Christi’s Blog

           The symptoms of inattention and impulsivity that characterize Attention Deficit Hyperactivity Disorder make forming and maintaining relationship extremely difficult.  To have a basic conversation with a new acquaintance, one must pay attention to the conversation and respond appropriately.  If a person with ADHD overcomes this hurdle, the new relationship must be maintained.  Too many missed events and unreturned phone calls will end a relationship.  A history of misunderstandings and failed relationships can cause individuals with ADHD to develop social anxiety disorders.  Relationship researchers find that when a person’s social relationships are frequently marked by confusion, misunderstandings, and failure, the person develops a low self-esteem (Banks,1999). 

Problems in Social Situations for People with ADHD

            The unregulated attention that characterizes ADHD makes it nearly impossible to stay tuned-in during conversations.  Adults with ADHD report difficulty noticing social cues - whose turn it is to talk or what subjects are inappropriate (White, 2008).  Persons with ADHD are easily distracted by the background activity of people in the room, or by random thoughts that come to mind.  Solden (2005) believes people with ADHD often move away from relationships in the initial stages of forming friendships because they have difficulty making small talk.  People with ADHD tend to talk too fast and jump from topic to topic in a way that is difficult for others to understand.  Halverstadt (1998) explains that when a comment triggers a thought for ADHD persons, they are compelled to say it immediately even if it is unrelated to the conversation, because they know they will forget it quickly.   It is not uncommon for a person with ADHD to interrupt, blurt out, or change topics in the middle of a conversation. 

            Maintaining relationships with friends and family can be difficult for a person with ADHD.  Each new relationship adds to the stress and increases feelings of being overwhelmed.  Solden (2005) characterizes the relationships of people with ADHD as a series of missed events or occasions, forgotten thank-you notes, invitations that are not reciprocated and phone calls that are not returned.  Many people with ADHD express a dislike of communicating through e-mail or the telephone because the social cues are even harder to interpret when you can not see the other person involved in the conversation (Solden).  As a result, relationships are not maintained and then the ADHD person fears rejection if they attempt to re-establish contact.  

            The amount of time and energy a person with ADHD must invest in organizing and getting their lives together so they can appear normal makes it difficult for them to keep up with the ordinary social and recreational events that people without ADHD do regularly (Solden, 2005).  It is not uncommon for a person with ADHD to have stacks and piles of things all over their house.  When a person with ADHD goes through a stack of papers, they find year old cards for friends and family members already addressed and stamped but never mailed.  Although these people felt forgotten by their ADHD friend or relation, a person with ADHD rarely completely forgets something, they are just unable to complete the steps required to meet expectations.

Anxiety Problems cause by Symptoms of ADHD

            After years of being misunderstood and criticized in social situations, many people with ADHD choose to avoid social gatherings all together. Large social gatherings require a person to pick up on and respond to social cues quickly, while blocking out the surrounding stimuli and focusing on the group they are with.  None of these tasks are easy for a person with ADHD.  Ward (2008) reports many ADHD individuals isolate themselves because of perceived relational failures, and mood or anxiety disorders. These disorders further exacerbate their social situations.  Young and Gudjonsson (2006) analyze the differences between individuals with ADHD and a control group in relation to antisocial behaviors, poor socialization and general adjustment.  On all three measures the ADHD group had the most dysfunctional scores. 

            Melinda White (2008) find that many ADHD adults report “feeling like a fraud” and living with a fear that someone is going to discover they are not “normal”.  Anxiety, for persons with ADHD, is not limited to social situations.  Because they fear criticism from others, the impulsive nature of the disorder makes it difficult for people to set limits in all areas of their lives.  The pressure people with ADHD feel to appear “normal” leads them to take on more responsibilities than they can manage.  Consequently, they leave trails of unfinished tasks.  Work, church, PTA and a countless number of other situations create enormous amounts of anxiety for people with ADHD as they attempt to live up to perceived expectations.          

