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10 Common Challenges and Best Practices for Teaching Students With ADHD

How real teachers and their students have found success in the classroom.

  • Grades: PreK–K, 1–2, 3–5, 6–8, 9–12

Jennifer Capps, a first-grade teacher in South Carolina, says she’ll never forget the moment she realized children with attention disorders need clear, one-step instructions. “During my first year of teaching, I gave the directions, ‘Use a marker to write your spelling words,’” she recalls. “Well, one of my kids used a black permanent marker that he snagged from my table. And...he wrote them on the carpet under his desk!”

Chances are, you’ve had a similar trial-by-fire moment in learning to work with students diagnosed with ADD and ADHD. The reality is, no matter how many books you read in school or how many professional development sessions you attend, you learn how to reach kids with attention deficits only through practice — by collaborating with support staff and families, and by tweaking lesson plans and rearranging seating charts dozens of times.

The good news is, your experience gradually makes you an expert. Dr. Ann Abramowitz, a clinical psychologist who does school-based interventions for students with attention disorders, says some teachers understand almost instinctually what attention-challenged kids need. But even the most experienced ones, she says, “are often happy to have another set of eyes, another point of view, a chance to discuss tweaks they can make to their practice to insure all children get the most of their school day.”And who wouldn’t be happy for a helping hand? That’s why we’ve gathered a host of experts and veteran teachers to discuss common challenges and best practices for your students with ADD and ADHD.

Read on to discover what the latest research says, as well as how other teachers have handled those writing-on-the-carpet moments.

Finding Your Place

Between you, a child’s parents, the school counselor, and outside professionals, there can easily be half a dozen adults involved in the care and teaching of a child with attention issues. That adds up to some strong opinions about how the child will spend her day in your classroom. When Anna’s mother tells you to simply redirect Anna when she acts out, and your principal demands she be delivered straight to his office, while the counselor recommends placing a sticky note on Anna’s desk as a reminder to focus and pay attention, what do you do?

Contrarily, you might find yourself in a position where it seems like you’re the only person worried about a child’s constant fidgeting. Your counseling staff is inundated with “more serious” problems, and the parents brush off any suggestion that the child might have an issue. Mary Rose, a long-time Florida teacher who is now retired, has run across “parents who keep telling the child to ‘just try harder’ or to ‘study more’ or to ‘read more books,’” rather than confronting the issue at hand. “Those admonitions are not helpful for a child that needs real strategies for dealing with his disability,” says Rose. “I think some parents are embarrassed for the child to have the ADHD label, so they pretend that it isn’t a problem.”

The conversation gets even trickier when it comes to medication. While you might feel a child would benefit from one of the drugs commonly prescribed for attention disorders, such as Ritalin, Concerta, or Strattera, many parents and professionals take a passionate stance against it. And recent results from a long-term study, released last spring, found that when it comes to outcomes for kids with ADD and ADHD, medication has its limits. After three years, kids who received intervention did about as well as kids on medication.

Ultimately, the decision to medicate is not yours to make. But there are classroom practices that, when done in concert with families and health professionals, have proven effective with children struggling with attention disorders.

Don’t Jump to Conclusions

Kids can be inattentive for a lot of reasons — and shots of energy or bouts of dreaminess don’t necessarily indicate that kids have ADD or ADHD. The American Medical Association says between three to five percent of the population has a diagnosable attention disorder. But in a study by Eastern Illinois University, teachers labeled nearly 25 percent of kids as having attention problems — five times more than commonly thought prevalent in the population. If you think a child may have a disorder, document, document, document, says Jennifer Capps, a first-grade teacher at Hunter Street Elementary in York, South Carolina. Bring anecdotal records to any meeting with parents or support professionals. But remember, she warns, “you are not the doctor. Teachers often place themselves in a corner by saying, ‘I think your child has ADHD.’”

If a child with persistent attention issues hasn’t been diagnosed with a disorder, think about other possibilities. “The most common reason kids tune out is that the work is too hard for them,” says Dr. Thomas Power, director for the Center for Management of ADHD at the Children’s Hospital of Philadelphia, so leveled skill testing may be in order.

Build a Support Team

When it comes to working with families of children with ADD and ADHD, experienced teachers all agree: Communication is key. “I talk with parents daily, giving them the ups and downs of the day,” says Elizabeth Kennedy, who teaches at New York City’s Claremont Prep School. “We are on the same page so the child does not get confused between school and home expectations.” Rose agrees that communication fosters consistency, adding, “It is helpful to ask parents what worked for them last year at school, as well as what works for them at home.” If the prospect of daily conferences threatens to double your workload, other teachers have had success touching base only one or two times a week — the most important factor is consistency, kindness, and clarity.

Stay on Top of the Social

Kennedy says that in her seven years of teaching, the biggest challenge of working with kids with ADD and ADHD has been managing the social issues that come with attention disorders. “I had a boy who would run his body into walls, for example,” she says. “So some of my kids would be scared or laughing at him.” Many children with attention problems — especially girls — fail to understand the social codes that govern the playground or the cafeteria. In certain cases, group discussion can work wonders — Kennedy had the child who ran into walls explain why he was sometimes so out of control, and from then on, his classmates actively helped to calm him. Kennedy also swears by role-playing various situations that can happen in the classroom. “It helps to build community,” she says.

But a more private, direct approach is often needed to help children with ADD survive socially. Talk with the child about social expectations and help him or her work on skills — such as approaching another child on the playground — one by one.

