Category Archives: ADHD

2019 Medley #22

Respecting teachers, Vouchers,
Shaming children, Stuttering,
An ADHD prosthetic, Looking back

RESPECT FOR TEACHERS

Are Teachers Allowed to Think for Themselves?

Teaching isn’t, as some legislators apparently think, professional babysitting. Teachers don’t just “tell” students what they need to know, and students don’t just “remember” everything.

Teaching a class of children — whether they are 6 years old, or 16 — is not easy. To do it well takes training, experience, support, resources, and a fair amount of luck.

Most licensed teachers in Indiana have four-year degrees from accredited university teacher training programs; many have master’s degrees. Yet almost half of all new teachers leave the field within the first five years. Perhaps they didn’t realize that teaching is hard work. Perhaps the hours are too long and they thought they were just getting a 7 – 3:30 job with lots of vacation time. Perhaps the pay isn’t good enough. Perhaps they find out that they’re not cut out for teaching.

The teachers who stay, then, are those who are committed to education. One would think that, with years of training, teachers would be considered experts in their field. Unfortunately, that’s not the case.

Panels of “education experts” regularly have no teachers on them. The National Reading Panel had only one middle school teacher. The Panel, which explored the way young children learned to read “included no teacher of early reading instruction.”

The National Commission on Education, authors of A Nation at Risk, consisted of twelve administrators, one businessperson, a chemist, a physicist, a politician, a conservative activist, and only one practicing teacher.

This lack of respect for the teaching profession seeps in from the various state legislatures. Teachers in Indiana, for example, are told what to teach, how to teach, and how to assess what they have taught. Then they are blamed for failure when the scores on the assessment (currently ILEARN) are lower than the arbitrary cut scores.

Teaching may be the only profession where you are required to get an advanced degree including a rigorous internship only to be treated like you have no idea what you’re doing.

DIVERTING PUBLIC MONEY TO RELIGIOUS SCHOOLS

The Supreme Court Is Considering Forcing You To Fund Religious Education

Since 2011 more than half a billion Indiana taxpayer dollars have gone to fund private and parochial schools despite the fact that vouchers don’t go to “better performing” schools…and despite the fact that the First Amendment (as seen in Madison’s support of the Establishment Clause of the First Amendment and Jefferson’s Virginia Statute for Religious Freedom) establishes a wall between Church and State.

Indiana’s voucher program, like others around the country, is free from any conflict between Church and State because the money is laundered through a parent “voucher” in which the parent “chooses” the school their child will go to. In truth, however, it is the school that does the choosing.

…many religious schools engage in blatant forms of discrimination. They may refuse to admit students who are LGBTQ, nontheists or religious minorities. Many apply similar religious litmus tests to faculty and staff. Unlike public schools, which are open to all, religious schools serve a private interest.

Finally, any diversion of taxpayer money to religious schools threatens the public education system. Public schools serve 90 percent of America’s children. They ought to be our priority when it comes to allocating taxpayer funding.

All of these reasons are important, but at the end of the day, this is an issue of freedom of conscience. Our founders understood that no one should be forced to support religion against his or her will. It’s one of the primary reasons why they built church-state separation into the First Amendment. The Supreme Court must not abandon this vital principle.

STOP BLAMING KIDS FOR THE IMPACT OF POVERTY

Penalizing kids for school lunch debt can harm their mental health

Nearly half of Indiana’s children are low income; more than one in five live in poverty. With this many children coming from homes without a lot of money, it’s even more important for schools to remember that it is not the student’s fault if their lunch bill isn’t paid. We have to stop blaming children for the impact of poverty on their lives.

Even when parents have enough money it’s not the child’s fault when parents are late with their payment.

Facing stigma around school lunches can negatively impact kids’ mental health, stress levels, and overall cafeteria experience, Cohen says. That’s seen with kids who feel labeled by receiving school lunch, for example. “When we remove that stigma, it makes a big difference in kids’ lives.” Some schools do so by giving all students cafeteria swipe cards so that it’s not apparent who is or is not paying for the meal. On the whole, Cohen says schools are getting better at free meals, but not lunch debt. “When you give a kid a cheese sandwich, you’re bringing that stigma back.”

ARE SOME OF JOE’S GAFFES SIMPLY COVERING UP HIS STUTTERING?

What Joe Biden Can’t Bring Himself to Say

I’m not going to comment on Vice President Biden’s education plans, but this article about his history of stuttering might explain some of his hesitations, and misstatements. “He lifts his hands up to his face like he did on the debate stage in July, to guide the v sound out of his mouth…”

“The paragraph I had to read was: ‘Sir Walter Raleigh was a gentleman. He laid his cloak upon the muddy road suh-suh-so the lady wouldn’t soil her shoes when she entered the carriage,’” Biden tells me, slightly and unintentionally tripping up on the word so. “And I said, ‘Sir Walter Raleigh was a gentle man who—’ and then the nun said, ‘Mr. Biden, what is that word?’ And it was gentleman that she wanted me to say, not gentle man. And she said, ‘Mr. Buh-Buh-Buh-Biden, what’s that word?’ ”

Biden says he rose from his desk and left the classroom in protest, then walked home. The family story is that his mother, Jean, drove him back to school and confronted the nun with the made-for-TV phrase “You do that again, I’ll knock your bonnet off your head!” I ask Biden what went through his mind as the nun mocked him.

“Anger, rage, humiliation,” he says. His speech becomes staccato. “A feeling of, uh—like I’m sure you’ve experienced—it just drops out of your chest, just, like, you feel … a void.” He lifts his hands up to his face like he did on the debate stage in July, to guide the v sound out of his mouth: void.

I stuttered. I stutter.

Blogger Fred Klonsky says he plans to vote against Biden in the primary election, but understands first hand that the story of Biden’s stuttering is a story about how we treat children with differences.

But Atlantic’s senior editor, who has a stutter himself, has written an article that is about way more than Biden.

It is about how we treat differences.

And it is about me, since I had a severe stutter as a child and I still stutter when I am tired or stressed.

TREATMENT AS AN ADHD PROSTHETIC

What Is an ADHD Prosthetic?

Is medication for ADHD a “crutch?”

“My concern,” the parent continued. “Is that if we get him glasses, we are sending him the message that it’s okay not to try to see. It feels like an excuse. Like we’re enabling him. I mean, he has to learn to see someday, right? He can’t go through life using his poor vision as an excuse not to see.”

A LOOK BACK AT CHANGE THAT HASN’T HAPPENED

School Choice Opponents and the Status Quo

This quote from a June 2017 blog post is a good reminder that not much has changed in the field of public education. There are still those of us who “continue to point out that poverty is the real issue in education” and there are still politicians who refuse to take their share of the responsibility for that poverty. Apparently, politicians think that schools are the sole public institution responsible for overcoming the effects of poverty. If they can’t, then they are blamed, castigated, taken over by the state, or privatized…none of which changes a damn thing.

Meanwhile, nearly 20% of America’s children live in poverty. If we include “low income” children the number doubles….for Black, Hispanic and American Indian children, it triples. The relationship between school success to economic status is well known, but they still blame the schools and teachers.

…To point out the obvious, that poverty is the number one cause of educational inequity, does not make me a champion for the status quo. It simply means that I will not fall prey to the false promise of super-teachers, standardized test driven accountability, merit pay, charter schools, and vouchers, all of which are futile efforts to put a thumb in the overflowing dyke that is systematic discrimination, segregation, income inequity, and, yes, poverty.

Poverty and Potential: Out-of-School Factors and School Success

We can’t ignore the impact of poverty on our students’ achievement.

From March 2009

The U.S. has set as a national goal the narrowing of the achievement gap between lower income and middle-class students, and that between racial and ethnic groups. This is a key purpose of the No Child Left Behind act, which relies primarily on assessment to promote changes within schools to accomplish that goal. However, out-of-school factors (OSFs) play a powerful role in generating existing achievement gaps, and if these factors are not attended to with equal vigor, our national aspirations will be thwarted.

