What is ‘normal’ classroom learning and behaviour? Are medical categories such as ‘ADHD’ reflective of real biological problems for which medical intervention is an effective solution? Or are they ‘socially constructed’ in the sense that they are merely labels that oppress children who engage in behaviour that teachers, parents and policy-makers deem undesirable? Is it possible for schools to take up concepts in ways helpful for children with different educational needs? Or can such concepts only lead to misunderstanding, confusion and frustration?
Various disciplinary lenses in this debate include, but are not limited to, neurobiology, social science, and sociology. What should be clear at this point is educational discourse, more generally, is interdisciplinary in nature. Psychology, sociology, economics, philosophy, history and the natural sciences (neuroscience) all play a role in informing one’s perspectives on these questions and one can observe elements of each among the various paper’s we’ve looked at this term.
Clearly, Travel and Visser are concerned, rightly or wrongly, that the use of labels may act as a sort of self-fulfilling prophecy. One might see some relevant links to Ecclestone’s idea of the ‘diminished self’ to be made, here. Cooper, on the other hand, thinks that such labels are defensible to the extent that people actually take the time to understand the actual science behind such categories (and not simply our assumptions or worries about that science) really mean.
Further reading:
Abidin, R. R., & Robinson, L. L. (2002). Stress, Biases, or Professionalism What Drives Teachers’ Referral Judgments of Students with Challenging Behaviors?. Journal of Emotional and Behavioral disorders, 10(4), 204-212.
Cigman, R. (2007). A question of universality: Inclusive education and the principle of respect. Journal of Philosophy of Education, 41(4), 775-793.
Schrag, F. (2011). Does neuroscience matter for education?. Educational Theory, 61(2), 221-237.
The readings of Travell and Visser (2007) and Cooper (2008) were very interesting. Though they came at the topic of ADHD from differing perspectives, I felt they came to a similar conclusion that ADHD is not simply a problem of brain chemistry: “ADHD is complex, and children and young people who receive a diagnosis do so for a variety of reasons resulting from a range of circumstances and events” (Travell & Visser, 2007, p. 213), “it is clear that ADHD is influenced by both biology and the social environment (Cooper, 2008, p. 461) and that medication should not be a stand-alone treatment. They both agree that treatment should use multi-modal approaches (Cooper, p. 469; Travell &Visser, p. 214).
Both articles also discuss the idea that educational settings can play an important role in helping diagnosed (and potentially) diagnosed individuals. Travell and Visser stated that some interventions were happening at the school level, but that they were not seeming to be related to the medical diagnostic and treatment process (p.210). Cooper dedicates a whole page (p. 468) to practices that teachers can implement in their classrooms to assist these students and states that such interventions may even prevent the necessity for medication (p.469).
Now, I found it hard not to let my biases interfere in my critical reading of these articles. Instinctively I felt my hackles rising, I felt a bit ganged up on and blamed for any student I might teach (or have taught or will teach) who has been medicated for ADHD. If only I had made my classroom more ADHD friendly, or taught in ways that are more conducive for a student with ADHD, then they may have been more successful. I must admit though that Cooper had included some good ideas, some of which I had implemented in the past. I had to also remember that, as they stated, every case is different and not all things will work for every child. I can think of a specific case in which several of those strategies were used with no success. Medication on the other hand made a world of difference.
In looking at these articles critically I also came up with a question that I posed in an earlier post, which is, can we be realistically expected to individualize our teaching for every child’s needs (diagnosed or not)? I love the idea and if time and class size allowed I would gladly tailor my lessons to be more individualized (which I think is the goal of our new curriculum), but we also have to take into account the variety of learners we have. It can become quite overwhelming to a teacher when they actually look at the incredible number of needs of their students beyond their simple expectation to teach the curriculum.
I also had a little laugh picturing Lawlor reading Cooper’s paper
Cooper states ‘Clearly, in the real world we may often attempt to combine environmental and individual changes. Nevertheless…medication is often…a reflection of the failure of the school to make changes that enable the student with ADHD to engage effectively.” (p. 466). I believe that there has been incidents where students have been medicated in order to benefit the school and the family, more so than the student. With limited resources in the school system and perhaps a general lack of understanding by the family and the school, it is easy to see how this may happen, it becomes a ‘quick fix’.
