A study out this month in the journal Pediatrics found that near sixty percent of children with ADHD have an associated writing disability. Beyond the effects of distractibility, rushing through assignments, impulsivity and all the rest of ADHD, these children have a neurologically based deficit around writing. The ability to effectively gather their thoughts, organize them, and get them onto the page is impaired directly, not only by their ADHD. Often overlooked and underdiagnosed, a writing disability impacts not only the specific tasks of producing coherent sentences, paragraphs and essays but also testing and note-taking. Without intervention the added time and stress around writing related tasks affects overall school performance
One of the most basic principles in supporting a child with ADHD is looking for other conditions that often tag along with it. These are termed 'comorbid conditions' and common ones include developmental delays (fine motor, language, etc.), various learning disabilities and specific mental health conditions such as anxiety. Nearly two thirds of people with ADHD have at least one of these, and that statistic doesn't even count the far-reaching effects of executive function deficits inherent to daily living with ADHD.
School planning sometimes overlooks these possibilities, many of which are of particular importance in the classroom. Academic motivation depends on a sense of mastery and success and rarely develops when children feel at a loss or lack the tools they require to thrive. For students to enjoy and take ownership of their own academic career, underlying issues affecting school must be addressed first.
Here are suggestions (in fewer than three hundred words) to avoid common pitfalls while planning for the upcoming year ...
• Make sure evaluations have looked for specific learning disabilities, especially when children with ADHD have persistent academic problems.
• Address difficulties with executive functioning at home and school. Children with ADHD require more structure and adult support to manage their work, and more direct instruction in organizational skills than peers. Because of ADHD they benefit from a scheduled routine instead of open-ended supports that say things like, 'you can visit Ms. Jones if you feel you are falling behind.' Their capacity to identify a problem ('I need help'), create a plan to address it, and then stick to it over time is directly impaired by ADHD. Instead of open-ended solutions, schedule supports into their day: 'Right after fourth period, you have a study session. Would you prefer to meet with Ms. Jones or Mr. Frank?'
• Implement a structured, reward based behavioral plan proactively. Don't wait for classroom tension to start before focusing on behavioral change.
• Ask for placement with structured teachers who run classrooms that permit fewer distractions in the environment. Classroom set up (e.g., desks facing the teacher when she's teaching and not peers) and management (e.g., clear and consistent rules) matter greatly when children have ADHD.
• Encourage schools to use evidence-based instructional methods for children with ADHD. Today, the most commonly used curriculums rely on learning through exposure to academics without an emphasis on direct teaching of skills. Children with ADHD are less likely than peers to thrive without an emphasis on core skills, repetition and rote instruction.
Educational planning of this kind is one of the three foundations of ADHD care. Integrated with appropriate behavioral supports and judicious use of ADHD medications, children with ADHD can thrive at home and school through the upcoming year and beyond.
Published on August 30, 2011 by Mark Bertin, M.D. in The Family ADHD Solution
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