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ADHD Info for teachers

Dear Colleagues,

If a student is not succeeding, there is a reason. You can’t allow him or her to languish; you must take action.

ADHD is the most common neurobiological disorder (9.5% according to the Center for Disease Control at cdc.gov), so it should be considered.

ADHD is a disability and is specifically addressed as such in the IDEA and state education codes.

There are three distinct subtypes: predominantly hyperactive, predominantly inattentive (but with a hyperactive brain that keeps switching channels), and the combined presentation.

Sadly, the combined type is most common.

We no longer separate the hyperactive and the inattentive with the different labels of ADD and ADHD. Since the inattentive type has a hyperactive brain, we now call them all ADHD.

A letter from the Office of Special Education Rights (OSER) was sent to every school district in 1991 clarifying that ADHD students must be identified, screened, and offered necessary support. Anything less is a violation of their civil rights.

Your district has known for more than two decades that ADHD students are supposed to be identified and properly supported.

ADHD students rarely need a special education setting. They usually need medication (when parents are willing) and simple classroom accommodations through a 504 plan.

ADHD accommodations are usually good for all students.

Unidentified ADHD students cost school districts time (meetings concerning behavior and grades), money (they are unnecessarily placed in expensive alternative sites), morale (unmedicated ADHDers wear-out educators and support staff) and test scores.

It appears to others as though unidentified ADHD students rob their classmates of valuable learning time and individual support from the over-burdened teacher. They are disruptive time and attention suckers- but it is not their fault. They would really like to be less difficult- but they can't.

ADHD sufferers are born with smaller frontal cortexes, less connective tissue between brain hemispheres, and impaired neural functioning. Their emotion center behaves differently.

This doesn’t affect their intelligence in the least. It affects their social skills, impulsivity, short-term memory, executive functioning, emotional reactions and maturity.

ADHD students are 30% behind developmentally. They do not catch up until they are 26 to 30 years old. A 16 year old ADHDer will have the maturity of an 11 year old.

ADHD is a physical disability, just like nearsightedness. Yelling at an ADHD child for acting impulsively is exactly the same as yelling at a nearsighted child for not seeing something. It won’t do any good whatsoever. It’s just cruel.

You cannot “train” an ADHD child to sit still, pay attention, remember directions, or follow the rules; just as you can’t train a nearsighted person to see better.

They know the rules; they lack enough executive control to follow them.

You can aid an ADHDer by making some modifications to their environment: allowing breaks such as a walk to the nearest outdoor drinking fountain, minimizing distractions, reducing homework, seating near the front, seating next to a helpful peer, using positive behavior interventions, etc…

…You would make modifications for a nearsighted student that didn’t wear glasses, wouldn’t you?..

…And if you suspected that a student of yours was nearsighted, you would bring that to the attention of the parents, right? Teachers must do the same for ADHD.

Even though we are not optometrists, we wouldn’t think twice about telling a parent that their child needs glasses. There is no stigma to wearing glasses. Yet many teachers are directly told not to talk to parents about the possibility of ADHD, even though it too is a physical disability- and a very disabling one at that. There is still too much stigma attached. We have to break that wall. It’s no one’s fault.

Parents often do not initially appreciate the info. Many equate organic brain dysfunction with environmentally induced mental illness- which might make it their fault. They become defensive.

Although unpleasant for you at the time, you have planted a seed. As soon as their child really struggles, they will ask for an evaluation.

Even when a parent reacts badly to the idea that their child should possibly be screened for ADHD, and anything similar, you must still report your suspicion of a disability to your principal or special education director.

Administrators all over the country tell teachers, “You are not a doctor. You cannot suggest to parents that their child might have ADHD, or something similar.” They are wrong. You can and must.

Even though the IDEA guidelines are clear, administrators are terrified that the school district will have to pay for doctor’s visits and medication. Not true.

It is against the law for administrators to discipline teachers for discussing any valid observations about a student to their parents/ guardians.

Report any retaliation to your union, the state office of education and/ or the federal Office of Civil Rights (www.hhs.gov/ocr - easy, online form).

