Sunday, September 25, 2016

6 Common Assumptions About ADHD That Aren’t Helping Students

Casey Quinlan
Education reporter at ThinkProgress.

Aug 17 2016 


The U.S. Department of Education released a letter to schools last week informing them of their obligations to identify and assist students with ADHD, or Attention Deficit Hyperactivity Disorder. The guidance reminded schools of their obligations toward students with ADHD, since 10 percent of the department’s 16,000 Office of Civil Rights complaints involve allegations of discrimination against students with the disorder.
According to the department, the most common complaint is that students aren’t identified in a timely manner or evaluated properly. Schools often fail to distribute information to staff on how to identify students and provide them with the right interventions and allow financial considerations into decisions about identifying and helping students.
The guidance also challenges pernicious stereotypes and assumptions that set students with ADHD back. Teachers may assume that students who perform well on tests and on homework don’t need to be diagnosed, that girls don’t have ADHD, and that interventions should only allow for things like more time on tests instead of teaching kids skills to manage their time. There are also a lot of misunderstandings about what learning disorders such as ADHD are and how they work. Here are some of the most common assumptions:
We’re identifying kids of all races and ethnicities
A 2013 study found that black children were almost two-thirds less likely to be seen as having ADHD symptoms compared to white children, and Hispanic children, Asian children, and children of other races were about half as likely to have these symptoms noticed compared to white students.
Myles Moody, a Ph.D. student at the University of Kentucky’s Department of Sociology, has studied issues of ADHD diagnosis of black students, the school-to-prison pipeline, and parent-teacher relationships. Research has shown that black students in particular are more likely to receive suspensions and expulsions, that teachers can be racially biased in doling out discipline, and that black children are seen as older than they actually are.
“They’re not getting the help that they need and studies continue to show that there is a huge gap in assessments, and that black children are disproportionately under-diagnosed for the disorder, even though it hasn’t yet been proven that they are less likely to have the disorder,” Moody said. “I believe that this is a cause for concern. Many other scholars have been working in this area, and it certainly warants attention from policymakers, teachers and parents of children with ADHD. It’s a cause for concern for everyone.”
Moody added that there are a number of reasons why this might be the case, such as a tendency to pursue discipline over identifying behavior and offering help when it comes to black students, a lack of connection between parents and teachers in schools in low-income neighborhoods, and the distrust some black people may carry of anything having to do with diagnosis or assessment of behavioral issues.
Moody said that his recent research on relationships between parents and teachers required him to speak to teachers at schools in low-income neighborhoods. He said that distrust of professional medical scrutiny — due to a history of black people being subjected to experiments in the scientific community — doesn’t help either, and may contribute to teachers and family members seeing diagnosis as a “last resort.”
“I asked him, ‘How many referrals for assessment have you made as a teacher?’ and he replied ‘None, I refuse to,’ and the reasoning was he felt as though he wasn’t doing enough as a teacher to improve his classroom management and he wanted to try every option before he resorted to ADHD assessment. He saw ADHD diagnoses and treatment as a last resort and when teachers are looking at it as a last resort, it can be a huge barrier [to diagnosis], even though they may mean well and have good intentions,” Moody said.
Kids with good grades don’t have ADHD
The letter also knocks down the idea that students who are excelling academically wouldn’t have ADHD or need assessment for ADHD. Judith R. Harrison, an assistant professor at the Graduate School of Education at Rutgers University whose research focuses on special education, pointed out that grades are not always the best indication of what a student is learning.
“If a child has support at home with organizing their materials so they get to school and manage to turn all of their assignments in and their grades are good, they still haven’t learned to organize their materials, so it doesn’t really reflect what skills they’re learning,” Harrison said.
Students with ADHD may also have issues with learning certain social skills as well, Harrison said.
“They’re impulsive and they interrupt, not all, but as a group they tend to be loud and hyper. So if you’re working on a group project and someone in your group is demonstrating those behaviors, then it makes group work difficult,” Harrison said.
Girls don’t have ADHD
There is a tendency for educators to identify boys as having ADHD far more than girls because people most associate a hyperactive-impulsive type of ADHD with ADHD. Girls, who are more likely to have Inattentive ADHD, which means they may be easily forgetful, disorganized, and don’t finish their work, may also try to cover up their symptoms because they are expected to perform better at school, experts say. These cultural expectations make it difficult for girls to ask for help or for educators to see them as being in need of help.
Rae Jacobson wrote about her experience with ADHD in New York Magazine last year. She wrote, “Beyond my failures at school and work, not being able to focus made me feel like I’d failed at being a girl. Having ADHD is challenging regardless of gender but in a world predisposed to undermining women, not having your shit together can feel like a dereliction of feminine duty.”
This under-diagnosis of girls is beginning to change, however. Diagnoses for girls have risen 55 percent from 2003 to 2011, according to a study in the Journal of Clinical Psychiatry and prescriptions for medicine for ADHD is increasing for women too. Since girls and women are often identified later, it has been beneficial to girls and women with ADHD that the Diagnostic and Statistical Manual of Mental Disorders was recently revised to show that ADHD symptoms could cause impairment before age 12 and explained how symptoms could appear in adolescence and adulthood.
It will fade over time
One of the challenges of identifying students is that parents may be reluctant to acknowledge the child’s struggles with attention and hyperactivity are more than a phase. According to a 2014 survey from the National Center for Learning Disabilities, parents surveyed said they assumed traits tied to learning disabilities in children ages 3 and 4 would go away and two in three were reluctant to ask about early intervention services.
Harrison said that assumption is becoming less of a problem but it is still there. The child’s symptoms may become less visible over time, but that doesn’t mean they aren’t there and affecting the child’s ability to organize and concentrate on a task.
“That has been a common belief for years, that they grow out of it, and I think it’s worse for kids with ADHD because the hyperactivity tends to get better as they get older so what you physically see — the movement — would turn more into things like doodling instead of running around the room. So maybe it looks like it’s going away but the inattention is still there. I think we’re learning over time that it’s not going away,” Harrison said.
Accommodations are the only solution
Harrison said there is a tendency for schools to think about accommodations as the only way to help kids with ADHD do better in school, but Harrison said it’s just as important for kids to learn the skills to do things they find challenging, such as taking notes or figuring out how to organize a long-term project for example. One of the things that impressed her about the department’s letter was its choice to downplay accommodations.
“For example, if we think a kid can’t take notes we give them notes instead of teaching them to take notes, and there is no research to support that. None. So what I am trying to do is see if there are interventions we can use to teach those skills. It may take longer, it may be a struggle, but we need to teach them and have those accommodations but phase them out,” she said.
Everyone’s needs are the same
As the department makes clear in its guidance, not all children with disabilities and learning disorders benefit from the same interventions, and neither students with ADHD. The interventions should depend on an individual child’s needs, a directive Harrison was happy to see. For example, the department said that one student may need more time on an exam but another child may need a different testing format because they struggle with multiple choice questions. Some children may need behavioral but not academic interventions.
“They talk about not just using a laundry list of strategies. They talk about it being needs-based, which is huge, so what does this child need compared to this child? Because those things could be totally different. Not all strategies work for all students,” Harrison said.

