Are colleges adapting to increasingly diverse students?

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I note that the media has recently been discussing the increasing numbers of children being diagnosed as being on the autism spectrum.

http://www.forbes.com/sites/emilywillingham/2013/03/20/autism-prevalence-is-now-at-1-in-50-children/

I was pleasantly surprised to hear and read the recognition that this does not mean there are necessarily ‘more’ autistic children – rather, that the medical community is becoming better educated about recognizing autism in it’s many different presentations – which can vary significantly from one person to the next.

I wonder though, about the way education is going to need to continue to change as socially we recognize the degree of difference that is present among a classroom full of children. I would suggest that with so many children experiencing autism, AD/HD, learning disabilities, dyslexia, affective disorders, etc. that the education system is past the point of being able to expect the ‘majority’ of children to have significantly similar learning styles, considering that even when they do not have any form of disability, people often have different ways of best learning new things.

 

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My own work and research echos what John Dewey observed at the turn of the last century; if there is one way of best teaching, it is to provide mentored opportunities for a person to learn, hands on, by doing. What it means to ‘do’ will vary – writing requires opportunities to write, discuss, revise (and read others’ writing); science requires experiments; social studies means experiencing other cultures, traditions, and ways of thinking about things…some of this does happen currently yet, hands-on practices still do not make-up the majority of learning opportunities in the education system.

Think particularly of higher education; how often do we still expect people to learn by sitting in a lecture hall and listening? This is particularly true for first year classes – a student’s crucial first year often requires trying to learn in a style that fewer and fewer students are well suited to. If a student survives the entry level classes, there will be increasing opportunity for the student to gain hands-on opportunities with field work, seminars, or work shops. These opportunities are seldom available to freshmen.

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It seems impossible to avoid the conclusion that as learners continue to change, the institutions responsible for educating them will also be required to adapt. Many of the students who previously were not diagnosed as autistic, were not diagnosed in part because they functioned well enough to still participate in social functions like seeking an education. As the medical community becomes more adept at recognizing that these high functioning people also live with a disability, more people who attend college will arrive with documentation that they live with a disability. Students who in the past would have had to struggle through on their own, will increasingly have documentation that they live with a disability – and will be at last eligible for the accommodations they require. Those who teach or administer in the higher education realm would be well served to be increasingly prepared as these students arrive on campus.

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Housing, classroom expectations, peer social interactions/support, needs for counseling – these are all areas where planning should be taking place now to facilitate the increasingly diverse student population. Meanwhile, families should be practicing routines with children which will also support their college success: taking medication, following basic social protocols when meeting new people, learning study techniques even if the student is intelligent enough to not need to study for class – these are all skills the child needs to practice at home, to support their eventual college success.

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Preparation is needed on both the home front and in the institutions that educate, if we are going to assist the increasingly diverse student population in becoming educated social citizens. Failure to rise to the challenging but necessary work of adapting to the changing needs of students will have a negative impact on society. Too many bright young people are in danger of being pushed out of the current education system – it is time to reconsider business as usual. Focusing on one ‘fix-all’ answer (like technology) is also not appropriate, as there is too great a range of learning styles to assume that any one answer will be suited to all student needs.Diversity of students requires diversity of methods in teaching.

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College doesn’t have to be for everyone; education does.

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There seems to be an ever increasing amount of talk in media sources that the future of the work force and the future of the economy lies in technology. As someone who is employed at a university which specializes in science, technology, engineering and math (STEM), I certainly can attest that the students graduating with degrees in these fields are very employable. What that truth overlooks though are several other truths: not everyone excels in these fields; one does not need to excel in these fields to be employable. In fact, not everyone has a learning style or capacity that is well suited to four/five year university degrees. There is more than one way for a person to become educated to do work and not all that education needs to take place in a university.

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Skilled tradespeople, technical degrees that take months or several years vs. four+ years, and manufacturing jobs all continue to provide employment opportunities for people. Not everyone is interested in, or may not be well suited to longer study periods of the four to six years necessary to obtain a degree in the STEM fields and these people should be encouraged to look into other opportunities that do still exist for employment.

Ro Khanna’s, “Five Myths about Manufacturing Jobs” which appeared in the Washington Post on 2-15-13 points out that despite the talk about China being the new source of all things manufactured, the U.S. continues to produce 1/5 of the world’s manufactured goods – the same amount as China. Khanna argues that manufacturing and service jobs continue to be large employers in the U.S. and that the service sector will see the largest growth in the near future.

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There have also been concerns being [under]reported since at least 2007 (Virginia Manufacturers Association; Manpower, Talent Shortage 2011 Survey Results) that a short fall of people in the skilled trades – such as welding, tool setting and operating, machine maintenance specialists – is slowing down economic growth as demand for these skilled tradespeople outstrips supply. The Virginia Manufacturers report for example, states that the statewide need was being met by “only 44 percent.”  A 66% shortfall of needed workers, trained in skilled trades.

