2020 Medley #9: Hunkered Down at Home Edition

Dumping the tests, Some things don’t matter, Social Distancing, Focusing on students,
Beating Coronavirus Capitalism, Disasters

DUMPING THE TESTS IS A GREAT IDEA

Why Scrapping School Testing This Year Is a Good Idea

Before I retired, I had the difficult task of serving as one of my school’s co-test coordinators. It was my job to count, secure, distribute, secure, package up, secure, and prepare our state’s Big Standardized Test (h/t Curmudgucation) for shipping. Sadly, I have been trained in tests and measurements so I understood why, for so many years, the Big Standardized Tests were being overused and misused.

Now that the overuse and misuse of testing pendulum is, hopefully, swinging the other way, my fervent hope is that perhaps we can limit the damage done by the tests.

In the meantime, this year’s Big Standardized Tests are being canceled. Jersey Jazzman explains why that’s a good idea and in the process, also explains why the tests aren’t so good for students anyway. They are extremely accurate in assessing the economic status of students, but that’s about all.

Start with the obvious: a “standardized” test has to be administered in a standard way. If some students receive the test in different platforms, or in different environments, the test is no longer standardized. Of course, there were already huge differences between students in these factors… but Covid-19 has made things far worse. There’s just no way to even come close to standardizing the conditions for testing in the current environment. Will the students be at home, in school but “social distancing,” in regular school, somewhere else… we just can’t say.

Next, we have always had big differences in students’ opportunity to learn — but now the differences are greater than ever. Again, there are huge variations among students in their access to qualified educators, high-quality facilities, adequate instructional materials, well-designed curricula, and so on. The best use of test results was to make the case that the variation in these things was creating unequal educational opportunities, and that public policy should focus on getting resources where they were needed the most.

But in a quarantine, we now have to add all sorts of other inequalities into the mix: access to broadband, parents who have the ability to oversee students’ instruction, schools’ ability to implement distance learning, etc. Why implement these tests when inequities within the same classroom — let alone between schools — have grown so large?

PUTTING THINGS IN PERSPECTIVE

Dear Teachers: There Are Many Things That No Longer Matter

A pandemic puts things in perspective. The health and safety of our students, and their families, are more important than the tests.

If you are attempting virtual learning with your students, now is the time to teach what you have always recognized are the crucial topics in your curriculum. Throw out the state requirements and embrace your professional decision-making skills. The state requirements do not matter. There will be no formal observations. No one will give you some annual professional performance review (APPR). We have known all along that those measures are bullshit. I am continuing to cover the most important content, but I am also asking my students to act as historians through recording a daily diary of this extraordinary time. This time will shape them forever, and we are their guardians.

TOP 10 THINGS TO DO WHILE SOCIAL DISTANCING

Top 10 Things I Want My Students to do During the Coronavirus Quarantine

Steven Singer, who blogs at Gadfly on the Wall Blog, lets his students know that there are things to do during “social distancing.” The first is to read a book. For those without access to books, there are the library apps Libby and Hoopla to get digital books.

He wisely includes writing, immediately after reading. Reading and writing are reciprocal. “Reading is the inhale; writing is the exhale.”

2) Read a Book

I ask all of my students to have a self-selected book handy for sustained silent reading in class. Hopefully, you brought it home. If not, take a look around the house. Maybe you’ve got a dusty tome hanging out in some corner. Or – hey – if you have Internet access, you probably have the ability to get an ebook.

Read something – anything you want.

It will while away the hours, relax you and maybe get your mind to thinking about things above and beyond how much mac and cheese you’ve got stored in the cupboard.

3) Keep a Journal

Do you realize you’re living through a moment of history? People will look back on this and wonder how people got through it. You could fill in the blanks for some future researcher. Just a description of your everyday activities, what you’re thinking and feeling, your hopes and dreams – all of it has historical value. Plus, you’ll get some practice expressing yourself in writing. And just think – a simple story about how you survived the great toilet paper shortage of 2020 could end up being taught in the classrooms of the future!

Make it a good one!

IT’S ALL ABOUT THE STUDENTS

Our Students Need Us Now More Than Ever

Are you keeping in touch with your students during this extended coronviracation? You should.

If anything, we teachers and support personnel are needed now more than ever.

