Checking out Coursera – ADHD Class – Week 2

Week two the Coursera class on ADHD Through the Lifespan taught by Dr. Anthony L. Rostain, M.D., M.A. of the University of Pennsylvania is focusing on the causes of ADHD. The lecture was well put together and very informative. The reading is from Brain Facts, a free publication from the Society for Neuroscience.

I am getting more enthusiastic about the course now that we are starting to tackle some of the science of ADHD. Although diagnosing ADHD can be an exercise in subjective opinion more that unbiased reality, ADHD does have a biological basis. The problem is that it is a complex genetic disorder where various factors alter the neural pathways. It doesn’t follow simple Mendelian inheritance rules although it is one of the most inheritable psychiatric diagnoses. The mean heritability of ADHD is 0.75 this is almost the same as the mean heritability of height and greater than the heritability of asthma, high blood pressure, breast cancer, or alcoholism. As an aside, autistic-like traits are 0.82-0.87 inherited which is something to keep in mind with the increase in autism diagnoses over the last 10 years.

The best data tells us that 65-75% of ADHD is due to genetics and 25-35% is due to acquired central nervous system injuries. If a parent has ADHD, their child has a 40-54% chance of having ADHD. The chance of a child being diagnosed with ADHD skyrockets when both a genetic factor and an environmental factor are both present. Specific genes associated with ADHD are serotonin and dopamine receptors and transporters, and synaptosomal-associated protein 25. The different types of ADHD may be associated with different genotypes and specific ADHD medications may be more or less effective, depending on which genes are contributing to ADHD in a specific individual.

Taking all this together, I believe there are some strong implications for public policy and preventative parent education programs. For example, after heredity, the largest cause of ADHD is low birth rate. In fact, low birth rate by itself is associated with ADHD as much or more than fetal alcohol syndrome, lead exposure, and the mother smoking during pregnancy, combined. Parents with low birth weight children should be educated on ADHD while they are still in the hospital. They need to know that if one parent has ADHD and their child has a low birth weight, there is an increased likelihood that child may eventually be diagnosed with ADHD. They must also be given ideas and tools for how to help their child learn impulse control and organization skills.

It is interesting to note the increase in ADHD, especially in boys, seems to parallel the decrease in recess, walking to school, and physically active gym classes. We know that serotonin and dopamine are positively affected by exercise and exercise can alleviate ADHD symptoms. I am hoping that Dr. Rostain includes exercise as a treatment option. Many parents, especially of very young children with ADHD, are looking for ways to help their children without medication. Again, if parents are aware of the genetic+environment risk factors for ADHD, they will hopefully be more proactive in helping their kids get effective, regular exercise.

Just like with autism, early intervention and extra effort can lead to improved outcomes for individuals with ADHD. It seems it is far better to help kids proactively develop good habits and coping skills instead of letting untreated or acknowledged ADHD symptoms derail their academic and social lives.


Continuing Education

When I was growing up, I viewed continuing education as either non-credit classes for adults with extra time on their hands or very specific classes with continuing education units (CEU) required for professionals to maintain their licensure. Most adults had a definitive end to their serious education. Once they received a high school degree or completed a college degree program, they were basically done with formal education.

While most people continue to learn new things throughout their lives, syllabus-driven learning with specific reading assignments, due dates, and tests usually ends in their late teens or early 20s. This is unfortunate because it makes formal learning seem more and more daunting the older we get. When learning stops, it impacts the mobility, flexibility, and performance of individual workers. It also hurts our economy, especially in industries that are undergoing rapid change.

Better educated individuals have higher earnings and lower unemployment rates and the gap between the economic success of the highly educated vs the less educated is increasing. Given that most people will work into their 60s, it is increasingly unrealistic to think a few years of school will give them all the all the information they will need for the next 40 years. The job that you have in your 40s, may not even exist when you are in your 20s.

What does this mean for today’s children? We need to cultivate within them a joy of learning and the attitude that their education should never end. I believe that in the future, adults will almost seamlessly move from traditional college and university programs to online self-study and back again. Learning will be much more continuous and something that people choose to do to maximize their employability and because learning is fun.

Most people have had at least one negative school experience. Mine was freshman calculus. I barely passed and to this day, when I think about it I get a bit queasy. The information I was supposed to learn still seems just barely out of reach and it has made me wary of other educational challenges. At the time I took the class, there wasn’t a good way for me to go back and actually learn the material properly. I had my grade and it was time to move on to the next semester. True understanding never happened — making it impossible for me to continue to build knowledge, when the new information required a solid foundation of calculus. Gaps in education like these can build over time and can contribute to the stagnation of kids and adults alike. We as a nation need to look at  how we can improve education both during the traditional school years and throughout a lifetime.