Saturday, September 24, 2016

Exercise Is ADHD Medication

Exercise Is ADHD Medication
Physical movement improves mental focus, memory, and cognitive flexibility; new research shows just how critical it is to academic performance.


Mental exercises to build (or rebuild) attention span have shown promise recently as adjuncts or alternatives to amphetamines in addressing symptoms common to Attention Deficit Hyperactivity Disorder (ADHD). Building cognitive control, to be better able to focus on just one thing, or single-task, might involve regular practice with a specialized video game that reinforces "top-down" cognitive modulation, as was the case in a popular paper in Nature last year. Cool but still notional. More insipid but also more clearly critical to addressing what's being called the ADHD epidemic is plain old physical activity.
This morning the medical journal Pediatrics published research that found kids who took part in a regular physical activity program showed important enhancement of cognitive performance and brain function. The findings, according to University of Illinois professor Charles Hillman and colleagues, "demonstrate a causal effect of a physical program on executive control, and provide support for physical activity for improving childhood cognition and brain health." If it seems odd that this is something that still needs support, that's because it is odd, yes. Physical activity is clearly a high, high-yield investment for all kids, but especially those attentive or hyperactive. This brand of research is still published and written about as though it were a novel finding, in part because exercise programs for kids remain underfunded and underprioritized in many school curricula, even though exercise is clearly integral to maximizing the utility of time spent in class.

