Category — ADHD: Education

Note: I’ve lectured on this subject for over 10 years. This will be the first time I’ve placed my collective thoughts into print. I’ll present the topic as a series of essays.

The Soviet Menace vs. Dennis the Menace

In the late 1950s, when Dennis the Menace was just beginning to annoy his neighbor, Mr. Wilson, certain dynamics would once again change the face of education; our nemesis, the Soviet Union, launched Sputnik. The Soviet Sputnik program involved the launch of a series of man-made satellites after testing their viability through unmanned space vehicles. The cold-war fear of the Soviet Union and their possible nuclear superiority also led to the creation of NASA.

Sputnik prompted the U.S. government to increase spending on scientific research and education. This led to the National Defense Education Act (NDEA). The NDEA provided federal money for increased instruction in math & science, as well as foreign language. Another important feature of the NDEA was the forgiveness of loans for higher education; educational expenses for prospective elementary and secondary teachers could be waived. The thrust of the NDEA also reasserted emphasis on academic fundamentals like reading, writing, and arithmetic.

So, now children in the Henry Ford production line model of education, tempered by John Dewey’s experiential, nurturing educational philosophy, were exposed to changes to curriculum based on society’s fear of satellites. Strangely enough, even with the crazy dynamics of the times, children with attention problems existed; however, they were viewed quite differently than today’s ADHD children and actually survived and thrived quite well. Nurturing was expected and practiced at school, boundaries were set and maintained; if you got in trouble at school, you were likely to be in twice as much trouble when you got home. Furthermore, without the demands of incredibly stringent testing in all grades, ADHD children could were not exposed to the demands currently place on them.

But this would change within a decade or so. Due to the emphasis on science and math, curriculum began to be pushed downward. What was once taught at first year university was now being pushed to junior and senior years in high school. Junior and senior high curriculums were pushed downward as well. Over the years, this chain of curriculum change found its way all down to kindergarten. More tests were now needed to assess whether the curriculum changes initiated by both federal and state mandates were making our children smarter and more competitive with the rest of the world.

Another dynamic was causing social change. With an ensuing space race and advancing technology, a new core value system was in play; happiness comes through owning material things like new technology or the next best automobile. To get more things and therefore be happy, one had to make more money. To make more money one had to pursue higher education. To get the opportunity to pursue higher education, make more money, and be happy, one had to perform better at school.

I won’t argue philosophically about material goods bringing happiness, but most research indicates this is not so. What’s important to note here is that we have a definite class system in place; those who perform well at school have access to higher education and happiness, and those who are cast out of higher education to go to technical or trade schools, make less money and are less happy. That’s the perception, anyway.

The other articles in the series “The Evolution of ADHD, Education, and Drugs in America” can be found below.

1. Dennis the Menace
2. Henry Ford and Education
3. Henry Ford vs. Dennis the Menace
4. Soviet Menace vs. Dennis the Menace
5. Sigmund Freud vs. Dennis the Menace

Note: I’ve lectured on this subject for over 10 years. This will be the first time I’ve placed my collective thoughts into print. I’ll present the topic as a series of essays.

Henry Ford vs. Dennis the Menace

Dennis the Menace began appearing as a comic strip character in the early 1950s. While his physical appearance changed slightly in the 1960s and 1970s, he was still considered a lovable child when I began my teaching career in the mid 1980s. We continued to laugh at his innocent acts of menace toward his family and friends without mention of medication or ADHD.

When I met my Dennis, or John, in the late 1980s, I was astonished that he was viewed by the other staff as ‘uncontrollable’ and ‘unteachable.’ He was considered a problem child. John was a square peg trying to fit in the round hole of an educational machine. The educational world had less tolerance for children like John, and ADHD was about to was about vastly change education – not necessarily for the better.

What had in fact affected John in the 1980s had its roots in much earlier times. A confluence of events was actually creating the perfect storm for the Ritalin revolution. Change was underway in education, mental health, and medicine that produced an enormous shift in American culture. This shift would greatly affect John and all children like him.

Dennis the Menace was not yet created in the early 1930s when Henry Ford’s efficient production line model was adopted into public education. In mass fashion, children were taught in classrooms with rows, using state issued textbooks, aggregately reciting the pledge of allegiance, and instructed at the same pace with the same curriculum by the same teacher. We now had efficient education for the masses.

