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FROM THE DIRECTOR'S DESK
A Great 20th-Century Invention for Children
Warren Buffett's partner, Charlie Munger, once said, "I think I've been in the top 5% of my age cohort all my life in understanding the power of incentives, and all my life I've underestimated it. And never a year passes but I get some surprise that pushes my limit a little farther."
There were many inventions in the past century that have profoundly changed our lives -- the telephone, automobile, Internet, and DVD, to name a few. But in a not-so-small way, one invention for children that has created a profound understanding of child behavior and learning but has been overlooked is the token-economy/point system.
The system is used primarily to increase and maintain incentive to learn and behave. Experience over the years has shown me time and time again how miracles can happen to a child under a point system, be his diagnosis autism, dyslexia, auditory processing problem, ADD, ADHD, oppositional disorder, or emotionally disturbed. But also how the same miracle can disappear when the point system is dropped or changed. The behavior, the learning, and the mood, could be day and night with or without a point system.
Like many inventions, the theory behind the point system, once explained, is surprisingly simple, although its application could be infinitely individualized and complex. It is partly based on the economic principle of creating and balancing earnings and spendings, and partly on the capitalistic principle of tying productivity to privilege.
Properly designed, a point system fosters independent learning, stamina and compliance. The child also learns important facts of life -- that things don't come for free, that we must plan ahead rather than live by the moment, and that we must be responsible to or own actions -- facts that we adults should all have learned.
Indeed, motivation is half the battle in child treatment. A properly designed point system is a great motivational device.
More Electronics in Bedroom, Less Sleep for Boys
A study shows that boys 8-17 years old sleep less when there is television, computer, or videogame in their bedroom. With a TV in the bedroom, they slept an average of 8.3 hours a night compared with 9 hours for boys who did not have one. Boys with an in-room video game system slept 8.3 hours vs. 8.8 hours for those without. A computer in the bedroom disrupted sleep the most: the hours dropped to 7.9 compared with 8.7 for those who did not have one in the bedroom.
How a drug company's share goes up riding
on the ADHD train
Many studies conducted or supported by drug companies are done sloppily with the goal of proving the drug's effectiveness. Often times stock investors bid up the share price after reading the headline proclaiming the effect. Few bother to read the actual experiment and data.
A headline from Medscape Today reads "Extended-release Metadoxine safe and effective for ADHD". TEVA pharmaceuticals and Alcobra Ltd did the study that purportedly showed the drug "improved ADHD symptoms scores compared with placebo." On the same day of 9/7/11, Teva's stock rose 2.5%. Bloomberg financials's Belinda Cao wrote "The success in Teva's new drug study is 'obviously a positive' according to Judson Clark", a stock analyst at Edward Jones & Co. in Missouri. So the study garnered the accolades of "success" and "positive", as though the drug is now a shoe-in.
But not so obvious yet. I tried to find a detailed report of the study on Teva's website but could only get a brief summary. From what could be fathomed, they used at least 7 assessment instruments and only one, the Investigator-rated CAARS-INV produced significant results, with secondary effects observed in another rating scale and insturment-measured brain waves of TOVA. We know ratings are notoriously subjective, but there was no description on whether the people who rated a patient's ADHD symtoms knew the patient was on the drug or not. Such knowledge would significantly affect the subjective ratings.
The TOVA and the Conner assessment for ADHD by the way are controversial and their correspondence to actual ADHD behaviors and to people who are not ADHD make them not a reliable instrument.
Somebody has made some money on that day!s
WHAT THERAPIES WORK FOR AUTISM?
In a large-scale review of 4120 citations and 183 articles representing 153 studies on treatment effectiveness of autistic children (http://www.effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productID=651), the authors (Warren et al, 2011)concluded that drugs have virtually no effects other than muting 'challengin behaviors' (noncompliance, hyperactivity, self-abuse).
Risperidone and aripiprazole seem to be the only kinds that produced the effects based on parent-reports (not actual observation and frequency counts).
Yet the positives are far outweighed by the negatives. The authors concluded "Both medications also cause significant side effects, however, including marked weight gain, sedation, and risk of extrapyramidal symptoms (side effects, including muscle stiffness or tremor, that occur in individuals taking antipsychotic medications). These side effects limit use of these drugs to patients with severe impairment or risk of injury."
As to other types of therapies, "Evidence is insufficient at this time to support the use of sensory or auditory integration, insufficient for speech and language interventions, and insufficient for CAM approaches." (CAM=alternative medicine)
What about ABA (applied behavior analysis) and the UCLA/Lovaas msdel? Their review is inconclusive - promising on some, disappointing on most.
There is little research on what happen when the children are 'mainstreamed', if the improvement will sustain or continue in a more normal settings.
In fact, the sparsity of long-term follow-up
likely indicates no long-term effects of
these treatments. This is not surprising
when one considers the paradigm in which
these behaviroal programs have been conducted
- labor intensive, training intensive, and
situation specific (university research clinic,
insitutions, etc.). Such paradigm is not
practicable and if it is, cannot be sustained
overtime. Many parents and teachers burn
out after a while of trying these behavioral
Is it possible to 'un-diagnose' ADD or ADHD, after a child has been so labeled? The answer is a qualified "yes". Qualified in the sense that certain conditions must be met.
First, the ADD or ADHD is not supplemented by secondary factors such as behavior/emotional problems, non-compliance, severe learning disabilities, inappropriate schooling, or dysfunctional families.
