ADHD in the Ontario School System

The Ontario Ministry of Education’s document, “Achieving Excellence: A Renewed Vision for Education in Ontario” lists three of the Ministry‘s renewed goals as, achieving excellence, ensuring equity, and promoting mental and physical well-being of all students. However, several issues are contributing to the prevention of these goals being realized for students with ADHD. Although research confirms high incident rates compared to other disorders, substantial risks to academic achievement for student with ADHD, including high-school drop-out (despite average or above average intellectual potential), and life-long socioeconomic costs as the result of ADHD, an inequity exists in the Ministry and boards’ attention to this disorder.

Areas of Concern:

  1. In the last decade significant strides have been made in the understanding of ADHD and other neurodevelopmental disorders. In the case of ADHD there has been significant focus on how the mental health (neurobiological) disorder impacts learning and the well-being of children as they grow into adulthood. The Ontario Ministry of Education and most school boards in Ontario are out of date with changes in current scientific understanding of neurodevelopmental disorders such as ADHD. Changes to our understanding of the disorder as outlined in the DSM 5 should result in changes to Ministry policy and documents. Other provincial jurisdictions have already begun these changes.

ADHD is now conceptualized and classified in DSM-5 as one of several Neurodevelopmental Disorders, and no longer as a disruptive behaviour as it was previously understood. This major change was based on scientific evidence on:

  1. High rates of coexistence with other neurodevelopmental disorders (e.g., Autism, learning disabilities, language impairments, intellectual disabilities, developmental motor coordination disorder)
  2. Shared genetic factors with other neurodevelopmental disorders

Shared cognitive processing deficits with other neurodevelopmental disorders (which implies that they will need and benefit from similar educational accommodations and in structural practices provided for students currently recognized under the category of ‘Communication’)

ADHD often co-occurs with autism spectrum disorder and DSM-5 now permits both diagnoses to be made in a given individual – in previous versions of DSM, ADHD could not be diagnosed in the presence of autism and visa-versa

Sub-types of ADHD (inattentive, hyperactive/impulsive , combined) are no longer recognized because they are unstable across time and invalid and best understood to be variations in the current manifestation

      3. Inadequate and out-of-date education on ADHD for educators in Ontario

With the significant scientific reconceptualization of ADHD new up-dated information should be made available through professional development to all educators

Less information on ADHD exists on the Ministry’s web site when compared to ASD and Learning Disabilities, although incident rates of ADHD far exceed those of ASD

Insufficient educator training on ADHD is taking place and what is occurring is often superficial, scientifically not up-to date, and is not focused on changing educators’ perception of ADHD

There is no existing sample IEP following the intent of the Memorandum on Categories of Exceptionalities on the Ministry’s web site (a student with ADHD and no co-occurring disorders that would automatically qualify them inclusion in one of the categories)

     4. Difficulties remain in the implementation of the Memorandum on Categories of Exceptionalities

Some boards continue to stipulate that the specific criteria for the Communication Category must be met before a student with ADHD will be identified under this category. This would indicate that an LD or ASD must still coexist with the ADHD diagnosis.

Inconsistencies in how school boards interpret the memorandum continue.

Inconsistencies remain across boards as to where the bar “of being impaired enough” sits to meet criteria to be deemed exceptional. Many boards continue to define where this bar sits by out-dated information on ADHD. The Ministry continues to support this situation by not distributing current research on neurodevelopmental disorders and giving ADHD the attention it deserves.

There is little transparency on this issue by school boards. This leads to inequity across the province and makes it very difficult for parents and medical professionals to know what documentation is required. Inequities in eligibility criteria and opaque definitions are vulnerable to legal challenges

      5. No representation of ADHD on SEACs, MACSE and other Ministry advisory or working committees

ASKS

  1. The development of a PPM, with input from medical experts in the field, outlining the reconceptualization and classification of ADHD and up-dating information on its impact on learning.
  1. Increase and up-date information on ADHD, with the assistance of experts in the field, on the Ministry web site and develop a sample IEP for a student with ADHD without a co-existing disorder focused on learning impairments caused by ADHD.
  1. Request that schools boards publish their requirements on what level of impairment must exist before a student may be deemed exceptional.
  1. The inclusion of representatives of ADHD experts and organizations in Ministry working groups and MACSE.