This brief details six OSFs common among the poor that significantly affect the health and learning opportunities of children, and accordingly limit what schools can accomplish on their own: (1) low birth-weight and non-genetic prenatal influences on children; (2) inadequate medical, dental, and vision care, often a result of inadequate or no medical insurance; (3) food insecurity; (4) environmental pollutants; (5) family relations and family stress; and (6) neighborhood characteristics. These OSFs are related to a host of poverty-induced physical, sociological, and psychological problems that children often bring to school, ranging from neurological damage and attention disorders to excessive absenteeism, linguistic underdevelopment, and oppositional behavior.

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Filed under ADHD, Article Medleys, Choice, poverty, Speech&Language, Teaching Career, vouchers

2019 Medley #10

Lead Poisoning, Segregation,
Charters are a Waste of Money,
Fearing Small Children, Testing,
Telling ADHD Kids to Try Harder,
Is it Achievement or Ability?

IT COSTS A LOT TO POISON OUR CHILDREN

American children are regularly exposed to lead at higher than safe levels, which, according to the Centers for Disease Control is ZERO [emphasis added]!

…There are approximately half a million U.S. children ages 1-5 with blood lead levels above 5 micrograms per deciliter (µg/dL), the reference level at which CDC recommends public health actions be initiated. No safe blood lead level in children has been identified.

In some places, the exposure is long term due to governmental neglect.

7 years later, new study shows East Chicago kids exposed to more lead because of flawed government report

Kids living in two of the contaminated neighborhoods actually were nearly three times more likely to suffer lead poisoning during the past decade than if they lived in other parts of the heavily industrialized northwest Indiana city, according to a report unveiled last week by an arm of the U.S. Centers for Disease Control and Prevention. Written in dry, bureaucratic language, the mea culpa is the latest acknowledgement that federal and state officials repeatedly failed to protect residents in the low-income, predominantly Hispanic and African-American city, despite more than three decades of warnings about toxic pollution left by the USS Lead smelter and other abandoned factories.

New evidence that lead exposure increases crime

The point of all this? By not spending the time and money to clean up lead contamination in our cities and neighborhoods we’re losing money. We’re losing money in increased crime and decreased academic productivity. What are we waiting for?

Three recent papers consider the effects of lead exposure on juvenile delinquency and crime rates, using three very different empirical approaches and social contexts. All have plausible (but very different) control groups, and all point to the same conclusion: lead exposure leads to big increases in criminal behavior.

STILL SEGREGATED AFTER ALL THESE YEARS

Trump judicial nominees decline to endorse Brown v. Board under Senate questioning

Candidates nominated by the current administration for Federal Judicial posts — and this administration is nominating judges at a fast pace — don’t seem to endorse the 1954 school desegregation decision in Brown vs. Board of Education.

Schools are more segregated today then they have been at any time since the 1960s. We have yet to fulfill the promise of Brown v. Board of Education. Segregated schools mean segregated opportunities. There is a $23 billion racial funding gap between schools serving students of color and school districts serving predominantly white students.

But the Federal judges now being appointed by the current administration decline to endorse Brown v. Board of Education. In fact, most of the entire country apparently disagrees with Brown…given the segregation present in our public schools.

The matter was especially pronounced in the nomination of Wendy Vitter, who was confirmed Thursday as a federal district judge in Louisiana without the vote of a single Democratic senator. “I don’t mean to be coy, but I think I get into a difficult, difficult area when I start commenting on Supreme Court decisions — which are correctly decided and which I may disagree with,” Vitter said during her confirmation hearing. “If I start commenting on, ‘I agree with this case,’ or ‘don’t agree with this case,’ I think we get into a slippery slope.” “I was stunned by her answer,” Sen. Richard Blumenthal (D-Conn.), who posed the question, said this week on the Senate floor. “Brown is woven into the fabric of our nation. How could anyone suggest disagreeing with Brown, as she did?”

Rucker C. Johnson is a professor of Public Policy at UC-Berkeley. His new book, Children of the Dream, explains how the school integration efforts of the 1970s and 1980s were not a “social experiment doomed from the start”. Instead, the integration of public schools in the 70s and 80s was overwhelmingly successful…until the advent of Reagan Conservatism which reversed the process.

A scholar revives the argument for racial integration in schools

The main argument of Johnson’s book is much bigger than racial integration. He says three things are essential for schools to give poor kids a chance to break out of poverty: money, preschool and desegregation. Johnson finds that black children make much larger academic gains when integration is accompanied by more funding for low-income schools. Similarly, the benefits of early child education endure when they’re followed by well-resourced schools. All three — money, preschool and desegregation — are a powerful combination in which the whole is greater than the sum of the parts. “Synergy has the power to take two policies that in isolation seem flat and transform them into one package of policies with profound promise,” Johnson wrote in his book.

Children Of The Dream: Why School Integration Works

An acclaimed economist reveals that school integration efforts in the 1970s and 1980s were overwhelmingly successful — and argues that we must renew our commitment to integration for the sake of all Americans

We are frequently told that school integration was a social experiment doomed from the start. But as Rucker C. Johnson demonstrates in Children of the Dream, it was, in fact, a spectacular achievement. Drawing on longitudinal studies going back to the 1960s, he shows that students who attended integrated and well-funded schools were more successful in life than those who did not — and this held true for children of all races.

Yet as a society we have given up on integration. Since the high point of integration in 1988, we have regressed and segregation again prevails. Contending that integrated, well-funded schools are the primary engine of social mobility, Children of the Dream offers a radical new take on social policy. It is essential reading in our divided times.

CHARTER SCHOOLS ARE A WASTE OF MONEY

Charter Schools Will Always Waste Money Because They Duplicate Services

We live in a throw-away civilization. When something doesn’t work, we throw it away and get a new one. That throw-away attitude has found its way to the issue of the public schools. When public schools aren’t working, we abandon them and get new schools in the form of charters and vouchers. Instead of spending money to improve the schools we have, our money goes to privatized schools which don’t do any better than public schools.

Steven Singer also reminds us that most charter schools aren’t really needed…they’re not opened because public schools can’t handle the number of students in a district. They’re not opened because schools are overcrowded. They’re opened because someone decided to use public education as a money-making venture.

When a district’s public schools aren’t performing well, instead of abandoning them and opening charter schools, we need to spend the time and effort it would take to improve.

You can’t save money buying more of what you already have.

Constructing two fire departments serving the same community will never be as cheap as having one.

Empowering two police departments to patrol the same neighborhoods will never be as economical as one.

Building two roads parallel to each other that go to exactly the same places will never be as cost effective as one.

This isn’t exactly rocket science. In fact, it’s an axiom of efficiency and sound financial planning. It’s more practical and productive to create one robust service instead of two redundant ones.

However, when it comes to education, a lot of so-called fiscal conservatives will try to convince us that we should erect two separate school systems – a public one and a privatized one.

The duplicate may be a voucher system where we use public tax dollars to fund private and parochial schools. It may be charter schools where public money is used to finance systems run by private organizations. Or it may be some combination of the two.

But no matter what they’re suggesting, it’s a duplication of services.

And it’s a huge waste of money.

THE ONLY THING WE HAVE TO FEAR…ARE SMALL CHILDREN?

Feds: No more education, legal services for immigrant kids

We have become a nation of cowardly, selfish, small-minded, ignorant, fools.

“By eliminating English classes and legal aid that are critical to ensuring children successfully navigate the asylum process, the Trump Administration is essentially condemning children to prison and throwing away the key until their imminent deportation,” Grijalva, who represents a district on the border, said in a statement.

TESTING: DOING IT WRONG SINCE 2001

Why The Big Standardized Test Is Useless For Teachers

I began teaching long enough ago to remember when the Big Standardized Test wasn’t so big. In the school system I worked in, we tested students in grades 3, 6, 8, and 10 instead of all of them. Back in 1976, I taught third grade. Our students’ scores were compared with other students around the country. Not only that, as the classroom teacher, I received a complete analysis of how each student did…and I got it a week or two after the test was taken. Yet, like tests today, the ones I gave didn’t really tell me anything that I didn’t already know. John couldn’t read but could add and subtract. Annie had to count on her fingers but was reading at a 9th-grade level. Michelle was an excellent all-around student. Paul and Stan probably needed special education services. The important information was not how each individual student scored. It was my understanding that the tests were used to help us determine if our curriculum was adequate. Were we teaching our kids things they needed to know? How did we compare to other schools around the country?