Second, the guardians and treating parties must accept the idea that ADD is a skill deficiency and is not subject to quick cure, but can be effectively treated only after careful planning and persistent training and follow-up. Thus, the family does not give up if immediate results do not occur.
The third condition is the ability by the child's family to follow prescribed procedures and be united in their way of dealing with the problem. This is often the toughest prerequisite, especially for single parents or for those who might themselves suffer from ADD.
Below I will describe a clinical case for an 11 year-old boy who was diagnosed to be ADD when he was a 9-year-old 4th grader by both the school psychologist and a pediatrician. The presenting problems were poor concentration at school, leading to D's in language arts and F's in math and spelling/writing. The teacher described Jimmy (not his real name) as "slow to follow instructions", "often spaces out, fiddle with things or loses things."
His mother stressed that Jimmy required a "fantastic amount of time every night to do his home work." Mom literally has to sit with him nightly, while he makes frequent trips to the bathroom and complains about being tired. The homework process at times drags on till mid-night, when both are exhausted and some of the homework had to be missed. Needless to say, much frustration and anger occur nightly.
Jimmy had an IEP that provided 60 minutes of speech therapy.
The treatment goals in this case were determined to be
a. independent task completion both at home and at school, and
b. improved school grades.
Jimmy was first evaluated for academic skills (reading fluency, spelling and vocabulary on par, comprehension and math both about ½ a year behind grade level) and for potential learning disabilities (none except Processing Speed at two Standard Deviations and Picture Arrangement at one Standard Deviation below the norm) to rule out the need for intensive educational therapy.
Next, the school curriculum, class work, homework and quizzes were analyzed to make sure they were appropriate for him. I did a detailed analysis of Jimmy's life style, energy level, behavioral and psychological adjustment in class and at home, and his interest and motivation to learn academic materials.
Treatment consisted of weekly sessions averaging two hours each time: Jimmy's study environment restructured according to the home's dynamics; a daily performance feedback system created based on the school's academic demands and his learning style; and a 'tight' motivational system developed. In each session, Jimmy was trained on processing speed and focusing and study skills. An integral part of the treatment was parent training using written procedures and weekly feedback. His mother was diligent in adhering to the treatment procedure. Another treatment facet involved telephone and written communications with the teacher regarding task assignments and grading criteria.
Treatment started two years ago. By the end of the second school year, Jimmy was completing his class work consistently and no longer missed any homework. The amount of time Mom needed to supervise him to do homework dwindled to less than 30 minutes a day. And last but not least, Jimmy averaged a B, with no D and F grades. The parents petitioned to pull him out of special education program and remove the label of ADD.
So it is possible to 'cure' ADD, by instilling the right skills and 're-engineering' the subject's milieu, and finally dismantling the label. But I must emphasize that, similar to many medical treatment paradigms, long-term maintenance and 'booster' sessions are required for continuous success.
HIGHER GPA's FOR HIGHER EDUCATION
The latest rankings of universities by US News and World Report show that the best California university is still Stanford at Palo Alto; Pomona College ranks 5th best liberal college in the nation. Harvard and Princeton are still the top universities nationally.
There are signs that among the most prestigious universities, the admission rates (the percent of applicants accepted) are dropping. From 2000 to 2003, Harvard went from 11% to 10%, likewise, Princeton dropped from 12% to 10%, UC Berkeley and UCLA declined from to 24% from 26% and 29% respectively.
UC Berkeley is the #1 public university in the nation and UCLA is #24.
The bad news is starting next year, the whole UC system is raising the minimum GPA requirement from 3.0 to 3.25, in response to the trend that high school graduates' GPA is getting higher and thus more of them qualify for admission. The GPA's have been getting higher because more students are taking Honors and AP classes, which give one more point for each grade but F. This, however, will make little difference for Berkeley or LA's admissions, as their freshmen's GPA's surpass 3.25 anyway. But for the other UC's, those that used to accept students with 3.0 GPA will require a GPA of 3.25.
This is a double-edged sword: the quality of high schools students is getting better, and the universities raise the admission bar to maintain the same number of freshmen.
-- The application essay for college admission often counts for 20% in admission decisions by colleges?
-- According to the National Insti-tutes of Health, children who are behind in reading skills by 3rd grade have only a 12 to 20% chance of catching up? Read: early intervention is crucial.
-- Even 40 years ago, back in 1964, the sociologist James Coleman found that school facilities like libraries and laboratories had virtually no relationship with student achievement, that is, some poorly equipped rural schools can produce high achievement while other physically sound schools did not?
(Coleman went on to conclude that schools can't be expected to cure poverty and low achievement - "The inequalities imposed on children by their home, neighborhood and peer environment are carried along to become the inequalities with which they confront adult life at the end of school.")
THE AUTISM MYSTERY
Incidences of children diagnosed with autism have increased exponentially, as described in our last summer's It's Academic ("In California alone, the incidents have increased more than six fold in the last 15 years.") When I first became State Director of Autistic Programs for Delaware in 1982, there were 21 children in the Programs. By the time I left in 1987, the population jumped to 40. Now I was told the Programs have more than 200 children!
Speculations on why we have more autistic children abound, from environmental pollution to chemical abundance to genetic mutations, better diagnostic techniques to better funding. The latter no doubt has contributed to the willingness of clinicians and educators to prescribe more autism diagnosis. Indeed, the Federal Government has been spending many more dollars on autistic programs. Last year, the National Institutes of Health spent about $81.3 million on autism research, versus $9.6 million in1993.
