ADHD @ high schools: Clear mismatch between the Evidence and the Practice

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Study: High School­ers with ADHD Receiv­ing Few Evi­dence-Based Sup­ports (Edu­ca­tion Week):

“A lit­tle over half of high school stu­dents with atten­tion deficit hyper­ac­tiv­i­ty dis­or­der are receiv­ing some kind of ser­vices from their schools, such as addi­tion­al time on tests or extend­ed time to com­plete home­work assign­ments, a recent study finds. But those par­tic­u­lar sup­ports have no report­ed effec­tive­ness in improv­ing the aca­d­e­m­ic per­for­mance of stu­dents with ADHD, accord­ing to the study pub­lished ear­li­er this year in the jour­nal School Men­tal Health…

Of par­tic­u­lar con­cern, the report authors said, is that only about a quar­ter of stu­dents report­ed receiv­ing school ser­vices that have been shown to sup­port stu­dents with the dis­or­der. For exam­ple, help­ing stu­dents with learn­ing strate­gies or study skills is evi­dence-based, but only about a third of the stu­dents who received sup­ports got that type of help. Anoth­er evi­dence-based support—facilitating post­sec­ondary tran­si­tion and employ­ment through teach­ing work-relat­ed, self-advo­ca­cy and self-man­age­ment skills—was pro­vid­ed to only about a quar­ter of the stu­dents receiv­ing ADHD-relat­ed supports.”

Study: Preva­lence and Char­ac­ter­is­tics of School Ser­vices for High School Stu­dents with Atten­tion-Deficit/Hy­per­ac­tiv­i­ty Dis­or­der (School Men­tal Health)

  • Abstract: This study exam­ines the preva­lence and char­ac­ter­is­tics of ser­vices report­ed by school staff for 543 high school stu­dents par­tic­i­pat­ing in the 8‑year fol­low-up of the mul­ti-site Mul­ti­modal Treat­ment study of ADHD (MTA). Over­all, 51.6 % of stu­dents with a his­to­ry of atten­tion-deficit/hy­per­ac­tiv­i­ty dis­or­der (ADHD) were receiv­ing ser­vices through an indi­vid­u­al­ized edu­ca­tion­al plan (IEP) or a 504 plan, a rate high­er than expect­ed for this age group. Less than 5 % of these had 504 plans; 35.5 % attend­ed spe­cial edu­ca­tion class­es. Very few ser­vices (except tutor­ing) were pro­vid­ed out­side of an IEP or 504 plan. Almost all stu­dents with ser­vices received some type of aca­d­e­m­ic inter­ven­tion, where­as only half received any behav­ioral sup­port or learn­ing strat­e­gy. Less than one-fourth of inter­ven­tions appear to be evi­dence based. Stu­dents receiv­ing ser­vices showed greater aca­d­e­m­ic and behav­ioral needs than those not receiv­ing ser­vices. Ser­vices var­ied based upon type of school, with the great­est num­ber of inter­ven­tions pro­vid­ed to stu­dents attend­ing schools that only serve those with dis­abil­i­ties. Orig­i­nal MTA treat­ment ran­dom­iza­tion was unre­lat­ed to ser­vices, but cumu­la­tive stim­u­lant med­ica­tion and greater sever­i­ty pre­dict­ed more ser­vice receipt. Results high­light a need for accom­mo­da­tions with greater evi­dence of effi­ca­cy and for increased ser­vices for stu­dents who devel­op aca­d­e­m­ic dif­fi­cul­ties in high school.

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