Any support required to enable the student to succeed at school and in extracurricular activities, academically, behaviorally, and emotionally, must be given at no cost to the parents. ADHD students usually need some support for all situations.

Disabled students are not entitled to “Cadillac” support- only enough support to give them a fair chance to get a good education.

By law, school administrators must actively seek out, screen, and whenever appropriate, offer to evaluate all students suspected to be disabled. This is called the “Child Find” law.

Teachers are in the best position to notice disabled students. Tell your principal or special education director about any students you suspect are disabled.

Child Find requires administrators to follow up on teacher reports concerning student disabilities with a screening to see if the request has merit.

If the child will be assessed, be sure that the child will be evaluated for all suspected disabilities. Don’t count on the psychologist to correctly understand what you noticed. Check!

Specify an ADHD inventory and evaluation whenever appropriate.

Suspected ADHD students should absolutely be evaluated for common comorbid conditions such as specific learning disabilities, Oppositional Defiance Disorder, anxiety disorders, depression, dyslexia, dyscalculia, etc.

They should be evaluated for conditions that look like ADHD such as Bipolar Disorder, Autism, substance abuse, PTSD, and a sudden change in their life.

To protect yourself legally, put the request for an evaluation in writing and keep a copy. See Compton v Addison for an idea of how many times your name will be listed in a court case pasted on the Internet. You will want to be the good guy.

If your school district refuses to do the screening, file an online complaint with the Office of Civil Rights. Don’t pass up a chance to change that child’s life.

40 years of studies now show conclusively that ADHD is best ameliorated with a multimodal approach: medication, family training, school staff training, modification of the environment, and therapy.

The next best ameliorative is medication alone. Just using meds came fairly close to achieving the same results as the multimodal approach in long-term double blind tests.

If severe ADHDers are not medicated by prescription, they will self medicate with drugs and alcohol by high school. That’s how badly their life sucks.

Juvenile halls, jails, drug dens, prisons, and rehabs are filled with ADHDers.

It is a myth that ADHD is over-diagnosed- just the opposite. Too many kids are not thriving in school. Too many adults are unable to keep a job.

It is common all over the world- although it may go by a different name.

European scientists were the first to do double blind testing. Many nations are far ahead of us in understanding ADHD and eliminating stigma.

Boys are diagnosed with the hyperactive type 4:1 over girls.

Girls are diagnosed 4:1 with the inattentive type.

Naturally, we catch the hyperactive boys at a younger age. They are a bigger classroom problem.

ADHD rates are exactly the same for male and females in adult populations, but in childhood far more boys are diagnosed than girls. This means we are not identifying enough girls.

If an unsupported ADHD child is of average or small size, he or she will be bullied and ostracized. If he or she is big, they will probably be the bully.

Identifying and supporting ADHDers will dramatically cut down on school bully problems.

ADHDers are ten times more likely to have trouble making friends, so help them out when you can.

ADHDers, especially the inattentive type, can usually manage classwork until junior high.

By about 7th grade their lack of executive functioning and poor short term memory make it impossible to keep up with complex schedules and multi-step assignments.

They really struggle to complete homework- unless they have patient one-on-one help and/or proper medication. They need constant praise, small rewards, and someone to keep them going.

Giving failing grades because homework was not turned in is unfair for these students.

Catching ADHDers in middle school is common but too late (but better than not at all). They should have received support much earlier for better long term results.

By middle school they’ve developed maladaptive coping behaviors and connected maladies such as depression and anxiety. Typically, they need three times the support of a student who is identified earlier, and they may not have enough time to develop coping skills for adulthood.

That amount of support is costly for districts. Earlier identification is cheaper.

ADHDers can easily be identified in preschool or Kindergarten- if we know what to look for. Teacher training is crucial- and it’s the law.

ADHD students can be identified by your school psychologist and then be eligible for services..

It is not necessary to have a doctor’s diagnosis before a student receives support for ADHD.

Of course, a doctor's diagnosis is required for medication.

