your thoughts on testing

CuriousMe · Dec 21, 2009

Last spring, one student nurse who had seen her grades on the borderline, dropped her classes and came back the fall semester. This time she still found only one of her classes too difficult to pass. so, now,after dropping it for the second time, she is going to be retaking it next semester (these are still the first block of classes). She recently brought it to the teachers attention that she has ADD -she had known about it ,and had been taking her medication for it for a few years now. She said she would not had made the mistakes she had made if she had untimed testing. What do you think? Should the school of nursing allow for untimed testing for those with ADD?

Not only should they....but if she has a documented diagnosis of ADHD (not just a prescription, but documentation of an evaluation & testing that led to a Dx of ADHD), then they legally have to let her have testing accommodations which could include un-timed testing, or a private room while testing, or any number of accommodations.

ADHD is considered a disability, so in order to comply with the Americans with Disabilities Act (Federal Law) they have to provide reasonable accommodations , that don't change the nature of the program. Giving time and a half or un-timed exams or a private room are the two most common testing accommodations I know of.

elkpark · Dec 21, 2009

It is up to the school's Student Services office to make that determination. There are federal and state laws that govern what accommodations are to be made for students with disabilities, and the school has an office/department that is responsible for being knowledgeable about the specifics of the laws and dealing with those kinds of students. The student has to declare and provide documentation of the disability, and that office/department will determine what the appropriate accommodations are for that student and inform her/his instructors.

CuriousMe · Dec 21, 2009

It is up to the school's Student Services office to make that determination. There are federal and state laws that govern what accommodations are to be made for students with disabilities, and the school has an office/department that is responsible for being knowledgeable about the specifics of the laws and dealing with those kinds of students. The student has to declare and provide documentation of the disability, and that office/department will determine what the appropriate accommodations are for that student and inform her/his instructors.

It is up to the school's disability services office to handle this matter. But if this student has the appropriate documentation, un-timed exams are a really common and accepted testing accommodation for ADHD....the disability office would be hard-pressed to justify not providing the accommodation, without that justification they would be jeopardizing compliance with the ADA.

keithjones · Dec 21, 2009

on one hand i understand making accomodations for disabilities, on the other hand nursing licenses don't include restrictions that dictate you get a quiet nursing environment, or extra time with patients. If you can't get through nursing school without accomodations then you probably don't need to be a nurse. that said, there are many places you could be a nurse and not have issues but critical care would probably be out of the question. also, just so you know I have inattentive type ADD, do not take meds and just completed one semester of prereqs with a 4.0

CuriousMe · Dec 21, 2009

on one hand i understand making accomodations for disabilities, on the other hand nursing licenses don't include restrictions that dictate you get a quiet nursing environment, or extra time with patients. If you can't get through nursing school without accomodations then you probably don't need to be a nurse. that said, there are many places you could be a nurse and not have issues but critical care would probably be out of the question. also, just so you know I have inattentive type ADD, do not take meds and just completed one semester of prereqs with a 4.0

The work environment and an academic classroom with xx amount of students in it trying to quietly take a test couldn't be more different. I don't have extra time for exams, but I do use a private room for exams. I would do better taking the exam at the nursing station than in a room with the rest of my class...the most distracting environment I can think of is a room were 50+ people are trying to be quiet...give me the chaos of the nurses station any day...I can totally pay attention there! The person isn't asking for more clinical time with a patient, but asking for time during a pen and paper exam. Oh and yes, the Board of Nursing has to follow the ADA as well, so even for the NCLEX someone who needs an accommodation of more testing time due to a disability; they can get it. Plenty of nurses work clinically, even in critical care, who have ADHD, both medicated and unmedicated.

I have combined type ADHD (so I get to be both inattentive and hyperactive ). I have worked all over the world, for 10+ years, as a computer professional and was always able to figure out ways to get what I needed done. But in academics, there's no flexibility...everyone has to sit in the classroom, while everyone tries to be quiet, and has to answer questions sitting at a desk. That's not a real world scenario. I don't know about you, but I've never seen a patient under those circumstances.

I never took meds until my third term of nursing school (had a 4.2 GPA when I applied to nursing school and have a 4.0 after 5 terms of nursing school and our grades include both theory as well as clinical) and honestly don't know why I would stop taking them. I think better, I don't have to work as hard to force myself to pay attention (ie I don't have to do as many fidgets...pacing while reading, playing with a paper clip under my desk during lecture) I can just pay attention without constantly working at it. And my stress level has dramatically decreased....I can actually sleep now...it's a wonderful thing. I don't see taking the meds as a negative, I see them as a tool that levels the playing field a bit for me....so I don't have to work so hard to compensate for my brain chemistry.

