Writen by George Gallegos
Parents are usually worried by the report of learning problems and under performance in school by their child. Once learning accommodations and positive incentives have been informally introduced in the classroom, the next level of possible interventions to help a student's academic performance in the classroom can become more complicated. The difficulty Johnny experiences in the classroom cannot be accurately understood without some amount of individualized evaluation primarily in the areas of intellectual ability, learning achievement, or his ability to regulate attention. Schools are more likely to refer a student for an ADHD evaluation prior to the initiation of a comprehensive learning evaluation completed by the school's special education team. Despite questions surrounding potential learning disabilities, schools often prefer to have the question of ADHD addressed prior to a decision to pursue special education testing for Johnny.
In the learned opinion of Russell Barkley (excerpts from his lecture on ADHD, San Francisco, June, 2000), up to 50% of children referred for ADHD also have learning disabilities. Although the incidence of these two conditions is independent from one another, there remains a need to carefully evaluate for both learning weaknesses and ADHD when problems present with academic performance. Barkley states that 75% of children referred for ADHD are found to have other co-morbid conditions including learning disabilities, Oppositional Defiant Disorder, anxiety disorder, depression, or conduct disorder. While these alternative conditions must be considered, student evaluation should always include some estimate of intellectual ability and measured academic achievement. It is important to recognize the distinct relationship between a student's ability to learn and the ability to sustain attention.
Learning weaknesses and/or lower cognitive ability will predictably interfere with student attention. Although learning and intellectual weaknesses usually result with the symptom of inattention, they are qualitatively different from the disruption of ADHD. Theoretically, a learning disability is defined as an inability to interpret information correctly and link it with other learned information stored in different parts of the brain. Standardized tests often concentrate on evaluating a student's ability to learn information primarily through the auditory and visual modes. A learning weakness can disrupt a student's efforts to comprehend, organize, sequence, categorize, and associate concepts or ideas. A student impaired by learning disabilities can demonstrate inattention when they struggle to process challenging information or tasks.
A student can also show inattention when they attempt to learn information or complete tasks that exceed their ability level. In this case, intellectual ability governs how well the student can think, problem solve, understand abstractions, make abstract comparisons, use vocabulary to describe thoughts, and express ideas in verbal and written language. Weaknesses in any of these thinking and problem solving abilities can interfere with performance. Even Low Average range intellectual abilities can effectively interfere with a student's routine efforts to comprehend and perform in the classroom. Ultimately, this student may feel lost, confused, or overwhelmed by the typical classroom curriculum. This inattentive and off-task behavior is often misinterpreted as ADHD rather than the actual thinking disruption recognized as part of lower cognitive ability. A student with lower intellectual abilities will demonstrate correspondent levels of poor attention. This means that attention is demonstrated at a level that conforms to the student's cognitive ability.
These areas of performance weakness are routinely monitored by classroom teachers. While delays in academic skill development can be informally observed in the student's daily performance, standardized assessment must be completed in order to formally identify either a learning disability or intellectual weakness. Testing can be completed by the special education team using achievement measures as well as an I.Q. test to evaluate the level of student functioning. Achievement measures will reflect what the student has learned through routine instruction. Intellectual testing will produce a theoretical ability score commonly recognized as innate thinking ability. It is then possible to compare the student's achieved learning to the student's theoretical ability to learn (I.Q.). Statistically significant differences between these two levels of performance will suggest the possibility of learning and thinking disabilities.
A referral for testing may be made by the classroom teacher in coordination with the student's parents. Generally, federal guidelines allow a 45 day window for testing to be completed by a school's special education team. All testing results will be shared at a staffing coordinated with parents, teacher, and special education team in attendance. Due to the period of time necessary for this assessment process to occur, schools may often encourage parents to seek an ADHD evaluation prior to the special education staffing date. The intention of the ADHD evaluation will be to rule out the possibility of contributing deficits in the student's ability to sustain attention to task.
I am a child psychologist recently retired from the public school district. I continue to maintain a private practice devoted to the assessment of ADHD in children. I have recently developed a parent questionnaire that helps parents decide whether to pursue a formal ADHD evaluation for their child. This questionnaire can be viewed at http://www.youadditup.com
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