EFFECTS OF ADHD ON EARLY LEARNING AND ACDEMIC PERFORMANCE 1

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1 EFFECTS OF ADHD ON EARLY LEARNING AND ACDEMIC PERFORMANCE 1 The Effects of ADHD on Learning and Academic Performance in the Pre- and Elementary School Years. Christopher Kalogeropoulos November 19, 2012 Submitted to Dr. Lisa Teather in partial fulfillment of the requirements for Psychology 333/2. Department of Psychology Concordia University

2 EFFECTS OF ADHD ON EARLY LEARNING AND ACDEMIC PERFORMANCE 2 The Effects of ADHD on Learning and Academic Performance in the Pre- and Elementary School Years. Research suggests that attention deficit hyperactive disorder (ADHD) is associated with learning difficulties, as well as behavioral problems, lack of peer acceptance, family life difficulties and low selfesteem which can all contribute to poor academic performance (Antshel et al., 2009). ADHD is a behavioral disorder diagnosed in 3-8% of children and adolescents (Mash & Wolfe, 2005). It is best conceptualized as a chronic neurobiological condition that makes it difficult for children to concentrate and control their behavior in school and social settings (Foley, 2011). According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), ADHD is characterized by inattention, impulsivity, hyperactivity and low task persistence (American Psychiatric Association [APA], 2000). Inattention is characterized by an inability to concentrate or sustain attention on tasks, inability to listen as well as proneness to distraction. Impulsivity refers to a tendency to respond quickly without thinking about the consequences of one s actions. Hyperactivity is characterized by behaviors such as fidgetiness, restlessness, talking excessively and racing from one thought/behavior to another (Lerner & Johns, 2012). There is significant evidence to suggest that the symptoms of ADHD impair a pre-school child s ability to develop the appropriate pre-academic skills that prepare him/her for future learning. As a result, children with ADHD tend to demonstrate poor academic performance in elementary school as early as the first grade (Lerner & Johns, 2012; Pennington & Ozonoff, 1996). The preschool years mark a crucial period of development as children learn to acquire behavioral, social and early learning skills that are required for later academic success (Kirk, 1987). During this period they acquire skills in visual and auditory processing and perception, extend their capacity to attend and focus, expand their working memory, develop their thinking skills, as well as develop

3 EFFECTS OF ADHD ON EARLY LEARNING AND ACDEMIC PERFORMANCE 3 receptive and expressive language skills (Lerner & Johns, 2012). The levels to which children acquire these skills are developmental indicators which can often predict later difficulties in academic achievement (Kirk, 1987). Lerner and Johns (2012) have identified pre-school predictors of later academic difficulties in children. Some of these risk factors include: extreme restlessness and proneness to distraction, trouble interacting with peers, poor inability to follow directions, difficulties with acquiring number and alphabet concepts, auditory and visual processing problems, difficulties in motor skills as well as delayed language development. ADHD pre-school children display several of these symptoms (Mash & Wolfe, 2005) and they may impede their ability to acquire the developmental skills which are crucial for future academic learning. Daley & Birchwood (2010) conclude that many preschool children who are diagnosed with ADHD display an impaired course of development which renders them unprepared for academic learning in elementary school. Children with ADHD show reduced neural activity in the frontal lobes of the cerebral cortex. This region of the brain is involved in attention, short-term memory and the inhibition of behavior (Mackie et al., 2007). Most cognitive theories of learning emphasize that attention and the ability to remain focused are essential in all phases of learning including the processing of sensory information, developing working and short-term memories, retrieval and other metacognitive skills (Greeno et al., 1996). This further explains why ADHD children may fail to acquire significant preacademic skills (Lerner & Johns, 2012). A study comparing preschool children with and without ADHD revealed that those with ADHD were more likely to experience problems in memory, academic skills, reasoning, cognitive deficits, conceptual development and basic pre-reading skills such as the development of phonological awareness (Dupaul et al., 2001). Cognitive deficits can lead to impaired executive functions in the brain,

4 EFFECTS OF ADHD ON EARLY LEARNING AND ACDEMIC PERFORMANCE 4 which integrate, activate and manage brain functions. Executive functions include, cognitive, motor, emotional and language processes (Mash & Wolfe, 2005). Children with ADHD have deficits in multiple executive functions such as: difficulty with working memory, planning, anticipation, organizational strategies, and flexibility in thinking and mental computation (Mash & Wolfe, 2005). Children with poor language development have diminished verbal fluency, communication and self-directed speech (Mash & Wolfe, 2005). They are also more likely to have difficulties with phonological awareness which is a crucial pre-reading and writing skill (Lerner & Johns, 2012). Problems with motor skills in ADHD preschool children often lead to difficulties in allocating effort, following directions, response inhibition as well as motor coordination and sequencing. Appropriate motor development in young children is essential in establishing the foundation for later more complex perceptual and cognitive development (Lerner & Johns, 2012). These deficits can all interfere with the child s ability to acquire the appropriate tools necessary to facilitate successful transition into elementary school. Barkley and colleagues (2002) conclude that it is a significant problem that the learning skills of ADHD children are impaired even before they enter first grade. ADHD students continue to experience academic difficulties when formal schooling begins. It is important to understand that children with the disorder can have normal to above-average intelligence, yet experience difficulties learning and/or applying themselves to a structured classroom setting as well as everyday life situations (Mash & Wolfe, 2005). ADHD children thus have the potential to succeed but often fail to do so because of their cognitive deficits. They thus often display a discrepancy between achievement and potential (Lerner & Johns, 2012). Research conducted by Loe and Feldman (2007) found that ADHD students have poorer grades, lower reading and mathematics achievement, and are more likely (than non-ahdh children) to repeat a school year.

