European Journal of Special Education Research ISSN: 2501 - 2428 ISSN-L: 2501 - 2428 Available on-line at: www.oapub.org/edu Volume 2 │ Issue 6 │ 2017 doi: 10.5281/zenodo.1058974 COMPUTER ASSISTED INSTRUCTION OF STUDENTS WITH ADHD AND ACADEMIC PERFORMANCE: A BRIEF REVIEW OF STUDIES CONDUCTED BETWEEN 1993 AND 2016, AND COMMENTS George Botsas1i, George Grouios2 Greek Ministry of Education & Frederick University, Cyprus 1 “ristotle’s University of Thessaloniki, Greece 2 Abstract: Computer Assisted Instruction (CAI) is an instructional context that uses a computer as the mean for teaching pupils in individualized settings. CAI has been proposed as a compensatory instructional strategy among others for pupils with attentional, impulsivity and hyperactivity disorder (ADHD). This brief literature review synthesizes the outcomes of CAI to improve academic performance in various school disciplines for children with ADHD. First, it addresses research that studies the impact on academic disciplines performance of elementary school individuals with ADHD. Second, it considers methodological and pedagogical aspects of the studies reviewed. Finally, comments and recommendations, either in instructional and research context are made. Most of the studies reviewed suggested that CAI is an effective strategy in order to improve academic skills of pupils with ADHD. Moreover, an improvement in on-task and a decrease on error and off-task behaviors emerged as a byproduct of CAI intervention in some of those studies. Keywords: ADHD, Computer assisted instruction, academic performance, brief review, comments 1. Introduction Since the second half of the last century, Attention Deficit Hyperactivity Disorder (ADHD) became a worldwide phenomenon and since then, a real hot point of Copyright © The Author(s). All Rights Reserved. © 2015 – 2017 Open Access Publishing Group 146 George Botsas, George Grouios COMPUTER ASSISTED INSTRUCTION OF STUDENTS WITH ADHD AND ACADEMIC PERFORMANCE: A BRIEF REVIEW OF STUDIES CONDUCTED BETWEEN 1993 AND 2016, AND COMMENTS discussion (Graham, 2006). ADHD is a neurodevelopmental disorder, and its diagnosis applies to children that exhibit a rather developmental inappropriate profile regarding attention, hyperactivity, and impulsivity (APA, 2013). DSM V refers to some essential features that form the diagnostic criteria of ADHD (APA, 2013). First, a "… persistent pattern of inattention and/or hyperactivityimpulsivity that interferes with functioning or development have to be present p. . Second, several inattentive or hyperactive-impulsive symptoms must have been present prior to 12 years of age . Third, an impairment caused by the above symptoms must also be present in two different child’s placements. Forth, there is clear evidence that the symptoms interfere with, or reduce the quality of, social, academic, or occupational functioning and finally, these symptoms do not occur and are not explained by another psychotic or mental disorder (p. 60). This profile mediates negatively everyday functioning at school, at home and other settings. As a result, students with ADHD encounter problems with sustaining attention to specific stimuli and especially academic tasks or activities; they do not follow directions and always being distracted by extraneous stimuli. This maladaptive and developmental inappropriate profile of students with ADHD affects their school life and has a rather negative impact on their overall academic achievement. Students' academic deficient achievement affects various disciplines, like reading, writing, mathematics, science (Barkley, 2006; Brand, Dunn, & Greb, 2002; DuPaul & Vople, 2009). Over the last 30 years, some teaching strategies have been suggested and supported to be efficient. One of them, targeting students’ with “DHD, academic performance is Computer Assisted Instruction (CAI). Computers’ use as a portion of the instructional procedure was presented by Skinner (1958), but it was not before 1970's that microcomputers' use in education became the focus of studies (Benjamin, 1988). This research period was followed by the "internet" one when online educational treatment was evaluated, in the early millennium (Aslan & Reigeluth, 2011). Research on CAI use has been proposed as a quite promising intervention through almost thirty years (1967 to 1991). Reviews and meta-analyses of studies in this period suggested that CAI was a valid instructional strategy, especially for nondisabledii students (Kulik & Kulik, 1991; Kulik, Kulik, & Bangert-Drowns, 1985). As computers’ use in daily classroom instruction was expanding, many studies in C“I were conducted in the last twenty years, along with several reviews and meta-analyses (Bayraktar, 2001; Blok, Oostdam, Otter, & Overmacht, 2002; Fuchs, Fuchs, Hamlet, ii The use of nondisabled word follows the guidelines of APA (2010) and refers to students without disabilities. European Journal of Special Education Research - Volume 2 │ Issue 6 │ 2017 147 George Botsas, George Grouios COMPUTER ASSISTED INSTRUCTION OF STUDENTS WITH ADHD AND ACADEMIC PERFORMANCE: A BRIEF REVIEW OF STUDIES CONDUCTED BETWEEN 1993 AND 2016, AND COMMENTS Powell, Capizzi, & Seethaler, 2006; Liao, 2007; Liu, Moore, Graham, & Lee, 2002; Slavin & Lake, 2008; Soe, Koki, & Chang, 2000). Most of those reviews and meta-analyses presented findings in phonological awareness, beginning reading, math and science performance improvement of nondisabled students. Research on CAI has also expanded on interventions for students with special educational needs. Special education took advantage