One big difference…we were told, specifically, not to teach to the test. In fact, as I recall, “teaching to the test” was a serious breach of testing etiquette. Our school district had developed a well-rounded curriculum and we wanted to see if teaching our curriculum yielded good scores. My classrooms of middle-class white kids generally did average to above average…just like today’s middle-class white kids.

It was interesting to see my students’ scores each year. But it was interesting because it reinforced what I already knew. Rarely did I see anything that surprised me. You could have ranked the report cards I made out for my class…and their standardized tests…and the rankings would have had a nearly perfect correlation.

One important difference compared to today’s tests; The tests didn’t determine student grade placement, school “grades,” teacher cash bonuses, or teacher evaluations. Standardized achievement tests — then and now — weren’t made to do those things. The tests were designed to test certain aspects of student achievement and nothing more. Misusing tests by using them to measure things they weren’t designed to measure invalidates the test. You wouldn’t use a teaspoon to measure the temperature. You shouldn’t use a student achievement test to measure teacher competence.

Imagine that you are a basketball coach, tasked with training your team for great things. Imagine that when game day comes, you are not allowed to be in the gym with your team to see them play, and that they are forbidden to tell you anything about how the game went. You aren’t even allowed to know about the opposing team. All you are allowed to know is how many points your team scored. And yet, somehow, you are to make efficient use of practice time to strengthen their weaknesses. You can practice the kinds of skills that you imagine probably factor in a game, but you have no way of knowing how they use those skills in a game situation, or what specifically you should try to fix.

That’s the situation with the standardized test. (Well, actually, it’s worse. To really get the analogy right, we’d also have to imagine that as soon as the ball left the players’ hands, a blindfold slammed down over their eyes, so they don’t really know how they’re doing, either.)

TRY DIFFERENT

10 Things People Need to Stop Saying About Children with ADHD

I grew up hearing this. No matter how hard I tried my efforts were rarely recognized. I was always “lazy” and “unmotivated.”

After struggling through four years of high school my senior English teacher told me “You have so much potential if only you’d put forth some effort.” She obviously cared about my success, but couldn’t see the effort that I was already putting forth.

One of my professors in college suggested that I stick to retail, at which I was very successful, by the way. After I graduated (before I went back for my teaching credentials), I made a mark in the retail business I worked at. Each month, it seemed I was given more and more responsibility. The difference was that the work was hands-on, and didn’t take the same kind of mental concentration that school work (K-12 or college) took. By the time I left my first job after two years, I had been given the responsibility of an entire sales department.

If you have a child or student who you suspect of having ADHD, saying, “just try harder” doesn’t help. Instead, help them “try different.”

3) “He just needs to try harder.” If you’ve ever worked one-on-one with a child who suffers from ADHD and who is trying to complete a homework task that they find challenging or tedious, you will see just how hard these kids try. It is a heartbreaking thing to witness.

ACHIEVEMENT OR ABILITY?

Why Streaming Kids According to Ability Is a Terrible Idea (Oscar Hedstrom) 

Streaming is what we used to call tracking…grouping kids by their class achievement. Years and years of research has shown that, while it’s more convenient for teachers, it doesn’t really help students achieve higher…and the author acknowledges that in the second paragraph below.

In the first paragraph, the author quoted British PM David Cameron who said, “Parents know it works. Teachers know it works.” I’m not sure about parents, but teachers know it’s easier. What teacher wouldn’t like a fourth-grade class, for example, where the range of reading levels is grade 4 through 6, instead of a class with reading levels from first-grade through ninth-grade. Planning would be easier, teaching would be easier. But, as already mentioned, the evidence doesn’t support doing that.

My main focus for this article is the tendency of education writers and teachers to conflate ability with achievement. Once in a while, the difference is understood, such as this explanation from the NWEA Map Test,

MAP Growth tests measure a student’s academic achievement, not his or her ability.

But in the article below, and in so many more discussions among educators, the difference is either not understood or just plain ignored and the words are used interchangeably. In the first paragraph below the author refers to mixed-ability classes, while in the third paragraph he refers to the meta-analysis of student achievement.

Here is what we need to remember. Ability refers to one’s potential, whereas achievement reflects what one actually does.

Mixed-ability classes bore students, frustrate parents, and burn out teachers. The brightest will never summit Everest, and the laggers won’t enjoy the lovely stroll in the park they are perhaps more suited to. Individuals suffer at the demands of the collective, mediocrity prevails. In 2014, the UK Education Secretary called for streaming to be made compulsory. And as the former British prime minister David Cameron said in 2006: ‘I want to see it in every single school. Parents know it works. Teachers know it works.’ According to the Organisation for Economic Cooperation and Development, 98 percent of Australian schools use some form of streaming.

Despite all this, there is limited empirical evidence to suggest that streaming results in better outcomes for students. Professor John Hattie, director of the Melbourne Education Research Institute, notes that ‘tracking has minimal effects on learning outcomes and profound negative equity effects’. Streaming significantly – and negatively – affects those students placed in the bottom sets. These students tend to have much higher representation of low socioeconomic backgrounds. Less significant is the small benefit for those lucky clever students in the higher sets. The overall result is relative inequality. The smart stay smart, and the dumb get dumber, further entrenching social disadvantage.

In the latest update of Hattie’s influential meta-analysis of factors influencing student achievement, one of the most significant factors – far more than reducing class size (effect: 0.21) or even providing feedback on student work (0.7) – is the teachers’ estimate of achievement (1.57). Streaming students by diagnosed achievement automatically restricts teacher expectations. Meanwhile, in a mixed environment, teacher expectations have to be more diverse and flexible.

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Filed under Achievement, ADHD, Article Medleys, Charters, Gadflyonthewall, Immigrants, Lead, Segregation, Testing

What’s Bugging Me Today: ADHD Denial, Misdiagnosis, and the Harvard Study

The parents of a young child with a summer birthday asked the pediatrician if their child was ready to start school. The pediatrician told them, “Go ahead and send him. It’s never too early to start them in school.”

Even if I hadn’t been a teacher involved in early education when I heard this, I would have known that this was bad advice. Starting school too early can be damaging. I knew because…

STARTING SCHOOL IN CHICAGO

In Chicago, in the early 1950s, the Kindergarten entrance date cutoff was October 1. My mid-September birthday made me eligible for entrance to Kindergarten which, back then, started the day after Labor Day, about two weeks before my 5th birthday.

I struggled all through school. I made progress…now and then good progress, but I had trouble paying attention; I didn’t always know what was going on at a given moment during class; I couldn’t focus on the task at hand; I couldn’t remember what I had read.

Every year I would start the school year with high hopes. I promised myself that I would keep up with the work, pay attention, and stay organized. And every year, by about the second or third month, those promises would be lost.

While in Elementary School I was diagnosed with Minimal Brain Damage, the horrifying 50s term for Attention Deficit Hyperactivity Disorder (ADHD). My treatment consisted of therapy with a child psychologist of which I remember very little other than the fact that I assumed that there was something “wrong” with me. At some point, and without any memorable closure, the therapy stopped. Nothing more was done for my MBD/ADHD, and I continued to struggle with the social and academic aspects of Elementary School.

 

MOVING ON TO HIGH SCHOOL

At various times my parents and teachers said things like this to me (note the mixed messages):

  • What were you thinking?
  • Why didn’t you think before you [insert behavior]?
  • You could do so much better if only you would try harder.
  • Did you even try?
  • You’re just lazy.
  • You’d lose your head if it wasn’t screwed on.

and my parents heard things like this from my teachers,

  • He’s just not bright enough to do the work.
  • He’s smart enough and can do the work, he’s just lazy.
  • He could do so much better if only he put forth some effort.
  • He needs to learn to pay attention.

In high school, I learned that words have power. One day during my senior year, my English teacher kept me after class. She was a good teacher who clearly cared about her students (think: Professor McGonagall). She said to me, “You could do so much better if only you would try harder.” Once again, I knew something was “wrong” with me…because I did try, but each year I would “forget” to pay attention. I would procrastinate. I would lose things. At that time in my life, I wasn’t really sure what “try harder” meant. I ended up with a “C” in her class, and I have dragged her words around with me ever since then.