 From Childhood to Adult Hood

            For years, people believed ADHD was a childhood disorder that was outgrown during puberty. In reality, the changes puberty brings only alter the expression of ADHD. Anderson and Teicher report that before and during puberty boys have an overproduction of dopamine receptors, explaining their hyperactivity and motor dysfunction (as cited in Taylor and Keltner, 2002). By adulthood receptor density in boys reduces 55%, explaining the remitting hyperactivity in ADHD symptoms. Girls, on the other hand, seem protected from the hyperactive component of ADHD untilpuberty, when they experience an increase in dopamine receptors. Therefore, it is not uncommon for the hyperactivity of ADHD in girls to hide until puberty (Taylor&Keltner,2002). In girls hyperactivity typically manifests verbally, causing them to become “hyper-talkative” rather than “hyper-active.” Yet this hyper-talkative behavior is not consistent. Taylor and Keltner point out that the production of estrogen which begins during puberty causes an increase in the production of dopamine. Since, in girls, the “hyper” behaviors are the result of an imbalance between the amount of dopamine and dopamine receptors, this decreases the severity of the symptoms –at least most of the time. 

            Many girls are never diagnosed with the disorder because their symptoms do not become obvious until the time when most people believed the disorder was out grown.  Because so many girls with ADHD enter adulthood without being diagnosed, they are at risk for a variety of other problems. Girls with ADHD realize that something is wrong with them, but society pressures them to appear normal. Consequently, many girls with ADHD internalize their feelings of inadequacy. Guilt and shame from failed attempts to control the symptoms of their ADHD are common feelings among women with this disorder.

Medical Aspects of Attention Deficit Hyperactivity Disorder

            ADHD is a genetically-linked medical condition caused by changes in the structure and functioning of the brain. Biederman (2008) reports a 76% heritability coefficient for ADHD (the heritability coefficient for breast cancer is only 35%).   Unfortunately, most researchers report that ADHD is probably the most under diagnosed condition in psychology today(Brassett & Butler, 2007; Hallowell & Ratey, 2006; Solden, 2005; White,2008; Young & Gudjonsson, 2006). Scudder found the boy:girl ratio of ADHD diagnosis is as high as 5:1. None of the genetic research on ADHD reveals any reason for a gender difference, and the adult male-to-female ratio of ADHD is 1:1 (as cited in Taylor&Keltner,2002).

            New studies using brain imaging techniques show differences in the morphology of the brains of those with ADHD (Brassett & Butler, 2007). Using new high-resolution, three-dimensional brain maps, Sowell and Peterson studied the brains of 27 children with ADHD and 47 children without the disorder (Rosack, 2004). They observed significant differences in brain structure in the frontal cortices of both sides of the brain, reduced brain size in areas of the dorsal prefrontal cortices and the anterior temporal areas, and increases in the volume of gray mater in the posterior temporal and inferior parietal cortices of the brains of children with ADHD compared to a control group.  These regions were previously identified as the areas of the brain controlling attention and impulse control. Sowell and Peterson correlated the anatomical variations of the brain with the symptoms of ADHD and found that there is a link in reduction of gray matter and increased inattentiveness, whereas larger frontal lobes were linked with higher levels of hyperactivity. “ADHD,” Sowell and Peterson concluded in the study, “is almost certainly a disorder of heterogeneous etiologies that have correspondingly heterogeneous neuro-anatomical underpinnings.  “These findings are very important to helping people understand the relevancy of the disorder because many people try to tell people with the disorder they are just lazy or unfocused. These brain scans prove there is a problem that a person with ADHD can not change by choice or desire.

            Finding an individual with ADHD and a comorbidity is more likely than finding a person with ADHD alone. ADHD contributes to substance abuse, depression, impulsivity, isolation, unemployment, low educational attainment, unintended pregnancy, and relationship disruption in adulthood (Ward, 2008).  Solden (2005) reports that each year that goes by without a diagnosis can lead to more severe secondary emotional problems, relationship difficulties, and feeling of under-achievement.