Yet autism, the most severe form of childhood affliction, remains a mystery. The exact cause is unknown, and treatment progress remains at best inconsistent, subject to a whole host of factors.
What is certain is autism is a congenital/genetic disease that affects normal brain development in processing multiple stimuli in the environment. Thus, it is not only language that an autistic child has problems acquiring, but also social interaction, human affects, and play activities or tasks involving multiple logical steps. The preference for repetitive movements or 'aloneness' are manifestations of the difficulty to process more complex information.
Exactly which part of the brain is afflicted is not known, but no doubt multiple genes and/or sites are involved. Hence, a physical or medical cure is not possible, at least in the near future. Behavioral treatment remains the best available. Even with that, a highly skilled, logical and analytical therapist, coupled with dedicated, cooperative and resourceful parents and schools are prerequisites for long- term, permanent gains. Indeed, about 12% can achieve total recovery under proper care.
DISCREET TRIAL TRAINING A MUST FOR AUTISM
Children and adults suffering from autism need a lot of help in order to learn. I don't mean helping them to do things or get around. I mean they need us to define the behavior to be learned clearly and analyze the learning situation carefully for them, and present it in a systematic fashion to them. Systematic means consistent, repetitive, and criterion-based.
A discrete-trial training format is an essential ingredient in helping autistic people learn. I came to this realization while developing the first autistic program for the Metro Toronto School Board in 1971, 34 years ago. The basic premises is like this: training is always expressed in terms of numbers of trials. A trial is prefaced by a clear definition of the stimulus condition, which may involve the therapist's instruction, the materials presented and the training setting, and by a clear definition of the mastery skill which may be a verbal answer or a physical behavior to be emitted by the patient. The amount of training is measured by the number of trials over a specific time (the session time), and learning is defined by number of correct (acceptable) trials over total trials.
Without the discrete trials, learning is often hit-and-miss and reduced to a general gussing game or subject to wishful-thinking. And more importantly, treatment effectiveness cannot be ascertained.
I have always maintained that whereas many regular children require only coaching or even merely observation to learn new things, making autistic children learn represents a test of the therapist/trainer's analytical skills and thus true teaching.
QUOTE OF THE SEASON
"The world won't care about your self-esteem. The world will expect you to accomplish something before you feel good about yourself." - Charles Sykes on how children are growing up with excuses. (From his book Dumbing Down Our Kids.)
SOME EASY WAYS TO FOSTER INTELLECTUAL CURIOSITY
The students that excel in college, and eventually career, differ from others in one major aspect: they are curious about the world, events and people. In addition to good college and career, intellectual curiosity also helps to expand a child's interests and reduce boredom.
However, unless a child loves the History or Discovery channels, or unless he/she is an avid reader of good magazines or newspapers, fostering intellectual curiosity in the TV/electronic/sportsman age is an uphill battle. Kids nowadays do not want to ponder or 'intellectualize' about anything but prefer impulsive actions and fast results, thereby fostering symptoms of ADD/ADHD instead.
A child with limited interests is a child more susceptible to depression and harder to motivate to achieve.
So what is there to do to combat these patches of intellectual wasteland? Some of the answers are surprisingly simple:.
1. Make use of 'trapped situations. Too busy to set aside a talk session or outing? No problem. Not having time to play with your kids is not as serious as you thought. (Remember the poor immigrant parents who worked day and night but their kids still excelled?) There are always routines in the course of the day when you have to be with them, like driving to and from school, taking him/her to the mall, grocery shopping. Of course, I have worked with parents that are so busy or that their kids have so successfully avoided them that they can only 'pass by' each other at home. Then it is tough going for intellectual curiosity and sharing of ideas!
2. Eat together - no buffet, self-help meals, and ideally, no TV dinner. My motto: the family that eats together stay together. Depending on your cooking, dinnertime is likely a pleasant and relaxing affair. Conversations associated with this time have a better chance of being heard and attended to.
3. Do household chores together. Have your kids cook and/or wash the dishes with you, mow the lawn or wash the cars together. The latter, asides from being good physical exercises, also give children a sense of belonging and responsibility to their home.
Plenty of conversations about current events, friends, movies seen, literature read, finances, etc. can occur during these times (in addition to "How was your day at school?"). From there, children might gradually foster a curiosity about the world, history, arts and most important, people, and might even develop an interest to read about things extra to their teachers' assigned readings!
RITALIN, DEXADRINE FOR ADD/HD? THINK TWICE!
There are finally worrisome realizations that, in addition to producing little long-term benefits, the drugs used to treat ADD and ADHD can have dangerous heart risks for children and adults. In February of 2006, an FDA advisory panel looked at the existing studies and data and listened to the FDA’s own medical officers’ presentations that contained dire warnings. And instead of recommending further research, the panel feels the risks are so great that it immediately recommends the strongest warning label (the ‘black box’) be used for Ritalin, Dexedrine, Adderall, Concerta and other drugs in the same class.
The risks are serious: these drugs can increase blood pressures that could lead to strokes, heart attacks. Canada recently banned Concerta after 24 deaths were reported. The FDA’s own reviews showed 25 sudden deaths, mostly children. (Keep in mind that FDA receives only a fraction of reported problems annually.)
According to the FDA’s own Medical Officers, these drugs can elevate blood pressures, and high blood pressure has been clearly proven to be linked directly to deaths from heart problems. Furthermore, these stimulants have similar chemical structures to ephedrine, which is known to increase heart risk.
