Guest Post: Living and Teaching With ADHD

In response to yesterday’s post about ADHD medication I was contacted by Ryan Barrett. Ryan is an elementary Core French teacher with the Hamilton Wentworth District School Board and has been since September 2008. Ryan shared his extraordinary and inspiring story of growing up, living and teaching with ADHD. I asked if I could share that story on this blog and he agreed. The following are his words, unedited by me.

I am 32 years old and teach grades 3/4/5 and have been undergoing medical treatment for combined type ADHD (both inattentive and hyperactive-impulsive types) for just over a year now. The ‘just’ is the important modifier here as I have spent my years from pre-school to university, and every year thereafter in classrooms, trying to find my footing in the simplest of routines we teach our students Day One.  I kept re-living that first day of school, struggling with unmanaged ADHD for 28 years, until last winter when I just couldn’t make it out of the house anymore.

My personal struggle in the classroom was never of the sort that distracted others or demanded additional support from the teacher. I was identified gifted, and at IPRC meetings (this was pre-IEP, but post-Bill 82) they said I was bored and that I needed to challenge myself. Eventually, they thought, I would learn to meet deadlines. I would learn that ‘practice makes perfect’, and the restlessness and indecision would eventually fade and I would find my one true calling. I would learn to use a binder, a highlighter, and keep a calendar — and follow it! I would be satisfied and confident enough to complete a piece of work without starting over, and over, and over…

While my proficiencies were lauded, supported medically, and formalized, my weaknesses were dismissed as the tiniest of challenges that maturity would overcome.

Today I still find it difficult to go seek help when I can’t concentrate, when I can’t focus, or can’t stay organized. I don’t tell enough people when I am frustrated, overwhelmed, or worried about deadlines looming or missed. I certainly don’t seek medical attention often enough, and especially not when I am unable — when my brain, and body are unable – to accomplish a task that is, at this stage in my life, vital to my survival. I can’t stress that enough. I can’t live like this without treating the root of the problem and not just the symptoms.  Last winter I didn’t think there was any hope at all.

Without the right medication, the dosage of which is still being adjusted since I am just at the start of this journey, I just haven’t enough strategies to do all of the  things most other grown-ups do in a day. Time and time again, I wake up in the morning and wonder what to do next.

Do I shower first? Where is my towel? I always end up leaving wet footprints on the carpet in the hallway. Keys: I need those to drive. I lost the checklist I made last night. It is probably with the one I made the night before last. If anything goes wrong, I’ll be late. I have just enough time to reinvent the wheel before the bell goes.

Still, I remain bound to the classroom, where I practice what I never learned. But this September, I’ll be a step closer, and all because I know now that my body lacks what it needs to propel me through the next day, and the next. And because it’s not a secret anymore…

The Use of ADHD Drugs in Schools

An article in the Wall Street Journal has re-started public discussion on why so many students are taking medication to treat attention deficit hyperactivity disorder (ADHD). It’s a thorny issue with implications for the kind of schools we have, the kind of schools we want and how we view students and their learning.

New research, conducted by the National Bureau of Economic Research and published in June, studied how taking Ritalin, a medication commonly prescribed for ADHD, affected students in Quebec. According to the study, taking Ritalin caused “…increases in emotional problems among girls, and reductions in educational attainment among boys…”. This is disturbing news for students, parents and educators.

There has been an explosion in the use of medication to treat ADHD in children in recent years. In March, 2013 the Center for Disease Control reported “…a 16 percent increase since 2007 and a 41 percent rise in the past decade…” in the number of US children diagnosed with ADHD. Currently nearly one in five high school boys and 11% of all school age children are diagnosed with ADHD. In the wake of these revelations some critics are suggesting that prescribing ADHD medication (and the resultant side effects) to children, without gains in learning constitutes “malpractice”.

I can’t find Canadian stats, but my own classroom experience suggests a similar pattern of use. My class last year, which was typical, had 16% of students taking ADHD medication. All of these students were boys. In fact, the majority of students diagnosed with ADHD are boys. Boys are five to nine times more likely to be diagnosed with ADHD, leading some to suggest that this is evidence of a ‘war on boys’ in our schools.

The high rates of ADHD, and the resultant medication use, says a lot about the culture in schools. Students who don’t progress are pathologized, and schools only accept or allow for deviation if it’s supported by a label. There used to be an understanding that schools can’t meet every student’s needs, but no longer. We devote extensive resources to finding out why a student isn’t learning and ensuring they have every chance to be successful. This process, along with the need for labels, leads to higher rates of diagnosis.

Learning is a complex process and it’s difficult to determine whether it occurred.  Standardized tests are unreliable indicators of the many ways learning happens. Further, just because a student can sit still and pay attention doesn’t mean they have the skills to learn. Students struggle with ADHD for years causing a skills deficit and layers of coping strategies that interfere with learning. Prescribing and using medication is merely the first of several steps in helping a student with ADHD to learn.

The presence of a student with ADHD often impacts on the learning of the whole class. Students with ADHD can be disruptive, making learning more difficult for other students. Teachers devote time to managing and supporting students with ADHD, meaning less time and support is available for other students. It’s likely that the learning of the class improves when a student with ADHD is successfully treated with medication, even though their individual learning may not.

The value of ADHD medication is not exclusively in improving academic learning. Students with ADHD  struggle daily to meet basic expectations leading to lower self-esteem. Medication helps students with ADHD to improve their quality of life, with more friendships and a more positive attitude about school and life. That may, in the long run, be more important than a gain in academic learning.

I prefer using methods other than medication to support students with ADHD whenever possible. A classroom environment where students work in collaborative small groups and have the freedom to move around if needed can be helpful. A well constructed and implemented IEP (Individual Education Plan) with useful accommodations and strategies is also recommended.

The decision of whether or not to use medication to treat ADHD is a difficult one for parents. There are multiple factors to consider and every case is different. It is especially complicated for parents without the resources to provide the extensive support a child with ADHD may need. Constantly taking time off work to deal with problems at school isn’t a viable option for most parents. Sometimes it isn’t a matter of choosing the best solution, but rather finding the right option given the many constraints. And sometimes, that’s medication.