Thursday, November 3, 2011

ADHD, Anxiety, Learned Helplessness and their Impact upon Academics

What happens when children with ADHD become teenagers with ADHD, in terms of their ability to complete their academic work? In elementary and middle school, the quantity of school work that is required by children may seem to be more than when we were growing up. However, the quantity and quality of academic work that is required of teenagers in high school grows exponentially with each year. The symptoms of these teenagers’ ADHD impact their academic work to an even greater extent than in the earlier grades. Additionally, if a teenager is characterized by ADHD and anxiety, their executive function difficulties become all the more complicated. Let me give you an example.

One of the teenagers with whom I work who has ADHD and anxiety, had an assignment in which he was required to write a continuation of what he thought might have have happened next in a Shakespearean play that his class had been reading. The students were not required or even asked to write this scene in Elizabethan English. This young man is a voracious reader and has a reading level that is well beyond his years, both in terms of decoding and comprehension  

However, his anxiety froze any ability that he might have had to write the required scene. I worked with him and together we traced what he could write. For example, if the main character had stayed in the room instead of running out, what might have happened next. We talked about several scenarios and he chose one.

He was supposed to go home and tell his Mom (who acts as a scribe for him due to the fact that he has a written language disability) what he wanted to say. Then, she would type the scene for him. You may be asking yourself why he does not type on the computer himself. He types very slowly, so for now, we are having his Mom write/type these assignments for him, just at the very least, to get him to complete his assignments.

We had an overall power outage this past week due to the October snowstorm, so he did not have school. The afternoon of the first day back at school, I met with this teenager, and asked if he had completed the English assignment. He began to behave in a very immature way, rolling his top lip over his bottom lip, and making sort of whining sounds. He finally told me that he had not done the English assignment. I asked why he had not completed the assignment.

He told me that he had asked the teacher in the learning center for help, but that she had helped him with another essay that he had not completed that was worth 100 points. I then redirected the conversation to find out the reason why he had not done the assignment. It appeared that due to the anxiety of the assignment, he just could not get himself to do it.

He told me that more straight- forward assignments, such as math or social studies were not a problem for him. He then told me that when he had to make things up, i.e., in this case a scene from a play, that he could not do it himself. I truly believe that this young man’s anxiety caused a type of writer’s block.

I have to tell you about another problem that I truly believe contributed to him not completing this assignment. He definitely has a type of learned helplessness, in addition to his ADHD and anxiety. He has learned over the years that he thinks that cannot accomplish certain things, which I believe is more directly related to his anxiety than his ADHD. Therefore, he will only complete those tasks with help.

When he first had this assignment, his first comment to me was “I can’t do this assignment. Ms. Smith will help me in the learning center.” The question was: How could I get him to do the assignment himself?  I told him that he could most certainly complete this assignment. However, there was no way that he believed what I said. I gave him several reasons why he could complete the assignment, but he did not agree with any of them.

I explained to him that this assignment was really no different than the scenes that he had made up with his brother when they were young and used imaginative play. I finally used humor to help him to understand that he could complete his assignment. He laughed, but still stated that he could not do the assignment.

Yesterday, I spoke to him in a very direct manner and told him that oftentimes teachers do not understand the impact of either ADHD or anxiety, in terms of students having difficulty completing assignments due to those issues.  They certainly understand that teenagers with ADHD need some help.
I continued our conversation by saying that since this is high school, however, the teachers also assume that students have learned self-regulatory skills which help them to complete and hand in all assignments on time. I then told him that I do not blame those teachers, because all assignments should be handed in on time by every student in the class.

In an effort to move this fifteen year old young man past his learned helplessness, I also told him that it is possible that some teachers might think that he was being lazy, or perhaps that he simply did not want to do the required work. He thought about what I said and was upset at the thought of the teachers thinking in that way. However, he still insisted that he could not do that English assignment.



I told him that he is so bright that his teachers expect him to hand in all of the assignments on time. I told him that he is the same as everyone else, in terms of handing in assignments. Then, he said to me, “But I am not the same as everyone else. I am different.” Before I give you my opinion of this young man’s comments, what do you think????

4 comments:

  1. I have a very bright 15 year old son with ADHD who has difficulty with task initiation when it comes to working on these types of open-ended homework assignments. His executive functioning skills are underdeveloped compared to his peers in 10th grade, and he has difficulty knowing how to approach this type of assignment. He knows that he has to complete the assignment and that he has a deadline, but his anxiety about how to approach the assignment gets in the way of him actually doing the assignment. He needs to be taught some strategies on how to approach this type of assignment.

