Of course we can't require that students take medication for ADHD - that's not legal nor is it ethical. As pointed out earlier in this discussion by Dr. Jarrow, sometimes medication does not improve the symptoms. We need to do our best to provide reasonable accommodations, and if a student is courageous enough to reveal a learning challenge, it's the least we can do to accommodate him or her.
I believe that providing engaging instruction is a huge help for students with ADHD and students who, like many of us, are used to a flashy electronic world and at times have trouble staying focused and on task (yes I am describing myself here). The National Center on Universal Design for Learning that is mentioned in this course gives some excellent insight on this topic - "It is, therefore, important to have alternative ways to recruit learner interest, ways that reflect the important inter- and intra-individual differences amongst learners." (http://www.udlcenter.org/aboutudl/udlguidelines/principle3)
In the Study Skills session that I teach, I try to stick with no more than 20 minutes of multimedia lecture, followed by an activity and reflection. This helps to keep students engaged.
I have heard success stories about medication dramatically helping symptoms of ADHD. However, in the learning setting, we have no control over a student's medical choices. So as instructors, if we are already communicating openly with a student about his or her challenges, it's entirely doable to make small adjustments and accommodations that will really help the student succeed. Communication, knowledge and engagement are the keys to success!
Tia,
You are right, of course. Medication is not the only way to manage the symptoms of ADHD, and we have no more right to dictate the use of medication for a student with ADHD than we would have to require a cochlear implant for a student who is deaf. There are lots of reasons why some individuals choose NOT to use medication, including the two you mentioned (expense and side effects). I am surprised to see you list meditation or yoga as alternatives to medication for this population, though. While both may have a calming effect and might possibly increase ones ability to focus, it is hard to see how they would have spillover effects to the kind of classroom issues that often hamper a student's educational pursuits (such as distractability, organizational difficulties, and time management). Fortunately, there are many practical strategies that can help students with ADHD to *manage* their symptoms, rather than masking them with medication.
Dr. Jane Jarrow
This question dangerously infers a zero-sum game in which people must submit to prescription drugs in order to be accomodated in school. ADHD drugs, like any drugs, are potentially expensive (especially without insurance) and may have undesired side effects. This question also implies that medication is the sole treatment for ADHD. Both of these inferences are fallacious. Non- pharamacological methods such as meditation or yoga are alternatives to medication and if one were to opt for them, a student should not be penalized.
Laurna,
I agree with the gist of your post -- the idea that medication has different impact on different students and that it is not up to us to question why a student does or does not choose to use it. I would caution, just a bit, about the suggestion that some learners can mitigate their symptoms just by being aware of their "weaknesses" -- you are right... many students with ADHD learn to compensate quite well. But don't let it slide into the idea that "they could control it if they just tried harder." For a long time, ADHD was recognized as a WEAKNESS on the part of the student, rather than a disability. "What he needs is a little discipline. Let's send him to a good military school!" GRIN
Dr. Jane Jarrow
Medication can have severe side effects and impact each individual differently. What might work well for one person may not be right for another individual. I have seen learners do well both with and without medication. Many symptoms can be managed by the learner simply being aware of their weaknesses and what they can do to aid themselves in those areas.
Sorry, I did not mean to lead towards medication. I have had many students be very successful with out being on medication.
Patricia,
There is no question but that the medication can make a significant difference for some individuals, and that is a great boon for those students. I would just caution against the assumption or generalization that "if you have ADHD you should be on meds, and that if you aren't you won't make it." It doesn't work for everyone.
Dr. Jane Jarrow
The medication helps the student to focus, and builds self confidence. I adopted older children with ADHD in their late teenage years, and saw this first hand, medcation help them progress with school and relationships. With self assurance like medication, help the student embrace the material easier and more enjoyable for that individual. What I have observed in the adults that I have taught and choose to not take their medcation usualy dropped out of school.
Patricia,
I am not sure that kind of general statement ("they do better when they take their meds") can be supported by hard evidence. The medication helps the student to focus, and that may make it easier for the student to achieve. But being on medication does not improve the odds that students know the material or are capable of demonstrating their knowledge.
Dr. Jane Jarrow
It is great when the medication works, Pamela -- but that isn't always the case. We tend to think of medicine as "curing" a problem. When we take the medication it makes the cold or flu or infection go away. But for those with ADHD, the medication simply dampens the problems. It helps to keep things under control so they can function better, but the problem still remains. Think in terms of a cold medicine that helps you limp through the day in the early stages of a cold, only to hit you like a brick when you get home at night and spend a miserable evening coughing and sniffling. How would you like to look forward to aa lifetime of such miserable nights? For some, they would rather TRY to learn other ways to manage their symptoms than to medicate forever.
