In the UK, NHS Digital estimates that 2.5 million people have ADHD, around a quarter of whom are children aged 0–17. ADHD is thought to result from a combination of genetic, environmental and neurological factors, with evidence suggesting it often runs in families.

Features of ADHD

• Not everyone experiences ADHD in the same way.It is usually diagnosed by a medical expert, after observations and discussions with the child, family and their school. To gain a diagnosis of ADHD the child or young person would generally display the behaviours consistently for at least a period of 6 months, in a least two different settings, e.g. home and school.
• People with ADHD may show persistent patterns of inattention and/or hyperactivity or impulsivity, which interferes with their daily life and routine.
• Behaviours can include a short attention span, restlessness, being easily distracted, constant fidgeting, forgetfulness, a tendency to blurt out or talk excessively, difficulty with taking turns, inability to follow through instructions and poor self-organisation. These behaviours have shown to impact the individual significantly both from a social and academic perspective.
• Studies suggest that ADHD is under-recignised in girls and older children (1)

Management of ADHD

As our understanding of ADHD improves, medical, psychological and social approaches are being developed. There are several medical treatments for ADHD, all of which should be accompanied by psychological, educational and social therapies.

Medication can be prescribed by a psychiatrist and monitored by a GP. The medication allows periods of time where someone with ADHD can concentrate better and be less impulsive; they may feel calmer and better able to learn new skills.

In addition to medication, programmes for children can also be helpful. For example, active social skills training can better equip a child or young person to manage socially and at school, as well as other school based interventions, occupational therapy and/or speech and language therapy.

Cognitive Behaviour Therapy programmes (CBT) and other psychological therapies either on a 1:1 or group basis, may help a child or young person manage their impulsive behaviour and help develop concentration skills.

Parent education programmes can help families work together on behaviour support.(1) ADHD in children and young people: prevalence, care pathways, and service provision

Prof Kapil Sayal, Vibore Prasad, Prof David Daley, Prof Tamsin Ford, Prof David Coghill 2018

Organisation

• Clear classroom routines
• A well-organised learning environment
• Clear classroom rules
• Advanced warning and planning for out of classroom activities.
• Buddy support
• Home -school diary/ communication system to support with organisation of homework tasks/revision/exams/events.
• At secondary school and university access to a learning mentor may be helpful. 

Support for written tasks

• Limit amount of work per page
• Allow extra time for completing tasks.
• Plan in work breaks
• Allow student to type or to use speech-to-text software.
• Reduce the length of written assignment

Behaviour support strategies

• Lots of praise to reinforce positive behaviour
• Use of choice as a reward
• Seat away from distractions (door, window)
• Encourage student to write down their thoughts/ideas in rough books/whiteboards/margins so they minimise ‘interrupting’ or ‘blurting out’ but also have a way to share their ideas with others.
• Use of timers to help structure work tasks
• Use clear and direct language or discrete (agreed) non-verbal cues for redirection if they become distracted. It is important that the non-verbal cues are agreed with the student in advance.

Socialising

• Making and keeping friends can be difficult for some children and young people, a buddy system and planned break-time activities can help reduce feelings of isolation and help develop social skills. It is important that others model turn taking and interactions to support the individual.
• A social skills group or a chance to practice ahead of an important event or situation can be helpful.