Chronic stress at school can make kids (particularly those with ADHD or LD) dread going — and change their brains for the worse. But parents and teachers can help alleviate the stress that is stopping these bright kids from succeeding.
BY JEROME SCHULTZ, PH.D.
For over 35 years, I’ve carried out comprehensive neuropsychological evaluations of kids and young adults, seeking to confirm, clarify, or rule out a diagnosis of ADHD. I’ve focused on the relationship between attention and the learning disabilities that often go along with ADHD. My role as a diagnostician has been to identify a pattern of neurocognitive weaknesses and strengths, so that I can help my clients and their parents better understand how they learn best.
An important part of the neuropsychological evaluation is to teach students what they can do to overcome or work around impediments to efficient learning and manage stress at school. This process is helpful, but it often falls short of my goal of helping a client change his or her learning trajectory. Many times, after I used test results to explain a client’s learning profile or convince a student that he or she had the cognitive capability to do well in school, I heard, “If I’m so smart, why do I feel dumb all the time?”
I felt compelled to find an answer to this question, and set out to do that.
The Missing Piece of the Puzzle
If you’re the kind of parent I’ve come to know, understand, and respect over the years—the parent of a child with ADHD or LD—you’ve probably heard the following words from your child:
“I hate school! I don’t want to go. You can’t make me go!” “I hate my teachers, the kids are mean to me, everything we do is stupid!” “They try to teach us stuff I’ll never need. It’s so boring!”
Getting your kid off to school in the morning can be traumatic for the family. Cajoling, soothing talk, and bribery aren’t always enough to get your kid into the car or on the bus. How many times have you given up and said, “OK, you can stay home, but this is a one-time deal!” Then the tears dry up (yours and your child’s), the mood gets calm, and things seem back in balance. But you know the problem has not been solved. Your spouse shakes his head as he leaves for work, and you feel like you’ve failed again. Your kid seems relieved, but you sense that she feels like a failure, too.
If you haven’t figured out why this happens over and over again (even though your child is a bright kid who acts like an angel as long as she’s not asked to do anything related to school), I have the answer. I’ve come to believe that stress is a key factor in solving the ADHD/LD puzzle. I believe that a better understanding of stress among parents, teachers, and learners is the key to unlocking academic potential. Such understanding will lead to a more satisfying, productive life.
It’s a sad fact that many students with LD or ADHD have more failures than successful moments in school, and this affects their attitude toward learning and their behavior. A student with impediments to learning needs a developmentally appropriate level of knowledge about his own cognitive profile. Without it, he is likely to attribute his lack of success to a lack of ability or intelligence.
Repeated bouts of fear, frustration, and failure in school create stress that builds up over time. This state of mind is actually neurologically damaging. It impairs brain function by fouling up the brain’s chemistry and even shrinking critically important neural brain tissue, making problems with learning and attention worse.
Chronic stress decreases memory and cognitive flexibility, as it increases anxiety and vigilance. This ratchets up a student’s alert level and gives rise to a protective defensiveness. As a result, too much energy is put into escaping the threat by avoidance, resistance, or negativity (see “Stress Tests”).
When teachers, administrators, and parents misread this behavior as willful or oppositional—not the defensive, protective stance of a student trying to avoid looking inadequate—they compound the problem by casting the student as a bad kid. Most students would rather be thought of as a “troublemaker” or a “class clown” than as stupid, and many, therefore, live up to their reputations.
We are equipped with the ability to perceive threatening events in our environment (stressors), and to respond in ways that keep us safe. A saber-tooth tiger at the mouth of the cave meant trouble for our ancestors. Their senses were so sharp that they knew the beast was there even before the firelight revealed its menacing eyes or large teeth. This early-warning system helped them stave off or escape from danger. We are equipped with the same protective mechanisms that kept our ancestors alive and allowed us to develop as a species. Faced with real or perceived fear, we respond by fighting or fleeing. This is not a conscious choice; under stress, the so-called fear centers deep within our brain (most notably the amygdala) go on high alert.
When the fear centers of the brain are activated, the area of the cortex in the front part of the brain, called the prefrontal cortex, is de-activated. The prefrontal cortex, along with the basal ganglia and the thalamus, controls the executive functions (organizing, planning, and executing tasks efficiently) that are critical to learning. In kids who are already at risk for academic difficulty because of ADHD, the secondary impact of stress puts them in a tailspin. Just when they need this important part of the brain, it shuts down. When stress goes up, cognitive ability goes down. In fact, research shows that chronic stress is associated with a larger amygdala and a decrease in the size of the cerebral cortex, suggesting that repeated, highly negative experiences actually re-form the architecture of our brain.
The mental relationship a child has with a challenging task in great part determines how he or she deals with what comes his or her way. When kids believe that they have little control over a task, and they are about to look ignorant or incompetent (yet again), this triggers the stress response. When a kid’s brain is sending the message that “This is too difficult! There’s no way I can do this!” the task becomes their saber-tooth tiger. Fear centers go on high alert, and the thinking part of the brain shuts down in the service of survival. It’s a circular, self-perpetuating cycle of fear, avoidance, and escape.
