Supporting students with ADHD: Indications for and effectiveness of teaching and exam accommodations...
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Transcript of Supporting students with ADHD: Indications for and effectiveness of teaching and exam accommodations...
Supporting students with ADHD:
Indications for and effectiveness of teaching and exam accommodations
Dieter Baeyens & Lotte Van Dyck
2Supporting students with ADHD
Attention Deficit Hyperactivity Disorder
July 2011
Inattention Hyperactivity/ Impulsivity
ADHD-IA ADHD-COM ADHD-HI
3Supporting students with ADHD
• Worldwide prevalence in children +/- 7% • Between 2 and 4% of university students
More students with ADHD in higher education because of increased screening at earlier age and better diagnosis at primary school age
With increasing demands in secondary and postsecondary education, this group is primarily facing increasing problems with attention, planning and organization.
ADHD
July 2011
(Weyandt & DuPaul, 2006)
4Supporting students with ADHD
ADHD
July 2011
If I really want to study efficiently, I get on the train. The ongoing noise seems to block all other stimuli. I don’t get distracted anymore and there is only me and my books.
5Supporting students with ADHD
ADHD
July 2011
This is the third key of the house, the seventh key of my bike and my second mobile since January.
I loose everything because I am not able to pay attention.
6Supporting students with ADHD
ADHD
July 2011
My mother knows the telephone number of the bus company by heart to claim objects I have lost. They are
really friendly people.
7Supporting students with ADHD
• Important to know that− ADHD is best described in terms of “not being
able” rather than “not wanting” understanding
− Symptoms are present in all settings it is not personal
− ADHD in childhood ≠ ADHD in adulthood many people outgrow the typical DSM-IV symptoms but still show impairment
ADHD
July 2011
8Supporting students with ADHD
• Important to know that− At the basis of the disorder lies a genetic
vulnerability that can be positively or negatively affected by environmental factors through these factors we have a moderate impact on the disorder
ADHD
July 2011
Need for evidence based diagnostics, treatment and support for each age group
9Supporting students with ADHD
Evidence based diagnostics
July 2011
Diagnostics of ADHD
Classification Assessment
“Universal”“Age and person
specific”
10Supporting students with ADHD
Evidence based diagnostics
July 2011
Diagnostic process of ADHD
• Number and peristence: ≥ 6 symptoms of inattention and/or ≥ 6 symptoms of hyperactivity/impulsivity
• Age of onset: 7 years
• Pervasiveness: present in ≥ 2 settings
Classification (1)
Heterogeneity
Developmental perspective
11Supporting students with ADHD
Evidence based diagnostics
July 2011
Diagnostic process of ADHD
• Impairment: social, academic/occupational
• Not only during the course of/better accounted for by other disorders
Classification (2)
Interpersonal variation
Comorbidities
12Supporting students with ADHD
Evidence based diagnostics
July 2011
Diagnostic process of ADHDAssessment (1)
Heterogeneity
Interpersonal variation
Comorbidities
Recent, comprehensive
assessment
Developmental perspective
13Supporting students with ADHD
Evidence based diagnostics
July 2011
Diagnostic process of ADHDAssessment (2)
• Identify the current cognitive processes responsible for the impairment
• Clear indications of student’s strengths and weaknesses
14Supporting students with ADHD
• Psycho-education− For the student with ADHD− For the context
• Psychopharmacology
• Cognitive behavioral therapy/techniques− For the student with ADHD− For the context
Evidence based treatment
July 2011
15Supporting students with ADHD
• ADHD – students− Lower grade point averages− More academic problems− Higher chance of dropping out− …
• As a result students with ADHD are encouraged to advocate for teaching and exam accommodations provided by Disability Services Offices (DSO).
Evidence based support
July 2011
(Barkley et al., 2008)
16Supporting students with ADHD
• Students with ADHD could potentially benefit from teaching and exams accommodations (Harrison & Rosenblum, 2010)
• However, little research available on effectiveness of accommodations in secondary education (SE) and postsecondary education (PE)
Evidence based diagnostics
July 2011
17Supporting students with ADHD
• This study: − Overview of accommodations for students with
ADHD in SE and PE quantitative approach
− Exploring indications for and effectiveness of accommodations qualitative approach
Aims
July 2011
Survey
Interviews
18Supporting students with ADHD
• Quantitative study A survey on accommodations in 91 settings of PE (n=49) and SE (n=42)
Qualtrics (www.qualtrics.com)
• Qualitative study 23 semi-structured interviews: − Students in PE and SE − DSO in PE and SE Nvivo8 (QSR International, 2008)
Methods
July 2011
19Supporting students with ADHD
1. Comparison ADHD – Learning Disorders2. Teaching accommodations3. Exam accommodations4. Needs
Outline results
July 2011
20Supporting students with ADHD
• Significantly more accommodations for learning disorders (LD) than for ADHD (χ²(1)=3.82, p<0.05)
Results – comparison
July 2011
SE PE
LD 100 % 100 %
ADHD 75.5 % 90.2 %
Survey
21Supporting students with ADHD
• Possible hypotheses:
Results – comparison
Are students with LD applying more often than students with ADHD?
