In a new paper, published in the Review of Education, U.K. researchers offer new guidelines on how school personnel can best help students with attention-deficit/hyperactivity disorder (ADHD) to improve academics and help minimize symptoms.

For the review, researchers at the University of Exeter and the EPPI (Evidence for Policy and Practice Information) Centre at the University College London analyzed all available research into non-medication methods for supporting children with ADHD in schools. Their findings show that interventions which include one-to-one support and a focus on self-regulation show the most improvements in academic outcomes.

Around 5 percent of children have ADHD, meaning most classrooms will have at least one child with the condition. Children with this disorder often have trouble sitting still, focusing their attention and controlling impulses compared to non-ADHD kids of the same age. The school environment is particularly challenging for these children, and their difficulty in waiting their turn or staying in their seat impacts peers and teachers.

Studies have shown that medication can be effective, but it does not work for all children and is not acceptable to some families.

The team looked through 28 randomized control trials on non-drug measures to support children with ADHD in schools. In a meta-analysis, they investigated the different components of the measures being carried out to determine which method was most effective.

The studies varied in quality, which limits the confidence the team can have in their results. Overall, they conclude that the most improvements in academic outcomes appear to occur when interventions focus on self-regulation and are delivered in one-to-one sessions.

Self- regulation is difficult for children who are very impulsive and struggle to focus attention. Children need to learn to identify how they are feeling inside, to notice triggers and avoid them if possible, and to stop and think before responding.

This is much harder for kids with ADHD than most other children, but these are skills that can be taught and learned.

The team also found some promising evidence for daily report cards. In this method, children are given daily targets to strive toward which are reviewed via a card that the child carries between home and school and between lessons in school. Rewards are given for meeting targets. The number of studies looking at this method was lower, and their findings did not always agree. But using a daily report card is relatively cheap and easy to implement. It can encourage home-school collaboration and offers the flexibility to respond to a child’s individual needs.

“Children with ADHD are of course all unique. It’s a complex issue and there is no one-size-fits-all approach,” said Tamsin Ford, Professor of Child Psychiatry at the University of Exeter Medical School.

“However, our research gives the strongest evidence to date that non-drug interventions in schools can support children to meet their potential in terms of academic and other outcomes. More and better quality research is needed but in the mean-time, schools should try daily report cards and to increase children’s ability to regulate their emotions. These approaches may work best for children with ADHD by one-to-one delivery.”

The research was funded by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South West Peninsula – or PenCLAHRC.

Source: University of Exeter