Cooper goes on to describe ‘educational interventions’ (p. 467) which he suggests should be the first step in supporting a student who has been diagnosed with ADHD, before using medication. I can honestly say that most of the suggested educational interventions Cooper suggests are in place in my own classroom and in many of my colleague’s classrooms. However with increased class sizes and decreased funding going into public education it is becoming more and more difficult to deal with the many issues our students are coming to us with. These issues/needs may be social, physical, psychological or medical or a combination of. As Amanda said, ‘we are only on person” and can only do our best with what we have.
Our district has trained many teachers in the Kagan style of teaching, in which student participation is far greater than in ‘western mass education’ which ‘stresses rigid authoritarian values’ (p. 466). But even with this style of teaching, it is difficult to address all individual needs within our classrooms. If a student is not self-motivated, is constantly disruptive to others and needs continual one-on-one support to be engaged throughout the day in a positive way, it makes it almost impossible to reach every student, unless there is extra professional supports in place, such as a CEA. As we all know, educational funding is cut every year and it seems that every year our students needs increase. I’m not sure what the answer is but something needs to change.
As I read this weeks articles, I too, like Amanda, felt a little disheartened. As a teacher, I really believe I try to meet the needs of all my students, but I have to admit Cooper’s article highlighted some unfortunate realities in our current education model.
According to Cooper our classrooms currently operate on certain “assumptions about the kinds of pupil behaviours that are expected” (Cooper 2008, 465). Cooper refers to these assumptions as a “factory model of education” and “at its worst it rewards conformity and passivity at the expense of intellectual curiosity, critical debate and creativity (p.466). It is these “culturally based assumptions about what appropriate behavior in schools and classrooms looks like that children who are predisposed to develop ADHD are disadvantaged” (Cooper 2008, p.466).
Cooper argues that schools and teachers need to learn from diagnosis’ such as, ADHD, “how we might shape the educational environment in order to improve access to learning opportunities” (p.466). I couldn’t agree more! However this brings me to the same question Amanda posed, “Can we be realistically expected to individualize our teaching for every child’s needs (diagnosed or not)? I would suggest that maybe we can’t meet every child’s needs individually(we are only one person), however could we not find a way to meet every child’s needs as a class? As I read the list of pedagogical strategies presented by Cooper (p. 467-469) I was surprised at how many times I thought of a number of students in my own classroom (diagnosed or not) who could benefit from many of the approaches listed.
As our classrooms become more inclusive shouldn’t our teaching approaches become more inclusive as well?
Complex and diverse classrooms can be very challenging to teach. At my school, we do classroom reviews to identify the groups of greatest need, so that some extra support can be put in place, for the classroom teacher, when possible. Now, the review process is quite interesting, as teachers are responsible for filling out a form identifying the needs within the group. Often, the term ADHD is used, without any diagnosis. I often hear teachers stating that particular students should be put on medication, as they feel it would solve a lot of problems for the child and their learning. Parents and teachers, from my personal experience, tend to use the term quite freely, without official diagnosis.
Now, it is easy to ask if a teacher is, or has, put all of the right strategies in place to support a struggling learner, but is this realistic, given the wide range of needs in today’s classrooms? At times, I believe it is, but there are definitely moments, within a teaching day, where you are not able to follow through with a particular structure or strategy, simply because of the needs of a classroom. Consistency is vital when dealing with students who struggle with attention, concentration, hyperactivity and impulsivity; are teachers really able to be as consistent as they need to be for these children?
I would argue that it may be a little easier in the elementary school, not because the job is easier than middle or high school, but, rather, because elementary teachers are generally with the same kids for the majority of the day. At least this provides a consistent environment and adult for the child in need. Now, having said this, many students that struggle in elementary, do much better in the middle because of the opportunities to move around and ‘reset’. Changing classes and interacting with different teachers, in different situations, often helps students with ADHD, however, that consistency piece is difficult to maintain with so many variables in a day.
