Accommodating Students

with ADHD
Diana Benish
Kathleen Ross
Kristin Schumacher-Smith
Myths
All kids with ADHD are hyperactive
Kids with ADHD can never pay attention
Kids with ADHD could behave better if they really
wanted to
Kids will eventually grow out of ADHD
ADHD is caused by kids watching too much TV and
eating too much sugar
ADD and ADHD are two completely different disorders
Definition of ADHD
Federal Definition
The Federal government defines ADHD under the classification of Other
Health Impairment, meaning a student has limited strength, vitality, or
alertness, including a heightened alertness to environmental stimuli, which
results in limited alertness with respect to the educational environment and
the impairment adversely affects a childs educational performance.
Definition of ADHD
State Definition
The State of Michigan also defines ADHD under the classification of Other
Health Impairment, meaning a student has limited strength, vitality, or
alertness, including a heightened alertness to environmental stimuli, which
results in limited alertness with respect to the educational environment and
the impairment adversely affects a students educational performance.
Determination of Eligibility
According to the State of Michigan, the determination of
an OHI shall be based upon a full and individual evaluation
by a multidisciplinary evaluation team, which shall include
one of the following persons: an orthopedic surgeon, an
internist, a neurologist, a pediatrician, or a family
physician.


Determination of Eligibility
Persistent pattern of inattention and/or hyperactivity-impulsivity that is
more frequently displayed and is more severe than is typically observed in
individuals at comparable level of development
Must have comprehensive assessments clearly indicating interference in
academic, social, and emotional functioning
Symptoms must be present for more than six months and must have been
present before seven years old
Must significantly limit one or more major life activity
The disturbance is not better accounted for by another mental disorder
Types of ADHD
ADHD I (predominantly inattentive)
This subtype is used if six (or more) symptoms of inattention (but fewer than six symptoms of
hyperactivity-impulsivity) have persisted for at least six months.

ADHD HI (predominantly hyperactive-impulsive)
This subtype should be used if six (or more) symptoms of hyperactivity-impulsivity (but fewer than six
of inattention) have persisted for at least six months.

ADHD-C (combined type)
This subtype should be used if six (or more) symptoms of inattention and six (or more) symptoms of
hyperactivity-impulsivity have persisted for at least six months.


Characteristics of ADHD
Inattention
Difficulty concentrating
Unrelated thoughts
Problems focusing and sustaining attention
Appears not to be listening
Performance depends on task
May have better attention towards enjoyed activities
Difficulty planning, organizing, and completing tasks on time
Has trouble with learning new things
Demonstrates poor self-regulation of behavior, that is, he or she has difficulty monitoring
and modifying behavior to fit different situations and settings

Characteristics of ADHD
Hyperactivity
Seems unable to sit still
Appears restless and fidgety
May bounce from one activity to the next
Often tries to do more than one thing at once
Impulsivity
Difficulty thinking before acting
Problems waiting his/her turn, such as when playing a game
https://www.youtube.com/watch?v=8ylIl8T-q7c



The Effect of Extended Test Time for Students with
ADHD
(Wadley & Lilgequist, 2012)
Aim of the study:
o Investigate whether a specific testing accommodation (extended time) affects test scores
for students with and without ADHD.
Hypothesis:
o Students with ADHD who were told they have the standard time to complete the test
would have lower test scores than both students with ADHD who were hold they have
extended time and students without ADHD who completed the same test.
o Students with ADHD who would told they have extended time would not have significantly
different scores than those without ADHD who completed the same test.
Method:
o College freshman (ages 18-19)
o 61 participants with ADHD; 68 participants without ADHD
Procedure:
o Half of the two groups were told they had standard time to complete a math test
o The other half of the groups were told they had extended time to complete the test
o Both groups completed emotion and self-esteem assessments at the end of the test
The Effect of Extended Test Time for Students with
ADHD
(Wadley & Lilgequist, 2012)
Results:
o Test performance did not significantly differ across test conditions (standard or extended
time), regardless of diagnostic status.
o Students with ADHD used more time to complete the test.
o Students with ADHD were less confident about their ability to perform well on the test and
their math scores were strongly correlated to self-esteem.
Implications:
o Results were unexpected and inconsistent with previous studies, yet this study had more
control variables than previous meta-analytic studies.
o Researchers challenge the assumption that simply giving students more time will
automatically accommodate their disability.
o Providing different or multiple testing accommodations could be the key to improved
performance. A one-size-fits-all model does not work.
Cumulative Benefits of Secondary School-Based
Treatment of Students with ADHD
(Evans, Serpell, Schultz, & Pastor, 2007)