In my book Nowhere to Hide: Why Kids with ADHD & LD Hate School and What We Can Do About It, I use the term “saving F.A.S.E.” to explain this phenomenon. Thousands of kids around the world are caught up in this cycle of defeat. Hundreds of teachers are reacting in absolutely the wrong way and making the problem worse. Only when children and adults understand this, and know how to break the cycle, will things get better.
The impact of stress on the brain is not all bad. Tolerable stress helps the brain grow and can inoculate a child from the negative impact of stress in the future. The key is to interpret the cause of stress so that it can be managed effectively. This means using stress as the fuel for success and not letting it turn inward to erode confidence and competence.
Neuroscientist and Nobel laureate Eric Kandel, M.D., explained that just as fear, distress, and anxiety change the brain to generate sequences of destructive behaviors, the right interventions turn the cycle around. That’s what my DE-STRESS model aims to accomplish.
It includes the following steps:
> Define the condition. Make sure that the adults involved in the child’s life understand and agree on the cause of the challenges. If there are “dueling diagnoses,” valuable energy is wasted on disagreements, legal challenges, and “doc-shopping” to resolve differences of opinion. The adults need to come to some consensus about the child’s condition. A plan built on guesses or misinformation is destined to fail.
> Educate. Informed adults (parents, psychologists, teachers) need to educate the child about the nature of his/her challenges. Only an informed child can be a self-advocate.
> Speculate. Think about how the child’s strengths and assets, as well as his challenges, will impact his prospects going forward. Think ahead: What’s going to get in the way of success and what should be done to minimize disappointments and derailments?
> Teach. Educate the child about how to use strategies that will address his specific needs and maximize his success. Give the student the tools he needs to take this bull by the horns and wrestle it to the ground.
>Reduce the risk. Create learning environments that focus on success and that minimize the risk of failure (small classes, individualized attention and support, providing time and space to reinforce learning, decreasing distractions).
> Exercise. There is scientific evidence that physical activity reduces stress. Make sure that the student is engaged in a regular program of physical activity. Collect evidence that shows that exercise enhances mood and learning.
> Success. Replace doubt with confidence by creating a learning environment that allows the student to experience success more often than failure. Make sure that fear, frustration, and failure are overshadowed by successes. Show the child that confidence and control are by-products of being competent. Help the child internalize a mantra: “Control through competence.”
> Strategize. Use what you and your child have learned about achieving success in order to plan ahead. Find opportunities to confirm that confidence and a stress-reducing sense of control come naturally from feeling competent. Teachers and parents should make learning from errors part of the plan, and help the child move from strength to strength.
Unless students have the opportunity to learn skills that allow them to bypass or overcome learning weaknesses, they are likely to exhibit the fight-or-flight response. Fortunately, the changes in neuronal circuitry associated with chronic stress are reversible in a healthy, resilient brain. Appropriate interventions like the ones mentioned above are simple, cost no money, and can result in re-setting the brain to a healthy state. Looking at stress through this lens will lead to better learning, enhanced self-esteem, and improved behavior.
The ADHD/LD label is not as disabling as one’s view of the label’s meaning.
Students who know they have a learning disability but who identify with the negative aspects of that label experience what researchers Claude M. Steele, Ph.D., and Joshua Aronson, Ph.D., call “stereotype threat.” Kids worry constantly that they will do something to confirm the stereotype that students with ADHD/LD are less competent than other kids.
Gabrielle Rappolt-Schlichtmann, Ed.D., and Samantha Daley, Ed.D., M.Ed., at the Center for Applied Special Technology, in Wakefield, Massachusetts, are currently working on projects funded by the National Science Foundation to better understand stigma and stereotype threat in the classroom. They have found that when students in a research project have to identify as having a learning disability before starting an academic task, they perform more poorly than a similar group of students who are not asked if they have a learning disability. Some take this as evidence that it is the label itself that is disabling, and make a case for not using it.
I believe that when a student does not understand his or her condition (in other words, his or her label), this can lead to a self-assigned label: “I have ADHD. I can’t focus well enough to do math. I’m stupid.” This is more disabling than the terms ADHD or LD.
My work in schools supports my view that stereotype threat, and the stress it causes, can be countered with positive self-attributions related to the disability label. Having had the opportunity to visit hundreds of programs for kids with ADHD/LD across the U.S., I have seen that those schools and teachers that give self-awareness and self-advocacy training, coupled with specialized approaches that lead to helping the student master academics, have found an antidote to stereotype threat that can be a central feature of the ADHD/LD profile.
These behaviors are good indicators that your child may be under stress at school:
> Refusal to do the work (passive or aggressive negativity)
> Devaluation of the task (“This is so stupid”)
> Acting up or acting out to direct attention away from the challenging task
> Acting “in” or becoming sad and withdrawn
> Exhibiting signs of anxiety (sweaty palms, tremors, headaches, difficulty breathing)
> Becoming engrossed in a task in which he is successful or one that’s fun (refusing to stop writing a story or doing a drawing, turn off a video game, or to take off a headset and stop listening to his favorite music)
> Efforts to encourage (“I know you can do this”) are met with more resistance
> Asking an adult to stay close and help with every problem (over-dependence)