5 EFFECTS OF ADHD ON EARLY LEARNING AND ACDEMIC PERFORMANCE 5 The difficulties with inattention, impulsivity and hyperactivity prevent ADHD students in elementary from engaging in appropriate classroom behaviors like sitting at their desk, focusing on the teacher, applying themselves to the task at hand and completing tasks (Spira & Fischel, 2005). These students also tend to produce careless and incomplete work because of poor effort and concentration (Spira & Fischel, 2005). These behaviors significantly comprise their ability to listen to, process and acquire new information and to be able to retrieve it. In addition, about 30% -to-60% of ADHD preschool and elementary age children have impairments in speech and language highlighted by the inability to listen, excessive talking and inability to comprehend others including the teacher. They thus often experience problems with both receptive and expressive language skills (Mash & Wolfe, 2005). These speech and language impairments, which appear in the preschool period, continue to create challenges for future language-based academic learning. In addition to the above deficits, about 25% of elementary ADHD students are also diagnosed as having a specific learning disability as they display a discrepancy between achievement and potential and significant difficulties in reading, spelling, and math (Mash & Wolfe, 2005). When a child s reading and spelling are impaired, their ability to understand academic material, such as the meaning of a story, is diminished as is their ability to express their thoughts and ideas through writing. Their general base of knowledge in both core and content subjects will thus remain limited (Lerner & Johns, 2012). In conclusion, there is significant evidence to suggest that the preschool period is important for developing the essential skills needed to prepare children for elementary school. ADHD children have difficulties in impulse control, hyperactivity and attentional capacity, which prevent them from acquiring important early learning and pre-academic skills that translate into future school success (Spira & Fischel, 2005). Impairments in a variety of executive functions weaken the child s ability to learn and grasp material that is being taught in the classroom. Research evidence suggests that ADHD

6 EFFECTS OF ADHD ON EARLY LEARNING AND ACDEMIC PERFORMANCE 6 children achieve lower grades than their non ADHD peers in several subject areas and they are more likely to be placed in special education classes or even repeat a grade (Mash & Wolfe, 2005: Weiss & Hechtman, 1993). ADHD children who suffer poor academic achievement may be negatively affected in other ways as well. Parents and teachers may become frustrated with them, peers may view them negatively and eventually this can lead to feelings of rejection and low self-esteem (Antshel et al., 2009). It is thus important to provide ADHD pre-school children with appropriate clinical assessment and diagnosis and to develop and implement early intervention programs aimed at helping them acquire the early learning skills that could facilitate future academic success (Mash & Wolfe, 2005; Lerner & Johns, 2012). Future research needs to examine the usefulness of such early intervention programs in ADHD pre- school children employing prospective, longitudinal designs.

7 EFFECTS OF ADHD ON EARLY LEARNING AND ACDEMIC PERFORMANCE 7 References American Psychiatric Association (APA). (2000). Diagnostic and statistical manual of mental disorder (4 th ed., text revision). Washington, DC, Author. Antshel, K., Macias, M., & Barkley, R. A. (2009). The child with attention deficit hyperactive disorder. In R. B. David, J. B. Bodensteiner, D. E. Mandellbaum, & B. J. Olson (Eds.), Child pediatric neurology (pp ). New York: Guilford Press. Barkley, R. A., Shelton, T. L., Crosswait, C., Moorehouse, M., Fletcher, K., Barrett, S., Jenkins, L., & Matevia, L. (2002). Preschool children with high levels of disruptive behavior: Three-year outcomes as a function of adaptive disability. Development and Psychopathology, 14, Daley, D. D., & Birchwood, J. J. (2010). ADHD and academic performance: Why does ADHD impact on academic performance and what can be done to support ADHD children in the classroom? Child: Care, Health and Development, 36(4), Dupal, G. J., McGoey, K. E., Eckert, T. L., & Vanbrakle, J. (2001). Preschool child with Attention- Deficit/Hyperactivity Disorder: impairments in behavioral, social, and school functioning. Journal of the American Academy of Child and Adolescent Psychiatry, 40, Foley, M. (2011). A comparison of family adversity and family dysfunction in families of children with attention deficit hyperactivity disorder (ADHD) and families of children without ADHD. Journal For Specialists In Pediatric Nursing, 16(1), Greeno, J., Collins, A., & Resnick, L. (1996). Cognition and learnining. In B. Berliner & R. Calfee (Eds.), Handbook of educational psychology (pp ). New York, NY: Macmillan.

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