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Teaching Students with ADHD

Special Education > Teaching Students with ADHD

Table of Contents

Abstract

ADHD, or Attention Deicit Hyperactivity Disorder, is con-

sidered a developmental delay, possibly based in neurological

dysfunction, and considered primarily genetic or congenital,

although environmental conditions may have an impact. This

article summarizes briely some deinitions of Attention Deicit

Hyperactivity Disorder (ADHD), and what impact it might have

on a student. It includes some theoretical discussion of the causes

of ADHD, and how each cause may impact treatment or behav-

ior modiication. It then summarizes suggestions from various

sources for how to organize a classroom, assign work and assist

students with ADHD in the public schools.

Abstract

Keywords

Overview

What is ADHD?

Challenges of Teaching ADHD Students

What Does Research Say About Teaching

Children with ADHD?

Applications

Overview

Behavioral Interventions

What is ADHD?

ADHD, or Attention Deicit Hyperactivity Disorder, is con-

sidered a developmental delay, possibly based in neurological

dysfunction, and considered primarily genetic or congenital,

although environmental conditions may have an impact. Chil-

dren with ADHD may be quite bright and capable, but their

behavior can be challenging for the teacher and for other stu-

dents to deal with.

Learning-Style Instruction

The Role of the Teacher

What Teaching Methods are Helpful to ADHD

Students?

Classroom Organization

Teaching Strategies

Children who have ADHD are generally inattentive, hyperactive,

and easily distracted. They may also be forgetful and have trouble

controlling their impulses. They exhibit limitations dealing with

self-regulation or self-control, and may have trouble waiting for

reward, acknowledgement or attention. If these symptoms occur

across a range of situations (e.g. at home, at school, at play) a

diagnosis of ADHD may apply.

Teaching Resources

The Behavior Management Process

Teaching Older Students

Conclusion

Terms & Concepts

Some critics believe that ADHD is not an actual disorder; rather,

the expectations of teachers and parents may simply be unrea-

sonable for children to fulill (e.g. sitting still for a time in a

classroom), or that children are developing at different speeds,

and those with impulsive tendencies will eventually catch up to

their peers. A diagnosis of ADHD can lead to medication and/

or therapy for treatment; some critics feel medical responses

may be overused. Some students are no longer considered to

have ADHD as adults, but ADHD may also be under-diagnosed

Bibliography

Suggested Reading

Teaching Students with ADHD

Essay by Kirsty Brown, Ph.D.

Keywords

What Does Research Say About Teaching Children

with ADHD?

Barkley (2007), Theoretically Driven Psychosocial Treatments for

ADHD) in reviewing progress in studying ADHD, suggests that:

Attention Deicit Hyperactivity Disorder

Behavior Modiication

Sometime over the last 15-20 years it became obvious

that ADHD and its related disruptive behavior and aca-

demic impairments were not the consequence of faulty

contingencies of reinforcement in natural ecologies

like classrooms or homes, as some originally claimed

in the 1970s (Willis & Lovass, 1977). Such behavior

does not need to function to gain positive reinforcement

nor escape from aversive situations to be produced and

sustained. We now recognize the etiologies of ADHD

and its various levels of phenotypic expression to be

largely in the realm of neurology and genetics (Nigg,

2006). This is not to say that social environments are

irrelevant or that certain contingencies make no con-

tribution in individual cases because they certainly

pertain to forms of impairment, risk for comorbidities,

and treatment resources. But it does say that no serious

investigator today could make the case that ADHD can

arise purely out of social causes such as bad parenting,

intolerant teachers, faulty social learning, or inappro-

priately learned cognition. There is simply too much

evidence against such ideas (Nigg, 2006) (Barkley,

2007, p. 281).

Developmental Delay

Executive Function

Functional Behavioral Assessment (FBA)

Multi-Sensory Instruction

Peer Tutoring

Positive Behavioral Interventions & Supports

(PBIS)

Self-Regulation

among adults, especially those who have learned to cope with

their challenges.

About 5 percent of people worldwide are diagnosed with ADHD

(Dey et al., 2002), about 10 percent of males in the US and 4 per-

cent of females (the difference between males and females may

be in frequency of diagnosis, rather than in actual occurrence).

The consequences for students with ADHD can be painful, and

affect their life outcomes. Brand et al. (2002) note that:

In other words, Barkley is saying that ADHD appears to be

primarily genetic, and is not a result of something wrong in

the home or school environment. He goes on to say that it has

recently come to be understood that ADHD is not merely a col-

lection of behaviors such as inattentiveness and impulsivity, but

is actually evidence of a broader array or disorder involving self-

control and related issues.

