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How can teachers support children with ADHD?

In the first in a series on neurodevelopmental disorders in the classroom, developmental psychologist Kathryn Bates collates the evidence on attention-deficit/hyperactivity disorder (ADHD). How can teachers create a supportive environment to help children with ADHD learn?

Neurodiversity describes the natural human variation – in brain and behaviour – that comprises our strengths and difficulties. Neurodiversity is particularly evident, and a challenge to manage, in the classroom. Children with a particular set of challenges, such as motor impairments or persistent inattention, might receive a diagnosis of a neurodevelopment disorder. Every year, most teachers will have some children in their classes with a diagnosed disorder such as dyslexia, autism, or ADHD.

“ADHD does not look the same in every child.”

ADHD is diagnosed in around 6% of young people and is defined as persistent and developmentally inappropriate levels of inattention and/or hyperactivity/impulsivity. In a class of 30, roughly 2 children will have a diagnosis of ADHD, some may be waiting for a diagnosis, and others, while undiagnosed, may show symptoms that are misinterpreted as bad behaviour. All these children are more likely than their peers to fall behind at school and to struggle to hold a job later in life.

ADHD in the classroom

When we think of ADHD in the classroom, we tend to picture children who are easily distracted (inattention), struggle to sit still (hyperactivity) and shout out the answer in class without waiting their turn (impulsivity). However, ADHD does not look the same in every child. As Sinead Rhodes, whose research has explored the cognitive components of ADHD, explains: “One of the best things a teacher can do to support a child with ADHD is to put aside misconceptions about their label. Treating the child as an individual and understanding each child’s specific difficulties is a really good starting point.”

Girls with ADHD tend to be less behaviourally disruptive, which sometimes means being overlooked when it comes to getting a diagnosis. A common but less well known issue in ADHD is social problems, which are often due to challenges in regulating emotions. Boys may become easily aggravated by everyday tasks, while girls are more likely to quietly internalise their frustration, which can negatively impact their self-esteem. Young people with ADHD also tend to be more sensitive to rejection and criticism than their peers. We might imagine that the young person with ADHD is the loudest in the room, but the combination of difficulties in emotion regulation and increased sensitivity can also lead to social withdrawal.

“To get a full picture of ADHD in the classroom, it is vital for future research to take a strength-focused approach.”

We know a lot more about impairments in ADHD than we do about strengths, as strength-focused research is much less common. Young people with ADHD can be creative, enthusiastic, and good at making quick decisions. Some report hyperfocus – getting completely lost for hours in one activity. While it may be difficult to encourage a child who is engrossed in one activity to move to another, harnessing this ability to hyperfocus can present an opportunity for learning. To get a full picture of ADHD in the classroom, it is vital for future research to take a strength-focused approach.

Cognitive training appears to be ineffective

As ADHD research tends to be impairment-focused, some interventions attempt to train specific cognitive functions, in the hope that improvements will lead to better learning and academic outcomes. Children with ADHD may have impaired working memory – the ability to hold and manipulate information in mind. Working memory is needed to write an answer while listening to the teacher’s next instruction, for example. Some programmes that try to train working memory using computer-based tasks have been packaged into commercial products for teachers and parents. However, this training seems to have little effect on working memory, and does not appear to reduce symptoms of ADHD or lead to improvement in academic outcomes.

Given the diversity of children with ADHD, these results are perhaps not surprising. Some researchers are now advocating a shift away from a “core-deficit” approach in understanding neurodevelopmental disorders towards a focus on individual differences. Recent research adopting this approach has shown that some children with ADHD have above-average working memory. Rather than trying to train cognitive functions, it might be more effective to create an environment that is conducive to learning for a diverse group.

Creating a supportive environment

For children with ADHD who do in fact have problems with working memory, there are ways to help. Teachers might provide a timetable for the lesson for children who struggle to remember long instructions whilst carrying out other tasks. The children could then keep the visual prompt on their desks to refer to if they miss a verbal instruction. More information on this and other helpful strategies can be found in the free EPIC Strategy Book published by researchers at the University of Edinburgh.

“Setting up peer mentoring programmes and encouraging participation in extra-curricular activities can be helpful.”

Teachers can also help improve self-esteem, which may protect against depression, anxiety, and attention problems in adolescence. According to the ADHD Foundation, setting up peer mentoring programmes and encouraging participation in extra-curricular activities can be helpful. Reception teacher and early years team leader, Jane Exell, emphasises the importance of encouragement: “Praise is really important, otherwise children can feel shame and confusion. One of our teaching assistants set up a block play club at lunchtime because children with ADHD often find the playground a scary place and can get into trouble. This has given children a sense of pride, focused attention and fun.”

One of the reasons why some children with ADHD fall behind in school is poor organisational skills. As a result, they may struggle to hand in homework on time. As educational psychologist Ella Mansfield recently pointed out in the “Psychology in the Classroom” podcast, a lack of organisation is not a reflection of a lack of ability. Varying assessment strategies might give teachers a better understanding of children’s abilities, especially since children with ADHD tend to perform worse on written tests. Game show-style quizzes could allow young people with ADHD to demonstrate and consolidate their knowledge.

Teachers need support and time to access resources and implement recommendations based on scientific research. Ultimately, we need to reframe how we approach ADHD in the classroom and maintain high expectations of children’s abilities. This will help young people succeed in an environment that is often laden with obstacles.   

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