“It’s Time for Society to Catch Up With Science.”
Impatient teachers and misconceptions about ADHD can cause students to feel out of place at school. Learn how one mom took her son’s education into her own hands by choosing a school with ADHD accommodations.
I’m a little bit late to pick up my son, T.K., at school, so he’s sitting in study hall finishing his math homework. On my way in, I see his geography teacher – the only one whose patience has not yet worn horribly thin. “How’s my boy doing?” I ask, in the most robustly positive tone I can muster.
“Don’t ask any questions you don’t want the answer to,” she says, head down as she hurries past me toward the door. I know in an instant that my last ally is lost.
T.K. has attention deficit hyperactivity disorder, but it’s not the garden variety case that makes kids fidget in their seats and drift off during class. His ADHD is severe; it muddles his thinking, impairs his memory, and undermines his efforts to control his social behavior. And that’s on a good day, with medications in full effect. Without them, he is almost totally disabled.
I’ve walked this dreadful walk through schools before. In preschool and kindergarten, the most well-intentioned teachers became exasperated eventually. T.K. hit other children, blurted “shut up” on the playground, talked incessantly during circle time, couldn’t follow directions. He wasn’t learning anything; nothing he said made sense. Two or three times a month the principal would call me to pick him up. He’d shoved a girl to the ground at recess, thrown clay at the art teacher, become disruptive in the library.
Yet T.K. was not malicious or mean. Even then, his teachers described him as compassionate, affectionate, unusually empathetic for his age. His verbal and physical outbursts were oddly out of character and almost always followed by remorse and self-recrimination. “Why can’t I stop?” he would sob. Timeout and other forms of punishment seemed so futile.
We were relieved when we got a diagnosis because ADHD is treatable. Behavioral therapy, medications and a highly structured home environment almost always help ADHD kids. Immediately after he started medication, T.K. slowed down enough to hear the teacher and begin to learn. Behavioral therapy helped him manage the hitting and verbal blurting. At home, positive discipline based on systemized behavior charts and earned rewards reinforced appropriate conduct.
While these interventions can — and did — provide dramatic results, they do not cure ADHD. T.K. was in far better control of himself, but only 80 percent of the time. The remaining 20 percent — coupled with his learning disabilities that often occur with ADHD — still proved too overwhelming for most of his public school teachers. Shunted into special education classes, T.K. fell even further behind his peers and faced ridicule on the playground. His confidence plummeted.
With great reluctance, we enrolled him in a private, special needs school primarily for children with ADHD. But to our delight, T.K. began to thrive in this environment. Teachers trained to work with ADHD kids turned him around. They provided a partition to put around his desk when other children distracted him. If he needed to do his math problems standing up, stand up he did. He didn’t just memorize the mountain regions of Tibet, he experienced them, building papier-mache peaks and painting the summits snowy white. He felt smart. He relaxed. He skipped the second grade.
The happy, helpful, engaging child I always knew was there emerged for the rest of the world to see. His friends’ parents loved having him over because he was so well mannered. He was generous and kind with his younger brother, sharing his toys, teaching him games, making him laugh. His teachers loved him. If a classmate fell on the playground, he’d be the first one — often the only one — to rush over and comfort his friend. His impulsive ADHD symptoms continued to plague him, particularly under stress, but he found ways to handle them. “Every now and then T.K. will fall into inappropriate behaviors,” his fifth grade teacher wrote on his report card. “But he assumes responsibility, apologizes and moves on. One-on-one, T.K. does very well, especially with adults, and is able to hold a meaningful conversation. I’ve enjoyed engaging in some of those conversations.”
This year, in sixth grade, it all fell apart. We mainstreamed T.K. — in part because his special needs school ends at fifth grade, but also because he seemed ready. While there were academic peaks and valleys, standardized tests showed him reading at an eleventh grade level. Indeed, one of special education’s primary goals is to prepare kids for the “real” world and integrate them as quickly as possible; kids with ADHD who can be mainstreamed fare far better academically and socially than those in special education, studies show. We knew if we could find a school that would work with us to manage academic stressors, his ADHD would not be a major problem.
I found a tiny private school — only 12 students per grade — willing to make the necessary accommodations. I suggested all the standard ADHD accommodations that had helped him get this far: seating in the front row; fewer and shorter homework assignments; study buddies and note-sharing; assignments provided in writing; stress breaks during long class periods; brief, daily written communication between his primary teacher and parents; tests given orally, untimed or to take home. To reduce his stress load even further, we hired a tutor for extra support.