Still, I somehow managed to get by and survive Elementary and High School. High school band and orchestra helped – I always got an A in each.

College was the same. I got into college because of my musical ability (though I only stayed in the music school for one semester) and barely made it through my freshman year. I was allowed to come back for a third semester as a freshman, on the condition that I improve. I did, slightly, but continued the same pattern from elementary school and high school. I managed to graduate with a bachelors degree using several rounds of summer school to make up for classes I missed or failed.

Sullivan High School (Chicago) Orchestra, c.1966

TURN-AROUND

After college, I worked in retail and, much to my surprise, I did very well, becoming the head of a sub-department in less than a year. When my first child was born I became interested in child development so I decided to go back to school. With the help of adulthood, marriage, and the responsibility of a child, I was able to get a teaching certificate and was even inducted into an education honor society. I followed this with a masters degree and a Reading Recovery certificate.

I spent my teaching career engaged in what was, ironically, the source of my childhood shame, embarrassment, and failure: elementary school education. I had some success and some failures as a teacher, but I kept at it and kept trying to improve. I eventually learned about ADHD (and ways to compensate for my own ADHD symptoms). In the middle of my career, I started working with children who were struggling in school…children who were like I was.

ALLEGED ADHD?

Last week I read a comment on a popular education blog that suggested that mental health diagnoses were quackery. The commenter accepted that there are mental health problems, but the diagnoses, at least to the commenter, were fake. The comment even referred to “alleged ADHD kids.” I can only assume that there is some painful mental health problem to which the writer was exposed which was misdiagnosed, undiagnosed, left untreated, or incorrectly treated.

Are all mental health diagnoses quackery? Absolutely not.

We can’t just deny that something exists because people screw up in their diagnosis. Medicine, like education, is not an exact science (there is no such thing as an exact science!), and the medicine of the brain is no different. We do the best we can with the knowledge we currently have, but we have to use that knowledge correctly.

JUMP TO HARVARD STUDY 2018

Harvard study: Children who start school early more likely to get ADHD diagnosis — even if they don’t have it

Harvard University researchers have found that children who start school up to a year sooner than many of their peers are more likely to be diagnosed with ADHD — even if they don’t really have the condition. As a result, large numbers of children may be improperly labeled with the disorder when, instead, they are just immature.

In other words, those younger children were misdiagnosed with ADHD. That doesn’t mean ADHD doesn’t exist…or is “alleged.”

WHAT IF…

What would my experiences in school have been if I hadn’t started kindergarten at the age of four

Would I still have been diagnosed with ADHD (Minimal Brain Damage) as a child and then rediagnosed with the same as an adult?

Would I still have felt inclined to work with children who were struggling in class?

Would I have had a completely different career?

In a study published in the New England Journal of Medicine, the researchers looked at the records of more than 407,000 children from every state and found that younger children in the same grouping of students had a 30 percent higher risk for an ADHD diagnosis than older students.

 

Was I part of that 30%?

A 30% higher risk does not mean that everyone diagnosed with ADHD who has a summer birthday has been misdiagnosed.

ADHD does exist…and some people live with it even if they didn’t start school at four years old. My lifelong experiences with the side effects and comorbid conditions related to ADHD suggest that I would have had the diagnosis anyway.

But the claim that ADHD is overdiagnosed is not new. Neither is the claim that ADHD is underdiagnosed. The truth is somewhere in between; ADHD is often misdiagnosed.

MISDIAGNOSIS

Schools and teachers shouldn’t diagnose ADHD, a medical condition. However, a classroom teacher is often the first to notice a problem with the behaviors associated with ADHD. Primary Care Physicians are also not necessarily qualified to diagnose ADHD and many of those who do, often do not follow the diagnostic guidelines in the Diagnostic and Statistical Manual of Mental Disorders (DSM).

Misdiagnoses and overdiagnoses are caused by poor medical practices — either by non-medical lay people (educators), slipshod work by untrained or overworked physicians, or mistakes by fallible, though well-meaning human beings.

That’s why I wrote, above, and would like to emphasize…

Medicine, like education, is not an exact science, and the medicine of the brain is no different. We do the best we can with the knowledge we currently have, but we have to use that knowledge correctly.

The DSM has specific criteria which must be followed if ADHD is to be diagnosed. In order for a condition to be considered ADHD, the symptoms must occur…

…to a degree that is inconsistent with developmental level and that negatively impacts directly on social and academic/occupational activities…

and are present

…in two or more settings (e.g., at home, school, or work; with friends or relatives; in other activities).

Misplacing your keys does not mean you have ADHD.

Occasional daydreaming does not mean your child has ADHD.

Excitability and clumsiness are normal human traits and do not mean that you or your child has ADHD.

ADHD in children is only ADHD if the suspected behaviors are “inconsistent with developmental level,” have a serious negative impact on the child’s life, and are present in more than one setting…otherwise, it’s just “childhood.”

 

WHAT TO DO…

Don’t automatically enroll a child with a late-summer birthday in kindergarten the moment they become eligible. The later in the year a child is born, the more parents ought to consider preschool instead of Kindergarten.

A teacher should not be relied on to diagnose ADHD. If you’re a teacher, remember that the youngest children in your classroom might have different behaviors than the older ones. It’s also important to note that other conditions might “look like ADHD” such as childhood depression, some learning disabilities, oppositional defiant disorder, and bipolar disorder. Leave the medical diagnoses to medical professionals.

Perhaps it’s time to let go of age-based grade grouping. No matter where we place the cutoff date for entrance into Kindergarten, there will be some children who are almost a year younger than the others. How about multi-age classrooms? Do the positive benefits of multi-age classrooms outweigh the negative?

Finally, it’s essential that we end the trend towards curriculum push down. Developmentally appropriate practice is needed for our preschools and elementary schools. Children, even gifted children, are not just small adults. Physical and emotional development have an important part to play in learning. Children will not learn before they are ready and we can’t depend on all students in a class learning the same thing at the same time.