Thus, the drugs are not only expensive, ineffective, but also dangerous. As discussed elsewhere in this website, a skill-deficiency, behavioral approach still remains the best and safest treatment.
STARTING THE SCHOOL DAY EARLY IS BAD FOR LEARNING
School used to start at 8:30 a.m. for me in elementary school, and 9 a.m. for high school. So when I first came to this country, I was shocked to see kids go to school at 8 a.m. I thought it was un-Godly hour, especially in the dead of winter.
Then school began to start even earlier. It is now not uncommon for high schools to start at 7 a.m., and saying "Good night" means 2:45 p.m. Many teachers have grown to like the idea that they have practically half the afternoon and evening off. Pities are the parents and the students who have to get up before 6 a.m. to prepare for school. This also means that for all practical purpose, activities stop at 9 p.m.
This means that after-school sports, band practice, music lessons, Internet surfing, e-mail chatting and TV, as well as homework and studying for tests have all to be done before 9 p.m.
On the other hand, for reasons still unknown, the biological clock on sleep pattern of teenagers is pushed back to become more of the adults', that is, they like to stay later than 9:30 p.m. and get up later than 6 a.m. The result - they fight to stay up at night but wake up drowsy and go to school with sleep fatigue.
More of us are realizing that early school day is a significant factor for chronic fatique for many students (and their family). Some parents and health association have started to rebel. The Minnesota Medical Association warned school districts that early start is incompatible to students' body clock and bad for their health. In 1996, Minneapolis postponed their school start time from 7:15 to 8:40 a.m.
According to the National Sleep Foundation, school districts in 13 states rolled back their start time. One hopes this trend will expand.
- Prescription of psychotropic drugs (Ritalin, Dexadrene, Prozac, etc.) for children increased 100% in the 10 years from 1987 to 1996?
Also, twice as many boys as girls are given drugs?
To combat side effects such as insomnia or loss of appetite, many children are also given secondary drugs like Remorin or Clonidine. As a result, sales of these
drugs also augmented tremendously.
- Elite private schools send most of their students to elite private universities?
Of the 100 U.S. high schools sending the highest percentage of students to Harvard, Yale and Princeton, 94 of them are private schools -- with tuition ranging from
$7,800 to $29,650 a year, according to a study by Worth magazine.
- The teenage sexual revolution might be losing steam?
According to the Centers for Disea-se Control and Prevention, last year saw the first time that the number of high school students who
say they are virgins (54%) is more than those claimed to be non-virgins (46%).
Also, the percentage of students who used condoms has increased from 46.2 to 57.9 over a 10-year period. And last but not least, most sexual activities (70%) occurred in the teenagers' home after 6 p.m., contrary to the back-seat-of-the-car or drive-in myth!
BRIGHT FUTURE FOR SCIENCE MAJORS
For the students who are going to or are majoring in science, a good career is almost a sure thing. The 21st century is revving up techno-logies and demand for good scien-tists in the U.S. and the world will jump - from Internet Information to bio/medical research to environ-mental controls.
On the other hand, the number of students studying science in the past 20 years has been decreasing. Up till five years ago, the shortfall has been largely filled by foreign Ph.D.'s and scientists. But lately, as global competition for scientists heats up, more and more foreign science Ph.D.'s have decided to go back to their country or else-where after finishing their study. Countries such as Ireland, China, Brazil and England are luring scientists internationally.
Opportunities for science careers will accelerate. According to the National Science Foundation, jobs requiring scientific skills increased by 5% each year. But at the same time, many scientists trained dur-ing the baby boomer generation are retiring in the next 20 years, and many foreign trained scientists are being lured back home owing to concerns of terrorism and benefits enticement. As a result, acute shortages of sci-entists in our country are going to be inevitable. Thus, the next generation's science graduates can practically write their own jobs.
QUOTE OF THE SEASON (On Children's Reading Habit)
"Today, 13 and 17 year olds are much less likely to read for fun than they were in the early 80's. Also they are much less likely to see their parents reading in the home than they were in the 70's and 80's and further, they are much more likely to be watching 3 or more hours of television a day." -- Wayne Camara, vice president of research and development, the College Board.
PROGRAMMED KIDS WITH HECTIC SCHEDULES
Derek has been on the school foot-ball team since 9th grade. He prac-tices on Mondays and Wednesdays till 6 p.m. On Saturday mornings, he is driven to either more football prac-tice or the real game. Derek also works at Dairy Queen’s one week-day evening and on Sunday after-noons.
So whenever I call to schedule an appointment to see him and his mom, I get "I’ll let Derek call to let you know which day and time he can make it." - a sure sign of a pro-grammed teenager’s schedule so hectic and fast-paced that his parents can’t keep up.
Suzie belongs to the school marching band. She practices two days a week after school, and also performs on weekends. On Monday evenings and Friday afternoons she takes Karate. Recently, she convinced her mother to let her take guitar lessons. The only time slot they could find was Sunday afternoons. And Mom obliged.
This spring, the band took a field trip to Silicon Valley for three days, and Mom went with along. The trip cost $450, on top of the cost for new uniforms.
Suzie’s mom is her official chauffeur, logging in 160 miles a week, more with the occasional doctor’s or dental appointments . Her duties are occa-sionally relieved when another parent can drive Suzie to the event. And Suzie has an eight-year-old brother who is quickly following his sister‘s footsteps to participate in different after-school program.
