Attention Deficit Hyperactivity Disorder (ADHD)

  • Attention Deficit Disorder/Attention Deficit Hyperactivity Disorder (ADD/ADHD) is a biological disorder that is most probably of genetic origin (Armstrong, 1999). It is a common behavioral condition affecting between 5 and 11 percent of school-age children. Symptoms continue into adulthood in more than three-quarters of cases. ADHD is characterized by developmentally inappropriate levels of inattention, impulsivity and hyperactivity (CHADD, 2017). Although ADD/ADHD proponents may disagree on certain matters connected with the paradigm, such as whether ADD/ADHD is over-diagnosed (e.g., Ingersoll, 1995; Gordon, 1995), many professionals, parents, and other proponents of ADD/ADHD seem to have arrived at a consensus concerning the existence of a discrete disorder (or disorders) (Armstrong, 1999).
  • Symptoms include (CHADD, 2017):

ADHD predominantly inattentive presentation

  • Fails to give close attention to details or makes mistakes do to inattention to details
  • Has difficulty sustaining attention
  • Does not appear to listen
  • Struggles to follow through with instructions
  • Has difficulty with organization
  • Avoids or dislikes tasks requiring sustained mental effort
  • Loses things
  • Is easily distracted
  • Is forgetful in daily activities

ADHD predominantly hyperactive-impulsive presentation

  • Fidgets with hands or feet or squirms in chair
  • Has difficulty remaining seated
  • Runs about or climbs excessively in children; extreme restlessness in adults
  • Difficulty engaging in activities quietly
  • Acts as if driven by a motor; adults will often feel inside as if they are driven by a motor
  • Talks excessively
  • Blurts out answers before questions have been completed
  • Difficulty waiting or taking turns Interrupts or intrudes upon others

Accommodations (From CHADD, 2017):

Accommodations are intended to help students with ADHD learn the same information as other students. They are changes to the structures and/or the environment that provide support to help students access the curriculum. Accommodations work best when they are tailored for the individual needs of the student based on the severity and symptoms of their ADHD and any other co-occurring conditions. It is important to observe the student to see which accommodations are effective – and effectiveness of accommodations can change over time. Students can also be enlisted in figuring out what helps them the most. This will also ensure that the accommodations are seen as support instead of punishment. Teachers, parents, and students should partner together to address needs and supports.

The Diagnostic and Statistical Manual, Fifth Edition lists two categories of symptoms of ADHD—inattentive and hyperactive-impulsive. Students may have only one type, or they may have both types of symptoms. The accommodations that are appropriate for each student depend on the symptoms and on how much they impact the student.

ADHD: Inattentive Symptoms

Students with inattentive symptoms are easily distracted and have trouble focusing. Everything competes for their attention. They often struggle to follow through with instructions and have difficulty with organization.

To help students with managing inattentive symptoms, the following accommodations can be effective:

  • Seating the student in an area with fewer distractions where he or she can focus on the lesson. For example, near the teacher’s desk, away from windows and the doorway, or in another area that has few distractions.
  • Seating the student next to positive role models, peers who are less likely to provide distractions and can help them stay on task.
  • Breaking long assignments into smaller parts. This allows students to see both the start and end of the task.
  • Making sure all assignments are clear and provided in writing in addition to giving them out loud.
  • Checking with the student before they complete an assignment to see if they heard and understood instructions. Ask them to repeat it back to verify understanding.
  • Allowing them to take tests in a different room, one that is quiet and has few distractions. Or using aids such as headphones or privacy boards to create quiet spaces in the classroom.
  • Giving more time to complete assignments, projects, and tests.
  • Using a timer or alarm to help with time management.
  • Providing breaks. Depending on the student, these could include stretching, walking to the board to complete a task, or handing out assignments or materials.
  • Limiting repetitive assignments, particularly those the students has already mastered, or tasks that are too far above the student’s level. Students are most able to pay attention to tasks that present some challenge but are within their current learning zone.
  • Making sure that the student has the opportunity for physical activities because active movement increases the ability to focus. Recess should never be taken away as a punishment for misbehavior.
  • Providing tools to help with organization, such as different colored folders, a notebook with dividers, or a homework assignment book.
  • Using computers or tablets for work. Computers are visually stimulating and allow for more engagement and also help students organize their thoughts.

ADHD: Hyperactive-Impulsive Symptoms

Students with hyperactive-impulsive symptoms move a lot. They fidget, squirm, and have difficulty staying seated. They often talk excessively, blurt out answers, and have trouble taking turns.

To help students manage their hyperactive-impulsive symptoms, the following accommodations can be effective:

  • Seating the student in an area of the room where there will be the least disruption. This might be towards either side of the classroom rather than the center.
  • Allowing for the student to move around. You could allow the student to do their work while standing, sitting on the floor, or moving between desks.
  • Pairing the student with a peer who is a good role model and can model appropriate behavior.
  • Providing activity breaks. Depending on the student, these could include stretching, walking to the board to complete a task, or handing out assignments or materials.
  • Ignoring minor misbehavior.
  • Allowing the student to move or fidget in a non-distracting manner. They might tap their foot in the air or rotate their pen back and forth in their hands. Asking the student to offer suggestions is always a great way to get more ideas.
  • Allowing them to take tests in a different room. One that is quiet, has few distractions, and lets them move around without interrupting other students.
  • Praising when they exhibit appropriate behavior such as raising their hands and waiting to be called.
  • Limiting repetitive assignments, particularly those the students has already mastered, or tasks that are too far above the student’s level. Fidgeting is often a symptom of boredom or overstimulation.
  • Making sure that the student has the opportunity for physical activities. Recess should never be taken away as a punishment for misbehavior.
  • Using a speaking stick or other object that gets passed around during class discussions as a cue to indicate whose turn it is to speak.

ADHD: combined symptoms

Many students with ADHD show a combination of inattention and hyperactive-impulsive behaviors. You can use a combination of accommodations from both lists. One of the best ways to identify which accommodations might work best is to observe the student’s natural behavior.

Some sample behaviors and accommodations include: