Academic Remediation

ADHD Goes to School

Mark Bertin, M.D.: ADHD Goes to School.

Executive Function and Educational Policy 

Many educational choices today put children with ADHD at a further disadvantage. From classroom design to curriculum, schools place huge demands on executive function. These skewed expectations often start in kindergarten, with academic tasks assigned far beyond the development level of an average 5-year-old. Fourth grade classrooms frequently require what used to be a sixth grade level of self-regulation and planning. For a child with ADHD, already years behind peers in this area of development, the gap grows between what is expected and their actual skills. 

Children with ADHD benefit from smaller, well-structured classrooms. Classes over the last generation have grown larger, with twenty-five or more students and one adult. Layout is often in desk clusters, with children sitting in a circle. And yet, it is intuitive that it is easier to attend when directly facing the teacher, without your best friend at your elbow and another across the way. Desk clusters lead to distractibility and off-task behaviors. Smaller classrooms that minimize distraction go a long way to helping children with ADHD, as well as all students. 

ADHD related deficits directly impair learning, separate from classroom focus or misbehavior. Children fall behind in reading as it requires attention to details, working memory to keep track of information, efficient processing of information and countless other aspects of executive function. One study suggested half of kids with ADHD have writing disabilities; the capacity to organize information and get it onto the page relies heavily on executive functioning. Math is the same, with careless mistakes rampant and multiple executive-function driven steps inherent to solving any problem.

Four Things Teachers Need to Know about Dyslexics

Dyslexics Struggle with Automated Processes

To cope with the multitudinous series of thoughts and actions that the brain coordinates every day, humans complete simple tasks on a subconscious, automatic level. For example, a non-dyslexic may pick up a sock and know instantly that it should be put in the sock drawer, or drive to work without thinking about how to turn the steering wheel. For dyslexics, however, these automatic processes can be more difficult due to poor memory recall. This may explain why dyslexics' bedrooms are often particularly messy!

A good way to help dyslexics improve their ability to complete simple processes more quickly is to encourage them to create models, such as "SLUR" (Socks Left-Drawer Underwear Right-Drawer) and "I before E except after C." Models can be created for anything from writing a paragraph (AXE: Argument, Explain, Evaluate) to remembering to pack essentials into an overnight bag (DTGMAP: Deodorant, Toothpaste, Glasses, Makeup and Pajamas).

Attention Research Updates: August 2003

Attention Research Updates: August 2003.

Concerns about Stigma Undermine Adolescents' Treatment for ADHD 

 Because ADHD frequently persists into adolescence, and continues to undermine teens' academic and social functioning, most adolescents continue to need treatment.  However, as issues of self-direction and autonomy become more important for teens, resistance to treatment for ADHD - medication or otherwise - frequently intensifies and many adolescents stop treatment prematurely.  This is a challenge that many parents struggle with. 

It is thus important to understand the factors - particularly adolescents' perspectives on treatment - that affect the receipt of ADHD treatment during this critical developmental period.  Examining this issue was the focus of a study published recently in the Journal of Adolescent Health [Bussing et al (2011). Receiving treatment for Attention-Deficit Hyperactivity Disorder: Do the perspectives of adolescents matter.  Journal of Adolescent Health, 49, 7-14.] 

Participants were 168 adolescents - about 50% female - and their parents recruited through a public school system in the US.  These adolescents screened positive for ADHD in elementary school and were contacted 6 years later for a follow-up assessment.  At follow-up, over 60% continued to meet full diagnostic criteria for ADHD and many others still had elevated levels of ADHD symptoms. The researchers were interested in how many adolescents had received ADHD treatment in the past year and the parent and child characteristics that predicted the receipt of treatment.

Attention Research Updates: Daily Distress in Mothers of ADHD

Attention Research Updates: 

Daily Distress in Moms of Children with ADHD 

Parents of children with ADHD have been found to experience elevated levels of parenting stress and distress in multiple studies.  This is not surprising given the greater challenges associated with raising a child who consistently exhibits high levels of ADHD symptoms.  

 Studies of child ADHD and parenting stress have typically relied on global and static measures of both children's behavioral problems, e.g., having parents complete rating scales and parents' reports of stress/distress.  Correlating these reports provides useful information on how children's ADHD symptoms relate to parents' average distress level, but say little about the moment-to-moment fluctuations in parents' stress that may occur in response to fluctuations in their child's behavior. This dynamic aspect of the parent child relationship can only be captured by relating parents' stress to children's behavior as it occurs in real time.

