such as being fidgety, leaving assigned areas, running about excessively, difficulty engaging or playing in activities quietly, appearing to be in constant motion, and talking excessively. (D'Alonzo 90).
Impulsivity - Blurting out answers, difficulty awaiting turn, and interrupting and intruding on others characterizes this category. (D'Alonzo 90).
PURPOSE
The purpose of my research is to gain a better understanding of the disorder throughout. I will explore various treatment options as well as the repercussions ADHD has on education. It is my intent for research gained to help myself better understand the disorder and pass this information, as relevant, to better my sons educational outcome.
SCOPE
This report includes information that is supported by WebMD, esteemed authors, doctors, about the studies of ADHD in education. In this report I hope to gain a better understanding of the disorder, treatment options and educational repercussions so that I may better help my son, Christian, within his educational realm.
DISCUSSION
The history of stimulant drug use to treat ADHD related symptoms began in 1937. Methylphenidate (Ritalin) was first synthesized in the 1940’s and marketed in the 60’s as a means to treat hyperactivity (Frankenberger 201). In addition to Ritalin, two other stimulants are also frequently used, Dexedrine or Cylert (Dextoamphetamine and emoline respectively). In the 1960’s stimulant treatment became more common when its short-term benefits, for what was then believed to simply be hyperactivity were documented in controlled trials. In 1970 it was estimated that 150,000 children were taking stimulant medication in the United States. During the 1970's public outrage over stimulants began to grow. This reaction stemmed from an article in the popular press charging that 10 percent of the children in the Omaha school district in Nebraska were being medicated with Ritalin (Maynard). Though this article was ultimately shown to contain inaccuracies, it spurred other reports of "mind control" and led to congressional hearings.
Problems with over prescription began in 1971 when the DEA listed stimulants as Schedule II controlled drugs, partly in response to an epidemic of methylphenidate abuse occurring in Sweden and the illegal use of stimulants in the United States. In 1988, it was predicted that by the early 1990s over one million US children would be receiving stimulants for treatment of ADHD. In fact, the prediction underestimated the growth in use of stimulants as nearly three million children now use stimulants to cope with ADHD and the number is rising (Read 14). According to studies conducted in 1994, 3 to 5% of school-aged children are expected to have ADHD and presumably a smaller percent would be expected to be receiving stimulant medication because stimulant medication is not effective in approximately 25% of children with ADHD. However, the number of school-aged children receiving stimulant medication is already approaching the 5% rate. In a national survey of school districts, it was found that approximately 1.5% of all public elementary age school children in the US was identified as having ADHD and subsequently received stimulant medication. The resulting increase in school-aged children receiving stimulant medication from 1988 to the present is approximately 330% (Frankenburger 200). In a series of studies conducted over a 22 year period, it was found that prescription of stimulants "for elementary school children increased from 1.07% in 1971 to 5.96% in 1987...for middle school students increased from 0.59% in 1975 to 2.98% in 1993...in high school students from 0.22% in 1983 to 0.70% in 1993...and the number of prescriptions for college students increased 2.5 fold from 1990 to 1995 (Jensen 797)."
It is unfortunate to note however that, in many cases chemical treatments for ADHD have been shown to be ineffective. Researchers have obtained conflicting results when investigating the effects of Ritalin, and other stimulants, on cognitive abilities. The results of a multitude of tests suggested that stimulant drug therapy did not produce significant changes in basic intellectual or cognitive abilities. (Frankenburger 210) A 16-week study that included cognitive training along with stimulant medication did not find an improvement in cognitive functioning as a result of medication (Abikoff 953). Overall the research examining the effects of Ritalin on laboratory tasks is inconclusive and effects of stimulant medication on school-related tasks are unknown. Again, there have been conflicting results when researchers have attempted to identify the long-term effects of stimulant medication on achievement. In fact very few studies have examined the effects of stimulant medication on achievement. One such report provided little support for the idea that stimulant medication had consistent positive effects on academic achievement test scores. They suggested that the effects of Ritalin were most effective for controlling hyperactive classroom behaviors on a short-term basis. Another report evaluated a group of stimulant-medicated hyperactive children for 16 weeks and then four years later. After four years, 81% of the children were no longer taking Ritalin. Some beneficial effects of Ritalin were seen at the beginning, but receiving medication did not seem to positively affect long-term academic achievement (Frankenberger 220).
With such disparaging results from chemical therapy, it is interesting to wonder why stimulant medications are still used in an attempt to remedy educational problems associated with ADHD. There are many varying methods by which children with ADHD can be taught, effectively, without resorting to stimulant medication. As George DuPaul noted "Because ADHD can be diagnosed in approximately 3 to 5% of school-aged children there is a pressing need for school personnel to be knowledgeable about the disorder and to have the ability to implement effective interventions (DuPaul 369)."
