A Blog by Dr. Gary G. Brannigan and Dr. Howard Margolis

Many parents of children with Attention Deficit Hyperactivity Disorder (ADHD) ask if their children’s ADHD will continue through adolescence. Usually, it will.  They then ask if their children will have special needs. Below is what the National Institute of Mental Health (NIMH) says.

Most children with ADHD continue to have symptoms as they enter adolescence. Some children, however, are not diagnosed with ADHD until they reach adolescence. This is more common among children with predominantly inattentive symptoms because they are not necessarily disruptive at home or in school. In these children, the disorder becomes more apparent as academic demands increase and responsibilities mount. For all teens, these years are challenging. But for teens with ADHD, these years may be especially difficult.

Although hyperactivity tends to decrease as a child ages, teens who continue to be hyperactive may feel restless and try to do too many things at once. They may choose tasks or activities that have a quick payoff, rather than those that take more effort, but provide bigger, delayed rewards. Teens with primarily attention deficits struggle with school and other activities in which they are expected to be more self-reliant.

Teens also become more responsible for their own health decisions. When a child with ADHD is young, parents are more likely to be responsible for ensuring that their child maintains treatment. But when the child reaches adolescence, parents have less control, and those with ADHD may have difficulty sticking with treatment.

To help them stay healthy and provide needed structure, teens with ADHD should be given rules that are clear and easy to understand. Helping them stay focused and organized—such as posting a chart listing household chores and responsibilities with spaces to check off completed items—also may help.

Teens with or without ADHD want to be independent and try new things, and sometimes they will break rules. If your teen breaks rules, your response should be as calm and matter-of- fact as possible. Punishment should be used only rarely. Teens with ADHD often have trouble controlling their impulsivity and tempers can flare. Sometimes, a short time-out can be calming.

If your teen asks for later curfews and use of the car, listen to the request, give reasons for your opinions, and listen to your child’s opinion. Rules should be clear once they are set, but communication, negotiation, and compromise are helpful along the way. Maintaining treatments, such as medication and behavioral or family therapy, also can help with managing your teenager’s ADHD.

What about teens and driving?

Although many teens engage in risky behaviors, those with ADHD, especially untreated ADHD, are more likely to take more risks. In fact, in their first few years of driving, teens with ADHD are involved in nearly four times as many car accidents as those who do not have ADHD. They are also more likely to cause injury in accidents, and they get three times as many speeding tickets as their peers.

Most states now use a graduated licensing system, in which young drivers, both with and without ADHD, learn about progressively more challenging driving situations. The licensing system consists of three stages—learner’s permit, during which a licensed adult must always be in the car with the driving teen; intermediate (provisional) license; and full licensure. Parents should make sure that their teens, especially those with ADHD, understand and follow the rules of the road. Repeated driving practice under adult supervision is especially important for teens with ADHD.

Reference

This column originally appeared in Attention Deficit Hyperactivity Disorder (the National Institute of Mental Health, U.S. Department of Health and Human Services, 2008, pp. 14-15).

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The reading goals of struggling readers should emphasize only what they must learn to make meaningful, important progress. Having only a few important reading goals that must be emphasized during reading and related instruction increases the odds that teachers will devote an adequate amount of instructional time to overcoming the struggling reader’s specific reading difficulties. Too many goals lead to diluted, unfocused instruction.

If struggling readers get little instruction in what’s important, they make little progress. If instruction emphasizes everything, it emphasizes nothing. When it gives equal time to everything, that which is most important gets little time. Thus, an IEP’s reading goals should emphasize only that which the struggling reader must master to make important progress in reading. As Gregory Harper and his colleagues noted more than a decade ago, “Academic achievement is related directly to the amount of time students spend actually thinking about and working with important instructional content. Student involvement, in turn, is influenced by … allocated time-amount of time scheduled for a particular subject, topic, or skill; [and] engaged time-amount of time students are actively engaged with [the] academic content”

Here’s a sample IEP goal. It’s personalized, deals with only what’s important, and is measureable:

“Word Recognition Goal: Given 200 of the 200 sight words that Sue did not know when tested with the Dolch Word List in the second week of school, Sue will correctly pronounce each of these 200 words when they’re individually presented on flash cards. She will correctly pronounce each word within one second of exposure, on five consecutive school days, by the end of the 4th marking period.”

Because a goal like this is readily measurable, it allows you and your child’s teachers to easily monitor progress and, if it’s poor, to quickly make whatever instructional changes are needed.

You can find this goal and related instructional objectives in the forthcoming book, Reading Disabilities: Beating the Odds, by Howard Margolis and Gary Brannigan.

Reference:  Harper, G. F., Maheady, L., & Mallette, B., 1994. The power of peer-mediated instruction. In J. S. Thousand, R. A. Villa, & A. Nevin (Eds.), 1994. Creativity and Collaborative Learning. Baltimore, MD: Paul H. Brookes Publishing, pp. 229-241, p. 231, italics added.