For myself, I’m going to be checking out the Khan Academy precalculus and calculus classes to see if I can learn it again for the first time and continue my education.

Checking out Coursera – ADHD Class – Week 1

I am a huge proponent of online education. Especially in the K-12 years, online education can become one of the great equalizers — allowing all kids to learn at their natural pace. As I wrote yesterday, gifted low-income students may have the most to gain from quality, online classes.

Right now one of the complications with online education is it is difficult to figure out the quality, difficulty, and educational effectiveness of any given program. This is particularly true with the free online options. Three of the big players in the free online education game are Khan Academy, iTunes U, and Coursera. Over the last several months I’ve played around with subject matter in Khan Academy and iTunes U and now it is time to take an in-depth look at what Coursera has to offer.

Unlike Khan Academy and most classes and material in ITunes U, Coursera structures its courses as much as possible as true college classes. They have definitive start dates, end dates, quizzes, homework assignments, and online discussion forums for creating class-centered virtual communities.

I am taking a University of Pennsylvania class on ADHD Throughout the Lifespan taught by Dr. Anthony L. Rostain, M.D., M.A. Dr. Rostain is a Professor of Psychiatry and Pediatrics at the Perelman School of Medicine at the University of Pennsylvania.

Gifted children whose needs are not being met may be misdiagnosed as having ADHD. Within the gifted community, many parents and experts know that ADHD type behavior may actually be a gifted child in need of more intellectual stimulation, not, in fact ADHD. I’m taking the class to learn more about ADHD in general and to see whether this issue of misdiagnosis of gifted children is mentioned in general ADHD material. The course is 12 weeks long and started March 18th. They estimate the workload at an easy 2-4 hours a week.

Week 1:

Having watched and listened to numerous web videos throughout the years, the quality and ease of use of the Coursera lecture is quite solid. The slides are integrated into the video, easy to read and appear onscreen throughout the lecture in a larger window than the video of Dr. Rostain. Three or four times during the lecture, it stops for a quick quiz to make sure students are following the material. This week’s reading materials basically covered the same ground as the lecture. This week focused on the DSM-IV definition of ADHD and the statistics on how common it is in children and adults, males and females. Also covered was an overview of diagnosis and treatment.

Sadly, the only mention of IQ was that ADHD occurs equally across all levels of intelligence. ADHD is primarily diagnosed in children by adults who are observing and having to deal with the child’s behavior. Basically the child needs to exhibit 6 symptoms over 6 months to be diagnosed. Although this wasn’t at all covered in the class, a highly gifted student in a class with a teacher who is not aware of common gifted traits could easily be diagnosed with ADHD. Interestingly enough, when parents and teachers rate the same child for the prevalence of ADHD symptoms, no more than half the time do the parents and teachers agree. This can sometimes lead to teachers pressuring parents to medicate students to make them easier to handle in class. A highly gifted student in a completely inappropriate educational environment could be diagnosed with both ADHD and Oppositional Defiant Disorder. Yes, gifted kids can also have ADHD and other issues but any diagnosis of mental disorders should be put on hold until the educational environment is examined. The DSM-IV ADHD diagnostic criteria states that a diagnosis of ADHD cannot be made unless there is, “Clear evidence of interference with developmentally appropriate social, academic or occupational functioning.” If a regular classroom doesn’t meet the needs of the highly gifted student, then it is the classroom that is developmentally inappropriate, not the child’s behavior. Given how we have made kindergarten into the old second grade, perhaps the increasing numbers of boys being diagnosed with ADHD has to do with how we have changed their school environments, not impairments within their brains. I hope later lectures will get into this idea of developmentally inappropriate environments. Within the discussion groups there does seem to be interest in the overlap between giftedness and ADHD diagnosis.

Overall, I’m having fun with the class. It is nice to be on a schedule with other students across the country and the world. The quick quizzes while not rigorous do help focus attention on specific points within the lecture. We will see how this next week goes.


An Educational Paradigm Shift for Low-Income Gifted Students


We also had lots of parents, rich people who had computers, and who used to tell me, “You know my son, I think he’s gifted because, you know, he does wonderful things with computers and my daughter, oh surely she’s extra intelligent.”  I suddenly figured all the rich people are having these extraordinary gifted children. What did the poor do wrong?

