Tuesday, June 26, 2012

Iceland, ADHD, and Homework

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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