Wednesday, March 19, 2014

The ADHD Explosion: Is NCLB to Blame?

A new book, The ADHD Explosion, by health economists Stephen Hinshaw and Richard Scheffler finds a recent explosion in cases of ADHD among children.  In 2003, 7.8 percent of students were diagnosed with ADHD.  The number has steadily increased since then, reaching 11 percent in 2011. They attribute the cause to high stakes testing.  Prior to NCLB, there were individual states with high identification rates for ADHD.  Those states tended to be ones with high stakes testing and accountability systems.  After the passage of NCLB, those states with formerly low rates of identification saw their numbers climb as well.  

If their conclusion is accurate, this may be one of the most eye-opening and important studies with education implications we have seen in some time.  Toward that end, I am going to try to rope some of our special education experts into commenting on it.  Until then, I will leave you with the book's synopsis:

Attention-deficit/hyperactivity disorder (ADHD) is one of the most controversial and misunderstood medical conditions today. With skyrocketing rates of diagnosis and medication treatment, it has generated a firestorm of controversy. Alarming questions have been raised about ADHD in recent years, including:

    • Why are one in nine children and adolescents in the U.S. now diagnosed with ADHD, with projected rates still rising?
    • Why are nearly 70% of those diagnosed with ADHD prescribed medication?
    • What is causing the fast-rising diagnosis and medication of adults? And why are over a quarter of all college students using stimulants for academic performance?
    • In some southern states, why are boys over 9 years old diagnosed at rates of almost one in three?
    • Can we trust the stories we read and hear about ADHD, even in major media outlets?
    • What is driving the current ADHD explosion–is it parents, doctors, schools, culture, the healthcare system, or Big Pharma? And will it end?

Stephen Hinshaw, a distinguished psychologist, and Richard Scheffler, an eminent health economist, uniquely blend clinical wisdom, current science, medical and school policy, and global trends to debunk myths and set the record straight in The ADHD Explosion. They describe the origins of ADHD and its huge costs to society; the science behind its causes as well as medication and behavioral treatment; and the variation in diagnosis and treatment across the U.S. Dealing directly with stimulants as “smart pills,” they describe the epidemic of medicalization, arguing that accurate diagnosis and well-monitored care could ease the staggering economic burden linked to ADHD.

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I have not read the book but certainly will because I am curious how the authors link NCLB to increased ADHD identification. On the one hand, the NCLB was carefully drafted with disability identification in mind. All subgroups, including the disability subgroup, must make AYP so schools should have no incentive to over-identify students with disabilities because these students cannot be “hidden” in general statistics and very few can be exempted from testing and reporting. On the other hand, the disability subgroup is the least likely group to make AYP, so there may be incentive to “pack” it with students that perform well on standardized tests but still qualify as disabled. I do not know whether ADHD students fit this profile, or whether this is the link the authors make in the book, which is why I will read it and share my thoughts once I am informed.

Posted by: Rob Garda | Mar 19, 2014 8:53:07 AM

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