This model was somewhat tempered by philosopher John Dewey. Dewey received his Ph.D from the School of Arts & Sciences at Johns Hopkins University in 1884. However, his theoretical basis for his Pragmatic school of thought was developed during his tenure at the newly founded University of Chicago beginning in 1899. The Pragmatic school of thought embraced an empirically based theory of knowledge which was further refined at the University of Chicago Laboratory Schools. Dewey developed his ideas for education based on his work at the Laboratory Schools and published Experience and Education in 1938 after many other books. Dewey emphasized a humanistic approach to education where development of problem solving and critical thinking skills were fundamental and paramount to increasing intellect. This contradicted the traditional practice of rote memorization. His philosophy of education also embraced individualization and accounted for the needs and differences among students. This was based upon Dewey’s vision that while a student is a small part of society, they student will in turn strengthen democratic society if he is a critical thinker and problem solver. This is analogous to the pilings in a bride; the stronger the pilings, the stronger the bridge.

While Dewey’s pedagogy was not officially adopted by schools, his influence affected national education for a long period and created an environment where nurturing and experience played important roles in rearing children. This would soon change.

The other articles in the series “The Evolution of ADHD, Education, and Drugs in America” can be found below.

1. Dennis the Menace
2. Henry Ford and Education
3. Henry Ford vs. Dennis the Menace
4. Soviet Menace vs. Dennis the Menace
5. Sigmund Freud vs. Dennis the Menace

Note: I’ve lectured on this subject for over 10 years. This will be the first time I’ve placed my collective thoughts into print. I’ll present the topic as a series of essays.

Henry Ford and Education

The great industrialist and inventor, Henry Ford founded his company on precision and efficiency in the early 1900s. To produce cars for the masses, he would need a method of assembly that could quickly assemble mass produced parts into a complete automobile. His assembly line model rapidly changed the world. Using the assembly/production line model, mass assembly of products became the norm. This in turn produced higher volumes of products available to the masses. Mass production allowed manufacturers to sell products for cheaper prices as well. All of this was based on efficiency. Educationalists were impressed.

Prior to the early 20th century and the assembly line, manufacture was performed by a single craftsman or team of craftsmen. Known as the English System, craftsmen typically would produce each part of a product individually. In the final phase of production, the craftsmen would assemble the components together into a single product. At that time, if changes were needed to the individual parts, the craftsmen would modify the parts to make them fit or work together. While this process was slow and did not produce mass quantities of goods, it produced high quality goods with attention to detail. This practice was similar to our method of teaching in rural one-room school houses where students sat together on benches.

If we envision a student as a basic raw component, like a car chassis, and following the production line model, we could get his wheels on by the end of kindergarten. In first grade we insert the engine. In second grade we put in the brakes. In fourth grade we put on the body. Thus, by the end of high school, we should have a completed student or car as it were.

There would be a need then, to make this process efficient. There would be no more need for small school houses. Big schools would be built where large numbers of students could be housed. Mass transportation would have to be implemented to ensure that large numbers of students could be assembled in the larger schools. Students should sit in rows as this would make it more efficient for the teacher when handing out mass produced work sheets and tests. There would be no need for individualized instruction when a generalized curriculum would fit. By senior year in high school, those students not prepared to move on to higher education (defective parts) can be diverted to technical schools to prepare them for work in the service industry.

And that’s what we did in the early 1900s.

The other articles in the series “The Evolution of ADHD, Education, and Drugs in America” can be found below.

1. Dennis the Menace
2. Henry Ford and Education
3. Henry Ford vs. Dennis the Menace
4. Soviet Menace vs. Dennis the Menace
5. Sigmund Freud vs. Dennis the Menace

Note: I’ve lectured on this subject for over 10 years. This will be the first time I’ve placed my collective thoughts into print. I’ll present the topic as a series of essays.

Dennis the Menace

Anyone remember Dennis the Menace? As a child, I watched Jay North portray that mischievous blond-headed boy who always got into trouble and annoyed his grumpy neighbor. Dennis was loved back then.

Dennis is the kid everyone seems to have on his street even now. He’s intelligent and uses it to get into everything. Even when he tries to help others out, he still finds trouble. He often acts out without thinking about consequences.

I taught ‘Dennis’ during my second year as a classroom teacher in the North Carolina school system in the mid 1980s. His real name was John. John was the type of boy that the other teachers called ‘hellion’ in hushed whisper in the faculty lounge. The other teachers told me that, “He won’t do anything. Tie a carrot to the end of a stick; he’ll play with it all year.” Instead of being that character we all loved, ‘Dennis’ was medicated.

Being a progressive teacher and not having become cynical, I was determined to save John. Since I had learned nothing at university about unfocused, hyperactive children, I consulted my professors. They advised me to move John closer to my desk; set up an individualized education plan (IEP) that included modifications to John’s curriculum, shortened assignments and instructions; and a daily checklist with rewards.