In the meantime, we need to be responsible and use the best knowledge that we have to identify the problems and conditions of children in order to prevent misdiagnoses.

~~~

Links to articles dealing with the science of ADHD:

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ADHD, Personal History, Neuroscience, Science

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2018 Medley #23

For Kids-Not For Profit,
McCormick Asks For Accountability,
Teacher Evaluations, Income and Testing,
The Reading Wars, Elections Matter,
DeVos’s Ignorance,
October is ADHD Awareness Month

PUBLIC EDUCATION: FOR KIDS, NOT FOR PROFIT

IRS Should Close Tax Loophole That Allows Private School Voucher “Donors” To Profit With Public Funds

Indiana has a tax credit of 50% for donors to scholarship granting organizations which means that half the donations to those organizations come from the state. It’s worse, however, in ten other states,  Alabama, Arizona, Georgia, Kansas, Montana, Oklahoma, Pennsylvania, Rhode Island, South Carolina, and Virginia. I must admit that I’m surprised Indiana hasn’t gone this far…

For example, imagine that a wealthy South Carolinian who is in the top tax bracket gives $1 million to a “scholarship organization” that funds the state’s private school voucher program. South Carolina will reimburse that donor $1 million – this means the donor hasn’t spent anything. Nonetheless, the federal government considers that $1 million a charitable donation and therefore not taxable. At the top federal income tax bracket of 37 percent, the donor saves $370,000 on their federal taxes. But because the donor was reimbursed by the state for every dollar of their $1 million donation, that extra $370,000 savings is pure profit. It’s outrageous.

 

STATE SUPER CALLS FOR CHARTER AND PRIVATE SCHOOL ACCOUNTABILITY

Superintendent of Education, Dr. Jennifer McCormick Supports Conditions on Receipt of Public Funds; Won’t Run for Re-Election

Jennifer McCormick, a Republican, ran for Indiana Superintendent of Public Instruction in 2016. Her opponent was the incumbent Glenda Ritz. During her tenure, Superintendent Ritz tried to use her position to support public schools and protect public education from the privatizers in the legislature and the Indiana State Board of Education (SBOE). Dr. McCormick professed to have a similar educational platform as Ritz, but she claimed that, as a Republican, the Governor, Legislators, and members of the SBOE, would listen to her.

They didn’t.

…Superintendent McCormick believes that “any school that takes public money should be an inclusive place for LGBT students and staff.” It seems pretty clear that she does not see eye-to-eye with her Republican colleagues on what the Superintendent of Public Instruction’s role should be or with how charters and private schools should be held accountable for their receipt and use of public money. This news came as Dr. McCormick discussed the Department of Education’s legislative priorities for the upcoming session. Among the priorities she announced for the Department were providing an inclusive environment for K-12 students, holding charter school authorizers accountable both fiscally and academically, and reducing testing time.

 

TEACHER EVALUATIONS

An Open Letter to NJ Sen. Ruiz, re: Teacher Evaluation and Test Scores

There are too many out-of-school factors for teachers to be held 100% responsible for the achievement of their students.

– You can’t hold a teacher accountable for things she can’t control. Senator, in your statement, you imply that student growth should be a part of a teacher’s evaluation. But a teacher’s effectiveness is obviously not the only factor that contributes to student outcomes. As the American Statistical Association states: “…teachers account for about 1% to 14% of the variability in test scores, and that the majority of opportunities for quality improvement are found in the system-level conditions.”(2)

Simply put: a teacher’s effectiveness is a part, but only a part, of a child’s learning outcomes. We should not attribute all of the changes in a student’s test scores from year-to-year solely to a teacher they had from September to May; too many other factors influence that student’s “growth.”

 

HIGH INCOME – HIGH SCORES

ISTEP results are a non-story

Speaking of test scores…ISTEP scores are finally here…delayed again…and still worthless for anything other than giving schools full of high-income students another “A” banner for their hallway. Meanwhile, schools full of low-income students fight to get equitable funding for wrap-around services. Where are the “F” banners for the legislators who fail to take responsibility for inequitable funding?

It’s a lousy week to be an education reporter in Indiana. ISTEP-Plus test results were released Wednesday by the State Board of Education, so editors are assigning – and readers are expecting – the usual stories. Which schools did best? Which did worst? Which improved, and which didn’t?

Reporters who spend their work lives visiting schools and talking to educators and experts know this is the epitome of a non-news story. They know that years of experience and research tell us that affluent schools will have higher test scores than schools serving mostly poor students.

 

THE READING WARS

The Reading Wars? Who’s Talking About Reading and Class Size?

“The ‘reading wars’ never go away — at least not for long.” — Valerie Strauss

There are more than two sides to The Reading Wars. Actual practitioners, reading teachers, understand that teaching reading is a nuanced process. You can’t ignore context and you can’t ignore sound-symbol correspondence.

A good teacher finds out what her students need and what helps her students learn. She then tries different approaches and chooses that combination which most benefits the student.

Class size matters. The larger the class the more difficult it is to focus on the needs of each student. Large classes force teachers into focusing on the approaches which meet the needs of the majority of students…which means some students miss out.

Any teacher who has studied reading, understands that both phonics and whole language are important. A great reading teacher is capable of interweaving the two, depending on the instructional reading needs of every student in their class.

Some students need more phonics. Other students don’t need as much phonics. Teachers are better able to address the individual needs of their students, while bringing the class together, if they have manageable class sizes. Questions involving how to teach reading are important, but class size is critical no matter how reading is taught.

Lowering class sizes enables teachers to create an individualized reading prescription, like an IEP. It enables teachers to provide more one-on-one instruction which we also know helps students. It also provides them with more time to work with parents.

 

VOTE FOR PUBLIC EDUCATION

Education — and Betsy DeVos — are issues in key political races this November

While it may not top the list of issues motivating voters to go to the polls, education is a key factor in some big races. (Depending on age, location, political affiliation or time of survey, other matters may come out on top, including the economy, immigration or health care.) And while Education Secretary Betsy DeVos isn’t on the ballot anywhere, her priorities are.

Americans have long cited education as a key concern when asked by pollsters to list issues important to them, but it has never been seen as one that could affect their vote. But for a combination of reasons, including the inevitable swing of the political pendulum, things seem different this year.

Hundreds of teachers and retired educators — an unprecedented number — are running for political office on the local, state and federal levels. There are hundreds of teachers — most of them Democrats — running for state legislative seats alone.

 

DEVOS DOESN’T KNOW WHAT SHE DOESN’T KNOW

Betsy DeVos doesn’t know what she doesn’t know about education

The Dunning-Kruger effect “…occurs where people fail to adequately assess their level of competence — or specifically, their incompetence — at a task and thus consider themselves much more competent than everyone else. This lack of awareness is attributed to their lower level of competence robbing them of the ability to critically analyze their performance, leading to a significant overestimation of themselves. In simple words, it’s ‘people who are too ignorant to know how ignorant they are’.”

Betsy DeVos is too ignorant about education to understand that she knows nothing about education.

“Parents, by their very nature, should decide what, when, where and how their children learn,” DeVos said.

But even amidst the barren, dystopian landscape of Ms. DeVos’ vision of American education, the quote above somehow caught my eye. You have to give it to her: Betsy has a real knack for distilling complicated, complex problems down into a single ignorant, nonsensical nugget of edu-drivel.

And she’s just clever enough to remember who her audience is here–and it’s not teachers, or teacher educators, or the 75+% of parents who are happy with their kids’ schools. No, her audience is the conservative base who believe that nothing public is better than anything private, who refer to public schools as “government schools,” and believe that paying even a single dollar in taxes is a form of robbery….

 

OCTOBER IS ADHD AWARENESS MONTH

7 Facts You Need To Know About ADHD

October is ADHD Awareness Month. It’s sad that we even have to post the following…

1. ADHD is Real

Nearly every mainstream medical, psychological, and educational organization in the United States long ago concluded that Attention-Deficit/Hyperactivity Disorder (ADHD) is a real, brain-based medical disorder. These organizations also concluded that children and adults with ADHD benefit from appropriate treatment. [1,2,3,4,5,6,7]

 

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What’s Bugging Me Today: Things Heard by an ADHD Kid

STOP THE ROUNDABOUT, I WANT TO GET OFF

A roundabout (aka traffic circle, road circle, rotary, rotunda or island) is a good metaphor for an ADHD life. When you approach a roundabout you need to note the entire traffic pattern in one glance. You must pay attention to all sides of the circle, watch for cars already in the circle and those which haven’t yet entered the circle. You also must make sure that you’re in the correct lane to exit the circle.

