The Effect of Attention Deficit Hyperactive Disorder on Learning - Essay Example

Attention Deficit-Hyperactivity Disorder and Learning Attention Deficit-Hyperactivity Disorder (ADHD) is the most commonly diagnosed mental health disorder among children. ADHD is found in between 3% to 5% of school-aged children and is more commonly found in boys than girls. Symptoms of ADHD include hyperactivity, impulsiveness, difficulty paying attention, being easily distracted and having difficulty following instructions. Oftentimes, children who have been diagnosed with ADHD are slow to develop social skills and may have poor grades in school. It is estimated that one quarter of children with ADHD have a learning disorder. Treatment options for children with ADHD include behavioral therapy, special education programs and medication. It is estimated that 70% to 80% of children with ADHD respond to medication which can help curb impulsive and overactive behavior, allowing children to focus, be attentive and learn (Parment, Lymn, Glass 1804). The term Attention Deficit Disorder with Hyperactivity (ADDH) was first properly coined in the DSM-III of the American Psychiatric Association in 1980 and was subsequently acknowledged as a serious disorder warranting scholarly scrutiny. In the early years little was known about this disorder with Barkley (1982) reporting in his review of 20 years of scientific papers on the syndrome that the majority provided no diagnostic criteria for ADDH or ADHD. As a result, early studies in the literature were largely subjective and perhaps replete with misdiagnoses (Barkley 1944). The DSM-III of 1980 changed this and was a “landmark in official diagnostic nomenclature”. For the first time, it provided detailed descriptions and diagnostic criteria for ADDH. The three criteria which were established for diagnosis were: 1) specific multidimensional symptoms (involving symptoms in impulsivity, motor over activity and attentional impairment), 2) age of onset (before the age of 7 years) and finally 3) duration (symptoms must be present for at least six months). Definitional issues aside, Attention Deficit Disorder with Hyperactivity (or ADHD) is now recognized as a serious disorder with possibly important effects on cognition (Cantwell and Baker 87-88). Two symptom clusters give rise to three subtypes of ADHD: Predominantly Inattentive, Predominantly Hyperactive-Impulsive, and a Combined type (Martinussen & Tannock 1073). This essay will address the relationship between ADHA and learning to discover whether or not there is a direct relationship between a ADHD on the ability to learn. In attempting to discover whether association between Attention Deficit-Hyperactivity Disorder (ADHD) and learning disorders (LD) exists, Cantwell and Baker undertook a study of 600 children with learning disorders. They used the definition put forth by the American Psychiatric Association and have defined ADHD as a syndrome with the following symptoms: impulsivity, motor over activity and attentional impairments. In selecting a definition for the term learning disorder, the authors took care to distinguish it from other terms often used interchangeably including academic retardation, academic performance problems and reading retardation. Cantwell and Baker decided to use a definition of learning disorder a put forth by the National Joint Commission on Learning Disabilities (1997) which reads: Learning disabilities is a generic term that refers to a heterogeneous group of disorders manifested by significant difficulties in the acquisition and use of listening, speaking, reading, writing, reasoning, or mathematic abilities. These disorders are intrinsic to the individual and presumed to be due to central nervous system dysfunction. Cantwell and Baker undertook an empirical study of 600 children with speech and language impairments. The authors assert that children with speech and language impairment constitute a “particularly relevant sample because they are at risk for both psychiatric and learning problems” (91). Of the 600 children, 69% were male, ranging in age from 1 to 16 years, with a mean age of 5.6. Psychiatric diagnoses revealed that initially 50% of the sample entered with the study with a psychiatric illness. ADDH was by far the most common diagnosis and was found in 19% of the children. In addition, conduct and/or oppositional disorders were found in an additional 7% of the sample, demonstrating that a total of 26% of the children involved in this study had some sort of disruptive behavior disorder (Cantwell and Baker 91-93). This study found an important correlation between learning disorder (LD) and ADHD. Although intuitively one would think that ADHD would lead to LD, in fact the relationship is not always so clear cut. Accordingly, “there is scant evidence that ADHD itself, as a diagnosis, leads directly to learning difficulties…in fact, there are many children who have the ADHD syndrome but do not have LD.” (Cantwell and Baker 92). This study reached the following conclusions: 1) There is an increased prevalence of psychiatric disorders – including behavioral disorders – in children with speech and language disorders. Importantly, ADHD is quite common. In addition to ADHD, anxiety disorders are also quite common. 2) There is an increased prevalence of learning disorders (LD) in children with both a speech and language disorder. 