Characteristics

            Most people associate ADHD with poor academic performance in school, however, the attention, focus, and planning needed for good academic performance are also required in many other areas of life. Biederman (2008) finds that respondents with ADHD report significantly poorer functioning on virtually every single measure he examined: quality of childhood experiences, educational impairment in high school, relationships with peers, teachers, and parents during high school, relationships in adult life, prevalence of addiction, antisocial or destructive behaviors.

            Individuals with ADHD must find away to stimulate the prefrontal cortex in order to activate it (Stein,2008). Activating the prefrontal cortex allows people with ADHD to focus their attention, thus they feel better about themselves and more in control. Considering the number of people that go through life with the ADHD and never seek medical attention, it is not uncommon to find them self medicating with alcohol, narcotics, risky behavior, or a variety of other things to stimulate the prefrontal cortex of the brain. Women with ADHD experience a higher rate of eating disorders than thos who don not have ADHD. Solden (2005) suggests these women use the stimulation from starvation as a form of self medication.  Since the sympathetic nervous system in the prefrontal cortex regulates the fight or flight response (Heffner, 2001), and ADHD affects the prefrontal cortex, it can be inferred that the disorder can affect an individual’s ability to handle stressful situations. Using SPECT brain imaging, Halverstadt (1998) identifies two primary ways people with ADHD respond to conflict. First, the person can become overwhelmed by stress if the prefrontal cortex is overloaded by data and stops functioning. Second, the person can become overly stimulated and seek to prolong this stimulation as a method of self medication. Both of these options make it difficult for someone with ADHD to overcome stressful situations. When the prefrontal cortex stops functioning, the person can no longer process informational or emotional stimulus. Often, a person with ADHD simply walks out of a room in the middle of a conversation, argument, exam, or other stressful situation to seek a quiet, dark place to sit until they are able to process information again. Without a functioning prefrontal cortex, people can not identify what they feel, emotionally or physically, or explain their behavior. On the other hand, when a person uses stress to self medicate, they seek stressful situations and prolong them, even though it may damage relationships.    

            Murphy and Barkley report that adults with ADHD have higher rates of impulsively quitting or being fired from their jobs. They also hold more jobs in their lifetime than those in control groups (as cited in Murray, 2004). Adults with ADHD typically have more jobs than adults without ADHD and rarely make it to higher pay scales. Even when an individual with ADHD achieves an advanced degree, their income is significantly less. According to Biederman (2008), the average household income among the ADHD group was slightly more than half that in the non-ADHD group ($52,000 vs. $91,000 respectively).

            Impulsive decision coupled with a need for high risk stimulation can impact the quality of life for people who have ADHD. Stein (2008) reports individuals with ADHD lose their virginity, on average, a year earlier than a control group. He also says 38% of the ADHD women report having an unplanned pregnancy, compared to only 4% of the control group. People with ADHD experience more traffic accidents and receive more tickets than those without ADHD. This is true from beginning of driving throughout adulthood, unless the ADHD individual is on effective medication. When a person with ADHD is properly medicated, statistics show no difference between them and the control group.

            The lowest performing students in Japanese schools consistently outperform the highest performing students in the United States.  This reality rocked educators in the United States.  As a result, educational reformers hit the educational system with a myriad of reforms.  Teachers taught more information to stricter standards.  Students endured more tests to ensure they remained competitive.  After they spent millions of dollars reforming the system, educators expected a change.  Much to their chagrin, students performed no better on international tests than before.  Stigler and Hiebert (1990) propose that the problem is not a learning gap between nations, but a teaching gap.

