By Carly Schwarmann
EDSP 6644 (Summer 2009)
The Exceptional Child and Inclusion
August 15, 2009
Online Instructor: Vanessa Tucker, PhC.
Abstract/Introduction to group
This Presentation is about ADHD and inclusion. I discuss
the criteria for determining whether a child has ADHD, the
definition, causes and effects. I reviewed three articles
about ADHD and inclusion and list the pros and cons as
well as recommendations and applications for the
classroom. The articles were very interesting and
informative. The first was about the over-diagnosis and
alternative methods for dealing with ADHD. The second
article was about the pros and cons of inclusion. The third
article describes an effective inclusion program. I included
an extra slide about the controversy of medication because
it is such a hot topic.
ADHD criteria
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ADD stands for Attention Deficit Disorder. ADHD is similar, but includes hyperactivity.
The American Psychiatric Association (APA) has determined that a person has ADD if they meet 8 qualifications from
the following list.
Unable to remain seated when required
Easily distracted from the task at hand by external stimuli
Difficult to hold attention to an activity or task
Frequently hops from one activity to the next without completing the first
Fidgets or squirms
Difficulty waiting for a turn
Interrupts question to answer
Problems with job or chore follow through
Difficulty playing quietly
Impulsively jumps into physically dangerous activities
Easily loses things
Interrupts inappropriately
Talks impulsively or excessively
Doesn’t seem to listen
(Bonilla, 1997)
ADHD statistics
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ADHD diagnosis is based on clinical criteria.
It is described as chronic behavioral symptoms of inattention, impulsiveness and hyperactivity, that
can significantly interfere with relationships, education, and occupational functioning.
APA has determined three main sub-types of ADHD
Mainly hyperactive/impulsive
Mainly inattentive
Combined hyperactive/impulsive and inattentive
International prevalence rates range from 3 to 6 percent of children.
Males outnumber females 3:1
Symptoms usually occur between the ages of 3 and 4, but the APA diagnostics criteria requires presence of
symptoms before age 7.
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(Cooper, 2001).
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Attention-deficit hyperactivity disorder (ADHD) is one of the most common disorders among
children
 inclusion provides the most appropriate education for students with ADHD in the least restrictive
environment
 the classroom teacher's involvement in the team process is important to success of the IEP
(Nichols, 1996)
Causes of ADHD
Theories of Causes
Theories come from cognitive, neurological , and genetic
research
 Dysfunctional response inhibition system, located in the
prefrontal cortical region of the brain, causing problems in
inhibiting or delaying behavioral response.
 Neurological problems of response inhibition lead to
problems in executive functions in cognition including
working memory, internalized speech, motivational
appraisal, reconstitution, and behavioral synthesis
 Neurological basis for cognitive dysfunctions similar to
brain injuries in the pre-fontal cortex.
 Abnormalities in development of brain regions
 Common in biological relatives, especially parents and
identical twins
 Abnormalities in dopamine system
 Biological causes of behavioral outcomes mediated by
experiential and environmental factors
 The early family unit plays a crucial role in shaping an
individuals behavioral characteristics
(Cooper, 2001)
Effects of ADHD
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Hyperactivity
Problems in school
Social isolation
Road accidents
Psychological dysfunction
Incompetent
Disorganized
Aggressive
Lazy
Disruptive
Untrustworthy
Neglectful
Selfish
Accident prone
Low academic performance
Relationship problems
Marital breakdowns
Employment difficulty
Imprisonment
(Cooper, 2001)
Medication
 Students with ADHD are often on medications such as
Ritalin, Cylert, Dexadrine or Adderol.
(Messina, 2007)
 Medication is a controversial topic.
 2 percent of all school-aged children in the US are
prescribed some kind of medication for hyperactivity
 Psycho stimulant medications in low and moderate doses
are relatively effective in reducing the core symptoms of
ADHD
 Methylphenidate is a safe, non-addictive medication with
mild side effects including loss of sleep and appetite, which
can be avoided through adjusting the dosage.
(Cooper, 2001)
Article reviews
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This article includes two papers, the first is "Club MED: Diagnosis ADD/ADHD" (Lynne A. Phillips et
al.), addresses drug therapy for children with ADHD. It discussed the over-diagnosis of ADD and
alternative methods to medication.
The author points out that ADD has become a national phenomenon and is being over- labeled.
Phillips notes that students with ADD can focus attentions in certain situations and often grow out of
it when adults.
Phillips picks apart methods used to determine whether a child has ADD/ADHD. She also accuses
teachers of jumping on the bandwagon to diagnose kids with ADD/ADHD. She claims parents also
push the diagnosis to cover for poor performance. She points out misbehaviors can stem from other
disorders and problems at home. She disapproves of the use of Ritalin because it often does not help
attention span and can have severe side effects.
