Spotlight on ADHD in Children (And School Accommodations)

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Some people, especially those in older generations, do not seem to fully accept ADHD as a disability.  I have even been told that people have become “soft” and that society is giving kids an excuse for poor grades through these types of disorders.  Well, ADHD is an actual disorder according to The Diagnostic and Statistical Manual of Mental Disorders (DSM-V) so there is nothing trivial about it.  Furthermore, accommodations in school for children with all of the different types of ADHD are critical in order to boost educational performance.

I was diagnosed with Inattentive Type ADHD over 25 years ago and can tell you first hand it remains a daily battle for me.  As a child, even the attempt to stay organized and manage my time was extremely challenging.  Today, I am a mother of three so the struggle is three-fold due to the additional schedules I need to manage.  As an adult, I appreciate the small tweaks in my routine that help me manage my ADHD.  I can sympathize with children struggling with this disorder and if there is a way to help a child manage their educational experience, I am all for it!

I believe all people face some challenges with attention and focus. Even someone with absolutely impeccable attention skills gets distracted from time to time.  This is something that most likely does not have a major impact on that person’s life.  But for others, ADHD can become quite debilitating and have an incredible burden on a child’s life and will most likely follow them into adulthood.  Let’s take a look into the different types of ADHD, how the disorder can affect educational performance and how schools can assist these children with making progress in school.

Different Types of ADHD and How They are Diagnosed

The Diagnostic and Statistical Manual of Mental Disorders, (DSM-V) remains the standard in diagnosing children with ADHD, but many clinicians go beyond that in their assessments.  In addition to reviewing the DSM-V criteria, doctors will conduct a thorough clinical interview using a standardized ADHD rating scale. A screening test is also often administered to rule out common coexisting conditions like learning disorders, autism, and mood disorders.

According to the latest DSM-V guidelines, in order to diagnose a child with ADHD, a child has to have shown at least six of the nine symptoms of inattention and/or hyperactivity/impulsivity prior to age 12. Additionally, these symptoms must impair the child’s functioning in more than one setting — home and school.

There are two forms of ADHD:  Inattentive and Hyperactive/Impulsive.  There are distinct symptoms for these different types of ADHD and children can primarily have one or a combination of both.  If a child meets both inattentive and hyperactive/impulsive criteria they are considered the Combined Type. If a child meets solely the inattentive criterion, they are classified as Predominantly Inattentive Type.  Lastly a child is considered the Predominantly Hyperactive/Impulsive Type if they meet the hyperactive/impulse criterion, but not inattentive criterion.  It is important to remember that a child may change types throughout their life. Once diagnosed, your school may make suggestions on medication but that is your right. See https://brylanadvocates.com/can-a-school-recommend-medicating-your-add-adhd-child/

Inattentive Type Diagnosis Criteria:

Displays poor listening skills
Loses and/or misplaces items needed to complete activities or tasks
Sidetracked by external or unimportant stimuli
Forgets daily activities
Diminished attention span
Lacks ability to complete schoolwork and other assignments or to follow instructions
Avoids beginning homework or activities requiring concentration
Fails to focus on details and/or makes thoughtless mistakes in schoolwork or assignments

Hyperactive/Impulsive Type Diagnosis Criteria:

Squirms when seated or fidgets with feet/hands
Marked restlessness that is difficult to control
Appears to be driven by “a motor” or is often “on the go”
Lacks ability to play and engage in leisure activities in a quiet manner
Incapable of staying seated in class
Overly talkative
Difficulty waiting turn
Interrupts or intrudes into conversations and activities of others
Impulsively blurts out answers before questions completed

Does IDEA Apply to Children with ADHD?

In order for a child to be eligible under the IDEA, and therefore qualify for an IEP, a child must have a disability and need special education and related services.  The IDEA lists ADHD under the “Other health impairment” (OHI) category. https://sites.ed.gov/idea/regs/b/a/300.8/c/9 OHI is one of the 13 qualifying disabilities listed in the IDEA so an ADHD diagnosis would meet this first element needed for eligibility.

