Classroom Behavior Management for Students with Attention Deficit/Hyperactivity Disorder (ADHD) in Elementary School 

Teachers need actionable strategies to improve the classroom day-to-day functioning of their students diagnosed with ADHD. Most of the evidence-based strategies available to support teachers are too broad to be actionable. For example, ” externalize working memory”, what does that look like in the classroom? This post aims to arm the school-based therapist with exactly how to support the student with specific data-driven targeted strategies.

Students with ADHD and Classroom Procedures

Procedures are the backbone of any successful organization, school, or home. All teachers know that good classroom management depends on creating, teaching, and following specific procedures and routines. Without them, the learning environment can be disorganized chaos.  

There are over 40 procedures that teachers are explaining to 5-year-olds as you read this. Kindergarten teachers patiently go through everything from how to push in a chair to how to manage backpacks. The first days and weeks are dedicated to teaching and practicing the classroom procedures. 

Procedures are essentially rules and routines wrapped up in one. A procedure is a sequence of actions conducted in a particular order or manner with specific behavioral expectations. 

Procedures work when they are practiced and practiced and practiced with fading support until they become automated routines. However, the ability to follow and automate a multi-step sequence of actions requires a certain level of development in underlying executive function. Working memory, cognitive shift, and inhibition are executive functioning skills that develop throughout elementary school. However, students with Attention Deficit Hyperactivity Disorder (ADHD) often have developmental delays in executive function, at a rate estimated 30 % behind peers. 

To a student with ADHD or executive functioning difficulties, a non-automated procedure is an indefinitely long sequence of expected actions and behaviors that can easily overload limited working memory resources. Difficulty in completing standard classroom procedures can be easily misunderstood as non-compliance. 

Procedural Problems

When observing a student in the classroom environment the first place I go is to procedures. Often the bulk of the “ behavior” is coming from not being able to meet the expectations in one or forty-one of the everyday classroom procedures. 

• What are the classrooms procedures?
• What are they expected to do?
• What level of independence is required?
• Were they ever explicitly taught?
• Do they have the skills needed?
• Do they need support or externalized prompts built in?

In my experience, third grade is where you see the worst procedural problems.  At this age, the children are expected to follow most common procedures pretty independently and many can. Third grade is often the “fall apart “ year for many students with ADHD and learning disabilities. As the focus shifts from learning to read and write to reading and writing to learn, they demonstrate difficulty keeping up with the classroom expectations.

“Kids do well when they can”. This does not mean, your student is not required to follow the same rules and procedures of your class because they have ADHD. The student with ADHD will be an adult with ADHD and will need to follow the rules and procedures of driving, health management, and paying taxes one day. They are not exempt, but they will require support and scaffolds to be successful in following the procedures on par with peers.

Procedure 1: How Enter the Classroom

The first classroom procedure that happens every day is, “How to enter the classroom”. To many, this appears to be a simple task. Exactly how much working memory, cognitive shift, problem-solving and inhibition is involved in entering the classroom?  Let’s zoom in on Procedure # 1. 

1. What do I need to bring with me when I enter the classroom? 
2. What can I not bring with me into the classroom?
3. Where do I put my Tuba?
4. Do I walk or run, I want to be first!
5. OMG my friends, it’s been days, so much to tell you! Not a good time?
6. Where do I go? Straight to cubbies or to the desk? 
7. Are seats assigned?
8. Are cubbies assigned? 
9. Is the desk always the same desk, in the same spot?
10. What if the teacher is not there? 
11. Do I wait outside the door?
12. How do I wait?
13. How long do I wait?  
14. What do I do while I wait? 
15. What if the teacher never comes?
16. Where do I go for help then? 

Before the day has even begun, the kid is already in trouble, off task, and distracting a whole room full of other children.

Entering the classroom in the morning is a critical procedure and a major transition after a series of major transitions. Students rapidly go from sleep to awake and from home to school, in environments that are the exact opposite of calm and peaceful.

What supports are in place for this critical procedure that sets the tone for the entire day? Typically none (outside of K).  I have heard frustrated teachers yelling across the room at students saying,

“C’Mon Guys, it”s November, you know this already”.

That is not support. Our students with ADHD or executive dysfunction may need more explicit practice than peers, self-regulatory support or visual support at the point of performance to walk in the classroom door. 

Procedural Performance Supports for Students with ADHD

Finding out which classroom procedures/routines your student is having difficulty performing independently is a critical step in supporting the classroom behavior of students with ADHD.

Imagine if the classroom has 45 existing procedures that students are responsible to complete independently(most do).  Your student is having difficulty with 20 of them. Imagine the difference in the classroom if we supported the performance in even half of those procedures. The results are night and day. For everyone involved!

The Procedural Performance Questionnaire

I created the Classroom Procedural Performance Questionnaire to help teachers and therapists determine the elementary students’ level of independence in classroom procedures. Not only can we see where to add support, but we can also use it to measure progress and determine strengths. Very often, we find what strategies/situations works best for the student in their strengths.

Here’s the step-by-step procedure. 😉

1. Download the Procedural Performance Questionnaire.
2. Ask the teacher to complete the Procedural Performance Questionnaire.
3. Score by dividing the number of independent procedures by total procedures. Adjust total for not applicable or omissions.
4. Repeat for other difficulty levels.
5. Schedule a time to observe students performing the procedure(s) they are having the most difficulty with.
6. Watch the other children during your observation to see if class-wide procedural scaffolds are necessary.
7. Collaborate with a teacher to provide externalized supports to working memory (visual supports) or executive function scaffolds to procedure steps. *As often as possible use externalized visual support over “human” prompting to avoid learned helplessness.
8. Trial strategy, review, and generalize to other procedures.
9. Slowly fade supports as the student automates the procedure into a routine.
10. Celebrate increased performance.

The difference between compliance and completion is difficult to determine in the classroom environment. Students with ADHD or executive functioning difficulties demonstrate a high rate of classroom “behavior” that may be due to being unable to meet classroom procedural expectations. Supporting performance in specific procedures will increase occupational performance in the classroom environment. Antecedent-based behavioral support at the point of performance is an evidence-based intervention for ADHD. Students with ADHD function best in a structured classroom with clear and explicit procedures that are supported until automation.

I hope this helps! Comment below or reach out for support using the tool.