Assessing students with Attention Deficit Hyperactivity Disorder (ADHD)
The Diagnostic and Statistical Manual of Mental Disorders – DSM–V (American Psychiatric Association, 2013) distinguishes three presentations of ADHD:
- Inattentive type: the student with ADHD who is predominantly inattentive
- Hyperactive/impulsive: the student with ADHD who is predominantly hyperactive and impulsive
- Combined: the student with ADHD who is both inattentive and hyperactive/impulsive
In the World Health Organisation’s International Classification of Diseases – ICD–10 (WHO, 2016), the term ‘Hyperkinetic Disorder’ corresponds to DSM-V combined type. It can be seen that the symptoms of ADHD do not just concern hyperactivity (i.e. restlessness, difficulty with sitting still, excessive movement or fidgeting). Rather, such students are equally, or even more, likely to have problems in sustaining attention on the task in hand, inhibiting impulsive responding, and generally in regulating and controlling behaviour. There are strong indications of genetic factors causing ADHD, although perinatal complications have also been associated with it (Amor et al., 2005). Current estimates suggest that the incidence of ADHD in school-aged children is between 5.9% and 7.1% (Willcutt, 2012). Between 18% and 45% of individuals with diagnosed ADHD also have dyslexia (Germano, Gagliano and Curatolo, 2010). Obviously, these reading difficulties could be the result of poor attention and concentration in the learning situation (i.e. an indirect effect of ADHD). In addition, it has been suggested that students with ADHD have problems with working memory (Holmes et al., 2014), which affects learning directly, because information is not stored properly nor is it retrieved fluently and reliably. Treatment for ADHD usually involves a combination of psychological methods (e.g. behaviour modification) and pharmacological methods (e.g. use of the drug Ritalin), but good educational management and committed parent involvement is crucial (Goldstein and Goldstein, 1993, 1998).
Students with ADHD are liable to experience difficulty with many types of assessment (not just computerised assessment) because of inattention and impulsiveness in responding. In cases of students with ADHD, teachers should therefore be prepared to take such factors into consideration when interpreting the results of CoPS tests. On the other hand, CoPS tests are typically found to be more stimulating than conventional tests, so students with ADHD will generally remain engaged and attentive for longer than might be expected. To maintain engagement and interest, however, and ensure that results are as reliable as possible, it is recommended that only one test per session should be administered to students with ADHD. Particular care should be taken when administering the Rabbits subtest as the student needs to watch the screen carefully to notice whereabouts the rabbits appear. Lapses in concentration and attention would be particularly expected to affect this test.
For practical guidance on identifying and teaching students with ADHD, the book by Cooper and Bilton (2002) is recommended.