School Interventions

As is the case with parent training, the techniques used to manage ADHD in the classroom have been used for some time and are considered effective. Many teachers who have had training in classroom management are quite expert in developing and implementing programs for students with ADHD. However, because the majority of children with ADHD are not enrolled in special education services, their teachers will most often be regular education teachers who may know little about ADHD or behavior modification and will need assistance in learning and implementing the necessary programs.

There are many widely available handbooks, texts and training programs that teach classroom behavior management skills to teachers. Most of these programs are designed for regular or special education classroom teachers who also receive training and guidance from school support staff or outside consultants. Parents of children with ADHD should work closely with the teacher to support efforts in implementing classroom programs.

Managing teenagers with ADHD in school is different from managing children with ADHD. Teenagers need to be more involved in goal planning and implementation of interventions than do children. For example, teachers expect teenagers to be more responsible for belongings and assignments. They may expect students to write assignments in weekly planners rather than receive a daily report card. Organizational strategies and study skills, therefore, need to be taught to the adolescent with ADHD. Parent involvement with the school, however, is as important at the middle and high school levels as it is in elementary school. Parents will often work with guidance counselors rather than individual teachers so that the guidance counselor can coordinate intervention among the teachers.

The following list includes typical classroom behavioral management procedures. They are arranged in order from mildest and least restrictive to more intensive and most restrictive procedures. Some of these programs may be included in 504 plans or Individualized Educational Programs for children with ADHD. Typically, an intervention is individualized and consists of several components based on the child’s needs, classroom resources, and the teacher’s skills and preferences.

  1. Classroom rules and structure
    • Use classroom rules such as:
      • Be respectful of others
      • Obey adults
      • Work quietly
      • Stay in assigned seat/area
      • Use materials appropriately
      • Raise hand to speak or ask for help
      • Stay on task and complete assignments
    • Post the rules and review them before each class until learned
    • Make rules objective and measurable
    • Tailor the number of rules to developmental level
    • Establish a predictable environment
    • Enhance children’s organization (folders/charts for work)
    • Evaluate rule-following and give feedback/consequences consistently
    • Tailor the frequency of feedback to developmental level
  2. Praise for appropriate behaviors and choosing battles carefully
    • Ignore mild inappropriate behaviors that are not reinforced by peer attention
    • Use at least five times as many praises as negative comments
    • Use commands/reprimands to cue positive comments for children who are behaving appropriately—that is, find children who can be praised each time a reprimand or command is given to a child who is misbehaving
  3. Appropriate commands and reprimands
    • Use clear, specific commands
    • Give private reprimands at the child’s desk as much as possible
    • Reprimands should be brief, clear, neutral in tone and as immediate as possible
  4. Individual accommodations and structure for the child
    • Structure the classroom to maximize the child’s success
    • Place the student’s desk near the teacher to facilitate monitoring
    • Enlist a peer to help the student copy assignments from the board
    • Break assignments into small chunks
    • Give frequent and immediate feedback
    • Require corrections before new work is given
  5. Proactive interventions to increase academic performance
    Such interventions can prevent problematic behavior from occurring and can be implemented by individuals other than the classroom teacher, such as peers or a classroom aide. When disruptive behavior is not the primary problem, these academic interventions can improve behavior significantly.

    • Focus on increasing completion and accuracy of work
    • Offer task choices
    • Provide peer tutoring
    • Consider computer-assisted instruction
  6. “When…then” contingencies (withdrawing rewards or privileges in response to inappropriate behavior)
    Examples include recess time contingent upon completion of work, staying after school to complete work, assigning less desirable work prior to more desirable assignments, and requiring assignment completion in study hall before allowing free time.
  7. Daily school-home report card
    This tool allows parents and teacher to communicate regularly, identifying, monitoring and changing classroom problems. It is inexpensive and minimal teacher time is required.

    • Teachers determine the individualized target behaviors
    • Teachers evaluate targets at school and send the report card home with the child
    • Parents provide home-based rewards; more rewards for better performance and fewer for lesser performance
    • Teachers continually monitor and make adjustments to targets and criteria as behavior improves or new problems develop
    • Use the report card with other behavioral components such as commands, praise, rules, and academic programs
  8. Behavior chart and/or reward and consequence program (point or token system)
    • Establish target behaviors and ensure that the child knows the behaviors and goals (e.g., list on index card taped to desk)
    • Establish rewards for exhibiting target behaviors
    • Monitor the child and give feedback
    • Reward young children immediately
    • Use points, tokens or stars that can later be exchanged for rewards
  9. Class wide interventions and group contingencies
    Such interventions encourage children to help one another because everyone can be rewarded. There is also potential for improvement in the behavior of the entire class.

    • Establish goals for the class as well as the individual
    • Establish rewards for appropriate behavior that any student can earn (e.g., class lottery, jelly bean jar, wacky bucks)
    • Establish a class reward system in which the entire class (or subset of the class) earns rewards based on class functioning as a whole (e.g, Good Behavior Game) or the functioning of the student with ADHD
    • Tailor frequency of rewards and consequences to developmental level
  10. Time out
    The child is removed, either in the classroom or to the office, from the ongoing activity for a few minutes (less for younger children and more for older) when he or she misbehaves.
  11. Schoolwide programs 
    Such programs, which include schoolwide discipline plans, can be structured to minimize the problems experienced by children with ADHD, while at the same time help manage the behavior of all students in a school.

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