Clinical research findings on ADHD need to be integrated into local educational policies. This might sound obvious; but currently, it is not entirely clear that many local education authorities in the UK even accept ADHD as a condition with neurobiological origins.
ADHD is very firmly rooted in the Diagnostic and Statistical Manual of Mental Disorders, Volume 5, and in the International Classification of Diseases, 10th revision (ICD-10), as a psychiatric and neurodevelopmental disorder. And yet in the UK, having a diagnosis of ADHD alone may not even qualify you for a statement of special educational needs.
So, it should come as no surprise then that ADHD is not accepted as a criterion for assistance by social services or by the local government housing offices. In fact, you will be lucky to receive any type of disability allowance for ADHD; whereas a diagnosis of Autism will likely qualify you.
Currently, obtaining a statement of special educational needs requires a child to meet criteria in one of four primary categories:
- Cognitive and learning, including special learning difficulty; moderate learning difficulty; severe learning difficulty; profound and multiple learning difficulty.
- Emotional, behavioural, and social development needs, including behavioural, emotional and social difficulty.
- Communication and interaction needs, e.g. speech, language and communication needs; autistic spectrum disorder.
- Sensory, and/or physical needs, such as visual impairment, hearing impairment; multiple sensory impairment; physical disability.
As you can see there is no mention of “neurodevelopment” or “ADHD”, in spite of its obvious classification in both DSM-5 and ICD-10. Many children with ADHD are pigeon-holed into category 2 and individual education plans written and designed with little or no mention of ADHD and its primary and most obvious symptoms. This is a gross failing of the child in question.
Lack of understanding and integration
The situation also demonstrates a lack of understanding and integration of scientific and clinical research. Attaching an EBD (emotional and behavioural difficulties) label to a child who has a pre-existing diagnosis of ADHD poses something of an ethical dilemma. The term EBD refers to a wide range of difficulties with very diverse and potentially untraceable origins. I use the word untraceable deliberately, as emotional and behavioural problems tend to be highly complex and multi-factorial; they are not isolated variables and can have their origins in factors including, but not restricted to: physical, verbal and psychological abuse, neglect, parental substance abuse or alcoholism, social maladjustment and low intellect.
That is not to say that children with ADHD cannot have emotional and behaviour problems, but rather that the presence of ADHD exists in spite of poor or maladjusted behaviour. There is a difference which is not obviously recognised in this description. We also need to address the apparent disparity between the publication of the latest scientific findings and the dissemination of these findings to the wider public community, including teachers and all professionals working with children. There appears to be an even wider gap incorporating scientific findings into policy and making appropriate adjustments and changes. (Please refer to this review for a more comprehensive outline of the special education needs provision in the UK.)
One published fact is that authorities in England are attempting to move away from a formal system for identifying special educational needs, which means putting specific measures in place to cut back on the number of statements given, and to have children’s needs recognised via more informal and less costly identification systems. This is of great concern: we need increased investment, not the opposite.