Colman Noctor: Children with ADHD struggle in traditional schools 

According to ADHD Ireland, 5% of Irish children have a diagnosis of attention deficit hyperactivity disorder, which amounts to around 60,000 children.

The main symptoms of ADHD include impulsivity, inattention and hyperactivity, and most interventions tend to focus on improving these behaviours. Stimulant medication like Ritalin is used to build children’s attention span so they can, for example, sit still and concentrate for longer. 

Behavioural strategies encourage children to pause before they act, reducing the negative consequences of their impulsivity. Support for parents aims to teach them techniques such as breaking down instructions into bite-size chunks to improve the child’s sense of organisation and regulation.

Although these strategies may improve their functioning, interpersonal issues however, like getting in trouble in school or falling out with peers, can continue to arise and erode their self-esteem.

Multiple challenges

The three main areas where children with ADHD struggle are academic environments, social interactions, and mastering daily tasks.

Academic challenges can significantly affect a child’s perception of their competence and intelligence, also leading to lower confidence. As a result of their inattention, children with ADHD struggle to adapt to the demands of conventional education environments, often resulting in them zoning out or becoming disruptive.

Social interactions can also present difficulties for children with ADHD. Impulsivity, hyperactivity, and inattention are core features of the condition, which inevitably lead to challenges in forming and maintaining friendships. A lack of understanding of ADHD symptoms in others can lead to multiple experiences of rejection and negative social experiences. 

Children with ADHD can blurt out things that are hurtful to others or they can impulsively act in an overly physical way, which is often not welcomed by their peers. The inevitable rejection that follows contributes to feelings of inadequacy, further depleting the child’s self-worth.

Daily tasks can be a source of difficulty too. Executive function deficits are part of the ADHD presentation, negatively affecting the child’s ability to plan, organise, and complete tasks. Repeatedly falling short in these areas by forgetting to bring their coat home, losing possessions, or not being able to follow rules or instructions can lead to negative self-perception and a sense of incompetence. Difficulties with time management and recurrent failure to complete tasks reinforce these negative beliefs about their abilities.

The school environment can be highly challenging for children with ADHD. Academic expectations, intense social environments, and the requirement to demonstrate good executive functioning mean that most aspects of school highlight these children’s struggles. Traditional school settings often require a child to follow highly structured schedules. Children with ADHD may struggle with transitions between activities and find it difficult to conform to rigid timetables. They also have difficulty sitting still for long periods, paying attention, or remaining engaged in activities that do not provide constant stimulation. Many traditional classrooms do not offer enough opportunities for movement, which can be challenging for children who benefit from physical activity to manage their symptoms. Also, large class sizes can make it difficult for teachers to provide individualised attention and support for children with ADHD.

Furthermore, the expectation of completing homework and studying independently can be particularly taxing for children with ADHD as these tasks often require sustained attention and organisation, creating high levels of stress for the child and their family.

Traditional educational assessment methods like the STens tests that occur in the final term of second, fourth and sixth classes may not fully capture the capabilities of children with ADHD. These standardised educational tests rely heavily on sustained attention, which may not accurately reflect the child’s true potential.

The impulsive behaviour and difficulty with self-regulation associated with ADHD often lead to disciplinary actions in schools. Such punitive responses can exacerbate the self-esteem challenges these children face. 

The inability of the child with ADHD to feel a sense of belonging in primary school and the emphasis on aspects of functioning they struggle with can negatively shape the child’s relationship with education and colour what follows in terms of their 14-year educational journey.

Putting the onus on these children to adapt and cope with the rigidity of the school environment is an unfair ask. Surely there are alternative opportunities for children with ADHD to show their value? Children with ADHD may have skills in creativity and spontaneity, which are often not showcased in a written exam or test.

The narrow lens of the standardised exams to capture children’s ability seems to be a larger scale deficit of the wider system, where the ability to memorise effectively and present one’s work in a uniform written format is the most valuable trait in the current educational system. This form of assessment can leave children with ADHD feeling unable — and inevitably — negatively impacts their self-worth and self-esteem.

Early intervention essential

Longitudinal studies have explored the relationship between ADHD and self-worth and repeatedly suggest that early intervention and support can positively influence long-term outcomes.

There is a need to create a more inclusive and flexible learning environment, which could include implementing accommodations like regular movement breaks, providing teacher training on ADHD awareness, fostering a better understanding of ADHD among classmates, and incorporating strategies that support the unique needs of children with ADHD.

Collaboration between parents, educators, and mental health professionals is crucial to creating a supportive and successful educational experience for children with ADHD.

If a child is continually chastised for something they cannot master and reminded of what they cannot do, it stands to reason they will lose interest in trying to succeed at school and give up.

These children often get reputations for being troublesome without anyone taking the time to remind them of their value.

Little changes when the focus is on the behaviour, not the child.

Instead of asking ‘how do we get this child to be able to sit for longer?’, why not ask, ‘how can we design our school environments so the child does not have to sit for as long?’.

Some worthwhile strategies outlined by ADDitide editor Chris Zeigler Dendy include:

• Assigning work that suits the student’s skill level;
• Offering choices, which encourages compliance and reduces negativity;
• Providing visual reminders; students with ADHD respond well to visual cues and examples;
• Increasing active class participation and creating learning opportunities where children experience things first-hand, like having students write and act out a play or record an assignment on videotape as opposed to writing it out in essay format.

Children with ADHD often struggle to navigate the world. We need to prioritise maintaining their self-worth and find ways to enhance their engagement rather than punish them for not being able to cope with the environments we have designed.

• Dr Colman Noctor is a child psychotherapist