Attention Research Updates: August 2003

The author is David Rabiner.  If you or a loved one are affected by attentional difficulties, diagnosed or not, you should sign up for his newsletter, Attention Research Update.

Attention Research Updates: August 2003.

New Review of Neurofeedback Treatment for ADHD - Current State of the Science Neurofeedback - also known as EEG Biofeedback - is an approach for treating ADHD in which individuals are provided real-time feedback on their brainwave activity and taught to alter their typical EEG pattern to one that is consistent with a focused and attentive state.  According to neurofeedback proponents, this often results in improved attention and reduced hyperactive/impulsive behavior. Several years ago I summarized the scientific support for neurofeedback treatment - see http://www.helpforadd.com/2007/september.htm - and noted that although positive findings had been reported in multiple published studies, limitations of these studies led many researchers to regard neurofeedback as a promising, but unproven treatment.

Study: 'Daily Report Cards' Improve Behavior of Students With ADHD - On Special Education - Education Week

Study: 'Daily Report Cards' Improve Behavior of Students With ADHD - On Special Education - Education Week.

Getting report cards once every six, eight, or 10 weeks is probably too often for some students. How about every day? 

So-called "daily report cards" appear to improve the behavior of students with ADHD, a new What Works Clearinghouse review of a study concludes. 

Teachers create daily report cards that are lists of target behaviors and behavior goals for students that are aligned with their special education plans. Teachers in this 2010 study used them to provide students with constant feedback, and they were sent home to parents every day. Parents had to reward or punish students based on the results of the daily report card. 

The study, involving 63 elementary school students, found there were statistically significant positive differences between students whose teachers used the daily report cards and another group of students, at least when it came to students' behavior. That included improvements in their productivity and violating fewer classroom rules. The report cards didn't have a statistically significant effect on students' achievement in reading or math.

AAP: Guideline Calls for Pre-K ADHD Evaluation - in Meeting Coverage, AAP from MedPage Today

Medical News: AAP: Guideline Calls for Pre-K ADHD Evaluation - in Meeting Coverage, AAP from MedPage Today.

BOSTON -- Primary care physicians should begin evaluating children for attention deficit hyperactivity disorder (ADHD) at age 4 and continue through age 18, according to a new clinical guideline from the American Academy of Pediatrics.

An accumulation of evidence in recent years has enabled diagnosis and management of ADHD in a broader pediatric population. Earlier versions of the guidelines covered children ages 6 to 12. "

There was enough evidence that we could feel comfortable about the criteria being appropriate for preschoolers and that the process for making the diagnosis was similar enough to what primary care physicians were doing with the elementary school-age children that it would be appropriate to recommend their diagnosing to four years of age," said Mark Wolraich, MD, of the University of Oklahoma in Oklahoma City, and chair of the writing committee for the updated guideline.

A similar accumulation of evidence led to expansion of the age range to 18, he added.

Consistent with the broader age range, the guideline addresses clinical issues specific to preschoolers, adolescents, and teenagers.

[more at the link above]

Why Do Some People Dismiss ADHD? | Child Mind Institute

Why Do Some People Dismiss ADHD? | Child Mind Institute.

It's not a stretch to say that most people who deny that these are real issues are not the parents of these kids, who are seriously impaired in many if not all aspects of their lives—in their homes, their schools and their communities.

But even parents themselves sometimes have trouble accepting a diagnosis of ADHD, for a different reason. When I probe, I find that it isn't really the diagnosis they resist—they see the problem behaviors very clearly—rather the possibility of medication being recommended as part of their treatment. They don't want to "drug" or be seen as "drugging" their children. The popular misconception that doctors are peddling scrips to normally developing kids has the effect of stigmatizing the diagnosis, even to the extent that parents who understand their child is suffering with a problem will avoid diagnosis and the treatment it allows.

When parents of a child who has ADHD say to me, essentially, "I'm afraid of the diagnosis," I urge them to see that NOT treating their child's ADHD is the thing they should be afraid of. What's important is to agree that ADHD behaviors are causing impairment, and to help the child before the disorder severely undermines his success in school, his friendships, his relationship with his family, and his sense of who he is and what he can accomplish.

