Educational Issues during Middle Childhood

What you’ll learn to do: examine common learning disabilities and other factors related to education during middle childhood

Two boys at a desk looking down at a book

Across the world, by the time a child is entering middle childhood, they are being educated in some form or fashion. In western society, most children are enrolled in a formal education program by the time they are in middle childhood.[1] That said, what children learn within that formal education program varies greatly across cultures. Further, most programs are set-up for typically developing children, but they may not be set-up to handle children who are accelerated learners or children with learning disabilities. In this section, we’ll take a look at some of these educational differences and developments, as well as struggles and learning difficulties during middle childhood.

Learning Outcomes

  • Evaluate the impact of labeling on children’s self-concept and social relationships
  • Describe autism spectrum disorders
  • Identify common learning disabilities such as dyslexia and attention deficit hyperactivity disorder
  • Compare Gardner’s theory of multiple intelligences and Sternberg’s triarchic theory of intelligence
  • Apply the ecological systems model to explore children’s experiences in schools

Developmental Disorders and Learning Disabilities

Girl screaming with anger and frustration as she works on some homework.
Figure 1. What are the pros and cons of labeling a child with a learning disability?

Children’s cognitive and social skills are evaluated as they enter and progress through school. Sometimes this evaluation indicates that a child needs special assistance with language or in learning how to interact with others. Evaluation and diagnosis of a child can be the first step in helping to provide that child with the type of instruction and resources needed. But diagnosis and labeling also have social implications. It is important to consider that children can be misdiagnosed and that once a child has received a diagnostic label, the child, teachers and family members may tend to interpret actions of the child through that label. The label can also influence the child’s self-concept. Consider, for example, a child who is misdiagnosed as learning disabled. That child may expect to have difficulties in school, lack confidence, and out of these expectations, have trouble indeed. This self-fulfilling prophecy, or tendency to act in such a way as to make what you predict will happen, comes true, calls our attention to the power that labels can have whether or not they are accurately applied.

It is also important to consider that children’s difficulties can change over time; a child who has problems in school may improve later or may live under circumstances as an adult where the problem (such as a delay in math skills or reading skills) is no longer relevant. That person, however, will still have a label as learning disabled. It should be recognized that the distinction between abnormal and normal behavior is not always clear; some abnormal behavior in children is fairly common. Misdiagnosis may be more of a concern when evaluating learning difficulties than in cases of autism spectrum disorder where unusual behaviors are clear and consistent.

Keeping these cautionary considerations in mind, let’s turn our attention to some developmental and learning difficulties.

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Autism Spectrum Disorder

Autism spectrum disorder (ASD) is a developmental disorder that affects communication and behavior. The estimate published by the Center for Disease Control (2018)[ is that about 1 out of every 59 children in the United States has been diagnosed with Autism Spectrum Disorder (ASD), which covers a wide variety of ranges in ability, from those with milder forms (formerly known as Asperger’s Syndrome) to more severe deficits in communication.[2]

Link to Learning

Learn more about Autism Spectrum Disorders at Autism Speaks (, or the Autistic Self Advocacy Network (

A person with autism has difficulty with and a lack of interest in learning language. An autistic child may respond to a question by repeating the question or might rarely speak. Sometimes autistic children learn more difficult words before simple words or can complete complicated tasks before they are able to complete easier ones. The person often has difficulty reading social cues such as the meanings of non-verbal gestures such as a wave of the hand or the emotion associated with a frown. Intense sensitivity to touch or visual stimulation may also be experienced. Autistic children often have poor social skills and are often unable to communicate with others or empathize with others emotionally. People with autism often view the world differently and learn differently than people who do not have autism. Autistic children tend to prefer routines and patterns and become upset when routines are altered. For example, moving the furniture or changing the daily schedule can be very upsetting.

Many children with ASD are not identified until they reach school age, although our ability to diagnose children earlier continues to improve. In the 2017-2018 school year, about 710,000 children on the spectrum received special education through the public schools.[3] These disorders are found in all racial and ethnic groups and are more common in boys than in girls. All of these disorders are marked by difficulty in social interactions, problems in various areas of communication, and in difficulty with altering patterns or daily routines. There is no single cause of ASD and the causes of these disorders are to a large extent, unknown. In cases involving identical twins, if one twin has autism, the other is also autistic about 75 percent of the time. Rubella, fragile X syndrome and PKU that has been untreated are some of the medical conditions associated with risks of autism.

