504, EXECUTIVE FUNCTION, BEHAVIOR, IEP, ADHD, ACCOMMODATIONS, SPECIAL EDUCATION, EDUCATIONAL EVALUATION
Practically every day in my IEP/504 Assistance Facebook group, I speak to the impacts of executive functioning in the educational environment. I think it is one of the least-discussed topics in public education. Many people blow off the disability, Attention Deficit Hyperactivity Disorder (ADHD), as being minor and something you can work with; however, that is not always the case!
As of 2016, according to the Center for Disease Control (CDC):
- Approximately 9.4% of children 2-17 years of age (6.1 million) had ever been diagnosed with ADHD, according to parent report in 2016. [Read key findings]
- Ages 2-5: Approximately 388,000 children
- Ages 6-11: Approximately 2.4 million children
- Ages 12-17: Approximately 3.3 million children
Parent report on ADHD diagnosis in previous years:
- The percent of children 4-17 years of age ever diagnosed with ADHD had previously increased, from 7.8% in 2003 to 9.5% in 2007 and to 11.0% in 2011-12. [Read key findings]
- The number of young children (ages 2-5) who had ADHD at the time of the survey increased by more than 50% from the 2007-2008 survey to the 2011-12 survey. [Read key findings]
The CDC goes on to report:
How many children with ADHD have another disorder? Attention-Deficit/Hyperactivity Disorder (ADHD) often occurs with other disorders and conditions.
In 2016, among U.S. children ages 2-17 years parents report:
- Nearly 2 of 3 children with current ADHD had at least one other mental, emotional, or behavioral disorder. [Read article]
- About 1 out of 2 children with ADHD had a behavior or conduct problem.
- About 1 out of 3 children with ADHD had anxiety.
- Other conditions affecting children with ADHD: depression, autism spectrum disorder, and Tourette Syndrome.
The guidance from the federal government’s Office of Civil Rights called Parent and Educator Resource Guide to Section 504 in Public Elementary and Secondary Schools is a great resource for those who have a Section 504 from the school for ADHD. If your child is only in need of accommodations, and maybe a bit of occupational therapy (OT) therapy with no associated goals, this can be covered under a Section 504. A 504 can be a great document to get in place for two reasons. One is, by accepting a 504, your child CAN be given Speech and/or Occupational Therapy. I don’t know how many times I hear a child cannot just get OT service on an IEP; however, you CAN on a 504. You can get accommodations and speech and/or occupational therapy. You can find the information in the guidance [see pg. 24]. The second important reason is it gives your child the rights to FAPE. This will give you a stepping stone to ask for an IEP if your child is not doing well in school after getting their 504.
All qualified persons with disabilities within the jurisdiction of a school district are entitled to a free appropriate public education (FAPE). The Section 504 regulation defines a person with a disability as “any person who: (i) has a physical or mental impairment which substantially limits one or more major life activities, (ii) has a record of such an impairment, or (iii) is regarded as having such an impairment.”
For elementary and secondary education programs, a qualified person with a disability is a person with a disability who is:
- of an age during which it is mandatory under state law to provide such services to persons with disabilities;
- of an age during which persons without disabilities are provided such services; or
- entitled to receive a free appropriate public education under the Individuals with Disabilities Education Act (IDEA).
What happens when a Section 504 is not enough?
If your child is still not doing well in school using the accommodations and supplemental aides and services in their Section 504 plan you may need to ask for testing, or new testing, for an Individualized Educational Plan (IEP). Guidance concerning Section 504 (pg. 12 and beyond) makes it very clear that schools cannot ignore a parents written request for testing and the school should evaluate students to determine if an IEP is needed.
Children with ADHD tend to suffer from many of the same impairments since ADHD is a neurological-based disability. This means that I can predict some possible learning issues with your child JUST because they have ADHD based on current peer-reviewed journal articles. If you are going to request the school complete testing (if the most recent comprehensive testing was less than a year old), or if you are going to ask for an Independent Educational Evaluation (IEE) here are some of the areas you will want evaluated…
Short-term auditory memory impairment, sometimes processing speed and (general) working memory problems, executive functioning impairment (hallmark of ADHD), visual-spatial and/or visual-motor integration impairment, fine motor skills impairment (visual-spatial dysgraphia along with the inability to organize their thoughts in their head to write paragraphs or longer essays), impairment in math [(dyscalculia) missing signs in math (add, subtract, divide, and multiply) and not being able to learn math facts)], impairments in reading (not dyslexia but an impairment with working memory and executive functioning), and anxiety, depression, behavior, social difficulties, and sensory issues. There are less commonly reported issues that are noticeable like time distortion (which impacts planning and organization), sleeplessness, issues with dehydration, increased risk of suicide, Obsessive Compulsive Disorder (OCD), Disruptive Mood Dysregulation Disorder (DMDD), Fetal Alcohol Syndrome (FASD), hoarding, Autism Spectrum Disorder, Tourette Syndrome, childhood trauma, being a preemie, epilepsy, other psychiatric disorders.
