But They Don’t LOOK Like They Have ADHD…
As a primary school teacher, it was normal for me to have at least one child in the class with ADHD. Later, when I was working as a SENCO, the number of children with ADHD on my caseload grew each year until I was working with more than a hundred young people with a diagnosis. I got used to filling in screening questionnaires for children who had been referred for assessment and lost count of the number of medication review forms that needed to be completed.
Whilst there have always been some key symptoms that present in some, or even most, of the children I’ve worked with, the differences between each young person always stand out as being just as significant as their similarities. When I hear statistics about how many children remain undiagnosed or who have been misdiagnosed with other conditions, I feel the same sense of despair as anyone else reading the same details. Yet, at the same time, it’s never really a surprise.
One thing my work in schools has taught me is that recognising the symptoms of ADHD is far from easy and, just to be clear, this applies to professionals who are trained in special educational needs, as well as classroom teachers. When I was working as a SENCO in a mainstream secondary school, I would send any ADHD screening questionnaire forms to several teachers to complete, rather than just one, to try to get a picture of how the student was presenting in different lessons. More often than not, the day after sending out a form, I’d get a knock at my door from a teacher. They’d walk in holding the copy of the form I’d left in their pigeonhole and I’d know straight away what was coming…
Are you sure this is for the right child?
But they don’t show any signs of having ADHD in my lessons.
I can’t answer a single question on this form.
Is this just the parents trying to make excuses for bad behaviour? Or get extra time for their child in their GCSEs?
It’s making me worried that I’ve missed something…
Each time the questions were asked, I’d have a similar conversation with the teacher at my door. It would start with me telling them to forget everything they think they know about ADHD and answer some different questions instead:
Does the student ever forget what they’re supposed to be doing?
How long does it take them to get started with their work?
How often do they manage to finish the work within the time you give them?
Do they seem more emotional than other students?
Do they get frustrated or give up easily?
Have you noticed any sudden mood changes?
Do they have low self-confidence?
As I worked through my own extensive list of ADHD-related symptoms, the lightbulb would go on, followed by the realisation that what they thought was a relatively simple condition of hyperactive and distractible behaviours may not be quite so simple after all.
Understanding and recognising the different ways ADHD presents in individual students is incredibly challenging. When I took on my first position as a SENCO, I had an expectation that everyone working in the school should be able to identify the traits and know that a child might have ADHD. I soon came to the realisation that my expectation was both extremely unrealistic and highly unfair so I came to adopt a new approach with teachers instead:
“I’m not expecting you to be able to identify that a student has ADHD, or even that they might have ADHD. I’m asking you to keep an open mind about neurodevelopmental differences, develop your inclusive teaching practice for all students, and acknowledge that, when a student appears to be struggling in some way, you cannot make assumptions about what they are experiencing.”
Some teachers are immediately open to the idea of taking an approach like this. After all, it takes the pressure off them needing to have all the answers. For others, who are more set in their ways, the hurdle of accepting the changing landscape of understanding individual differences can be more challenging to overcome. Over the years of delivering staff training on special educational needs, I’ve found one story from my own experience to be particularly helpful in explaining my rationale and building momentum for a new approach…
Once, a Maths teacher approached me with concerns about the behaviour of a student with ADHD in her Year 10 Maths class. This boy was calling out, making inappropriate jokes, interrupting her when she was teaching and distracting other students. The teacher was finding it impossible to make progress in her lessons and felt that she was losing control of the whole class because of the behaviours of this one student. She agreed to let me observe a lesson so that we could find a suitable way forward.
As soon as I entered her classroom, I could see exactly what she was talking about. In fact, as the voice of the student we’d been discussing reverberated at full volume down the entire length of the corridor, I didn’t even need to enter the classroom to recognise that there was a problem. While the class was busy at work, I quietly slipped in and hovered at the back of the room.