Everyone with the capacity to learn should have the opportunity to become educated to work. The best education for working though has to be dependent on an individual’s learning interests and capacities. Those who have an aptitude for a STEM education ought to have that option; we should as a society though, continue to value and provide opportunities for people to become skilled in trades that support the manufacturing we continue to do and recognize that the service sector continues to be vital to the way our society functions. [There is a separate argument/concern that service sector jobs may not pay well enough to support a family – as a society dependent on service sector jobs to support lifestyles we enjoy, this certainly seems to be another issue we ought to be addressing.]

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Improving a grade in a problematic class.

 

 

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Students moving from high school to college sometimes believe that because professors appear to pay less attention to who is in class – they may not take attendance, they may not learn names, they may even say, “I don’t care if you come to class” – that going to class is not necessary, or that it is a waste of their time. “The professor just lectures from the book” or “I don’t learn anything in class” are two reasons I’ve heard students say they do not go to class. What students often do not realize is that going to class can still make a difference in what they learn.

Very few people are able to remember everything they hear during a lecture or discussion. We all tend to pick up some words, ideas, or points though. If a student does the assigned reading for a day, goes to class and even half-listens to what is said, they are likely to pick up a few key terms that are repeated by the professor that were mentioned in the textbook. This is a good indicator of a foundational idea that the student will need to learn in order to be successful in the class – these are also clues to the concepts the teacher will use when writing test questions.

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If a student is having trouble grasping the key concepts, then being present in class can provide opportunities to ask the professor questions. If the professor doesn’t have time to answer the questions during class, then a student who has a face the professor recognizes from class will find they have a warmer welcome going to the professor’s office and asking their question(s).

If a student needs more support than asking the professor questions, or if the professor provides answers which don’t clarify enough for the student, then a tutor or learning center appointment(s) are a useful strategy to make use of. Many learning centers allow students to sign up for reoccurring appointments or offer study sessions so that a student can have support while working on homework.

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If a student isn’t sure what to try next, then it is time to make an appointment with their academic adviser, or disability support person. The longer a student struggles in a class without support, the less likely the student is to be able to catch up on the foundational ideas they need to pass the class. There are few things more frustrating than working hard on a class only to fail it or achieve a low grade because the information was not adequately understood. Schools are attempting to provide academic support for students – students have to be willing to make use of that academic support when they are struggling in a class. Do not suffer in silence, seek out the support that is available.

 

 

The “real” me: with medication or without?

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I’ve been doing research for my latest book and was interested to find studies are showing that students who take medication for AD/HD are conflicted about their identity. These students seem to be absorbing larger social impressions/myths that imply that some kinds of medicine are less valid than others.

While starting medication from a young age can allow a student to suddenly focus in class, students are also being impacted from a young age by the social myth that goes something like this, “Normal means being who you are without taking medication [unless you need medicine for life and death], so when you take medication for AD/HD you aren’t behaving like your normal self; you only are your normal self if you aren’t taking medication.”

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Obviously there are a few problems with the myth that says we aren’t our normal self when we take medicine, or that medicine impacts our identity and makes us someone else; that the behavior we exhibit when taking medication is not our ‘real self.’

In order to make it clearer why I think this is problematic, let me compare this version of what it means to be ‘normal’ or authentic, with what it would mean to be Type One diabetic and to not take insulin. We understand that people who need insulin and do not take it are more likely to have serious health impairments and that they will potentially die. So as a society we do not label someone who takes insulin as more or less their true self – we say they need to take insulin to maintain their health. As a society we suspend judgement about the person’s ‘authentic’ identity and tend to think that someone who is diabetic is their regular self while taking their insulin.

Yet, when someone takes medicine because of a health issue that affects their mental state, we seem – as a society – to be quicker to make judgements about the person: about how normal they are, about who they ‘really’ are; as if a person can be separated out and  should have to choose between being authentic, or being healthy. We don’t seem to be as quick to accept that a person can be their authentic self while taking their medication to remain healthy, or to function to their potential when the medicine impacts mental states. This seems most true for AD/HD medication but applies to a lesser extent to medications given for unrelated mental health issues (depression, anxiety, etc.)

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We’re giving young people in our society a very troubling message, and studies are showing that young people are absorbing this message. As a society we’re saying that there are medicines we see as being legitimate, and medicines which we see as enabling poor study habits, unruly behavior, and medicines which enable people who should be able to just ‘pull themselves together’ to get by without the effort other people put into life.

As parents, caregivers, and educators, we need to promote the idea that a medication that assists a child in being healthy, productive, and happy is not a crutch. Nor is the child less him or herself when taking their medicine. Just as our behavior will change if we don’t sleep for several days in a row, or our behavior changes if we consume a lot of sugar at once, our behavior can change under many circumstances. We remain ourselves, even when our behavior changes. Medicine may impact our behavior however, the medicine does not make us less real or genuine. We remain our true selves when we use medicine to assist our quality of life. We are not less genuine, less normal, or less our ‘real selves’ when we are using medication.

Of course, some people will always choose to not use medication and I certainly believe that individuals have the right to make choices. An insulin dependent diabetic who chooses to stop using insulin will have dramatic consequences. Young people who choose to stop using medication as they become adults entering college will also find they face some dramatic consequences; when any person stops using a medication that their body is accustomed to, both their health and their study habits will be significantly impacted. One’s body will react to any sudden change in chemical balance.