Robert Eaker characterized the traditional school as a collection of independent contractors united by a common parking lot (as cited in Schmoker, 2006).  The isolation of teachers makes it easy to hide ineffective or non-compliant practices, as teachers can go an entire day or, for some, an entire week without speaking with a colleague or administrator.  Despite having a shorter school year, teachers in the United States work more hours per day and per year than teachers in any other country (Darling, 2001).  Most elementary school teachers in the United States have 8.3 minutes to prepare for every hour they spend in the classroom.  Secondary teachers have 13 minutes to prepare per teaching-hour (Darling, 2001).  Most teachers only have 50 minutes per day to prepare an engaging lesson, modify the lesson for various students, grade 150 or so papers from the previous lesson, give the students feedback on their work, record grades, stay in touch with parents, and complete state-mandated paperwork.  Consequently, Linda Darling-Hammond (2001) found, the average American teacher works an additional 15 hours per week outside of school.  Unfortunately, teachers do not have time to learn and implement reforms designed by people who most likely never taught in a classroom.  Before reforms can impact the educational system, the culture of isolation must be removed and teachers must have time to collaborate and learn from each other.

           Teachers in the United States spend more hours teaching than teachers from Japan and Germany.  Yet students in Japan and Germany consistently outperform students in the United States.  Much of the gap in United States’ students on international testing is a result of the limited amount of time teachers have to plan with their colleagues (Stigler & Hiebert, 1999).  Robert Marzano (2003) did a meta-analysis of in-school factors that affect student achievement.  At the top of his list is what is actually taught.  He refers to this as “guaranteed and viable curriculum”.  Despite the volumes of curricula guides on the shelf, teachers ultimately decide what they actually teach.  Unfortunately, teachers do not have enough time to plan and confer and this directly impacts what teachers teach in the classroom.

            The culture is not learned in education courses, it is absorbed during the formative years people spend in the educational environment created by this culture.  And, while there are many positive aspects of this culture, (working long hours, taking work home, attending trainings on vacation days and putting the needs of the students first) there are many which undermine attempts at reform.  Teachers, for example, work in isolation, making it almost impossible for reformers to know what actually occurs in the classroom (Supovitz & Turner, 2000).  Additionally, teachers have a strong suspicion of anyone outside the profession because of constant public criticism of their calling.  Advice from outside the profession is suspect, because teachers tend to discount educational research.  Overall, the deeply entrenched culture of education resists change and is a significant barrier to reform.  Educational reformers must understand this culture if they hope to shift it and significantly impact education in the United States.

Systematic

           By definition, a system is any group of parts that can do more than any of the individual parts.  As such, the system of teaching works well.  Systems, however, evaluate new additions according to how well they work within the system as a whole.  If a change works well within the system as a whole, it becomes part of the system.  If it does not benefit the whole, the system rejects it.  Historically, education reform focused on adding strategies to one part of the system without considering how those strategies affected the entire system.  Consequently, the system rejected the reform and the system of education did not change.  Thus, even with a vast history of reform, education has not changed much since its inception. 

            Effective educational reform must address the whole system.  Since teachers control the system, they have to be convinced of the need and effectiveness of reform strategies - before implementation - if those strategies are to work.  Research on human behavior provides exhaustive evidence that people strongly value, and are reluctant to relinquish, the perception of control (Rothbaum, Weisz & Snyder, 1982).  Teachers control what happens within the classroom.  Consequently, reform strategies forced on teachers that do not address this control will fail. Reformers must consider what each classroom teacher needs to do and then identify the school, district, state and federal policies most likely to cause these things to happen, without discounting the importance of the teacher who then decides if they will implement the policy (Slavin, 1996).  System-wide reform is impossible unless it impacts the daily classroom practices of every teacher in the system.  

      On December 15, 1791, Congress ratified the Bill of Rights.  The Tenth Amendment, part of the Bill of Rights, perhaps the biggest barrier to national education reform in the United States, says:  “The powers not delegated to the United States by the Constitution, or prohibited by it to the States, are reserved to the States respectively, or to the people.” (Legal Information Institute [LII], n.d.).  This article leaves education in the hands of the state government because the Constitution does not expressly give the national government authority over education or deny the state government authority.  As a result, the only way the national government can affect education on a national level is through influence – influence backed by money.  For this reason, No Child Left Behind determines where the national government allocates funding for education, rather than establishing a national system for education.

