An Expanded View of The Problem

 

Every year, poor reading outcomes cost taxpayers more than 225 billion dollars (NCES, 2005). The US economy spends 100 billion each year to fund unemployment (Staiger & Waldmann, 2017) and underemployment (Faraone & Biederman &, 2006). In 2015, the National Adult Literacy Survey revealed that 44 million Americans were categorized as “functionally illiterate” (UNESCO, 2015).  This means that 23% of adults do not have reading skills beyond the 4th-grade level (National Center for Education Statistics [NCES], 2007).   Research states that “functionally illiterate” individuals lack the ability to implement reading, writing, and mathematical skills that prolong one’s personal, occupational, or societal development (Vagvolgy, et al., 2016).  Research shows that low achievement in literacy leads to substandard job performance (Biederman et al., 2008), criminality (Mannuzza, 2008), higher rates of criminal recidivism (Drakeford, 2002), and mortality (Bardone et al, 1996; Beautrais et al., 1996; Lynskey, Coffey, Degenhardt, Carlin, & Patton, 2003). Low literacy rates are associated with many comorbidities such as anxiety, depression, (Boetsch, Green, & Pennington, 1996; Willcutt & Pennington, 2000; Stouthamer-Loeber, 2003), post-traumatic stress disorder (Biederman, 2004; Kessler et al., 2006; Spencer et al., 2016), Parkinson’s Disease (Fleisher, Shah, Fitts,  & Dahodwala, 2016), traumatic brain injuries (Adeyemo et al., 2014; Max et al., 2004; McKinlay et al., 2009) and coronary disease (National Institutes Health [NIH], 2000).  Over time, the attenuation of literacy skills causes prodigal deficits that encourage long-term health, economic, occupational, and educational distress.

In 2017, the CDC datasets show that six million children were diagnosed with ADHD in the United States (Centers For Disease Control & Prevention[CDC], 2017). Aggregated data from The National Center of Special Education Research shows that students with (LD), such as Attention Deficit Hyperactivity Disorder  (ADHD) and Dyslexia (DYX) are at higher risk of falling behind others in literacy as compared to children without ADHD or DYX symptoms (Czamara, et. al., 2013).  Statistical data reveals that children with ADHD experience reading disfluency, (Odds Ratio (OR) = 2.80, p = 6.59×10−13), in early childhood and adolescent development (Schneider, 2006). The prevalence of reading and spelling dysfunction is higher in males (14.1%) than in females (8.7%) (Czamara, et. al., 2013), and estimates of 25–40% of medical cases report bidirectional comorbidity between ADHD & DYX (DuPaul, et. al., 2013; Willcutt, et. al., 2000).  Not only does poor student achievement in literacy fracture the health of our economy, but also it challenges educators in the 21st century to enact effective educational interventions to meet the needs of older students with special needs such as those with attention deficit hyperactivity disorder (ADHD). 

ADHD has been defined as a common neurobiological psychiatric disorder that is characterized by impulsivity, inattention, and hyperactivity (American Psychiatric Association, 2020).  Individuals with ADHD typically experience challenges with staying focused, planning, organizing, and thinking before acting (Arnett, 2012).  Often they may be distracted, fidgety, and less apt to adapt to changing situations (Willcutt, et.al., 2011). ADHD is also recognized as a modulating factor that influences student achievement (Barkley, 1990). According to DSM-V (Diagnostic and Statistical Manual of Mental Disorders), symptoms of ADHD may co-occur at school and at home (Czamara, et. al., 2013). Neuroscience research shows that adolescents with ADHD experience neurological deficiencies that disrupt the learner’s working memory (Rapport, Chung, Shore, Denney & Isaacs, 2000; Rubia et al., 1999), and inhibit engagement (Lorch et al., 2000). Sustaining cognitive engagement in reading is a fundamental challenge for students with ADHD (Lemberger et al., 2004).  Additionally, neuroscience research shows that dopaminergic activity is reduced in children with ADHD due to postsynaptic cell brain dysfunction (Giedd et al. 1999; Gogtay et al. 2004; Shaw et.al., 2007).  This means that more dopamine for sustaining attention and focus is required for children with ADHD. Particularly, aspects related to internal drive and motivation are compromised in the substantia nigra (Becker, Seufert, 1995), which is a region of the brain that plays a role in learning, emotion, engagement, and reward (Gogtay et al. 2004; Shaw et.al., 2007). 

Untreated ADHD symptomatology is associated with cognitive imbalances, inattention, disengagement, and working memory problems (Faraone et al., 1993).  Research also shows that unmedicated students suffer from poor mental processes, and tend to engage in mind wandering, involving the default mode network in the brain (Willcutt, Pennington, & DeFries, 2000). According to the 2015 National Parent Survey, about 23% of children with ADHD did not receive behavioral treatment. As a consequence of being left untreated teachers still have the responsibility of delivering reading instruction to these students. Thus, this lack of treatment poses a significant challenge for literacy teachers since many children with ADHD (Maughan, 2003) require additional metacognitive and behavioral strategies for stimulating and sustaining engagement (Lan, 2014; Williams, 2009).  

There are two main types of treatment approaches designed to treat adolescents with ADHD. One common clinical approach is the use of stimulant drugs such as methylphenidate and dextroamphetamine (Faraone, Biederman, 2000). This form of treatment works to influence the neurobiological underpinnings of ADHD by stimulating neural circuitry that involves dopamine receptors. The second type of treatment uses cognitive behavioral therapy (CBT) as a form of goal-oriented psychotherapy that sets out to change patterns of thinking and mindset. There are many dissenting opinions concerning the most effective practices for treating and supporting children with ADHD. To this day, this controversy continues to lead us astray. This is a problem.

Untreated ADHD symptomatology is associated with cognitive imbalances, inattention, disengagement, and working memory problems (Faraone et al., 1993).  Research also shows that unmedicated students suffer from poor mental processes, and tend to engage in mind wandering, involving the default mode network in the brain (Willcutt, Pennington, & DeFries, 2000). According to the 2015 National Parent Survey, about 23% of children with ADHD did not receive behavioral treatment. As a consequence of being left untreated teachers still have the responsibility of delivering reading instruction to these students. Thus, this lack of treatment poses a significant challenge for literacy teachers since many children with ADHD (Maughan, 2003) require additional metacognitive and behavioral strategies for stimulating and sustaining engagement (Lan, 2014; Williams, 2009).  

**Please note** (My paper is still in draft form)

Early Stage Drafting

Drafts can be very insightful.I surely do welcome comments, questions, and feedback. Thank you for reading.