Next, it is imperative to show that the child needs special education and related services.  To determine if there is a need, ask yourself if your child’s ADHD adversely affects their educational performance and how.  While determining this, remember that educational performance is much more than merely academic performance.  A child’s educational performance includes academic, social, health, emotional, communicative, physical and vocational needs.

How Does ADHD Affect Educational Performance?

ADHD can affect educational performance in a multitude of ways.  As a parent it is important to observe your child in the home setting, especially when doing homework.  You can use this information to share with the school if it is suspected your child’s ADHD is having a negative impact on school performance. Here are some ways ADHD can affect a child’s educational performance. ADHD affects all children differently so this list is not inclusive to all but rather sheds light on the many ways this disorder can affect a child’s educational performance.

1. Inattentive and poor concentration: difficulty listening in class; daydreams; spaces out and misses lecture content or homework assignments; lack of attention to detail; makes careless mistakes in work, errors in grammar, punctuation, capitalization, spelling, or changes in signs (+,-) in math; difficulty staying on task and finishing school work; moves from one uncompleted task to another; lack of awareness of time and grades.

2.Impulsivity:  Academically this includes rushing through work; not double checking work; not read directions; taking short cuts in written work, especially math;  Beyond academics, impulsivity may affect children socially as oftentimes impulsivity leads children speak without thinking first.  What is spoken is often offensive, inappropriate or harsh. Furthermore, children who are extremely impulsive tend to strongly dislike waiting and lack patience.

3. Language-processing problems: These are common among children with ADHD, primarily the Inattentive Type. Language-processing problems include listing and reading comprehension, spoken language (oral expression) and written language.  Parents should pay close attention to symptoms linked to language-processing disorders including but not limited to, slow processing of information; reading, writing, and responding slowly; and slow recall of facts.

4. Poor organizational skills: disorganized; loses homework; difficulty beginning tasks; uncertain as to what steps should be taken first; difficulty organizing thoughts, sequencing ideas, writing essays, and planning ahead.

5. Impaired sense of time: loses track of time; often late; lacks time management; unable to accurately plan how long a task will take; doesn’t plan ahead for future.

6. Poor memory: difficulty memorizing material such as multiplication tables, math facts or formulas, spelling words, foreign languages, and dates.

7. Math computation: difficulty automatizing basic math facts; cannot rapidly recall basic math facts.

8. Forgetful: forgets chores or homework assignments, forgets to take books home; forgets to turn in completed assignments to teacher; forgets special assignments or make-up work.

9. Poor fine motor coordination: handwriting is poor, small, difficult to read; writes slowly; avoids writing and homework because it is difficult; prefers to print rather than write cursive; produces less written work.

10. Weak Executive Functioning: deficits in working memory, control of emotions and behavior, internalizing language, problem-solving, and organization of materials

Modifications and Accommodations for Children with ADHD

Some suggestions for modifications and/or accommodations that may be useful for your child at school include:

  • Untimed tests
  • Use of calculator or computer
  • Modification of assignments (fewer problems but still master concepts)
  • Elimination of unnecessary writing (i.e. write answers only, not questions)
  • Reduced demands on limited working memory capacity
  • Utilization of note takers, guided lecture notes, typed notes or an outline of the lesson to help with note taking
  • Work on the most difficult concepts early in the day
  • Give directions to one assignment at a time instead of directions to multiple tasks all at once
  • Give directions out loud and in writing and have the student repeat them
  • Vary the pace and type of activity to maximize the student’s attention during day
  • Be seated away from potentially distracting areas (such as doors, windows, and computers) or seated near another student who is working on a shared assignment
  • Flexible seating like wiggle chairs, standing desks, footrests, seat cushions or resistance bands on chair legs
  • Post a written schedule for daily routines and rules
  • Provide an extra set of books to keep at home
  • Color-code materials for each subject
  • Break long assignments into smaller chunks
  • Provide a rubric that describes the elements of a successfully completed assignment
  • Allow understanding of concept to be demonstrated in different ways like oral reports, posters or video presentations.
  • Provide different ways to respond to test questions, like stating answer or circling
  • Minimize number of questions per page
  • Have frequent short quizzes rather that one long test
  • Grade for content, not neatness
  • Use a nonverbal signal to get student’s attention (i.e. sticky note on desk)