Aim of the study:
o Compare social and academic outcomes for participants receiving school-based treatment
to those who are are not receiving treatment.
Hypothesis:
o Students receiving the modified school-based treatment will benefit positively and
experience improved functioning. Use of the program will lead to symptom reduction.
o CHP-C: The Challenging Horizons Program was implemented during regular school hours
and was staffed by educators, school-employed mental health professionals, and
paraprofessionals.
o A community development team comprised of parents, teachers, school administrators,
and physicians modified the original CHP program to create a training and consultation
model.
Method:
o 79 young adolescents (ages 10-14)
o 5 middle school in rural Virginia
o Students with treatment were monitored monthly

CHP-C Treatment:
o Interventions primarily targeted academic skills
Assignment tracking
Note taking skills
Organization
o Also targeted social skills
Social problem solving
Conversational skills
Anger or frustration management
o Each student was assigned an individual educator (mentor) who coordinated interventions
o Certified school psychologist provided ongoing school-based consultation
Cumulative Benefits of Secondary School-Based
Treatment of Students with ADHD
(Evans, Serpell, Schultz, & Pastor, 2007)

Outcome measures
o Behavior Assessment System for Children
o Disruptive Behavior Disorders Rating Scale
o Grades
o Impairment Rating Scale
o Social Skills Rating System
Results
o Relatively small dosages of treatment provided over an extended period can lead to a
cumulative benefit greater than what might be obtained in the first few months of
intervention
o Persistence and patience over time may be more important than short-term interventions
Implications for intervention planning in schools
o IEPs and 504s can focus primarily on accommodations (i.e. reducing expectations, giving
credit for late assignments, extended test taking time)
o These strategies may not be in the best interest of the students; instead, focusing on
interventions over accommodations could be best
Cumulative Benefits of Secondary School-Based
Treatment of Students with ADHD
(Evans, Serpell, Schultz, & Pastor, 2007)


Working With Children With ADHD: Strategies for
Counselors and Teachers
(Reid, 2001)

Children with ADHD are more likely to have academic problems
Multimodal approach
o Includes 4 major areas of intervention: educational accommodations,
promoting appropriate behavior, medical management and additional
support services
o This article focused on educational accommodations and
interventions for promoting appropriate behavior.


Working With Children With ADHD: Strategies for
Counselors and Teachers
(Reid, 2001)
Educational accommodations
o Alter classroom environment, tasks/materials, and
curriculum/instruction
o Classroom management and physical setup
o Teachers need to create and maintain a stable and structured
instructional regimen
o Behavior of children with ADHD often deteriorates over the course of
the day
o May need additional prompts or cues of what is expected
o Provide frequent feedback
o Students easily distracted
Working With Children With ADHD: Strategies for
Counselors and Teachers
(Reid, 2001)
Intervention for promoting appropriate behavior
o Behavior-modification techniques work well with children who have
ADHD
o Need powerful reinforces
o Reinforcement and consequences should be immediate
o Behavior problems should be addressed in the setting where they
occur
o No one intervention will be effective for all students with ADHD
For most people, ADHD behavior will be a lifelong problem
Improving Expressive Writing Skills of Children Rated for
ADHD symptoms
(Re, Caeran, & Cornoldi, 2008)
Very little information is available about writing skills of children with ADHD
High risk of academic failure in children with ADHD; need for academic interventions
Aim of Study:
o Provide investigation into the effects of intervention on expressive writing of primary
school children
o Examines how general procedures designed for improving expressive writing skills may be
adapted and become effective for children with ADHD symptoms
o Also examine whether both groups can improve expressive writing skills through
procedural facilitation (guide scheme)
Hypothesis:
o Children with ADHD could benefit from training in the use of a guide scheme
Method:
o Two groups of 35 children:
One group were children with ADHD
Control group of children that do not have ADHD
o 24 males and 11 females in each group