ADHDers are often misdiagnosed with bipolar disorder, particularly the boys, because they can throw quite a tantrum when they perceive mistreatment by authority figures. It appears to be a sudden mood change, but the meltdowns do have a trigger.

If a student is offered an IEP with the designation of “Emotionally Disturbed” (a category sometimes used for emotional ADHD students) be sure to insist on a Functional Behavior Assessment (FBA). If the trigger that causes the emotional behavior can be identified and eliminated, then a huge barrier to that child’s progress has been removed.

An FBA is far cheaper and less invasive than all the possible money-sucking alternatives. Many of these students end up in expensive district-paid residential schools.

You must attend your student’s IEP and 504 meetings and actively participate.

Speak up for what is best for your student. That’s why you are there.

It is not your job to save your district money. In the long run, your lack of advocacy will cost your district and your community much more. Just follow the law for the correct result.

All decisions at IEP/504 meetings are made by consensus. Your voice is equal to any other at the table. Don’t let any one person rule the meeting. No one can make a unilateral decision. Be sceptical of agendas that try to limit participation.

You have the right to request an IEP/504 meeting whenever you believe your student needs a change in services. Let your union and your state agency know if your requests are ignored.

Parents are rapidly becoming quite savvy concerning special education laws- and they expect the people with whom they entrust their child to be an advocate. Federal and state laws back up their contention.

During the last ten years, lawyers have found it lucrative to take on special education cases- particularly ADHD cases.

As time goes on, it becomes much more difficult for a district to plead that they interpreted the laws a certain way. Each court case further defines the laws. There is little wiggle room left.

Compton Unified School District v Addison cleared the way for individual educators and entire school districts to be sued under 42 USC section 1983 (also known as the Ku Klux Klan Act) for damages related to educational neglect. Essentially, educators are accused of robbing the student of their education.

60% of ADHDers are also diagnosed with Oppositional Defiance Disorder (ODD) by 8th grade. Scientists seem divided: is it in their genes, or does it develop over time because adults and peers are so hard on them?

Left untreated, ODD can progress into Conduct Disorder, where rules and laws are meaningless. When they become adults, we usually label these people psychopaths.

It is crucial that we intervene with massive support as soon as ODD is identified.

ADHD is primarily an inherited condition (75%). If one parent is ADHD, there is a 50% chance each child will be ADHD.

ADHD students most often come from low income families. Most likely one or both adults have ADHD, therefore they often have addictions and trouble holding a job.

Ironically, parents who have ADHD are usually not the best fit for their children with ADHD. Special Education administrators and teachers have to brace themselves for possible inappropriate parent responses. It’s no wonder that districts avoid providing support to ADHDers - but they must.

ADHDers have neural receptors that work inefficiently- and they are the parts that control brain function. Proper medication helps them work more efficiently.

Proper medication for an ADHDer is the equivalent of taking blood pressure medication, or insulin. Some need a lot, some just a little.

Most ADHD children suffer without medication. They can’t think properly, and therefore act properly. They will fail at something everyday. They are yelled at and picked on. It’s humiliating.

Parents that medicate their ADHD child are heroes. It is difficult to prescribe just the right drug at the correct dosage on the first try. Parents have to return to the doctor, sometimes several times, to get the dosage just right. As the child grows, the dosage must change. Typically, parents must visit the doctor once per month. With co-pays for visits and prescriptions, it can be expensive, but the right thing to do.

Parents worry about the long-term effects of ADHD medication. Most of the medications have been in use for several decades. New medications are usually variants of older tried and true meds. There are many books and online forums for information.

Unmedicated ADHDers are reckless. They are in significantly more serious accidents than non- ADHD children. (Unmedicated ADHD teens should not be allowed to drive.)

They have a higher suicide rate. Depression is common for ADHDers.

Parents that medicate their children are often thought of as lazy, bad, and uncaring. There is a stigma. They need our support. Speak up whenever one is maligned.

Con artists are making a fortune by selling parents herbal remedies, or “special no-meds-needed cognitive therapy.” No herb or therapy will re-shape their brain. If they ask your advice, just tell them “NO.”

