There was a recent study conducted in Iceland indicating
that early treatment of children with ADHD improves educational success. Right
now, medication for ADHD is in vogue. Should we begin medicating our children
at an earlier stage? I don’t have the answers, but I do recommend looking
carefully at a study conducted on Icelandic children and asking the question:
Does this apply to children here in the United States?
According to the book by Baker
and LeTendre, National Differences, Global Similarities: World and the
Future of Schooling. LeTendre, Stanford. University Press, 2005, students
in countries such as Japan, Denmark, and the Czech Republic, which give low amounts
of homework have students who earn higher test scores than countries with high
levels of homework, such as Greece, Thailand, and Iran. The United States is
among the countries that gives a lot of homework. Unfortunately, although I have
seen this reference quoted in many places, I don’t have the original study and
was unable to find a country by country listing of homework policies in which I
could see where Iceland rates (If one of my readers has that information,
please pass that on). But I think it is important, before we draw conclusions
about early treatment of ADHD here in the United States, that we consider that
factor, and also consider whether there are differences in how we treat
children with ADHD here and there, specifically, are Icelandic children getting
an afternoon dose of medication?
The fact is that children with
ADHD appear different in class on medication than they do off medication. Then,
they go home. There, they need time to unwind, to expend energies that have
been controlled throughout the day. If they come home to high amounts of
homework, they will have to do it either medicated or unmedicated. If we
medicate them, we disrupt appetite and sleep, and are likely to take away the
respite and relief they need after a hard day at school, one that may be harder
for them than for an average child. If we don’t medicate them, we set up a
situation where the teacher has an idea about what the child can do at home
that is totally unrealistic given that the teacher observed the child in a
medicated state and is making assumptions about the child’s capability when
unmedicated. Even with the medication, the assumptions may still be unrealistic
because that child, despite a good day at school, simply cannot go on and keep
working into the afternoon and night.
So, researchers, practitioners,
parents, and teachers: Beware. This study may have its value. It could also do
considerable damage if we don’t look at it for its broader implications and how
such treatment interacts with the homework policies and expectations of the
culture in which the study was done, and the culture in which the interventions
will be made.
Dr. Kenneth Goldberg is a clinical psychologist with 35 years of professional experience in dealing with many different psychological issues. He is the author of The Homework Trap: How to Save the Sanity of Parents, Students and Teachers and currently works in his own private practice.
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