Attention deficit/hyperactivity disorder (ADHD) is one of the most prevalent disorders of childhood. The CDC estimates that between 3 and 7% of school-aged children have ADHD. Characterized by inattention, impulsivity and/or hyperactivity, ADHD impacts many areas of a child’s life. This includes social participation with peers and relationships with adults, academics, executive functioning skills like organization and time management, and more. Pediatricians may recommend medication and/or a variety of non-pharmaceutical interventions.

Nonpharmacological Interventions

1. Behavior modification: This intervention involves using behavioral strategies in everyday routines to provide structure, reward positive behavior, and communicate expectations.

2. Cognitive Behavioral Therapy: Also known as CBT, cognitive behavioral therapy involves self-management that results in behavior modification. The process involves identifying and challenging problematic thoughts and behaviors and replacing them with practical actions.

3. Environmental Modifications: Children with ADHD are more likely than their peers to be overresponsive to sensory input; thus, the classroom can be more difficult for them to navigate.

4. Sensory Integration: Sensory integration is a specific intervention approach used by occupational therapists. This sensory-rich therapy allows children to process and integrate different kinds of sensory input in a controlled environment.

5. Activity Modifications: For the child with ADHD, a multi-step activity can become overwhelming and result in behaviors or withdrawal. Breaking down large tasks into manageable chunks can allow the child to experience success. Reduce the size of homework or the amount of written material on handouts.

6. Social Skills Training: Social skills training provides children with ADHD the opportunity to learn and practice social skills. Several professionals use this intervention, and intervention may include education, use of social protocols, modeling, role-playing, practice in the community, and more.

7. Team Collaboration: When a child’s disability impacts their participation at school, the child’s team may adopt an IEP or 504 plan. Children benefit from interdisciplinary collaboration, and the team may consist of the parents or caregivers, the child’s physician, special education teacher, regular education teacher, social worker, counselor, or occupational therapist.

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Tracking student progress is one of the most crucial components of a child’s journey in special education. Data collection allows us to provide children with the best possible interventions and actively impact their education. Special educators, occupational, physical, speech-language, and behavior therapists all use SMART goals as an efficient way to support intervention planning and data collection.

SMART is an acronym that stands for specific, measurable, attainable, relevant, and time-bound. The SMART template provides a consistent structure for goal-writing. They are widely recognized in education and help professionals ensure that the goal includes all necessary components.

S: Specific
Educators should write goals with definitive criteria. Break down anything that might be considered vague. ‘Play-group’ could be described more specifically as ‘a teacher-facilitated recess group with five same-age peers.’ If the child has to switch school districts without notice, the new educators should easily distinguish all the goal criteria. Don’t forget to include any adaptive equipment, modifications, or cues that the student will use to meet their target.

M: Measurable
This part of the goal reveals the intended outcome and helps track progress. To improve a goal, add one specific behavior that an educator can measure. For example, “Hakim will initiate three social interactions with peers, as measured by teacher data collection” rather than “Hakim will participate in a play-group.” Be sure to include who will collect the data or if there will be an observation period, retesting, or portfolio collection.

A: Attainable
When a child qualifies for special education or transitions into a program, they undergo a thorough evaluation. The evaluation should contain the child’s present levels of educational performance. Use this information to create goals that are attainable within the term of the IEP. If a child is currently speaking with one-word responses, it is unrealistic to expect them to use an average of six words per sentence within a year. Use their present levels along with your clinical reasoning to determine what is an attainable goal.

R: Relevant
Does the goal fit into the context of the child accessing their education? Does it make sense given the child’s individual learning profile and needs? If it is unclear, try using vocabulary that ties the goal back to the student’s educational needs. If it still doesn’t fit, consider what the team wants to prioritize to ensure that the goal is relevant.

T: Time-bound
The goal should be attainable within the timeframe of the IEP. An IEP is typically valid for one year. However, if a related service gets added to the plan mid-year, the specialist will create goals for a shorter time. To ensure that you are using the correct timeframe, look for the next annual IEP date and write it into the goals.

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Universal strategies support learning for all students regardless of their disability status. However, systems embedded in the classroom are especially beneficial to students at risk of falling behind or receiving special education or related services. Providing best practices to all of your students is a win-win for general and special education staff and, of course, students.

• Flexible Seating

Many people picture elaborate chairs and spaces when the topic of flexible seating comes up. T-stools, rocking chairs, and swings built into classrooms are excellent but flexible seating doesn’t have to be complex! Allow your students to stand at their table, move to a different space, or lay on their bellies during read-aloud. Movement helps both children and adults focus (hence the popularity of the office sit-stand desk).

• Positive Reinforcement

Positive reinforcement helps create a nurturing classroom environment and is a tool that encourages children to engage in appropriate behaviors. Positive reinforcement also builds up a child’s self-esteem. Give your students a high-five, recognize their hard work, or allow them to earn a fun activity. Use positive reinforcement often and with all of your students.

• Use a Routine

Routines provide structure for a day with academics, social participation, lunch, breaks, and more. A transition is much smoother when a student is expecting it. Let your students know when there will be a change in the routine and remind them throughout the day. Post a schedule of the day where everyone can see it. Use picture images for young children and write the plan out for students who are confident readers.

• Check-in

For student well-being to occur at school, an adult must connect with them. Touching base with them each day can foster a community of positive mental health. You can use the Zones of Regulation or other programs or even teach and provide language for them in the classroom. Make them feel comfortable sharing by using examples from your own life and validating that experiencing different emotions is okay. When appropriate, offer strategies such as deep breathing or movement to help your students feel their best, and feel supported.

• Provide Extra Time

Some children can easily recognize and process sensory information in the world and then quickly recall information and figure out how to respond to a question, for example. For others, it takes longer. Giving extra time to all students offers everyone a chance to participate in the conversation. Especially after asking, “does anybody have questions?” try to pause for five to ten seconds.

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