Authors of descriptive and correlational studies have reported

that students with ADHD are more likely than others to have a

number of problems:

•

Grade retention

•

Delinquency

Applications

•

Academic underachievement

Behavioral Interventions

Barkley (2007) discusses various treatment programs for ADHD

behaviors, and suggests that it may be necessary to keep some in

place over a length of time, as symptoms, or speciic behaviors

perhaps, do not go away as a result of the treatments; they are

merely controlled:

•

Behavioral problems

•

School failure

•

Drug abuse

•

Social and emotional adjustment dificulties and

•

Dropping out of school (p. 269).

Behavioral treatments, like hearing aids, wheelchairs,

ramps into public facilities, lower bathroom ixtures,

glasses and large-print books, and prosthetic limbs for

amputees, are artiicial means of altering environments

so as to reduce the adverse effect of a biological handi-

cap on the performance of major life activities. No one

would rationally claim that physical disabilities arise

from the lack of wheelchairs and ramps. Similarly, no

one would claim that using a wheelchair or associated

ramps for a month or two would result in their either

Challenges of Teaching ADHD Students

Melton (2007) explains that because of the various challenges

they face, it can be challenging to teach student with ADHD.

Students may be unable to sit still; may blurt out answers or

questions impulsively may distract other students, or be easily

distracted by them—and other stimuli in the classroom; and may

ind it dificult to organize the tasks and materials they need to

accomplish assignments.

Page 2

Teaching Students with ADHD

Essay by Kirsty Brown, Ph.D.

being internalized or so altering the social environment

that they would be sustained by changes in naturally

occurring contingencies after the chairs and ramps are

withdrawn And so no one should now rationally claim that

ADHD arises from faulty learning or that several months

of contingency management produces sustained beneits

for ADHD once treatment is withdrawn. Behavioral meth-

ods are prostheses--means of rearranging environments

by artiicial means so as to yield improved participation

in major life activities (Barkley, 2007, p. 281).

Brand et al. (2002) concluded after studying 230 students in

both elementary schools and secondary schools who had been

assessed via a particular learning tool, that learning styles were

widely varied among children with ADHD. They did, however,

ind some commonalities among students, both young and older,

and recommended for further study that educators and research-

ers should try to monitor what happens when children with

ADHD are taught new and dificult information under differing

conditions, such as:

•

In the afternoon as opposed to in the morning

He goes on to suggest that although behavioral interventions may

be helpful, they are not necessarily addressing the root of the

problem, “ADHD is now thought to be as much a disorder of self-

regulation and executive functioning as it is in attention. What we

most need now is a theory of how normal self-regulation develops,

where it goes awry in producing ADHD, and what this may mean

for constructing better interventions” (Barkley, 2007, p. 281).

•

With tactile and kinesthetic instructional resources

rather than lecture and reading

•

In soft illumination (or full-spectrum lighting) rather

than luorescent lighting

•

With Multisensory Instructional Packages that accom-

modate all perceptual strengths rather than single- or

dual-sensory approaches; and

Thus, although behavioral, medical and other interventions may

address symptoms of ADHD, and may make life more manageable

for students with ADHD and the people around them, Barkley sug-

gests that more research is needed, and that ADHD may need to be

addressed from an entirely different perspective:

•

With parental supervision (for elementary school

children) rather than supervision by the teacher (Brand

et al., 2002, p. 273).

•

Studying the role of self-management and self-regula-

The Role of the Teacher

Glass (2001) reports that a child’s experience in the classroom

can depend on the teacher’s tolerance to ADHD behaviors and

how that teacher “chooses to work students who display the

behaviors related to ADHD” (p. 71). Using a survey of teach-

ers, of which 225 were returned from 400, she examined what

factors inluenced a teacher’s strategies for dealing with children

with ADHD in the classroom, and found that a teacher’s age,

his or her experience in the classroom, and the information pro-

vided about ADHD by school administrators all had an impact

on teacher classroom behavior towards students with ADHD.

tion;

•

Considering the role of genetics;

•

Assessing the roles of various medications and other

treatments, along with their side-effects; and

•

Examining the impact of any kinds of treatments (or

of packages of treatment combinations) on individual

outcomes.

Learning-Style Instruction

Brand et al. (2002) examined the varied learning styles of children,

suggesting that different learning styles may contribute to a label

of learning disability, which might, in turn, not adequately relect a

child’s capacity to learn well. They report, for example, that:

Glass (2001, p.78) found that older teachers, and those who were

more experienced, were most likely to use positive teaching

strategies in the classroom with ADHD students. She also found

a strong positive inluence on classroom behavior when school

administrators distributed information about behaviors associ-

ated with ADHD and included guidelines for positive strategies

to deal with those behaviors. She also found, however, that many

teachers chose not to use some strategies, such as frequent breaks,

hands-on activities, and allowing children to work at their own

pace, since they believed these would not be helpful to the class

as a whole (despite evidence to the contrary cited by Glass).

