What services are available for my child/adolescent struggling with ADHD?

​Often, bright students with attentional difficulties “fall between the cracks” of services available in the school system. While Attention Deficit/Hyperactivity Disorder (ADHD) is not included in the 13 disability categories covered under special education law, some students qualify for an Individualized Education Plan (IEP) and special education services through a label of “Other Health Impaired.” However, in order to qualify for such services in most school systems, the student typically needs to be failing. This is not an entirely accurate interpretation of the law, however, which merely states that the disability must “adversely affect educational performance.”  Nonetheless, to qualify for an IEP in most school systems, the child needs to be struggling academically and deemed to require specialized instruction (or special education). 

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​But what about the student doing “just well enough,” who manages, through extra hard work and effort—and the more-than-occasional parental “rescue” to make adequate grades?  With some strong parental advocacy, that student may qualify for accommodations via a “504 Plan,” which is supported by federal civil rights law and provides accommodations to the learning environment (but no direct, or “specialized” instruction). 

Although Section 504 of the Rehabilitation Act defines disability more broadly as “a physical or mental impairment that substantially limits one or more major life activities,” some schools still try to insist that the student must be failing in order to qualify for services. But going to school is a major life function—and having difficulty attending, organizing, remembering and planning substantially limits a student with ADHD in school.  Decisions about whether your child qualifies for a 504 plan need to consider information from a variety of sources—such as parental input, doctors’ notes, observations, test scores and, if appropriate, a formal evaluation. If your child was diagnosed with ADHD as the result of a school-based assessment, a private psychological evaluation, or by her pediatrician, then those results should be considered in developing a 504 plan. 
 
The most common accommodations for students with ADHD include extended time on tests, taking tests in a quiet location, or preferential seating away from distractions.  Other accommodations should be considered as well, and should address your child’s specific areas of difficulty. For example, some students benefit from reducing the number of homework problems, being provided positive behavioral interventions, being given a copy of teacher’s notes or an outline, listening to books on tape, dictating rather than writing lengthy assignments, having assignments broken down into manageable chunks, or not being penalized for turning work in late. It may also be helpful to request an extra set of textbooks or materials that can be kept at home, a communication notebook so that you can stay informed of your child’s progress or difficulties, or regular meetings for your child with the school counselor to work on organizational or behavioral challenges. 
 
A 504 plan is designed to level the playing field and allow your child to get the accommodations and modifications needed to access the curriculum at the same level as his peers. However, it does little to directly address the attentional, organizational and/or behavioral difficulties your child experiences as part of her ADHD. 
Often, to secure the correct intervention (like a 504 plan) parents need to seek outside services in the form of independent educational evaluation, tutoring, cognitive-behavioral therapy, or computerized intervention.  For children that have “fallen between the cracks” a combination of the above is often very effective. For instance, for a student who has difficulty sustaining attention and concentration, a 504 Plan combined with a relatively low cost computerized program such as Working Memory Training can be most beneficial in supplementing school services.  Cogmed is one such program and is an adaptive computer program shown to help children, adolescents and adults to improve their ability to sustain attention and concentration through training their working memory. Working with a qualified administrator, your child would be provided access to the program and on-going coaching. Your child would log on to the working-memory program from your home computer and complete a series of exercises in a video game format. The program stays a step ahead of your child’s ability, making exercises increasingly harder to maximize increases in working memory, which underlies most of the executive functions, such as the ability to sustain attention, organize and problem-solve.
 
Another approach is cognitive-behavioral therapy combined with school-based accommodations. Cognitive-behavioral therapy is based on the premise that our thoughts--not external events-- cause our feelings and behaviors. In solution-focused therapy, the counselor and child collaborate to identify distorted thought processes and replace them with more productive responses. Your child or adolescent can be taught the mental tools to self-monitor thoughts and behaviors and learn to improve her ability to manage time, stay organized, plan/prioritize, and reduce destructive behavior patterns such as procrastination or test anxiety.
 
For older students, often goal-based academic coaching combined with school programs can be very effective.  Particularly as they enter upper high school and college, students are expected to manage large amounts of work independently over time. Unfortunately, students with attentional and/or learning difficulties often lack the self-management and other organizational skills necessary for success in these less structured situations.  A qualified academic coach/counselor can teach your student these critical skills in the context of his courses- to ensure success both in the short and long-term.
 
Ideally, you want to help your child learn the skills to become more focused and independent as a life long learner. Work with a qualified psychologist to decide what services will most benefit your child in his/her formative years.  A skilled practitioner can help you advocate for appropriate school-based services and help steer you toward effective supplemental services tailored to your child’s specific needs. For help you can learn more at www.educationalsolutionscny.com
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