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Instructor's Handbook: Accommodating Students with Disabilities
7.6 Students With Attention Deficit Disorder (ADD)
It is estimated that Attention Deficit Disorder (ADD) occurs in 3 to 5% of the general population. It was previously thought that ADD was a disorder of childhood only, but recent research indicates that some children do not outgrow their extreme difficulties with inattentiveness, hyperactivity and/or impulsivity. While ADD is a heterogeneous disorder, with each individual having a particular blend of symptoms, research indicates that neurological dysfunction, and probably biochemical imbalance, underlie problems maintaining attention, controlling restlessness and acting with sufficient forethought. It is important to know that a valid diagnosis of ADD requires a psychologist or physician to determine that these problems are:
- extreme in frequency and impact compared to normal fluctuations in attention, activity level and impulsivity
- produce clinically significant impairment in more than one life area
- evident and linked to poor functioning in early childhood
- NOT attributable to a primary emotional or psychological problem (although coexisting anxiety or depression is not uncommon)
- NOT attributable to problems with motivation or substance abuse
Some portion of adults with ADD, probably 20 to 30%, also have a specific learning disability. Therefore, Queen's students who are suspected of having ADD complete the same psycho-educational assessment described in Section 7.5 (Students With Learning Disabilities), as well as a thorough diagnostic interview to determine current and past ADD symptoms.
Many students with ADD find that their problems with inattention, restlessness and disorganization are helped by medication. Counselling to improve self-management strategies and study skills is also often useful, as is therapy aimed at reducing co-existing depression.
Using some instructional strategies for course preparation, presentation of lectures, developing assignments and exams will not only help the students with ADD in your classes to succeed, but will be useful to all your students. In general, strategies which provide structure and organization are central. Furthermore, although the instructor is not obliged to "entertain" the students, any efforts to provide variety and novelty in teaching methods will be helpful in maintaining attention to the material. As is true for students who have a learning disability, it is recommended that instructors:
- select well-organized texts with aids such as chapter summaries, glossaries, indexes
- make book lists and other materials available well in advance
- provide a role model for organization: present overall plans for the course, unit and lecture
- use the "tell them what you are going to tell them, tell them, tell them what you told them" approach
- indicate main points before viewing videos or films
- clearly indicate the main points of your lecture, using written and oral techniques to emphasize them
- emphasize the relationships between ideas, using visual as well as verbal methods (e.g. concept maps, diagrams)
- use overhead projections, diagrams and charts whenever possible to supplement your oral presentation of information
- explain assignments clearly, both orally and in writing, with set deadlines
- modify test questions to avoid double negatives, extremely complex sentence structure, and questions embedded within questions
- encourage group work when feasible (e.g. brainstorming, assignments)
Some students with ADD are reluctant to discuss their disability with their instructor, often because of negative past experiences with teachers, sometimes based on their own struggles to accept their disability. Disclosing a disability and discussing it can make a student feel nervous, alienated and even ashamed. It is important, therefore, for instructors to become knowledgeable about ADD, address concerns about the validity of the diagnosis and appropriate accommodations with the Learning Disabilities Specialist (not the student), and communicate with the student in an open and approachable manner.
It is helpful at the beginning of the course to invite any students with disabilities to introduce themselves to you individually during office hours. Then you may find out, in a non-challenging way, as much as the student can tell you about his or her learning style, strengths and weaknesses, and recommended accommodations. It is important to treat these conversations as well as any documentation about students as strictly confidential.
Some students may not yet be aware of having ADD, but you may observe significant problems with attention, "careless" mistakes, extreme restlessness or "fidgetyness", organization and time management. In this case, it may be helpful to privately discuss your observations with the student, suggest available learning support such as tutoring if appropriate, and/or consult with the Learning Disabilities Specialist about the value of a referral for an interview.
Finally, it is important to be aware that the student has responsibilities as well, including: to contact you in advance to make arrangements for accommodations on exams not handled by the Exams Office (e.g. midterms); to attend classes and to fulfil the essential requirements of the course. While most students with ADD struggle with organizational and time-management skills, it is nonetheless their responsibility to meet the demands of their course load, via Learning Support available at the Student Counselling Service, perhaps by reducing their course load, careful course selections and so on. Sometimes, just like their non-disabled classmates, students with ADD don't meet their responsibilities. It may be useful to consult with the Disability Services Advisor at this point, but typically, the properly accommodated student should have normal consequences for missing deadlines, handing in poor quality work, etc.
Allow taping of class lectures for students who have difficulty processing auditory information and/or listening and writing at the same time.
It is helpful to give students written and oral information about their assignments; to be very clear regarding expectations; to provide examples of good and poor quality products; to be willing to discuss the assignments and look over drafts (class size permitting); and to offer choices whenever possible (e.g. oral presentations, essays, group format, etc.). It is typically not helpful for students with ADD to get extensions on their assignments since this usually just pushes forward their "time crunch". Students who are struggling with the work load may do better to take fewer course at a time, often supplementing these with summer courses.
A number of exam accommodations are typically recommended for students with ADD. As noted, these recommendations should be based on a professional diagnosis and psychometric findings, demonstrating, for example, poor sustained attention, slow processing, reading and/or writing speed. It is the responsibility of each department and/or faculty member to determine the essential requirements of a course and whether the recommended accommodations undermine or jeopardize these. The Learning Disability Specialist is available for consultation when making such determinations.
Typical accommodations include:
- extra time for tests and exams (or frequent breaks)
- writing exams in a smaller room with fewer distractions
- writing exams alone to allow for talking aloud, even fewer distractions
- access to a computer to allow for spell checking, sequencing written material, legible results
- consideration (no penalty) for spelling or grammar mistakes when a spell checker was not used
- a reader to read aloud the test questions and, infrequently, a scribe to write answers