V. Education: How do we determine whether an ADHD child is educationally handicapped and needs a Section 504 Plan or special education? This is now left to individual districts. The PGARD group has suggested the following definition:

A. "ADD adversely affects educational performance to the extent that a significant discrepancy exists between a child's intellectual ability and that child's productivity with respect to listening, following directions, planning, organizing, or completing academic assignments which require reading, writing, spelling, or mathematical calculations."

B. Put simply, this is a way to operationalize the concept of "not working up to potential." It focuses on assignments completed in a timely fashion, the quantity of work done per unit time. This is the area where ADHD students fall down the most in school. Grades or achievement scores are not the primary criteria for judging the need for extra help.

C. IQ is easily assessed through our standardized tests.

D. Productivity is assessed through obtaining work samples of the student's tasks. Use representative homework and in-class assignments. But take into account teacher demands, e.g. compare with other children in the same class.

1. Calculate percentage of work completed and percentage completed correctly during written assignments over approximately a two-week period.

2. Obtain similar data for the child's non-disabled peers, e.g. the class average.

3. Is the ADHD child getting less done per unit time that non-disabled peers?

4. Is the ADHD child's work less accurate than non-disabled peers?

5. Is the ADHD child getting less work done than would be expected for a child of his/her IQ?

6. Is the ADHD child's work less accurate than would be expected for a child of his/her IQ?

VI. Overview of Intervention for School-Related Problems

A. School-related interventions are part of a broader intervention which involves the following stages:

1. Family ADHD Education

2. Getting medication started

3. School-based interventions

4. Home-based interventions

5. Residual individual problems

6. Dental checkup model of follow-up care

B. Pinpoint and prioritize the targets for change for a given adolescent

C. Divide up responsibility for change-student, teachers, parents, school support services, therapist, tutors, others, etc.

D. Approach the school (teacher, principal, etc.) to do its part.

E. Therapist works on his/her part with student and parents

F. Start with the highest priority targets and develop specific behavioral interventions for each target, until all of them have been addressed.

G. We will give suggestions for the most common problems mentioned above. Readers interested in more exhaustive examples should consult:

1. Markel, G., & Greenbaum, J. (1996). Performance breakthroughs for adolescents with learning disabilities or ADD. Champaign, Illinois: Research Press

2. Robin, A.L. (In press). Guiding the adolescent with ADHD New York: Guilford Press

VII. Pinpointing Targets for Change

A. Classroom Performance Survey-practical rating scale which teachers can complete in 5 minutes (CH.A.D.D., 1996). Table 1

B. Go over with the adolescent and the family a comprehensive checklist such as Table 2. Anything rated 3 or less is a potential target for change

C. Review report card, asking how each class is going

1. Which classes are easiest or most difficult?

2. Which classes does teen like or dislike?

3. How does teen get along with each teacher?

4. What help is available?