Close a school for a while and the community instantly feels the effects. Shut them down across the state and everybody has to adjust.

Our students look to us for guidance, direction, assistance, validation, answers, and the ability to use voice. Nothing has changed in that respect.

Educators advocate for students and schools. Nothing has changed in that respect.

We collaborate with each other and remove obstacles for our students. Nothing has changed in that respect.

We will adapt. We will overcome this obstacle. No one adapts to situations and change like we do.

Because it’s all about the students.

BEATING CORONAVIRUS CAPITALISM

Coronavirus Capitalism — and How to Beat It

Last week, in my post, Public Education, Disaster Capitalism, and COVID-19 (expanded into an op-ed in our local paper here), I discussed how “edupreneurs” will be likely to swoop in and take advantage of public education to further their dreams of privatization. I quoted author Naomi Klein from her book, The Shock Doctrine: The Rise of Disaster Capitalism. Today, I saw this post by Ms. Klein talking about the exact same thing.

The COVID-19 disaster is exactly the sort of disaster that disaster capitalists exploit. Klein wrote…

This crisis — like earlier ones — could well be the catalyst to shower aid on the wealthiest interests in society, including those most responsible for our current vulnerabilities, while offering next to nothing to the most workers, wiping out small family savings and shuttering small businesses. But as this video shows, many are already pushing back — and that story hasn’t been written yet.

DISASTER UPON DISASTER

Midwest Girds for Floods While under Corona Lockdown

While we’re worrying about COVID-19, we can’t forget that the Earth is still reacting to human-induced climate change.

As an upsurge in coronavirus infections stretches thin the capacity of health care workers and emergency managers nationwide, the Midwest is bracing for another battle: a potentially devastating flood season.

😷🚑🩺

2020 Medley #8: Public Education, Disaster Capitalism, and COVID-19

UPDATE: A version of this blog entry appears in the Friday, March 20 edition of the Fort Wayne Journal Gazette, titled: Coping in the time of COVID

DISASTER

Naomi Klein, in her book The Shock Doctrine: The Rise of Disaster Capitalism, described how natural and man-made disasters open the door to privatization. During the COVID-19 disaster, we must ensure that the same thing doesn’t happen to public education.

Schools have been starved over the last few decades. The lack of funding for public education, and other public institutions and public infrastructure, have opened up schools to vulnerability under the Shock Doctrine. Klein wrote…

When it comes to paying contractors, the sky is the limit; when it comes to financing the basic functions of the state, the coffers are empty.

and…

The American Society of Civil Engineers said in 2007 that the U.S. had fallen so far behind in maintaining its public infrastructure — roads, bridges, schools, dams — that it would take more than a trillion and half dollars over five years to bring it back up to standard. Instead, these types of expenditures are being cut back. At the same time, public infrastructure around the world is facing unprecedented stress, with hurricanes, cyclones, floods and forest fires all increasing in frequency and intensity. It’s easy to imagine a future in which growing numbers of cities have their frail and long-neglected infrastructures knocked out by disasters and then are left to rot, their core services never repaired or rehabilitated. The well-off, meanwhile, will withdraw into gated communities, their needs met by privatized providers.

COVID-19

As of this writing, schools are closed for more than half of America’s children. But, as we’ve discussed in these blogs over the last fourteen years, public schools, and public school teachers, are about more than academics.

Teachers care about their students. Friends of Betsy DeVos may think that we’re only in it for the money, but public school teachers care about the whole child…and as Nancy Flanagan writes below, teachers are First Responders when it comes to taking care of the nation’s children.

The following articles describe what public school teachers and public schools are doing to help children and their parents thrive during this stressful time. I recommend that you read all of them in their entirety…

ED-TECH

HEWN (Hack Education Weekly Newsletter), No. 344

Ed-tech is ready to dump their items on schools (for a price, of course)…especially now when those schools that have closed are using technology to connect with their students. Remember that computers, phones, iPads, and similar digital devices are tools, not ends in themselves.