Despite the negative labels associated with children

who learn differently from their same-aged classmates,

research reveals that many students oficially classiied

as failing have achieved statistically higher standardized

achievement test scores in both reading and mathematics

when they were taught with approaches and resources

that complemented their learning styles.

For example, after only one year of learning-style-based

instruction, Special Education (SPED) high-school stu-

dents in Buffalo, New York’s public schools achieved

signiicantly higher test scores than their counterparts

who had not experienced learning-style-responsive

teaching. And after two years, many of these special

education students achieved almost as well as their non-

classiied counterparts (p. 268).

What Teaching Methods are Helpful to ADHD

Students?

A multitude of organizations have addressed ways to help stu-

dents with ADHD learn. A structured program and classroom can

be very helpful to students with ADHD, as is reducing distrac-

tions as much as possible, and making guidelines for regulation

(and assistance with it) very explicit and clear.

Page 3

Teaching Students with ADHD

Essay by Kirsty Brown, Ph.D.

Classroom Organization

•

Give directions one step at a time

Proteacher (2007, Room Set-Up) suggests the following arrange-

ments for a classroom to assist with those issues:

•

Ask the student to reiterate directions to ensure clarity

•

Set accuracy goals and encourage the student to take time

•

Make rules clear: post them.

to complete tasks, rather than rushing to complete them

•

Make a schedule clear: post it

Teaching Resources

The U.S. Department of Education (2007) offers a tip sheet on

working with students with ADHD. They focus on behavioral

intervention techniques, irst encouraging “verbal reinforce-

ment of appropriate behavior.” that is, when the student does

something correctly, or well; immediate positive praise should

be offered. Teachers may need to look for opportunities to offer

such praise while the student is beginning the task.

•

Seat students with ADD/ADHD near the teacher or

near a focused child

•

Seat students in rows, if possible, rather than at group

tables

•

Closed classrooms, rather than ‘pod’ arrangements are

helpful

•

Students easily distracted by sounds may do better

Another avenue for success involves speciically teaching stu-

dents how to manage their own behavior appropriately. The

USDOE tract (2007) recommends offering social skills classes

involving role playing and discussion of behavior to all students,

but suggests it may be especially helpful to those with ADHD.

seated in the rear of the room, so they don’t have to

turn around to see the distraction

•

Interact personally with the student often

•

Seat students with ADHD away from the hall and the

Similarly, problem-solving sessions are recommended for all

students, and can be structured to respond to conlicts as they

occur. In this case, the participants can be asked to consider how

to resolve their differences, and lessons learned can be discussed

and generalized to other situations.

windows

•

Keep one part of the room relatively distraction-free

•

Stand near students with ADHD when presenting a

lecture or giving directions

•

Individual headphones, classical music, or background

The Behavior Management Process

white noise may be helpful in reducing distractions

Since structure is very helpful for children with ADHD, many

teaching tip sheets include ways to introduce that structure, both

in the classroom (as outlined above) and in the daily process of the

child’s experience. The USDOE (2007) recommends individual

assessment of a child with ADHD, beginning with a Functional

Behavioral Assessment (FBA). The FBA process involves teachers,

parents, and/or professionals observing the child’s behavior, assess-

ing what conditions contribute to the behavior and what aspects of

the behavior are problematic, and determining the frequency of the

behavior. Once the behaviors are clearly identiied and deined, a

plan can be developed to address problem areas systematically.

Teaching Strategies

Some strategies to use in the classroom include varying the pace

and keeping lessons interesting, using multi-sensory presenta-

tions, and involving children with ADHD in the presentation

process. Proteacher (2007, Presenting Your Lesson) provides the

following suggestions:

•

Use peer tutoring, either have older students tutor the

student with ADHD, or have him/her tutor younger

students

After completion of an FBA, a Positive Behavioral Interventions

and Supports (PBIS)--a research-based method of address-

ing challenging behaviors--can then be used to develop a plan

to assist the child (USDOE, 2007). This process is intended to

improve behavior, and to provide the child with skills to enhance

his or her own behavior and experience across environments.

•

Include a variety of activities in each lesson

•

Appeal to a variety of senses during the lesson (visual,

audio, tactile, kinetic etc.); include hands-on experi-

ences when possible

•

break lessons into short pieces separated by breaks

The irst step in the process is to develop a contract or plan around

managing behavior. The child and parents are usually involved,

and the goal is to identify target behaviors and tasks the child

will attempt to complete or maintain.

•

Encourage interaction during lessons (answering ques-

tions etc.)

•

Try role playing and acting out lessons when possible,

involving the class

Successful completion of the tasks (getting homework done, fol-

lowing rules in a speciic situation) is rewarded by something

tangible, such as a sticker, or other privileges); something upon

which the child has agreed will be motivational. The USDOE

(2007) also suggests ‘token economies’ in which a gathering of

points (for example) can be successfully exchanged for a larger

‘prize’ such as computer time or another reward.

