Monday, January 16, 2006

Children, Education, and Ethics

We were surprised and honored last week to get an invitation to speak to the President's Council on Bioethics. We'll be going to Washington D.C. at the beginning of February. It seems the Council is discussing the ethics of children and they're going to give us the opportunity to discuss how we think the health professions, the educational system, and our current culture (including the culture of parenting) are meeting children's needs. The general question they are discussing is, how well is society meeting it's moral obligations to children?

Here are some facts to think about:

- expulsion rates for preschoolers 3x that of K-12 (more here; boys 5x higher)
- 3-5-fold increases in the number of 2-4 year old children put on stimulant or other psychiatric medication (here)
- dramatic increases in the numbers of adolescents and young adults abusing prescription stimulants or other psychiatric medications (here and here)
- the absence of diagnostic gold standards for ADHD or autism spectrum diagnoses
- the broadening of these diagnostic categories and increasing role for teachers suggesting the diagnosis (despite the fact that teachers are not trained to make the diagnosis, are not educated about possible medication side effects, and tend to overestimate the numbers of children with ADHD) [references here, here, and here)
- parents told not to have children return to school unless they are medicated, prompting a Congressional bill (here)
- surprising lack of recognition and educational differentiation for different learners (in one study, 53% of teachers stated they did not accommodate educational expectations for students diagnosed with ADHD in their classes because they felt it wouldn't be fair to the whole class)(here)
- teachers untrained in normal neurodevelopment; assessments that are not neurodevelopmentally appropriate, and lack of neurologically-informed educational strategies for different learners
- most teachers unknowledgeable dyslexia, though up to 20% of their students will have it (dyslexia is lumped into a general learning disability category under the IDEA, rather than ADHD which has its designation)
- professionals who may have the most clinical or scientific understanding of cognitive differences typically spend the least amount of time evaluating particular children or counseling their families (for instance, doctor visits may last 10-15 minutes)

Well, what do you think? How well are we meeting our moral responsibility to our children?

A topic for a future post is the need for more positive messages in education. We are losing so students in their middle and high school years, just when they should be looking forward to the future.


  1. As a teacher, I am very worried about the increasing amount of medication being used to control behavior and the decreasing amount of differentiation in most public school classrooms. It is especially troublesome to see pre-k students on medication because they can't sit still or complete worksheets. Good luck in D.C!

  2. What popped out at me from reading this post was that teachers seem to be overestimating the number of behavior-based problems, while underestimating the number of learning problems like dyslexia. I think there is an underlying pattern here. A child may appear inattentive or disruptive due to a lack of understanding about the material, especially if there is an inability to successfully verbalize his or her difficulties and get remediation.

    It always shocks me at how little kids are accomodated in the mainstream. We give kids a certain number of opportunities to master material, or expect them to intuitively figure it out, and then feel that we've spent enough time on it and now the class is ready to move on. Kids who don't get it are probably "lazy" or "not paying attention" or "not motivated". Teachers feel pressured to keep the group happy or to meet some arbitrary benchmark that is on a standardized test. Bottom line, we think it's acceptable when a child fails. Maybe the child even "deserved" it. Saying it's ADHD is actually a step away from blaming the child - but doesn't do anything to change the school structure that is failing many children.

    I work with plenty of kids with ADHD (I am a special education teacher) and have seen that medication can make a real positive difference. It also needs to be continually monitored and adjusted, and does not teach the child coping or educational skills. It puts the child in the driver's seat, but doesn't teach her how to drive! There is still going to be a need for good education and differentiation.