We love our children and want the best for them. We want them to be athletic, we want them to be artistic, we want them to develop good work ethics, we want them to learn the value of money, we want them to learn team work, etc. In short, we want them to be well-rounded and
happy. That explains, of course, why we say yes to our children for extra-curricular programs and activities.
A study by Child Trends, a non-partisan research group in Washing-ton, found that about 82 percent of American children had participated in at least one extracurricular activity in 1999.
But somehow something is lost in the process. We became slaves to the schedule and the self- (or child-) imposed responsibilities. We drive hundreds of miles every week to take our children to events, a condition exasperated by suburban sprawl. (I remember the days I used to take a bus to violin lessons and to soccer games with my brother.)
The only time we get to have quality interaction is in the car on the way to an event. The sit-down family dinner is rare, still rarer is the leisurely sit-down family dinner with pleasant chatters.
The role of the parents slowly descends into that of the chauffeur and the treasurer (to pay). The children leads more and more
independent lives, to the point that we lost tracks. What is alarming is school and academic achievement get lost in the shuffle. Kids remember their baseball team scores better than their achievement test scores. They have to ‘squeeze’ studying in between events.
Hence the difficulty of scheduling appointments without checking with the children.
EXPENSIVE EDUCATIONAL TOYS -- WORTH IT?
Some parents may cringe at the notion of pricey electronics' becoming more popular than Play-Doh. But LeapFrog, which sells LeapPad at $50.00 and the LeapPad Pro (for children ages 7 and 8) at $64.99 a pop, is jumping high. Supported by its parent company, Knowledge Universe, LeapFrog spends lavishly on television commercials (paid for in part by your $50 purchase).
Like Hook-on-Phonics, toys now have great appeal to parents if they can be linked, however remotely, to the E word -- Educational.
It is true that many of the educational toys like LeapPad, the Piccolo Touch and Talk Interactive Discovery Center can do two things: provide both a visual and an auditory stimuli. So if a child sees and touches the picture of a truck, and he can also hear the word "truck". . They are thus multi-sensory. The assumption is that by seeing, touching and hearing a word simultaneously, children will get a head-start in learning to read.
On a superficial level, this multi-sensory approach to learn seems to make sense. But learning theories say otherwise. The extra senses that are supposed to aid learning might actually distract. Think about learning to read music with little frogs attached to the notes. The frog’s hopping up and down is supposed to help a child remember how far the notes go up and down. Yet the child may be so fascinated (distracted) by the cute frogs that he does not focus on the real cues for this learning - the five lines of the staff. What I am saying is - multi-sensory learning might distract rather than focus.
No wonder a NY Times article on educational toys concluded, "while the word "educational" may be splashed across their packaging, no broad studies have been done to assess whether these toys actually teach anything, something even the manufacturers acknowledge."
GOOD READING SKILLS FOR GOOD HEALTH
With the advent of technology and e-commerce, many families now view getting on the ’Net’ as part of daily life. And much more information is now presented through the Internet. That includes information about children’s health care, and effects and side effects of children’s drug.
America, while being the richest nation on earth, also has the dubious distinction of having half of their adults reading only at 8th grade level. For this unfortunate half, read-ing and understanding the written information presented on various website is a haphazard, often amounting to a guessing game.
In a study published in the Archives of Pediatrics and Adolescent Medicine, researchers from Iowa University found that most Websites containing health information for children are written near the 12th grade level. And this spells trouble for the barely literate person. He either finds the information incomprehensible, or worse, misunderstands it and forms erroneous conclusions.
The need for literacy has never been more acute as more and more written information is conveyed to people’s home through the Internet. We can download complicated written materials that used to be available only to professionals, like law codes and statutes, financial and stock analyses, even manuals on making bombs, and of course literature on health and diseases.
One researcher of the study suggested that health Websites be rewritten at lower-grade levels. But the complex nature of the subject matters like diagnoses and prognoses, or law cases, cannot be fully described at 8th grade language. Rather than diluting the information and adulterating the subject matter, we should raise reading comprehension level of our citizens.
DO VIOLENT VIDEO GAMES MAKE LESS VIOLENT KIDS?
Common sense often loses out in the face of systematic research. Witness the whole language approach, or the no chemical, no food additive diets. Here comes the latest.
Contrary to popular belief and opinions of many progressive educators, violent video games appear to have not even a correlation with, less be a cause for, increased teen violence. According to the New York Times, juvenile homicides, the most violent crime category, had been increasing until 1993, when violent games Mortal Kombat and Dome (the one favored by the Columbine teenage murders) made their debut. Since then, teen violence crimes have actually decreased! "Juvenile murder charges dropped by about two-thirds from 1993 to the end of the decade and show no signs of going back up. The rate of violence in schools hasn’t increased, either -- it just gets more media coverage.", asserts Lawrence Sherman, a criminologist at the University of Pennsylvania, in a New York Times Magazine article.
Violent games or stories, seem to lie mainly in the domain of male interests and fantasies. Thus, despite all the liberal efforts to equalize activities and opportunities between the sexes, boys are still boys and girls are still girls. Surveys show few girls get interested in Mortal Kombat, and few boys in Barbie.
Indeed, playing or reading or seeing violent media seem to be a fantasy and release valve for males, not unlike car racing or bungee jumping. Henry Jenkins, Director of Media Studies at MIT, goes so far as to argue that these games are the modern day answers to the old fantasies of Treasure Island, Huck Finn that used to be loved by boys.