Phillips recommends alternatives to medications including strict discipline and EEG neurofeedback,
where the child learns to read, understand and influence his own brainwave activity. The drawback is,
it is expensive, and could take up to 80 sessions. She also suggests testing for other learning
disabilities.
Bonilla raises the ethical question, Is it appropriate to medicate children without a clear diagnosis in
hopes that it will improve their school work? The idea of using biofeedback to treat ADHD is very
interesting. It makes me wonder why more people aren’t doing it and what other ailments it could
benefit.
Source: Bonilla, C., & Goss, J. (1997, January 1). Public (K-12) Education's Hot Jalapenos. Topics
Picantes in Special Education. . (ERIC Document Reproduction Service No. ED405684)
Retrieved August 15, 2009, from ERIC database.
Article Review 2
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The second article, "Full Inclusion: One Size Fits All?" (Lisa Dondero et al.) describes successful
implementation of inclusion as well as pros and cons. It concludes that a continuum of services are
necessary to meet the individual needs of the child.
The article introduces the discovery program, which is an inclusion program that helps redesign
classroom and modify teaching styles. This multi-age classroom has individualized instruction that is
technology based, and uses hands-on activities that promote self-esteem. Students progress at their
own rates within the class. Regular and special education teachers work together to create lessons.
Classrooms are organized into learning centers and students can move freely to centers of their
choice.
Some people believe social acceptance is more important than education. The supreme court ruled
that public schools may not remove a disruptive or emotionally disturbed student from class for more
than 10 days, even to protect others from physical assault. The author points out a classroom must feel
safe for the teacher to teach and the students to learn. Dondero brings up the question, what about
the rights of the other students in the class?
On the other hand, some parents fear full inclusion because they are afraid their child will lose the
range of services. Determining the most appropriate and least restrictive environment should
include the needs of the regular education student as well as the individual needs of the disabled
student. One size does not fit all.
Source: Bonilla, C., & Goss, J. (1997, January 1). Public (K-12) Education's Hot Jalapenos. Topics Picantes in Special
Education. . (ERIC Document Reproduction Service No. ED405684) Retrieved August 15, 2009, from ERIC database.
Article Review 3
 This article presents a rationale for why students with ADHD should be educated in the general
education classroom, addresses problems in educating students with ADHD in the general
education classroom, and introduces a program designed to address these problems. The Irvine
Paraprofessional Program provides at-risk students with ADHD with short-term intensive
intervention. The program uses in-class token system and collateral training in social skills. They
use specially trained paraprofessionals (behavioral specialists) as interim instructional aides.
The paraprofessional conducts twice-a-week skills training groups of six students or less. After
12-weeks, responsibility for the behavioral program is turned over to the classroom teacher.
 Although students with ADHD typically are average or above average intelligence, they often
have trouble performing at the quality and quantity of their grade level because of attention
problems. Many students lack social skills due to a deficit or performance deficit. Placing them
in the general education facilitates classroom generalization where they can learn social skills in
context.
 One of the problems with implementing inclusion is that school psychologists are not able to
monitor programs, so there is a gap between development of a plan and effective
implementation. Use of behavior modification is one of the more popular methods to support
inclusion, unfortunately not everyone is properly trained to implement the program. Frequent
feedback and reinforcement is crucial for ADHD students. Too often they are only given attention
when their behavior is inappropriate.
Source: Kotkin, R. (1995, March 1). The Irvine Paraprofessional Program: Using Paraprofessionals in
Serving Students with ADHD. Intervention in School and Clinic, 30(4), 235-40. (ERIC Document
Reproduction Service No. EJ499254) Retrieved August 15, 2009, from ERIC database.
Recommendations
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Teacher modeling
Set clear policies
Firm boundaries
Have a good attitude
Stay informed
Keep in contact with parents, special education teachers, and
counselors
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Create a plan
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Ask for help
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Intensive teacher training and preparation
(Adams, 2006)
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Strong administrative leadership
Collaboration
Service supports for students
Parental and family involvement
(Bonilla, 1997)
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Provide additional, appropriate stimulation when needed
Foster student independence.
Provide scaffolding for organization-specific tasks
Pick your battles
Use ADHD students as an asset to motivate yourself to be multimodal
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Reinforce even tiny successes
(Zelkowitz , 2009)
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Involve other students
Differentiate instruction
Organize and break down directions into single steps.
Break down long-term assignments or projects into individual
chunks. Show examples from previous students.
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Give students a specific scoring guide so they know exactly how
much each part of the project is worth.
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Review new vocabulary daily. Make sure everyone knows the words
before moving onto the breadth of the concept.
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Keep a list of words and pages they can be found on in the
classroom for quick reference for each topic.
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Allow students to work in diverse groups
(Young, 2006)
Frequent feedback and reinforcement for performance (task completion,
following classroom rules, following directions, peer relations etc.)
