Evidence-based strategies for teaching in secondary schools for students with ADHD in Australia

Introduction

Attention Deficit Hyperactivity Disorder (ADHD) that The World Health Organization included in its 2010 Global Burden of Disease Study (GBD), aiming to highlight health conditions with a significantly high prevalence (Living With ADHD, 2015). This essay examines evidence-based strategies for teaching in secondary schools for students with ADHD in Australia.

Key characteristics of ADHD

ADHD is internationally recognised as a medical condition involving brain dysfunction, where individuals experience difficulties controlling impulses, inhibiting behaviour, and sustaining attention. This condition can significantly impact a student's life, as well as the lives of their family, friends, and teachers (Living With ADHD, 2015). Although ADHD is widely known, it is often misunderstood as merely a behavioural problem. This misunderstanding can lead teachers and parents to question why a bright child continues to perform poorly in school (Anderson & Boyle, 2015). ADHD is also frequently confused with other learning difficulties such as dyslexia, dyspraxia, and dyscalculia (O'Regan, 2005, p.5). Consequently, teachers may overlook the issue, leading to feelings of frustration and the assumption that the child is simply not trying hard enough. This can result in students with ADHD being excluded from school due to stereotypes and misconceptions about the condition (Toye et al., 2019).

Across studies, students with ADHD consistently show similar patterns of behaviour related to four executive functions: (a) working memory; (b) self-regulation of emotion, motivation, and arousal; (c) internalisation of language; and (d) reconstitution (behavioural analysis and synthesis) (Living With ADHD, 2015; Jain & Newmark, 2022) categorised key characteristics of students with ADHD into two persistent patterns:

Observable Characteristics related to Inattention:

·?????? Fails to give close attention to details and makes unnecessary mistakes.

·?????? Find it challenging to stay focused during lectures.

·?????? Frequently daydreaming in class and gets easily distracted by external stimuli.

·?????? Keep losing focus on tasks and get sidetracked.

·?????? Find it difficult managing sequential tasks or keeping belongings in order.

·?????? Tend to struggle with poor time management.

Observable Characteristics related to Hyperactivity and Impulsivity:

·?????? Distracting with hands or feet, or squirms in the seat.

·?????? Feels uncomfortable being still for extended periods.

·?????? Often running around in inappropriate situations.

·?????? Find it challenging to engage in leisure activities quietly.

·?????? Talk excessively in class and complete other people's sentences.

·?????? Attempt to interrupt or intrude on others.

·?????? Tends to use others’ things without asking for permission.

Although, observing these signs does not necessarily indicate that a student has ADHD unless they have received a diagnosis from a medical professional. Therefore, comprehending ADHD entails more than simply acknowledging it as a medical condition. It is a call to action for secondary school teachers by incorporating their knowledge of ADHD into their teaching, teachers can enhance the quality of education and create a more compassionate learning environment for all students (Anderson & Boyle, 2015).

Analysis of Students with ADHD

Possible strength for Students with ADHD

Students with ADHD often possess creativity, empathy, and innovation. They excel in roles that allow for autonomy, artistic expression, interpersonal interaction, or high-energy environments such as firefighting or journalism (NSW Department of Education, 2021). Although certain challenges associated with ADHD may persist, many individuals with ADHD can still achieve success in both their professional and personal lives. This is particularly true when individuals focus on challenging tasks and leverage their strengths to their advantage (Jain & Newmark, 2022)

Possible Learning Needs for Students with ADHD

Firstly, it is of the utmost importance for teachers to empathise with their students, show respect, and avoid judgement (Living With ADHD, 2015). Providing prompt feedback, gentle guidance, and outlining consequences for mistakes can aid their learning process. In Living With ADHD (2015), a student with ADHD compared their condition to watching a movie while only being able to look at the bottom left corner of the screen. This analogy highlights the necessity of clear rules, expectations, and concise instructions to facilitate learning for students with ADHD.

Secondly, it is crucial to assist students with ADHD in completing tasks, complying with school regulations, arriving on time, and adhering to dress codes (if applicable). Additionally, it is essential to encourage kindness towards others while discouraging physical aggression and verbal abuse (O'Regan, 2005). Consequently, educators should integrate strategies to instruct students on time management, task planning, and organisational skills. This is anticipated to markedly enhance their academic performance (NSW Department of Education, 2021).

