Classroom-possible, evidence-based supports for children with ADHD

By Timothy (Tim) Grivois, Ed.D.

I’ve co-presented on evidence based interventions for children with ADHD, twice to the American Academy of Family Practice Physicians and once at the Association for Supervision and Curriculum Development. Schools frequently ask me for suggestions and strategies to support children and youth with children with ADHD 

As an adult with ADHD and a parent of a school-age child with ADHD, I’m keenly aware of how most schools and workplaces—implicitly and explicitly—view ADHD as a deficit, rather than a different way of engaging. While I certainly work hard to make sure my ADHD is my problem, and not a problem for my colleagues and clients, I’ve often wondered how neurotypical educators might function in environments where they can

• Take breaks when they need to
• Pursue topics that interest them for as long as they want
• Seek help to break down big tasks into smaller chunks
• Receive direct, unambiguous communication about expectations
• Have reasonable, yet flexible deadlines
• Enjoy clear, consistent, and predictable daily routines and environments

One of the best choices I’ve ever made for my own mental health was to start a business where I can create my own ideal work conditions, since anyone who’s ever worked in a school knows that school is not always the best place for a child or an adult with ADHD to be their best. As much as most schools strive to support all students, to succeed, most students (and their teachers) must

• Direct their attention on a task for as long as someone else needs them to
• Pursue someone else’s topics, for as much or as little time as someone else wants
• Figure out how to complete complex projects largely on their own
• Decipher indirect, implicit communication about expectation
• Fixed and arbitrary deadlines
• Negotiate a wide range of learning environments throughout the day

Unsurprisingly, students without ADHD tend to manage better. 

One of the best researched and most effective interventions for ADHD is medication. However, medication is not an option for every child, and schools can’t require families to seek a diagnosis or a prescription. Since schools generally can’t control whether a family chooses medication as a treatment for ADHD, often the most effective, evidence-based supports for children with ADHD involve “classroom-possible” strategies that are good for all students, yet demonstrate the most benefit for students with ADHD:

• Play-based skills coaching with peers
• Recess at the beginning of the day, and ideally throughout instructional time
• Positive reinforcement paired with clear, predictable expectations for behavior and classroom routines
• Explicit training in organizational skills

The success of any of these strategies is whether or not they are feasible within the classroom environment.For example, few schools can schedule an occupational therapist trained in play-based interventions to coach students in pairs and then support at-home interventions with families. However, schools can replicate key elements of each strategy within the resources already available.

One way to get started is to read the articles cited below and implement what makes sense for your school, classroom, or youth-serving space. Another way is to join us for an online overview of how schools might do this in real life. Join us on Saturday, 4 December, 2021 from 9:00am to 10:30am (PT) for a 90 minute workshop on Evidence-Based Supports for Learners with ADHD. Workshop registration is $37.00 and includes access to slides, digital, and print materials post workshop.

References:

 Wilkes-Gillan, Sarah, Anita Bundy, Reinie Cordier, and Michelle Lincoln. “Evaluation of a pilot parent-delivered play-based intervention for children with attention deficit hyperactivity disorder.” AJOT: American Journal of Occupational Therapy 68, no. 6 (2014): 700+. Gale Academic OneFile (accessed November 9, 2021). https://link.gale.com/apps/doc/A392070186/AONE?u=azpcld&sid=bookmark-AONE&xid=d55b0711.

Liang, Xiao, et al. “The impact of exercise interventions concerning executive functions of children and adolescents with attention-deficit/hyperactive disorder: a systematic review and meta-analysis.” The International Journal of Behavioral Nutrition and Physical Activity, vol. 18, no. 1, 22 May 2021, p. NA. Gale Academic OneFile, https://link.gale.com/apps/doc/A665438171/AONE?u=azpcld&sid=bookmark-AONE&xid=66cb30cd. Accessed 9 Nov. 2021.

 Evans S, Owens J, Bunford N. Evidence-based psychosocial treatments for children and adolescents with attention-deficit/hyperactivity disorder. Journal of Clinical Child & Adolescent Psychology 2014;43(4):527-551