ADHD
`Very, very frustrating' search for ADHD support
May 16, 2009 04:30 AM
Andrea Gordon
Family issues reporter
Margo Brunning knew something wasn't right when her son started school. Mitchell struggled to hold a pencil. He was constantly distracted and in trouble. He couldn't decode words or grasp other stepping-stones to reading. And as learning got harder, he became more disruptive.
The boy's Toronto school said he was too young for an assessment, so the family paid for private testing. It revealed Mitchell had ADHD (attention deficit hyperactivity disorder), causing inattention, impulsive behaviour and difficulty sitting still.
But the relief of finally knowing what was wrong soon turned to dismay, Brunning says. Because even though ADHD interfered with her son's ability to learn, the diagnosis didn't automatically entitle him to supports at school.
Unlike learning disabilities, autism or other conditions that qualify as "exceptionalities," an ADHD diagnosis, by itself, does not give students the legal right to accommodations though special education in Ontario.
"It's very, very frustrating and it's a constant struggle," Brunning says.
The lack of formal recognition means that when it comes to teaching children with the disorder, there is no consistency among teachers, schools and school boards, says Heidi Bernhardt, national director of the Centre for ADD/ADHD Advocacy Canada (caddac.ca).
Mitchell is now 14 and his mother has spent eight years fielding calls and complaints about his behaviour and school work, fighting for supports in the classroom, and paying for tutoring and other outside help. She explained strategies to teachers: seating him at the front of the class; if he was restless, sending him to the office on errands or out for a drink of water; breaking down instructions into bite-sized chunks he could remember.
She stressed that constant punishment only makes things worse for kids with ADHD, who struggle with self-control; that positive reinforcement is critical.
She says her son, a competitive skier, is bright, with strong verbal reasoning skills. He likes school. With the right strategies and supports, he can succeed and function in a way that doesn't disrupt the classroom. But to get those, "you have to be in their face."
ADHD kids tend to be intelligent, or often gifted. But experts say the trajectory for those who don't get school supports can be grim, leading to a cycle of frustration, acting out, punishments and being labelled as bad or lazy. Self-esteem plummets; they may be socially ostracized or bullied.
There is mounting scientific evidence about how ADHD reflects delayed brain development, says Rosemary Tannock, senior scientist of psychiatry research at the Hospital for Sick Children and a leading expert on ADHD.
"It interferes with a child's learning in school, friendships and their ability to follow the rules," says Tannock, an OISE professor and one of the founders of teachadhd.com, a website for teachers.
She cites a U.S. longitudinal study in the 1990s that found over a four-year period, kids with ADHD saw reading and math scores decline by 8 to 10 per cent. Scandinavian research yielded similar results.
Bernhardt says the school system's failure to acknowledge or accommodate the disorder reflects a widespread lack of understanding.
ADHD has been recognized for decades as a medical, neurobiological disorder and is the most prevalent mental health problem among children, affecting between 5 and 12 per cent of school-age kids, which means several students in every classroom.
"But there's still a reluctance to view ADHD as a cognitive deficit that impacts learning," Bernhardt says. "People see it as a behaviour problem."
Teachers aren't trained to recognize and cope with it, even though it can cause havoc in classes. Instead, most focus on the behaviour that erupts when students can't pay attention and learn, and treat that as the source of the problem, rather than a symptom.
Bernhardt says it's "ludicrous" that, when it comes to getting help in school, a child with ADHD is better off having another physical, behavioural or learning disability as well, "which then gives them the right to request accommodation and extra help."
This is not the case in provinces like Alberta, which supports kids with ADHD and provides training and resources for teachers and extensive online material.
Kids with ADHD need a combination of clinical treatment, classroom supports and behaviour strategies, says Dr. Umesh Jain, Toronto child psychiatrist and chair of the Canadian ADHD Resource Alliance (caddra.ca), an association of physicians and researchers.
He says medication that increases a child's ability to pay attention is often, but not always, part of treatment. It can help kids concentrate so they can learn coping skills, develop new habits and change their behaviour, he says. But it needs to be accompanied by strategies in classrooms and at home.
"The misguided belief is that medication solves the child's problems," he says. "I have parents say `I feel like I'm being held hostage by the school because they won't give my child any accommodations.'''
Jain says children with ADHD are often creative high-achievers who have the potential to be "the powerhouses of society" if they are properly taught and supported.
Bernhardt says when the teaching and school supports aren't there, parents feel pressured to resort to higher doses of medication, simply so kids can function in school. She says countries that focus more on accommodating students have lower rates of medicating.
Experts say many school accommodations don't cost money or even require a formal plan, but can be adopted for entire classrooms. Teaching tactics include: breaking down instructions into small chunks, pausing and repeating; reinforcing verbal material with visual and written versions; leaving material on the board; giving a restless child a task or allowing them to move around; taking five minutes at the end of the day to help them organize homework.
Tannock recently completed a study with teachers in Owen Sound schools who adopted the strategies for breaking down information and instructions in their classrooms. Teachers reported less stress, inattention and hyperactivity across the board.