The testing accommodations are the same thing, they're a tool that help to level the playing field a bit. To deny them, is just unfair (and illegal).

However, just because I don't use extra time for my exams (and from your post you don't either) doesn't mean that no one with ADHD should have them. We all have a different experience. Our neurotransmitter deficits (the reason that stimulant meds are so effective with ADHD) are all just a bit different. I'm so happy for you that you've done so well and found other ways to compensate for your neurotransmitter deficits, but to expect everyone to have your level of success with no meds or accommodations just because you have....well, it's unrealistic.

keithjones · Dec 22, 2009

I never meant to say that anyone should go without ADHD meds, my family already consumes more than $300 worth of ADHD meds per month and I can't afford to add more expense for mine. I learned through 32 years of trial and error how to cope but it is still very hard and I will be getting meds once I get good health insurance!

I forgot 2 homework assignments this semster, luckily only 5 points each, due to my ADHD (combined with blackboard glitches that threw of my scheduled homework times) and could request accomodations, but some of my classmates "hate" me already due to my excellent grades, I prefer to gloat a little (in that funloving sort of way) rather than lose that ability and get told I only did so well due to special accomodations.

bennettsmith · Dec 22, 2009

I understand that the laws are in place to accommodate for those with a learning disability. The thing I do not understand is that in a medical program one has to meet a certain amount of criteria to get through. Everyone is held to the same standards and not everyone makes it through. Those students who give birth mid semester, have full time jobs and family to help stress things out ,or those who deal with family tragedies during the program do not get special treatment. In one way or another we all deserve untimed testing -it is true. So why is it fair to be selective?

CuriousMe · Dec 22, 2009

I understand that the laws are in place to accommodate for those with a learning disability. The thing I do not understand is that in a medical program one has to meet a certain amount of criteria to get through. Everyone is held to the same standards and not everyone makes it through. Those students who give birth mid semester, have full time jobs and family to help stress things out ,or those who deal with family tragedies during the program do not get special treatment. In one way or another we all deserve untimed testing -it is true. So why is it fair to be selective?

Because all the things you mentioned above (getting pregnant, going to school while having a family, working full time) they are all choices...tragedies are awful and can happen to anyone as well....and BTW, the ADHD person has all that in their life as well. (and yes I know some folks will say that things like working full time or family aren't choices....but they are....folks just don't--quite understandably--like the consequences of choosing not to have those things).

Technically, ADHD is not a learning disability, it is a deficit of dopamine in the pre-frontal cortex and dopaminergic pathways of the brain. No choice involved....their brain chemistry makes some things harder for them. The pre-frontal cortex is the bit of your brain that makes you do things that aren't interesting, but that you know you need to do (well it does a bunch of things, but that's one of them)....it's kind of like a Mama nagging the rest of your brain to keep on task, monitor how long things take, and keep everything on schedule. With decreased pre-frontal cortex input (due to a lack of neurotransmitter to make it active) those kinds of things are much harder for an individual with ADHD. On top of their brain chemistry, they're dealing with the same things you spoke about....family, work schedule, yadda, yadda, yadda.

The point of testing is to see if I understand what I'm supposed to understand (with that I agree with you) but how does the program know about how much I know if (due to my neurotransmitter deficits) every time someone coughs or shifts papers, or gets up (or a thousand small sounds that happen in an exam room) my concentration is broken (distractability is one of my primary hurdles) so then I have to figure out what question I'm on again, start reading through it again, then someone moves behind me, well I automatically turn around and see someone leave the room, now my head is wondering where they are going, wow it's chilly in here when they open the door, I wonder why the school doesn't turn the heat on sooner in the year, I understand them trying to save money and all but do they need to freeze us, maybe we could make some kind of formal request, I wonder who I would speak to about that, should I go through the school of nursing or the Dean of students, or maybe I should bring it to student government, they're supposed to be a liaison between us and the school, this might be the kind of thing they're involved with--who is my representative again, I think it's Mary--I'll be sure to try and grab her after lab tomorrow and chat, that will be fun to, I really enjoy her a lot, she always has a different perspective on things...oh wait I need to pay attention to the exam...what number am I on again...oh, ok..so read the question, hey I've read this before, didn't I finish this question, let's check the answer sheet, nope no answer yet...and turn around again because whomever left the room just came back in...wow, I really like that shirt she's wearing, great color. Oh, dang....20 minutes have gone by...need to focus on the exam...what question was I on? (My apologies...I know that was the longest run-on sentence in the world....but I wanted to give an idea of what it feels like to be be distracted by, well everything.)