            Modern educational reformers must understand that the educational system in the United States evolved over at least 200 years.  As Ruthven (2005) points out, many of the educational policies currently in place were based on public opinion and are not supported educational research.   The current curricula developed over an extremely eventful century.  National funding for education is rooted in Standards Based Reform.  And, finally, a nation-wide overhaul of the whole system is prevented by Article 10 of the Bill of Rights.  The road to national reform is long, and shifting the focus of reform is a monumental task at best.

            The development of modern education in the United States established a pattern of dealing with educational reform.  Consequently, any discussion of educational reform must begin with an understanding of the evolution of education in the United States.

Establishing the System

            Education in the United States is rooted in the Protestant Reformation.  At the heart of the Reformation was the belief that everyone should read the Bible for themselves, that a priest did not have to interpret the Bible for the common man.  When Puritans settled in New England, they established common schools to teach reading, writing, and basic arithmetic.  The middle colonies established similar community schools.  In the rural south, landowners taught their children to read in the home or hired tutors.

            For Puritans, education was a means to know God.  The Enlightenment, on the other hand, believed education was the path for every person to realize their full potential as a human being (Lewis, 1992).  Jefferson, in particular, thought education should be available to all free men.  He proposed two bills to the Virginia legislature:  the Bill for the More General Diffusion of Knowledge and the Bill for the Establishment of a System of Public Education.  Although neither bill passed, they outlined a plan for a state-wide system of education that influenced subsequent proponents of public education.

            Horace Mann was one such reformer.  In fact, Horace Mann’s plan for a state-wide education system was similar to the plan Jefferson explained in the Bill for the Establishment of a System of Public Education (Brulatour).  Horace Mann, called ‘The Father of Education’ by many, worked to establish the first state-wide board of education in Massachusetts.  In 1837, Horace Mann became the first secretary of the Massachusetts State Board of Education.  By the early 1900s, every state in the Union established similar boards of education and Jefferson’s dream of public education in the United States became a reality.

Establishing the Curricula

While reading, writing and arithmetic were enough for basic education in the Colonies, an increasingly industrial society required much more. Technological advances like electricity, the light bulb, the telephone, the computer, and the cell phone increased the importance of science in the curricula.  

Technological advances were not the only catalyst for change in classroom curricula.  Throughout the 20^th century, the United States became an important player in the international stage.  Two World Wars, the Vietnam Conflict, the Korean War, the Cold War and the first Gulf War underscored the importance of a basic understanding of international affairs.  Significant cultural shifts also affected curricula. Americans experienced the Roaring 20s and endured the Great Depression.   John F. Kennedy pointed Americans toward space and a country watched the as Neil Armstrong took the first steps on the moon.  A more global economy increased the importance of languages and history in the curricula. These changes forced the original curriculum of the Colonies to expand from four basic subjects and eight years to six broad categories of subjects (English, Mathematics, Natural Sciences, Social Studies, Additional Courses and Electives) covered in 13 years (ACT, 2008).

Establishing the Standards

            In 1980, the educational reformers shifted focus from the educational system and curricula to actual students.  Rather than have student achievement measure by class ranking, reformers talked about the need for an external standard to measure student achievement. Standards-based Reform became a central issue in 1996 during the National Education Summit.  Forty-four state governors and fifty corporate CEOs met to set priorities for education in the United States.  Over the next two years, most states passed legislation that established educational standards for all students.  According to this new standard, successful education was the result of each student’s ability to meet a state-wide standard.  In January 8, 2002, President George W. Bush’s No Child Left Behind Act (NCLB) underscored the impact of Standards-based Reform.  This act required states to establish a standard of educational achievement for different grade levels and measure state-wide achievement through standards-based testing.  If students meet standards set by the state, then that state is eligible to receive federal funding for schools.  With federal funding driving states to establish and meet standards, Standards-based Reform and student achievement became the issue dominating modern educational reform (Library of Congress, n.d.).

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