In life, as in a roundabout, events, objects, and people come at you randomly from all different directions at the same time and you must decide which ones to notice…which ones to pay attention to…which ones to listen to…and which ones to act upon. If you can’t navigate entering the roundabout of life, or can’t figure out how to get off, your stress level will rise, your ability to function decreases, and you get stuck. That’s life in the ADHD world.

As an example, let’s look at a discussion I had with my insurance company a few years ago about ADHD medications.

ADHD is considered a childhood disorder. This is changing slowly, but when this particular conversation took place most insurance providers balked at covering treatment for adults with ADHD. Therapy had to be described as treatment for depression or anxiety and medication was difficult to get since stimulants were rarely prescribed for any other medical problems. The latter issue was the basis of the problems with my insurance company.

My doctor had prescribed an ADHD medication for me and my insurance company required that he inform them of my diagnosis every six months in order to continue the medication. At one point, I tried to refill my prescription only to be told that it wasn’t covered. I called my insurance company.

ME: I tried to refill my prescription for [ADHD medication] and was told it wasn’t covered. I don’t understand. It was covered last month.

INSURANCE INDUSTRY: You must remember to have your doctor send us an update every six months to keep your prescription current.

ME: If I could remember that, I wouldn’t need the [ADHD medication]!

Similarly, many children and adults with ADHD have difficulty remembering to take their medication (assuming they can get it). This difficulty is a common symptom of ADHD…and would be alleviated if they took their medication…

Round and round and round…

FAILURE SHAME LOW SELF-ESTEEM ➔ FAILURE…

Academics is an area where the impact of ADHD is often felt the strongest.

The trigger for this post was the following story. It is representative of the experiences of many, if not most, children and adults with ADHD.

Uniquely Different

In 3rd grade, my mother was once again called to the school to speak with my teacher who told her “Buddy should be removed from normal class and maybe put into special education. He’s quite stupid and I don’t think he has the mental capacity to learn.”

That did it!

Needless to say, my mother lost her temper with the teacher. A school psychologist was called in and I was rigorously tested for the next 3 months.

I was given reading tests, writing tests, interest assessments, personality tests, IQ testing, and weekly visits for counseling.

When it was all said and done, the psychologist called a meeting with me, my teacher, and my mother.

Not only …

He told them “You’re right that Buddy should be pulled from your class, but not because he can’t learn. Your class probably bores him.”

Then he informed them that I was reading at a high school level, I was registering 136 on his IQ testing (which apparently meant something), and that I was a visual/active learner that would always have issues with memorizing things that I didn’t find interesting.

More negative

In typical fashion, my teacher’s commentary changed at that point from “He’s stupid” to “He is just not applying himself”. I was given the opportunity to participate in some advanced activities, but I was still required to learn the things that I was struggling with at the start. No one at that time ever mentioned ADD or ADHD and there was no talk of medication.

After reading this story, especially the final paragraph, I thought about two of my teachers…

Mrs H, my eighth grade math teacher who frequently and publicly shamed me for my failure to pay attention and achieve. When I started my own teaching career I vowed never to be anything like her. I met with mixed success on that…much to my own disappointment.

Mrs. G, my high school English teacher who recognized that I had, at least some ability, but kept harping on the fact that I didn’t try hard enough. I’ve often wanted to find her and talk to her…to tell her, “See, I was successful and it had nothing to do with not trying hard enough.” Sadly, I waited too long and she passed away last year.

NEGATIVE VOICES…FAILURE TO LIVE UP TO EXTERNAL EXPECTATIONS

Throughout their years of growing up, children with ADHD are fed constant negative messages: sit still, pay attention, you’re just not applying yourself, you just don’t give a damn.

Those negative messages are reinforced throughout our lives and feed a pattern of failure and shame in a vicious circle – a roundabout – of frustration.

this negative chatter, the inner critic, that voice inside our head that creates doubts and worries, saying things like “you’ll never be able to complete this”, “this isn’t good enough”, “you aren’t smart enough”. However, the inner critic may be stronger in people with ADHD due to childhood struggles.

If you grew up with ADHD you probably grew up with negative messages like these

You’re lazy.
You’re not good enough or smart enough.
You’re stubborn.
You can’t do anything right.

You also probably grew up with many hardships, including a poor academic record, parental disapproval and frequent punishments

I heard them all…and others like…

What were you thinking?
You’d lose your head if it wasn’t screwed on!
You could do better if only you would try harder.

TRY HARDER

The advice to “try harder” is understandable. If you don’t have trouble with ADHD symptoms, then it seems like it’s only a matter of effort to keep you focused, keep you awake when you’re supposed to be studying, and keep you sitting still when you’re in class.

But it takes more than just effort, and the constant negativity, the constant feelings of failure, the constant inability to measure up, takes its emotional toll. As a result, ADHD is often accompanied by other mental health issues like depression or anxiety disorders. The difficulty of overcoming the emotional and social deficits caused by ADHD and it’s accompanying problems makes the suggestion to “try harder” seem silly at best…insensitive and cruel at worst.

A child with ADHD might sit down to do homework and find themselves distracted by various visual or auditory stimuli or they might fall asleep while working only to awake hours later with the work undone.

A child with ADHD might enter their classroom promising themselves to pay attention and then find their mind wandering to the sound of the teacher’s voice, the light from the sun reflecting off of passing cars outside the classroom, the noise of shuffling feet, or the hum of the fluorescent lights above their head.

Trying harder isn’t the problem. Saying “pay attention” won’t help. Shaming the child for “drifting away” only adds to the roundabout of failure.

OVERCOMING THE NEGATIVE VOICES

For some children – and adults – the only way to learn to navigate entrance and exit from the roundabout is with treatment, either with therapy, medication, or both.

ADHD is like any other condition, but because it is unseen and hard to diagnose…because it’s a neurological disorder, there’s a tendency to feel embarrassment and to deny that it exists.

But denying that ADHD is a real disorder can be as damaging as it would be to deny that a vision or hearing impairment exists…as damaging as ignoring a diagnosis of diabetes or  kidney failure.

Parents of ADHD children should get treatment for their children.

Teachers of ADHD children should educate themselves about the disorder, practice patience and understanding, and treat children with ADHD the same as they would any child with a condition affecting their learning.

Adults with ADHD need to get treatment and learn how to overcome the voices of criticism and shame.

Most of all, anyone who is, or works with a person with ADHD, would do well to heed the advice of Terry Matlen, a psychotherapist specializing in ADHD.

“Surround yourself with people who celebrate who you are, and let go of toxic relationships,” Matlen said. Initially, you might’ve picked people who tear you down, because that’s what you thought you deserved, she said. Again, remember ADHD is not a deep-seated flaw, but a real neurobiological disorder. “[F]ind a team of professionals, a group of loving, caring individuals who want to see you succeed.”

Once people with ADHD get the support they need from medical and mental-health professionals, family, and friends, they can learn to navigate the ins and outs of life’s roundabout.

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I Haven’t Seen it, Therefore it Does Not Exist

ABNORMAL PSYCHICAL CONDITIONS IN CHILDREN

ADHD is real. The fact that it first appeared in the DSM in 1968 doesn’t mean it was somehow invented out of thin air. It has been identified, though called by other names, as far back as the 18th century. Modern names (post 1900) include “minimal brain damage”, “minimal brain dysfunction”, “hyperkinetic impulse disorder”, and “learning/behavioral disabilities.”

Interview: Russell Barkley

…there is no controversy among practicing scientists who have devoted their careers to this disorder. No scientific meetings mention any controversies about the disorder, about its validity as a disorder, about the usefulness of using stimulant medications like Ritalin for it. There simply is no controversy. The science speaks for itself. And the science is overwhelming that the answer to these questions is in the affirmative: it’s a real disorder; it’s valid; and it can be managed…

RESTRICTIVE DIAGNOSIS

The DSM-5 is very clear. Normal, age-appropriate inattentiveness or activity does not mean that a child is ADHD. In order to correctly diagnose ADHD symptoms must…

…have been present for at least 6 months, and they are inappropriate for developmental level…

Inappropriate for developmental level means that the average child’s normal impulsiveness, distractibility, and restlessness are not criteria for a diagnosis of ADHD.

Additionally, the condition must be present in more than one area (for example, home AND school), and other conditions, such as childhood depression, must be ruled out first. The condition must also create “significant” life issues in those two (or more) areas. A child who is “very active” but has no problems related to his “activity” should not be diagnosed with ADHD.

MIS-DIAGNOSIS?  OVER-DIAGNOSIS?

