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Getting
bored quickly - particularly in the classroom - is one of the most common
features of children with ADHD. Some have proposed that this observed
behavior is related to cortical under arousal in individuals with ADHD - i.e.
certain regions in the brains of people with ADHD tend to be under active
relative to what is found in those without ADHD. As a result, researchers
have suggested that people with ADHD are especially likely to be under
aroused during dull tasks which impair their actual performance during these
conditions. This is certainly one plausible factor that could contribute to
the difficulty that many students with ADHD experience in the classroom.
If under arousal is at least part of the basis for difficulties experienced
by students with ADHD than, in theory, some of the performance differences
that are evident between students with and without ADHD during low arousal
conditions should disappear under conditions of high arousal. This
interesting question was the subject of a paper published recently in
Developmental Neuropsychology (Shaw, G., & Brown, G. (1999). Arousal, time
estimation, and time use in attention-disordered children. Developmental
Neuropsycholgy, 16, 227-242.
This study was conducted with students in an English high school. As you may
know, ADHD is diagnosed much less frequently in England than in the US, not I
think because of any actual difference in how many children are affected by
ADHD in the two countries, but instead, because of very different attitudes
towards the disorder in England and the US. Thus, none of the participants in
the study to be described had actually received a formal diagnosis of ADHD.
Participants in the study were all 12 years old. Teacher ratings of
children's ADHD symptoms were used to identify 2 groups of 12 students each.
One group (10 boys and 2 girls) received extremely high ratings of ADHD
symptoms using a standardized behavior rating scale. As noted above, none of
these students had been formally diagnosed with ADHD and none were receiving
any type of medical treatment. Their scores were well within the range of
those obtained by children with ADHD, however, and it is likely that many of
these children would have qualified for the diagnosis. At the very least,
they were certainly displaying very high levels of inattentiveness and
hyperactive/ impulsive behaviors according to their teachers. A comparison
group - matched on a variety of characteristics including gender composition
- was created from students who received very low ratings on this scale.
The design of this study was actually quite interesting. The experimenters
were especially interested in how students' arousal level effected their
ability to accurately estimate time (problems with time estimation has been
proposed by Dr. Russell Barkley to be an important problem in those with
ADHD) and their performance on tasks that assess creativity. Arousal level
was manipulated by having students watch both a "boring" and an
"arousing" videotape (i.e. a high speed car chase scene).
After watching each tape, students were asked to estimate the amount of time
each clip had lasted. They were also then asked to perform two tasks that are
believed to assess creativity. These creativity "tests" presented
students with various types of stimuli on paper that the students were asked
to use to develop as many different figures or pictures as possible. In
addition to collecting these data, the authors also collected data on a
variety of other issues. This included students' self-reports of ADHD
symptoms, their tendency to seek out "risky" types of activities,
and their own assessment of their ability to use time wisely. Teachers
provided estimates of students' ability to use time wisely as well (e.g.
being on time for activities, being able to plan the right amount of time to
finish work, etc.).
(Note: Pulse rate data collected on students after the low and high arousal
videotapes indicated significantly higher pulse rates after students viewed
the latter tape. Thus, the manipulation of arousal level was confirmed to be
successful.)
Results
A number of interesting and potentially important results are reported. As
one would expect, students in the ADHD group (remember, these are not
students who had actually been diagnosed with ADHD but those whose teachers
had rated them as showing high levels of ADHD behaviors) reported much higher
levels of ADHD symptoms than the comparison group. Thus, at least on this
dimension, they seemed to be aware of their difficulties. Also consistent
with expectations, the students with ADHD described themselves as being more
interested in seeking out high stimulating (i.e."risky") types of
activities.
For self-reports of ability to use time wisely (e.g. "Can I plan the
correct amount of time to complete my homework?) the results were quite
different. Here, the ADHD students reported that they were just as competent
as students in the comparison group. This was true even though the teachers
reported that these children had substantial deficits in their time-planning
abilities. This contrast is interesting and a bit perplexing - i.e. the
students are aware of and acknowledge their high levels of ADHD behaviors but
seem oblivious to the difficulties they have in structuring and organizing
their time.
The data pertaining to time estimation and creativity under the low and high
arousal conditions are especially interesting. After watching the low arousal
video, children in the ADHD group reported that the video lasted
significantly longer than children in the comparison group. Time estimates
for the high arousal video did not differ between the two groups. In this
condition, the students with ADHD were just as accurate. For the creativity
tasks, the scores received by children in the two groups did not differ for
the task performed after the low arousing video was watched. After watching
the high arousal video, however, the students with ADHD obtained
significantly higher scores.
Implications
The results of this interesting study indicate that how the performance of
students with ADHD compares to their peers can vary significantly depending
on their arousal level. When aroused, their ability to correctly estimate the
passage of time did not differ from comparison children and their performance
on a test designed to estimate creativity was actually better.
Although these data certainly do not prove the hypothesis that cortical under
arousal may be the neurological underpinning of ADHD, they are consistent
with this proposition. The data also imply that when evaluating the ability
of students with ADHD to perform certain tasks, estimates that are made in
low-arousal conditions may give an inaccurate impression of their abilities.
Unfortunately, this is often the
context in which such performance estimates are obtained in educational
settings.
As the authors note "...although most students are able to organize
themselves and function effectively under low levels of stimulation, this is
not true of ADHD students." Thus, developing ways to make the school
environment a more "interesting and arousing" one may be especially
important for improving the performance of students with ADHD. Figuring out
reasonable ways to accomplish this provides an interesting and important
challenge for parents and educators alike. I would hope that research on this
issue is currently underway and will be published in the near future.
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