Regardless of the situation, I believe that students who struggle with ADHD need to have the proper structures of support put in place to help them succeed, as Rose (2005) suggested, “Ritalin no more cures ADHD than aspirin cures toothache.” We need to be equipping students with the skills they need to manage their lives and learning successfully. Numbing kids out with medication is not the answer, for the majority of kids. Yes, medication does have its place, but it definitely needs to be reserved for those who struggle in multipole areas, as suggested by Travell and Visser, ” few young people and parents described all three core symptoms occurring together, which might be expected in cases of ADHD severe enough to warrant treatment with medication.” (p. 207) Medication must be a last resort.
I completely agree with you on the piece that medication shouldn’t be the immediate resort for everyone. I also agree that it’d be easier for primary or middle school teachers because there are more moving-around group work or classes happening each day. And that does not only benefit those who may have ADHD symptom, but also everyone else who may be falling asleep in class, after all, they are still children! However, I’m a high school teacher who barely has the time to finish all the contents in my daily teaching, how do I help those who need the extra moving arounds and kinetic activities?
As we explore more changes to our already innovative school model at ERS, Cooper’s (2008) words resonate with me when he observes that “we can either strive to change the educational environment to accommodate the student, or we can attempt to change the student to enable him or her to engage with an unchanging environment.” (p. 466). We have been exploring cross-grade (8-10) cross-curricular (Eng, Sci, SS, Ma) ‘core’ courses for the last four years. Our project-problem based inquiry learning has been celebrated, but I don’t think it is good for our ADHD students.
I had a student with severe ADHD in two classes last ter: one the vaunted new-style learning (‘core’ class) and in the other, while also project based, I had a CEA who removed him from the class room, and supervised him while he worked on his own creative writing project. In isolation he was hugely successful. In the busy class room he couldn’t function. In one class he completed all tasked and did well. In the other he completed nothing and failed to meet a single competency.
When I think of this student in terms of the quote above, I wonder what is the educational environment that accommodates him best? One on one learning? A private space? These are the very supports our districts are trimming as schools are consolidated and CUPE jobs are cut. While this student actively engaged in the ‘core’ class, it was generally off-topic or unfocused engagement. He could not exercise the self-discipline necessary to complete his research or produce a product to demonstrate learning.
I wonder the structure of a so-called traditional school (desks in rows, rote learning, lecture) is easier for these students than the busy, active, project-based class room with its unending distractions, discussions, chatter. Could this explain increase in ADHD diagnosis? Cooper (2008) quotes Hinshaw et al (1984) stating that “Interventions based on the belief that students with ADHD tend to have an active (‘kinaesthetic’) learning style have been shown to increase levels of attention to task in pupils with ADHD and to reduce disruptive and impulsive behaviours.” (p. 467). That does not seem to be my experience. For my student, activity seemed to over-stimulate him; an opportunity to focus in isolation allowed him to work.
Perhaps this is reflected in Cooper’s (2008) reflection that when “extraneous stimuli” are limited, it enables “the pupil with ADHD to practice self-pacing.” (p. 468). When my student was isolated with the CEA, he settled down to his project, asked clarifying questions, and focused on what he was doing. He could vary what he was working on and take breaks, but he used his time effectively. In an active project based class room, there are many distractors that challenge a student with ADHD.
I am curious about the experiences of other secondary teachers, particularly those using project based learning models. What environmental changes have shown success for your students?
I like how you have mentioned that you were wondering what would be the best teaching method for your ADHD student, is it one on one teaching? I started wondering don’t we all want one-on-one teaching? At least, I would like to receive one-on-one because I get all the individual attention, support, etc.
In terms of your last question, I found successful learning takes place in group activities/discussions, for example, instead of calculating slopes of 100 functions, I asked my students to go around the school and take photos of objects that they can calculate slopes of (newspaper stand, roof, umbrella handle, bicycle, etc.) and make connections to real lives, e.g. what does it mean to have a big/small slope for the staircase, which one is safer? what does the slope of an umbrella represent, will you get all wet if the slope is steeper or flatter, etc.