3) There appears to be a specific association between the presence of a psychiatric disorder – such as ADHD – and the presence of LD in children. Accordingly, “this specific association is strongest for the disruptive behavior disorders” (Cantwell and Baker 93). Cantwell and Baker’s research demonstrates an association between ADHD and LD which is to a much greater degree than would occur by mere chance. Despite this, the nature of the association remains unclear. Does ADHD lead to LD or does LD lead to ADHD? While bringing to light some important implications for future study on the effects of Attention Deficit-Hyperactivity Disorder on learning, Cantwell and Baker were unable to conclusively demonstrate that ADHD directly inhibits learning. In another study on the comorbidity of learning disabilities (LD) and Attention Deficit-Hyperactivity Disorder (ADHD), Mayes, Calhoun and Crowell undertook clinical and pyscholeducational tests and data for 119 children ranging from the ages of 8 to 16 years of age. With the intent of investigating the relationship between attention and learning problems in a typical sample of children, the authors engaged a random sample with a median age of 11.1 years. The male to female ratio was 93:26 and 114 of the 119 children were white. Data obtained and analyzed in this study were derived from the WISC-III (FSIQ and Freedom from Distractibility, Verbal Comprehension, and Perceptual Organization Index scores), the WIAT (an achievement test for individuals ages four through adulthood), and the Gordon Diagnostic System. Accordingly, the GDS is a portable, electronic performance test designed to measure attention (Mayes, Calhoun, Crowell 417-419). Of the children who had been previously diagnosed with ADHD, 70% of them also experienced learning disabilities. The most common types of learning disabilities involved challenges with written expression, reading, writing, math and spelling. The researchers described written expression as two times more common (65%) than the other types of learning disabilities exhibited by the children. Accordingly, children who displayed signs of both LD and ADHD had more severe learning problems than children with diagnosed learning disabilities but no ADHD. The authors found that children with LD but no ADHD exhibited degrees of attention problems – not enough to warrant a full ADHD diagnosis on its own – and children with ADHD but not LD had learning problems, likely as a result of attention problems such as the inability to stay focused and concentrate. Accordingly, children with LD and ADHD had the greatest problems with learning, followed in order by children with LD and no ADHD, then children with ADHD and no LD, and finally children without LD and ADHD. After extensive data gathering and analysis, the authors of this study concluded that “learning and attention problems are on a continuum, are interrelated, and usually coexist”. (Mayes, Calhoun, Crowell 417-424). Arguing that it is diagnosed on the basis of “persistent, developmentally inappropriate and impairing symptoms of inattention and hyperactivity/impulsivity”, Martinussen & Tannock undertook a study to better delineate the cognitive effects of ADHD on learning and memory. Their study involved 143 children, broken up into four separate groups, and between the ages of 7 and 13 years of age. Children were recruited from an outpatient department of psychiatry in a pediatric academic health sciences center, where they had been referred for attention, behavior, and/or learning problems. Children were also brought in for a comparison sample and were recruited from two local elementary schools. Qualitative research was conducted through clinical diagnostic interviews with teachers, parents and students while the child assessments for the participants included the Wide Range Achievement Test-3 (WRAT-3; Wilkinson 1993) as well as the Word Attack and Word Identification subtests of the Woodcock Reading Mastery Test-Revised (Martinussen & Tannock 1073-1088; Woodcock 1987). In their study, Martinussen & Tannock found that working memory limitations may contribute to both the behavioral expression of inattention and the academic underachievement of children with ADHD. Therefore, children with ADHD, particularly children with significant attention problems or those who exhibit language learning disorders, may also exhibit a range of functional impairments because of deficits in working memory. Learning Disorders (LD) thus can have an important effect on ADHD, but similar to the study undertaken by Cantwell and Baker, a direct link between the effects of ADHD on learning has not been conclusively proven (Martinussen & Tannock 1087-1090). Attention-deficit hyperactivity disorder (ADHD) is one of the most common developmental disorders of childhood (American Psychiatric Association, 1994). This essay has provided an overview of three independent studies on the association between ADHD, learning and learning disorders (LD). The research shows that the association between ADHD and LD is to a much greater degree than would occur by mere chance but the nature of this particular association remains unclear. Does ADHD affect LD or does LD lead to ADHD? While bringing to light some important implications for future study on the effects of ADHD on learning, each study was unable to conclusively demonstrate that ADHD directly inhibits learning. Conversely, the overarching conclusion by each set of research teams was that learning disorders can contribute to ADHD and the two routinely go hand in hand. Works Cited Barkey, R. “Guidelines for Defining Hyperactivity in Children: Attention deficit Disorder with Hyperactivity.” In B.E. Lahey & A.B. Kazdin (Eds), Advances in Clinical Psychology (1982): 137-180. Cantwell, Dennis P. and Lorian Baker. “Association between Attention Deficit Hyperactivity Disorder and Learning Disorders.” Journal of Learning Disabilities 1:2 (2001): 88-95. Diagnostic and statistical manual of mental disorders (4th ed). American Psychiatry Association. Washington, D.C, 2004. Mayes, Susan D., Susan L. Calhoun, and Errin W. Crowell. “Learning Disabilities and ADHD: Overlapping Spectrum Disorders.” Journal of Learning Disabilities 33 (September 2000) 417 - 424. Martinussen, Rhonda and Rosemary Tannock. “Working Memory Impairments in Children with Attention-Deficit Hyperactivity Disorder With and Without Comorbid Language Learning Disorders.” Journal of Clinical and Experimental Neuropsychology 28:7 (2004): 1073-1094. Parment, Sharon, Cassio Lymn and Richard M. Glass. “Attention Deficit/ Hyperactivity Disorder.” The Journal of the American Medical Association 288:14. (Oct. 9 2002): 1804. Wilkinson, G.S. Wide Range Achievement Test-Third Edition (WRAT-3). Wilmington, DE: Wide Range, 2003. Woodcock, R.W. Woodcock Reading Mastery Tests-revised. Austin, TX: DLM Teaching Resources, 1987. Read More