Saturday 25 November 2017

Is there a special need or not?

Are children with ADHD and Asperger syndrome just suffering from 'Low Frustration Threshold'? If so, perhaps they don't really need special needs help in school

Shane Dunphy

'Michael'* is a teacher in a school that has been designated as 'socio-economically challenged'. Some years back the school received clearance for a certain number of special needs assistants (SNAs). "We had kids with ADHD (Attention Deficit Hyper-Activity Disorder), with Asperger syndrome and with all sorts of problems. The SNAs were a godsend."

Recently, however, Michael's school was visited by a psychologist from the Department of Education. "It was hard to read between the lines of what was being said, but our interpretation was that cuts are coming down the line," Michael says, clearly angry.

"We were informed that a huge number of the existing diagnoses of ADHD, not just in our school but across the board, are incorrect, and that these children are experiencing what the woman from the department called 'Low Frustration Threshold' syndrome. Such children do not need SNAs, apparently, and can simply be treated using behaviour-management techniques."

So these children are just bored, it seems, and should not pose any difficulty in the classroom if handled correctly. But 'Low Frustration Threshold' syndrome does not exist. Look it up -- you won't find it. I know, because I tried.

Tina Gilbert's* five-year-old daughter Mary* has been diagnosed with ADHD.


"When she was a baby, right from the very beginning, she was a crier. She is my only child, so I had no frame of reference. She was exhausting: she'd have what are referred to as 'blue fits' where she'd scream so hard she would forget to breathe, but I thought she was just highly strung.

"When she was diagnosed, it all suddenly made sense."

ADHD has become what some might call a 'fashionable' disorder. In my own experience of working with children with behavioural problems, I have found that parents are much happier when their child has been diagnosed with a 'condition'.

A mother will sleep much easier if she believes her child has some kind of chemical imbalance than if the problem lies in her child-rearing abilities.

This has caused a sea change in our attitudes. Children who, 50 years ago, would have been written off as simply willful, or just plain bold, are now joining the ever-widening ranks of youngsters who are being labelled with a range of various intellectual, psychological and chemical imbalances. "Our approach towards children's learning and general experience in the classroom has changed a lot," Michael agrees. "There is no such thing as a bold child any more, and no such thing as a stupid child, and, ideally, no such thing as an anti-social child.

"We now have ADHD, dyslexia and Asperger syndrome. Don't get me wrong," Michael adds, "I do believe these are real conditions."

Tina explains ADHD: "What it means, very simply, is that the bits of our systems which govern energy and keep us active are all messed up. Most people have a cut-off system, a sort of natural alarm that goes off when it's time to stop, to wind down. My daughter doesn't have one of those."

Children with the disorder are also incapable of focussing on activities, particularly those which involve remaining seated in one spot for even short periods of time. This can make them highly disruptive in a classroom situation.

Some therapists attempt to treat ADHD through diet and behaviour-management techniques. It has long been suggested that the root of the aggression and frenzy is an inability to cope with certain chemicals present in foods and not just processed ones.

Children with ADHD will often experience high levels of anxiety after eating tomatoes or oranges, cheese or potatoes. I once worked with a child who would climb the walls after drinking apple juice.

The trouble for many parents is finding the food -- or combination of foods -- which cause the problem. There are practitioners -- most of whom are utter quacks with questionable qualifications -- who will offer (at a hefty price) to do a barrage of dietary tests on troubled children. Such tests produce very mixed results.

Another issue is exercise. "Children are so sedentary, and spend such vast bulks of time watching dumbed-down television and playing computer games, it is hardly any wonder they find it difficult to cope in a classroom situation," Michael says.


"Television works, at most, in blocks of 15 minutes duration, after which there is an ad break, where information is further divided into chunks of about a minute. A half-hour lesson of focussed activity can be a real challenge for many kids."

The easiest option for parents of difficult children -- far easier than consistently denying sweets or insisting on an hour of exercise every evening and dealing with the consequences -- is Ritalin.

Ritalin is referred to by many parents of 'problem' children as 'valium for kids'. Its main job is to increase production of dopamine, a neural transmitter, thereby increasing the levels and quality of information the child with ADHD is experiencing, aiding concentration and the duration of periods of attention.

The drug can, however, have side-effects: bed-wetting, periods of vacancy (children literally shut off, like a computer going into sleep mode), weight gain and depression. Some parents report that their child's personality changes totally.

"All those things are true," Tina nods enthusiastically when I list off the above symptoms. "But when Mary took Ritalin, it was like someone had hit a button, and switched the behaviour off. I kicked myself that I hadn't tried it before."

Mary started school this year. Her class has a teacher and two SNAs. Tina had hoped that Mary would have an SNA attached to her, but found out that things were not so simple.

"Mary's diagnosis is from a fully qualified, certified and experienced child psychologist. When I visited the school to meet the principal shortly before Mary was to start, I was informed that the diagnosis I had was not recognised by the Department of Education.

"I would have to have Mary reassessed by a psychologist from NEPS. I had no problem with this -- another psychologist might have a new perspective. I asked the principal how I might set up an appointment. She looked embarrassed, and told me it could take some time."

Paula McEvoy is involved in a support group for parents of children with special educational needs. Her child has Asperger syndrome, a high-functioning form of autism.


"NEPS is the National Educational Psychological Service," Paula tells me. "It is not uncommon for parents to be waiting two years and more to get an assessment for their children.

"Teachers are struggling to work with classes where children just cannot learn. SNAs try to spread themselves across five and six children per room who need help, and parents will try to be available at lunch and break times to offer an extra hand on yard duty, where problems can occur.

"I speak to parents who are at their wits' end, feeling that their child is basically being denied an education. It makes you very cynical, and very selfish. You'll do whatever you can for your own child, and to hell with anyone else's."

As the dreaded recession progresses unabated, it looks like children with special needs are going to be a target.

On the issue, the Department of Education had this to say: "The review of numbers in terms of special needs assistants is ongoing. There are certainly differing attitudes towards disorders like ADHD, but exactly what cuts are coming down the line in the Budget, or anywhere else, have not been decided yet."

An educational psychologist I spoke to was more candid. "There is a strong belief within certain circles that problems like ADHD just don't exist. They have become catch-all phrases used to describe a range of behavioural and emotional problems that could be better dealt with through a process of re-educating parents on everything from proactive, positive parenting practices to dietary requirements.

"SNAs cost a lot of money. If their numbers were reduced and they were simply catering for children with, for example, physical disabilities, expenditure would be greatly lessened. And you would be cutting public sector spending in one fell swoop."

"It all comes down to the issue of visible and invisible disability," Paula says. "Asperger syndrome or ADHD -- these are very, very real conditions, which can destroy a family if proper support is not given. To suggest that they do not exist is sickening and frightening."

* Not their real names

Shane Dunphy is a child protection expert and author

Irish Independent

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