…an assertion that rests on the assumption that ed-tech is good, that it can replicate at home what happens in the classroom. “This may be our moment,” ed-tech folks exclaim, giddily sharing lists of their favorite digital learning tools (with little concern, it seems for questions of accessibility, privacy, or security) and tips for quickly moving “to the cloud.” Of course, education technology — as a field, an industry, a discipline, a solution, what have you — has had decades and decades and decades to get this right. It still hasn’t. So when you hear “this is our moment,” you should recall perhaps the thesis of Naomi Klein’s The Shock Doctrine. What we’re poised to see in response to the coronavirus — and not just in education, to be fair — is more disaster capitalism, and “disaster capitalists share this same inability to distinguish between creation and destruction, between hurting and healing.”

TEACHERS AND SCHOOLS STEP UP

Coronavirus Has Shown Us the Vital Role Schools Play, But Will America Listen?

Schools feed and house (and sometimes clothe) students every day. Those students who have little or no home resources will suffer most from the lack of open school buildings.

The coronavirus pandemic has laid bare something that educators have always known. Schools, side by side with hospitals, are the most important institutions in our country’s social safety net. Of course, we’ve said this since the era of school shootings, where teachers have placed their bodies (literally) in front of students to keep them safe.

But the coronavirus pandemic has put this into even sharper focus, as we grapple with the domino effects of closing entire school districts for prolonged periods at a time. Some public schools will be closed anywhere from a day to a month. Yet, others, such as the New York City system, are still, at this writing, open.

Thus far, dealing with the coronavirus has highlighted four important things about our nation’s schools:

Schools are key to keeping the economy running…
Schools provide respite housing for homeless students during daytime hours…
Schools help to prevent large-scale child hunger every day…
Schools are the primary source of public health information for many families.

Once Again Teachers are First Responders

Schools and teachers have stepped up to help their students.

…Teachers are like those firefighters in Kirkland, Washington who came to transport extremely ill nursing home residents to the hospital, without gloves and masks. Just doing our jobs, just following directions.

Thank you to the hundreds of thousands of teachers who organized take-home packets and figured out how to get coursework online, even if they didn’t have a clue about how to do it before last week. And thank you to those who pointed out, with considerable asperity, how incredibly inequitable virtual instruction will be, but went ahead and made plans to do it anyway. Thanks to all who sent home food or arranged for food pickup—or even made a single call to a single household, to make sure an adult was home.

Nobody knows how to do this well. Nobody. But schools and teachers are still trying.

Disaster Capitalism, Online Instruction, and What Covid-19 Is Teaching Us About Public Schools and Teachers

Nancy Bailey’s blog entry was the catalyst for this post.

We’re reminded of disaster capitalism, a concept highlighted by Naomi Klein in The Shock Doctrine: The Rise of Disaster Capitalism, how Katrina was used in New Orleans to convert traditional public schools to charter schools. Within nineteen months, with most of the city’s poor residents still in exile, New Orleans’ public school system had been almost completely replaced by privately run charter schools. (p. 5-6). Who thought that could happen?

The transitioning of technology into public schools, not simply as a supplemental tool for teachers to use at their discretion, but as a transformative means to remove teachers from the equation, has been highlighted with groups like Digital Promise and KnowledgeWorks. Both promote online learning and it’s difficult to find teachers in the mix.

Combining this with the intentional defunding of public schools, shoddy treatment of teachers including the unwillingness to pay them appropriate salaries, inadequate resources and support staff, crumbling buildings, and the destruction of public schooling in America, should we not question what placing students online at this strange time will mean in the future to our schools?

👩‍🏫🏘🧑🏽‍🏫

2020 Medley #7

Poverty, COVID-19 and school, Testing,
Online instruction, Charters = risky business, Undermining religious liberty,
Talking to students about race

IT’S STILL POVERTY

We have a learning crisis but it’s not about the kids

We know that student achievement is based largely on out of school factors yet we continue to try to “fix” the schools. Changing curriculum, blaming schools or teachers, privatizing, or overtesting won’t solve the problem of low student achievement. The main link to low school achievement is poverty.

About a fifth of American students live in poverty (the same as child poverty in Indiana) and millions of those children live in food-insecure households.

As long as we, as a nation, refuse to address the growing inequality among our students, we’ll continue to have high child poverty levels. Since high poverty correlates with low school achievement, we’ll continue to have a large number of our students who fail to achieve.