Brunning agrees that simple strategies can make a big difference.
"When the teacher doesn't understand, it's brutal. But when they do, and especially if a core teacher communicates strategies to other teachers and people in the office, things can go pretty smoothly."
Truth vs fiction
Myth: ADHD is a childhood disorder. Fact: It is a lifespan disorder; 60 per cent of those diagnosed as children continue to be impaired in adulthood.
Myth: ADHD is a Western phenomenon. Fact: It is worldwide, with higher incidences in Southeast Asia and parts of Europe than reported in Canada.
Myth: Kids with the disorder are always hyper. Fact: ADHD is an attention disorder. Often it includes hyperactivity, but not always.
Myth: It primarily affects boys. Fact: Many girls go undiagnosed because they may be inattentive in a less noticeable way that resembles "daydreaming." By adulthood, the male-female ratio is almost equal.
Myth: It is a behaviour disorder. Fact: It is a medical disorder.
Myth: ADHD is caused by too much sugar, TV or computer time, lax parenting or lack of exercise. Fact: The cause is neurobiological; the scientific evidence is recognized by all major medical associations and government health agencies.
Myth: Kids with ADHD can't pay attention.
Fact: The nature of the disorder is they cannot regulate their attention, so it may change quickly. They are capable of focusing, particularly on stimulating activities.
Sources: Canadian ADHD/ADD
Resource Alliance
Comments
a huge problem
I have a grade 9 art class of 26. 14 of them have special needs. I have 75 minutes a day to deliver curriculum content and if I break that down into a fair distribution of my time that's not a lot of time per student. Add in the special needs of all 14 identified students and I am swamped. Of that 14, 4 of them are ADHD, 3 have safety plans because of behaviour, 1 must be contantly monitored as his behaviour is so violent that the police are involved, 4 are unable to read handouts, 1 can't even spell his own last name and the rest have processing issues...and I have absolutely no training in how to deal with special needs students. The students who are "normal" are usually left to figure things out on their own because I end up spending my time helping students understand a project, stay on task, ask them to stop throwing paint, & transcribe answers for those who can't write. This is a fairly average classroom. How am I supposed to do meet everyone's needs every day?
Submitted by 123456abcde at 6:49 PM Monday, May 18 2009
People in general are extremely ignorant regarding ADD
As Adult with ADD in the 1970's you were place in special classes with mentally challenge kids. People said and criticized you inability to stay focus. ADD or ADHD is a disability both federal and provincial fail to recognize this. In order to function fully we need medication or minds are just going float around. Teachers today need further training on this issue and how to spot it. There is too many teachers that will just single out a student because of lack of training and understanding. Latter in life employers need also be more understanding. That is why ADHD must be recognized has a disability to prevent discrimination.
Submitted by revelations at 9:58 AM Monday, May 18 2009
Accommodations are made
It was somewhat disheartening to read the frustration felt by families of those children having ADHD. I work for the DCDSB in Durham and in my role of program support teacher, we work very hard with our families in supporting all the needs of our students. We do not have to wait for a formal identification before we are able to put accommodations in place that support the learning needs of students. Our mission is to work TOGETHER with families, Board Personnel, outside support (i.e.medical and other) in order to BEST understand and address those needs. A.M.Sacco
Submitted by amo at 6:58 PM Sunday, May 17 2009
@ jjsmith
I see where you're coming from, but you obviously don't understand what's going on here. A badly-behaved, poorly raised child is one thing, and there are a lot of them out there. But there's a big difference between a kid who won't behave, and a kid who literally *can't* behave. I have ADD; because I am a girl and not hyperactive, I wasn't diagnosed until I was 18. So I spent nearly 13 years of schooling catching $h*t from everybody because I literally could not pay attention in class, or get my assignments done even if I wanted to. High School was one long, lonely nightmare. When you don't know what's "wrong" with you, it can be really terrifying, especially when you get labeled as lazy, insolent and bizarre by everyone around you.
Submitted by hiboucornu at 11:49 AM Sunday, May 17 2009
measures beneficial for all
My son has a diagnosed ADHD. High school was a torture for him, university was a pure enjoyment and now he is a grad student in one of the most prestigious universities of US. As an university instructor I see that certain practices mandatory at university could be beneficial for all students but are crucial for those with ADHD. Unfortunately all my attempts to point this out were dismissed by the school administration: "We are not university!" *** School courses usually do not have a clear marking scheme announced before or during the first class; students have no way to see their current marks as recorded by the teacher. *** Home assignments usually are not placed on the course website (most of the courses do not have websites). Students (especially those with ADHD) tend to forget their home assignments. Sometimes they are missing the class and have no means to recover assignments except asking classmates (this is a usual advice of the teachers aka invitation to plagiarism .