HM

Several months ago, The New York Times published a blog by Will Okun, a Chicago high-school teacher who was worried about Etta, a conscientious, enthusiastic, hard working student whom he might have to fail. His blog was touching, perceptive, and troubling. It dealt with an all-too-common dilemma that affects struggling readers and their teachers. He wrote:

Unfortunately, Etta reads and writes at approximately a 7^th grade level…. How have students like Etta reached the 11^th grade with only basic reading and writing skills?…. If I fail her, she will have to repeat my class. Because of our school’s resources, the class size and my own teaching abilities, there is little hope that I can significantly strengthen her reading and writing skills…. If I automatically fail students who are not performing at grade level, I will be forced to fail Etta year upon year until she inevitably drops out.

I was so moved by his blog and so angry at his dilemma that I sent his blog a quick, superficial response. Here’s a more comprehensive one.

Demanding the Unreasonable

All a school can reasonably ask of struggling readers is that they sustain a good effort to achieve and conscientiously use the knowledge, skills, and learning strategies they’ve mastered. Schools should not hold them responsible for reading disabilities, language difficulties, impoverished backgrounds, chaotic homes turbulent communities, and inadequate school resources. Unfortunately, politicians have forced schools to hold struggling readers, especially economically impoverished ones, responsible for these and other factors they cannot control. This is more than unreasonable — it’s disgraceful.

It’s disgraceful that teachers should have to fail hard-working students for below-average or below grade-level work. Not everyone has had average opportunities, not everyone has average abilities, not everyone can be average. By definition, grade level performance means average; it’s a standard based on average performance. Thus, many students will always perform above and many below grade level, above and below average. Take my story. Despite my great effort, despite my determination, despite two encouraging football coaches, I could never run as fast as the average high school student. Some players could speed-walk faster than I could run. But I wasn’t cut; I didn’t fail; I wasn’t punished for what I couldn’t control; I was treated with respect. And so I kept my enthusiasm. I suited up for lots of games, watching from the end of the bench. And despite not getting into a single game, I won a game ball for determination. Some 48 years later, the opportunity and treatment I received — despite my sluggish speed — continues to serve me well.

Like my sluggish speed, some students — for untold reasons — simply lack the underlying language and cognitive abilities to achieve what’s average, despite herculean efforts. But often schools, perhaps unwittingly, punish them: Schools fail them, retain them, set them on the path to dropping out. Why? Because their hard work hasn’t produced average academic achievement or acceptable test scores. This is, euphemistically speaking, disgraceful. It punishes hard working students for what they cannot control.

Preventing Problems

Certainly, preschool intervention is one of the keys to preventing learning problems that lead to failure and retention. Another key is comprehensive, sustained economic and health support for impoverished communities. But these solutions receive minuscule, if any political support and are often far too late for high school students who, despite reading problems, work hard in school but continually face failure.

Responding to Failure

So, what should teachers do for struggling high school readers who work hard, but for many reasons, like reading and language disabilities, are failing their subjects? The answer: Pass them. After all, they’re working hard. They’re doing all anyone can do-making the effort. Teachers (and parents) should also advocate for the services these learners need to succeed, services often unavailable to them. Without needed services, it’s unlikely that they’ll ever function on grade level. The odds for success are against them. Failure and despair may become their frequent companions.

Services might include mentoring, counseling, homework help, tutorials from reading specialists, training in assistive technology (like Flamereader and TextAloud, two excellent, inexpensive text-to-speech software programs), health care, and social work. Let’s look at the last two, as they’re often ignored. Health examinations can identify and help solve common but often invisible problems that sabotage students’ academics and well-being, problems like anemia, poor nutrition, sleep deprivation. Social work services can identify and help solve numerous problems, especially problems that plague students from poor, turbulent neighborhoods. These include loneliness, hunger, exhaustion, excessive after-school work, responsibility for siblings, unrelenting fear of tough, violent neighborhoods.

The argument against passing struggling readers is that that they cannot do grade level work. But failing and retaining them rarely helps them achieve grade level. Often, it destroys motivation, exacerbates academic difficulties, scars students emotionally, and creates social problems. Having a 13-year old student in fifth grade can easily create social and emotional problems for everyone: the teacher, the student, and his 10- and 11-year old classmates. It makes far more sense to promote him, note his instructional levels on his report card, and provide him with the academic and related services he needs.

What should schools do for struggling readers who work hard, but fail their high-stakes “graduation” tests? If legally possible, let them graduate — they’ve done what they could. Denying graduation will tell them that effort doesn’t matter. It will create a gigantic, perhaps insurmountable obstacle to getting a decent job or attending a post-secondary program. It may well create or perpetuate poverty.

To remove this obstacle and to communicate more effectively to prospective employers and post-secondary programs, high schools can award diplomas that list students’ high-stakes test scores, list their grade point averages in different subjects, specify how to request official transcripts, and indicate students’ positive personal attributes, such as perseverance, reliability, and talents. This will help hard-working students to get better jobs and to get into post secondary programs that challenge but don’t overwhelm them. It will show them that they’re more than test scores and that when challenge matches achievement, effort produces growth and success.