Some individuals benefit from medications that alleviate some of the symptoms of ASD, but the most effective treatments involve behavioral intervention and teaching techniques used to promote the development of language and social skills. Children also excel when they are in structured learning environments that accommodate the needs of children on the spectrum.

Learning Disabilities

What is a learning disability? If a child is mentally disabled, that child is typically slow in all areas of learning. However, a child with a learning disability has problems in a specific area or with a specific task or type of activity related to education. A learning difficulty refers to a deficit in a child’s ability to perform an expected academic skill (Berger, 2005). These difficulties are identified in school because this is when children’s academic abilities are being tested, compared, and measured. Consequently, once academic testing is no longer essential in that person’s life (as when they are working rather than going to school) these disabilities may no longer be noticed or relevant, depending on the person’s job and the extent of the disability.

Dyslexia is a specific learning disability that is neurobiological in origin. It is characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities ( Dyslexia is one of the most commonly diagnosed disabilities and involves having difficulty in the area of reading. This diagnosis is used for a number of reading difficulties. For example, the child may reverse letters, may have difficulty reading from left to right, or may have problems associating letters with sounds. Dyslexia appears to be rooted in some neurological problems involving the parts of the brain active in recognizing letters, verbally responding, or being able to manipulate sounds (National Institute of Neurological Disorders and Stroke, 2006). Treatment typically involves altering teaching methods to accommodate the person’s particular problematic area.

Watch It

Reading expert Margie Gillis explains dyslexia in the following video:

Attention Deficit Hyperactivity Disorder (ADHD) is considered a neurological and behavioral disorder in which a person has difficulty staying on task, screening out distractions, and inhibiting behavioral outbursts. The most commonly recommended treatment involves the use of medication, structuring the classroom environment to keep distractions at a minimum, tutoring, and teaching parents how to set limits and encourage age-appropriate behavior (NINDS, 2006). Some people say that the term Attention Deficit is a misnomer because people who suffer from ADHD actually have great difficulty tuning things out. They are bombarded with information… their brains are trying to pay attention to everything. They do not have a deficit of attention- they are trying to pay attention to too many things at once, so everything suffers.

Recent research suggests that several brain structures may be implicated in ADHD. These studies have mainly focused on the frontal lobe and prefrontal cortex.[4] Some studies suggest that the frontal lobe is underdeveloped in children and adults with ADHD.[5][6] The frontal lobe is involved in executive function, attention, planning, impulse control, motivation, and decision making. In some cases the development is delayed, but catches up to expected standards by adulthood; in other cases, the frontal lobe never fully develops.

Link to Learning

How is ADHD diagnosed? The DSM-V lists the criteria that must be present in order for a diagnosis to be made and an official diagnosis must be made by a qualified mental health professional.  It is also important to note that the term ADD is an older term that has been phased out in the newer versions of the DSM. Review the criteria for ADHD ( Do you think that making a diagnosis would be difficult? Why or why not?

In general, ADHD is treated with stimulants. While this may seem counter-intuitive (why give a hyperactive child a stimulant?), when you understand the neurological processes involved, it makes a lot of sense. There are two ways that stimulants may work to help people with ADHD focus. Some researchers have found that the stimulants activate the underdeveloped parts of the brain (prefontal cortex and frontal lobe) thereby making these brain areas function more as they should.[7] This allows the child or adult to focus properly. Other researchers suspect that the stimulants affect the way the neurotransmitters function in these brain areas, leading to better function in those areas.[8][9]

There is still a lot of controversy about medicating children with ADHD. While there is clear evidence that medication works to control the negative effects of ADHD, there are also negative side effects that must be dealt with including problems sleeping, changes in appetite, headaches, and more. Further, the long term effects of medicating young children are not well understood. For these reasons, many parents prefer an intervention that does not involve medication. The most common non-pharmaceutical intervention for ADHD is Cognitive Behavioral Therapy (CBT). CBT works by helping children to become aware of their thought processes, and then to learn to change those thought processes to be more beneficial or positive.[10] CBT can also help by educating parents about ways to help their children learn about self-control and discipline. There is very good evidence that CBT is an effective strategy in treating ADHD. Indeed, in some studies, children treated with CBT have better long term outcomes than children treated with medication. Some studies show that a combination of medication and CBT is most beneficial because the medication helps with behavior change more quickly, allowing for the child to learn through CBT more quickly. The CBT then helps with longer-term behavior change so that the child can stop taking medications and deal effectively with their ADHD symptoms based on what they have learned through CBT.

