New York City public schools have recently intensified their efforts to work with children with dyslexia. A $100,000 investment for the structured literacy school pilot is one such example. However, there’s another learning difference that is widely known but hidden with respect to meaningful categorization and that’s attention deficit hyperactivity disorder (adhd). Research done in 2014 by Gregory Fabiano, PhD. Et.al, indicates that across New York State there are 10.4% of diagnosed and suspected children with adhd in the classroom.   And yet, like dyslexia, this learning difference does not have its own unique place among the 13 special education classifications.

Source: New York State Education Department

We know that children who have this diagnosis attend NYC public schools so where are they within those classifications?  Most likely, they are a subset of the “learning disability” or “other health impairment” categories, but they can just as easily be included or mis-categorized under “emotional disturbance, intellectual disability, or the multiple disabilities” category.  In the worst-case scenario, students are completely undiagnosed and not counted among children with special needs at all.  If we were to infer based on Fabiano’s research and the numbers of identified students with disabilities, there would be at least 23,000 NYC public school students that have adhd. Recently, Dr. Monica McQuaid presented information on learning disabilities at a seminar sponsored by the ADAPT Community Network.  She stated that 40 to 50% of those with learning disabilities also have adhd. Based on this updated information, the inferred number of our students with adhd would be estimated even higher at more than 30,000.

ADHD can show up as misbehavior but it’s a neurological disorder based on imbalanced brain development. A brain imbalance means that the right and left hemispheres of the brain have trouble communicating with each other because the connectivity between the two hemispheres needs to be strengthened. This can affect executive functioning skills that most people take for granted.  ADHD can manifest as disorganization, inability to maintain focus, impulsive or hyperactive behavior but it is neither a behavior problem nor a discipline problem.

It is concerning that often; symptoms of adhd are overlooked for children of color which contributes to disparities in treatment.  A 2014 study of “Linking Early ADHD to Adolescent and Early Adult Outcomes among African Americans.” (https://doi.org/10.1016/j.jcrimjus.2013.12.005) found that adhd symptoms are commonly interpreted as school behavioral problems in African American children, which are then associated with negative behavior assessments from teachers and lower standardized test scores. This, in turn, can be predictive of school suspensions, expulsions, and arrests later in life. Without identification, diagnosis, and treatment, the researchers conclude that adhd can be a factor that feeds into the school-to-prison pipeline.

I recently attended a webinar about the impact of environmental factors on brain development led by Dr. Amanda Gunther.  She discussed how research by the Center for Disease Control shows there is a connection between adverse childhood experiences and a diagnosis of adhd and anxiety disorders partially because trauma causes brain differences.  I would say that all of us now have the shared trauma of a global pandemic that certainly qualifies as an adverse experience.  Who among us can fully grasp the depths to which our children and young people with developing brains, have absorbed the misery, stress, anxiety, sickness, and death that kept us all isolated during the height COVID-19? How do we know this moment didn’t exacerbate learning disabilities such as adhd for our students? 

Photo by: Markus Spiske

I propose NYC public schools immediately begin a two-part plan that begins with early screening and intervention not only for dyslexia but also for adhd, especially for the cohorts of students who were in the early grades (Kindergarten through grade 3) during the 2020 and 2021 school years. The second part of the plan refers to carefully curated and personalized treatment in consultation with parents that does not automatically default to medication as the first treatment strategy.  There are non-medical approaches that could be scaled for NYC students not to mention many online courses that can be available for enhanced educator training.

Researchers Fabiano and Pyle say that formal school approaches through individualized education plans (IEPs) and behavior plans may not provide substantial improvements, but they say quick intervention within the general education classroom can help.  However, to do this we have to motivate our schools and educators to move away from stigmas or racist stereotypes about student behavior to move forward into understanding and actionable solutions. Schools cannot be allowed to hide their student problems due to fear of reprisal or a bad rating but instead NYC public schools’ administration must be willing to fund and provide a menu of support including professional development along with appropriate staffing.

Not only is adhd a disability that remains hidden within the 13 special education classifications but potentially it’s a hidden systemwide cost for NYC public schools. Parents of NYC students with IEPs can privately place their children in non-public schools that are better equipped to meet their needs. However, the costs of educating those students remain the public school system’s responsibility.  Known as Carter Cases, (Carter Case Spending Continues to Climb) private tuition per child can be anywhere from $75,000 to more than $100,000 annually.  This cost far exceeds the annual average cost of $38,000 that NYC already spends per child.  Just as children with adhd are a subset of the special education categories, they are most likely also a portion of the Carter Cases too!

Photo by: Norma Mortenson

Perhaps it’s not difficult if we just commit to do it. Clara Hemphill was quoted in an article (Elite School Boy Suicide) as saying that “public schools have the will but not the capacity and private schools have the capacity but not the will”.  I don’t know if the will is apparent if the problem remains opaque and shadowy.  The current Mayor and Chancellor have committed to a bold and brave agenda that places a spotlight on dyslexia and I hope that we can also begin to match that effort for adhd.