Improving Expressive Writing Skills of Children Rated for
ADHD symptoms
(Re, Caeran, & Cornoldi, 2008)

Procedure:
o All children given two expressive writing tasks
o One task had to write without support, other had a guide scheme to follow
o 1 hour training given for second writing
o Students scored on adequacy, structure, vocabulary, grammar, essay length, richness of
themes, and percentage of errors
Results:
o Showed evidence of the difficulties for students with ADHD symptoms
o All children benefited from the guide scheme and practice session
Interventions to Address the Academic Impairment of Children and
Adolescents with ADHD
(Raggi & Chronis, 2006)
The academic difficulties of children and adolescents with ADHD are significant, and typically include
failure to complete homework, poor comprehension of material, poor study skills, low test and quiz
grades, poor preparation for class, disruptive behavior, peer conflict, and conflict with teachers
(Evans et al., 2004; Hinshaw, 1992b; Robin, 1998; Zentall, 1993).

Current Evidence-Based Approaches
Stimulant medication
Behavioral intervention
o Parent Training and School-Based Interventions
Environmental variables
Positive consequences
Negative consequences
Interventions to Address the Academic Impairment of Children and
Adolescents with ADHD
(Raggi & Chronis, 2006)
Peer Tutoring
One-on-one instruction with a peer
o 18 hyperactive male 3rd graders
o Teamed up with another student to be coached on reading and vocab
o Token reinforcement used
o Number of tasks completed rose to over 9 times the number completed during reversal
conditions
Classwide Peer Tutoring (CWPT)
o All students are trained in tutoring procedures and paired with a random partner
o The tutor reads from the script to the tutee, and the tutee answers the problem orally, but
may use paper to work it out
o Points and feedback are provided
o Students switch roles
o Meanwhile, teacher monitors the pairs
Interventions to Address the Academic Impairment of Children and
Adolescents with ADHD
(Raggi & Chronis, 2006)
Computer-Assisted Instruction (CAI)
Few studies done on children with ADHD specifically
o 21 third and fourth grade students with ADHD
o Used various reading and math computer software packages
o Each package used two different formats
Game vs non-game format
Playing against a computer vs a partner
Animated vs non-animated graphics
Unlimited vs limited time to response
o Results showed that attention of participants increased on
software with a game format, without animation, and with
unlimited time to respond
Task/Instructional Modifications
Visual versus Auditory Presentation of Material
o Oral vs silent reading
Oral reading produced more effective comprehension than silent reading, reducing by
nearly one-half the number of comprehension errors produced by silent reading
Adding Structure to a Task
o 15 hyperactive and 16 non-hyperactive kids
o High-structure and low-structure task
o Results found reduced activity levels for both hyperactive and control children in the high-
structure task
Choice-making
o Two 5th grade participants (ADHD & SED)
o Choice vs no choice
o Choice making resulted in significantly higher levels of task engagement and less disruptive
behavior than no choice conditions
Interventions to Address the Academic Impairment of Children and
Adolescents with ADHD
(Raggi & Chronis, 2006)
Self-Monitoring
Improves on-task behavior in the classroom
Strategy Training
Involves teaching and transferring a specific skill to children that they can implement in an academic situation to improve
their performance
Takes burden off of teacher and parents, giving added responsibility to the student
o 18 hyperactive children
o Taught more effective and less impulsive strategies for approaching cognitive tasks, academic problems, and social
situations
o After 3 months, the group showed significant improvement on several cognitive measures compared to a no-
treatment control group
Homework-Focused Interventions
The use of goal setting and contingency contracting, parent training in structuring the home setting, and parent-teacher
consultation are beneficial in the remediation of homework difficulties
o Establishment of a specific homework routine
Interventions to Address the Academic Impairment of Children and
Adolescents with ADHD
(Raggi & Chronis, 2006)
Multimodal Treatment Approaches
Summer Treatment Program (STO)
o Combines an intensive summer treatment program with a school-year
outpatient follow-up program
2 hours are spent in classrooms
The rest of the day is spent in recreationally based group activities
o 258 boys with ADHD who attended STP found improvement in on-task and
disruptive classroom behavior but limited improvements in academic
productivity.
Interventions to Address the Academic Impairment of Children and
Adolescents with ADHD
(Raggi & Chronis, 2006)
Functional Assessment: A Method for Developing Classroom-Based Accommodations
and Interventions for Children with ADHD
(Reid & Maag, 1998)
Functional Assessment
Allows the teacher to individualize academic interventions for the target child,
based on the identification and manipulation of environmental variables that
serve to initiate and maintain the childs problematic behavior in a particular
setting
Teacher tolerance levels
Classroom arrangement
Curriculum and instructional variables
Peers reactions to a child
Task difficulty
Functional Assessment: A Method for Developing Classroom-Based Accommodations
and Interventions for Children with ADHD
(Reid & Maag, 1998)
Functional Assessment
Two categories
o Antecedents
Events that precede behavior
Physical environment
Tasks-materials
Curricular-instructional
o Consequences
Events that follow behavior
Positive reinforcement
Token economy
Behavioral contracting
Group-oriented contingencies
Universal Accommodations
Give frequent feedback: including positive reinforcements and mild punishers.
Create and maintain a predictable and structured instructional regimen and clearly communicate expectations.
Provide a physical layout of the classroom that reduces or eliminates potential distractions.
Shorten assignments, intersperse different activities within assignments, and provide frequent breaks or
alternative activities.
Break tasks into smaller pieces.
Increase engagement of activities.
Reinforcement and consequences should be given immediately after behavior occurs.
Have students repeat instructions back to you.
When reading material in class, have students read out loud to you, rather than silently.
Provide high-structure tasks.
Offer multiple forms of accommodation for various tasks.
Coordinate with school administration and possibly create long-term in-school interventions in addition to
every-day classroom accommodations.
References
Journal Articles

