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  • Virginia Spencer

ADHD, issues with this spectrum disorder


What you can see and what you can't

"Bobby looks fine. He was watching the teacher and doing classwork for the entire period"

However, Bobby doesn't think so. He reports that when he asked questions, they were out of sync with the class topics. Several classmates made fun of him for asking a question on material that had been covered 20 minutes prior. He tells mom that he can't remember how to apply concepts to his homework. He is ashamed and won't hand it in tomorrow.

"You are stupid" is something Bobby hears in a few of his classes so he stops participating. Better to not ask questions, when he misses instruction, than bear insults. Mom requests an IDEA evaluation for him because he receives failing grades for late work and she has heard that ADHD is under the Other Health Impairment (OHI) category. If Bobby cannot start tasks and hand in homework without being prompted, does he need to learn how to, or is it acceptable for his homework to be 2 days late? Is it OK for him to avoid participation and what does that portend for later grades and beyond? Bobby has already developed a negative method of coping with his own advocacy needs.

Observation Pitfalls

Some of the mostly commonly used assessments for Attention Deficit Hyperactivity Disorder include observation rating scales. The Conners' Rating Scale and Behavior Rating Inventory of Executive Functioning (BRIEF) provide a screen for behaviors in different environments according to you and several of your child's teachers. The question is, how can we know that a screen is sufficient information? Can a rater know how often a child is really off-task and anticipate how much support the child will need to stay on task to learn with these assessments? If any individual can walk into a classroom and point out, with overwhelming success, who is depressed then they may well be able to look into the mind of a child with misfiring synapses. If not, the validity of their observation should be questioned. When the parent form and the teacher forms are significantly different in their perception of the problems, the parent form is often dismissed as an outlier. Other interpretive problems related to these assessments are sweeping generalizations made by assessment personnel based on the T-scores such as: "it just tells us he has ADHD." This analysis is not actionable.

How to get an accurate idea of impairment

A private evaluator can perform continuous performance tests that provide standard scores for both visual and auditory attention and hyperactivity (control of impulses). While these tests don't necessarily reflect the educational environment, it can be argued they provide the best case scenario for the child's performance. They are administered one-to-one in contrast to the school day with classroom instruction and multiple external distractions. The classroom is likely to present greater challenges and, it follows, diminished performance. Another way to assess your child's severity level if using stimulant medication, is to determine if the medication works to improve measures of attention and vigilance. If it does, the child gains self-awareness of their capabilities and can compare their performance on and off medication. For example, ask your child how they feel after taking a pill. If it is the first time your son can watch a football being thrown to him, think about the time that elapses from the moment the ball is thrown to the moment it is caught. If your child loses attention every 3 to 4 seconds, they have a significant impairment.

Instruction and support

Just as a child with Autism may contend with black and white interpretation of social cues and processing problems that create anxiety, the child with ADHD is not in control of the emotions and functional deficits caused by differing brain chemistry. Should a child who is unable to turn in work on time be expected to use 504 accommodations? Compare this to a child with an orthopedic impairment. Should that child walk to their wheelchair without having received the appropriate gross motor skill instruction? Children with ADHD should not be given a list of the usual accommodations handed out to all 504 students, but should learn to compensate for executive functioning weaknesses with an IEP. Skill development is critical to successfully continuing education after high school and living independently. Your Special Education Advocate should help you in securing these services.

@vmspencer

#ADHD #behavior #emotionaldisturbance #anxiety #educationalneed

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