This book is licensed under a Creative Commons Attribution 3.0 LicenseThe tendency to “over-diagnose” is more likely for boys than for girls (Maniadaki, et al., 2003), presumably because
gender role expectations cause teachers to be especially alert to high activity in boys. Over-diagnosis is also
especially likely for students who are culturally or linguistically non-Anglo (Chamberlain, 2005), presumably
because cultural and language differences may sometimes lead teachers to misinterpret students’ behavior. To
avoid making such mistakes, it is important to keep in mind that in true ADHD, restlessness, activity, and
distractibility are widespread and sustained. A student who shows such problems at school but never at home, for
example, may not have ADHD; he may simply not be getting along with his teacher or classmates.
Causes of ADHD
Most psychologists and medical specialists agree that true ADHD, as opposed to “mere” intermittent
distractibility or high activity, reflects a problem in how the nervous system functions, but they do not know the
exact nature or causes of the problem (Rutter, 2004, 2005). Research shows that ADHD tends to run in families,
with children—especially boys—of parents who had ADHD somewhat more likely than usual to experience the
condition themselves. The association does not necessarily mean, though, that ADHD is inborn or genetic. Why? It
is because it is possible that parents who formerly had ADHD may raise their children more strictly in an effort to
prevent their own condition in their children; yet their strictness, ironically, may trigger a bit more tendency, rather
than less, toward the restless distractibility characteristic of ADHD. On the other hand (or is it “on the third
hand”?), the parents’ strictness may also be a result, as well as a cause of, a child’s restlessness. The bottom line for
teachers: sorting out causes from effects is confusing, if not impossible, and in any case may not help much to
determine actual teaching strategies to help the students learn more effectively.
Teaching students with ADHD
Research also shows that ADHD can be reduced for many students if they take certain medications, of which the
most common is methylphenidate, commonly known by the name Ritalin (Wilens, 2005; Olfson, 2003). This drug
and others like it act by stimulating the nervous system, which reduces symptoms by helping a student pay better
attention to the choices he or she makes and to the impact of actions on others. Unfortunately the medications do
not work on all students with ADHD, especially after they reach adolescence, and in any case has certain practical
problems. Drugs cost money, for one thing, which is a problem for a family without much money to begin with, or
for a family lacking medical insurance that pays for medications—a particularly common situation in the United
States. For another thing, drugs must be taken regularly in order to be effective, including on weekends. Keeping a
regular schedule can be difficult if parents’ own schedules are irregular or simply differ from the child’s, for
example because of night shifts at work or because parents are separated and share custody of the child.
In any case, since teachers are not doctors and medications are not under teachers’ control, it may be more
important simply to provide an environment where a student with ADHD can organize choices and actions easily
and successfully. Clear rules and procedures, for example, can reduce the “noise” or chaotic quality in the child’s
classroom life significantly. The rules and procedures can be generated jointly with the child; they do not have to be
imposed arbitrarily, as if the student were incapable of thinking about them reasonably. Sometimes a classmate can
be enlisted to model slower, more reflective styles of working, but in ways that do not imply undue criticism of the
student with ADHD. The more reflective student can complete a set of math problems, for example, while
explaining what he or she is thinking about while doing the work. Sometimes the teacher can help by making lists of
tasks or of steps in long tasks. It can help to divide focused work into small, short sessions rather than grouping it
Educational Psychology 95 A Global Text