    I agree that a teenager with ADHD and anxiety should still be expected to hand in assignments, but that they should also get support from the school in learning strategies to approach these types of assignments. If the teen is not getting this type of support, either in school, or outside of school with the help of a professional who knows how to teach these skills, then the assignment will not get completed in a timely manner, and it may not get done at all. The problem that we find is that the school does not have the time/resources to work one on one with our son to teach these skills, and it is hard to find someone outside of the school who is able to do this. Do you have any ideas on how to get this type of help?

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  2. Hi Deborah:
    Is this a relatively new problem? How long has your son experienced those difficulties in school? Has he been able to complete his homework up to this point? Has he been able to hand in larger assignments previously? If he has not handed in his assignments in a timely manner, what were the teachers’ responses? Have teachers helped him in the past?

    Is your teenager designated either under IDEA 2004 or 504? If so, he should be receiving services under one of those laws. If not, then the first thing that I would recommend is that you have him evaluated by a neurologist or a psychiatrist so that he will hopefully, be designated as having ADHD or whatever diagnosis that the doctor deems correct. In that way, he will be mandated to receive the services of the type that you mentioned that he so desperately needs.

    Unfortunately, when a child suffers from anxiety, even if he had the appropriate executive function skills for his age, (FYI: The less you can make his executive function difficulties a comparison to his peers when you are thinking about him or speaking to him, the better) his anxiety would act as an obstruction to him actually doing his work. That being said, a good way to allay his generalized anxiety about large, looming assignments is to break each of them down into very small tasks. In that way, he will see those assignments as more approachable than assignments that are described in a more general way.

    The first job, therefore, no matter how much time and effort it takes on everyone’s part, is to get all of his assignments done and handed in to the teacher so that he becomes current. The second job, which is a steeper learning curve, but CAN be accomplished, is to begin to teach him how to evaluate the requirements of each of his assignments. After he understands each assignment’s requirements, he then has to learn to break down each assignment into smaller parts.

    Have you asked his teachers to suggest someone who can help him after school? I would only suggest someone who is an expert in ADHD, anxiety and executive function, or it would be a waste of your son’s time and your money. (However, I would have to know what state in which you reside in order to recommend someone to help your son after school, which is certainly not a good idea to specify here.)
    The Children and Adults with Attention Deficit Hyperactivity Disorder (CHADD) which can be located at www.chadd.org lists professionals in each state. Additionally the Council for Exceptional Children (CEC) has a similar list, which is at www.cec.sped.org.

    Before his self-confidence and self-esteem are impacted negatively by his inability to begin and then complete his assignments, he needs to work with someone who will teach him how to plan, how to inhibit his anxiety and then, finally, to complete his assignments.

    Let me know if you have any other questions.

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  3. My son has been diagnosed with ADHD (inattentive type) and does receive services at school under an IEP. We just had private educational testing done on him last year which confirms the ADHD. He does well with most homework assignments as long as they are well defined (ie reading, doing worksheets, answering questions about a reading etc.)although he does tend to rush through the assignments. However if he perceives something as being too difficult, he will get anxious and feel overwhelmed, and it takes longer for him to complete the assignment. He is a typical teenager and does not want to receive help from us (his parents). We would like to find an ADHD coach to work with him and help teach him some of the coping strategies you mentioned (planning, inhibiting his anxiety and completing the assignments), however there are very few in our state (NH), and none in our area.

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  4. I know exactly what this kid's problem is.
    Go back & read what you wrote. Count how many times you used the word "expectations".
    Doing this drama assignment was not at all like making up stories when he was growing up. When he's just fooling around, he has no idea what he's doing, ok? There's no right, no wrong, no expectations.
    Now this assignment wants him to think a certain way, perceive what he's doing s certain way. Frankly, he does not understand how to adjust his unstructured thinking to think like you. He does not know how to meet your creative expectations. He knows how to do Math, because the rules are very concrete and everyone has to find the same answer; creativity does not exist in a math class.
    But you want him to meet your expectations, meet your demands, be your kind of "creative" even though he doesn't understand your creativity or your thinking. Your perception, your demands,your expectation of his potential, your demands that he think like you, be like you, want what you want, you you you. Conform or die. Conform or else. Think like we say, or live in a box. Be creative the same way as everyone else, or forget it.
    I graduated high school, went to college, jumped through everybody's hoops and met everybody's expectations. Yet they kept telling me to relax and stop being so uptight. Relax, and be what you're told.
    Reach the potential expected of you, but don't care what other people think.
    Be yourself, and be mature, and don't care what people think, and don't disappoint ever. And somehow you're supposed to be a mindreader and just "know" what everybody wants all the time.

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