In Travell & Visser (2007) they talk about ways school experiences can be improved by staff acquiring great awareness of individual needs, more staff training, provision of “more appropriate intervention, planning, and support,” and improved work with parents. (p. 210) I look at those recommendations and see dollar signs. In this time of cutbacks, we know that these students who need greater expertise and greater support are the ones who will suffer when money for training and support workers is eliminated. It’s stressful.
In Travell’s paper, he mentions that the process of diagnosing and treating young children with ADHD remains to be controversial. As a coin has two sides, there are benefits and negative impacts associated with medication usage. There have been studies done that believe in the positive effects of medication, “These benefits are reported as more acceptable behaviour at school and at home, improved family life and greater engagement with academic work.” (Travell, p. 206). However, criticisms have been made that those benefits are only short term effects and the studies were conducted poorly. Travell argues that “… the phenomenon of ADHD is complex… have complex causes…” (Travell, p. 213). The many negative effects include but are not limited to, have to take medications indefinitely, being different than others and be bullied for it (thinking there is something wrong within them and therefore the need to take medicaitons), etc.
I can see why it’s difficult to diagnose or to draw the line between a lack of maturity and ADHD. However, this should be used as an excuse to simply prescribe medications for everyone who seems overly hyper or immature. I agree with the paper that in the long run, young people become heavily reliant on medication, which have severe negative medical impact to health; furthermore, the medications become ineffective as a result of overdosing or long-term usage, “… dosage of medication had been increased over time as lower dosages became ineffective…” (Travell, p. 210), the children can certain be given to another kind of medication and stays with it until it becomes ineffective. Eventually, the young children may run out of medications as they have tried all different types of medications. Therefore, medications shouldn’t be used for the entire population, especially those who resemble to have ADHD characteristics.
Having said that medication shouldn’t be the immediate and sole solution, it does not imply that we shouldn’t intervene. As Travell pointed out, it’s better to intervene at the early stages (least intrusive) to avoid harmful consequences or to be left with harmful interventions as the only choice (Travell, p. 214). To recognize the feelings and views of the young children, to make them feel that they are listend to, understood and respected, to give them power or control over themselves, help them improve their self esteem, to provide guidance, support and consultation with parents will steer them in the right direction of learning.
A study published in the Canadian Medical Association Journal, studied 937 943 children in British Columbia between the ages of 6-12 and found that boys born in December were 30% more likely to have a diagnosis of ADHD than boys born in January. Girls born in December were 70% more likely to have a diagnosis than girls born in January. Boys and girls from the same dates were 41% and 71% more likely to receive medication to treat ADHD. This would suggest that maturity has a large role to play in those diagnosed with ADHD. It would be possible for children to be born days apart (eg. December 28, 2015 and January 1, 2016) suggesting that not simply age plays a role in diagnosis and treatment, but rather relative age in one’s grade cohort. So your statement, “I can see why it’s difficult to diagnose or to draw the line between a lack of maturity and ADHD” proves to be true for the majority of students in BC, in this particular age range.
Morrow, R. L., Garland, E. J., Wright, J. M., Maclure, M., Taylor, S., & Dormuth, C. R. (2012). Influence of relative age on diagnosis and treatment of attention-deficit/hyperactivity disorder in children. Canadian Medical Association Journal, 184(7), 755-762.
I think you bring up a good point Jeremy. I have a daughter who was born in February and so is almost a year older than several of her classmates. She has done well academically and behaviourally. I also have a son, who was born in November. Now, he is not school age yet, but my husband and I both being teachers are aware of some of the difficulties that students with late birthdays sometimes have in the primary years and are prepared to hold him back if necessary. So I agree that there is definitely a difference between maturity and readiness and ADHD. I also think though, that we need to leave the diagnostics to the medical professionals. This may be difficult as Travell and Visser have stated that there are doubts rising about the nature of diagnostics and treatment of ADHD (2007, p. 208), but the reality is, it is not our job. All we can really do is try to, as Delsey stated above, make our classrooms as inclusive as possible and deal with each new student as they come.
