Providing an Appropriate Education to Children with Attention
Deficit Disorder
Throughout this digest, ADD will be used to refer to "attention
deficit disorder," or "attention deficit hyperactivity disorder" (ADHD). In
the past, the term "minimal brain dysfunction" was also used.
CHILDREN WITH ADD
It is estimated that children with ADD constitute 3% to 5%
of the current school-age population, which would represent 1.35 to 2.25 million
children. Most experts agree that ADD is a neurobiological disorder that can
have multiple causes. Research indicates that children with ADD are likely
to have a biological relative with ADD. In addition, evidence also suggests
that neurologic, neurochemical or, in some cases, toxic factors may be involved.
Other factors such as medical conditions, medication side effects, familial
functioning, or environmental conditions may exacerbate an existing disorder
or contribute to the development of ADD-like problems in some children (Parker,
1992).
DIAGNOSIS
As with all other disabling conditions, evaluation of children
suspected of having ADD should be a multistep, multidisciplinary procedure.
First the assessment should determine whether a child meets criteria for diagnosis
of ADD; then, further assessment should determine the degree to which the child's
educational performance is adversely affected. This information will help determine
what types of educational services are necessary to assist the student.
The first step requires gathering information about the child
from a number of sources and in a variety of ways. Medical information; parent
or guardian descriptions of the child's physical, mental, social, and emotional
development; school information; descriptions of social behavior and classroom
adjustment; and assessment of the child's cognitive functioning are essential
to making an accurate diagnosis. Because the behavior of children thought to
have ADD can vary widely in different situations and environments, experts
recommend obtaining information from many sources, and observing the child
in different settings and at different times. Evaluations of children suspected
of having ADD often include rating scales completed by parents and teachers.
SCHOOL RESPONSIBILITIES
Schools must provide appropriate educational services to students
who have been identified as having ADD. In September 1991, the Department of
Education issued a policy clarification on the topic of children with attention
deficit disorder (Davila, Williams, & MacDonalt, 1991). The memorandum
was intended to clarify state and local responsibility under federal law for
meeting the needs of children with ADD in the educational system as a whole.
The responsibility for meeting the educational needs of children
with ADD rests with the entire educational system, not just with particular
sectors. Thus, if the needs of these children are to be fully met in the schools
(whether through general or special education programs), increased coordination,
collaboration, and consultation will have to occur among regular educators,
special educators, administrators, and related services personnel. The report
recognizes that:
- Regular classroom teachers are important in identifying appropriate
educational adaptations and interventions for many children with ADD.
- State and local districts should take the necessary steps to
promote coordination between special education and regular education programs.
- Regular education teachers and other personnel need training
to develop a greater awareness of children with ADD and of adaptations that
can be implemented in regular education programs to address the instructional
needs of these children.
Children who are experiencing educational difficulties, whether
from ADD or some other cause, often fail to receive any assistance until after
difficulties, such as distractibility, disorganization, or inability to complete
assignments on time, have caused them to fall significantly behind their classmates.
By the time children have experienced such failure, they generally have already
lost a great deal of academic ground. In addition, school failure may contribute
to, or worsen, a student's feelings of low self-esteem, depression, or anxiety.
FEDERAL LAWS AFFECTING CHILDREN WITH ADD
Both the Individuals with Disabilities Education Act (IDEA)
and Section 504 of the Rehabilitation Act of 1973 provide coverage for children
with ADD. When the disability adversely affects educational performance, eligibility
for special education should be approached through the processes of IDEA. When
the disability does not affect educational performance but does substantially
limit one or more major life activities, eligibility should be approached through
Section 504. The following are highlights of each law as it affects the education
of children with ADD.
1. Individuals with Disabilities Education Act, Part B:
- Requires that state and local districts make a free appropriate
public education (FAPE) available to all eligible children with disabilities.
- Requires that the rights and protections of Part B of IDEA are
extended to children with ADD and their parents.
- Requires that an evaluation be done, without undue delay, to
determine if the child has one or more of 13 specified disabling conditions
and requires special education and related services.
- Requires that children with ADD be classified as eligible for
services under the "other health impaired" category in instances where ADD
is a chronic or acute health problem that results in limited alertness that
adversely affects a child's educational performance. Children with ADD can
also be served under the categories of "learning disabilities" or "seriously
emotionally disturbed," if the evaluation finds these conditions are also present.
- Does not allow local districts to refuse to evaluate the possible
need for special education and related services of a child with a prior medical
diagnosis of ADD solely by reason of that medical diagnosis. On the other hand,
a medical diagnosis of ADD does not automatically make a child eligible for
services under Part B (IDEA).
- Requires that a full and individual evaluation of the child's
educational needs must be conducted in accordance with requirements in Part
B (IDEA). These requirements include:A multidisciplinary team must perform
the evaluation. At least one teacher or other specialist with knowledge in
the area of ADD must be on the team.
- Requires that a due process hearing take place, at the request
of the parents, if there is disagreement between the local district and the
parent over the request for evaluation, the evaluation, or the determinations
for services.
2. Section 504 of the Rehabilitation Act of 1973:
- Prohibits discrimination on the basis of disability by recipients
of federal funds.
- Provides appropriate education for children who do not fall
within the disability categories specified in Part B (IDEA). Examples of potential
conditions not typically covered under Part B (IDEA) are:
- communicable diseases (HIV, tuberculosis)
- medical conditions (asthma, allergies, diabetes, heart disease)
- temporary medical conditions due to illness or accident, drug/alcohol
addiction
- Requires that a free appropriate public education be provided
to each qualified child who is disabled but does not require special education
and related services under Part B (IDEA). A free appropriate education (FAPE)
under Section 504 includes:
- Regular or special education and related aids and services that
are designed to meet the individual student's needs and are based on adherence
to the regulatory requirements on education setting, evaluation, placement,
and procedural safeguards.
- Guarantees parents the right to contest the outcome of an evaluation
if a local district determines that a child is not disabled under Section
504.
- Requires the local district to make an individualized determination
of the child's educational needs for regular or special education or related
aids and services if the child is found eligible under Section 504.
- Requires the implementation of an individualized education program
(IEP). One means of meeting the free appropriate public education requirements
of Section 504 is to follow the IEP guidelines as set forth in the regulations
for Part B (IDEA).
- Requires that the child's education must be provided in the
regular education classroom unless it is demonstrated that education in the
regular environment with the use of supplementary aids and services cannot
be achieved satisfactorily.
- Requires that necessary adjustments be made in the regular classroom
for children who qualify under Section 504.
Article References
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