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Learning and Intelligence

Schools and Testing

When Should School Begin?

four elementary students sit in front of computers taking a standardized test.
Figure 2. An average elementary schooler will spend around 7 hours a day in school.

In the United States, children generally begin school around age 5 or 6. In fact, most Western countries follow this model. But WHY do we begin school at 5 or 6? For the most part, this age was chosen as a matter of convenience. In countries where the mother is expected to work, the age at which children begin school tends to be younger. That said, research does not support that children should begin formal education so early. Many research studies suggest age 7 is the most appropriate age to begin formalized school.[11] Before age 7, children learn best through play. By age 7, most children are capable of learning in a more formal academic-forward setting.

The Controversy Over Testing In Schools

Children’s academic performance is often measured with the use of standardized tests. Achievement tests are used to measure what a child has already learned. Achievement tests are often used as measures of teaching effectiveness within a school setting and as a method to make schools that receive tax dollars (such as public schools, charter schools, and private schools that receive vouchers) accountable to the government for their performance. In 2001, President George W. Bush signed into effect the No Child Left Behind Act mandating that schools administer achievement tests to students and publish those results so that parents have an idea of their children’s performance and the government has information on the gaps in educational achievement between children from various social class, racial, and ethnic groups. Schools that show significant gaps in these levels of performance are to work toward narrowing these gaps. Educators have criticized the policy for focusing too much on testing as the only indication of performance levels.

Aptitude tests are designed to measure a student’s ability to learn or to determine if a person has potential in a particular program. These are often used at the beginning of a course of study or as part of college entrance requirements. The Scholastic Aptitude Test (SAT) and Preliminary Scholastic Aptitude Test (PSAT) are perhaps the most familiar aptitude tests to students in grades 6 and above. Learning test-taking skills and preparing for SATs has become part of the training that some students in these grades receive as part of their pre-college preparation. Other aptitude tests include the MCAT (Medical College Admission Test), the LSAT (Law School Admission Test), and the GRE (Graduate Record Examination). Intelligence tests are also a form of aptitude tests which are designed to measure a person’s ability to learn.

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Theories of Intelligence

Intelligence tests and psychological definitions of intelligence have been heavily criticized since the 1970s for being biased in favor of Anglo-American, middle-class respondents and for being inadequate tools for measuring non-academic types of intelligence or talent. Intelligence changes with experience and intelligence quotients or scores do not reflect that ability to change. What is considered smart varies culturally as well and most intelligence tests do not take this variation into account. For example, in the West, being smart is associated with being quick. A person who answers a question the fastest is seen as the smartest. But in some cultures, being smart is associated with considering an idea thoroughly before giving an answer. A well-thought-out and contemplative answer is the best answer.

Watch It

Watch this video to learn more about the history behind intelligence testing.

Multiple Intelligences

Howard Gardner (1983, 1998, 1999) suggests that there are not one, but nine domains of intelligence. His theory is known as the theory of multiple intelligences. The first three are skills that can be measured by IQ tests:

  • Logical-mathematical: the ability to solve mathematical problems; problems of logic, numerical patterns
  • Linguistic: vocabulary, reading comprehension, function of language
  • Spatial: visual accuracy, ability to read maps, understand space and distance

The next six represent skills that are not measured in standard IQ tests but are talents or abilities that can also be important for success in a variety of fields: These are:

  • Musical: ability to understand patterns in music, hear pitches, recognize rhythms and melodies
  • Bodily-kinesthetic: motor coordination, grace of movement, agility, strength
  • Naturalistic: knowledge of plants, animals, minerals, climate, weather
  • Interpersonal: understand the emotion, mood, motivation of others; able to communicate effectively
  • Intrapersonal: understanding of the self, mood, motivation, temperament, realistic knowledge of strengths, weaknesses
  • Existential: concern about and understanding of life’s larger questions, meaning of life, or spiritual matters

Gardner contends that these are also forms of intelligence. A high IQ does not always ensure success in life or necessarily indicate that a person has common sense, good interpersonal skills or other abilities important for success.

