Sharon Russell watched Josh struggling in class. She could tell that Josh had ADHD, just as she could tell that the student squinting in the front row needed glasses. After so many years of teaching, you begin to recognize these things.
Sharon talked with the school psychologist and asked him to come in and take a look. After the observation, Josh was sent home with information about ADHD and the possible benefits of medication.
Josh's parents read the information, talked with their son's teacher and called a doctor. The child's behavior and grades showed almost immediate improvement once he began treatment.
Such a scenario would be illegal under a new law passed in Connecticut. The law — approved unanimously by the Legislature and signed by Gov. John G. Rowland — prohibits teachers, counselors and other school officials from recommending psychiatric medication.
The Connecticut law is the latest reaction to concerns about medications and children. Driven partly by legitimate concerns about the increasing numbers of children on medication, and partly by misinformation and political pressure about ADHD, over a dozen states have either considered or passed similar laws and resolutions.
Some parents feel that the Connecticut law is unnecessary because it is simply restates what should be common sense. "Teachers should not be diagnosing ADHD," said one mother of an ADHD child. "We don't need a law that says that." Advocates for the ADHD Community fear that this may be an escalation of attempts made to discredit or even ban medications used to treat ADHD.
Many educators feel that the problem is overstated. Headlines proclaim that the federal Drug Enforcement Administration says that as many as 6 percent of students in some elementary and middle schools take Ritalin or other psychiatric drugs. However, the headlines don't point out that according to the National Institute of Health, 3 to 5 percent of children have ADHD. In fact, recent research published in the journal Pediatrics (March, 2001) indicates that as many as 4 to 12 percent of children may have ADHD.
Caught in the middle
There is no question that teachers are in a unique position to be able to observe the problems of children. An accurate ADHD diagnosis requires input from the teacher and other adults in the child's life. It's hard to watch a student fail when you know that he or she could succeed given the proper tools and treatment.
But ADHD is a complex diagnosis. There are conditions that may mimic the disorder and other conditions that may accompany and complicate the diagnosis. While teachers may be in an excellent position to observe classroom behavior, they may not have the advantage of knowing the child's medical history or personal circumstances. They lack the medical expertise to make a diagnosis.
The teacher finds herself caught between her desire to help the child and her inability to do so. "This student could do so well, if only they would... "
What can a teacher do?
Treat any case of ADHD as you would any other suspected student health problem. Report the symptoms and suggest that the student see a doctor. That's what you would do if the child had a sore throat. You wouldn't hold a conference telling the parents that they have to have the kid's tonsils removed.
Hopefully the parents will seek treatment. But, even if they don't, there are still some simple classroom accommodations that you can make for this child. The Attention Deficit Disorder Association (ADDA) makes the following recommendations:
- Reduce potential distractions. Always seat the student who has problems with focus near the source of instruction and/or stand near student when giving instructions in order to help the student by reducing barriers and distractions between him and the lesson. Always seat this student in a low-distraction work area in the classroom.
- Use positive peer models. Encourage the student to sit near positive role models to ease the distractions from other students with challenging or diverting behaviors.
- Prepare for transitions. Remind the student about what is coming next (next class, recess, time for a different book, etc.). For special events like field trips or other activities, be sure to give plenty of advance notice and reminders. Help the student in preparing for the end of the day and going home, supervise the student's book bag for necessary items needed for homework.
- Allow for movement. Allow the student to move around, preferably by creating reasons for the movement. Provide opportunities for physical action — do an errand, wash the blackboard, get a drink of water, go to the bathroom, etc. If this is not practical, then permit the student to play with small objects kept in their desks that can be manipulated quietly, such as a soft squeeze ball, if it isn't too distracting.
- Let the children play. Do not use daily recess as a time to make-up missed schoolwork. Do not remove daily recess as punishment.