https://www.gosh.nhs.uk/wards-and-departments/departments/clinical-specialties/department-child-and-adolescent-mental-health-dcamh/the-tic-service/tourette-syndrome-and-adhd-in-the-classroom/

Tourette Syndrome and ADHD in the classroom

About half of children with Tourette syndrome (TS) also have Attention Deficit Hyperactivity Disorder (ADHD). This page explains the condition and shares some tips for supporting children with ADHD in school.

What is ADHD?

Attention Deficit Hyperactivity Disorder (ADHD) is a condition where a young person has trouble paying attention, is more energetic than others their age, and struggles to control certain impulses. These children can sometimes be labelled as "difficult" or "out of control," and their parents might be seen as if they "can't control" their children. We know this isn't true because ADHD is a neurodevelopmental condition, so these behaviours can't be helped. However, certain approaches in working with a student with ADHD can be helpful for the child and other people at school and home.

What challenges could ADHD lead to at school?

Attention deficit

The student may:

  • Have difficulty paying attention in class.
  • Seem not to listen to instructions.
  • Forget equipment, such as games kit, books, pens, etc.
  • Have difficulty completing tasks, especially if they last for more than a few minutes.
  • Be easily distracted.
  • Disrupt other students’ work.

Hyperactivity

The student may:

  • Always be ‘on the go’ and rarely able to sit quietly for more than a few minutes.
  • Fidget when sitting down.
  • Make lots of noise, especially in quiet places.

Impulsivity

The student may:

  • Interrupt with answers before the question is finished.
  • Have problems with waiting in line or taking turns with other students.
  • Interrupt conversations or activities.
  • Talk at ‘the wrong’ times.
  • Have trouble controlling behaviour e.g., getting frustrated easily.

How can teachers help?

Young people with ADHD benefit from early identification of their challenges, before they are labelled as ‘tricky’ or ‘uncontrollable’. As a teacher, you may have concerns about a young person before other people, as you are seeing the student in a controlled setting where certain standards of behaviour are expected.

Students with ADHD may find it hard to ask for help because it can draw attention from classmates and make them feel overwhelmed. Many young people with ADHD are not aware of their behaviour and how it may affect their performance. Although school can be challenging for a young person with ADHD, simple adjustments like those described below can improve their school experience and help them achieve academic goals.

Suggestions for helping young people with ADHD

Click on the drop down boxes to view suggestions that we hope are helpful for all your students, not just those with ADHD.

  • Seat the young person with ADHD where there are as few distractions as possible. Often this is near the front and closer to you and the board.
  • Display timetables in a visible area, highlighting activities with images or symbols.
  • Keep an extra supply of pens, pencils and paper for students who may lose or forget them.
  • Allow a larger ‘personal space’ for students who find it harder to control their impulses, especially if they tend to bump into other students.
  • Have a transition routine for finishing one class and moving to the next. This could include a stepped approach; starting to pack away a few minutes before the class ends, tidying the desk and check the location of the next class before leaving.
  • Show students an example of a completed task so that they can understand the aim of the task.
  • Teach students to break large tasks down into smaller, simpler steps.
  • Emphasise accuracy and quality of work over quantity so the student concentrates on doing the task well.
  • Set a deadline for each smaller step as well as the final due date for the large task. Make sure deadlines are clearly marked on handouts or worksheets and are reinforced regularly.
  • Colour code or highlight important instructions.
  • Use a mind map to help students organise their thoughts about a particular task. Mnemonics can be useful for key pieces of information that need to be remembered.
  • During question-and-answer sessions, say the student’s name and pause before asking the question so that it is clear their attention is required.
  • Use worksheets with enough space for large handwriting. Use gridlines so that text and numbers can be aligned.
  • Teach study skills, e.g. note taking, ‘to do’ lists and time management, so the student can become more self-sufficient. Encourage self-testing - BBC Bitesize has plenty of sections to look at.
  • Unstructured times, such as lunch break or playtime, may be difficult for a student with ADHD, so extra supervision may be needed. This is also true of less structured activities, such as watching audio-visual materials or going on outings.
  • Use rewards for good behaviour instead of punishment for bad behaviour whenever possible.
  • Avoid public criticism but create a system of visual cues so the student knows about possible mistakes.
  • Work with parents to make sure that discipline and reward methods at school match those used at home. A joint "reward scheme" where good behaviour at school is rewarded at home could be set up.
  • Pair up a distractible student with a focused and mature peer, to sit alongside or work together can facilitate positive behaviour.
  • Work with parents to set up a homework routine, deciding when homework will start and possible rewards for finishing tasks.
  • If homework is hard for the student to do at home, suggest going to a homework club or something similar.
  • Home-school diaries can help parents see what homework needs to be done.
  • Have a regular way of giving out homework tasks, explaining what needs to be taken home, and maybe asking the student to pack needed items right away instead of later. Suggest using a timer to finish homework in a reasonable time. This also helps get ready for exams.

Further reading

  • Challenging Kids, Challenged Teachers: Teaching Students with Tourette's, Bipolar Disorder, Executive Dysfuction, OCD, AD/HD and More (2010) by Leslie Packer and Sheryl Pruitt SK (Woodbine House Inc, ISBN 1 890 627 828)
  • Helping Kids and Teens with ADHD in School: A Workbook for Classroom Support and Managing Transitions by Joanne Steer and Kate Horstmann (2009). (Jessica Kingsley ISBN 1 843 106 639).