ADHD: Fictitious Epidemic?

I, like Sir Ken Robinson, am not qualified to determine whether ADHD is such a thing or not. I am not a health care professional - I'm an educator.

The purpose of this post is not to end the discussion because I've come to a conclusion which we must all adopt; rather, I simply want to continue this very important dialogue that affects a great deal of our children.

The first ten years of my teaching career were spent in middle school, but I've recently changed my teaching assignment - rather drastically, actually. I now teach in a "one-room school house" inside of the local hospital for children under the age of 18 who present a wide range of mental health related difficulties; ADHD is a popular one.

So now I have a question:

What kind of learning environment should I provide these students?

At first this question might seem benign: one might be quick to answer "whatever is best for the child's needs"... but it might not be that simple.

Here's what I mean: let's be honest, if everything was peachy with these kids at home and school, they might not be in the hospital in the first place. So while they are with me, we are trying to figure out how to help them so they can experience success in the world that they came from.

If I provide them with the traditional sit-and-get, in your desk, in your row, remain seated, raise your hand, be quiet, do your worksheet, study for and write your test - kind of education, I will end up providing far different observations and assessments than if I provided the students with a more differentiated and engaging education that more appropriately meets their needs.

But if I provide a differentiated learning environment that broadens the definition of real learning and achievement (beyond just getting kids to do whatever it is we want them to do), might it be possible that these students would need less medication? And yet, might it be possible that these students would need more medication in order to "properly" fit into their traditional sit-and-get schooling?

At the very least, could it be possible that school needs to change at least as much as the kids? To take this further, could it be that our current, narrow definition of school is at least as much of the problem (if not more) as the kids?

I fear that at the end of their stay, many of these children will return to a school that will want to know if the child has changed enough to properly fit the system's needs when it might be more appropriate for the school to ask how the system will change to meet the child's needs.

What do you think?