Challenges in Mainstream Classrooms

Researchers have identified two major challenges for teachers in mainstream classrooms: firstly, classroom management, and secondly, teachers' knowledge of ADHD, both of which directly influence the positive learning environment (PLE) of managing classrooms. A lack of preparedness to handle classroom management challenges, especially for students with mental health concerns, is one of the leading causes of teacher attrition (Poznanski et al., 2018). The traditional approach to education often fails to support the diverse needs of students with ADHD, who frequently encounter stereotypes and misconceptions in mainstream classrooms (Anderson & Boyle, 2015). A recent study involving 107 preservice teachers (95.3% female; 75.4% Hispanic) examined their understanding of classroom management strategies and knowledge about ADHD. The findings revealed significant issues. Many teachers hold erroneous perceptions of ADHD, lack accurate knowledge about the condition, and are not well-equipped with effective classroom management strategies. Moreover, the study highlighted a general deficiency among teachers in applying evidence-based practices and resources to support students with mental health needs (Owens, 2017, as cited in Poznanski et al., 2018).

A study conducted in Australia aimed at understanding teachers' knowledge of ADHD suggests that although teachers may gain a deeper understanding of the disorder as they continue to encounter students with ADHD, they often become less confident in managing the associated behaviours. Over time, this can lead to increasingly negative perceptions and emotions towards these students. In-service teachers typically possess greater knowledge of ADHD compared to preservice teachers. However, in-service teachers report less favourable experiences with ADHD students despite their greater knowledge. This highlights the importance of early training in the acquisition of skills to effectively manage ADHD and other disruptive behaviours in the classroom, which could prove to be particularly beneficial (Poznanski et al., 2018).

Finally, another challenge in the classroom is the peer relationships of students with ADHD. Studies on clinical samples have demonstrated that students with ADHD are at a higher risk of being disliked and victimised by their classmates. Peer problems not only impede the development of adolescents with ADHD but also increase the risk of depression. Therefore, challenging peer relationships in classrooms can be seen as partial mediators of the pathways from ADHD to depression (Roy et al., 2015).

Inclusive Teaching Practices and Differentiated Strategies for Teachers

Teaching inclusively begins with understanding each student's individual learning needs. In education, it is crucial to use effective strategies and focus on the process, especially when involving students with ADHD. According to NSW Government Education (2021), it is important to use proven strategies in secondary education and create an inclusive environment for all students.

Strategies: Teacher (In-Classroom – Content Delivery)

The table below summarizes evidence-based strategies for teachers, specifically in inclusive classrooms that include students with ADHD (Jain & Newmark, 2022; NSW Department of Education, 2021).

Content Delivery / Pedagogy

Communication Strategies

• Securing Attention: Ensure you have the student's full attention before instruction. Techniques such as making eye contact, using gestures, and auditory cues are crucial in engaging students with ADHD.
• Clarity in Instruction: Use a direct language to communicate learning objectives. Provide instructions with visual aids and provide written prompts at the student's workspace to provide understanding.
• Simplifying Tasks: Break complex tasks into smaller, manageable tasks. Provide verbal instructions with visual instructions and confirm comprehension before proceeding.
• Diverse Teaching Methods: Utilize a variety of teaching strategies such as multimedia presentations, hands-on activities, and direct instruction to cater to different learning styles and keep students engaged.
• Technological Integration: Provide educational software and interactive platforms that provide immediate feedback. Establish routines regarding technology to maintain focus and engagement.

Designing Inclusive Activities

• Aligning with Interests: Modify teaching methods to suit students' interests and abilities, gradually increasing the difficulty as their ability grows.
• Providing Support and Extra help: Provide additional assistance through prompts or demonstrations as needed, ensuring that independence grows. Encourage students to actively seek assistance when needed.
• Practice Opportunities: Allow students to practice new skills across different settings, reenforcing learning and application in various areas.
• Collaborative Learning: Group work or buddy systems can minimize distractions and increase focus. Peers can serve as a positive role model and provide additional assistance.

Classroom Management

Class Structure

• Establishing Expectations: Clearly outline classroom rules and expectations, ensuring they align with broader school policies. Develop strategies to ensure understanding and compliance.
• Routine Consistency: Maintain a consistent daily schedule with visual schedules or timers, assisting students in managing their time and preparing for future tasks.
• Feedback Mechanisms: Offer timely, specific feedback on accomplishments and areas for improvement, cultivating a growth mindset among students.
• Reward Systems: Utilize activities that acknowledge positive behaviour and learning abilities, providing choices to boost motivation.