Sugarta Mitra: Build a School in the Cloud
TEDTalks Education
Wednesday, February 27, 2013


In his TEDTalk Mr. Mitra is telling a story about his experiences teaching computer programming classes in New Delhi at a school located next to a slum. The story is wonderful and I highly recommend watching his entire talk. This one line stood out to me because in many ways it also applies to the state of gifted education in the US.

We live in a time of increased recognition of giftedness and ever expanding enrichment opportunities for gifted students. However, while gifted programs are enjoying more publicity, there is an increasing scarcity of high-quality school programs for both regular and gifted students.

Our free, public educational system is suffering from a combination of the effects of decreased funding, overall decreased teacher knowledge and talent (yes, there are still great teachers out there but they are more in the minority), administrative and state policies that emphases test scores over actual learning, and a mindset that locks innovation and creativity out of classrooms. Today’s classrooms might have more technology than a classroom from the 1950s yet the teachers generally use smart boards and computers the same way the 1950s teachers used their blackboards.

As long as our schools continue to use a top-down, rigid curriculum, lockstep, district micromanaged and dictated approach to teaching, our classes will remain inadequate to meet the needs of average and gifted students alike. Parents with resources make up for the gap between what their children have available in school and what they need to succeed as adults through enrichment activities. Gifted children lucky enough to be born into upper middle class families have huge advantages over gifted children in families that are less well off. They are generally sent to high quality preschool programs that prepare them to succeed in academic environments. Once in a K-12 school, they are more likely to benefit from free school programs for the gifted because their wealthier districts have better funding of gifted education and their parents made sure they were ready for the gifted screening tests — sometimes by hiring expensive private test prep companies. Outside of school they may be sent to academic camps, take private music lessons, have personal tutors and mentors, and through their parents’ connections, have access to knowledgeable, successful adults that serve as role models and inspire greatness.

Gifted children born into families that are struggling financially have fewer opportunities. By the time they graduate from high school they have had fewer enrichment experiences and, despite high test scores, they generally don’t even apply to top colleges.

For the first time in human history technology has made it possible to provide individualized education to the masses. Online educational courses such as Khan Academy, Aleks, Rosetta Stone and Coursera classes allow students to learn at their own pace. Students can soar ahead when they have an intuitive understanding of the subject matter or slow down when a particular concept is confusing. By allowing each student to work at their own pace and by freeing teacher time to work with students as individuals, these new educational programs can and should revolutionize our schools.

Teachers and districts need to back away from the explicit age-based and grade-based standards that many times dictate exactly what every teacher in every school in a district will be teaching each week of the school year. Mass testing should only happen one a year with explicitly limited prior prep time and all US public schools should use the same tests. This is already done with the Explore, the SAT, and the ACT. A similar, national test should be used in elementary schools and should be the only mass test students are subject to each year. Too much time is wasted these days prepping for high-stakes tests. Instead, we should use technology to flip the classroom. Flipped classrooms allow students to work at their own pace while giving instructors the technical tools to track students and target help exactly where it is needed most.

When all students are allowed to work at their own pace, yes, certain students may end up significantly above grade level in some classes and some may end up below official grade level. This is one of the reasons schools traditionally have rejected the idea of students being given a full curriculum which they can work through at their own pace. This is ridiculous. There have always been students who fall behind. That is why we spend billions of dollars on remedial education, special education, and No Child Left Behind. There have also been students that pull ahead, although we as a nation have not wanted to spend much helping those students reach their full potential. The big difference, it seems to me, is that with a flipped classroom, the students demonstrate their abilities and are in control instead of having the school define them as a special needs, average, or gifted student. One of the interesting things Mr. Khan has noticed is that in flipped classrooms the groups of “gifted” kids and the groups of “slow learners” are much more fluid than current educational policy would lead us to suspect. The same child that was noticeably ahead six weeks ago may have slowed down to wrap their head around a new concept and the child that a snapshot look said was clearly in the bottom of the class last month may now be racing ahead. Yes, there will still be students who are gifted and those who are below average. The basic reality of the bell curve won’t go away. What will hopefully go away is administrators and teachers locking down student potential based on pre-conceived notions, one-time test scores, and age.

We need a paradigm shift in our classrooms and educational policies. While we cannot eliminate the extracurricular advantages wealthy gifted students have over poor gifted students, we can and should equalize educational opportunities and experiences within our public schools. We need to embrace the use of technology to give each student a high-quality, customized educational experience that allows them to learn at their natural pace, regardless of their age, neighborhood, parental income, or school assigned label.