If schools can’t or won’t do this, at a minimum, they should do what some California districts are doing: Award a certificate stating that the student has successfully completed his or her coursework.

Creating Opportunities

Education is about showing all students — including those suffering from economic impoverishment or reading disabilities — that schools respect them, care about them, and will do all they can to give them meaningful opportunities. Failing them and slamming doors in their face by denying graduation will harm more than just these students. In all likelihood, stories about retaining hard-working students or denying them graduation will spread to other students and to their communities. Three messages will emerge: Effort means little; test scores trump students’ needs and futures; schools punish, not empower. This will crush the academic motivation of many students and will induce many to drop out, a sad but understandable decision that typically creates irreparable damage.

It will also damage the nation. Repeated exponentially across communities, punishing hard working students for their academic problems will likely add to America’s high poverty rate, increase its high incarceration rate, and further damage its eroding ability to compete globally. Thus, self-interest should have-but has not-compelled federal and state governments to help schools develop and sustain a rich array of alternative programs that create attractive opportunities for hard-working students who struggle, yet fail to pass or gain much from their general education courses.

To succeed, alternative programs must be well-funded, well-staffed, highly-personalized, and have high-status. Their curriculum must match the interests and current abilities of their students and prove to them that with effort and the proper application of learning strategies, they can achieve what they and society value highly. They must show students that success will improve their futures in ways they value. The design of such programs and their status must prevent them from becoming “dumping grounds.”

Taking Political Action.

Teachers and other educators must follow state, district, and building policies, no matter their effects. If these policies are destructive, teachers have two options for changing policies: Do nothing, and let the students suffer — a legal but morally unsatisfying option — or take sustained political action.

To prevent the negative effects of destructive policies and inadequate budgets, teachers (and parents) must take political action that focuses on both the long and short term. Long term, they must work to develop deep, widespread public support for programs that prevent failure and offer attractive, beneficial options for struggling readers. This involves focusing on policies-including tax, health, and community development policies-and the hidden but powerful driving force behind them: values. Focusing only on what happens in school is insufficient to prevent or remediate many learning problems. Sick, hungry, frightened students from poor, turbulent neighborhoods have far less chance of succeeding in school than do healthy, well-nourished students from neighborhoods with safe parks, good libraries, and good median incomes. (Yes-zip codes count.) Short term, teachers (and parents) must work to develop widespread support for annual budgets that create opportunities for struggling readers to succeed and that quickly give them the extra instruction and supports they need. This involves joining advocacy groups (e.g., Children’s Defense Fund), giving talks, discussing budgets with politicians, speaking to boards of education, campaigning for budgets, and publishing opinion pieces. As part of a group, they can also meet with administrators to discuss the effects of local policies and offer alternatives.

Helping Etta and All the Ettas

Unless Will Okun and all the other Wills can get Etta and all the other Ettas the help they need — in and out of school — it’s unlikely that the Ettas will prosper in school and life. They live in a time of punitive policies cloaked in the mantle of standards and personal responsibility.

So, to get help for all the Ettas, Will and his peers, like all dedicated teachers, will have to ask, plead, and perhaps cajole their administrators-who probably don’t have the resources to give. And even if the resources suddenly appear, it will probably take Etta two or more years of intensive, highly knowledgeable, highly skilled reading help to reach grade level and pass her tests, if she has the language and cognitive abilities to pass them. By then, it may be too late-policy may have dictated failure and retention. Nevertheless, Will should try to get Etta the services she needs.

To prevent this depressing, unconscionable problem from continuously destroying lives, Will, and all the Wills who care about all the Ettas, need to engage in focused, sustained political action that advocates for humane, comprehensive, empowering programs supported by high-quality research. To do less is to continually see this dilemma replayed-like “Groundhog Day” with tears, not laughs.

This article was first published in Strategies for Successful Learning (Learning Disabilities Worldwide; www.ldworldwide.org).

HM

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When comprehensively evaluating the reading of children with reading disabilities, many evaluators limit their evaluations to reading tests and perhaps a quick, superficial observation of the child in class. They fail to supplement testing with a structured analysis of the reader’s learning environment and the teacher’s instructional practices. As two leading university professors, Marjorie Lipson and Karen Wixson, concluded, understanding the struggling reader’s instructional environment is often key to remedying her problems:

Traditional assessment looks only to the student as the source of reading and writing difficulties. Clearly, students’ knowledge, skill, and motivation are crucial factors in reading and writing achievement. However, a growing body of research demonstrates that instructional context and methods can support learning or contribute to disability. Assessment that is intended to inform instruction requires careful descriptions of how different aspects of the instructional environment influence learning in general and how they match the needs of particular students.

Because no test can evaluate a struggling reader’s instructional environment, evaluators need to do more than administer reading tests; they need to systematically observe and assess the struggling reader’s instructional environment. Doing so will help to identify barriers to learning.

HM