Issues in the Education of Students with Attention Deficit Disorder: Introduction to the Special Issue

ISSUES IN THE EDUCATION OF STUDENTS WITH ADD * This special issue of Exceptional Children presents current information on a topic of major significance to both general and special education: the education of children and youth with attention deficit disorder (ADD). This issue is intended to inform the field about (a) the current definition and conceptualization of ADD, (b) assessment and identification of students with ADD, (c) the educational characteristics of students with ADD, and (d) interventions for ameliorating the attentional and behavioral problems manifested by students with ADD. We hope to stimulate discussion among educators as they develop or refine policies, procedures, and practices necessary to provide an appropriate public education for children with ADD under either Section 504 of Public Law 93-112 or the Individuals with Disabilities Act (IDEA). ISSUES IN THE EDUCATION OF STUDENTS WITH ADD Definition of Attention Deficit Disorder Currently, the definition of ADD is established by the American Psychiatric Association (APA) in the Diagnostic and Statistical Manual of Mental Disorders, 3rd Edition-Revised (DSM-III-R) (APA, 1987). DSM is a clinical manual that describes behavioral symptoms of all disorders currently recognized by the APA and specifies the diagnostic criteria for each. Periodically, the criteria and symptom descriptions of various disorders are reviewed and modified based on current research and field trials on their clinical utility in practice. The term attention deficit disorder was first used in DSM-III (APA, 1980). DSM-III changed the conceptualization of the disorder from one that was defined primarily as the presence of hyperactive-impulsive behavior in DSM-II (APA, 1968) to one that reflected developmentally inappropriate levels of inattention, impulsivity, and hyperactivity. Also, DSM-III listed the behavioral symptoms of each feature separately and specified two primary subtypes based on the presence (ADDH) or absence (ADD no H) of hyperactivity. However, because ADD without hyperactivity was seldom classified in the subsequent field trials (Shaywitz & Shaywitz, 1988), the revised edition (APA, 1987) maintained the three primary features of inattention, impulsivity, and hyperactivity, but listed the three types of symptoms together in a composite syndrome called attention deficit hyperactivity disorder (ADHD). At the same time, evidence was found for the validity of ADD without hyperactivity as a distinct subtype (Lahey & Carlson, 1991). Of particular interest in educational assessment are findings suggesting that ADD without hyperactivity may co-occur more often with learning disabilities (LD), whereas ADD with hyperactivity may be more frequent among children with disruptive behavior disorders (Barkley, DuPaul, & McMurray, 1990; Hynd et al., 1991; Lahey & Carlson, 1991). As a result of these findings and the opinion of many scientists and clinicians, it is anticipated that DSM-IV will contain separate criteria for ADD with and without hyperactivity and will clarify the distinctions between the two (see McBurnett, Lahey, & Pfiffner, this issue). Congressional Action While Congress was considering the 1990 amendments to the Education of the Handicapped Act, advocates of children and youth with ADD argued that these students have a problem that reduces their educational performance and proposed that ADD become a qualifying disability for special education and related services (Aleman, 1991). Many educational organizations (e.g., the National Association of State Directors of Special Education, the National Education Association, and CEC), however, objected to the inclusion of ADD as a separate disability category. These groups argued that (a) many children and youth with ADD already qualify for special education and related services because they also have learning disabilities or serious emotional disturbance; (b) if all students with ADD were to become eligible for special education, limited resources would be diverted away from students with more serious disabilities; and (c) ADD is difficult to define or identify (Aleman, 1991). …