•

Use cooperative teams in learning, where each student

has a deined role

•

Interact verbally with students with ADHD and main-

tain eye contact when giving directions

Page 4

Teaching Students with ADHD

Essay by Kirsty Brown, Ph.D.

Finally, self-management systems are recommended, in addition

to other techniques already mentioned. In this scenario, (USDOE,

2007) the teacher selects behaviors that the student will attempt to

manage, along with a rating scale indicating how performance will

be measured. Both student and teacher grade the student on a given

behavior, and when the grades are close, points are awarded to the

student to exchange for rewards or privileges. Eventually, the stu-

dent should learn to master or manage his or her own behavior.

•

Addressing the child directly in class and involving

him or her in classroom discussion and activity;

•

Assisting with breaking large tasks into smaller ones

with clear, deined goals for completion; and

•

Helping the student develop a behavioral plan that is

encouraged by rewards of tangible objects or privileges.

Having expectations or plans written down can be helpful, as stu-

dents with ADHD may be distracted and miss verbal instructions.

Teaching Older Students

Although some students appear to outgrow a diagnosis of ADHD,

perhaps as they ind different pathways to self-regulation, others

will maintain it through adulthood. Summer (1999) has described

the dificulties of older students with ADHD and has posted on

the University of California at Berkeley website some guide-

lines for teaching ADHD students in college. Many of these are

similar to those for K-12 students, and based on similar ideas of

providing structure, maintaining clarity in instruction, and assist-

ing with organizational skills.

Terms & Concepts

Attention Deicit Hyperactivity Disorder (ADHD) :

ADHD is a developmental disorder that results in children or

adults being unable to focus for long periods of time on any one

topic. Children with ADHD are easily distracted, often disorga-

nized, and sometimes unable to sit still in class.

Summer (1999) recommends, for example, that a syllabus with

“clear explanations of tasks and speciic due-dates” be provided,

and that teachers expressly remind students of upcoming dead-

lines and due dates. In addition, students may need help breaking

down assignments into smaller pieces, with deadlines for each

short piece to be completed. Teachers are encouraged to assign

all projects in writing, as students with ADHD may inadvertently

miss them otherwise.

Behavior Modiication : This refers to strategies used in

the classroom or at home that are intended to change a child’s

behavior, without necessarily attending to the underlying causes

of that behavior.

Executive Function : Executive function in this instance

refers to the function of the brain that oversees other areas and

exerts control over behavior, for example.

Functional Behavioral Assessment (FBA) : “FBA is

a systematic process for describing problem behavior and

identifying the environmental factors and surrounding events

associated with problem behavior” (USDOE, 2007).

Another hint providing structure for students is to provide a sum-

mary of impending materials to be covered at the beginning of

each lecture (Summer, 1999). A printed summary is especially

helpful, and if it includes space for notes so that the material is

already organized for the student, that is even better. They also

recommend a review at the end of class.

Multi-Sensory Instruction : Multi-Sensory Instruction

means teaching students in ways that allow them to use a vari-

ety of senses to process information, such as visual, auditory,

tactile, kinetic etc.

Just as with elementary and other K-12 students, variety in format

is highly recommended; breaks should be permitted during long

classes; and students should be encouraged to sit near the front,

away from hallways and windows, to minimize distractions.

Peer Tutoring : Peer tutoring occurs when students teach each

other; it can occur between students in the same grade, or those

who are ahead by several years, but indicates a difference from

tutoring by adults, teachers, or parents.

Conclusion

A student with Attention Deicit Hyperactivity Disorder can ind

it dificult to learn in a classic classroom situation, as he or she

may be easily distracted by unrelated stimuli, may be distract-

ing to other students, and may be unable to organize tasks and

materials necessary to complete school work. ADHD is likely a

genetically based condition related to a reduced ability to regu-

late the self and behavior.

Positive Behavioral Interventions and Supports (PBIS) :

“This method is an application of a behaviorally based systems

approach that is grounded in research regarding behavior in the

context of the settings in which it occurs” (USDOE, 2007).

Self-Regulation : Self-regulation refers to an individual’s

ability to control his or her own behaviors, reactions and

responses. This is a skill that develops during maturation, but

begins relatively early in life.

Parents, teachers, and professionals can create circumstances to

enhance the child’s learning potential, in conjunction with the

student. Some of these activities include:

Bibliography

•

Providing clear, structured directions for behavioral

expectations and for work;

Barkley, R. A. (2007). School interventions for attention

deficit hyperactivity disorder: Where to from here? The

School Psychology Review, 36 (2), p. 279-86. Retrieved

•

Providing an uncluttered, less distracting place to

study or work;

Page 5

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