What Does Research Tell Us about Students with ADHD in the Chilean Context?

Introduction

In attempts to provide an education for all, education must be in a continuous state of improving itself. The way to do so is to look into the new challenges that people face as to obtain a proper education. One of the current obstacles of the educational system worldwide is the inclusion of students who experience a special educational need. In order for inclusion to occur, one of the steps to take is to become familiarized with the needs of the students. Students have all types of needs and conditions. One of the most commonly known conditions is the Attention Deficit Hyperactivity Disorder, or generally known as ADHD. In the present essay, a deep dive into the literature will reveal the connotations of ADHD as a condition and the implications of living with it as a student, all based on the research available within the literature. More precisely, this piece of work will focus on those ADHD students in the Chilean school context, attempting to answer the following question: What does the research tell us about students with ADHD in the Chilean context? Firstly, information on both the topics of ADHD and the Chilean educational setting will be provided to better prepare for the explanations of the pieces of research. Then two studies conducted in Chile regarding ADHD students will be presented in full. Finally, some conclusions and recommendations will be brought to light.

What is ADHD?

To begin with, a clear understanding of the Attention Deficit Hyperactivity Disorder must be obtained. ADHD is described as a disorder most related to experiencing behavioural difficulties, combined with the display of symptoms such as impulsivity, a lack of attentiveness and hyperactivity (NHS, 2018). Amongst the different mental health conditions, Furman (2005, p. 994) and many others point out that ADHD has been labelled as the most commonly diagnosed condition in childhood related to the neurobehavioral side of psychiatry, with 9,4% of the child and adolescent population between the ages of 2 to 17 years old having been diagnosed with ADHD (CDC, 2016). The term ADHD was also a difficult one to coin. Briefly mentioned by British paediatrician Sir George Still in 1902, Holland and Valencia (2017) reveal that the term of ADHD in itself was finally coined in 1987 by the American Psychiatric Association through a revised version of the DSM-III, after years of multiple definitions which neglected certain valuable aspects of the condition.

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Concerning the symptoms, people with ADHD are characterised by a number of features. As generally known, the core signs of ADHD are inattention, hyperactivity and impulsiveness. Millichap argues that people who experience ADHD are most notoriously characterized as being distracted with ease and active to an extreme, no matter the age of the individual (2011, p. 1). In addition, the disorder has also been identified by Faraone and Biederman (1998) as being an early-onset and heterogeneous condition, meaning that it is visible since infancy and that the nature of the condition depends on the type of ADHD present within the person. Despite assumptions, ADHD is not a one-size-fits-all condition. There exist three types of ADHD. The first one being the Inattentive type, which is overall defined by the difficulty of concentration within the individual. Secondly, the Hyperactive/Impulsive type, which can be identified by an anxious and restless behaviour. Finally, the Combined type presents a mixture of the previously mentioned types (APA, 2017).

Regarding the symptoms imposed within the literature, ADHD has been identified as provoking a significant number of impairments in a person’s life, quite specifically referring to behavioural skills in mainstream schools where students with ADHD are seen as less able to succeed. That is the reason behind the identification of ADHD as a special educational need, which following the definition by the Code of Practice (2015, p.15), is considered special provision due to a person’s disability or learning difficulty. Despite this, it is worth noting that people who live with such condition are still able to live what is traditionally known as normal lives, it only complicates it in certain aspects of it, which are mostly attributed to academic development within a school setting. Needless to say, ADHD takes a toll on people’s lives no matter their background, ethnicity, gender, etc.

The educational system in Chile

Bearing this in mind, Chilean students who live with ADHD must also be considered. Found within the South American region, Chile has been identified by the PISA Report as the country with the best educational system out of all in Latin America (OECD, 2015). The country has also been identified to have the highest literacy rate in Latin America (Just Landed, Unknown). Correspondingly, education in Chile is compulsory in both primary and secondary education, as stated by the General Education Law which was promulgated in 2009 (MINEDUC, 2009). Regarding the SEN population, Chile had approximately 2.05 million of citizens who, as of 2012, has experience with a special educational need (FND, National Foundation for People with Disabilities, 2012).

