Importance of Teacher Training in Supporting Neurodivergent Students with ADHD

If the best scientists in the world were asked to create an environment that would be the most challenging for a student with ADHD, they’d be hard-pressed to devise anything worse than a contemporary elementary school classroom: six-hour days filled with expectations of sitting still, following endless instructions, completing tedious tasks, and navigating challenging social situations on playgrounds, in cafeterias, or on the bus during times of little adult monitoring. Indeed, the only setting that might exacerbate ADHD symptoms more would be a middle or high school where behavioral expectations are spread across multiple teachers, organizational and time-management demands become the responsibility of the student, and assignments have short- and long-term deadlines that require routine monitoring.

It is, therefore, not surprising that the long-term academic outcomes for students with ADHD are strikingly poor. Compared to students without ADHD, those with ADHD have lower grades, more discipline referrals, and more special education placements. These issues can follow students into adulthood, leading to poorer adult occupational outcomes and lower lifetime earnings, likely due to underachievement.

Given that 9 percent of school-age children have an ADHD diagnosis, according to the Centers for Disease Control and Prevention,1 it is surprising that scant formal attention has been dedicated to supporting teachers, and by extension, students with ADHD. In a 1999 survey, only 15 percent of teachers stated they had received “a lot” of training related to ADHD. When this survey was repeated 20 years later, the number of teachers reporting this level of training had doubled to 29 percent. In other words, more than two-thirds of educators are in classrooms without substantive training on ADHD, and without knowing how to support the condition in school settings.

Educators in special education settings may also need additional training to help students with ADHD in classroom settings. In a recent study of students with ADHD receiving special education supports, only those who worked with a behavioral consultant to establish a daily behavior report card that addressed goals and objectives improved in behavior and academic productivity at the end of the year.2 Students who received special education as usual did not improve on these outcomes, suggesting more direct and ongoing behavioral supports are needed for many students with ADHD supported by special education.

Current school policy may exacerbate these problems. For example, there is no special education category for ADHD, even though this is the reason many students receive an Individualized Education Program (IEP). Students with ADHD may also be eligible for a 504 Plan, but these are characterized by considerable heterogeneity and inconsistencies in application. Indeed, many formal school interventions and supports are unlocked only when a family secures an outside diagnosis or for a co-occurring concern (e.g., specific learning disability). The lack of explicit school policies to govern ADHD-focused support and intervention may explain why more than 10 percent of complaints to the U.S. Department of Education, Office of Civil Rights, “involved allegations of discrimination against a student with ADHD,” according to Wrightslaw.com, a legal resource website.

All too often, the reactions by educators to a student’s misbehavior or challenging academic situation result in suspensions, expulsions, exclusions, class failures, and grade retention. Instead, parents and educators should focus on addressing the antecedents of school success, such as getting the child to school on time and prepared for the day so that there is not a difficult transition into the morning activities. This also means frequent reminders of rules and expectations prior to starting a new activity in class. Clearly established routines and procedures will also help a child with ADHD be successful in academic settings. Once these procedures are in place, consequences can focus on positive results and outcomes rather than negative ones.

IEPs and 504 Plans can be useful mechanisms for promoting effective supports, accommodations, and interventions in school settings. Yet, they can also be insufficient or ineffective. Most children with ADHD who have a 504 Plan or an IEP will spend the majority of their day in a general education setting, the very setting that may have resulted in the initial referral for additional supports. If these mechanisms do not provide additional and adequate support for the general education teacher, they are unlikely to improve important functional outcomes.

Parents and educators should make sure that the content of these plans address improvements in academic learning and progress, social relationships with peers and adults, and the child’s self-esteem, rather than addressing the symptoms of ADHD (e.g., fidgeting, distractibility).  Indeed, there is now clear evidence that symptom-focused accommodations—providing extra time to complete tasks or provision of fidget-toys—do not result in meaningful improvements. Parents should make sure meetings with school professionals continue to focus on how to include effective interventions in these plans (a daily behavior report card is one such example).

There is surprisingly little empirical research to help parents and teachers know the best accommodations and interventions to include in 504 Plans or IEPs. Often the contents of these plans include out-of-class therapies or accommodations of unclear effectiveness (e.g., preferential seating). Parents and educators should ensure that the contents of these plans include:

I believe all students with ADHD should have a daily behavior report card and older children in middle or high school should have a behavioral contract. (MyGoalPal is a free app that creates a daily report card that parents and teachers can use). These approaches clearly outline specific goals and expectations, provide a mechanism for frequent (i.e., daily) parent-teacher communication and, importantly, positive consequences at home are contingent on meeting the daily goals. For most children with ADHD, a daily report card or contract will provide a critical foundation of positive behavioral support.

Gregory A. Fabiano, Ph.D., is a professor of psychology at Florida International University. He has written two books, Interventions for Disruptive Behavior Disorders and Daily Behavior Report Cards.

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1Bitsko RH, Claussen AH, Lichstein J, et al. Mental health surveillance among children—United States, 2013–2019. MMWR Suppl. 2022;71(2):1-48. 2Gregory A. Fabiano, Rebecca K Vujnovic, William E. Pelham, Daniel A. Waschbusch, Greta M. Massetti, Meaghan E. Pariseau, Justin Naylor, Jihnhee Yu, Melissa Robins, Tarah Carnefix, Andrew R. Greiner & Martin Volker (2010) Enhancing the Effectiveness of Special Education Programming for Children With Attention Deficit Hyperactivity Disorder Using a Daily Report Card, School Psychology Review,39:2, 219-239, https://doi.org/10.1080/02796015.2010.12087775″>10.1080/02796015.2010.12087775