This is an strong reference Jeremy. I too have seen anecdotal evidence of students with late birthdays struggling with attention that is likely a result immaturity in comparison to their peers. I know some other countries and systems use other methods for grouping young students, such as Waldorf schools using multi-age groupings in Kindergarten. Some students will undergo Kindergarten for an extra year in an age 4-6 cohort ensuring that they are ready before they move on.
I wonder just how significant the impact of a December birthday on a young child is long term? I also wonder why it is so frowned upon in our system to hold students back for an extra year of kindergarten when it is very clear to the school and family that a student isn’t ready to move on?
Both articles explore the role medication has taken in the treatment of students with ADHD. While exploring the causes of ADHD, Cooper states that it is “influenced by both biology and the social environment” (Cooper, p. 461). Travell & Visser state that “biological, psychological, social and cultural factors all influence the behaviour of children, young people and adults” (p. 213). So while medication is at times the only treatment a student may officially receive, ADHD is a complex diagnosis whose treatment requires a multi-modal approach (Cooper, p. 467; Travell & Visser, p. 214). As part of the multi-modal approach, both Cooper and Travell & Visser emphasize the importance early educational interventions. “Educational interventions were most effective in promoting positive cognitive outcomes” (Cooper, p. 469).
Both articles gave the impression that schools, teachers and the education system itself is failing students with ADHD and that we rely too heavily on medicating kids. “For most, medication was the sole treatment with the possible addition of some poorly monitored actions such as the use of star charts” (Travell & Visser, p.210).
This is made me think of two of the students in my current school. One is in grade 2, on medication and one in grade 4, no longer on medication. Neither student struggles academically but both struggle with attention, impulsiveness and need to move constantly. Both children have expressed that they wish they could stop the whirlwind in their minds. The child in grade 2 has explained what it feels like to have ADHD to her class. When she describes the difficulties she has to work through to concentrate on her work, you realize that it must be exhausting. Until I met these two children and listened to them describing what it is like to sit in a classroom, I questioned medicating kids. I still have trouble with the idea, especially when you think about the question Travell and Visser (p. 206) brought up about the long term effects of medication. But at some point, no matter what you do in your classroom to help children with ADHD, you will come across a student or two where medication as an option needs to be explored.
“Young people in this research appeared in many instances to have been more like external observers of processes which were to bring about significant effects upon their lives.” (Travel and Visser 2007) This quote stuck out to me significantly. So often with ADHD in our field we see parents, teachers, and doctors filling out evaluations, discussing pros and cons, and deciding on a treatment path. As illustrated earlier in the article and in the Cooper article as well, there are serious symptoms and consequences that come along with an ADHD diagnosis. Involving students, especially as they get older in the decision making as well as taking ownership of the learning strategies that work for them should be essential. We talk about teaching strategies that teachers can put into place, which are excellent suggestions, that often help all students, but could part of the treatment plan not be behavioural training for the student? Jumping quickly to medication seems to often be the first step in our medical system with preventative and alternative forms of health care as secondary. I know that locally we have the ADHD clinic that works with some students, but with the amount of students with ADHD in our district I feel like there needs to be more.
The issue of normalizing childhood behaviour is controversial. Travell and Visser (2006) explore the effects of diagnosing children with ADHD and how this can have long-term psychological effects on sufferers and can influence instructional quality and bias (pg. 205). They take issue with the process of diagnosis and treatment and relay how the nature of the inconsistencies with these processes have further aggravated the existing problems in the adoption of ADHD diagnoses in education (pg. 210).
Cooper (2008) believes that the real problem is the small cross-section of educators who decry the existence or validity of ADHD diagnoses and believes that they are grossly misinformed (pg. 643). The stigma associated with such a diagnosis has often been to the detriment of leaners as it has driven the idea that these students are “unteachable .
As educators, is it really fair for us to operate under such assumptions and to let this type of labelling influence our approach to education? I sometimes find myself wondering whether this label is influencing me teaching and whether or not I fully understand the scope and nature of this illness. I think, more than anything, it’s important for me to understand the effects of ADHD on leaners but also to work diligently towards inclusive education that encompasses all types of learners.