Triarchic Theory of Intelligence

Another alternative view of intelligence is presented by Sternberg (1997; 1999). Sternberg offers three types of intelligences, known as the triarchic theory of intelligence. Sternberg was concerned that there was too much emphasis placed on aptitude test scores and believed that there were other, less easily measured, qualities necessary for success in a higher education and in the world of work. Aptitude test scores indicate the first type of intelligence—academic, or analytical.

  • Analytical (componential): includes the ability to solve problems of logic, verbal comprehension, vocabulary, and spatial abilities.

Sternberg noted that students who have high academic abilities may still not have what is required to be a successful graduate student or a competent professional. To do well as a graduate student, he noted, the person needs to be creative. The second type of intelligence emphasizes this quality.

  • Creative (experiential): the ability to apply newly found skills to novel situations.

A potential graduate student might be strong academically and have creative ideas, but still be lacking in the social skills required to work effectively with others or to practice good judgment in a variety of situations. This common sense is the third type of intelligence.

  • Practical (contextual): the ability to use common sense and to know what is called for in a situation.

This type of intelligence helps a person know when problems need to be solved. Practical intelligence can help a person know how to act and what to wear for job interviews, when to get out of problematic relationships, how to get along with others at work, and when to make changes to reduce stress.

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Think It Over

As an adult, what kind of intellectual skills do you consider to be most important for your success? Consequently, how would you define intelligence?

Theories of Intelligence

You may have heard the myth that there are specific learning styles, but research tells us this is not, in fact, the case. Click through this interactive to learn more and to review theories about intelligence.

The World of School

Remember Urie Brofenbrenner’s ecological systems model we learned about when we first examined theories of development? This model helps us understand an individual by examining the contexts in which the person lives and the direct and indirect influences on that person’s life. School becomes a very important component of children’s lives during middle childhood and one way to understand children is to look at the world of school. We have discussed educational policies that impact the curriculum in schools above. Now let’s focus on the school experience from the standpoint of the student, the teacher and parent relationship, and the cultural messages or hidden curriculum taught in school in the United States.

Parents vary in their level of involvement with their children’s schools. Teachers often complain that they have difficulty getting parents to participate in their child’s education and devise a variety of techniques to keep parents in touch with daily and overall progress. For example, parents may be required to sign a behavior chart each evening to be returned to school or may be given information about the school’s events through websites and newsletters. There are other factors that need to be considered when looking at parental involvement. To explore these, first ask yourself if all parents who enter the school with concerns about their child are received in the same way? If not, what would make a teacher or principal more likely to consider the parent’s concerns? What would make this less likely?

Lareau and Horvat (2004) found that teachers seek a particular type of involvement from particular types of parents. While teachers thought they were open and neutral in their responses to parental involvement, in reality teachers were most receptive to support, praise and agreement coming from parents who were most similar in race and social class with the teachers. Parents who criticized the school or its policies were less likely to be given voice. Parents who have higher levels of income, occupational status, and other qualities favored in society have family capital. This is a form of power that can be used to improve a child’s education. Parents who do not have these qualities may find it more difficult to be effectively involved. Lareau and Horvat (2004) offer three cases of African-American parents who were each concerned about discrimination in the schools. Despite evidence that such discrimination existed, their children’s white, middle-class teachers were reluctant to address the situation directly. Note the variation in approaches and outcomes for these three families:

  • The Williams family: This working-class, African-American couple, a minister and a hair stylist, voiced direct complaints about discrimination in the schools. Their claims were thought to undermine the authority of the school and as a result, their daughter was kept in a lower reading class. However, her grade was boosted to “avoid a scene” and the parents were not told of this grade change.
  • The Irving family: This middle class, African-American couple was concerned that the school was discriminating against black students. They fought against it without using direct confrontation by staying actively involved in their daughter’s schooling and making frequent visits to the school so make sure that discrimination could not occur. They also talked with other African-American teachers and parents about their concerns.
  • Ms. Caldron: This poor, single-parent was concerned about discrimination in the school. She was a recovering drug addict receiving welfare. She did not discuss her concerns with other parents because she did not know the other parents and did not monitor her child’s progress or get involved with the school. She felt that her concerns would not receive attention. She requested spelling lists from the teacher on several occasions but did not receive them. The teacher complained that Ms. Caldron did not sign forms that were sent home for her signature.