Several areas must be addressed in order to come to terms with ADHD-related issues. The first area of an effective behavioral program addresses how the child with ADHD can be accommodated in the classroom, whose physical environment can be altered to help prevent problematic behavior. Such activities include adjusting student-seating, study-type carrels or privacy boards lessen visual and auditory distraction, alternative lighting, music background, and finally, using an overhead projector (Flick 51). The second area of an effective behavioral program addresses how children with ADHD can be taught to better deal with some of the difficulties they experience. A number of skills, strategies, and techniques for dealing with problematic behavior can be learned and practiced. Children diagnosed from ADHD should learn to repeat and review directions silently, model problem solving, organizational structure, and teach self-monitoring (Flick 53). Both at home and in the classroom, difficult-to-manage behavior may result in a similar increase of disciplinary techniques that can become increasingly more restrictive and perhaps even counter productive. Several techniques are essential for ensuring educators have a good knowledge and understanding of ADHD; flexibility, taking time in teaching, providing structure and routine, integrating exercise, avoiding information overload, establishing behavioral priorities, and finally, providing consequences for inappropriate behavior (Flick 55). Many situations at home closely resemble or parallel behaviors in school. Some basic activities are following instructions, getting along with siblings and friends, and obeying rules (Flick 51-5).
The most valuable reward in teaching
is hearing a student say,
"Thank you for understanding me."
Though these methods may seem simple, it is easy to understand how a parent or an educator can overlook them. Most experts tend to agree that there are several methods by which one can positively affect the environment of ADHD students in class. As in any situation involving children, it is important for parents, teachers, and students alike to realize that a child with ADHD will need special attention and consideration. "Each student with ADHD presents a unique set of characteristics. The strategies and accommodations that are imperative or the academic success of one student with ADHD may be completely different for another. Therefore, teachers will need to pick and choose from a variety of strategies and accommodations to meet the individual needs of their particular student (Yehle 13)."
CONCLUSION
Attention Deficit Hyperactivity Disorder is a frustrating disorder for all involved. In today’s times, research has shown, there is a light at the end of the tunnel. The key to the disorder is identifying and diagnosing the problem. The next step is to meet the needs of the individual student with a program that is carefully planned and implemented to assure the student’s best development and appropriate education. As more research is conducted, it is becoming clearer that the symptoms of this disorder are not simply the result of biological factors, but rather appear to be due to the interaction of the student’s biological characteristics and environmental stimuli. This is why the use of chemical stimulants has been questioned. "Many contributing cultural feelings about the use of drugs to over come a person’s problems contribute to feelings of inadequacy in medicated children." (Diller, Lawrence H. 18) As more children and adults use stimulant medication to function more efficiently, will those who are also struggling to perform feel pressured to consider medication? Why aren't more alternative methods for treatment being explored? Will there be a desire to keep up with others, to compete for the good grades, bonus, or job promotion by whatever means necessary? The answers to these questions are at the very heart of the issues surrounding appropriate treatment of ADHD in education today, and have yet to be answered
Works Cited
Abikoff, H.; R.Gittelman. "Hyperactive Children Treated with
Stimulants." Archives of General Psychiatry. 42 (1985): 953-960.
“Attention-Deficit/Hyperactivity Disorder: ADHD in Children.” WebMD. 1 October 2005.
D'Alanzo, Bruno J. "Identification and Education of Students with
ADHD." Preventing School Failure. 40 (1996): 88-94.
Diller, Lawrence H. "The Run on Ritalin: ADD and Stimulant Treatment in
the 1990's." The Hastings Center Report. 26 (1996): 12-18.
Du Paul, George; Tanya L Eckert; Kara E McGoey. "Intervention for
Students with ADHD: One Size Does not fit all." The School Psychology
Review. 26 3 (1997): 369-381.
Flick, Grad L. "Managing ADHD in the Classroom Minus Medication." The
Education Digest. 63 9 (1998): 51-56.
Frankenburger, William; Christie Cannon. "Effects of Ritalin on
Academic Achievement from First to Fifth Grade." International Journal of Disability, Development, and Education. 46 2 (1999): 199-221.
Jensen, Peter S. Lori Kettle, Margret T Roper. "Are Stimulants
Over prescribed? Treatment of ADHD in Four U.S. Communities." Journal of the American Academy of Child and Adolescent Psychology. 38 7 (1999): 797-804.
Yehle, A.K.; Wambold, Clark. "An ADHD Success Story: Strategies for
Teachers and Students." Teaching Exceptional Children. 30 (1998): 6 8-13.
Graphics
ADHD.org.nz, The neurobiology of ADH. Information retrieved on July 12, 2007
Outside the box, Helping Misunderstood Kids. Information retrieved on July 12, 2007
