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).
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.
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.
- Davila, R. R., Williams, M. L., & MacDonalt, J. T. (September 16, 1991). “Clarification of policy to address the needs of children with attention deficit disorders within general and/or special education.” Washington, DC: U.S. Department of Education, Office of Special Education and Rehabilitation Services. Parker, H. (1992). “The ADD hyperactivity handbook for schools.” Plantation, FL: Impact.
- Note. This digest is adapted from two sources:
- “Children with ADD: A Shared Responsibility. Based on a Report of The Council for Exceptional Children’s Task Force on Children with Attention Deficit Disorder (1992).” Reston, VA: The Council for Exceptional Children, 1920 Association Drive, Reston, VA 22091. Order No. P385.
- Irland, B. (1992, Winter). “Making It Perfectly Clear; ADD/ADHD Students Can Qualify for Services.” THE SCOOP. National Learning Differences Network, 82 S. Townline Road, Sandusky, MI 48471.