Actual violent acts are probably controlled more by an individual’s own socioeconomic environment and life history than vicarious modeling of violent games or stories.
- Nearly 6 million American children receive special education instruction and services at a cost of
almost $40 billion? And about $5.7 billion of which is federal money?
- According to the New York Times, home schooling is gaining more favor of traditional families. The reasons - parents worry that their kids are not getting enough individual attention in school or are excelling faster than their peers.
- About 10% of college freshmen want to become teachers in 1998. This is almost double the percentage in 1982. At the same time, the number of college degrees granted in education increased by 31% from 1986 to 1996. Although the percentage is higher, the real total is still dismal. Princeton saw a 500% increase in students enrolled in its teacher preparation program since 1990; in real number terms, it went from 5 to 25 students.
- According to the Center for Media Education, a nonprofit group in Washington, an average child "will witness more than 100,000 acts of violence on TV, including 8,000 murders" by the time he completes elementary school. The numbers double by the end of high school.
- The Center for Media Education says by the age of 21 the average viewer sees a million commercials, including 100,000 ads for alcohol? "Children see at least an hour of commercials for every five hours of programs they watch on commercial TV," it noted, adding that most children under 6 don't even know they're being sold something when they watch commercials.
- The Los Angeles Times asserts that “math is the biggest barrier to student achievement”? The lack of math skills surface most acutely in students enrolled in community colleges. About 47% fail their math classes. Only 4% achieve college level math on placement testing, the gateway to eventual transfer to university science and medicine programs.
- The American Management Association said a survey of 1,000 U.S. personnel executives shows that more than a third of the nation's job seekers lack the basic math and reading skills needed to do their jobs, up from 19 percent three years ago.
But at the same time, many special education
programs are sub- standard? And parents often
have to sue to improve the service?
- Patients often do not follow what the doctors ordered? And even with reminders, many still don’t?
Researchers from Ohio State University found that patients who received reminders encourag-ing them to take cholesterol-fighting prescriptions did so at about the same rate as others who were not reminded. In both cases, one in five reported not following the doctor's instructions.
- According to the LA Times, most preparation programs for elemen-tary teachers only require two basic math classes?.
An alternative route is to take a test that has 24 mostly arithmetic ques-tions and for which teachers can use a calculator?
(Thus the saying goes: "You can’t teach what you don’t know.")
- Prescription drug sale skyrocketed from 42.7 billion in 1991 to 111.3 billion dollars in 1999?
- In 1994, only 5% of households were wired with the internet and this year, half of households are online, but on the other hand, TV watching also averages seven hours and 11 minutes a day, 32 minutes more than in 1992? (NY Times, 11/3/00)
- After Florida Governor Jeb Bush (brother of George W.) abolished race-based admissions (Affirma- tive Action) to that State’s colleges last year, minority en- rollment actually increased 12 percent?
- If functional illiteracy is defined as an adult who cannot fill out an application form, read food labels, or a simple story to a child, then a third of Los Angeles County’s adults are functional illiterates?
- Children are getting fatter in all ages and in all income groups? Up until 1980, ‘only’ 6.5% of children age 6-11 were overweight, but by 1994, the figure jumped to 11.4%, meaning more than one in ten children was overweight, according to the National Center for Health Statistics.
HOW ‘SPECIAL’ IS SPECIAL EDUCATION ?
The intent of special education cannot be faulted. Some children, for a variety of reasons, don’t learn under the regular curriculum or environment.
There are, however, reasons why children might not be best served by special education programs. One is society’s tendency to over-diagnose. Each year new diagnostic labels are created by the Diagnostic and Statis- tical Manual of Mental Disorders (DSM) and in just 25 years, the number of labels doubled. That means extravagant gambling or shopping can now become a mental disorder. Previously rambunctious or forgetful children can now be ADD.
Indeed, the number of students receiving special services have tripled in ten years. Many children end up there because the move often creates a relief for the regular classroom teacher extra Federal funding for each special ed student with a diagnosis.
Another concern lies in the com- mon sense but risky perception that ‘special’means ‘quality’ or ‘effec- tive’. In reality, the teaching pro- cedure or materials used in special programs are often no more effec- tive than regular teaching. The ma- jor difference is quantity -- special ed. students get more individual attention, but also less classwork, homework and academic subjects.
Perhaps most devastating is the low expectation to learn once a student is in a 'special’ program. I have witnessed many a case in which a child capable of learning much more is held back after years of special education services. The student after a while developed a dependence on learning only with individual help, and excuse himself for not learning because of his ‘special’ status.
It is in large part due to these con- cern that the Individuals with Disa- bilities Education Act (IDEA) man- dates the requirement of educating ‘disabled students’ in the least restrictive (read most normal) envi- ronment (LRE) possible. The mandate requires the justification of why a student needs special educa- tion, and once in, why he/she needs to continue to receive it.
A good case in point is the whole- sale mainstreaming of Hispanic ESL, LED (Limited English Pro- ficiency) students from special bi- lingual programs to regular class- rooms in California because voters abolished all bilingual classes two years ago.
By law, while one school district can scrape the program altogether and put all ESL students into regu- lar classes, a sort of sink-or-swim process that could cause many liberal educators to crinch, another district can choose to give parents a waiver so that their child can continue in the special program.
This was exactly what happened to two districts located next to each other with very similar student populations and demographics. The Oceanside District abolished the special programs while neighboring Vista kept the status quo. The students achievements in these two districts thus provide interesting comparison.