Cigman argues that “failure to address the needs of a ‘very small minority’ means failure to accord respect to all, in favour of the contested and puzzling value of inclusion for all” (2007, p. 793). Cigma asserts that the notion of inclusion for all students is not impossible. However, certain parents voluntarily register their special needs children in segregated schooling and pay the necessary resources to make that happen. Historically, there hasn’t always been a choice where special needs children were refused entry into mainstream schools and they were compelled to attend special institutions. Some suffer humiliation or injury to one’s self-concept.
Once again, I find myself arriving late to this party. Thank you all for the interesting reads and perspectives on this topic. I find myself agreeing with most of what Allison and Danai wrote. Allison, one thing you mentioned was Travell & Visser’s questioning of the long term effects of medication. I did not find those authors to provide sufficient evidence of potential harm of medication to make this a strong claim, and I am wondering if you (or anyone else) has read arguments that offer more support for this concern. Danai, your closing sentence (“I think, more than anything, it’s important for me to understand the effects of ADHD on leaners but also to work diligently towards inclusive education that encompasses all types of learners”) really resonated with me. It made me wonder how often we put certain types of learners in a box, and feel it is too hard to meet the needs of all the different types of boxes, when there may be a way to design learning to be more open to meet the needs of all or most.
Once idea that has stuck with me from these readings was from Cooper’s paper where he writes, “More worrying is the possibility that an extreme and entrenched position on one side of an argument might lead to a reciprocal entrenchment on the other.” (p.470) I find this to be a very strong point, not just for the discussion of medication and ADHD, but also for many other issues. I think this leads to one of the key points I have taken away from this course – If we are arguing from a personal or an emotional perspective, it becomes easier to become strongly entrenched in one extreme position, whereas if we are looking for evidence to support our claims, we are able to make more logical arguments.
Better late than never! The question of what is ‘normal’ classroom learning behaviour stuck with me while reading both of these articles. Cooper’s section of his article where he critiques the ADHD diagnostic criteria resonated the most with me when questioning what or who determines what ‘normal’ is. He makes a persuasive argument about the impossibility of humans being able to take a “culture-free” stance and ties this into how our out-dated Western culture’s current model of education that has influenced the category of ‘normal’ classroom learning behaviour. He says, “There are situations where cultural values and assumptions serve to disadvantage members of the social group and require adjustment… An important point to observe about the ADHD diagnostic criteria is that it harbours taken-for-granted assumptions about the kinds of pupil behaviours that are to be expected in properly functioning classrooms” (465). I found this particularly interesting because of how accurately he describes our basic “factory-model” of schooling, which obviously has been being reproduced in classrooms many years. It works, yes, but does it accommodate our society’s growing number of students with learning disabilities? No. I realize there are some schools today that have alternative teaching methods, but I think our culture has really internalized this basic model at the very core of what we think classroom learning behaviour should look like. I might also question if this number really growing or is the trend of self-diagnosis the greater problem? So, if any students show behaviour outside of the socially and culturally constructed ‘normal’ they are being singled out, oppressed, excluded, or marginalized. It almost seems too obvious then to say our current educational provisions need revision and pedagogical practices need to integrate strategies that will engage students with ADHD effectively. As many of you have already noted, how realistic is that request? How can a teacher or should a teacher individualize their lesson plans to meet every child’s needs? I think Delsey made a great point asking instead, “Can we not find a way to meet every child’s needs as a class?” I agree that if the goal is to make classrooms more inclusive for all learners, the teaching approaches need to become inclusive first.
