3 Specific Rules for Managing ADHD
The CDC reports that 6.4 million children in the United States have been diagnosed with ADHD. As the prevalence of the diagnosis continues to rise, it's important to have tools and strategies at the ready for managing ADHD in school.
Here are three classroom rules that are easy to implement and follow:
1. Rules and instructions provided to children with ADHD must be clear, brief, and often delivered through more visible and external modes of presentation than is required for the management of children without ADHD.
Stating directions clearly, having the child repeat them out loud, having the child utter them softly to themselves while following through on the instruction, and displaying sets of rules or rule-prompts (e.g., stop signs, big eyes, big ears for "stop, look and listen" reminders) prominently throughout the classroom are essential to proper management of ADHD children. Relying on the child's recollection of the rules as well as upon purely verbal reminders is often ineffective.
2. Represent time and time period externally (physically).
Children with ADHD are less capable of using their sense of time to manage their current behavior and get work done in time, over time, and on time. When short time intervals of an hour or less are required to do work, then represent that time period using a clock, kitchen timer, counting device or other external means to show the child how much time they have and how quickly it is passing. A spring-loaded kitchen cooking-time placed on the child's desk can serve this purpose. For longer time periods, break the work down into shorter periods with smaller work quotas, and allow the child to take frequent breaks between these shorter work periods.
3. Anticipation is the key with children with ADHD.
This means that teachers must be more mindful of planning ahead in managing children with this disorder, particularly during phases of transition across activities or classes, to ensure that the children are cognizant of the shift in rules (and consequences) that is about to occur. It is useful for teachers to take a moment to prompt a child to recall the rules of conduct in the upcoming situation, repeat them orally, and recall what the rewards and punishments will be in the impending situation before entering that activity or situation.
Think aloud, think ahead is the important message to educators here. By themselves, such cognitive self-instructions are unlikely to be of lasting benefit, but when combined with contingency management procedures they can be of considerable aid to the classroom management of ADHD children.
Russell A. Barkley, Ph.D., is a Clinical Professor of Psychiatry at the Medical University of South Carolina. He served as the Director of Psychology at the University of Massachusetts Medical School for more than 15 years (1985-2000) and established the research clinics for both child and adult Attention Deficit Hyperactivity Disorders.
Russell A. Barkley, PhD, recently retired (January 1, 2022) from his position as a Clinical Professor of Psychiatry at Virginia Commonwealth University School of Medicine (2016-present). He is also a retired Professor of Psychiatry and Neurology from the University of Massachusetts Medical Center (1985-2002) and subsequently worked as a Professor of Psychiatry and Health Sciences at the Medical University of South Carolina (2003-2016). Dr. Barkley is the founder and Editor of the clinical newsletter, The ADHD Report, which he continues to edit in this 30th and final year of publication (2022). He is board certified in Clinical Psychology (ABPP), Clinical Child and Adolescent Psychology, and Clinical Neuropsychology (ABCN, ABPP).
Dr. Barkley is a clinical scientist, educator and practitioner who has published 27 books, rating scales, and clinical manuals numbering more than 43 editions, and creator of 7 award winning professional videos. He has published more than 300 scientific articles and book chapters related to the nature, assessment, and treatment of ADHD and related disorders and is the author of the book Managing ADHD in School (PESI, 2016).
Dr. Barkley has presented more than 800 invited lectures in more than 30 countries and appeared on nationally televised shows such as 60 Minutes, the Today show, Good Morning America, CBS Sunday Morning, CNN, and many others. He has received numerous awards from professional societies and ADHD organizations for his lifetime achievements, contributions to research and clinical practice, and the dissemination of science.
Speaker Disclosures
Financial: Dr. Russell Barkley receives royalties as a published author. He previously received a speaking honorarium from Astra Zeneca and Takeda Pharmaceutical Company. Dr. Barkley receives royalties from ContinuingEdCourses.net and a speaking honorarium from Ochsner Medical Center and Medical College of Wisconsin. He receives a speaking honorarium, recording, and book royalties from PESI, Inc. He has no relevant financial relationships with ineligible organizations.
Non-financial: Dr. Russell Barkley is a member of the American Psychological Association, the South Carolina Psychological Association, and the American Professional Society for ADHD and Related Disorders.
