Attention deficit and learning disabilities (ADHD/LD) among high school pupils in Holon (Israel)
Introduction
ADHD is the most common neuro-behavioral disorder of childhood. Its prevalence is controversial. These pupils have difficulties in the following areas: learning, behavior, social and emotional [1]. ADHD will cause lower self-image of the adolescent [2]. Barkley [3] classified ADHD into three subgroups: ADHD (inattentive), ADHD-hyperactivity-impulsivity (HI) and a combination of the two. The ratio of boys to girls having ADHD is between 3:1 and 6:1 [4], [5]. Mannuzza et al. pointed out the relative persistence of ADHD throughout adolescence and its apparent decrease in early adult life [6]. Cantwell remarked that 10–60% of these adolescents would continue to suffer from ADHD during adulthood [7]. The prevalence of ADHD in school age pupils in the US is between 1 and 7% [3], [5]. In some studies from the US, Europe, China and Colombia, the prevalence varies between 1.7 and 17.8% [1], [8], [9], [10], [11], [12]. The prevalence of ADHD (inattentive) alone mentioned by other authors varies between 4.1 and 10% [13], [14], [15]. In Israel, Zohar et al. have found a prevalence of 3.9% among adolescents (17–18 years) before joining the army [16]. Learning disabilities (LD): These pupils although of their normal intelligence will have difficulties with school achievements [1]. LD may be expressed by difficulties in speaking, reading, writing, mathematics, foreign languages, coordination, spatial adaptation, memorization and social studies. In this disability also, the self-image of the adolescent will be lower [17]. The prevalence of LD at school age is between 6 and 7% [18], and in the group of ADHD children the prevalence of LD range from 20 to 80% [8]. The prevalence of reading difficulties varies between 5 and 17.5% of school children [18], [19]. The prevalence of dysgraphia in the school age children is 2–8% [18]. The prevalence of dyscalculia in school age children is between 5 and 6.5% [20]. Ganschow et al. mentioned that pupils with ‘Foreign-Language-LD’ would have difficulties in syntax and phonology, while learning a foreign language [21]. LD pupils may have difficulties with social studies, such as learning history, which necessitates memorization and sequencing of events [22].
The aim of the study was to estimate the prevalence of ADHD and LD among pupils attending an academic high school program and to determine the gender ratio between them.
Section snippets
Methods
Five hundred forty-three students in three grade levels (10th, 11th and 12th) participated in the study. They were studying in an academic municipal school in Holon. Two classes were chosen at random out of the eight in each grade level, and the school physician who was familiar with ADHD/LD interviewed all these students. Four pupils refused to participate in the study. Their educational and medical records were examined, including the results of their learning ability tests, which had been
Results
The prevalence of complaints concerning ADHD (in all three subgroups) is shown in Table 1.
Fifteen point two percent of students had ADHD, subdivided as follows: ADHD (inattentive)- 9.7%; ADHD (HI)- 1%; and ADHD- combined form- 4.5%. Seventeen point six percent of students had LD, categorized as follows: dyslexia 6.2%; dysgraphia 6.8%; dyscalculia 9.2%; foreign language difficulties 4.6%; social science difficulties 3.1%; fine motor skill difficulties 2%; and spatial adaptation problems 3.5%.
Discussion
The actual prevalence of ADHD is still controversial. In our study, the total number of ADHD students amounted to 15.2% and the prevalence of LD was 17.6%. These results are in a higher range of those reported in the literature. These students had significantly low academic achievements with resulting low marks.
The diagnosis of ADHD is based upon use of the Connor's questionnaire, which is completed by parents and by teachers [23]. High prevalence is influenced by the use of broad definitions
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