The deficiency disorder of attention and hyperactivity (ADHD) is a neurosviluppo disorder characterized by a Persistent inattention patterns (difficulty in concentrating in tasks that require prolonged attentive effort, organize tasks, listen, take care of objects and material that can be lost), hyperactivity And impulsiveness which also translates into motor behavior (difficulty in being still or seated, difficulty in respecting your game round, tendency to shoot the response or stop the interlocutors).
In the DSM-5 (APA, 2013) it is expressly referred to the impact that this disorder has on social, school and professional skills. Just to encourage assistance, social and school integration and the rights of people with different skills, in 1992 Law 104 was issued. In cases where the compromise of daily activities is very important, even people with ADHD can take advantage of of the provisions of this rule.
In addition, in 2010, with law 170 the rules on specific learning disorders in the school field were defined. With the Directive of December 2012, the Ministry of Education extended the measures provided for by law 170 also to people with ADHD.
We will try to provide some indications to orientate in this complex world to encourage the recognition of rights and thesocial inclusion, school And professional of people with neurodalence.
ADHD: Law 104 or 170?
What are the main differences between law 104/92 and law 170/2010?
The purpose of the Law 104/1992 It is to promote the social, familiar, school and professional integration of people with different skills by guaranteeing dignity, rights, freedom and autonomy.
The difficulties of learning, relationship, work integration with impact in terms of social disadvantage establish the right to take advantage of the provisions of the law. However, the services can be accessed are commensurate with the degree of impairment and residual individual skills. This element is of fundamental importance in ADHD’s paintings.
In fact, children with ADHD is not always recognized as the right to school support or tocivil disability. In the case of the ADHD, the evaluation of the impact that the symptoms have on the person’s family, school and work everyday life is decisive.
There Law 170/2010 Instead, it establishes the new rules for specific learning disorders (dyslexia, dysgraphia, dysortography and discalculia) in the school field. The law was born expressly to define the rights of people with DSA, or school success, reduction of relational inconvenience, provide support to parents who may request the reduction of working hours, individualized and personalized teaching, compensatory and dispensing tools.
With the Ministerial Directive of 27 December 2012 The measures of law 170 are extended to all students with special educational needs (BES), including students with ADHD. Among the planned interventions is the preparation of the personalized educational plan in which compensatory and dispensing tools are identified, individualized didactic methods to allow the school success of pupils with BES.
Adhd and law 104
Law 104 dates back to 1992 and does not explicitly mention situations in which it is the ADHD that determines a significant impact in terms of social, working or school disability on people’s lives. It is in the aforementioned ministerial directive of December 2012 that we refer to the fact that Not always those who have ADHD have the right to support. In the text of the directive, in fact, we read:
“In some cases the particularly serious clinical picture – also for comorbidity with other pathologies – requires the assignment of the support teacher, as required by law 104/92. However, there are many guys with ADHD who, due to the lower severity of the disorder, do not obtain the certification of disability, but are the right to see their training success protected “.
Hence the need to extend the provisions of Law 170/2010 also to subjects with ADHD.
Speech still different for civil disability. Meanwhile, it is not the law 104 of 1992 that defines the subjects who are entitled to invalidity, but the law 118 of 1971. Even the paths to request and see recognized handicaps, disabilities and disability are different and provide for the assessment by different medical commissions.
For civil disability from ADHD the process is as follows:
- request a competent doctor the introductory certificate certifying the disabling pathology
- submit electronic application to INPS to receive the benefits required by law
- undergo the medical examination of assessment at the ASL Medical Commission integrated with the presence of the INPS doctor. Depending on the percentage of disability found (variable from 33 to 100%), concessions of different nature (economic subsidies, accompaniment) can be recognized.
In the case ofdisability connected to the ADHDfor the purpose of recognizing a monthly checkone is needed Reduction of working capacityascertained in the commission, at least 74%. During the visit, therefore, the impact of symptoms on daily, working life and, as for the question of school support provided for by law 104, the benefits are not allowed to all those who have the ADHD is therefore carefully evaluated.
Forhandicapon the other hand, the assessment takes place through special ASL medical commissions integrated with the presence of social workers and expert specialists. The disability can be ascertained even in the absence of civil disability. The most recognized benefits provide for tax breaks, support for school and social integration, but not direct economic supports.
There disabilitywhich instead concerns the residual working capacity, is regulated by law 68/1999. Specific medical commissions evaluate the ability to carry out a specific work in relation to the limitations imposed by the pathology. The possibly recognized benefits materialize in concessions for job placement, training, paid leave for family members.
Does the ADHD pupil are entitled to support?
It is the 2012 ministerial directive that underlines that It is not obvious that an ADHD pupil has school support. These are the situations in which the symptoms have an important impact on the family and school life of children and families that proceed with the certification.
The process is normally the following:
- The teachers can report a situation of particular difficulty
- The class council evaluates the report and decides whether to start a targeted observation and teaching recovery period
- during the period of observation A team of doctors, psychologists and teachers evaluates the situation. In this phase neuropsychological tests are carried out
- If the difficulty persists, the class council can request certification. This is performed by a special medical commission that evaluates the severity of the disorder and the level of compromise
- Once the certification is obtained, the pupil has the right to the support teacher and other forms of personalized educational support.
Once the certification for ADHD is obtained, How many hours of support Are they guaranteed? Handicap certification allows you to be entitled to the presence of the support teacher for a quarter of the overall hours of lessons. In the event that instead a serious handicap is recognized, the coverage can instead concern the entire school hours.
As mentioned, however, the seriousness of impairment due to the ADHD is not always recognized as such as to certify handicaps and consequent right to support. Often the presence of other disorders in comorbidity, such as a DSA, favors the certification of the handicap.
ADHD AND LAW 170
Law 170/2010 also does not directly contemplate people with ADHD, but is aimed at recognizing specific learning disorders. Given the difficulty of accessing school support, the Ministerial Directive of December 2012 extends the measures provided for by law 170 also to subjects with ADHD.
The main facilities planned are as follows:
- Preparation of the personalized didactic plan which defines the individualization of teaching in relation to compensatory tools (for example calculator, tables, patterns) and dispensing (fewer exercises or more time available to carry out the tasks), methods of verification of learning (structure and number of questions and checks), tasks, study and teaching method
- Possibility of reducing working hours of parents to allow children’s assistance
Adhd and disability in adults
According to what is reported in the INPS guide The rights of people with disabilitiesthe disability percentages that give the right to economic subsidies are as follows:
- the disability of at least 74% guarantees a monthly assistance check for people who are in particular income conditions
- total disability (100%) guarantees the right to the disability pension. In the case of non self -sufficiency, the right to the accompanying allowance is added.
The gravity level of the ADHD, established by the mild, medium or serious DSM-5, must be such as to severely limit the possibility of the person to work. If gravity is not certified by the appropriate evaluator commission, the person with ADHD will not be recognized by any economic support.
For this reason, the process that leads to the diagnosis of ADHD in adults, as in early childhood, is fundamental and must be carried out in an adequate professional frame.
How to orient themselves between regulations and rights
Orienting yourself in the complex jungle of rules that protect the rights of people with ADHD is not easy. Furthermore, this type of neurodactiveness does not easily see the characteristics that allow access to measures such as school support or economic disability subsidies.
For this reason it is necessary to promote interventions on several levels:
- to institutional level It may be useful to promote training and awareness to raise to be provided with adequate support for people with ADHD and their family members not only in the most serious and complex situations
- to individual level Promote, also through psychoeducation, a greater awareness of people about the neurodicing characteristics related to the ADHD. Often, in fact, children with this type of disorder are labeled as very lively, rebellious, rude, not recognizing the discomfort and frustration that can derive from having to do with impulsiveness and difficulty of concentration
- to level of the treatment processencourage access to diagnosis services, evaluation, possible certification by not neglecting the importance of adequate psychological support for both people and family unit
- to school level Support families, teachers and pupils in deepening the meanings and manifestations of the ADHD, in order to create an environment capable of enhancing the resources of all students in compliance with individual needs. From this point of view, it may be useful to adequately support families in understanding and emotional management of aspects such as those related to any pharmacological intervention or the need for school support for the child with ADHD.