You get the idea. That doesn't demonstrate what I know.....this demonstrates my inability to block out distractions in a testing environment (not a clinical environment). Now everyone experiences stuff like this to some degree....it's the degree that's the issue. In order to be diagnosed with ADHD, there has to be a demonstrated deficit that shows up in more than one place in your life....so, while everyone has a hard time paying attention to boring things, most folks can just make themselves do what they need to...a Dx of ADHD means there was evidence that they couldn't....in two different areas of their life (home, work, school, etc). And that it's been this way since before they were 7 years old. It's all a matter of degree...kind of like depression. Everyone has times in their life when they feel low.....but chemical depression is more than that. Well everyone has times in their life when they feel distracted, and unable to focus.....but ADHD is more than that.

Testing accommodations aren't there to cut some slack to the student because they're having a bad time of it. An analogy might be running a race while carrying weights. As students, we're all carrying a load. The load is a bit different for each person....and the weight of each person's load can be different day-to-day...depending on what else is going on in their life. But let's say that just being a student in nursing school, the load can be between 50 - 100lbs. Well, the ADHD person has the same range of 50 - 100lbs....but they're born with a 100lb weight that is always sitting on their shoulders. Accommodations might minimize the 50-100lbs load to 50-75lbs. So, yes, it's a bit lighter....but they're still working harder just to keep up with everyone.

We're learning to be nurses....not test takers. She's not asking for accommodations in clinicals....but in taking pen and paper exams.

CuriousMe · Dec 22, 2009

I never meant to say that anyone should go without ADHD meds, my family already consumes more than $300 worth of ADHD meds per month and I can't afford to add more expense for mine. I learned through 32 years of trial and error how to cope but it is still very hard and I will be getting meds once I get good health insurance!
I forgot 2 homework assignments this semster, luckily only 5 points each, due to my ADHD (combined with blackboard glitches that threw of my scheduled homework times) and could request accomodations, but some of my classmates "hate" me already due to my excellent grades, I prefer to gloat a little (in that funloving sort of way) rather than lose that ability and get told I only did so well due to special accomodations.

So glad you have methods of coping. I have a lot "tricks" I use as well and yes the meds can really get up there in price. I was really happy this past spring when the generic for Adderall XR came out. My meds are half as much cash now.

I guess I don't much care if students think I only do well because of my testing accommodations. If they think that, they obviously don't have an understanding of what's really going on. I have had one person make a negative comment to me saying they wish they could test in another room and I just said that I wish I could pay attention without help but we're dealt the cards we're dealt.

Truthfully though, I don't generally share my grades. I'll ask others if they were happy with how they did and when I'm asked about my grades I'll share about if I did as well as I wanted. That's really the important question anyway....we all have different goals on what we're shooting for; to me what grade they got is less important than did they get the grade they were shooting for.

Peace.

CuriousMe

bennettsmith · Dec 22, 2009

Because all the things you mentioned above (getting pregnant, going to school while having a family, working full time) they are all choices...tragedies are awful and can happen to anyone as well....and BTW, the ADHD person has all that in their life as well. (and yes I know some folks will say that things like working full time or family aren't choices....but they are....folks just don't--quite understandably--like the consequences of choosing not to have those things).

So you can choose your family? Just to stray from the original question even further -How would you go about choosing not to have those things?

CuriousMe · Dec 22, 2009

So you can choose your family? Just to stray from the original question even further -How would you go about choosing not to have those things?

You choose to have relationships with your family, you chose to spend time with them, sometimes live with them. All choices....of course you can't choose who your biological family are.....but you chose to be in relationship with them or not.

Family was brought up as a constraint of nursing school. One could choose to walk away from family and go to nursing school. Now the likelihood of making that choice is between slim and none and for the overwhelming majority....it is a completely terrible idea to give up all ties with family to go to nursing school.

But brain chemistry is never a choice at any level....your brain chemistry is your brain chemistry. You can take medications that temporarily modifies it to some degree....but your brain chemistry is still your brain chemistry.

That's why ADHD is considered a disability and having a family while in nursing school isn't.