Working within the system without direct confrontation seemed to yield better results for the Irvings, although the issue of discrimination in the school was not completely addressed. Ms. Caldron was the least involved and felt powerless in the school setting. Her lack of family capital and lack of knowledge and confidence keep her from addressing her concerns with the teachers. What do you think would happen if she directly addressed the teachers and complained about discrimination? Chances are, she would be dismissed as undermining the authority of the school, just as the Masons, and might be thought to lack credibility because of her poverty and drug addiction. The authors of this study suggest that teachers closely examine their biases against parents. Schools may also need to examine their ability to dialogue with parents about school policies in more open ways. What happens when parents have concerns over school policy or view student problems as arising from flaws in the educational system? How are parents who are critical of the school treated? And are their children treated fairly even when the school is being criticized? Certainly, any efforts to improve effective parental involvement should address these concerns.

Student Perspectives

Imagine being a 3rd-grader for one day in public school. What would the daily routine involve? To what extent would the institution dictate the activities of the day and how much of the day would you spend on those activities? Would you always be on task? What would you say if someone asked you how your day went? or “What happened in school today?” Chances are, you would be more inclined to talk about whom you sat at lunch with or who brought a puppy to class than to describe how fractions are added.

Ethnographer and Professor of Education Peter McLaren (1999) describes the student’s typical day as filled with constrictive and unnecessary ritual that has a damaging effect on the desire to learn. Students move between various states as they negotiate the demands of the school system and their own personal interests. The majority of the day (298 minutes) takes place in the student state. This state is one in which the student focuses on a task or tries to stay focused on a task, is passive, compliant, and often frustrated. Long pauses before getting out the next book or finding materials sometimes indicate that frustration. The street corner state is one in which the child is playful, energetic, excited, and expresses personal opinions, feelings, and beliefs. About 66 minutes a day take place in this state. Children try to maximize this by going slowly to assemblies or when getting a hall pass-always eager to say ‘hello’ to a friend or to wave if one of their classmates is in another room. This is the state in which friends talk and play. In fact, teachers sometimes reward students with opportunities to move freely or to talk or to be themselves. But when students initiate the street corner state on their own, they risk losing recess time, getting extra homework, or being ridiculed in front of their peers. The home state occurs when parents or siblings visit the school. Children in this state may enjoy special privileges such as going home early or being exempt from certain school rules in the mother’s presence, or it can be difficult if the parent is there to discuss trouble at school with a staff member. The sanctity state is a time in which the child is contemplative, quiet, or prayerful. Typically the sanctity state is a very brief part of the day.

Since students seem to have so much enthusiasm and energy in street corner states, what would happen if the student and street corner states could be combined? Would it be possible? Many educators feel concern about the level of stress children experience in school. Some stress can be attributed to problems in friendship. And some can be a result of the emphasis on testing and grades, as reflected in a Newsweek article entitled “The New First Grade: Are Kids Getting Pushed Too Fast Too Soon?” (Tyre, 2006). This article reports concerns of a principal who worries that students begin to burn out as early as 3rd grade. In the book, The Homework Myth: Why Our Kids Get Too Much of a Bad Thing, Kohn (2006) argues that neither research nor experience support claims that homework reinforces learning and builds responsibility. Why do schools assign homework so frequently? A look at cultural influences on education my provide some answers.

Cultural Influences

Another way to examine the world of school is to look at the cultural values, concepts, behaviors and roles that are part of the school experience but are not part of the formal curriculum. These are part of the hidden curriculum but are nevertheless very powerful messages. The hidden curriculum includes ideas of patriotism, gender roles, the ranking of occupations and classes, competition, and other values. Teachers, counselors, and other students specify and make known what is considered appropriate for girls and boys. The gender curriculum continues into high school, college, and professional school. Students learn a ranking system of occupations and social classes as well. Students in gifted programs or those moving toward college preparation classes may be viewed as superior to those who are receiving tutoring.