Individuals with ADHD problems make bigger acadimic gains if they are taking stimulants medicatin compared to other individuals who aren't receiving medication, but commodations can be made for both groups as long as composure in the classroom is maintain by the student.
You would hope that students, who know they have ADHD, would want to take medication; I just talked to a student, who has come back to our college, who is on medication for it.
When we were talking, catching up since he was here last, he told me about the problem. He knew there was something wrong, not being able to hold a job, and other things in his life were affected. When he was finally diagnosed, and on medication, he said that it has made a world of difference. He can focus, work more, everything that he had a hard time doing before he can do now, etc. This student is in a different program than before, and has a better chance of completing it this time.
I understand about side effects of certain medications,or that the student cannot afford them. If either is the case, maybe we can take time with them after class to help them. If it is causing behaviour problems, that needs to be addressed outside class, as soon as possible.
You are right on target here, Joshua. While the medication may do exactly what is hoped (in helping to manage their ADHD symptoms), it is possible that it will do much more, as well. Many students choose NOT to take their medication because of the difficult reactions they have. It would not be appropriate to DEMAND that a student take his/her ADHD meds any more than it would be to force anyone else to take a certain medication.
The problem with those medications is that they are usually associated with unwanted side effects. We cannot force someone to have to switch one set of issues for another one.
I don't disagree with anything you've said here, Christopher. You have recognized the problem -- there ARE side effects to medication, and the medication doesn't FIX the problem, only helps manage it. We don't get to decide how the student deals with his/her disability. We only get to have our impact in providing an opportunity for the student to demonstrate capabilities in whatever state he/she is in. I like your focus on accepting the student as eligible and capable, and letting everything else play itself out.
As a parent of a child with ADD, I understand the struggle to decide between the side effects of medicatiion and the benefits. Even with medication, my son still struggles with his hyperactivity, but it is more managable. Unfortunately, I don't feel his teacher understands his condition as well as she should.
As an instructor, I can see how he is affected, and try to understand what my students are going through. I can see first hand that medication can help, but it won't solve all the issues these students face. It can also be difficult to find the correct medication. We as instructors should provide reasonable accomodations regardless of their treatment, as long as they are not disruptive to the rest of the class.
As long as they are maintaining their composure, and not being disruptive, they are doing their part, regardless of whether or not they are taking medication.
I think you have approached this in just the right way, Brad. Medication doesn't work for a lot of students, and others choose not to take it for a host of reasons. Even those who do take medication do so to help them manage their attention problems -- it doesn't cure the problem. The bigger issue, though, is that nothing is Section 504 or the ADA gives us the right (or the obligation!) to engage in rehabilitation. It is not up to us to tell the student how he/she should be managing the disability. Our responsibility is only to respond to the student appropriate AS WE FIND THEM. Nice said.
Taking medication for ADD or ADHD does mean that a student has done their part, or he or she has taken "the appropriate" measure to deal with their activity disorder. Many people have found different ways to deal or coup with their energy levels to become a successful student; Meditation is one thing that comes to mind. It is quite probable that a student could take medication and still have the same problems, or more enhanced problems. Therefore, I would not suggest or expect students to take medication, even if it is proven to work with a majority of patients or even if it is required (nothing is a 100%). My only suggestion would be to encourage students with ADD or ADHD to try alternative methods to help control their behavior. Regardless, if they find a solution or not, I would never deny a disabled student from their accommodations because I feel they are not doing their part. I do not feel that it is up to me to make that decision. I could wrongfully perceive that a student is not doing their part by not taking require medication, and then strip them of their accommodations; what good would come of this situation? If we, teachers and educators, have agreed to help people with disabilities then we have to accommodate those who have and who have not found an appropriate solution to deal with their activity disorder.
I agree with you Roxanne. I don't think we can or should force students to take medication. The question is not "are you taking your meds?" but "are you able to control your symptoms?" If the answer to that is "yes", then there is no problem. If the answer is "no -- not without the medication", hen I think the answer should be "that's a problem -- because we aren't going to excuse poor performance or poor behavior simply because you have a disability. You have a decision to make."
I am against forcing people to take medication against their will, ,but I do understand the challenge we instructors are faced with managing the behavior. I still believe we must do all we can to encourage use of medication and still do our job. I see it as my spiritual responsibility to still do all I can no matter what.
