Tuesday, June 14, 2011

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?


  1. I have two kids who are being treated for ADHD. Having an attention system that takes in new information and stimuli rapidly is fantastic, until you have to sit in school all day, in which case, your neurology no longer fits the demands of your environment. I would love it if school were a place where my kids could explore more, work on projects, and use their strengths to their fullest, like they will be able to later on in life. However, right now, society has said they need to learn a very long list of fundamental skills, and need to stay focused in the classroom, regardless of the material or how it is presented.
    I agree, in a classroom with a teacher who differentiates, medicating these kids might not be an issue- they will better fit in to their environment. But the question is, how do we make classrooms all over the country flexible enough for all the kinds of minds in it?
    Differentiation is an answer, and that's why I wrote the Differentiated Instruction Book of Lists with Jenifer Fox, to help classroom teachers start to find ways to make differentiation work day to day, rather than seem more like a platonic ideal that sounds nice but they have no idea where to start.
    I think we have to start facing the facts that the "standard classroom" and acceptable behavior has become narrower and narrower over the years, and it's time for the pendulum to start swinging the other way, especially since we know so much more about how the brain works, functions and develops.

    1. Good! I like that you are addressing a larger audience that concerns brain plasticity in order to think outside the box. I am a grad student working on helping students (from primary to college levels) with pragmatic methods that have been well received b/c the results have been significant to the point of life changing for generations to come. Happy to share "where to start" if you are interested.

  2. Hello Joe, thanks for the thoughtful comments. I have no great answers to your questions, but I do want to recommend a blog called SpeEd Change, which has some of the most challenging ideas I've read about what disability means. This post called When Rethinking School Itself might be of use.

  3. @wsh1266: I agree that we have a steep hill to climb before we can comfortably say that we have an education system that properly differentiates for our children's diverse needs; however, rather than seeing this as a situation to resign ourselves or our children to, I see it as a problem to be solved.

    If we don't address these issues in our time, our children will have to do all this with their children.

    @shiftingphases.com - thanks for the link. Ira does remarkable work.

  4. "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?" Quite simply, Joe ... YES.

  5. I too believe there is a mass over diagnosis of ADHD. I also believe that we need to have a more authentic, experiential education for all children. We do not, en masse, and sadlywhat happens is this:

    Most children respond really well to having that opportunity in their school years. They embrace it, and eagerly look for more. Some may even demand it. They quickly adapt and learn the importance of using a variety of materials, as well as working cooperatively, without constant guidance (prison guard monitoring).

    The children who struggle with this have experienced YEARS of the worksheet, disengaging curriculum. They have come to learn that school is not a place where they will be honored, and that their needs (them) are not important. So even given the opportunity, throw it away. It is almost as if they think it's too good to be true. Or if they know it is true, they have been so loaded with worksheets and workbooks that they have no idea how to work without someone standing sentinel, constantly telling them to get back to work. Often times a year is not enough time to convince them or Provide them with the necessary habits that will helpmthem be successful in life.

    It breaks my heart to hear tales of ignored children. Hopefully, we can change this one classroom, one school, one district at a time.

  6. I don't know what the answer is either but I DO know that the old, "institution" model of public education is out of sync with the needs of today's students--the vast majority of them. I keep coming back to the central problem though, we need resources, support, and funding to meet student needs and our society (at least here in the states) does not match its actions to it's words on that front. I have often said that education would look MUCH different if actual educators were making the "big decisions." I think that is also true in this case. How many of us are expected to "control" our classrooms via the old model--the model we know is ineffective?

  7. Joe et al - have you ever read anything by Peter Breggin? He's an anti-psychiatry psychiatrist who's written extensively about all kinds of 'medicalizing' of human issues....very well-researched, also - it could blow your mind.
    Try 'Talking Back to Ritalin' for ADHD issues...or 'The War Against Children of Color'...or breggin.com or breggin.org.

