What are Specific Learning Difficulties and Attention Deficit Hyperactivity Disorder?

Specific Learning Difficulties (SLD) and Attention Deficit Hyperactivity Disorder (ADHD) are neurobiological disorders that affect children worldwide.  Dyslexia, a relatively common SLD, is characterized by unexpected difficulty in reading.  This difficulty in reading is unexpected because the student has the intelligence and motivation needed to succeed.  Overall, approximately 5 – 10% of students in the world have a Specific Learning Difficulty.

Students with Specific Learning Difficulties may or may not have ADHD.  Significant and unexpected levels of inattention or hyperactive/impulsive behavior characterize ADHD.  A student may also have difficulties with both areas: inattention and hyperactivity/impulsivity.   In 2007, G. Polanczyk, MD, PhD, and his colleagues conducted a review and meta-analysis of 9,105 records and 303 full-text articles (The worldwide prevalence of ADHD: A systematic review and meta-regression analysis. The American Journal of Psychiatry, 164(6), 942-8).  The study revealed that the worldwide prevalence of ADHD is 5.29%.  Given these statistics, every classroom in Hong Kong has students with SLD and/or ADHD.  In a class of 30 students, approximately two or three of them have these difficulties. 

 

Isn't it normal for children to be hyperactive and easily distractible? What makes this a disorder?

It's true that young children are more hyperactive, more easily distractible, and misbehave more frequently than older children or adults. This is a normal part of growing up. As the AD/HD criteria state, a disorder may be present when the behaviors are significantly different from other children of the same age. 

 

How do I know if all of my child's learning and behaviour problems are caused by AD/HD? Could he/she have other problems as well?

 

This is an important question. Up to 65% of children with AD/HD may have another disorder as well. Fifty percent of children with AD/HD have co-existing Specific Learning Disabilities. Forty percent may have Oppositional Defiant Disorder, a syndrome in which a child is resistant to authority. Twenty percent may have a mood disorder, such as anxiety or depression. Another twenty percent may have Conduct Disorder, a disorder in which a child disregards the law. Seven to ten percent may have Tourette's syndrome, a disorder in which a child has "tics" in which he/she involuntarily moves or speaks.

 

What do these students need?

Students with SLD and ADHD face many challenges in the educational environment.  These students are intelligent; indeed, most have average to above average cognitive ability.  However, neurobiological differences often make learning very difficult.  The student with a Specific Learning Difficulty needs early intervention from his/her teacher that is research-based, along with direct, explicit instruction and opportunities for repeated practice.  The student with ADHD may demonstrate behavior that interferes with learning and social skills.  To ensure educational success, these students need teachers that are skilled in developing a specific educational plan that reinforces appropriate behavior, and allows for accommodations within the classroom.

 

Can adults have AD/HD? Is medication an appropriate treatment?

Yes, as many as 60% of those diagnosed with AD/HD as children will carry the diagnosis into adulthood. Over 75% of adults with AD/HD will benefit from medication.

 

What resources are already available in Hong Kong?

The Education Department Bureau (EDB) recognizes that Specific Learning Difficulties and Attention Deficit Hyperactivity Disorder exist, and is working to address these students’ needs at school.  The English Schools Foundation (ESF) offers in-class support to students with mild difficulties at their government subsidized schools.  Some students with SLD and ADHD need higher levels of support, such as small group instruction and classroom accommodations.  For them, the ESF offers learning support from specialized teachers, within the mainstream school setting.  However, there are long waiting lists to secure a spot in which one will receive learning support, and only designated ESF schools offer this learning support. 

The international schools of Hong Kong, which are not subsidized by the government, vary in the amount of support they offer students with Specific Learning Difficulties and ADHD.  It ranges from very little support to a few teachers serving a large school population.  The international schools have long waiting lists in most cases, and often limit the number of SLD and ADHD students they accept.  In both ESF and international schools, the majority of the responsibility for educating students with learning differences falls on the classroom teacher.   

Some external resources in the community are available to help these students, their parents, and their teachers.  There are psychologists that can diagnose the difficulties and consult with the school team.  In addition, there are some opportunities for teacher professional development, such as the quarterly lecture series at the Hong Kong Institute of Education or workshops through F.O.C.U.S.  Students have very few options for supplemental reading instruction, and there are currently no classes to address their specific learning and behavioral difficulties.

 

What resources are needed to meet the needs of SLD and ADHD students and their teachers?

In order to ensure educational success for these students, two areas of need must be addressed.  First, we must directly instruct the student with SLD and/or ADHD, with the goal of improving his/her academic skills and behavior.  This instruction should be supplemental in nature, complimenting the instruction given at school.   Research states that this instruction must be direct and explicit, and be delivered in a small group setting.  There must also be opportunities for practice and feedback. 

Second, teachers must be given opportunities for professional development.  By educating teachers about these difficulties and how to address them, a sustainable model begins to develop.  The education the teacher receives will impact her/his ability to create educational success for many students over the years s/he teaches.

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