Students with Attention Deficit Hyperactivity Disorder

National Association of School Psychologists. Communique, June 2018 | Go to article overview

Students with Attention Deficit Hyperactivity Disorder


Many students with academic and adjustment problems exhibit a constellation of behaviors commonly associated with attention deficit hyperactivity disorder (ADHD), and NASP recognizes the critical importance of supporting the academic, behavioral, and social–emotional needs of students with ADHD in school settings. The core symptoms of ADHD, including both inattention and hyperactivity–impulsivity, are neurobiological in nature, interact in unique ways with environmental features and demands, and have the potential to adversely affect a child's educational performance as well as social–emotional development (Barkley, 2015). NASP also recognizes that students may present with attention problems due to a variety of conditions or factors other than ADHD, such as academic difficulties, anxiety, depression, or environmental factors (e.g., teaching practices, ineffective discipline, or stress; DuPaul & Stoner, 2014). The behaviors associated with ADHD exist along a continuum from mild to severe and appropriateness of supports and interventions will depend on the nature, chronicity, and severity of the behaviors of concern (Pfiffner, 2011).

SCHOOL-BASED ASSESSMENT AND ADHD

School psychologists are trained in child psychopathology and behavioral assessment practices and have the expertise to evaluate whether students are presenting with ADHD. Further, school psychologists are qualified to conduct psychological and psychoeducational evaluations to help determine if a child has a disability under the Individuals with Disabilities Education Improvement Act of 2004 (IDEA). Along with other members of the evaluation team (including parents), school psychologists conduct comprehensive evaluations to determine if a child has a disability and if so, is in need of special education services or other supports. NASP supports the recommendation of the American Academy of Pediatrics (AAP) that in the assessment of ADHD, “… information should be obtained primarily from reports from parents or guardians, teachers, and other school and mental health clinicians involved in the child's care” (AAP, 2011, p. 1012). Such information should be used to evaluate the core symptoms of ADHD in various settings: the age of onset, duration of symptoms, and degree of functional impairment (DuPaul & Stoner, 2014). Evaluation of students presenting with attention problems, and assessments conducted to rule in or rule out ADHD as a diagnosis, should be carried out with care and with the understanding that attention problems may reflect typical development, environmental conditions (e.g., instructional match, home stress, social factors), other psychological or medical conditions, or some combination of these factors (Wolraich & DuPaul, 2010).

As such, school psychologists should be aware of diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and use developmentally appropriate multi-informant, multisetting behavioral assessment methods when evaluating students with regard to ADHD (DuPaul & Stoner, 2014; Tobin, Schneider, & Landau, 2014). The evaluation process generally includes direct observations, diagnostic and other interviews, and behavior rating scales, along with a review of student work samples, in order to gather comprehensive information on behavioral concerns, academic functioning, and social and organizational skills across settings. Screening and assessment for other presenting problems and disorders is also important, as the presence of co-occurring disorders may be linked to increased functional impairments in social and academic skills (Booster, DuPaul, Eiraldi, & Power, 2012).

School psychologists engaging in assessment activities related to attention problems should have knowledge of environmental variables and reinforcement contingencies in the school and other settings that may serve to ameliorate or exacerbate behaviors of concern. If the student is presenting with problem behaviors, functional assessment procedures can inform intervention planning. …

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