In his blog post, Is ADHD A Fraud?, teacher Tom does not come out and deny that ADHD is a real condition, but he doesn’t acknowledge that it’s real either.

I’m not a psychiatrist, but I know the symptoms (inattention, hyperactivity, impulsivity) and I can honestly say that of the hundreds of children that have passed my way over the past couple decades, I’ve never met one upon whom I would hang that label.

Now, I admit to be completely unqualified to make that diagnosis, but you would think that by now I would have run across at least one child who set off my alarm bells. Or perhaps there is something about our school that attracts non-ADHD kids, or maybe I’m looking right at the symptoms and just see normal behavior, or it could be that the folks performing the diagnoses are wrong more often than they are right.

Is ADHD over- and mis- diagnosed? Very likely, but that doesn’t mean that the condition doesn’t exist As Teacher Tom said, he’s not qualified to answer that question.

A German study found that most diagnoses do not meet the DSM criteria for ADHD. The study also found that, given the same symptoms, boys were diagnosed with ADHD more than girls.

Do these erroneous diagnoses mean that the condition does not exist? Diagnosing ADHD isn’t easy. The idea of what constitutes appropriate developmental behavior is not as easy as looking at an x-ray to identify a broken bone. But, the difficulty of the diagnosis is, by itself, not sufficient to deny that the condition exists. The anecdotal fact that Teacher Tom never “ran across” an actual case of ADHD as a teacher for several decades might be unusual, but it doesn’t mean that the condition is non-existent.

He suggests the possibility that the condition was created by “big pharma” in order to increase profits. It’s true that the over-diagnosis of the condition might be a product of pharmaceutical salesmen putting ideas in doctors’ heads about how easy it is to “treat” the condition, but since the condition has been identified for more than 2 centuries, making the claim that it was created in order to cash in is questionable (I also expect that many doctors would object to being characterized as that easily swayed by pharmaceutical salesmen).

Is ADHD Overdiagnosed or Underdiagnosed? Looking at Evidence.

The problem with misdiagnosis is that it undermines the legitimate condition that is ADHD. Some people that are severely affected by this condition may be overlooked and/or not properly treated. Some would argue that the most successful individuals with ADHD tend to be those who find ways to cope with and manage the symptoms on their own.

Although there are drawbacks associated with ADHD, some people are able to channel their hyperactivity towards being productive. Keep in mind that there are many different types of ADHD that a person could be dealing with. According to the DSM-5 there are 3 types, but according to others there are 7 types. Therefore individuals that don’t know much about this subject may be prone to making a misdiagnosis.

ON THE OTHER HAND…

All that being said, Teacher Tom is right about several things. First, journalist Thom Hartman has written about the evolutionary aspects of ADHD…and why the condition is, in his opinion, not a disorder. Hartman makes a good argument, and I agree that the possibility exists that the condition is more a product of civilization than an inherent disorder. [Unfortunately, we live in a society built upon certain social norms. The societal conditions which combine to make ADHD a “disorder” must be considered. This, however, is a conversation for another time. Please see Hartman’s work…]

Teacher Tom is also correct in implying that the problem “belongs” to the adults. It’s our job as teachers to accommodate our students, not vice versa. ADHD, is real, but teachers shouldn’t use it as an excuse to ignore a child’s academic, social, and emotional needs.

On the other hand, denying the existence of the condition – or in Teacher Tom’s case, a “denial-not-denial” – isn’t helpful. Neither is blaming it on inferior teachers or schools, which he does as well.

Traditional schools emphasize paying attention, sitting still, and concentrating on one thing at a time and children who struggle with that simply show up as a problem. I mean, that’s tough for any kid, let alone one with a highly energetic brain and body. In contrast, when we don’t place those artificial expectations on kids, like in a play-based curriculum, the “problem” disappears.

and

I suspect that for the most part, ADHD is mental health disorder that largely only exists under certain, unnatural circumstances, namely in traditional schools…

Essentially, he’s saying, “I haven’t seen ADHD because my school and the way I teach is the ‘right’ way, and other people, who are doing it wrong, are ‘creating’ the condition by their unnatural circumstances and inferior teaching.” Unfortunately, the fact is that even in developmentally appropriate school conditions, ADHD doesn’t “disappear.”

Let me be very clear…

I agree that a play-based curriculum is developmentally appropriate and preferable for pre-schoolers and kindergarten.

Adults are responsible for creating a learning environment which fits children’s needs, not the other way around. Forcing children to accommodate adult preferences is counter productive to educational progress. It’s up to us to accommodate ourselves to our students’ learning needs.

ACCURATE DIAGNOSIS

However, Teacher Tom’s statement indicates that he really doesn’t understand what an ADHD diagnosis is. Perhaps that’s why he hasn’t seen it in his years of teaching. Check out the diagnostic criteria again. Read carefully…

Notice first, the DSM-5 requires that the behaviors in question are inappropriate to the development of the child. It would be (and is) completely appropriate for children attending pre-schools in which they were forced to sit still for long periods of time, be unable to concentrate, to fidget, and to act out. The same is true for schools which require long periods of sitting in kindergarten and primary grades. Developmentally appropriate means that the developmental age and needs of children are taken into consideration when a curriculum and means of delivery are chosen.

Second, the DSM-5 is very clear in its requirement that ADHD symptoms must be present in two or more settings. As a teacher, he wouldn’t be able to diagnose a child with ADHD because he is, most likely, with his students in only one setting – the school. That’s why an accurate and complete diagnosis requires input from teachers, parents, and others who have contact with the child. Neither should doctors diagnose children just on the parent’s say-so.

Third, the behaviors must interfere with a child’s functioning. They must “get in the way” of a child’s learning, or social development. If they don’t, then the diagnosis of ADHD can not be made.

COMMON MISCONCEPTIONS

Teacher Tom seems to accept common misconceptions about ADHD. Not every child who runs around yelling has ADHD. Not every child who is distractible has ADHD. A true diagnosis of ADHD is not easy to make, and shouldn’t be made on the basis of seeing a few symptoms and then slapping a label on a child. Like any other medical diagnosis, ADHD must be done carefully and by experienced professionals. Unfortunately, there are many cases where care is not taken and undiagnosed or untreated ADHD can result in emotional and academic damage which can last a lifetime.

The problem with misdiagnosis is that it undermines the legitimate condition that is ADHD.

ADHD exists, whether Teacher Tom has seen evidence of it or not. And, like other conditions affecting children in school (e.g. poverty, divorce), ADHD affects every aspect of a child’s life. It must be considered when creating a child’s educational program. Ignoring it, or claiming ADHD doesn’t exist – even with the half-hearted qualifiers that Teacher Tom included in his piece – is irresponsible.

This is a revisit of a topic I wrote about in a post titled, The Task of Your Life.

🙋🏻👩‍🏫🙋🏽‍♂️

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The Task of Your Life

DEFICITS, DYSFUNCTION, HYPERKINESIS, AND BRAIN DAMAGE

  • In 1902 Dr. George Frederick Still included it in a lecture on “some abnormal psychical conditions in children.”
  • Later in the 20th century it was referred to as, the brain-injured child syndrome, minimal brain damage, and minimal brain dysfunction.
  • By the 1960s it was “Hyperkinetic Reaction of Childhood.”

It wasn’t until the 1980s that the term Attention Deficit Disorder was included in the Diagnostic and Statistical Manual of Mental Disorders (DSM).

The latest version, the DSM-5, published in 2013, separates the disorder into three distinct types, or “presentations.” The three, simply put, are 1) hyperactive, 2) inattentive, and 3) combined. People still argue about the terms “hyperactive” and “deficit.” Adults with ADHD are often driven, energetic, and impulsive, but the term hyperactivity is considered childish and insulting. Children and adults with ADHD might seem not to be able to pay attention, but chances are that they are paying attention to too much, and not able to isolate that to which they are supposed to be paying attention. Attention deficit, then, is actually an attention excess.

DIAGNOSIS: TWO IMPORTANT CRITERIA

Hank Green, of Vlogbrothers fame, recently did a video blog (vlog) entry about his own experience with ADHD.

Coincidentally, I answered a Facebook question about a similar disorder about the same time as Hank’s video was released. The Facebook question implied that the disorder wasn’t real and was just an excuse for misbehavior.

It may be true that some doctors over-diagnose ADHD, but that doesn’t mean that the condition doesn’t exist. To those who live with ADHD it’s very real (the DSM-5 gives specific criteria for the diagnosis which you can read here).

[In fact, some argue that ADHD is under-diagnosed. See ADHD CHILDREN LEFT BEHIND, below.]

Two of the most important criteria in diagnosing ADHD are, 1) in order to be diagnosed as ADHD,  the condition cannot be better explained as another disorder (such as anxiety disorder, depression, etc.) and 2) as Hank explained it…

Disorders are only classified as disorders when they’re ongoing, frustrating, impairments.

In other words, a rambunctious, active child is not necessarily suffering from ADHD if his behaviors are within the normal range and there is no impairment in social and occupational (school) functioning. In other words, if it doesn’t cause serious problems in social situations, home, or at work or school, it’s not ADHD no matter how “hyper” the behavior.

