Children with Attention Deficit Hyperactivity Disorder
and accomadations for teaching children with attention deficit disorder
(ADHD and ADD).
Defining Attention Deficit Disorder/Attention
Deficit Hyperactivity Disorder (ADD/ADHD)
Attention deficit disorder is a syndrome characterized by serious and
persistent difficulties in the following three specific areas:
- Attention span.
- Impulse control.
- Hyperactivity (sometimes).
ADD is a chronic disorder that can begin in infancy and extend through
adulthood, having negative effects on a child's life at home, school,
and within the community. It is conservatively estimated that 3 to 5%
of our school-age population is affected by ADD.
The condition previously fell under the headings, "learning disabled,"
"brain damaged," "hyperkinetic," or "hyperactive."
The term attention deficit disorder was introduced to describe the characteristics
of these children more clearly.
Diagnosis of Attention Deficit Disorder/Hyperactivity
According to the criteria in the Diagnostic and Statistical Manual of
Mental Disorders (4th ed., rev.) (American Psychiatric Association, 1994),
to be diagnosed as having ADD/ADHD, the clinician must note the presence
of at least 6 of the 9 following criteria for either Attention Span or
Attention Span Criteria
Pays little attention to details; makes careless mistakes
Has short attention span
Does not listen when spoken to directly
Does not follow instructions; fails to finish tasks
Has difficulty organizing tasks
Avoids tasks that require sustained mental effort
Is easily distracted
Is forgetful in daily activities
Fidgets; squirms in seat
Leaves seat in classroom when remaining seated is expected
Often runs about or climbs excessively at inappropriate times
Has difficulty playing quietly
Blurts out answers before questions are completed
Has difficulty awaiting turn
Often interrupts or intrudes on others
Establishing the Proper Learning Environment
- Seat students with ADD near the teacher's desk, but include them as
part of the regular class seating.
- Place these students up front with their backs to the rest of the
class to keep other students out of view.
- Surround students with ADD with good role models.
- Encourage peer tutoring and cooperative/collaborative learning.
- Avoid distracting stimuli. Try not to place students with ADD near
air conditioners, high traffic areas, heaters, or doors or windows.
- Children with ADD do not handle change well, so avoid transitions,
physical relocation (monitor them closely on field trips), changes in
schedule, and disruptions.
- Be creative! Produce a stimuli-reduced study area. Let all students
have access to this area so the student with ADD will not feel different.
- Encourage parents to set up appropriate study space at home, with
set times and routines established for study, parental review of completed
homework, and periodic notebook and/or book bag organization.
Giving Instructions to Students with ADD/ADHD
- Maintain eye contact during verbal instruction.
- Make directions clear and concise. Be consistent with daily instructions.
- Simplify complex directions. Avoid multiple commands.
- Make sure students comprehend the instructions before beginning the
- Repeat instructions in a calm, positive manner, if needed.
- Help the students feel comfortable with seeking assistance (most children
with ADD will not ask for help). Gradually reduce the amount of assistance,
but keep in mind that these children will need more help for a longer
period of time than the average child.
Require a daily assignment notebook if necessary:
- Make sure each student correctly writes down all assignments each
day. If a student is not capable of this, the teacher should help him
- Sign the notebook daily to signify completion of homework assignments.
(Parents should also sign.)
- Use the notebook for daily communication with parents.
- Give out only one task at a time.
- Monitor frequently. Maintain a supportive attitude.
- Modify assignments as needed. Consult with special education personnel
to determine specific strengths and weaknesses of each student.
Develop an individualized education program.
Make sure you are testing knowledge and not attention span.
Give extra time for certain tasks. Students with ADD may work slowly.
Do not penalize them for needing extra time.
Keep in mind that children with ADD are easily frustrated. Stress, pressure,
and fatigue can break down their self-control and lead to poor behavior.
Modifying Behavior and Enhancing Self-Esteem
Providing Supervision and Discipline:
Remain calm, state the infraction of the rule, and avoid debating or
arguing with the student.
Have preestablished consequences for misbehavior.
Administer consequences immediately, and monitor proper behavior frequently.
Enforce classroom rules consistently.
Make sure the discipline fits the "crime," without harshness.
Avoid ridicule and criticism. Remember, children with ADD have difficulty
staying in control.
Avoid publicly reminding students on medication to "take their medicine."
Reward more than you punish, in order to build self-esteem.
Praise immediately any and all good behavior and performance.
Change rewards if they are not effective in motivating behavioral change.
Find ways to encourage the child.
Teach the child to reward himself or herself. Encourage positive self-talk
(e.g., "You did very well remaining in your seat today. How do you
feel about that?"). This encourages the child to think positively
about himself or herself.
Other Educational Recommendations
Educational, psychological, and/or neurological testing to determine
learning style and cognitive ability and to rule out any learning disabilities
(common in about 30% of students with ADD).
A private tutor and/or peer tutoring at school.
A class that has a low student-teacher ratio.
Social skills training and organizational skills training.
Training in cognitive restructuring (positive "self-talk," e.g.,
"I did that well").
Use of a word processor or computer for schoolwork.
Individualized activities that are mildly competitive or noncompetitive
such as bowling, walking, swimming, jogging, biking, karate. (Note: Children
with ADD/ADHD may do less well than their peers in team sports.)
Involvement in social activities such as scouting, church groups, or other
youth organizations that help develop social skills and self-esteem.
Allowing children with ADD to play with younger children if that is where
they fit in. Many children with ADD have more in common with younger children
than with their age-peers. They can still develop valuable social skills
from interaction with younger children.
American Psychiatric Association. (1994). Diagnostic and statistical manual
of mental disorders (4th ed., rev.) (DSM-IV-R). Washington, DC: APA.
Bender, W. (1997). Understanding ADHD: A Practical Guide for Teachers
and Parents. Upper Saddle River, NJ:Merrill/Prentice Hall.
Fiore, T. (1993). Educational interventions for students with attention
deficit disorder. Exceptional Children, 60(2), 163-73.
Gardill, M. (1996). Classroom strategies for managing students with attention
deficit/ hyperactivity disorder. Intervention in School and Clinic, 32(2),
Hallowell, E. (1994). Driven to Distraction: Recognizing and Coping with
Attention Deficit Disorder from Childhood through Adulthood. Tappan, NJ:
Simon & Schuster.
Hartmann, T. (1993). Attention Deficit Disorder: A Different Perception.
Novato, CA: Underwood-Miller.
Reeve, R. (1996). A Continuing Education Program on Attention Deficit/Hyperactivity
Disorder. Reston, VA: Council for Exceptional Children.
Rief, S. (1997). The ADD/ADHD Checklist. An Easy Reference for Parents
and Teachers. Reston, VA: Council for Exceptional Children.
Robelia, B. (1997). Tips for working with ADHD students of all ages.
Journal of Experiential Education, 20(1), 51-53.
Schiller, E. (1996). Educating children with attention deficit disorder.
Our Children, 22(2), 32-33.
For more information on ADD, write to:
Children with Attention Deficit Disorder
1859 North Pine Island Road
Plantation, FL 33322
Contact your local school psychologist, examiner, or personnel in charge
of assessment and diagnosis in your school district for specific information
and local programs.
ERIC Clearinghouse on Disabilities and Gifted Education
ERIC EC Digest #E569 September 1998