And guess what? Oceanside’s mainstreamed ESL students im- proved much faster in English and also in math than Vista’s, accord- ing to a report by the normally liberal New York Times. Their second graders’ reading jumped from 13th to 32nd percentileand math from 27th to 41st percentile in standardized testing. “In nearly every grade, the increases in Oceanside were at least double those in Vista, which is similar in size and economic background to Oceanside,” the article reports. “Only in the 10th and 11th grades, in a reflection of the entrenched language
problems of teenage Spanish speakers statewide, were the increases below four percentage points.” - reflecting on the detrimental effects of prolonged confinement in the special program.
Thus, here is a case where thou- sands of students benefited from the abolition of a special program. So as the taxpayers!
BONUS FOR PERFORMANCE - Even Teachers Liked To Be Rewarded
California will reward the staff of several thousand schools that have improved student scores on standarddized tests. The teachers and ad- ministrators in these schools will each receive a bonus of about $800. In December, it will reward about 200 improving schools with even more dollars - from $5,000 to $25,000 per teacher and administrator. So giving reward for a job well done, an idea that not too long ago was unthinkable for public educa- tion, has finally arrived. The trend is inevitable. The idea is in line with the principle of reinforcement, which has been successfully appli- ed to children, businesses, and industires.
THE PATHOLOGIZING OF BEHAVIORS
As the American Psychiatric Asso- ciation has recently ordained new entries into the diagnostic bible, the DSM IV, many previously undesir- able social behaviors are now ‘pathologized’. These include Compulsive Shopper, Pathological Gambling, Social Phobia, and Post Traumatic Stress Disorder.
The tendency towards clinical diagnosis is partly responsible for the soaring number of ADD/ADHD children.
THE SMALL CLASS MYTH
I have always doubted a smaller class size in itself can improve student learning, as it is well known that countries which beat us on student achievement have much larger class sizes than ours.
After spending literally billions of dollars to cut class sizes from K-3 and pinning much hope for it, California has seen only marginal learning improvement but severe shortage of teachers, according to a comparison study conducted for the years1996 to 1998 by the Rand Corp., the American Institutes for Research and three other research organizations.
Specifically, 34% of 3rd graders in small classes of usually 20 scored above the national average in reading on last year's Stanford 9 exam, but 32% of large classes also did so last year. Thus the difference is merely 2%. Similarly, 36% of third-graders in reduced classes exceeded the national average in language arts, while 33% in larger classes did so. In math, 38% of the former exceeded the average, compared to 35% in larger classes.
For these two-to-three percentage points differences, the price tag was more than $4 billion!
It is interesting to note that the quantity and quality of instruction in smaller classes did not differ significantly from those in larger classes. The amount of individual attention did not increase much in small classes, and the curriculum content has not changed as well.
I have long maintained that classroom learning depends more on the curriculum content, the amount of classwork and homework, the length of academic classes, and last but not least, the social and familial emphasis of education and respect for the teacher. These factors characterize the education system in many Asian and European countries which have much larger classes than our large classes, but whose students consistently beat ours in academic comparisons. Take respect for teachers as an example, parents in these countries tend to fault their child when he/she did poorly on a test. The child might be scolded or reprimanded for not studying or listening to the teacher enough. But here, more often than not, the ‘blame’ is on the teacher.
Also, students in these countries receive much more assistance and monitoring after school on homework and exam preparation from their family or by private tutors.
Still, the idea of a small class lending more individual attention and easier classroom management, which in turn produces better learning, makes logical sense. One could look to the small-class experiment in Tennessee for support. It claims to have produced impressive gains for their primary-grade students.
It is possible that the meager improvement in California is the result of the initial restructuring shocks - suddenly, many more classrooms and teachers were needed as large classes were split up. In some schools, libraries or computer rooms double as classrooms. Also, teachers for elementary grades are now in hot demands. The last two years saw 23,500 new teachers, many of whom are rookies not experienced enough to manage student behaviors and group teaching.
Having spent $4 billion, the Governor and State officials consider the reform worth continuing and are prepared to stay on course. The State is prepared to spend another $700 million for construction and renovation for smaller class sizes.
I just wish this were not such an expensive experiment. In case the positive results aren't forthcoming, there could be more voter revolts.
PERIL OF BEHAVIORAL DRUGS RECOGNIZED AFTER COLUMBINE
It is heartening to see that a resolution recently passed by the Colorado Board of Education specifically “discourages teachers from recommending behavioral drugs like Ritalin and Luvox.” It urges teachers and other school personnel to “use discipline and instruction to overcome problem behavior in the classroom, rather than to encourage parents to put their children on drugs that are commonly prescribed for attention deficit and hyperactive disorders.”
This new sense of urgency came in part after the Columbine High School massacre, where one of the two student assailants was on Luvox, an anti-depressant. The other part came from the concern that some teachers and mental health professionals pressure parents to put their child on medication as a precondition to returning to class.
We quote Dr. Peter Breggin, director of the International Center for the Study of Psychiatry and Psychology, a nonprofit research organization in Bethesda, Md., “It's a tremendous mistake to subdue the behavior of children instead of tending to their needs. We're drugging them into submission rather than identifying and meeting the genuine needs of the family, the school and the community. It's wrong in principle."
