Thursday, November 6, 2008

ADHD and Academic Difficulties

The following is an excerpt from my 2007 Dissertation Study entitled,
"ADHD Coaching and College Students"

ADHD and Academic Difficulties

There are three subtypes of ADHD: Predominantly Inattentive, Predominantly Hyperactive/Impulsive, and the Combined Type. In the Predominantly Inattentive type, the individual experiences the symptoms of inattention at the clinical level, but not the hyperactive-impulsive symptoms. In the Predominantly Hyperactive-Impulsive type, the individual experiences the symptoms of hyperactivity and impulsivity at the clinical level, but not the symptoms of inattention. In the Combined type, the individual shows clinical levels of symptoms of inattention, hyperactivity, and impulsivity (APA, 2000).

While students with ADHD seem capable of learning, their hyperactivity, impulsivity, and/or inattention make concentration difficult and negatively affects their performance (Fowler, 1994). Both motor and verbal hyperactivity may keep these individuals from being able to sit quietly during lectures. Impulsivity causes difficulty in any task requiring a delay such as raising hands to answer questions, reading or listening to directions, asking questions to clarify information, planning, and organizing (Zentall, 1993). Inattention leads to problems focusing on tasks and assignments.

Traditional school practices make academia an ordeal for many students with ADHD. The current degree of fit between the within-person variables of an individual with ADHD and standard classroom environmental variables is not effectively producing a successful outcome for students with the disorder. Students with ADHD risk school failure at a higher rate than students without disabilities who have equivalent intelligence (Rubinstein & Brown, 1981). As children, individuals with ADHD struggle with failure rates double to triple those of other children, with about 50 percent repeating a grade by adolescence (Ingersoll, 1988). One early study reported that 80% of students classified as having ADHD scored at least two years below their peers on measures of reading, spelling, math, or written language (Anderson, Williams, McGee, & Sylva, 1987).

Some studies have shown that younger students with ADHD may exhibit deficits in a specific academic skill. For example, one study found that approximately 15% of children and adolescents classified as having ADHD presented with profiles similar to students classified as having reading disorders (Aaron, Joshi, Palmer, Smith, & Kirby, 2002). Controlling for IQ and phonological processing skills, another study found that children and adolescents classified as having ADHD do not exhibit deficits in reading vocabulary (Nussbaum, Grant, Roman, Poole, & Bigler, 1990) or have problems with the comprehension of short passages (Javorsky, 1996). Instead, students classified as having ADHD had problems with the comprehension of longer passages (McGee, Partridge, Williams, & Silva, 1991).

In spelling, studies (that have controlled for IQ differences) have found that students classified as having ADHD score lower on standardized measures of spelling than their peers without disabilities (e.g., August & Garfinkel, 1990). Although spelling is primarily a phonological-orthographic (sound and sound-symbol) task, some researchers have suggested that the spelling problems of students classified as having ADHD may also be, in part, a selective attention task (e.g., Zentall, 1993). One study showed that the spelling performance of students classified as having ADHD could be improved simply through practice with target words (Fitzgerald, Fick, & Milich, 1986).

In math, studies have shown that students classified as having ADHD performed significantly lower than their peers without ADHD on timed tasks of math calculation, even when differences in IQ were controlled (Ackerman, Anhalt, Holcomb, & Dykman, 1986; Zentall, 1990; Zentall, Smith, Lee, & Wieczorek, 1994). As in the studies of spelling, researchers have speculated that the slower speed of students classified as having ADHD on math tasks might be attributed to their inability for sustained attention on repetitive tasks and lack of mastery of rote skills. Other studies suggest that students classified as having ADHD may have more difficulty on timed math tasks because of a combination of weaker computational skills, slower visual-motor speed, and more off-task behaviors (Barkley, Anastopoulos, Guevremont, & Fletcher, 1991; Zentall, 1990).

In addition to specific problems with one academic area such as reading, spelling, or math, researchers have reported that younger students classified as having ADHD exhibit handwriting difficulties; however, the reasons for these difficulties may be confounded by other factors. When controlling for visual-motor skill, for example, differences in handwriting errors between students classified as having ADHD and students without the disorder were not significant (Zentall & Kruczek, 1988). This finding suggests that the handwriting difficulties of students classified as having ADHD may be due to visual-motor deficits (Zentall, 1993). Alternatively, both poor handwriting and deficits in visual-motor skill may be the result of a third variable, failure to sustain attention to tasks that involve repeated practice (Zentall, 1993). Zentall and Kruczek (1988) found that students classified as having ADHD made more errors and had poorer handwriting ratings on a copying task than students without ADHD even after repeated practice on the task.

Barkley (1998) found that adults who were diagnosed with ADHD as children not only had lower levels of educational attainment but also reported having been suspended or expelled from school more often than their counterparts. Taken together, expulsion and dropout rates for these students approach 50 percent. Studies suggest that these early failures in academia lead to a lifelong downward spiral in terms of academic performance for students with ADHD.

Please contact me for a full list of references.

No comments: