ADHD is a neurodevelopmental disorder that can also be classified as a mental health disorder. Latest Canadian ADHD prevalence rates tell us that every classroom will include at least 1 to 3 students with ADHD. Students with ADHD can be a challenge for even the most experienced teachers if they do not understand ADHD, how it presents and how it impairs learning. However, it is important to remember that children with ADHD do not wake up each morning and decide that they are going to be a thorn in their teacher’s side. Their attention regulation and sometimes also their activity and impulsivity levels are impaired by a legitimate neurodevelopmental disorder. Children with ADHD may also be impaired in their cognitive, emotional and behavioural regulation as well as in their executive functioning.
Since students with ADHD can present in a wide variety of ways, it is impossible to use just one or even a few profiles for these children. The ADHD student is more recognizable when they present as the hyperactive little boy running around a classroom, easily distracted and unable to complete their work, but often missed as the quiet girl at the back of the class, who is anxious and obsessive about her schoolwork. Both of these children may have ADHD, but present very differently.
Maintaining a view of ADHD as a medical deficit that can significantly impair learning rather than a behaviour problem is essential. Classroom accommodations and teaching strategies can go a long way in helping students with ADHD succeed at school. Not only do they lead to a more enjoyable and successful year for the child, the teacher will find things run more smoothly if strategies are proactive rather than reactive. An added bonus is that many of these strategies can also benefit other students in the class.
Facts on ADHD and Learning
- Students with ADHD are at higher risk for lower levels of academic achievement, higher rates of disciplinary referrals, grade repetition, placement in special education, and spending more years in special education.
- Students with ADHD are 2.7 times more likely than those without ADHD to drop out of school before graduation.
- Students with ADHD score 8 to 10% lower in literacy and numeracy than their classmates without ADHD, even when a learning disability does not exist.
- Although some incorrectly believe medication will treat all ADHD impairments, research shows that medication treatment alone does not improve many of the skills required to be academically and socially successful.
- While most classroom interventions focus on decreasing disruptive behaviour and increasing on-task behaviour, these changes do not result in better learning and academic outcomes.
- Research indicates that interventions that target academic impairments should be targeted first, as this frequently also improves other problem behaviours.
- It is inattention during the elementary years that predicts long-term academic impairment, not hyperactivity or impulsivity. For better learning and academic outcomes to happen, specific interventions targeting learning deficits and accommodating and improving cognitive difficulties need to be implemented.
It is difficult to imagine a more difficult setting for a child with ADHD then the classroom.
- Stay attentive and focused on what the teacher is saying even when numerous distractions are present
- Switch their focus on command
- Prioritize their focus on the most important, rather than the more interesting, thing their brain is automatically drawn to
- Sit still for long periods of time and stay quiet
- Listen and comprehend continuous lists of instructions
- Follow lists of multiple directions and execute them in the correct order
- Initiate and compete work
- Work independently and be productive
- Self-regulate their behaviour and emotions to be able to interact appropriately with their classmates and teachers
General Impairments Seen in Academic Settings
- More frequent off-task behaviour
- Work less accurate and less work produced
- Interfere with classmates more often
- Disobey class rules more frequently
- Less likely to obey teachers’ requests & demands
- More difficulty shifting between classes or tasks
ADHD is not just inattention, it is actually a deficit in the regulation of attention or focus; symptoms include under-focusing, over-focusing, difficulty in switching focus and prioritizing focus. Students with ADHD can sometimes focus so intently that they miss everything else going on around them. This can occur when they are doing something that is very stimulating, often screen time, or when they are involved in something that they find very interesting. They are unable to switch their attention from these activities even though they know that they should be doing something else.
The student’s inattention may also fluctuate frequently throughout the day or from day to day. They may be able to focus on their math one day and be unable to remain attentive and productive during math class the next day. These students are frequently punished for their successes. We witnessed them being able to pay attention and get their work done yesterday, so we assume that they are just lazy and not trying today. Inconsistencies in the degree of impairment can be due to a wide variety of factors, including time of day, degree of novelty and difficulty of the expected task, distractions in the environment, amount of recent sleep and physical activity, whether their treatment has worn off, or just due to the inconsistent nature of ADHD.
Students with ADHD frequently have impaired executive functioning skills. This will not only impair their working memory, organization, time management, hindsight, forethought and planning it will also make self-regulation and emotional regulation more difficult. Some educators misinterpret these difficulties as the student attempting to be manipulative. Since effect manipulation requires planning and forethought, it would seem illogical that the behaviour children with ADHD exhibit, is manipulative. In fact, much of the behaviour seen in a child with ADHD is impulsive, reactive and poorly, if at all, thought out.
Children with ADHD who are very impulsive do not stop long enough to consider consequences before the thought in their head is put into action. Continually increasing the severity of consequences is unfair and unproductive for these children. When consequences are used, they should be consistent, immediate and most often positive. Altering a child’s behaviour to what we want to see them doing with positive rewards and praise is much easier and better for the child than stopping a child’s “bad” behaviour with negative consequences. Even labelling ADHD behaviour as bad behaviour is not wise. It implies that unwanted behaviour driven by impairments is under the child’s control.
There are many reward systems that can be implemented, but often when a child feels understood and supported by their teacher, positive feedback when they are doing the right thing can be a strong motivator. Unfortunately, if a child is very impulsive, they must first be taught how to slow themselves down (medication may help with this) long enough to think about what they should be doing.
Educators may also find that using a Behaviour Tracking Chart or ABC chart can be useful when trying to identify triggers for problem behaviours or emotional meltdowns. This chart can also be very useful when deciding on which behavioural strategies are successful and which may actually be escalating behaviours.
Students with ADHD often present with learning disabilities and other co-existing conditions such as anxiety, depression, Autism, oppositional defiant disorder (ODD), obsessive compulsive disorder (OCD) and other neurodevelopmental or mental health disorders. Before a diagnosis is reached a thorough assessment for ADHD by a physician, knowledgeable in ADHD, should take place. This assessment will screen for other disorders. If learning disabilities are suspected a psychoeducational assessment should also occur. The reports of these assessments should contain detailed recommendations so a complete and accurate educational profile can be developed.
However, it is important to note that psychoeducational assessments were never designed to quantify ADHD impairments. In fact, few if any of the standardized tests (performance based) accurately quantify the nature of the cognitive or academic impairments that characterize ADHD.1 Also, neuropsychological tests of executive function have low ecological validity for those with ADHD. Less than one third of adolescents and adults with ADHD, although functionally impaired by their ADHD, show impairment levels in test data alone within standardized psycho-educational assessments2 and only half of children with ADHD show significant impartment in specific EF functions on performance based tests.3
Students with ADHD are frequently impacted by a particular executive function called working memory. Difficulty with working memory can impact; writing; reading comprehension; problem solving; the ability to solve more complex math problems, following directions, monitoring their own progress and evaluating their own strengths and needs.
Research has shown that using ADHD medication to treat a child with ADHD should only ever be part of a treatment plan. Medication treatment can improve a student’s attentiveness and help reduce hyperactivity and impulsivity however it does not improve many other cognitive impairments that go along with ADHD or academic scores. In other words, “Pills do not teach skills”.
Treatment for ADHD should always be multi-modal. For more detailed information please access information under Understanding ADHD, Child – Treatment.
- Understanding ADHD as a Disability in the Post-Secondary Environment, CADDAC 2015
- Barkley, R. A.,& Fischer, M. (2011).Developmental Neuropsychology, 36(2),137-161
- Willcutt, E. G., Doyle, A. E., Nigg, J. T., Faraone, S. V., & Pennington, B. F. (2005). Validity of the executive function theory of attention-deficit/hyperactivity disorder: A meta-analytic review. Biological Psychiatry, 57(11), 1336–1346