The improvements in this case came in executive control, which consists of inhibition (resisting distraction, maintaining focus), working memory, and cognitive flexibility (switching between tasks). The images above show the brain activity in the group of kids who did the program as opposed to the group that didn't. It's the kind of difference that's so dramatic it's a little unsettling. The study only lasted nine months, but when you're only seven years old, nine months is a long time to be sitting in class with a blue head.

t may potentially be advisable to consider possibly implementing more exercise opportunities for kids.

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Thursday, September 22, 2016

probiotics for Depression

Evolutionary Psychiatry

Feb 21 2016 

A few weeks ago the first video in our monthly series with Dr. Drew Ramsey came out on Medscape Psychiatry, discussing some of the highlights of brain food and the microbiome from research in 2015. Some interest expressed in the comments focused on one of the last studies we mentioned, published late in the year in the journal Nutrition: “Clinical and metabolic response to probiotic administration in patients with major depressive disorder: A randomized, double-blind, placebo-controlled trial.”

There are a number of fascinating things about this paper, which to my knowledge is the first trial of probiotics in people with major depressive disorder specifically looking at biomarkers of inflammation and depressive symptoms. 40 patients total so not huge, but bigger than most pilot trials. They used three strains of probiotics in a capsule (Lactobacillus acidophilus, Lactobacillus casei, and Bifidobacterium bifidum, two billion colony forming units of each), and checked not only records of diet, but also serum glucose and other measures of metabolism along with a lab test that looks at inflammation called C reactive protein.
Probiotics are anti-inflammatory microbes that seem to affect the gut in a positive way, decreasing stress signaling in the body and possibly even increasing the transformation of the amino acid tryptophan to serotonin in the brain. In both their anti-inflammatory capacity and their serotonin capacity, probiotics have *some* overall effects similar to antidepressants such as SSRIs, but so far I’ve seen no literature to suggest that probiotics could cause problems such as serotonin syndrome, anxiety, jitteriness, or an increase in suicidal thoughts, or an uncomfortable discontinuation syndrome that SSRIs can sometimes cause when stopping the medication too suddenly.

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Monday, September 19, 2016

Why French Kids Don't Have ADHD

Why French Kids Don't Have ADHD
French children don't need medications to control their behavior.

In the United States, at least 9 percent of school-aged children have been diagnosed with ADHD, and are taking pharmaceutical medications. In France, the percentage of kids diagnosed and medicated for ADHD is less than .5 percent. How has the epidemic of ADHD—firmly established in the U.S.—almost completely passed over children in France?
Is ADHD a biological-neurological disorder? Surprisingly, the answer to this question depends on whether you live in France or in the U.S. In the United States, child psychiatrists consider ADHD to be a biological disorder with biological causes. The preferred treatment is also biological—psycho stimulant medications such as Ritalin and Adderall.
French child psychiatrists, on the other hand, view ADHD as a medical condition that has psycho-social and situational causes. Instead of treating children's focusing and behavioral problems with drugs, French doctors prefer to look for the underlying issue that is causing the child distress—not in the child's brain but in the child's social context. They then choose to treat the underlying social context problem with psychotherapy or family counseling. This is a very different way of seeing things from the American tendency to attribute all symptoms to a biological dysfunction such as a chemical imbalance in the child's brain.
French child psychiatrists don't use the same system of classification of childhood emotional problems as American psychiatrists. They do not use the Diagnostic and Statistical Manual of Mental Disorders or DSM. According to Sociologist Manuel Vallee, the French Federation of Psychiatry developed an alternative classification system as a resistance to the influence of the DSM-3. This alternative was the CFTMEA (Classification Française des Troubles Mentaux de L'Enfant et de L'Adolescent), first released in 1983, and updated in 1988 and 2000. The focus of CFTMEA is on identifying and addressing the underlying psychosocial causes of children's symptoms, not on finding the best pharmacological bandaids with which to mask symptoms.
To the extent that French clinicians are successful at finding and repairing what has gone awry in the child's social context, fewer children qualify for the ADHD diagnosis. Moreover, the definition of ADHD is not as broad as in the American system, which, in my view, tends to "pathologize" much of what is normal childhood behavior. The DSM specifically does not consider underlying causes. It thus leads clinicians to give the ADHD diagnosis to a much larger number of symptomatic children, while also encouraging them to treat those children with pharmaceuticals.
The French holistic, psychosocial approach also allows for considering nutritional causes for ADHD-type symptoms—specifically the fact that the behavior of some children is worsened after eating foods with artificial colors, certain preservatives, and/or allergens. Clinicians who work with troubled children in this country—not to mention parents of many ADHD kids—are well aware that dietary interventions can sometimes help a child's problem. In the U.S., the strict focus on pharmaceutical treatment of ADHD, however, encourages clinicians to ignore the influence of dietary factors on children's behavior.
And then, of course, there are the vastly different philosophies of child-rearing in the U.S. and France. These divergent philosophies could account for why French children are generally better-behaved than their American counterparts. Pamela Druckerman highlights the divergent parenting styles in her recent book, Bringing up Bébé. I believe her insights are relevant to a discussion of why French children are not diagnosed with ADHD in anything like the numbers we are seeing in the U.S.
From the time their children are born, French parents provide them with a firm cadre—the word means "frame" or "structure." Children are not allowed, for example, to snack whenever they want. Mealtimes are at four specific times of the day. French children learn to wait patiently for meals, rather than eating snack foods whenever they feel like it. French babies, too, are expected to conform to limits set by parents and not by their crying selves. French parents let their babies "cry it out" (for no more than a few minutes of course) if they are not sleeping through the night at the age of four months.
French parents, Druckerman observes, love their children just as much as American parents. They give them piano lessons, take them to sports practice, and encourage them to make the most of their talents. But French parents have a different philosophy of discipline. Consistently enforced limits, in the French view, make children feel safe and secure. Clear limits, they believe, actually make a child feel happier and safer—something that is congruent with my own experience as both a therapist and a parent. Finally, French parents believe that hearing the word "no" rescues children from the "tyranny of their own desires." And spanking, when used judiciously, is not considered child abuse in France. (Author's note: I am not personally in favor of spanking children).