The lesson was on algebra. There was an example written on the board and the students had a page of questions in front of them to complete. All but three students had started their work and, whilst there was some chattering, they seemed to be relatively on task. Of the three who were not, two were boys sitting in the front row: the first was the boy whose voice I’d heard down the corridor and the other, although sitting quietly, seemed too distracted by the first to get anything done. The third child was a girl in the back row who was gazing out the window in a daydream.
After the lesson, I spoke with the teacher. We discussed the strategies she had used so far and considered what else she could try instead. While we were talking, I asked about the two other students I’d noticed. She acknowledged that they weren’t really engaged but had put this down to lack of interest and being distracted by the student who was making a lot of noise. I suggested we have a chat with each of three of them to see how they all felt.
“I used to like Maths but now I don’t anymore. I feel like I’m always in trouble and I don’t understand why. I get into the classroom and I try to remember what to do but I’m being told off before I even have chance to sit down. There are things to copy from the board but I get the order muddled and then I can’t remember the explanation so I don’t know what to do. I try to ask someone but I always get told I’m not listening or that I shouldn’t be talking and then I have to wait so long to get help so I have nothing to do and then I get distracted. I’m just rubbish at Maths.”
“I like Maths but I’m not very good at it. I feel like I get into trouble a lot but I don’t know what I’m doing wrong. I get in a muddle when I try to copy everything down from the board. I can’t work out what order I’m supposed to do things in and there are a lot of instructions but I can’t remember them all so I don’t know what I need to do next. One time I tried to ask someone but I got told off for not listening so now I just wait to get help instead and it takes ages. Sometimes other people are talking near me and then I get distracted.”
“Everyone said I was really good at Maths at primary school but now I’m not. I get told off but I’m not sure if it’s just me or everyone else too. I get distracted when other people are making noise and then I can’t remember all the different steps or what order they go in so I’m not sure what I’m supposed to do. I get really bored and the lesson always feels like it goes on forever. I don’t want to ask a question in case someone else already asked it and I get told off for not listening.”
Over the next few weeks, the teacher began to implement different support strategies that she’d agreed together with each student. She kept a folder of books and stationery in the classroom for both boys so they didn’t have to worry about forgetting anything. Before each lesson, she wrote up a checklist at the side of the whiteboard of what needed to be done in case any of them lost track. She gave a copy of the examples she was writing on the board to all three students so they could follow them without having to look up every time. She moved the girl to a seat nearer the front so it was easier to check in with her each lesson. After explaining the instructions to the class, she went over to each of the three students to check whether they needed to ask any questions, with the reassurance that they wouldn’t get into trouble for needing the same information repeated again. As it turned out, all three of these students had ADHD (one had already been diagnosed, the other has been assessed more recently).
About a month later, I met with the teacher for a review. There were still challenges and difficult moments but she happily reported a positive difference in her classroom. On reflection, she noted, understanding ADHD and the different ways it can affect students was more important than being given a list of ‘ADHD strategies’ to follow. With such drastically different behaviour presentations, it had never occurred to her that the internal experiences of all three students could be so similar or that similar strategies could be used to support each of them in her lessons.
Children and young people with ADHD face countless challenges in the classroom every day but, with only an outdated understanding of what ADHD is to guide them, teachers will be forever limited in their ability to provide effective support. This story describes the experiences of only three young people and one teacher but it resembles that of many others too. Until we equip our teachers with the knowledge and skills they require to accurately identify the barriers that are faced by their neurodivergent students, these young people will continue to encounter the daily struggle of classes in which they cannot fully engage with their learning and which are so detrimental to both their education and their sense of self-worth.
Miriam Saffer is a highly experienced special educational needs practitioner. She educates teachers, parents and various professionals on topics relating to neurodevelopmental disorders and supports them to develop inclusive practice in a range of settings. Miriam also hosts webinars for Illuminate Inclusion. You can purchase on-demand webinar on Understanding and Supporting Girls with ADHD here.