Student Services
Resources - Articles
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I feel it is important to respond to statements in the article written on ADHD in Spectrum’s December issue. Here are the facts:
Attention Deficit Hyperactivity Disorder is only 1 term with many subtypes. The core symptoms of ADHD are easy to remember if you follow the acronym HID - Hyperactivity, Inattention, Distractibility.
The 3 (common) subtypes of ADHD are:
1) Predominantly Attentive type, which includes:
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| | Ex: Fidgets with hands or feet; often leaves seat in classroom or in other situations in which remaining seated is expected.
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| | Ex: Often “on the go” or often acts if “driven by a motor”.
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| | Ex: Often blurts out answers before questions have been completed. Often interrupts or intrudes on others. Does not stop and think. (DSM IV Rating Scale)
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Referrals for testing usually made for behavior. The symptoms are present in 2 or more settings (home, school, activities), and some symptoms are present before the age of seven. (DSM IV Rating Scale)
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2) Predominantly Inattentive type, which includes a mixture of problems with sustained attention/focus, organization, test performance consistency, and completion of projects & homework. Referrals usually made for poor grades, not behavior. Ex: Difficulty sustaining attention while listening or reading, taking tests. Not seeming to listen when spoken to. Not following through on instructions. Failure to begin or finish schoolwork, chores. Difficulty organizing tasks/activities. Losing things necessary for tasks/activities. Easily distracted by outside stimuli. (DSM IV Rating Scale)
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3) Combined type, which includes hyperactivity/impulsivity along with problems of concentration/focus.
Without this information many assume that all students with ADHD are hyper- active. The Inattentive type is less common than the Attentive or Combined types. It is the most difficult to diagnose because Inattentive type symptoms mimic the same symptoms associated with thyroid condition (medical), emotional issues such as, anxiety & depression, and specific learning disabilities. How- ever, sometimes one of these may be diagnosed along with ADHD. Because of this complexity, students do not walk into a doctor’s office for a 20 minute consultation and get meds. In fact, there is no one definitive measure (test) for ADHD. An evaluation for ADHD is an extensive process which includes:
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- A physical exam to rule out any medical condition.
- Parent, Student Interview
- Teacher Observations
- Rating scales completed by student, parent, and teachers. (Rating scales list symptoms most often associated with ADHD according to current diagnostic guidelines).
- Test of Variables of Attention (T.O.V.A.) A computer based continuous performance test, which evaluates the consistency of sustained attention.
- Tests of Cognitive Ability & Achievement - 5+ hours.
- Follow up sessions
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This evaluation occurs after several years of frustration that the student encountered at home and in the school setting. ADHD is a disorder of inconsistencies, not inability. The inconsistency of performance over time is the problem... a failure to perform to one’s ability, often falling into one of these categories.
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- Strong test grades but low homework grades because of missing and late assignments.
- Strong homework and class work, studies hard but poor test grades.
- Completes homework but loses homework or forgets to turn in.
- Strong verbal expression but cannot get his/ her thoughts on paper.
- Says “I understand” then seems to have not truly understood because of his/her actions.
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Since all of us have learning differences we have struggled with from time to time we feel free to express our opinion and the ADHD student is often labeled as “underachiever”, “lazy”, “rebellious”. Also, we offer well-meaning advice, “If you just try harder”......”If you put your mind to it”, etc. However, all of us do not have learning disabilities or ADHD, a valid neurobiological disorder, often referred to as the “Hidden Disability” which requires: 1) Cognitive training - encouragement coaching, learning & study strategies, learning tools , sometimes in combination with 2) Medical intervention (medication), and 3) Documentation for accommodations in school. Accommodations are interventions and strategies implemented in a school setting which enable a student with ADHD to perform at a level equal to others. Extended time is one of the accommodations for, as Erin Adams (US counselor) stated, “Leveling the playing field”. The purpose is to help students’ perform in line with their abilities, not as an advantage over other students. Dr. Susan Storti (Learning & Language Specialist) compares this to a person who wears glasses for nearsightness. Is this fair to normal sighted students? Again, this is another example of leveling the playing field so the student can perform to his/her ability.
ADHD has always been with us, but only in the last few years with current brain research have we made real progress in our ability to diagnose and treat it appropriately. As a community we need to continue our efforts in recognizing ADHD as a valid diagnosis. These diagnoses will enable us to help students achieve their potential in our school setting. We can do this if we just try harder.
Marilyn Marn
Learning Specialist
Upper School
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