I followed their instructions implicitly. John sat right next to my desk. The modifications to his curriculum quickly began to change John’s self-esteem. We got work done everyday and his math and reading ability began to improve. His parents, however, only had eighth grade educations. They failed to return John’s checklist after a couple of days. They also didn’t have the skills to provide positive reinforcement at home. To my dismay, John’s father began to hit him with a leather belt. Corporal punishment was still used at school, so this wasn’t unusual, even though I didn’t approve.

A few days later, John came in and placed his forehead on his desk behind folded arms.

No more than three feet from my right hand, I nudged him and said, “Didn’t you get enough sleep last night?”

He looked up at me without the mischievous twinkle, his eyes a little bloodshot. He pushed a folded note at me across my desk. “Medicine,” he said.

The note was from John’s family doctor. It was actually a checklist for me to complete that would assist the doctor in determining dosage. I completed 4 checklists without seeing much change in John’s groggy demeanor. The hellion was gone, his spark was gone, but he was manageable at home. At least John’s father wasn’t beating him anymore.

The other articles in the series “The Evolution of ADHD, Education, and Drugs in America” can be found below.

1. Dennis the Menace
2. Henry Ford and Education
3. Henry Ford vs. Dennis the Menace
4. Soviet Menace vs. Dennis the Menace
5. Sigmund Freud vs. Dennis the Menace

Dr. Lawrence H. Diller’s book, The Last Normal Child: Essays on the Intersection of Kids, Culture, and Psychiatric Drugs, is a fascinating and provocative work. As an experienced developmental/behavioral pediatrician, Diller examines the current trend to quickly diagnose attention deficit hyperactivity disorder (ADHD) and the perfunctory prescription of stimulant drugs even when there is scarce evidence regarding academic improvement, social improvement, or long-term efficacy.

Diller’s perspective is quite evenly balanced; he prescribes stimulant medication for ADHD when indicated, but only as part of thorough assessment and comprehensive management program.

It is clear that Diller believes that ADHD is being over diagnosed. He states that over the last 15 years brand name stimulant production has increased by an astounding 1700% and generic stimulants by more than 3000%!

The number of U.S. children taking psychotropic drugs has doubled over the last ten years. We currently have more than 4.5 million children under 18 taking psychotropic drugs – mostly stimulants. Perhaps even more alarming are the percentages of ADHD children being reported by the Centers for Disease Control (CDC): typically common rates between 5% to 7% are reported in children in Colorado and 5.5% in California. However, as many as 10.5% of children in Louisiana are diagnosed with ADHD as are 11% of children in Alabama.

Diller suggests that the rampant diagnosis and pharmacological treatment of ADHD might be related to the fact that, “The drug industry hijacked American psychiatry in the 1990s….Insurance companies structure doctors’ reimbursement so as to reward short visits, ones in which a prescription brings the session to a definite conclusion.”

Diller also suggests that the Individuals with Disability Education Act of 1990, actually accelerated pharmacological treatment as well as the ADHD diagnosis because its amendment in 1991 now included ADHD as a diagnosis that makes a child eligible for special services and accommodations in public schools. As parents quickly learned, an ADHD diagnosis could gain their child special services and testing accommodations.

The pharmaceutical industry parleyed this trend by targeting parents with direct ADHD drug advertising. Parents, having diagnosed their child via the effects of the advertising campaign, could now approach their family practitioner to request stimulant drugs as a remedy. Diller suggests that many parents welcomed a brain-focused diagnosis that relieved them of responsibility for problem behavior.

The book encompasses far more than I’ve described here and is well worth reading. It is an excellent, balanced perspective that provides insight into the staggering $3 billion juggernaut known as ADHD.

ADHD haunts children into adulthood, study shows

Psychological Association published research from Dr. Mariellen Fischer, a psychologist with the Medical College of Wisconsin. Her study was co-authored by Dr. Russell Barkley. The results of her 13 year study show that if AD/HD is left untreated in childhood, children will carry their disorder into adulthood.

For thirteen years they monitored 147 children with ADHD by age 7, comparing them with 76 neighbor children who didn’t have the disorder. About one third dropped out of high school. This seemed significantly high as none of the neighbor children dropped out. Leaving school is quite likely due to the public school system’s inability to accommodate the needs of ADHD students as well as ADHD student inability to learn coping skills which are seldom taught in school or at home.