Environment and Organization

• Minimizing Distractions: Create seating strategically to reduce distractions, using tools such as earplugs or noise-cancelling headphones for concentrated tasks.
• Encouraging Organization: Develop organizational skills with strategies such as color-coded materials or planners, assisting students in managing their duties.
• Consider Seating Arrangements: Place students in positions that reduce distractions and facilitate interaction, providing breaks to enhance focus and reduce restlessness.
• Teach Note-Taking Skills: Educate students on effective note-taking and summarizing techniques, using prompts and guidance to enhance skill acquisition.

In addition, it is of equal importance to recognise and utilise the unique strengths of students with ADHD. Many students with ADHD are naturally creative and adept with technology. Therefore, incorporating design and digital technologies can be a powerful tool to maintain their interest and enhance their learning across all subjects (NSW Department of Education, 2021). Furthermore, according to the NSW Department of Education (2021), establishing personal connections to the subject matter can significantly enhance the engagement of students with ADHD.

It is therefore recommended that a combination of different learning strategies be employed, rather than relying on a single approach, to support students with ADHD (Young, 2015). This approach facilitates an effective learning cycle and highlights the necessity of Individualised Education Programs (IEPs), which establish measurable goals tailored to each student's individual needs and provide scaffolding for student success (Twachtman-Cullen & Twachtman-Bassett, 2011).

Therefore, to best assist individuals with ADHD, therapy should aim to facilitate their transition from vulnerability to resilience. This involves aiding them in adapting to their challenges and leveraging their strengths. The objective is to empower individuals to effectively utilize their abilities and resources, rather than be obstructed by their difficulties (Lesch, 2018).

Strategies: Teacher (In Classroom – Soft Skills development)

Time management is a crucial aspect of daily life and is closely linked to impulse control issues commonly observed in individuals with ADHD. Children with ADHD may benefit from focusing on three main areas of timing: motor timing, perceptual timing, and temporal foresight (Living With ADHD, 2015). The following table summarizes my findings and outlines effective strategies that can be implemented across all school disciplines to develop soft skills for students with ADHD (Jain & Newmark, 2022; NSW Department of Education, 2021).

Supporting Self-Management

• Goal Setting: Engage students and their families in setting realistic academic and behavioural goals that are specific, measurable, and transparent to the student.
• Self-Reflection: Assist students in problem solving and self-reflection to overcome challenges independently.
• Self-Monitoring: Promote the use of self-assessment checklists to encourage students to actively manage their behaviour and learning progress.
• Self-Evaluation: Teach students to critically evaluate their choices and outcomes, helping them to recognise what supports or hinders their success.

Parental and Carer Engagement

• Home-School Communication: Develop a strong system of communication with parents or carers to keep them informed of the student's progress and to ensure consistent support at home and at school.

Strategies: Teacher and Other Teaching Staffs (In School)

Research also indicates that children diagnosed with ADHD may experience difficulties in social situations due to challenges in impulse control, behaviour management, anger regulation, and clear thinking (Living With ADHD, 2015). It is important to note that this is not always the case, and that each child's experience is unique. Therefore, it recommended that IEP include a statement about the student's current performance level, known as a Present Level of Performance (PLP) (Twachtman-Cullen & Twachtman-Bassett, 2011). These strategies require active participation from all support staff and school administration.

This statement should be created with input from parents, doctors, and community members. It should detail the student's strengths in social thinking and how this impacts their academic performance and overall functioning. The Individualized Education Program (IEP) should identify any challenges the student faces with social thinking, particularly in relation to their academic performance, overall functioning, and future learning needs (Twachtman-Cullen & Twachtman-Bassett, 2011). Thereafter, this comprehensive information will be used to establish specific goals and objectives for the student's IEP, which will enable progress to be measured both in the short and long term (Twachtman-Cullen & Twachtman-Bassett, 2011).

Strategies: Teacher and Community

Furthermore, NSW Department of Education (2021) highlights additional roles that parents and the community can play in supporting students with ADHD by

• Working closely with teachers and the school to understand the student's needs and create a consistent support plan at home and at school.
• Encouraging and praising the student's efforts and achievements, both academically and socially.
• Helping the student to practice and reinforce the skills they are learning at school, such as organisation, problem solving and emotional regulation.
• Provide a structured and predictable home environment with clear routines and expectations.
• Advocate for the student to ensure appropriate accommodations and support services are provided at school.
• Linking the student to community resources such as counselling, mentoring or social skills groups to further support their development.
• Learning about ADHD and sharing information with others to increase understanding and reduce stigma.