World-class education nations don’t do what seems to be our main strategy: Insist schools compete against one another, use toxic accountability measures to control and measure what schools do, and hold teachers as scapegoats for plunged education rankings…

Half a century of systematic research has shown that teachers account for about 10 to 15 per cent of the variability in students’ test scores. A similar amount of variability is associated with other school factors, such as curriculum, resources and leadership. This means that most of the influence on students’ educational achievement lies outside school — in homes, communities, peer groups and students’ individual characteristics.

Make no mistake, teachers are the most influential part of school. We should stop thinking that teachers have the power to overcome all those inequalities that many children bring to school with them every day.

Schools Alone Cannot Save Children from Economic Inequality. Public Policy Must Assist Families in Deep Poverty

Public policy can ameliorate child poverty without being revolutionary. However, programs need to be redesigned and targeted to alleviate instability, privation and misery for the more than 2 million children living in America’s poorest families. Child poverty overall was reduced in the decade between 1995 and 2005, but during that same period, the number children living in the deepest poverty rose from 2.2 to 2.6 million children. These are the conclusions of a new report from the Center on Budget and Policy Priorities.

The Center on Budget and Policy Priorities (CBPP) defines deep poverty as families living below half of the federal poverty level—below $14,000 per year for a family of four. Who are these children? “Children living in deep poverty are a diverse group…. In 2016, 37 percent were white, 30 percent were Latino, 23 percent were Black, and 6 percent were Asian; 45 percent lived in suburban areas, 32 percent in urban areas, and 11 percent in rural areas; 51 percent lived in a single-mother family, 37 percent in a married-couple family, and 6 percent in a single-father family; 16 percent lived in a family where someone had a work-limiting disability; and 89 percent were U.S. citizens and 31 percent lived in a family with a non-citizen.”

A TEACHABLE MOMENT?

Listen to Trusted Expert Advice: Coronavirus, Schools, Fear, and an Uncertain Future

Children all over the country are getting an unplanned vacation from school because of COVID-19. Their schools are moving to “virtual instruction” (more on that below). The virus seems to be the perfect “teachable moment” as explained by Ed in the Apple. Students who are still in school could also benefit.

I was speaking with a school supervisor yesterday: he was teaching a kindergarten class: how to wash their hands. The lessons should be replicated in all classrooms across the city.

Science lessons, by grade, should explain what a virus is; English classes should be reading non-fiction about viruses and epidemics.

When I mentioned this I was told, “We don’t want to unduly scare children.” Knowledge is power: the more we involve the children, teach children, we all know that the “teachable moment” is at the heart of impactful instruction.

STANDARDIZED TESTS — A LOW PRIORITY

Public Schools Can Recover from the COVID-19 Quarantine by Skipping High Stakes Tests

What should schools do when they come back from the forced COVID-19 layoff? Skip the test!

First, debrief your students. They will all have stories to tell about how their family survived, who got sick, who might still be sick, what they did to amuse themselves, and how they coped.

Then, get back to the curriculum. We should not waste time on tests. Remember that the greatest impact on a child’s standardized test is what happens outside of school (see also We have a learning crisis but it’s not about the kids, elsewhere in this Medley).

The question remains – what do we do when we get back to class?

We could extend the school year, but families have vacations planned and other obligations. This wouldn’t solve much and frankly I don’t think it will happen unless we’re out for longer than expected.

I anticipate being back in school by mid April or so. That would leave about a month and a half left in the year.

This really leaves us with only two options: (1) hold our end of the year standardized tests and then fit in whatever else we can, or (2) forgo the tests and teach the curriculum.

If we have the tests, we could hold them shortly after school is back in session. That at least would give us more time to teach, but it would reduce the quality of the test scores. Kids wouldn’t be as prepared and the results would be used to further dismantle the public school network.

Much better I think is option two: skip the tests altogether.

How Can K-12 Schools Make Up Time Lost To The Coronavirus? Scrap High Stakes Testing.

There will simply be no way to know how much of this year’s test data is the result of coronavirus disruption. They will be a waste of time.

So don’t give them.

Schools can not only recoup the time lost for giving the tests, but all the time spent preparing for the tests (plus, in some cases, all the time spent on zippy test pep rallies).

Cut the test. Reclaim the instructional time and use it to patch the holes that the coronavirus is going to blow in the school’s curriculum. It’s not a perfect solution, but it makes far more sense than wasting a bunch of time and money on a meaningless standardized test.