Gracy (2004) suggests that cultural training occurs early. Kindergarten is an “academic boot camp” in which students are prepared for their future student role-that of complying with an adult imposed structure and routine designed to produce docile, obedient, children who do not question meaningless tasks that will become so much of their future lives as students. A typical day is filled with structure, ritual, and routine that allows for little creativity or direct, hands-on contact. “Kindergarten, therefore, can be seen as preparing children not only for participation in the bureaucratic organization of large modern school systems, but also for the large-scale occupational bureaucracies of modern society.” (Gracy, 2004, p. 148)

Emphasizing math and reading in preschool and kindergarten classes is becoming more common in some school districts. It is not without controversy, however. Some suggest that emphasis is warranted in order to help students learn math and reading skills that will be needed throughout school and in the world of work. This will also help school districts improve their accountability through test performance. Others argue that learning is becoming too structured to be enjoyable or effective and that students are being taught only to focus on performance and test-taking. Students learn student incivility or lack of sincere concern for politeness and consideration of others is taught in kindergarten through 12th grades through the “what is on the test” mentality modeled by teachers. Students are taught to accept routinized, meaningless information in order to perform well on tests. And they are experiencing the stress felt by teachers and school districts focused on test scores and taught that their worth comes from their test scores. Genuine interest, an appreciation of the process of learning, and valuing others are important components of success in the workplace that are not part of the hidden curriculum in today’s schools.

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Think It Over

  • Do an online search for “kindergarten schedule” and look for a typical daily schedule. Do you think it includes a healthy amount of learning and play? Why or why not?
  • To what extent do you think that students are being prepared for their future student role? What are the pros and cons of such preparation? Look at the curriculum for kindergarten and the first few grades in your own school district.


achievement tests: used to measure what a child has already learned
aptitude tests: used to measure a student’s ability to learn or to determine if a person has potential in a particular program
attention deficit hyperactivity disorder: a neurological and behavioral disorder in which a person has difficulty staying on task, screening out distractions, and inhibiting behavioral outbursts
autism spectrum disorder: a developmental disorder that affects communication and behavior
dyslexia: a specific learning disability that is neurobiological in origin. It is characterized by difficulties with accurate and/or fluent word recognition and by poor spelling and decoding abilities
ecological systems model: Brofenbrenner’s theory that we all belong to many communities and are influenced in the context of multiple environments, also known as ecological systems; organized into five levels of external influence: microsystem, mesosystem, exosystem, macrosystem and chronosystem
hidden curriculum: cultural values, concepts, behaviors and roles that are part of the school experience but are not part of the formal curriculum
home state: occurs when parents or siblings visit the school. Children in this state may enjoy special privileges such as going home early or being exempt from certain school rules in the mother’s presence, or it can be difficult if the parent is there to discuss trouble at school with a staff member
sanctity state: a time in which the child is contemplative, quiet, or prayerful. It is often only a very brief part of the day
self-fulfilling prophecy: the tendency to act in a way that makes what you predict will happen come true
street corner state: state in which the child is playful, energetic, excited, and expresses personal opinions, feelings, and beliefs
student state: this state is one in which the student focuses on a task or tries to stay focused on a task, is passive, compliant, and often frustrated
theory of multiple intelligences: Garner’s theory that there are many kinds of intelligence. The modern version of the theory recognizes 9 forms of intelligence
triarchic theory of intelligence: Sternberg’s theory that recognizes three forms of intelligence: academic, creative, and practical

  1. The World Bank. Primary school starting age (years). Retrieved from
  2. Data & Statistics on Autism Spectrum Disorder. Retrieved from
  3. National Center for Education Statistics. Children 3 to 21 years old served under Individuals with Disabilities Education Act (IDEA). Retrieved from
  4. Sheridan, M. A., Hinshaw, S., & D'Esposito, M. (2010). Stimulant medication and prefrontal functional connectivity during working memory in ADHD: a preliminary report. Journal of attention disorders, 14(1), 69–78. doi:10.1177/1087054709347444
  5. American Academy of Childhood and Adolescent Psychiatry. ADHD & the Brain No. 121 (February 2017). Retrieved from
  6. Low, Keath.  How Stimulants Work to Reduce ADHD Symptoms. Verywell Mind. Retrieved from
  7. Sheridan, M. A., Hinshaw, S., & D'Esposito, M. (2010). Stimulant medication and prefrontal functional connectivity during working memory in ADHD: a preliminary report. Journal of attention disorders, 14(1), 69–78. doi:10.1177/1087054709347444
  8. Stimulant Medications for ADHD. WebMD. Retrieved from
  9. Low, Keath.  How Stimulants Work to Reduce ADHD Symptoms. Verywell Mind. Retrieved from
  10. Understood. Cognitive Behavioral Therapy: What You Need to Know. Retrieved from
  11. Whitebread, David and Sue Bingham (2013). Too much, too young: Should schooling start at age 7? New Scientist. Retrieved from


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