We’ve come a long way in developing ADHD meds. We can now successfully treat 85% of ADHDers without debilitating side effects. On the other hand…

1.4% of the student population will have ADHD that will be difficult or impossible to medicate. They may need a 1:1 aide to survive. They don’t deserve to be excluded or punished unfairly.

Usually, these ADHDers did not inherit their ADHD. Instead they have the acquired type, which is harder to medicate. They may have been exposed to prenatal tobacco, alcohol, or drugs. They may have had a traumatic brain injury, exposure to lead or other toxins, or were born very prematurely.

If you have a diagnosed but unmedicated ADHDer in your class, it is far more likely that the parent(s) decided not to medicate.

Currently, only 6.1% of ADHD students take meds.

Out of 32 students, you have a 50% chance that one of the three with ADHD will be medicated.

It is against the law to require a parent to medicate.

It is not against the law to discuss medication with parents- but don’t push your opinions- just offer researched facts.

Be aware that as they get older, unmedicated ADHDers are far more likely to abuse drugs and alcohol. Watch for signs.

Study after study shows that it is far safer to properly medicate ADHDers than to allow them to drift into addiction and illegal activities.

By law, school districts are required to train all educators about the disabilities they will encounter. They must know how to identify and support students with disabilities.

IEPs and 504 plans should always include a requirement that all staff members who interact with a particular ADHD student be knowledgeable and properly supportive. This includes the bus driver, school secretary, lunch servers, etc.

Untrained teachers and classroom aides can make ADHD effects much worse. They can do far more damage than good.

ADHD students can, and often do, get PTSD when mistreated.

If you feel you need training, let your administrators know.

Students need to learn all about their ADHD. They need to be able to speak up if their school modifications are not in place.

There are appropriate books for all ages. Ask your librarian to stock them.

It is a relief to students to finally understand why they are different. Otherwise they think they are bad, lazy, stupid, and crazy.

ADHD usually lasts a lifetime, but only half of identified adult ADHDers use medication. When they receive early support, they develop coping skills (and drink a lot of caffeine).

Imagine how life altering it would be if you identified an ADHD student early enough so that they did not need medication for the rest of their life!

Hyperactivity usually calms down after puberty. But it will remain difficult to focus on just one thing unless it is really interesting to the ADHDer.

ADHDers have the ability to hyperfocus on something they enjoy. They will stick to it for hours and days.

With meds, ADHD students can do fine in college, but their counselor needs to be informed. He/she can recommend professors and arrange some accommodations. Let your high school parents know.

Sadly, only one out of every eight ADHDers that starts college will ever finish. Parents must stay proactive because they are developmentally behind.

Autism and ADHD share at least one gene. It seems likely that we will someday include ADHD in the autism spectrum. Since they both present with poor social skills, this makes sense.

Currently, autistic sufferers are often misdiagnosed with ADHD. It is important that teachers speak up if they suspect a misdiagnosis. Meds and modifications are not the same.

If you have 30 students, it’s probable you’ll have 2 or 3 ADHD students. Don’t expect them to already be diagnosed and medicated. Look sharp for the inattentive type.

You are with your students for six hours a day. YOU are their educational advocate. So please do your job. Report any concerns. Please stand up for your students’ civil right to a good education.

For more information:

Go to youtube and watch: 30 Essential Ideas for Parents, by Dr. Russell Barkley, an internationally acclaimed ADHD researcher and activist. He also has several great books.

Check out ADDitudemag.com, cdc.gov, chadd.org, and wrightslaw.com for far more information. Wrightslaw.com is a central source for legal information.

All my information came from the sources above, particularly Dr. Barkley’s excellent book, Taking Charge of ADHD, Revised Edition: The Complete, Authoritative Guide for Parents, completely revised in 2013. It is well-written, with several laugh-out-loud passages, and a few stories that will break your heart.

Respectfully,

A teacher with ADHD (I HATED school!)

Updated: 2-14-2015

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