As you can see, there are a lot of co-morbid, or co-occurring, conditions with ADHD. You can also see why a child with ADHD could STILL be impacted in the educational environment; especially if they are not properly supported! With this many known, co-occurring conditions, it really bothers me when people blow off ADHD as no big deal OR that you can simply treat ADHD with some medication and all the problems go away. ADHD symptoms can be treated with medication but that does not necessarily resolve issues in the educational environment nor does that guarantee that the psychotropic medications won’t cause severe side effects like hallucinations and/or increased risk of suicide.
I am not a medical doctor, and I cannot dispense medical advice. I can only give suggestions of things to try based on my own experiences dealing with family members with ADHD along with the collective knowledge I have learned in my Facebook groups and the research I read for my FB groups. For children with ADHD, try natural remedies, first, before moving on psychotropic medications unless the symptoms are putting the child, or others, at risk of harm/danger. Start with the diet! I know, I know, many people do not think diet can impact you; yet, science is starting to say otherwise as new research comes out concerning the gut-brain axis. ADHD is a condition that can be greatly impacted by nutrition. For more reading on this topic see my blog post on Food Coloring and ADHD: What you need to know. It was interesting post to research! I did not believe the impact of diet myself until I started on the ketogenic diet. [I have a keto group on Facebook called Going Keto and Getting Healthy that you are welcome to join.] I keep my children on a low-carb and low-amount-of-processed-foods diet. I have noticed a HUGE difference in my husband with ADHD on the ketogenic diet. He has a lot more anger control, more impulsivity control, and is better able to concentrate. I see these same things in my kids but to a lesser degree. I think that is because I do not have them on a strict ketogenic diet and they are younger (less EF control due to lack of maturity of the frontal lobe). So please consider diet as the first tier intervention to try if you are experiencing behavior issues in your child with ADHD.
After trying to modify the child’s diet look for help with executive functioning coaching, cognitive training, or cognitive therapy to increase executive functioning. Executive functioning coaching can be done by the school though IEP goals. The IEP team, along with the help of the parent (who is part of the IEP team), can develop IEP goals to teach a child HOW to develop executive functioning (EF) strategies/control. You can work on EF skills at home. I found the book Smart But Scattered to be quite helpful in understanding my ADHD family. With the help of the book I was able to start using strategies to give my children support to enable them to develop their Executive Function control. Their private (medical) occupational therapist started to work with the children on the Zones of Regulation which helps them identify their emotions and gives children strategies to improve their self-regulation. You can also try a sensory diet. This approach is also commonly seen in schools so a school should not have an issue trying to use a sensory diet to help a child self-regulate.
If you need, or want to try, medications for ADHD please make sure you read ALL the adverse side-effects BEFORE you give your child the medication. To research the side effects of a medication, I highly recommend Drugs. com. I think they really help make reading all the drug interactions and side-effects clear and simple to understand.
Don’t forget to try some simple things to increase executive functioning control like exercise. It sounds so simple but many children with executive functioning problems can have their symptoms decreased by vigorous exercise. This is one reason it greatly upsets me when I hear from families in my IEP/504 Assistance say their child is being punished for misbehavior in school by havingtheir recess taken away. Recess gives children with ADHD some sensory input, a chance to burn off excess energy, and an opportunity to learn socialskills.
It is hard to encompass ALL the areas that ADHD impacts in a child or even try to round up all the impacts that occur due to a child having an ADHD impairment. I hope this blog post helps shed some light on the most prominent areas that are impacted by ADHD. All research for this article is embedded into the article’s hyperlinks. There are a LOT of hyperlinks in the post. I hope you take time to review the information!
You are welcome to join us for more discussion on ADHD and/or executive function disorder at our FB groups, IEP/504 Assistance for parents of public school students from all over the United States, or at our homeschool group, Homeschooling Special (Needs) Kids. We also have a group for all parents and caregivers of special needs children called Special Needs Parenting Advice and Support where we discuss ALL things related to special needs care and Educating Gifted Children is where we discuss topics concerning gifted children and those that are twice exceptional (2e). I hope to see you there!
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