In the mean time, more than 2.5 million children in the United States are using behavioral drugs, many without much careful evaluation and consideration of alternatives, such as life style, interests, energy level, learning disabilities, academic achievement levels, and the appropriateness of the school structure and curriculum.
IS IT ADD? ADHD? LD? -- EXPERTS CAN'T AGREE
According to the National Institutes of Health, Attention Deficit Disorder (ADD) is a "profound problem" that might affect as many as 5 percent of American school children. However, accurate diagnosis and effective treatment of ADD remain ‘elusive’, according to the Institute. The chairman of the panel in charge of examining the situation, Dr. David J. Kupfer, declares, "There is no current validated diagnostic test." Another member on the panel, Dr. Mark Vonnegut, says flatly, "The diagnosis is a mess!"
As for drug treatment like Ritalin, the long-term (taking the drug for at least 14 months) effects have never been examined, according to Dr. Kupfer.
Indeed, accurate and consistent diagnosis and treatment is problematic in dealing with many mental/learning afflictions such as dyslexia, learning disabilities (LD), emotional handicaps, and now ADD and ADHD. The reasons are several. First, unlike medical diagnoses, where the cause and locations of the symptoms can be seen and/or measured (e.g., an infection), the cause of a learning disability is not. Thus, we don’t know exactly which part of the brain is defective and responsible for the hyperactivity or emotional out-bursts. Second, the symptom at issue is not exclusive but is rather on a continuum, meaning that normal people can at times be very active or have emotional outbursts. Thus, how active or how emotional before it is called ‘hyper’ or a ‘handicap’ is subject to personal interpretation.
Following the same vein, how inattentive a person must be before it is called a ‘deficit’ and then becoming a ‘disorder’ depends on which expert you see. Even the difference between ADD and ADHD is imprecise. The panel of experts in fact treat the two interchangeably.
When Dr. Vonnegut says that ADD kids “stick out like a sore thumb’, he is not talking about the quiet, dreamy type, but in fact includes hyperactivity as part of the diagnosis.
There is no doubt that lack of attention causes serious problems in learning and in executing daily activities. We are just beginning to realize how wide-spread and detrimental it could be. Numerous kids have problems following the ‘flow’ of the classroom, and unless talked to by the teacher in close range, they do not ‘take in’ what is said.
Others forget assignments or test dates, or lose finished assignments on the way to school. But Some adults could ostensibly overlook something that was encountered minutes before. Still some others could ‘freeze’ on an activity in mid-course and get into a daze. Still others are so ‘hyper’ that their hands have to constantly doodle or play with things.
Under the current mess of diagnosis and treatment, the best tactic is to evaluate each presented problem thoroughly, logically and most importantly, without pre-conceived notions of diagnostic classification. One must recognize that there are no standard treatments for standard diagnoses. Instead, the treatment must be personalized and tailored to the learning style, intellectual functioning, and personality of the afflicted person.
Biofeedback and medication have at times been known to create general, non-specific improvement for some people by ‘tuning up’ or ‘toning down’ the brain. But in the long run, the ADD/ADHD person, the LD person, or the simply disorganized person would still need to be taught the right kinds of skills and use them consistently in order to achieve the desired goal.
Hence, treatments that emphasize the acquisition of learning strategies and pragmatic skills achieve the best results - such as training in behavioral focusing, study habit, study skills, time management, information processing, organization, and listening/ focusing skills. Often times systematic tutoring gets immediate results also.
An article published by UCLA Healthcare illustrates the confusion of the terms. The article’s title is “New Data on Hyperactivity”, but the content refers exclusively to ADHD children, thus treating hyperactivity and ADHD as synonymous terms. And as I have always contended, the first alarm signal for many parents to seek professional guidance comes from their ADHD child’s poor grades and behaviors at school.
Indeed, the article describes ADHD children as “unable to sit still and pay attention in class; many of these children are aggressive with others and defiant with adults. As a result, they often suffer from significant academic and social difficulties.” I can already see protests from some parents and professionals on the use of the adjectives “aggressive” and “defiant” on their ADHD child. But “academic and social difficulties” are pretty much universal to children diagnosed as ADHD or ADD.
If we follow this reasoning, then any treatment effectiveness should be measured by improved academic and social performance. In other words, how can we tell a treatment is working? - Ultimately by the child getting better grades, doing tasks independently and well, following teacher instructions and interacting appropriately with peers and family. The UCLA article describes a treatment using Ritalin under “structured medical management with frequent follow-up is the most effective (treatment) for the symptoms of ADHD: hyperactivity, impulsivity and inattention.”
As to the initial and perhaps more important symptoms of poor grades and interactions, it cited Dr. James McGough, UCLA child and adolescent psychiatrist, “Still, if a child has a learning disability, or if he or she is performing below expected potential or has difficulty making friends, special tutors or psychological counseling can help.”
Thus, the article carefully makes it clear that Ritalin deals with the hyperactive, impulsive and inattentive behaviors but not learning, study habits and social adjustment. For these deficits, therapy using a skill-building approach is the key - from the training of study skills, study habits, motivation, time-management, to academic knowledge of reading, writing and math. The underlying assumption we adopt is that many of the symptoms of ADHD - the inattention, the dreaming in class (not at home), the forgetfulness, the defiance - are related to special learning disabilities, or lack of skills and motivation. As these elements are successfully treated, the ADHD symptoms often disappear and school performance improves.
The article also reports that ADHD has become the most commonly diagnosed behavior disorders, comprising 3 to 5 percent of school-aged children in the U.S.