Attention Deficit Hyperactivity Disorder (ADHD) is a common condition affecting 5-7% of school-aged children. Whilst much information about ADHD centres on the core symptoms of Inattention, Hyperactivity and Impulsivity, it is also helpful to focus on the Executive Function (EF) impairments typical of the disorder. EF dysfunction has serious implications in the classroom for students with ADHD, as well as their teachers, who can find themselves frustrated by behaviours typical of these students.
EFs broadly refer to a set of cognitive processes, moderated by the prefrontal cortex that are responsible for goal-directed, problem-solving behaviours, and attention control. EFs enable us to do what we know we should do, much as the conductor of an orchestra enables the musicians to perform together and create harmonious sound. They exist in the gap between intentions and actions by organising what, when, where and how we do things.
What do EF Impairments Look Like?
EF theories vary, as the concept continues to evolve. Yale University’s Professor Thomas Brown offers a clear model with six separate clusters of functions that work together continually and unconsciously, to help each individual manage many tasks of daily life. As Dr Brown explains: while anyone can have occasional impairments in their executive functions, people with ADHD experience much more difficulty in the development and use of these functions than do most others of the same age and developmental level. Interestingly, even those with severe ADHD usually have some activities where their executive functions work very well. This makes it hard for people to accept their challenges in other domains.
- Activation: Students have difficulty getting started on tasks. Prioritising, time management and organising skills are lacking. Procrastination can be excessive, even on tasks they know to be important.
- Focus: Students have difficulty focusing attention on the task at hand, sustaining that attention, and shifting attention when required. They are easily distracted by things happening around them and also by their thoughts.
- Effort: Students with ADHD can be great ‘sprinters’ performing short-term tasks well, but they struggle to sustain effort over longer periods.
- Emotion: Students struggle to control their emotions. Frustration, worry and disappointment, among others, dominate their thoughts interfering with their ability to focus on tasks.
- Memory: Working Memory (WM) has been described as our ‘mental workbench’- a place to hold information in mind long enough to manipulate it in order to solve a problem or complete a task. Students with ADHD have significant WM impairments, forgetting where they put things, what they were doing, what they meant to say, or what was said to them.
Prospective Memory is the ability to ‘remember to remember’. It is our mental to-do list that reminds us to do things at a certain time. Impairment in this area causes students to remember important tasks before or after the fact, and forget to do them at the right time. They can also experience difficulty when trying to recall information from their long-term memory as required.
- Action: Students have difficulty controlling their actions, often reacting impulsively. They also experience difficulty reading social cues, resulting in behaviours that are inappropriate. Social isolation is not uncommon.
What can teachers do?
Chunk – and then dot-point. Most teachers are great at chunking work for students. However, they often do not realise the level of chunking that needs to occur for students with ADHD. Because of their inability to break work down, students become overwhelmed by what they perceive to be an enormous task. Giving students a short list of dot points creates an entry point for them, making it easier to get started.
Make Time Visible. For students with ADHD there are two deadlines: work that is due NOW and work that is due NOT NOW. They understand the timeframe of work that is due immediately, but not long-term projects. Have a planner on display with assignment due dates clearly marked. Cross off each day as it passes to give students a reference point. This creates a picture of the time available to them to complete a task. Encourage them to keep similar planners at home which include due dates of all assignments and out of school commitments.
Encourage ‘Free-Writing’. Sometimes the best ideas get lost as students struggle to articulate them in an appropriate format or style. Encourage students to get their ideas onto a page first and then arrange them into the appropriate format. This works best on a computer. For example, students might write the body of an essay first, and then go back to writing the introduction.
Use white noise. Allow students to listen to music, ambient sounds or white noise through earphones while working independently. This will block external and internal distractions, and prevent students from distracting others.
Brain Dump. When they find themselves focused, students are often reluctant to stop working, knowing how hard it will be to get started again. If at all possible, leave a focused student to complete a task. However, if work must stop, have students write down the next steps of the task. When they return, those notes will provide their next entry point.
Sprint to get started. Because ADHD brains are great sprinters, they often leave work until the last minute. Once they can see the finish line, however, all things become possible. Help students create sprints by setting a 10/20/30 minute timer, and have them complete as much work as possible in that time.
Frequent breaks. Along with sprints, frequent short breaks can be extremely effective. Allow your student to create a cycle of timed sprints and timed breaks to get through a large task.
Expect inconsistency. One of the most frustrating aspects of ADHD for students, teachers and parents is inconsistency, even when students are medicated. It is difficult to understand that they may be capable of a task one day, but not the next. Celebrate their good days, and encourage them to keep a Success Diary to remind themselves of their achievements.
Take the load off working memory by making information available for students and their parents on the school portal, and keeping it up to date. Write all assigned homework on the board, and allow students to photograph the board at the end of class. Students with ADHD may be inconsistent with homework diaries and should be given accommodations in this area.
Provide regular check-ins by encouraging students to complete portions of assignments and discuss these with you before proceeding. Aside from the discussed benefits of chunking, this will keep them focused on the correct aspects, and prevent them from over-focusing on one aspect of the assignment to the detriment of others.
Allow Fidgeting to Focus. When students with ADHD are told to stop fidgeting they spend a huge amount of mental energy concentrating on sitting still. Consequently, they find it hard to focus on what is being taught. Teach your students discreet fidgets to overcome this problem. Doodling is a great fidgeting strategy, as is playing with a small piece of blutack, or rubbing a small pebble.
There is no doubt that students with ADHD can present challenges for teachers. However, with an improved understanding of the impairments they deal with on a daily basis, teachers can provide the scaffolding required in order for them to flourish.
Michele wrote this article for publication in ACEL e-teaching. A PDF of the article can be found here.