2011: ADHD Treatments Reviewed | Suite101.com

2011: ADHD Treatments Reviewed | Suite101.com.

Researchers at Brown and Duke Universities collaborated in an upcoming ADHD article. They reviewed over 200 prior studies and weighed in on ADHD treatments.

Parents and researchers will find a useful summary of numerous ADHD treatments and research is coming out in the August 2011 issue of Pharmacology, Biochemistry, and Behavior. If you are a parent and/or researcher for ADHD, this article is chockfull of information and the reference list is golden, covering over 200 academic and professional sources.

In order to understand and treat ADHD, researchers emphasize the importance of understanding what parts of the brain and thinking processes are involved. The article walks through the definition of the cognitive or brain thinking activities associated with ADHD. They weigh in on several types of FDA-approved medicines being used, several non-FDA approved agents or substances that have been tried, and some alternative non-drug intervention methods.

Read more at Suite101: 2011: ADHD Treatments Reviewed | Suite101.com http://www.suite101.com/content/2011-adhd-treatments-reviewed-a379502#ixzz1S1NvlLFy

ADHD Diagnosis, Treatment Differ Across the Globe

ADHD Diagnosis, Treatment Differ Across the Globe.

In Israel, highly active children are well tolerated in the classroom, making it difficult to distinguish high activity from attention-deficit/hyperactivity disorder (ADHD) manifestation. In Brazil, light physical punishment is considered by a large number of teachers to be “therapeutic,” and physical exercise is considered a viable alternative to medication for children with ADHD. In Canada, health professionals view ADHD as an impairing, often lifelong disorder that requires careful assessment and multimodal intervention.

These are just a few of the insights that came out of a meeting of 18 international leaders in developmental psychopathology research who met in Berkeley, Calif., in March 2010. The members represented nine countries—Australia, Brazil, Canada, China, Germany, Israel, the Netherlands, the United Kingdom, and the United States—all specifically selected because they were known to have either low or high rates of diagnosis and treatment of youth with ADHD. The group published a report in the May Psychiatric Services.

The Changing Epidemiology of ADHD: Data From the National Survey of Children's Health 2007

The Changing Epidemiology of ADHD: Data From the National Survey of Children's Health 2007.

The results of the second administration of the 2007 National Survey of Children's Health (NSCH) have been reported in the Morbidity and Mortality Weekly Report.[1] The report documented an almost 22% increase in the percentage of children 4-17 years of age with a parent-reported diagnosis of attention-deficit/hyperactivity disorder (ADHD). These findings illustrate the substantial impact of ADHD on both families and pediatric providers. Laurie Scudder, DNP, NP, of Medscape sat down with Susanna Visser, MS, Lead Epidemiologist, National Center on Birth Defects and Developmental Disabilities, US Centers for Disease Control and Prevention, Atlanta, Georgia, to discuss the report.

The Trouble With Boys: Forum October 7 in Santa Rosa

 A free public event focusing on boys’ educational performance and needs will take place on Oct. 7 at the Santa Rosa Junior College Petaluma campus.

When: 6:30 p.m. to 9 p.m, Oct. 7 2010

Where: Carole L. Ellis Auditorium, Santa Rosa Junior College,  680 Sonoma Mountain Parkway, Petaluma, CA

Speakers:  Richard Whitmire, author of the book, Why Boys Fail,  keynote speaker;  Joe Manthey,  talking on “A Brain-Based Approach to Academic Success for Boys.”

Audience: For parents and others who care for, educate or make policies affecting the lives of boys. 

Cost: No charge for event;  $4 parking fee. Call 285-2143, ext. 138 to register.

=====

I've read Why Boys Fail and found it somewhat of a mixed bag.  Geek Dad's review captures most of my response.  I haven't heard Manthey's presentation, but the phrase "brain-based" usually gets my skeptical senses tingling.

That said, I too have a hunch that, starting in kindergarten, we are asking all children to do academic work that many are not developmentally ready to do.

Rob Lamberts, M.D. at the ADHD Fact or Fiction? Conference

Dr.Rob Lamberts is a family practice doctor who himself has ADHD.  He writes a wonderful blog called Musings of a Distractible Mind Recently he attended a conference and took the time to interview Dr. Ari Tuckman and Katherine Schantz, head of the Lab school. I highily recommend both interviews -- and Dr. Rob's blog as well.