Evans, S., Serpell, Z., Schultz, B., & Pastor, D. (2007). Cumulative benefits of secondary school-based treatment of students with ADHD. School of Psychology
Review, 36(2), 256-276.

Raggi, V. L., & Chronis, A. M. (2006). Intervention to address the academic impairment of children and adolescents with ADHD. Clinical Child and Family
Psychology Review, 9(2), 85-111.

Re, A. M., Caeran, M., & Cornoldi, C. (2008). Improving expressive writing skills of children rated for ADHD symptoms. Journal of Learning Disabilities,
41(6), 535-44.

Reid, R. (2001). Working with children with ADHD: Strategies for counselors and teachers. Counseling and Human Development, 33(6), 1.

Reid, R., & Maag, J. W. (1998). Functional assessment: A method for developing classroom-based accommodations and interventions for children with ADHD.
Reading & Writing Quarterly: Overcoming Learning Difficulties, 14(1), 9-42.

Wadley, M. & Lilgequist, L. (2012). The effect of extended test time for students with ADHD. Journal of Postsecondary Education and Disability, 26(3),
263-271.

Other Resources
https://www.youtube.com/watch?v=Dd62-eL0JYI

Attention Deficit/Hyperactivity Disorder (ADHD). (n.d.). Retrieved from American Speech-Language-Hearing Organization website:
http://www.asha.org/public/speech/disorders/adhd/
Aupperlee, J., Greer Swank, M., Lien, M., & Ripinski, A. (n.d.). DSM-IV diagnosis of ADHD. In Attention deficit hyperactivity disorder. Retrieved from
https://www.msu.edu/course/cep/888/ADHD%20files/DSM-IV.htm
Michigan Department of Education. (2013). Michigan administrative rules for special education. Retrieved from State of Michigan Department of Education
website: http://www.michigan.gov/documents/mde/MARSE_Supplemented_with_IDEA_Regs_379598_7.pdf