T.K. was so eager to be in a real school with regular kids and lockers. I will never forget the mix of joy and trepidation on his face as he scampered down the aisle at Target picking out posters and Pokemon figures for his locker, iridescent green book covers, psychedelic pencils, his first protractor. He so desperately wanted to fit in, and so desperately feared he would not. But the problems began on day one. Most teachers made no modifications to the homework load; T.K., a slow worker intent on succeeding, was up well past bedtime trying to complete assignments. Many never even got started.
From there, things went downhill fast. We’d stay up until 11 to prepare for a quiz until he knew the material down cold. But most of his teachers were unwilling to modify test-taking procedures: T.K. went blank on paper and brought home F’s and D’s. They didn’t provide assignments in writing: T.K. wrote the instructions incorrectly, turned in the wrong work. He forgot to bring home his books. He got distracted by the Pokemon figures in his locker and showed up late for class. The teachers got annoyed and angry. When he left his science folder in his locker and asked to go get it, his science teacher said no, then grumbled loudly enough for his classmates to hear: “Because it would probably take you about 40 minutes.”
T.K. came home in tears. We had prepared him for teasing from kids his own age, but not from his teachers. “I used to love science,” he cried. “I really wanted to like her, but she’s so mean.”
The stress got to him. When I told him it was homework time, he’d throw his notebook to the floor, papers flying. “Why should I work so hard if I’m only going to get a D,” he’d ask. I tried to tell him that grades didn’t matter, as long as he tried his best. But the damage was already done: He felt stupid.
Then the phone calls from the school officials started. T.K. had told other kids to “shut up” in class. He couldn’t pay attention; his answers and comments began to make less sense. He flew into a rage when the geography teacher handed him a hefty assignment, slamming it down on her desk. Halfway through a particularly difficult science test, he left the room, punched his locker with his fist and banged his head on the wall. They were concerned about his participating in an overnight field trip because he couldn’t manage his own medication.
The tutor met with the teachers. She told them T.K. would do fine if they would only abide by the basic classroom accommodations I had suggested. The science teacher flatly refused. “I don’t have the patience for this,” she said. And T.K. no longer had the will. “I just want to be with kids who are like me,” he finally confessed on the way home one day. “I’m not comfortable in this school.” And neither was I.
Sadly, the real world is not a friendly place for children with problems like ADHD. There are too many people who refuse to believe it exists, choosing instead to blame parents and kids for its symptoms. Our situation blew up because some of those nonbelievers were among T.K.’s teachers. Totally disregarding all scholarly research and evidence, they framed his behavior as poor discipline, laziness and willfully bad behavior, then got frustrated and angry when he didn’t respond to their “methods.”
I wonder what will happen in Colorado, where the state’s school board recently told teachers not to recommend medical treatment for ADHD, and to employ “discipline” in the classroom instead. These teachers are going to get frustrated and angry, too, because that approach is not going to work. Research and experience clearly demonstrate that children truly afflicted with ADHD and similar disorders don’t respond to punishment/reward-based discipline, in large part because of their neurologically impaired memory and diminished insight.
Fortunately, we found T.K. an excellent new school for special needs kids, one that not only accepts his differences but also helps him use them as part of the solution; when T.K. takes tests orally, the verbal interchange somehow jogs his memory and helps him find the correct answer. His teachers treat him with respect, never blame him for his symptoms and help him take as much responsibility as he can handle. With the same accommodations I had asked of the mainstream school, T.K. is happy and thriving again. And once again he sees himself as a good kid and not a troublemaker. And smart.
But what happens to the millions of other ADHD kids whose parents don’t have the wherewithal to advocate for them, or to afford special schools, or who don’t live in communities where excellent public or private special programs exist? They drop out. They think of themselves as stupid. Many end up in dead-end menial jobs. Others end up in prison; studies show as many as 76 percent of male juvenile detainees have ADHD. And teachers hold the keys as surely as prison guards do.
Perhaps part of the problem is that there is so much misdiagnosis. Too many parents and teachers cry “ADHD” when normal kids behave badly. But the larger issue is that brain-based disorders make us uncomfortable. We only seem to believe and embrace the suffering when their problems are visible physically.
Clearly, it’s time for society to catch up with science. As the surgeon general recently announced, more than half of Americans suffer from a psychiatric disorder at some point in their lives, yet most don’t get treated because of stigma. And stigma exist in large part because of the ignorant conviction that psychiatric disorders like depression and ADHD are signs of weak will and moral failure, not neurobiological — and treatable — problems.
Originally published in The Washington Post, Tuesday, March 14, 2000.