In terms of inclusion, Chile has just fairly recently begun to explore the issues regarding the inclusion of individuals with special educational needs. As a way of promoting the end of exclusion, many laws and policies have been issued by Chile’s Ministry of Education, which is mostly referred to as MINEDUC. The first law regarding SENs is Ley 20.422 called “Igualdad de Oportunidades e Inclusión Social de Personas con Discapacidades” (Equality of opportunities and Inclusion for people with disabilities), which establishes that it must be ensured for all SENs students to have equal opportunities to achieve full social inclusion without suffering discrimination of any kind (MINEDUC, 2010). Within said law, Article 34 is the most important one in this essay context, as it is the one which revolves around the idea that the State is the responsible institution which must secure that all educational establishments, both public and private, must guarantee access to individuals with a disability. Therefore, schools in Chile are now obliged to accept any student with a SENs.

Generally speaking, Chile is yet to achieve a greater sense of inclusivity, both in its policies and in real-life settings. Even though it would be appropriate to highlight the existence of more Chilean laws and policies of inclusion, it must be said that it would not make much of a difference. The laws previously mentioned are the prime example of the approach which Chilean policies have regarding the inclusion of SENs students. Chile still has a long way to go when it comes to meeting the needs of students with SENs. Although a clear intention to move forward with history has been noticeable amongst the general population and current politicians, the efficiency of the laws has been thoroughly questioned because of still considering integration as a mere option and not a human right (García-Cedillo et al, 2015). Furthermore, there is not much literature regarding SENs in the Chilean educational context, which hinders the development of a proper understanding of the implications of inclusion. Overall, Chile has still yet to deliver in terms of inclusivity.

What does research tell us about students with ADHD in the Chilean educational context?

Throughout the essay, a comprehensive narrative regarding both the implications of ADHD as a condition and the state of the Chilean educational system and its ties with inclusion has been provided in a simple manner. The main goal of this essay is to reach into the existing literature and reveal what researchers have discovered about the treatment of ADHD students within Chilean educational institutions. In order to do so, two wildly different studies corresponding to mostly Chilean authors will be explained in detail

The first research to be mentioned is called “Epidemiology of ADHD in Chilean children and adolescents”, which was published in 2013 by Chilean authors Flora Eloísa de la Barra, Benjamin Vicente, Sandra Saldivia and Roberto Melipillan. This study is created due to the desire of broadening the data regarding ADHD in various countries. It is mentioned that quite extensive data can be found about the USA or Europe but notes a lack of it in the context of Latin America. Therefore, the main objectives of paper are identified by De la Barra et al (2013, p. 5) to be to report the prevalence of ADHD from the pool of mental disorders by sampling children and teens between the ages of 4 and 18 years old of four different provinces of Chile, as well as to provide a description of the factors, comorbidity and the services used by said community.

In the methodology, it is explained that four provinces out of the 51 existing provinces in Chile were selected due to the representation of the distribution of the Chilean population. Consequently, Santiago, Concepción, Iquique and Cautín were chosen. The methods used in this study were surveys and interviews in randomly selected blocks of each province using the data provided by the 2002 National Census. Likewise, the size of the target sample was determined via the higher probability of younger individuals displaying the symptoms of certain conditions more clearly. The surveys were conducted by trains psychology graduates. The study looked for specific information. Firstly, some mental disorders which were picked to be evaluated, such as social phobia, separation anxiety disorder, generalized anxiety disorder, eating disorder, major depressive disorder, schizophrenia, ADHD, etc. The research also investigated the support through public and private services assigned to people who have a special need, as well as looking into family functioning.

The results of the research were analysed considering that the sample consisted of 1,558 children and teens in total, with 50.9% being males and 49,8% being females. Overall, the prevalence of a mental disorder, in general, was 22,5 % amongst the youth. More precisely, the prevalence of ADHD was 10.00%.  Results also revealed that Chilean youngsters living with ADHD are also more likely to experience anxiety and OCD. The authors note that the study is far from being perfect. The lack of parents and teachers’ voices attributes to a bias presented within the research, and so does the exclusive use of the DISC-IV instead of utilising more tools. The study contributed to the recognition of children and adolescents with ADHD in Chile.

