BIRMINGHAM, Ala. – As a new school year approaches, an estimated 55 million children will return to classrooms, and some of them bring a diagnosis of attention-deficit/hyperactivity disorder (ADHD) with them. For teachers and parents of a child with ADHD, the beginning of school leads to new challenges and opportunities for learning.
“ADHD is a common neurobehavioral disorder that affects 6 percent of school-age children,” said Laura Montgomery-Barefield, M.D., associate professor of child and adolescent psychiatry at the University of Alabama at Birmingham (UAB). “As children and teens return to class, it is important to reassess the need for new strategies at home and school.”
ADHD is usually first diagnosed in childhood and often lasts into adulthood, according to the Centers for Disease Control and Prevention (CDC). Children with ADHD may have trouble paying attention or controlling impulsive behaviors without regard to consequences, or they may be overly active. The CDC says the reported rate of ADHD in Alabama is among the highest in the nation, and that the rate of diagnosis nationwide increased by 22 percent between 2003 and 2007.
Montgomery-Barefield suggests that parents and teachers should work together to create an ADHD-friendly study environment at both home and school. This can include introducing good study skills and time management techniques.
She says medication management is an effective treatment for ADHD. As students get older, medication regimens may need to be adjusted to include coverage for homework.
“As with any chronic condition, it is important to partner with a child psychiatrist or pediatrician to ensure that your child receives the best treatment,” she said. “And get feedback from teachers.”
Angela Walker, an elementary school principal in Shelby County and a doctoral candidate in early childhood education at the UAB School of Education, has studied coping strategies for students with ADHD.
“During my research, I really came to feel that ADHD is not so much a disorder as it is a different way of learning,” Walker said. “Students with ADHD need hands-on learning, as well as physical and intellectual engagement. We know that all kids benefit from student engagement, but it is essential for kids with ADHD. They require this kind of approach in order to learn.”
Walker reports that her survey of 109 elementary teachers in a suburban Alabama school district identified nine strategies that teachers said were the most effective tools to manage a child with ADHD.
The most effective was to  call the student by name, touch the student, use a private signal word or simply move closer to the student. Eighty-three percent of teachers thought this strategy was effective at least 75 percent of the time.
The other most effective techniques were praising any effort in waiting for turns (78 percent effective); giving verbal compliments for improved work or behavior (77 percent); teaching activities that encouraged active response such as talking, moving, organizing or working at the board (74 percent); and allowing the student to sit closer to the teacher (72 percent).
“The most effective strategies seem to have a theme of praising and engaging students,” said Walker. “That appears to be a really effective combination.”
Other successful strategies Walker reported were asking a student to explain back to the teacher their understanding of directions (66 percent); allow directed movement in the classroom or change in seating that is not disruptive (62 percent); allow standing during seatwork – especially at the end of a task (60 percent); and giving the child an activity reward such as running an errand, cleaning the room or organizing the teacher’s desk (60 percent).
Walker suggests that parents and caregivers can reinforce these strategies at home to create a unified environment.
“It is important to note that with appropriate medical treatment and in an appropriate learning environment, ADHD students usually excel and rise to their academic potential,” said Montgomery-Barefield.  “ADHD is only a disability when treatment is inadequate.”

By Douglas E. Schoen

Congress just departed for their annual August recess, and to no one’s surprise, Democrats and Republicans could not agree on the 2014 budget. Now, Congress will return this fall for what will undoubtedly be major battles over significant fiscal issues: the approval of a 2014 budget, raising the U.S. debt ceiling, and allowing sequestration to continue for another year.
First, Congress must pass a 2014 budget that will fund the government beyond September 30, the last day of fiscal year 2013, to avoid the shutdown of the federal government. Congress must then negotiate an agreement to raise the U.S. debt ceiling by November, or else the U.S. faces defaulting on its debts. And finally, Congress must determine how to implement the $91 billion in sequestration cuts, or cuts in federal spending, allotted for 2014.
As Democrats and Republicans are struggling to agree on where federal spending can and should be cut, it is critical to differentiate the spending programs that work from the ones that do not.
One program that has been successfully working for 10 years is Medicare Part D. Part D is a widely popular, bipartisan program that has been saving Americans money since its inception in 2003, when it was created as part of the Medicare Modernization Act to cover the drug coverage gap that that existed in Medicare’s plan. Under Part D, which is run on a free enterprise model, seniors choose from a wide variety of privately run drug plans that negotiate individually with drug makers.
Part D is the most cost-effective and successful entitlement program the federal government runs. The Part D prescription drug benefit has subsidized costs of prescriptions drugs for millions of seniors and Americans with disabilities. In fact, it was recently announced that more than 6.6 million people with Medicare have saved more than $7 billion on prescription drugs as a result of Part D – or about $1,000 per Medicare recipient.
This news marks just the latest indication of the program’s ongoing success, and was followed by a USA Today article, which revealed that Medicare Part D premiums will remain stable, and the deductible will fall from $325 to $310 in the upcoming year.
And not only is Medicare Part D saving Americans money, the program has consistently come in under budget. Costs are now 45 percent below the program’s initial 10-year projection – the program will cost $340 billion less than original estimates. Even more impressive, Medicare Part D is helping to save costs in other ways: the Congressional Budget Office found every 1 percent increase in prescriptions filled has led to a .20 percent decrease in Medicare spending.
The program’s success is reflected in the ratings beneficiaries have given it. Ninety-four percent of Medicare recipients say they are satisfied with their drug coverage, and 95 percent are confident that their level of coverage meets their needs.
Thus, it is clear that Democrats and Republicans should make sure this program stays out of the fray of upcoming budget negotiations, and enable this cost effective and continuously thriving bipartisan program to successfully continue.
Yet the Obama administration wants to change Medicare Part D by imposing mandatory government rebates on drug companies that participate in the program. Framed as a cost saver, these new rebates could have significantly damaging effects on the program.
The proposed rebates could ultimately contribute to higher premiums and copays and increased drug prices for private sector consumers, thus resulting in reduced access to critical medications. Because rebates would mean less funding for biopharmaceutical research, this policy could delay potential scientific and medical developments that could realistically change and save lives by making drugs more effective and safer to use. Mandatory government rebates to Medicare Part D would also translate into fewer jobs in the biopharmaceutical sector.
Recently, 45 House Democrats signed a letter urging legislators to reject any proposals from the administration that would impose new government rebates on Part D, citing each of the aforementioned potentially negative impacts as cause. This is a good step.
At a time when Congress is struggling to balance the budget, it is imperative for Democrats and Republicans to preserve a cost effective, well-liked program that saves Americans money like Medicare Part D. Rather than implementing destructive changes, Democrats and Republicans must preserve what works, and increase support for an already established and flourishing program.
Put simply, both Democrats and Republicans have an opportunity to drive bipartisan cooperation and reduce health care spending through a proven government program.

Douglas Schoen is a political strategist and author of Hopelessly Divided: The New Crisis in American Politics and What it Means for 2012 and Beyond, published by Rowman & Littlefield Publishers.