Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by levels of inattention or hyperactivity and impulsivity that are developmentally inappropriate. ADHD affects approximately 3–12% of children, with more boys being diagnosed than girls. The Diagnostic and Statistical Manual of Mental Disorders classifies ADHD as (1) combined inattention and hyperactivity/impulsivity; (2) predominantly inattention; and (3) predominantly hyperactivity/impulsivity. Conversely, the International Classification of Diseases requires the presence of inattention, hyperactivity, and impulsivity for a diagnosis of hyperkinetic disorder, the European label for ADHD. ADHD is a complex disorder that requires a rigorous diagnostic process that typically begins with a detailed family, developmental, medical, psychiatric, academic, and behavioral history. The next step involves a variety of assessments in areas including but not limited to neurological, intellectual, academic achievement, memory, attention, concentration, executive functioning, response inhibition, and behavior. One of the challenges in diagnosing ADHD is ruling out the nature of any comorbid conditions and ascertaining the primary condition should more than one secondary condition be identified. A variety of treatment and intervention approaches exist for children and youth with ADHD. The most common and most evidence-based approaches include the use of cognitive behavioral interventions, psychostimulant medication, or a combination of the two. In addition, a variety of instructional strategies have been found to be effective, particularly when combined with self-regulatory strategies, executive control, and active learner participation with a teacher or adult mediator. There is continuing debate as to whether learners with ADHD are better served in general classrooms or in more specialized settings. However, the solution is not to use one approach instead of the other. An effective program should meet the needs of learners using the appropriate combination of specialized supports and general classroom practices. Implementing such programs can place a lot of demand on individual teachers. The Universal Design for Learning (UDL) approach is designed to support teachers in responding to diverse learning needs and to focus on the limitations of the classroom environment rather than on the limitations of the learner has been developed and is demonstrating promise. UDL incorporates differentiated instruction to focus on curricular design techniques that emphasize setting motivational factors pertinent to learning, finding alternative and interesting ways to represent the material to be learned, and enabling alternative ways for learners to express their knowledge. Combined with creating safe and supportive classrooms for all learners, UDL affords a more planful approach, so responding to learning differences is not seen as an add-on but as an integral component of the teaching/learning process that combines various tiers of instruction aimed at meeting a wider range of learner strengths and needs.
Frederick French and Carmel French
Rosalyn H. Shute
Mindfulness, adapted from ancient Buddhist thought and practice, was introduced into the West in a secularized and Westernized form during the 1980s. In subsequent decades, it spread around the world, into clinics, workplaces, and schools. The practice involves cultivating the ability to focus attention, and to notice any distracting thoughts and feelings without judgment or elaboration, in order to reduce stress and improve mental health. As such, it is a psychological phenomenon involving metacognition, or thinking about thinking, though this can be placed within a holistic framework that sees the mind as intricately linked with the body and the external world. In the early years of the 21st century, concerns grew about children’s mental health, and schools became seen as places to address this through universal programs; that is, mental health promotion programs that reach all students and that therefore do not stigmatize those who already have psychological difficulties, or are at risk of developing them. Evidence was also accruing that, with samples of healthy (non-clinical) adults, mindfulness had moderate effects on measures such as anxiety, and strong effects in reducing stress. Although research designs were generally not very strong, the positive results and public enthusiasm for mindfulness encouraged the introduction of universal programs into schools, and even preschools. However, the dissemination of school-based mindfulness programs ran well ahead of the scientific evidence examining their efficacy (under tightly controlled conditions) or their effectiveness in real-world school contexts. While studies were suggestive that mindfulness could affect many aspects of children’s and adolescents’ wellbeing and development, the body of research as a whole fell short in terms of scientific rigor. There were few well-designed randomized controlled trials that would enable firm conclusions to be drawn that any identified effects were due to the mindfulness program rather than to unknown factors. Moreover, little attention was paid to the presumed mechanisms of change or to the developmental appropriateness of programs. As more, and better-designed, studies began to emerge, accumulating results suggested that effects were generally small, but stronger for older than younger adolescents, and longer lasting for adolescents than for children. Issues that remained for further systematic attention included many matters of program design and implementation, the safety of the practice, its basis in developmental theory and research, and its ethical and political implications.