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Whatever medication a young person is accustomed to, if they are planning to stop using the medication on even a trial basis in college, I would suggest they begin this trial stoppage before college begins. At least allow one’s body the summer in between leaving high school and beginning college as an opportunity to begin the adjustment – I would also recommend staying in contact with a health care provider during this transition as any sudden change in body chemistry can threaten a person’s health.

Parents need to understand that they cannot force a student in college to remain on medication. Again, I would suggest families allow their students the summer months to practice what it is like to function without medication, so that students have some idea of what to be prepared for in college. I also recommend that anyone stopping their medication because they feel their identity/personality is impacted by the medication, work with a counselor. Identity is complex and fluid. We all tend to reach a point in our lives when we question who we are and what makes us our genuine selves. Students who have been medicated from a young age are increasingly finding this an internal debate that needs to be worked through and families can assist a young adult by making sure he or she has the necessary counseling support to assist talking through their concerns.

To recap: medicine is a valuable advancement that allows individuals to live a quality of life that is not possible without medication. Not everyone, however, will always choose to use medication, particularly if they are concerned that the medicine they take impacts their identity – their sense of self and personality. In cases where a person is questioning their identity due to the impact medication has on them (or on their behavior) then families can be supportive of counseling which helps a person work through the issues they are encountering. As a society, we can support the idea that a doctor and patient are best able to judge the medication a person legitimately needs and as individuals/groups we can spend less time and energy second guessing medical judgements about medication. The average person is not qualified to determine if someone really needs to take medication – leave that judgment to people who are qualified; when you hear someone else second guessing a person’s need for medication, then remind them that the doctor’s opinion is more valid than their personal bias.

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Whatever our personal bias about medicating children, particularly children living with AD/HD – we need to stop voicing these opinions in front of children. We, as part of our larger social groups, are having a negative impact on how these children view themselves. We, as individuals, can be the source of improving the social climate these children grow up in.

 

Who made your child’s diagnosis, how was it arrived at, and does it matter?

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Recently I’ve had people send me several news stories about the over-medication, or inaccurate medication of young people.

(Examples: “Drowned in a Stream of Prescriptions” – this story is about an ‘adult’ child and therefore different from the younger children I’m speaking of in what follows in this post. http://www.nytimes.com/2013/02/03/us/concerns-about-adhd-practices-and-amphetamine-addiction.html?emc=eta1&_r=0

“Attention Disorder or not, pills to help in school” – a story of pills being used to make up for over-crowding and other school and social issues.

http://www.nytimes.com/2012/10/09/health/attention-disorder-or-not-children-prescribed-pills-to-help-in-school.html?pagewanted=all)

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These stories prompted me to think — does the average busy parent, (possibly with more than one disabled child to care for), even have an opportunity to stop and think about the qualifications a doctor needs to accurately diagnosis a disorder like AD/HD? Even if a doctor is qualified to make the diagnosis, did the doctor take the time and go through the necessary steps to accurately diagnose a child? Or did a doctor take shortcuts that led to a quick best guess? Is a doctor ‘just trying’ medication to see if it helps; in this case ‘help’ being shorthand for getting a child to focus more at school.

Unlike antibiotics, which arguably aren’t going to leave a person any worse off if prescribed when not needed, anti-depressants, and the stimulate medication usually prescribed for AD/HD, can both lead to dangerous outcomes if given to a child who doesn’t have a medical need that warrants these drugs.

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What I am suggesting today is that when parents are given a diagnosis of depression, or AD/HD – or any other disability that a doctor feels requires medication – that parents ask what diagnostic tests have been given that helped the doctor arrive at this diagnosis. Particularly with AD/HD it isn’t enough for even a qualified doctor to just talk to the family or give a quick questionnaire about a child’s symptoms. Along with a full medical history, a doctor should give a child a range of diagnostic tests before arriving at an AD/HD diagnosis. The actual tests may vary slightly between health care providers, but there should be some ‘proof’ that supports the clinical diagnosis.

Depression and other affective disorders are more complicated to diagnose, in that there is not a set of standardized tests that can necessarily be applied to reach an accurate diagnosis. This is why it is important to seek out professionals who are qualified to make the diagnosis: a psychiatrist or neuro-psychologist who works with young people is the sort of professional I would seek out to work with a child. The qualified doctor should take a complete medical history of a child including the child’s family medical history, ascertaining if there is any family history of affective disorders.

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The doctor should also have follow up meetings with a child, particularly if medication is prescribed, to accurately judge how a child is responding to the medication. Finally, depression and bi-polar disorder both respond best when medication is accompanied by talk therapy – if a doctor is prescribing medication and not requiring follow up talk therapy you need to find a different professional to treat your child.

A qualified doctor making a legitimate diagnosis of a mood disorder, AD/HD or similar disorder and finding a useful medication to prescribe to a child can be a life safer. Parents as always, however, have to be their child’s advocates. Do not allow someone to medicate your child without having first done ample medical tests to ascertain that the medication being prescribed is treating a disorder your child actually has. The right medication is only ‘right’ if it treats an illness or disorder that one lives with.

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