Strategies: Teacher and Parents/Carers

Finally, as previously discussed, students with ADHD are frequently the victims of bullying by their peers. In this context, parents can play a vital role in addressing their children's involvement in bullying and cyberbullying. Abusive practices by parents, such as physical punishment and psychological aggression, accompanied by a lack of affection, poor communication, little promotion of autonomy, and excessive behavioural control, combine to increase their children's vulnerability. This makes them more prone to victimisation, either at school or online. Consequently, it is of paramount importance for parents to be actively engaged with schools as a fundamental component of intervention and prevention programmes. Such engagement is vital not only to enhance their awareness of their role in the genesis of these violent phenomena and to refine their parenting skills, but also to equip them with the most effective strategies to assist their children in coping with bullying and cyberbullying (Gómez-Ortiz et al., 2019).

Thus, by promoting collaboration between parents, teachers and community members, a comprehensive, multi-agency intervention can be developed to enable students with ADHD to excel academically, socially, and emotionally (O'Regan, 2005, p. 87).

Conclusion

ADHD has a profound impact on multiple aspects of children's lives, spanning social, academic, personal, physical, and psychological domains (Living With ADHD, 2015). Brantlinger (2006) encapsulates a fundamental truth with the statement, "Inclusion begins with us." The journey toward inclusivity and understanding in education is not just an institutional mandate but a collective moral imperative. This admonition challenges us to recognise our role within an exclusionary system that marginalises people with ADHD. It calls for reflection on our contributions to the perpetuation of this system and how we might reshape its future. While the discourse around systemic change is important, it should not distract us from our personal responsibility to create a more inclusive environment. Instead, it should compel us to ask a critical question: "What does it mean to create an equitable classroom?" (Brantlinger, 2006).

References

Anderson, J., & Boyle, C. (2015). Inclusive Education in Australia. Support for Learning, 30, 4-22. https://doi.org/10.1111/1467-9604.12074.

Brantlinger, E. A. (Ed.). (2006). Who Benefits from Special Education? Remediating (fixing) Other People's Children (1st ed.). L. Erlbaum Associates.

Gómez-Ortiz, O., Apolinario, C., Romera, E. M., & Ortega-Ruiz, R. (2019). The Role of Family in Bullying and Cyberbullying Involvement: Examining a New Typology of Parental Education Management Based on Adolescents’ View of Their Parents. Social Sciences, 8(1), 25. https://doi.org/10.3390/socsci8010025

Jain, P., & Newmark, S. (2022). Attention-Deficit/Hyperactivity Disorder. In D. P. Rakel & V. Minichiello (Eds.), Integrative Medicine EBook (5th ed., pp. 56-66). Elsevier Health Sciences.

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Living with ADHD: Timing Perceptions and Their Applicability to the Experience of ADHD. (2015). In M. Gordon (Ed.), Challenges Surrounding the Education of Children with Chronic Diseases (pp. 117-136). Information Science Reference. https://doi.org/10.4018/978-1-4666-9452-1.ch006

NSW Department of Education. (2021, November). About ADHD. NSW Department of Education. Retrieved April 18, 2024, from https://education.nsw.gov.au/campaigns/inclusive-practice-hub/all-resources/secondary-resources/understanding-disability/adhd

O'Regan, F. J. (2005). Attention Deficit Hyperactivity Disorder. Bloomsbury Academic.

Poznanski, B., Hart, K. C., & Cramer, E. (2018). Are Teachers Ready? Preservice Teacher Knowledge of Classroom Management and ADHD. School Mental Health, 10(3), 301-313. https://doi.org/10.1007/s12310-018-9259-2

Roy, A., Hartman, C. A., Veenstra, R., & Oldehinkel, A. J. (2015). Peer dislike and victimisation in pathways from ADHD symptoms to depression. Eur Child Adolesc Psychiatry, 24, 887–895. https://doi.org/10.1007/s00787-014-0633-9

Toye, M. K., Wilson, C., & Wardle, G. A. (2019). Education professionals’ attitudes towards the inclusion of children with ADHD: the role of knowledge and stigma. Journal of Research in Special Educational Needs, 19, 184-196. https://doi.org/10.1111/1471-3802.12441

Twachtman-Cullen, D., & Twachtman-Bassett, J. (2011). The IEP from A to Z: How to Create Meaningful and Measurable Goals and Objectives. Wiley.

Young, C. (2015). An exploration of the learning strategies used by women who disclose with a formal diagnosis of attention deficit hyperactivity disorder (ADHD) in the context of higher education. Macquarie University.

Kazi N. Hassan is a seasoned Growth Leader and Change Catalyst with extensive experience in leveraging data analytics across various sectors. His work spans healthcare, mining, education, and more, underscoring his commitment to innovation and strategic problem-solving.