I do agree that medical interventions are an effective solution for extreme cases or in circumstances where resources and support for an individual may not be accessible. For example, Travell and Visser admit that if a child or young person were experiencing all three ‘core symptoms’ of ADHD, this would be a severe enough case to warrant treatment with medication (207). I agree with Amanda’s point that we should leave it to the medical professionals regardless of the doubts rising about the nature of diagnostics and treatments of ADHD. Because at the end of the day, teachers are not trained to decided whether a child has ADHD and making that judgement or assumption could be socially excluding or marginalizing a student who may have other external factors influencing their behaviour. As educators, we must instead take the time to learn about the current diversity of learners that may enter the classroom and be prepared to handle these situations case-by-case, as each one may be entirely different. Based on the knowledge I have on ADHD, which isn’t a lot, I think it is important that educators understand their role in a multi-modal approach to support the diagnosis and options of treatment available to students with ADHD, or any other learning disorder.
I found Travell and Visser’s qualitative analysis of the 17 young people and their families quite interesting as well as disheartening regarding the lack of consistency in most areas regarding ADHD. Besides the fact that every child was prescribed medication there was little consistency regarding diagnosis. The biggest shock was how little the children were involved in the process, often receiving no opportunity to try and explain what they were going through. Rather the whole process seemed to be a deal between the parents and doctor to pacify the child.
I believe that, in terms of the diagnosis, the whole process needs to be reversed. Medication should always be a last resort, especially since the symptoms of ADHD range so dramatically. There are multiple strategies to help kids deal with hyperactivity and lack of focus ranging from diet, sport, breathing exercises, proper routine structures etc. Medication certainly has its place, but only when there has been a strong attempt with natural strategies first and foremost.
Yes, I agree with you that medication treatment should be use after other interventions. Moreover, I think before we use interventions, Just as cooper (2008) claims, that we need to understand the nature of ADHD and realize those taken-for-granted assumptions in the progress of diagnosis of it. We need to ask ourselves that we want to help young people get out of ADHD or just want them to act as our expectations. The diagnosis without evaluating young people’s feelings and experiences mentioned by Travell and Visser may be because that the doctors just want young people to act as social expectations rather than helping them from the nature of ADHD. The awareness of those assumptions also gives a direction to educational interventions to ADHD.
Travell and Visser (2006) question the vadility of the diagnosis of ADHD and the use of medical treatment. They claim that the diagnosis of ADHD might be flawed since the process focuses on young people’s behavior problems or “symptoms” rather than the nature of ADSD. Young people’s behaviors have complex casual and contributory routes, not only including biological ones, but also psychological, social and culture ones. Moreover, they point out that the medical treatment that always follow the diagnosis of ADHD is likely to be ineffective or even counter-productive in the long term since ADHD is not just neurochemical dysfunction. In addition, they indicate that other effective interventions should be provided before medication. For example, educational interventions.
On the other hand, Cooper (2008) states that the understanding of ADHD is really important for its diagnosis and treatment. He explains, “ADHD is influenced by both biology and the social environment” or “socially constructed (p. 461)”. Moreover, he emphasizes that school is a major setting where this process of social construction takes place and educational interventions can be more effective than medical treatment. In addition, He points out that the diagnosis of ADHD relies on social culture. Since the diagnostic criteria “harbours taken-for -granted assumptions about the kinds of pupil behaviours that are to be expected in properly functioning classrooms (p. 465)”. Therefore, He illustrates that some young people’s behaviors may be not problems by themselves, it is because people have culturally based assumptions about “what appropriate behaviour in schools and classrooms looks like (p. 466)” and are not inclusive enough to individual differences and needs. Teachers should strive to make education more inclusive in order to improve access to learning opportunities.
I am impressive to Cooper (2008)’s ideas that the diagnosis of ADHD is grounded in the social culture. When someone acts different from others around or far from “right” expection, people are likely to think that there is something wrong with him or her. For example, in China, because of over 1000 feudal history, students are expected to be quiet and submissive to their teachers. Free discussions and different perspectives are compressed, all presentation and move should get teachers’ permission. A student that always give his opinions openly and show different ideas with teachers or interupt teachers’ demostration will not be seen as the best students, or even affect his evaluation. On the contrary, such a student maybe really welcomed in Canadian class. As to me, Canadian education is more inclusive than that in China. Because of my language problem and character, I am not really eager to express my perspective in classrooms. However, the lucky thing to me is that teachers here didn’t regard me as “bad” or “different” students.