Interesting data about adults with AD/HD in this study:

• They are more likely than their peers to get fired
• They are more likely to shun birth control and become parents by age 21
• They are more likely to have higher credit card debt and fewer saving
• They took medication for AD/HD as children, but few were being treated by their early 20s
• They are more likely to start having sex a year earlier than classmates
• 1 out of 3 had become parents by their early 20s vs. 1 in 25 of the classmates
• They had less than half the savings of young adults they had grown up with and more debt

Dr. Fischer indicated that many children maintain their disorder into adulthood. The article is not clear whether this data was relevant to treated or untreated ADHD. However, clinical data suggests that perhaps 60% of ADHD children will carry their disorder into adulthood. This may be a conservative estimate.

While the data are compelling, the study is too small to conclude that ADHD alone causes these ill effects.

Clearly, there is no current research (2005) that has determined that ADHD is genetic either partially or entirely. While empirical data suggest that a genetic link exists, research is still sparse as scientists primarily focus on childhood onset of the disorder with little research on adult AD/HD.

Andrea Chronis of the University of Maryland  has focused on AD/HD mothers and their performance as parents. In her study of 70 families with elementary-school-age children she found that:

• Mothers of ADHD children are 24 times as likely as the average woman to have it
• Fathers of ADHD children are 5 times higher than average to have it
• The mothers often weren’t very involved with their children
• The mothers had few skills to cope with their children
• The mothers didn’t give praise or show affection regularly
• Discipline was inconsistent
• Most of their children also had ADHD

While Chronis’ research does not prove a genetic link, it offers strong support for the theory. And while poor parenting may exacerbate ADHD symptoms, it does not cause ADHD. Thus, the aforementioned poor parenting skills would likely contribute to worsening their childrens’ symptoms. This would lead one to think that parenting skills/counseling should be a primary consideration for families with ADHD.

Girls With ADHD Are Often Overlooked

HealthNewsDigest.com – August 29, 2005 (HealthNewsDigest.com) reports that ADHD likely affects 3% to 7% of the entire child population in the US. However, girls are frequently overlooked because they often do not display hyperactive symptoms.

When teaching at the elementary level, I found this particularly true. Girls with ADHD often were simply daydreamers with poor time management skills. While some did display the outward social and behavioral problems that their male peers did, it was not very frequent.

HealthNewsDigest.com is published by the American Psychological Association. I’ve cited bits of this report and am alarmed by its look and feel. It reads like an endorsement and advertisement for Adderall XR.

Their report, edited down:

The federal Food and Drug Administrations (FDA) recent nod to ADDERALL XR for the treatment of attention deficit hyperactivity disorder (ADHD) in adolescents aged 13 to 17 spotlights an underidentified and under treated population with this disorder, experts tell Health NewsDigest.com.

If left untreated, the symptoms of ADHD can have a profound effect on a child’s life, both inside and outside of a classroom setting.

For Janice Lowder, a quiet, well-behaved child, learning was always stressful.

“My husband and I hired a one-on-one tutor to help Janice with her studies. We also tried to help her, and all dreaded the nightly battle of completing a homework assignment. Janice would get so frustrated with her homework and the fact that she didn’t ‘get it,’ that she would cry,” said her mother Beth Lowder.

“By the time Janice reached the seventh grade, a nurse at her school suggested we talk to a doctor. Janice was diagnosed with ADHD and was started on treatment,” Beth explained.

“I knew my daughter just needed the right help,” said Beth.

By the tenth grade, Janice had improved from a C to a B student but homework was still challenging. In addition, she had low self-esteem and was embarrassed to take her medication at school. Her psychiatrist prescribed Adderall XR®, an extended-release formulation that enabled Janice to take her medication once a day at home.

With continued tutoring and medication, her grades improved.

“She came home from school one day and said, ‘Mom, I’m smart,’” said her mother.

A recent study presented at the American Psychiatric Association annual meeting showed that girls with ADHD demonstrated significant improvement in both behavior and attention with Adderall XR.

“The study suggests that girls with ADHD can benefit from Adderall XR and that this treatment will help them control symptoms all day while they are in the classroom, during after-school activities or doing homework with relatively few side effects,” said Joseph Biederman, M.D., professor of psychiatry, Harvard Medical School and Chief of Pediatric Psychopharmacology at Massachusetts General Hospital. “While ADHD in girls is becoming more recognizable it is still often overlooked, and there is a need for safe and effective treatments that will allow girls to interact more effectively with other children and adults, to concentrate in school and to focus on finishing tasks.”

I’d expect to find a more diluted version in Parents Magazine or Family Journal as an outright advertisement. Makes one wonder who wrote this? Shire Pharmaceuticals?

To IEP or not to IEP that’s the $100,000 question!