The Dangers of Labeling

I don't agree with everything she says, but this struck me

a child develops a healthy sense of self when the people who care for him recognize the meaning of his behavior, rather than substituting their own adult meaning. Parents who receive a diagnostic label for their child inevitably go through a period of mourning. The child they had is gone and replaced by the child with a "disorder." For a very young child whose development is unfolding, his "true self" might be lost.

April 17 in San Francisco's ATT Park: Ed Rev, for those who learn differently

From  the excellent Robin Hanson, the  Special Education Examiner

Education Revolution or Ed Rev as it is nicknamed, is a wonderful event for all families who have a member who has a learning disability. This is the second annual celebration sponsored by the Parents Education Network (PEN) . Again, this year, it is located at AT&T Park in San Francisco. My family went last year and we all had a wonderful time. It was a special treat to be able to go out on the field and run around the bases!

Keynote speakers include Dr. Ned Hallowell & Jonathan Mooney.

....

Admission for children and teachers (use school email) are free. Adult admission is $50. but scholarships are available on line.

To register:

http://parentseducationnetwork.org/Default.aspx?pageId=491429&eventId=101915

At EdRev 2010 , the Club Level of AT&T Park will feature over 100 exhibitors with services and products for the LD community. For a detailed list click here.

The exhibit hall will be open from 10:30 am - 3:30 pm.

It will be arranged by the vendor's target age range so that the hall forms a journey from early childhood to career launch, through four sections:

Starting the Journey (0-5 yrs)
Road Work Ahead (6-12 yrs)
Learning to Take the Wheel (13-18 yrs)
You're in the Driver's Seat (18+)

Confirmed Exhibitors:

1st Voice
Abbey Neuropsychology Clinic
Arbor Bay School
Association of Educational Therapists
Bay Area Parent
Bayhill High School
Bodin, An Educational Consulting Group
BOLD - Bright Options for the Learning Disabled
Books Aloud, Inc.
Books, Inc.
Bookshare
Camp Kodiak
Center for Adaptive Learning
CHADD Northern California
Charles Armstrong School
Children's Health Council
City College of San Francisco (CCSF)
Claro Software Ltd
College Internship Program
College Living Experience
College of Marin - Disabled Students Program
Communication Works
Community Gatepath
Davis and Thronson Associates
Disability Rights Advocates
Disability Rights California
Don Johnston Incorporated
Drew School
Edge Foundation
EdTrainingSF
Everest College
Foothill College Adaptive Learning Division
Freedom Scientific Learning Systems Group
Ginger Software, Inc.
Hope Academy
HumanWare
Immaculate Conception Academy
Institute for Insight and Transformation
Intel Corporation
Jewish Vocational Service
Just Kids Learning Center
Kaplan Tutoring
Kidspace
Landmark College
Leonardsherman.com
Life Development Institute
Lindamood-Bell Learning Processes
Livescribe
Making Math Real
Maplebrook School
McClure Mallory & Baron
Mediated Learning Experience
Mid-Peninsula High School
Mindset Works
Mitchell College
Morrissey-Compton Educational Center, Inc.
Moving Forward Towards Independence
Muskingum University Plus Program
National Stuttering Association/Counseling and Consultation Services by Nina Ghiselli, Psy.D.
NCBIDA
Northern California Learning Disabilities Association
One Smart Kid
Orinda Academy
Parents Helping Parents
Pediatric Developmental Specialists
Pine Hill School - Second Start Program
Quest Therapeutic Camps, Inc.
Raskob Learning Institute and Day School
Recording for the Blind & Dyslexic
Resource Center for Children, Youth and Families (RCCYF)
Riordan High School
Russell Bede School
San Francisco Public Library
School for Independent Learners
Shelley Haven
SI KID SF
Slingerland Institute for Literacy
SOAR
Sparking Your Genius
SPEECH, Inc.
Mary Morelli
Stanbridge Academy
Star Academy
Sterne School
Student Organizational Services
Study Wizards Tutoring
Support for Families of Children with Disabilities
The HANDLE Institute
The Hearing and Speech Center of Northern California
The Laurel School
The Learning Pyramid
The Listening Center
The Literacy and Language Center
The New High School Project at Chartwell
The Oak Hill School
The Pratt Center
The Reading Clinic
Tutor Corps
Tutorpedia
UC Berkeley
UCSF Child and Adolescent Psychiatry
University of Arizona, SALT Center
University of San Francisco