As a therapist who works with children, it makes perfect sense to me that French children don't need medications to control their behavior because they learn self-control early in their lives. The children grow up in families in which the rules are well-understood, and a clear family hierarchy is firmly in place. In French families, as Druckerman describes them, parents are firmly in charge of their kids—instead of the American family style, in which the situation is all too often vice versa.

Sunday, September 18, 2016

MAP: How Did Your Child's Elementary School Do on State Tests?

By Nigel Chiwaya | August 10, 2016

NEW YORK CITY — Every single elementary school district saw improvement on the elementary school state exams this year, but how did your child's school do?
DNAinfo New York mapped out the test results below, coloring each school based on the percent of students in third through eighth grade that passed the English Language Arts (ELA) or math exam. Click on your school to see how it fared on each exam along with where it ranked among schools in its district.
Mayor Bill de Blasio and Schools Chancellor Carmen Fariña touted big gains in English Language Arts and math test scores for third through eighth graders when the results were released last month. Citywide, the number of students who scored at a proficient level reached 38 percent on the ELA exam and 36.4 percent on the math exam.
Citywide, Manhattan District 2 and Queens District 26 performed the highest on the tests. The best performing school was the Baccalaureate School for Global Education in Astoria, which saw more than 96 percent of its students pass both exams and ranked first in the city in math and second in English Language Arts.
Check the map below to see where your child's school scored on the exam:

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Thursday, September 15, 2016

Why It Doesn’t Pay to be a People-Pleaser

By Christine Carter | August 9, 2016 | 26 Comments

Christine Carter always tried to meet other people’s expectations—until she realized how out of sync with her own wants and needs she’d become.

People ask me all the time what the secret to happiness is. “If you had to pick just one thing,” they wonder, “what would be the most important thing for leading a happy life?”
Ten years ago, I would have told you a regular gratitude practice was the most important thing—and while that is still my favorite instant happiness booster, my answer has changed. I believe the most important thing for happiness is living truthfully. Here’s the specific advice I recently gave my kids:
Live with total integrity. Be transparent, honest, and authentic. Do not ever waiver from this; white lies and false smiles quickly snowball into a life lived out of alignment. It is better to be yourself and risk having people not like you than to suffer the stress and tension that comes from pretending to be someone you’re not, or professing to like something that you don’t. I promise you: Pretending will rob you of joy.
I’ve spent the better part of my life as a people-pleaser, trying to meet other people’s expectations, trying to keep everyone happy and liking me. But when we are trying to please others, we are usually out of sync with our own wants and needs. It’s not that it’s bad to be thinking of others. It’s that pleasing others is not the same as helping others. 