More acceptance for impairments caused by LD than ADHD?
More knowledge about accommodations in case of LD?
More students with LD than ADHD in SE/PE?
July 2011
More need for accommodations in case of LD?
22Supporting students with ADHD
• DSO:
− Knowledge about the disorder in adolescents/young adults: LD > ADHD
− Guidelines about effective accommodations: LD > ADHD
Results – comparison
July 2011
Interviews
23Supporting students with ADHD
• Students:
− Fear social stigma− Refuse to accept support− Positive effect of accommodations unknown− Option of applying for accommodations
unknown
Results – comparison
July 2011
Interviews
24Supporting students with ADHD
Top 3 reported teaching accommodations:
1. Teaching staff receives information on ADHD 66%
2. Developing strategies to coach the student 41%
3. Supporting self-management in students 40%
Results – Teaching
July 2011
Survey
25Supporting students with ADHD
Results – Teaching
July 2011
information strategies selfmanagement0
10
20
30
40
50
60
70
80
90
100
SEPE
Survey
* **** = p<.05
*** = p<.005
26Supporting students with ADHD
• DSO:
− Little is known about ADHD in adolescence and young adulthood
− Psycho-education for the teaching staff could increase awareness of ADHD symptomatology
− The teaching staff fears the additional effort
Results – Teaching
July 2011
Interviews
27Supporting students with ADHD
• Students:
− Fear a lack of understanding by making use of accommodations - this is less the case for LD
− Fear social stigma− Open communication between the student
with ADHD, peers, teaching staff and DSO is needed
Results – Teaching
July 2011
Interviews
28Supporting students with ADHD
Top 3 reported exam accommodations:
1. Students receives more time 73%
2. Option of (at least partial) oral exams 40%
3. Option of taking breaks during exams 13%
Results – Exams
July 2011
Survey
29Supporting students with ADHD
Results – Exams
July 2011
more time breaks oral explanations0
10
20
30
40
50
60
70
80
90
100
SEPE
Survey
*
*
**
* = p<.05** = p<.01
30Supporting students with ADHD
• DSO:
− No guarantee that the accommodation is effective
− The teaching staff fears the additional effort− The teaching staff fears doing ‘too much’ for
students with ADHD
Results – Exams
July 2011
Interviews
31Supporting students with ADHD
• Students:
− Most accommodations are not effective − Taking exams in a separate room is perceived
as the most effective exam accommodation− Medication is perceived as the most effective
treatment− A single typical accommodation profile for ‘the
student with ADHD’ does not exist− Fear social stigma
Results – Exams
July 2011
Interviews
32Supporting students with ADHD
• Needs according to DSO:
1. More information on coaching student 71%
2. A national policy on accommodations 50%
3. Help from external specialists 37%
Results – Needs
July 2011
Survey
33Supporting students with ADHD
• There are no clear guidelines from the government:
− The selection of accommodations is made locally and on intuitive basis
Results – Needs
July 2011
Interviews
34Supporting students with ADHD
• Because of the heterogeneity in ADHD, a recent, comprehensive assessment is needed:
− To identify the current cognitive processes responsible for the impairment on which to base accommodations
− Reports from qualified specialists should provide clear indications of students’ strengths and weaknesses
Results – Needs
July 2011
Interviews
35Supporting students with ADHD
• Extra effort, motivation and creativity often insufficient to deal with school and academic impairments of ADHD
• If some specific conditions are met, teaching and exam accommodations are potentially effective to alleviate these impairments:
Conclusions
July 2011
36Supporting students with ADHD
• Accommodations should be individually designed by the DSO based on recent comprehensive assessment of the students’ strengths and weaknessess, reported by a qualified specialist
• Open communication and a better knowledge of ADHD will result in more goodwill on the part of the teaching staff, as is already the case for students with learning disorders.
Conclusions
July 2011
37Supporting students with ADHD
• A clear (national) policy on accommodations for disabilities should guarantee sufficient and effective support for students with ADHD as well as adequate resources for SE and PE settings to organize these accommodations.
Conclusions
July 2011