Compensating for cognitive deficits in students with Attention Deficit Hyperactivity Disorder

"...The precise nature of the impact of the disorder on learning is as yet unclear, however current understanding of the disorder indicates that ADHD results in deficits in executive functioning and it is possible that the learning difficulties experienced by students with ADHD are the results of these deficits. While acknowledging that the current understanding of ADHD is still incomplete and many aspects remain controversial, this latest understanding of the disorder has been used to design a reading intervention to improve the reading achievement level of students with ADHD..." -- abstract. Attention Deficit Hyperactivity Disorder (ADHD) is one of the most widespread disorders affecting approximately three students in every classroom with individuals affected to differing degrees for their entire lifespan. Success in school is affected by this disorder with both social development and learning compromised. Socially, students with ADHD may experience peer rejection and have difficulty conform-ing to rules and behavioural expectations. This often leads to negative relationships with teachers and other school staff. Educationally, symptoms of ADHD often include academic underachievement and learning difficulties with reading being the area most affected. The precise nature of the impact of the disorder on learning is as yet unclear, however current understanding of the disorder indicates that ADHD results in deficits in executive functioning and it is possible that the learning difficulties experienced by students with ADHD are the result of these deficits. While acknowledging that the current understanding of ADHD is still incomplete and many aspects remain controversial, this latest understanding of the disorder has been used to design a reading intervention to improve the reading achievement level of students with ADHD. The intervention was designed to support the executive function deficits thought to be experienced by these students. It used a multi-modal approach combining students' current ADHD medication, reading strategy training, the cognitive training comp-onents of self-instruction, self-monitoring, and selfreinforcement, paragraph summaries and visual memory prompts to address the cognitive and affective deficits and needs of the students with ADHD. The intervention was evaluated using a qualitative case study methodology that included a pilot study and a main study. A purposive sample of six students selected from a regional state primary school was included in the pilot study and a further six students were selected as the sample for the main study from two state primary schools and one state high school. Both the pilot and the main study used a pre-test post-test design and included an Intervention phase, during which students attended intervention sessions two to three times a week for eight weeks, and a Maintenance phase of ten weeks during which students used the intervention independently when reading both in the classroom and at home. Baseline data were compared to post-test data to identify changes in the students' reading achievement; range and effectiveness of strategy use; attitude to reading and motivation to read, and attributional beliefs about success and failure instances during reading. The Peabody Picture Vocabulary-Ill was used to gain a general indication of students' potential levels of achievement at the pre-test. Reading achievement levels were assessed using the standardised reading tests of The Burt Word Test and the CLOZE Test, miscue analysis of each student's oral reading, and semi-structured interviews with students and their teachers and parents. Strategy use was assessed using focused observation of students' oral reading supported through the use of video recordings of this reading, and semi-structured interviews with the students and their parents and teachers. Semi-structured interviews were also used to assess students' attitude to reading and their motivation to read. The Specific Attribution Questionnaire was used to assess students' attributional beliefs about success and failure with these results triangulated with data from semi-structured interviews with students and their parents and teachers. The theoretical framework used to interpret the results of the study was a synthesis of Barkley's theoretical model of ADHD, Vygotsky's sociocultural theory of learning and Bandura's social cognitive theory. Evaluation of the effectiveness of the intervention indicated that all students had increased in their reading achievement, and in the effectiveness and range of strategy use, increasing both the range and flexibility of their use of strategies. Students' attitude to reading also became more positive and students became intrinsically motivated to read. Most students also developed a greater sense of control over their reading achievement indicated by positive changes in their attributional beliefs about success and failure during reading. It is likely that these changes occurred due to the impact of the intervention which externalised the reading process, making the knowledge and skills required for successful reading explicit, and scaffolding the students' active engagement in the process so that the required knowledge and cognitive processes were developed and internalised by the students. The development of a more positive attitude to reading and increased motivation to read may have been the result of the students' increased reading achievement and the role of the intervention in making their success accessible and tangible throughout the reading process.