of data gained by studies in the effectiveness of CAI. Thus, Schmidt, Weinstein, Niemiec, and Walberg (1985-1986) reviewed studies on CAI for students either at risk or diagnosed with disabilities. They found that 23 out of the studies supported C“I’s effectiveness. Several studies, mostly single subject ones, studied CAI effectiveness on teaching students with autism, learning and other high incidence disabilities (Hall, Hughes, & Filbert, 2000; Pennington, 2010; Seo & Bryant, 2009; Stetter & Hughes, 2010). In the s a research interest in C“I’s impact on academic performance of students with “DHD emerged. C“I’s special features like visual and auditory stimulation and immediate feedback availability, along with step by step and in the students’ pace presentation of tasks, suggested this strategy to be an opportunity for success in several academic fields (DuPaul & Stoner, 2003). As researchers supported, CAI could provide instructive and consistently efficient compensatory actions, in a pedagogical context of teaching strategies to overcome academic difficulties through direct instruction and scaffolding. Although repetitive tasks are associated with boredom and impulsivity of students with ADHD, computers could support rehearsals and repetitions for practice and fluency, in an active and motivated manner (Rieth & Semmel, 1991). CAI effectiveness as an academic intervention for students with ADHD was examined by several studies between 1993 and 2016, and reviews and meta-analyses have been conducted. Alper and Raharinirina (2006) reviewed sixty studies focused on assistive technology for individuals with disabilities, including students with ADHD. Most of those studies examined CAI effectiveness in students’ treatment. “lthough they suggested that computers and other assistive technology features could improve skills and performance of disabled children, they posed concerns about professionals’ adequate training and usage of CAI. Kroesbergen and Van Luit (2003) presented a meta-analysis of fifty-eight studies of mathematics interventions for elementary students with special needs. Among those interventions was CAI and some of the participants of the studies were students with ADHD, supporting computers’ use impact on achievement. Respectively, DuPaul, Eckert, and Vilardo (2012) examined school-based interventions effectiveness, some of them referring to CAI, for students with ADHD. European Journal of Special Education Research - Volume 2 │ Issue 6 │ 2017 148 George Botsas, George Grouios COMPUTER ASSISTED INSTRUCTION OF STUDENTS WITH ADHD AND ACADEMIC PERFORMANCE: A BRIEF REVIEW OF STUDIES CONDUCTED BETWEEN 1993 AND 2016, AND COMMENTS They suggested that contingency management, academic intervention, and cognitivebehavioral intervention strategies were associated with positive effects on academic and behavioral gains. Fitzgerald, Koury, and Mitchen (2008) reviewed studies on Computermediated instruction impact on the learning of students with mild and moderate disabilities (ADHD among them) in curriculum content areas of reading, writing, and mathematics. Although they found computer use in daily instruction to be supportive to learning, they posed a lot of concerns about methods, samples and confounding variables' presence. Finally, Xu, Reid, and Steckelberg (2002) reviewed studies on technology applications, with computer-based instruction among them, in diverse areas of achievement (like academic, behavior and others) of students with ADHD. They concluded that there were little well-controlled experimental studies on the effectiveness of technology applications for students with ADHD. The above reviews and meta-analyses offered data that need clarifications. Although most of them supported the value of CAI as a valid intervention for improving the performance of students with ADHD, no one was focused on CAI, students with ADHD and their academic achievement, at the same time. Some of them reviewed outdated studies, being out of the present technological literate context of instruction. The purpose of the current review was to analyze studies regarding Computer“ssisted Instruction’s impact on academic performance of elementary school-aged children with ADHD on reading, writing, mathematics and other academic disciplines briefly. Interventions concerning CAI, especially for students with ADHD, form a rather heterogeneous context. Nonetheless, a review could benefit instructional practice not only by positive outcome identification but also by deepening our understanding of those students and encountering their instruction in a differentiated and efficient way. Another aim of this review was also to comment and make recommendations for using C“I in compensating students’ difficulties and providing their integration in typical classroom settings. CAI was considered as a tool for instructional delivery, targeting students' with ADHD academic performance improvement, regarding practice and fluency or new academic skill establishment. Also, it's a brief review of studies concerning CAI implementation depending on and presented by the academic discipline context, not in chronological order. Moreover, it addresses concerns about the studies' methodology designs and hardware or software used, along with the presentation of pedagogical comments about instructional practice and research recommendations. For viewing / downloading the full article, please access the following link: https://oapub.org/edu/index.php/ejse/article/view/1193 European Journal of Special Education Research - Volume 2 │ Issue 6 │ 2017 149