For example…

Child A reads adequately, but has difficulty concentrating and remembering. He often falls asleep when reading, does not complete homework, and has trouble remembering details. He has high intellectual ability, but fails academically because of 1) his inability to remember things he reads and 2) his inability to pay attention during discussions. Furthermore, he has a tendency to fly off the handle at real or imagined slights. He reacts without thinking and often becomes enraged if things don’t go his way. He is frequently impulsive and will often do things which cause upset to others due to his inability to control his behavior and speech. Because of this he has difficulty in social situations and is often isolated. 

Child B has some trouble sitting still. He needs a lot of room to move around and sometimes breaks things at home because of his inability to control his large motor movements. His mother has put valuable pieces away and has provided a place in the basement where he can jump and play without breaking things. He is encouraged to go outside whenever the weather permits to “run it off.” At school he will sometimes drop things during class, or bump into people, but is generally easy to get along with and is an above average student. At recess he is constantly active, but is able to settle down when he returns to the classroom.

In the examples above, Child A is the child with ADHD. While he is not hyperactive he is inattentive, impulsive, and unable to focus and remember things. This condition is causing problems both at school and at home, and among his peers. Child B shows some symptoms of “hyperactivity,” but those symptoms aren’t getting in the way of his social functioning and school achievement. After discounting other possible conditions, a competent professional will correctly make a diagnosis of ADHD for Child A.

TREATMENT

ADHD can be debilitating. About half of all children with ADHD also suffer from a related condition such as a learning disability, or have symptoms of another disorder like depression or anxiety. Treatment for ADHD varies with the patient. Hank describes what’s needed for treatment.

There’s kind of two parts to minimizing the negative effects of your brain not working…normal. [1] Changing the environment to suit the brain, and then [2] there’s improving the functionality of the brain itself through things like medications or mindfulness or exercise.

The second one is how most children and adults are treated for ADHD. Therapy, biofeedback, and medications are all tools professionals can use to help patients cope with the symptoms of ADHD. Treatment is important because, like Hank said,

Figuring out how to live in your own mind and your own body is, like, the task of your life.

GROWING UP WITH UNTREATED MBD

Full disclosure: Child A, above, was me.

I went to elementary school in the mid 50s and was diagnosed with minimal brain dysfunction (MBD).

Back then Ritalin was used to treat kids diagnosed with MBD and hyperactivity. Since I wasn’t hyperactive, I received no medications, or any other treatment, for the condition.

Most of my elementary teachers were kind and patient, but weren’t sure how to help a student who couldn’t remember what he read and couldn’t focus when explanations were given.

By the time I got to middle school the diagnosis was forgotten (or discounted), possibly because I wasn’t hyperactive, and probably because, even though I wasn’t a very good student, I was “getting by.” As the content became more difficult, I was given less and less leeway and words like “lazy” began to haunt me. Teachers would report that I “didn’t try hard enough,” ask me “why don’t you listen?” and comment that I was smart, but just “not willing to put forth any effort.”

Meanwhile, I had learned (through a massive personal effort) to control my temper (see Child A, above). I still embarrassed myself repeatedly by blurting out the wrong thing at the wrong time, but at least the fights occurred less often.

Every school year started with me promising myself that I would do better. I promised to keep up with my classwork, and pay attention in class…but after a few weeks I was already lost and far enough behind that catching up was rarely an option.

Hurtful and embarrassing phrases directed at my “deficit” increased…from school and home. I became convinced that I wasn’t very bright. My friends were good students, but there must be something wrong with me. I often heard the dialogue in my head, “What were you thinking?” “You’re just lazy,” “You’re just not trying,” “Maybe you’re not really smart after all.” The phrases and lectures were, I’m sure, meant to encourage me, but instead they taught me that I was incompetent, incapable, and inept.

Somehow, and with a significant amount of help (and many mistakes), I got by. I even went to college and earned a teaching degree…and I only almost flunked out once.

During my teaching years I continued to question my ability and competence, despite receiving good reviews from principals and positive feedback from colleagues and administrators. After spending 20 years in general education classrooms, I moved into a position as a reading specialist. When offered the job I jumped at the chance. Here was an opportunity to help children who were struggling in class, like I did when I was their age.

As part of my work diagnosing learning problems, I began to learn about students with learning disabilities and ADHD. Reading about the struggles students had with reading and ADHD was like reading my own biography. Finally, after all that time (I was nearly 50), I began to understand the source of my own academic and social failures.

THE DANGER OF UNTREATED ADHD

I was fortunate. A few of the bullets below apply to me, but I have been able to get by in life with a bit of luck, hard – sometimes stressful – work, and most of all, the patience and help of family, friends, and professionals. Most people who have untreated ADHD are not so lucky.

When left untreated ADHD can

  • Lower educational attainment
  • Negatively impact employment

  • Increase interpersonal problems
  • Reduce earnings
  • Increase emergency room admissions
  • Result in greater healthcare utilization

People with untreated ADHD are

  • More likely to be divorced
  • More likely to suffer from anxiety
  • More likely to have traffic accidents
  • Twice as likely to smoke cigarettes
  • Six times more likely to suffer depression
  • Twice as likely to abuse drugs or alcohol
  • Four times more likely to have sexually transmitted diseases

Untreated ADHD: Lifelong Risks [emphasis added]

Children with ADHD who fare the best are those who have effective parents, are correctly diagnosed, and receive a combination of psychological, behavioral, educational, and pharmacological interventions. Yet even when treated, ADHD has a significant impact on an individual from childhood through adulthood.

When ADHD is left unmanaged, every area of life is negatively affected. In fact, research shows that untreated ADHD is one of the most highly impairing disorders to live with.

Kids, and adults, with ADHD are not just “normal kids being kids.” In order to be classified as a disorder it has to be beyond what is “normal” and have a significant impact on one’s ability to function in society. With appropriate treatment, however, children and adults with ADHD can thrive.

AHDH CHILDREN LEFT BEHIND

Two recent articles from ADDitude Magazine suggest that large numbers of children and adults are having trouble getting treatment, for two separate reasons.

First, children of color are not being identified as having ADHD at the same rate as white children when, in fact, the condition is present and consistent among all racial, ethnic, and economic groups.

Children Left Behind

Evidence shows that people of color — black and Latino in particular — are much less likely to be diagnosed with ADHD, even though they show symptoms at the same rate as white people. And if they are diagnosed, they aren’t as likely to receive treatment — even though many studies show that it can dramatically help kids and adults manage symptoms.

The reasons for the discrepancy based on race and ethnicity is complicated, but one factor is health insurance inequity. It’s clear that a significant number of children and adults with ADHD are “falling through the health care cracks” based on the fact that health insurance rates are lower for people of color. Children are struggling in school because of lack of diagnoses. Adults are struggling with job loss, relationship issues, substance abuse problems, and other symptoms of ADHD because of the inability to afford treatment.

The lack of insurance, coupled with diagnostic biases – assuming that “certain” kids are just “bad” or “uncivilized” instead of seeking a neurological source for misbehavior, the taboo of mental health issues, and fear of medication are all part of the problem.

Second, the lack of health insurance is not the only economic issue when it comes to affording medical care. Often insurance doesn’t cover the complete cost of treatment. ADHD diagnosis and treatment can cost thousands of dollars a year when one factors in medication, psychiatrists, and therapy. When health care dollars are short, an “invisible” diagnosis like ADHD has a tendency to get slighted.

ADDitude surveyed readers and found that people often found ways to work around the limitations of poor or non-existing health insurance. Sometimes this “working around” meant not getting needed treatment.

“We Can’t Afford to Treat Our ADHD”

A learning specialist in a private school, in New Orleans, tells a variation on this story. Both she and her two children have been diagnosed with ADHD, but her insurance plan pays only 60 percent of her family’s health expenses, making it impossible to pay for services like occupational therapy, speech, and behavior therapy for her two children. She estimates that she spent more than $5,400 out of pocket on medications and therapists in 2016.

In her job, she says, she often talks to wealthy parents “who come to me crying” about the high costs of paying for ADHD treatment, making her worried about the comparative pressures on parents with fewer resources.

Given the fact that untreated ADHD is so damaging, we can’t afford to ignore the consequences of this health issue.

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