ONLINE INSTRUCTION

Ohio’s Charter School War fails us when we could really use them.

If online charters are worthy of education dollars from the state, shouldn’t they be taking the lead in teaching students “laid-off” from school during the COVID-19 crisis? This article is specifically about Ohio but is appropriate for any state with public money going to online charter schools.

With all this COVID-19 talk, every Ohio Public School District is planning to move to online instruction through the end of the year. While that seems like a heavy lift, it really shouldn’t be. Why?

Because no state has more students already attending virtual schools than Ohio.

Yet in no instance has the Ohio Department of Education or any school district — despite this emergency crisis — said, “Hey, we have a lot of online schools already, why don’t we ask them for help?”

CHARTERS — A BAD RISK

Credit Ratings Agency: U.S. charter school sector “inherently risky and volatile”

Will higher risk relieve us of the charter school scourge which diverts public funds from real public schools?

5) National: Standard & Poor’s has issued an assessment of the charter school sector’s creditworthiness as part of an overview of public finance. “The charter school sector is inherently risky and volatile, relative to other public finance sectors, as reflected in our ratings distribution, and charter nonrenewal or revocations can affect credit quality swiftly. However, despite these intrinsic risks, the majority—82%—of S&P Global Ratings’ ratings in the sector carried stable outlooks as of Dec. 31, 2019. While the sector is facing increasing political support for stricter charter laws or oversight in some states, federal government support for school choice remains strong, per-pupil funding is generally stable to growing, and demand for charter schools continues to grow. From a financing standpoint, charter schools’ opportunities and options have expanded and interest rates remain low…

“Our rated universe increasingly reflects more established charter schools, which generally have completed several successful charter renewals, maintain steady academics, and experience less credit volatility than newer schools. While there are inherent credit risks that can affect schools throughout the year, such as failure to meet authorizer standards, charter nonrenewal due to factors such as academics, or enrollment shortfalls, we believe the sector’s outlook for 2020 will continue being stable due to continued demand and growing per-pupil funding levels. However, should charter law and policy changes of significant impact occur in states where we hold a large number of ratings, or some of the broader risks (such as a slowing national economy or recession) transpire during this calendar year, charter schools could face more credit stress.” [Registration required]

VOUCHER PROGRAMS UNDERMINE RELIGIOUS LIBERTY

School Voucher Programs Undermine Religious Liberty, Misuse Taxpayer Funds

The following is from the Baptist Joint Committee for Religious Liberty. Vouchers aren’t good for anyone…

Yes, “choice” sounds like it is associated with “freedom,” but by funneling government funds to religious schools, vouchers actually undermine the religious freedom of both the taxpayer and the religious institution receiving the payment.

Not only do vouchers force taxpayers to support religious education they might disagree with, they also threaten religious autonomy by attaching government regulations that may compromise the religious mission of the school. Once dependent on voucher funds for its success, a church-based school can be even further pushed toward gaining favor with government regulators.

In other words, government neutrality toward religion is good for the state and good for religion.

TALK TO WHITE KIDS ABOUT RACE

White Fragility in Students

We should talk to all our students about race in America.

In our interviews with young people around the country for our Teaching While White podcast, we have seen firsthand an inability among white students to talk about race without exhibiting racial stress. We hear white children as young as nine years old express anxiety about being white and what they think that means. Often these white students, who mind you have volunteered to be interviewed, feel ill equipped and sometimes unable to engage in racial conversations. It seems that we are successfully raising the next generation of white people who, like too many in the current generation of adults, feel afraid and reluctant to talk about race.

There is a common cultural myth that racism is diminishing among youth today. In reality, not only are white students not talking about race, but incidents of blatant individual acts of racism are currently on the rise. According to the Southern Poverty Law Center (SPLC), there has been a surge in reports of hate and bias in schools in the last three years. Racism appears to be the motivation behind a high percentage of these hate and bias incidents, accounting for 63% of incidents reported in the news and 33% of incidents reported by teachers in the SPLC survey. School responses to this uptick in racialized incidents has been disappointing. More than two-thirds of the educators SPLC surveyed had witnessed a hate or bias incident in their school. According to the report, “most of the hate and bias incidents witnessed by educators were not addressed by school leaders. No one was disciplined in 57% of them. Nine times out of 10, administrators failed to denounce the bias or to reaffirm school values.”