Submitted by Red Herring at 3:56 AM Sunday, May 17 2009
Cost of ignoring ADHD = Some teaching resources for ADHD students
Unfortunately Adults and children with ADHD are 2nd class citizens in Canada. People with learning disabilities get accommodations, but people with ADHD don't. As an adult ADHD coach & blogger, I have people across Canada constantly complaining to me that they can't find a doctor who knows enough about ADHD to diagnose or treat them. ADHD students are more likely to repeat a grade 42% vs 13% control group, get suspended 60% vs 19%, be expelled 14% vs 6% and drop out 32% vs 0. http://bit.ly/hoiKV With these real problems, why aren't provincial governments taking ADHD seriously? For parents of students with ADHD I've got 5 pages of links to articles and ebooks on teaching students with ADHD on my website http://bit.ly/16oxmR Also important to realize ADHD is the #2 genetically inherited condition in the world, 80%. If a child has it the parents should be screened for it. Men unfortunately are usually are in denial longer than women.
Submitted by Pete Quily at 8:57 PM Saturday, May 16 2009
If you identify you must accommodate.
That was the reason one of my vice principals gave me for not running an IEP on a disruptive student. A school only has so many resources. If everyone is identified for everything, the schools will need more money. On the other hand, my administration once let me run a class with a full class size of 3 and a daily average of two students. One of the two was an in identified special student who needed individual attention. He had a great semester with me and I think it changed his high school trajectory. There are people who care in the education system, and they do what they can. It all comes down to how much they can do with what they are given. If there are people out there with a magic bullet, then fine, but abandoning a child to flounder in a system not designed for their needs would be cruel. Sure a lot of us who grew up before these things became known suffered and got by. That didn't make it right then, and it certainly doesn't make it right now.
Submitted by normhead at 8:56 PM Saturday, May 16 2009
Be Realistic
Every parent should be the primary educator for their child. Never give this responsibility over to anyone else. Fact: there may be 30 other students in the classroom and the special needs of the ADHD/ADD student are very difficult to arrange, especially for one child. Fact: The Ontario school system does have a system in place, it is called the IEP and this is based on performance. Fact: as is all life situations, the child will need and must be taught to be responsive to taking personal responsibility for adapting to their individual challenge.
Submitted by muskokaphotog at 11:27 AM Saturday, May 16 2009
final comments...
In my experience, some students also take advantage of their diagnosis of ADHD/ADD, to the detriment of the others trying to learn. They need to be willing to work within the accommodations - not just killing time in the classroom trying to avoid suspension. This can be better addressed in a classroom of 15, instead of 20 - that personal attention is absolutely vital to helping an ADHD student, especially one whose frustrations have grown until they get to you. If the disorder has slipped through the cracks and diagnosis doesn't happen until high school, they will come to class feeling that they are stupid or bad, which isn't true. But diagnosis can happen faster in elementary schools if teachers aren't overworked and don't have crowded classrooms.
Submitted by witchelemental at 10:24 AM Saturday, May 16 2009
objection
As a teacher of eight years, I received thorough training in recognition and support strategies while in teacher's college at Trent and Queens, in their Con-Ed program. Professional development in schools do frequently provide retraining and discussion on PD days; the board I work for does provide IEPs for students with ADHD, after diagnostic tests (and before, if it is suspected, a Non-Identified IEP can be prepared for the student). To say that there is a failure to acknowledge or accommodate is wrong - it would be more accurate to say that despite promises of lower class sizes, the teacher-student ratio is still too high to enable or facilitate positive interactions for teachers and ADHD / ADD students.
Submitted by witchelemental at 10:14 AM Saturday, May 16 2009
Because of the lack of training for teachers my son was not diagnosed until he was 14 yrs old. His kindergarten teacher said he didn't pay attn; he did not follow instruction; his Gr. 1 teacher had me have his hearing tested. She believed he chose to not pay attention. A special ed teacher in high school suggested we have him tested for ADHD; she believed it was a simple blood test. After extensive testing we found that he was ADHD with a slight learning disability. I wrongly assumed that the professionals in our school system might catch something like that in early years. School was a constant struggle. After 4 years of HS teachers no longer returned my calls nor did they do their part as was laid out in his education plan. Yet they expected my son to do his part. He is 23 years old - a 'late bloomer' but I know that he will come into his own. He has many talents and he makes me laugh when I need it most. He is a gentle soul with a big heart.
Submitted by LK at 10:02 AM Saturday, May 16 2009
ADHD is difficult for all concerned
I sympathize with the kids and parents who are dealing with the difficulties linked to ADHD. But I want them to try to imagine the chaos in a class of 37 with 4 kids with ADHD, one with Asperger's, one with hearing loss, two with receptive language disorders, and 3 traumatized kids living in foster care. Most teachers do the best we can -- honestly. There's only so much one adult can accomplish with those conditions and no support. I've read many articles to learn strategies for these disorders and conditions, attended workshops, and taken special ed courses ($1000 each) to try to succeed, but sometimes it feel overwhelming from my perspective too. Every class needs an EA.
Submitted by what the what? at 9:02 AM Saturday, May 16 2009