MICHAEL BARBER of the Bradenton Herald reports that:

 The Manatee County school district has spent more than $100,000 in legal fees battling an attempt to get an 11-year-old boy with attention deficit disorder a special education plan, according to documents The Herald reviewed.”

Since the AD/HD boy has performed well academically and on the Florida Comprehensive Assessment Test, the school doesn’t believe it’s responsible to provide a special education Individualized Education Plan (IEP).

School officials argue that accommodating this student could set a costly precedent for the district and state by allowing thousands of other ADHD students to apply for special education plans.

Final arguments in the federal case were heard in Tampa on Thursday. U.S. District Judge James Whittemore is expected to render a decision in the next couple of weeks.

While I agree that this could precipitate a flood of AD/HD requests for accommodation, what’s more important here, students’ educations and well beings or money?

Every student has a right to an IEP.

It simply defines what goals and objectives will be used over the student’s academic year to achieve success. If some accommodations like computer software, lengthened test time, etc. need to be implemented, then do it. It is mandated and paid for by the federal government under IDEA (Individuals with Disabilities Education Act). It does require extra effort and perhaps even extra staff to write and implement the IEP.

“On Thursday, Superintendent Roger Dearing told The Herald the district had spent an estimated $50,000 on the case.

…Although exact legal fees the school district paid to the various firms were not available Friday, district records indicate the total figure spent on the case exceeded $100,000.

When asked whether he thought the $100,000-plus legal tab was worth it, Dearing was emphatic.

“Would you spend $100,000 to save $10 million?” Dearing asked.

Dearing said that there are more than 2,000 students in Manatee County schools who are ADHD and that special education plans can cost $5,000 or more. If all of those ADHD students applied for special education plans, the cost could be as much as $10 million per year.”

In order to save money, the school system is arguing that AD/HD is not covered by the IDEA.

School board members Larry Simmons and Harry Kinnan both said they did not like having to spend district money on costly court cases, but in this instance they thought it was the right thing to do.

“I think it’s an important enough case that we have to spend what it takes,” Simmons said. “It’s not about this particular young man or his mother. It’s about a potentially serious financial impact to the school district.”

Kinnan agreed.

“I think it’s regrettable the money can’t be marked for other things, but we’ve decided as a school district that it’s important to stop a precedent from being established,” Kinnan said.

“You have to weigh the implications for the school system if you don’t fight this case.”

Who is right? and who is wrong? seem to be moot questions. The question is, what is the best education for this child and what would a special education IEP provide that? If that answer is yes, then do the right thing. We’ll see what the courts say.

I have written for years that only by redefining ADHD can we address the problem through education and training. Finally, the movement is approaching mainstream as indicated in the article from Scientific American entitled, Training the Brain, Cognitive Therapy As An Alternative To ADHD Drugs.

It is interesting to note that the techniques mentioned in the article have been incorporated in the Play Attention cognitive tools for about ten years.

“Recent studies support the notion that many children with ADHD have cognitive deficits, specifically in working memory–the ability to hold in mind information that guides behavior. The cognitive problem manifests behaviorally as inattention and contributes to poor academic performance. Such research not only questions the value of medicating ADHD children, it also is redefining the disorder and leading to more meaningful treatment that includes cognitive training.”

Salient issues raised by the author include:

1. The difficult decision by parents “To medicate or not? Millions of parents must decide when their child is diagnosed with attention-deficit hyperactivity disorder (ADHD)–a decision made tougher by controversy.”
2. While medication may calm a student’s outward behavior, research shows that it does not increase cognitive ability manifesting in improved academic performance, social relationships, or defiant behavior over the long-term.
3. This has led scientists to research effective means of cognitive training as a substitute.

This is really a shift in our understanding of this disorder from behavioral to biological,” states Rosemary Tannock, professor of psychiatry at the University of Toronto. Tannock has shown that although stimulant medication improves working memory, the effect is small, she says, “suggesting that medication isn’t going to be sufficient.” So she and others, such as Susan Gathercole of the University of Durham in England, now work with schools to introduce teaching methods that train working memory. In fact, working-memory deficits may underlie several disabilities, not just ADHD, highlighting the heterogeneity of the disorder.”

The article focuses on Dr. Torkel Klingberg of the Karolinska Institute in Sweden who trained around 40 kids with ADHD with a software program that addressed “working memory.” After more than 20 days of training parents reported that their children had greatly improved attention and lessened hyperactivity.

Klingberg essentially proved that cognitive retraining improved neurobiological function. This work has been underway with Play Attention since 1994. It’s good to see the paradigm shift beginning to happen.