Rethink the Seating Chart

You probably know that the classroom environment has a great deal to do with kids’ attention, and different setups work for different situations. In Capps’s first-grade classroom, children most often sit on a rug while Capps teaches. She puts students with attention problems near the front, but also to the outside of the rows. “That way, if they move, they don’t bother others,” Capps says. “They can stretch or sit on their knees without drawing attention.” If your students primarily work at desks, seat children with attention disorders next to those with laser-sharp attention. During writing workshop or silent reading, you may need to provide a completely private area for a child with ADD or ADHD. Dorit Sasson, a teacher at Colfax Elementary School in Pittsburgh, occasionally places a student at a corner desk with a folder divider so that the child can work without distraction.

Keep It Simple

When planning lessons or giving instructions, be as clear as possible and go step by step. Even the most basic routines, such as arriving at school, should be broken down. “We give them steps,” explains Capps. “First, put your folder in the basket. Then, put your book bag in your cubby. Next, begin your morning work.” More complicated assignments should also be separated into manageable goals — a good skill for all kids to develop, whether or not they have attention issues. To make sure children are with you, ask them to restate your instructions in their own words. “I try to give every child the job of explaining what is expected,” says Rose, “but for the more confusing lessons, I often call on the ADHD child to make sure they can tell me what is to be done.”

Know How to Refocus

Every teacher loses touch with her students in the middle of a lesson once in a while. The trick is knowing how to get children back on track. Some teachers swear by moving around the classroom to be in closer physical proximity with their dreamers and fidgeters. Touching a child’s desk may also snap them out of la-la land. Rose asks her students with ADD and ADHD to deliver a secret signal, such as putting their hands on their heads, when they feel lost or confused. “Most kids love to have this kind of secret communication with me,” she says. For more teachers’ “secret weapons,” see the sidebar.

Don’t Take Away Downtime 

Currently, 29 percent of first graders get 20 minutes of recess a day or less — far too little, according to experts who study human development. And to make matters worse, some teachers reduce these precious minutes as punishment for kids who don’t follow the rules. Taking away recess “is a questionable practice for any kind of student but especially for kids with ADD or ADHD,” says Power, of Children’s Hospital’s ADHD center. If you don’t give them adequate time to blow off steam, they will stop trying. “I try not to plan a lesson immediately after recess, either,” adds Capps. “Students need a hands-on but calming-down activity before hitting the books again.”

Favor Rewards Over Punishment

Students with ADD and ADHD already take a lot of hits — they are told “no” day in and day out and are forced to ignore basic impulses — and may develop a negative image of school early on. Teachers and researchers have found that positive reinforcement works wonders in curbing negative behavior. Some teachers use charts where kids can keep track of their daily routines and larger goals. Others use incentives like stickers or lunch with the teacher. “When I show my compassion to them,” says Kennedy, “they in turn show their best behavior.”

Play to Kids’ Strengths

In Mindful Education for ADHD Students,experts Victoria Proulx-Schirduan and C. Branton Shearer, remind us of the many strengths that are part of the profile of a child with an attention disorder, including keen spatial intelligence, creativity, and “naturalist intelligence,” or understanding of the outside world. All too often, these strengths are drowned out by the more traditional demands of the school environment: speaking softly and sitting still. A child with ADD, however, may not only thrive working in your school garden but lead other children in caring for it. Teachers agree it takes time to uncover the strengths of all students, not just those with attention disorders. Remember, says Capps, “All children are teachable and loveable. Even the one hanging from the coat hooks singing Bon Jovi at the top of her lungs.”

Strategies Used by Teachers

Buddies
“A buddy can help a child make sure she has the right materials or cleans up at the right time. I make sure to choose someone who is soft spoken and not bossy.” —Jennifer Capps

Classroom Jobs 
"My ADD/ADHD students always have a special job so they don’t have free time to get off track.” —Elizabeth Kennedy

Extra Credit 
"Two words that can be music to a struggling student’s ears. And the credit can be 10 more minutes on the playground, 10 more points on an assignment, a skip homework pass, or a brag slip to go home to the parents." —Mary Rose

Highlighters 
"I use one to discreetly mark the paper of a student with ADD to let them know they don’t have to do all of the problems.” —Mary Rose

High-Interest Reading 
"If students exhibit spatial intelligence, they may benefit from...comic books, graphic novels, and picture books.” —Proulx-Schirduan, Shearer, and Case

Rubber Balls 
"I give one to students to squeeze during lessons to control impulsive behaviors and outbursts.” —Dorit Sasson

Stickers
"I use them as rewards for completing instructions. Once students have a certain amount, they get a prize.” —Dorit Sasson

Stretching
"I monitor the most severe students to see when they are building up pressure that needs to be released. Then the whole class will do some stretching or deep breathing exercises. It is good for everyone to take a break.” —Mary Rose

Tap Time
"If everyone listens or cleans up, I give them 'tap time' right after the lesson. They get to make a beat with pencils or feet.  Once tap time is over...no more noise.” —Jennifer Capps

Three-Ring Binders 
"I use them with colored labels to help kids stay organized and keep papers off the bottom of the book bag.” —Jennifer Capps

Timers 
"Students with ADHD may perform better for shorter periods of time.” —Proulx-Schirduan, Shearer, and Case

Velcro
"Put a strip on the underside of students’ desks. They run their fingers on it rather than tapping feet.” —Jennifer Capps

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