Use a behavioral program to improve work
(Kotkin, 1995)
Applications to classroom
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Discipline should include rules, consequences and assertive communication
Use body language, eye contact and gestures to communicate directly
Provide work areas free from distraction
Break the task down into manageable segments and give frequent encouragement and support
Involve them in activities where they excel
Find avenues to channel excess energy in a positive way
Hold child accountable for behavior and decisions
Stress the stop and think approach
Use charts, graphs, and lists to provide structure and feedback
Maintain a consistent and predictable schedule
Help child use notebooks and charts to get organized
Accept that sustained concentration is difficult
(Bonilla, 1997).
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Let students know what items they will be responsible for presenting to the class ahead of time so they can focus and feel successful in front of their peers. This can be done by
simply circling an item on an assignment sheet or indicating a number to them by holding up your fingers.
During testing read every question in the beginning of the period so students know what the questions say and can ask for clarification if needed.
Vary types of questions on the test.
Consider other types of assessments such as posters explaining a concept, diagrams or graphic organizers, and oral presentations explaining concepts to the rest of the class.
Hands-on labs and activities can be used as assessments.
Student logs and portfolios help keep track of assignments and monitor progress.
Help students set and keep track of goals
Have high expectations for ALL students in the class.
Parents Can:
• Help your children organize their schedules at home.
• Break their studying down into 15-minute chunks each night so they are prepared for class the next day.
• Encourage your children to complete as much of an assignment as possible and write a short explanation of what they did not understand about an assignment.
• Communicate with the teachers about problems as soon as possible.
(Young, 2006)
Pros to inclusion
“Responsible inclusion means the child goes into regular classroom with the skills needed to participate.”
“ Being treated fairly doesn't mean that everyone is treated the same.“ (Adams, 2006).
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Least restrictive environment
Classroom support
Positive discipline
Children can experience success
(Adams, 2006)
 Positive peer models
 Improved social acceptance
(Cooper, 2001)
 Social acceptance
 Regular Education students
benefit
(Bonilla, 1997)
“ Statistics show that some
students with learning
disabilities benefit more when
placed in an inclusive program
than when in a self-contained
special education class.” (Young,
2006)
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Cons to Inclusion
The rights of students with disabilities must be honored--but it can be a tough balancing act when behavior impacts
the classroom.” (Adams, 2006).
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Conflicts with teachers, parents, and students
Aggressive behavior
Disruptive behavior
Unsafe learning environment
Creating modifications
At risk of failure
Classroom may not be set up to meet child’s needs
(Adams, 2006)
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Learned helplessness
Low academic achievement
Inequality of separate education
Need of aides and a support system
(Cooper, 2001)
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Special education classes are smaller
More equipment is available in a special education
classroom
General education teachers do not receive as extensive
training as special education teachers do
Increases teacher workload
Cost is higher (about $6000 vs. $19,000)
(Bonilla, 1997)
References
Adams, C. (2006, January 1). When Is Challenging Behavior Too Much?. Instructor, 115(8), 25-27,. (ERIC Document Reproduction Service No.
EJ792307) Retrieved August 15, 2009, from ERIC database.
Bonilla, C., & Goss, J. (1997, January 1). Public (K-12) Education's Hot Jalapenos. Topics Picantes in Special Education. . (ERIC Document
Reproduction Service No. ED405684) Retrieved August 15, 2009, from ERIC database.
Cooper, P. (2001, January 1). Understanding AD/HD: A Brief Critical Review of Literature. Children & Society, 15(5), 387-95. (ERIC Document
Reproduction Service No. EJ647717) Retrieved August 15, 2009, from ERIC database.
Kotkin, R. (1995, March 1). The Irvine Paraprofessional Program: Using Paraprofessionals in Serving Students with ADHD. Intervention in School
and Clinic, 30(4), 235-40. (ERIC Document Reproduction Service No. EJ499254) Retrieved August 15, 2009, from ERIC database.
Messina, J (2007). Classroom Strategies for Inclusion of Students With Communication and Learning Disorders. Retrieved August 15, 2009, from
Livestrong Web site: http://www.livestrong.com/article/14717-classroom-strategies-for-inclusion-of-students-with-communication-andlearning-disorders/
Nichols, W., & Others, A. (1996, April 1). Academic Diversity: Reading Instruction for Students with Special Needs. (ERIC Document Reproduction
Service No. ED409551) Retrieved August 15, 2009, from ERIC database. Chicago/Turabian: Author-Date.
Young, K (20006, January). Classroom Inclusion: What It Takes. Retrieved August 15, 2009, from ADHD and LD Support Web site:
http://www.metrokids.com/january06/guesteducator0106.html.
Zelkowitz , A (2009, March 9|). ADHDialogue. Retrieved August 15, 2009, from Strategies for Special Education & Inclusion Classrooms Web site:
http://blogs.scholastic.com/special_ed/2009/03/adhdialogue.html.