Despite the importance of acknowledging ADHD youngsters, it is more prominent to highlight the lack of certain aspects in the research. Overlooking socio-economic and cultural differences amongst the sample size can be seen as politically irresponsible. It is also interesting to see the study not including the genetic factor in its variables, which is one of the main causes of ADHD. Another point is that the research failed to provide the format and questions which was used to conduct the survey, which would have also provided a closer look into the thought process behind the study and whether or not it was sensible enough. Finally, and the most obvious one regarding this essay’s context, there is no mention of the education of the individuals. Although it can be interpreted that because of their age, then it is most likely that the number of ADHD students can be identified from that. Regardless, the study does not move forward and is missing crucial information which could have been entirely more useful. Overall, this first study provides solid data about the number of children and teens who have ADHD in Chile, but it could have done so much more than that if it had wanted to.

The second and final research in question is called “Pharmaceutical entanglements: an analysis of the multiple determinants of ADHD medication effects in a Chilean school”. Published in 2017 by authors Sebastian Rojas Navarro and Scott Vrecko, the study focuses on the effects which medication has amongst the Chilean student population who live with ADHD. Navarro and Vrecko (2017) begin their article by explaining the misconceptions of ADHD medication, in which one group has argued that medication can be quite advantageous for those who live with ADHD, while the other group claims it to be another form of social control and oppression. The authors argue that ADHD drugs are varied and create different effects, therefore it creates different realities. Despite the clinical undertone, the authors have claimed their wish to avoid over-generalisations and the use of the medical model to diminish ADHD individuals. Instead, their study explores day-to-day interactions between students with ADHD and members of the school community who do not have ADHD, as well as non-human elements.

The first phase of Navarro and Vrecko’s ethnographic research (2017) consisted of observation sessions conducted by the lead researcher through four different Chilean classrooms, in which he observed students of the ages of 10 and 11 years old. The four classes were two all-boys classes and two all-girls classes. The observation process is narrated based on the events witnessed in one of the classes. The researcher describes the different attitudes of three young boys diagnosed with ADHD and their interactions with their classmates and teachers in a Catholic mainstream school. The first boy has been recently gotten off his medication due to improvement, but after a week off of them, he began to display unpleasant traits to both his parents and teachers, for which all parties decided to medicate him once more. The second student was diagnosed with ADHD two years prior to the investigation, and although he struggled to improve his concentration skills, he had no problem focusing when asked to do a particularly specific task. The last boy has been medicated throughout one year, and despite not displaying obvious symptoms of the condition, his mischievous nature usually would be tied to his diagnosis. Following the observation process, the researcher conducted a series of semi-structured interviews to medicated students, non-medicated ones and various members of the school staff.

All in all, Navarro and Vrecko (2017) illustrated that ADHD can be displayed in different ways, and so can the medication for it. Thus, medication can affect students with ADHD differently. In the context of the students observed and their environment, ADHD drugs were viewed as a tool for potentiality instead of an obstacle. However, the study was keen in noting that such positive expectations of ADHD medication are heavily linked with the efficacy of the social support which surrounds the student, which should create a safe space. Through a process of engaging with interacting agents who provide emotional support, motivation and validation, alongside a safe and consensual amount of medication, students with ADHD can thrive and become excelling learners. As heavily implied, Navarro and Vrecko’s research contributed highly to the literature of ADHD in Chilean education.

Despite the immense contribution of Navarro’s’ and Vrecko’s work, it still presented several issues. Firstly, the spectrum in which the research was conducted was quite narrow and lacking in details. No major information regarding the schools was disclosed, and only one setting was investigated, instead of looking for other types of schools. Furthermore, the vagueness of the Chilean context as a major factor was unquestionable, meaning that neither the findings nor the narration of events were clearly associated with Chile, so severely that at times the reader would forget that Chile was even in the picture. Finally, more suggestions could have been made by the authors.

Throughout the process of engaging with the literature and the two studies presented, many issues arose. The selection of studies has a troublesome task, as the literature regarding the education of ADHD students in Chile was severely lacking content. Even though there are a significant amount of articles and studies regarding those topics, they are separated. Plenty of studies on ADHD can be found. Plenty of articles regarding Chile’s educational context are also found. But to find studies and articles which discuss both topic in an united way, it was a daunting task. It can be understood that a lack of literature about ADHD in Chilean schools has been visible.

References

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