  8. This is exactly I homeschooled my son from age 11-14. He did badly in (US) public schools, okay in a Montessori school that I soon could not afford. He got stuck with a truly horrible 5th grade teacher, and began saying he was stupid. (He's very smart.) We started visiting a homeschooling family who lived on a large ranch. One day it hit me that here he was just a normal kid, fit in well with their kids. School was the problem. If I'd left him in public school, he might have ended up like the kids you work with.

  9. Let me begin my saying - very nice post Joe. A good educator always has more questions

    1. Oops... More questions than answers. I also have a horse in this race. I work in a classroom with E.D. Students but am uncomfortable with the labels bantered about. Mostly I see students who need validation as sentient beings. Now I mentioned a horse in the race - my child was labeled ADHD because the school sought that label . I reframe it as quirky and exuberant . My man cub has been through multiple stressors in his short life but once I took him off meds and changed my patenting style I rediscovered a lad who is reachable and teachable.

      Feel free to look into the life and mind of a quirky and exuberant young man. I blog about our life , blemishes and all.

      Lastly may I post a link to your blog?
      Thanks and keep learning!

    2. Here's my blog for those interested in the perspective of a man and his man cub navigating this diagnosis .


    3. We're an ADHD family... I look at ADHD as a sort of human evolution - wrote about it here - http://ortals.wordpress.com/2010/08/16/addhevolution/ . Of course I have some opposition, within my own family too. A grown up sister who claims though she enjoys her abilities and way of thinking, she also feels like a Handicapped woman when it comes to managing her family's daily life. A brother who was so totally against medications, but now, as a grown up, discovered they can really help him. I was totally against drugging my son. But the given environment is so complicated for him. We still live in a world that requires a high school diploma. Whether he chooses to be an artist, a musician or a chef - he will need to be able to concentrate and remember more than a one-item list of tasks. So it's really frustrating and there is no easy answer of yes or no about medication. Sometimes we just have to play it as we go along.

  10. Oh, I DO think our definition of school should change. Out of 4 boys, one has severe ADHD. His best year? A teacher that recognized the wiggles, arranged for him to non-disruptively move around the room, and then return to his work. Don't we all need to move to stay engaged and awake? Why is SITTING so important? He learned his spelling words by pacing around the room. Sitting still took too much concentration and he couldn't learn. Are stand up desks an option? It is possible to do something different that meets the same goals? Yes, I think it is ultra possible.

    1. Thank heaven for your very empathetic teacher.

    2. The students whom I am assisting in my research have drastically improved reading and writing while applying methods on their feet!

  11. I am intrigued, you discuss differentiation as if it does not happen in your classrooms.

    In the school I teach in we have a staff agreement that we differentiate 4 ways for much of our lessons; ensuring that we cater for our gifted children and supporting our children with barriers to learning within that subject. This will be anything from rewriting a text or sourcing pictures for support to ensuring that group has an adult with them for problem solving. Some kids may go off and explore the task after minimal input, whilst others are given the option of teacher led group input to bolster confidence. It takes a great deal of pre lesson preparation but always, always pays out in the longer run as the achievement levels and confidence increases for most.

  12. To answer your question I would suggest talking to my 18 year old daughter, who just graduated high school. She's got lots of wonderful ideas ranging from "Why" classes to teach sciences, and failure workshops, another plan to get kids to learn.
    What do these kids need?
    They need to be curious, they need to want to learn.
    What you should offer them (I believe) is the ability to learn.
    Medications or mental state have nothing to do with it. Everybody is born curious with an aching need to learn. Look at babies and how quickly they learn a language for example.
    What jobs will be out in the world when today's 1st grader will go out to look for a job? No one knows. But I am willing to bet, they'll need to be a learner.
    Here's something I wrote about the Want to Learn: http://ortals.wordpress.com/2012/03/21/wantordont/

  13. Great post Joe. I love this video. Yes, we have to change and adapt. As teachers we have to be constantly asking ourselves: How we can do better? Are we meeting the needs of every student in our classroom? What changes will help our students learn better? How can we expect our students to be good learners if we are not doing the same?

  14. just wrote this, joe — tell me what you think



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