👧🏾🚌👦🏻

Listen to the Experts

FIGHTING THE INSURANCE COMPANY

Remember that time you called your health insurance company because they denied your claim…

You probably thought, “why should an insurance company representative deny or attempt to deny coverage for something prescribed by my family doctor? What expertise do insurance company workers have in the field of medicine?”

A recent article in the Washington Post by Dr. William E. Bennett Jr., associate professor of pediatrics at Indiana University’s School of Medicine, highlights part of the problem…

Insurance companies aren’t doctors. So why do we keep letting them practice medicine?

We know how important it is to have insurance so that we can get health care. As a physician, parent and patient, I cannot overemphasize that having insurance is not enough.

As a gastroenterologist, I often prescribe expensive medications or tests for my patients. But for insurance companies to cover those treatments, I must submit a “prior authorization” to the companies, and it can take days or weeks to hear back. If the insurance company denies coverage, which occurs frequently, I have the option of setting up a special type of physician-to-physician appeal called a “peer-to-peer.”

Here’s the thing: After a few minutes of pleasant chat with a doctor or pharmacist working for the insurance company, they almost always approve coverage and give me an approval number. There’s almost never a back-and-forth discussion; it’s just me saying a few key words to make sure the denial is reversed.

Because it ends up with the desired outcome, you might think this is reasonable. It’s not. On most occasions the “peer” reviewer is unqualified to make an assessment about the specific services. They usually have minimal or incorrect information about the patient. Not one has examined or spoken with the patient, as I have. None of them have a long-term relationship with the patient and family, as I have.

In other words, according to Dr. Bennett, doctors should be the ones to make medical decisions…not some distant bureaucrat in an insurance office. What a concept!

EXPERTS

It would seem, then, that those with expertise in an area ought to be the ones we listen to…and that’s true in all areas, not just medicine.

For example, it makes sense for us to pay attention to actual climate experts when discussing the problems associated with climate change…instead of a former insurance executive who threw a snowball in the Senate chamber as “proof” that there was no such thing as global warming, or a reality television star who decided that climate change was a hoax created by the “Chinese in order to make U.S. manufacturing non-competitive.”

We need people with expert knowledge to help us understand and deal with things we don’t know or don’t have experience in. In his 2017 book titled The Death of Expertise: The Campaign Against Established Knowledge and Why it Matters, Tom Nichols wrote,

…experts will make mistakes, but they are far less likely to make mistakes than a layperson. This is a crucial distinction between experts and everyone else, in that experts know better than anyone the pitfalls of their own profession.

We regularly listen to people with expertise in an area because it’s impossible for one person to know everything. Even within fields we sometimes have to go to specialists.

We go to cardiologists when we have heart disease, dentists to repair or replace damaged teeth, and ophthalmologists when we need cataract surgery.

If you’re accused of tax fraud you should find a tax attorney. If you’re accused of a crime you should find a criminal lawyer.

We rely on plumbers, electricians, engineers, and mechanics to take care of our plumbing, electrical, structural and automotive needs because it’s impossible for one person to know everything.

It just makes sense.

K-12 EDUCATION

It makes sense for the field of education, too. Who should you seek out if your child is struggling with reading? or middle school math? or high school English?

Who should you ask if you want to know what is going on in public schools in your town, city, or state? Who can tell you about the value (or lack thereof) of standardized tests, third-grade retention tests, and curriculum development? Who can you go to for help with your child with special needs? Where can you learn about the impact a lack of resources has on your child’s classroom?

Who are the experts in public education?

A. A college drop-out who grew a tech company into a $100 billion net worth and spends millions of dollars experimenting with education.

B. A political appointee and basketball buddy whose only education experience was watching his mother teach.

C. A billionaire who never attended a public school, never sent their children to public schools, and never worked in a public school, but contributed to the campaigns of state legislators, US Senators, and Presidents.

D. Politicians, pundits or policymakers who were lawyers, florists, political science majors, auctioneers, accountants, or college graduates with various non-education degrees.

E. Your child’s teachers.

Rely on those who have been trained and have experience. Ask the experts.

🎓🚌🎓

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.

👨‍🎓📿💊