Live with total integrity. Be transparent, honest, and authentic. Do not ever waiver from this; white lies and false smiles quickly snowball into a life lived out of alignment. It is better to be yourself and risk having people not like you than to suffer the stress and tension that comes from pretending to be someone you’re not, or professing to like something that you don’t. I promise you: Pretending will rob you of joy.

I’ve spent the better part of my life as a people-pleaser, trying to meet other people’s expectations, trying to keep everyone happy and liking me. But when we are trying to please others, we are usually out of sync with our own wants and needs. It’s not that it’s bad to be thinking of others. It’s thatpleasing others is not the same as helping others. 
People pleasing, in my extensive personal experience, is a process of guessing what other people want, or what will make them think favorably of us, and then acting accordingly. It’s an often subtle and usually unconscious attempt at manipulating other people’s perceptions of us. Anytime we pretend to be or feel something that we aren’t, we’re out of integrity with ourselves.
And anytime we’re doing something that is more about influencing what others think of us than it is about authentically expressing ourselves—even something as simple as a Facebook post that makes it seem like we are having a better day than we actually are—we end up out of integrity with ourselves.
Being out of integrity has pretty serious consequences for our happiness, and for our relationships. Here’s what happens when we aren’t being authentic.

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Tuesday, September 13, 2016

Why Do Students Cheat?


JULY 19, 2016 9:57 AM


Zachary Goldman, a 2016 graduate of the Harvard Graduate School of Education, is a former teacher and educational data analyst and a City Year AmeriCorps alum. Follow him on Twitter at @Zachary_Goldman.
In March, Usable Knowledge published an article on ethical collaboration, which explored researchers’ ideas about how to develop classrooms and schools where collaboration is nurtured but cheating is avoided. The piece offers several explanations for why students cheat and provides powerful ideas about how to create ethical communities. The article left me wondering how students themselves might respond to these ideas, and whether their experiences with cheating reflected the researchers’ understanding. In other words, how are young people “reading the world,” to quote Paulo Freire, when it comes to questions of cheating, and what might we learn from their perspectives?
I worked with Gretchen Brion-Meisels to investigate these questions by talking to two classrooms of students from Massachusetts and Texas about their experiences with cheating. We asked these youth informants to connect their own insights and ideas about cheating with the ideas described in "Ethical Collaboration." They wrote from a range of perspectives, grappling with what constitutes cheating, why people cheat, how people cheat, and when cheating might be ethically acceptable. In doing so, they provide us with additional insights into why students cheat and how schools might better foster ethical collaboration.


Students critiqued both the individual decision-making of peers and the school-based structures that encourage cheating. For example, Julio (Massachusetts) wrote, “Teachers care about cheating because its not fair [that] students get good grades [but] didn't follow the teacher's rules.” His perspective represents one set of ideas that we heard, which suggests that cheating is an unethical decision caused by personal misjudgment. Umna (Massachusetts) echoed this idea, noting that “cheating is … not using the evidence in your head and only using the evidence that’s from someone else’s head.”
Other students focused on external factors that might make their peers feel pressured to cheat. For example, Michima (Massachusetts) wrote, “Peer pressure makes students cheat. Sometimes they have a reason to cheat like feeling [like] they need to be the smartest kid in class.” Kayla (Massachusetts) agreed, noting, “Some people cheat because they want to seem cooler than their friends or try to impress their friends. Students cheat because they think if they cheat all the time they’re going to get smarter.” In addition to pressure from peers, students spoke about pressure from adults, pressure related to standardized testing, and the demands of competing responsibilities.
Students noted a few types of extenuating circumstances, including high stakes moments. For example, Alejandra (Texas) wrote, “The times I had cheated [were] when I was failing a class, and if I failed the final I would repeat the class. And I hated that class and I didn’t want to retake it again.” Here, she identifies allegiance to a parallel ethical value: Graduating from high school. In this case, while cheating might be wrong, it is an acceptable means to a higher-level goal.

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