Supporting children with inattention, hyperactivity, and impulsivity

Eight-year-old Sophie’s teachers are worried: Sophie is forgetful and prone to daydreaming. She finds it difficult to sit still and wait her turn. Her inattention, hyperactivity, and impulsivity are symptoms of attention-deficit/hyperactivity disorder (ADHD). ADHD is a medical diagnosis given to children with high levels of such difficulties – challenges that can also affect children without a diagnosis, albeit to a lesser degree. Without high-quality support from those around her, Sophie’s learning and academic success may be in jeopardy. For Sophie’s teachers, the question is how they can best support her development, learning, and academic outcomes.

Making changes in the classroom

Sophie’s concentration and behavioral difficulties most likely reflect a mismatch between her abilities and the characteristics of the school environment – in other words, the classroom is not set up to meet her needs. In line with the UN Convention on the Rights of Persons with Disabilities, efforts should be made to mitigate this mismatch and its negative effects on learning. Sophie and her parents, supported by health care professionals, can benefit from evidence-based guidelines for managing ADHD-related symptoms inside and outside the classroom. Although it is important to remember that not all children diagnosed with ADHD are alike, there are certain steps teachers can take to help students like Sophie.

Teachers can implement the Universal Design for Learning guidelines, which seek to ensure that all students have equal opportunities to succeed. This means allowing for flexibility in how students access learning material, engage with it, and show what they know. For example, teachers might provide both digital and audio information, permit the use of noise-cancelling headphones during silent work, or use roleplay and discussion to engage students emotionally. This flexibility gives all students – whether or not they struggle with concentration and behavioral challenges – more opportunities to do well in the classroom, as they engage with learning content and demonstrate their learning in ways that suit them best.

“This means allowing for flexibility in how students access learning material, engage with it, and show what they know.”

Another way of leveling the playing field is to change classroom practices, while still maintaining performance standards. However, little is known about whether such changes are in fact effective. To take one example: Despite the fact that students with a diagnosis of ADHD believed that extended exam times were helpful, there is little evidence that this accommodation actually leads to greater academic success. A common recommendation is to have students with ADHD sit near their teacher, and while this does benefit learning, that holds true for any student.

Whether measures like these are useful for individual students also depends on the students’ characteristics, such as age, strengths, and needs. Accommodations should be tailored to the specific student and learning environment. Ideally, teachers should be encouraged to closely monitor the effectiveness of such measures to determine whether they are achieving the desired outcome.

Emotional, organizational, and instructional support

Through different types of support, teachers can shape aspects of student development to prevent or reduce mismatches between an individual’s abilities and the classroom environment. Interactions between teachers and students can prevent behavioral difficulties such as inattention, hyperactivity, and impulsivity from intensifying. Teachers can provide emotional support by communicating with students with sensitivity and due regard for their perspectives. This creates a safe and protected environment in which students can explore and improve their social interactions and better regulate their emotions. Emotionally supportive interactions are particularly relevant for students with behavioral difficulties.

“Through different types of support, teachers can shape aspects of student development to prevent or reduce mismatches between an individual’s abilities and the classroom environment.”

Organizational support is also helpful for these students. Through classroom management, teachers can subtly, and proactively, manage student behavior in a way that promotes attention and behaviors conducive to learning. By making expectations clear and acting as a role model, teachers show their students how to behave and how to improve their own learning.

Finally, teachers can boost students’ cognitive and learning skills and enhance learning outcomes by providing instructional support, which includes offering well-designed learning opportunities at an appropriate level of difficulty. In a well-designed activity, children are given sufficient time to practice at each level before moving on to the next. Useful tasks challenge problem-solving skills and help students learn how to use those skills in new situations. Scaffolding is beneficial as well; targeted feedback from teachers helps children to attain levels of learning and functioning that they would not otherwise be able to reach.

All of these supports can help students like Sophie improve their concentration and manage their behavior. Such positive teacher-student interactions in the classroom are even more effective when the relationship between student and teacher is close and as free of conflict as possible.

Individualized support

Teachers who work with students struggling with concentration and behavioral difficulties know that no two individuals are alike; they all have varying strengths and needs, and they respond differently to interventions. What has helped one student in a given lesson will not necessarily help this student in a different context. Unfortunately, current evidence regarding support measures fails to take into account individual differences. In our future research, we hope to find out which measures work best for which students, and under what circumstances. We hope that our research will enable teachers to provide students like Sophie with the best possible learning experiences.