Update on Attention Deficit Disorder

There is a general tendency to label as ADD (Attention Deficit Disorder) students who are restless and overly active in the classroom, or who appear to have difficulty attending to academic tasks. But, Cassandra Meents (State University of New York – Albany), who has reviewed the research studies on ADD, states that there is still considerable disagreement over the precise definition and cause of ADD as well as its treatment.

Despite such disagreement, there is a general consensus that inattention, impulsivity and hyperactivity are factors which contribute to a diagnosis of ADD. Researchers who believe ADD is a distinct, identifiable developmental disorder, maintain that symptoms “generally begin early in life and are exacerbated when the child enters school [and] is confronted by classroom rules, teacher demands, [and] increased parental expectations.”

Some researchers suggest that ADD may be a chemical brain disorder that is genetically based. Although it cannot be cured, they say, it can be treated and controlled. The majority of experts agree that ADD is not caused by diet, head injuries or poor parenting.

Treating the symptoms of ADD

Research efforts have been aimed primarily at identifying and treating the symptoms of ADD, rather than determining its cause. Increasingly, standard treatment consists of a trial on drugs plus behavior therapy and special education, if necessary.

But, surprisingly, few studies have been done to determine the success of special education classes or to determine how academic problems might be treated. Most research has focused on improving behavior and social relations, rather than on academic achievement.

To avoid the use of drugs, many parents turn to alternative therapies: diets, vitamins, behavior modification and psychotherapy. However, in several well-controlled studies, none of these alternatives has been proven effective.

One alternative to prescription medication suggested by researchers is to teach ADD children to self-monitor their own attending behavior. Keeping a record of their behavior can make children aware of their inattention and can be a way to begin learning self-control.

While there has been a considerable amount of research on drugs (psychostimulant medication), the results remain inconclusive, suggesting the need for further research. Although medication sometimes reduces the activity level of a child, it has no proven effect on academic achievement. It is probable that because it reduces disruptive behavior, medication of the ADD child remains popular among teachers.

Underachievers may be labeled ADD

Meents writes that ADD may remain essentially a problem for educators, whatever the conclusions reached by researchers. She reports that an ever-increasing number of children are being labelled ADD, and that this is a matter of concern. She reminds teachers that behavior-rating scales are imperfect tools of assessment and should not be used as the sole factor in determining ADD. Diagnosis of ADD, as mandated by Public Law 94-142, should always be (but often is not) based on sustained observation of students in various classroom settings.

Some researchers believe that inattentiveness can be due in some measure to “deficiencies in the educational environment.” Underachievers who do not necessarily exhibit ADD characteristics but who, for unknown reasons, simply cannot or do not perform, are sometimes mistakenly identified as ADD.

High-ability boys, for example, are frequently intolerant of rote activities and may exhibit poor attention during many routine classroom tasks. Also, children of lower ability may respond to inappropriately difficult tasks by not paying attention. Researchers suggest that teachers try lowering the difficulty level of academic tasks to see if the child’s “time on task” increases.

For high-ability students who have difficulty attending, they suggest assigning challenging, highly interesting tasks to see if their attention improves. Observation should, therefore, include evaluation of the learning environment to determine the appropriateness of assigned work.

The precise nature of ADD is still under study, but Meents concludes that it appears certain that ADD inhibits learning in group situations where these children experience the most difficulty attending to tasks. Although many ADD children do quite well on a one-to-one basis, in general, they have difficulty in any situation that requires self-control. Meents states that evidence is emerging which indicates that the ability to task varies with the situation. Individualizing instruction – making lessons interesting to the child as well as instructionally appropriate – can help.

“Attention Deficit Disorder: A Review of Literature” Psychology in the Schools, April 1989, Volume 26, Number 2, pp. 168-178.

Published in ERN November/December 1989 Volume 2 Number 5

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