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Options and Choices: ADHD/ADD

Here is a selection of some of the main strategies that might be used to address respective needs. These are just the main strategies so additional links to further useful resources are also included.

These strategies are divided into universal or inclusive approaches that can be applied for the benefit of all learners, and more specific interventions that may be needed over and above these to benefit students with specific needs.

As you work through these, things about which of them would have been most beneficial to Anwar and Daniel’s situations.

Universal design / inclusive practice solutions

The principal here is that by predicting the needs of a wide range of learners in the design of learning programmes, we can negate the need for specialist and sometime intrusive interventions. In the context of autism, these solutions will likely need to work alongside more specialist support such as counsellors and specialist support tutors.

Solutions include:

Teaching

Teachers should utilise a range of teaching pedagogy that is inclusive. This might include:

  • Use of multi-media and delivery methods in teaching sessions
  • Including a variety of activities within programmes of study, such as questions, discussions, practical activities, etc.
  • Clearly define all tasks in advance, including assessment and group activity. This to include clearly defined tasks, instructions and deadlines and clear outcomes Provision of a glossary of main terms and concepts for all topics. This is most useful if in advance of starting teaching in this subject area.
  • Facilitating the recording of lectures and group sessions by individual students. NOTE: Though lecture capture may exist, students being able to record content themselves and sync this with their note-taking software or strategy is often preferable to listening back to whole lectures. 
  • Recording and making available all synchronous (live) online learning to enable students to access and review content afterwards.
  • Providing accessible electronic formats of lecture notes and presentations and supervision handouts, in advance on the VLE. This is so that electronic notes can be made during the lecture/supervision. At least 24-48 hours in advance is considered desirable.
  • Ensure captioning (subtitles) of all video materials.
  • Build in sufficient time during question-and-answer sessions and group discussion to enable students with communication barriers to formulate ideas and take part in discussions.
  • Ensure students can take rest breaks in teaching and assessment activities if needed. 
  • Allow time at the end of teaching for students to ask clarification questions or raise issues.

Inclusive practice in-class

  • Provide a safe environment within which disclosure of a disability or long- term medical condition is supported and encouraged. Encourage people to contact you if they have accessibility or other issues.
  • Set out clear expectations and guidance on behaviours in class – including embracing and supporting diversity and embracing others different working styles
  • Outline and reinforce group/class discussion protocols e.g. one person speaking at a time, introduce yourself before you speak, allow other speakers to finish.
  • Repeat key learning points and points made by fellow students, to aid understanding in class
  • Make sure students can see you, the whiteboard and/or screen at all times.
  • Ensure you make eye contact and face all students, thus including everyone in classroom discussions.
  • Use a microphone in larger rooms.

Inclusive practice online

Many of the principles above apply equally in an online environment but just need to be delivered differently. These might include for example, consideration of clarity of instructions and clear and unambiguous communication and materials accompanying asynchronous (recorded) lectures etc.

For live (synchronous) teaching, additional considerations might be:

  • Clear advance notice of timings, what to expect and how this fits with assignment tasks etc. Reminders may be required here – with texts working better than emails.
    • Advance notice of any activities or tasks with clear explanations of how they will work.
    • Proactive check-ins with students afterwards to gauge understanding of key instructions.
    • Recording the session and circulating this to students.

For online group work or collaborative activity, clear expectations in terms of cameras being on and/or off and use of online forums should be set out at the start. There is some evidence that students actually find cameras being off more un-nerving than them being on so clear expectations around this are likely to be beneficial.

As with face-to-face teaching, it is important not to assume that students are disengaged because they do not fully participate all the time or play a proactive part in discussions and activities. At the same time, it is good to check afterwards.

A key barrier to students accessing online learning has been lack of information and support about how to use the platforms themselves. It should not be assumed that students have the technical or practical ability to access online learning so support and information about this at the outset and throughout teaching should be considered (many universities have dedicated teams to support this activity).

Induction / course information

Evidence shows that teaching staff can play a key role in connecting students to appropriate support services e.g. counselling services

  • Offering clear guidance on how, when and where students can expect to access teaching staff.
  • Acknowledge that some students will find it harder to adapt to a new level of study and may need additional guidance or support during transition into university.

Student support / Personal tutoring

  • Allocate a single point of contact for students to speak to about issues relating to their course. At the University of Worcester this role is called a Personal Academic Tutor (PAT). This tutor should ensure that regular reviews are being held with students to ensure that their support needs are being met.
  • When providing one to one tutor support, always consider the learning journey (and life journey) of the student to date. Don’t make assumptions. Ask.
  • Provide written feedback in accessible formats from all one-to-one sessions and tutorials*. This will ensure students do not have to worry about taking extensive notes. *It is accepted that sometimes co-design of these notes by the student and tutor is desirable.

Course design

  • Anticipate the broadest range of student needs, experiences and preferences in your course design.
  • Offer alternative methods for students to demonstrate achievement of learning outcomes e.g. through written, visual or verbal methods. Clearly outline what is required in each and offer support with new methods.  
  • Embed diversity and inclusion and disability awareness concepts in the curricula.
  • Ensure that course requirements such as learning outcomes are clearly written.
  • Ensure sensitive timetabling to accommodate the time it takes for some students to travel between different learning activities
  • Provide consistent timetables and locations for all teaching activities.
  • 24 hours+ notice of any changes should be given to ensure students can plan for the journey, find the venue and arrange human support if necessary.
  • Provide clear course guidelines and notification of deadlines, well in advance
  • Were possible work with other tutors to stagger assessments deadlines so that these do not all come at once.
  • Integrate key study skills support within the curricula to ensure anxiety about these is reduced.

The learning environment

It is important to consider physical accessibility of learning environments at all times. 

Access might relate to the physical accessibility of the rooms themselves.

  • Are facilities such as parking spaces, lifts and toilets nearby (and are these accessible)?
  • Are corridors, entrances and doors accessible (e.g. wide enough?
  • Can students easily navigate within rooms (particularly if they need to leave or if group work is involved).

However, there is more to accessible learning environments than physical access to the room itself. Ask:

  • Is there space to adapt layout and move furniture
  • Is lighting appropriate and can it be adjusted
  • Can background noise levels be avoided/reduced?
  • Is accessible technology such as microphones and hearing loops available (and can tutors use it)?
  • Can everyone see and hear tutors, whiteboards and screens etc?

Specific interventions. 

Where universal inclusive practice solutions are not possible, special arrangements need to be made for students with ADHD and ADD to ensure their equal access to teaching and learning.

As students with ADHD may experience difficulties with the structured environment of a tutorial or lecture or focusing on their assigned work, they may need adjustments to the learning environment to help them remain focused on the task in hand.

  • Students may need to be asked where they prefer to sit within the learning environment to help them to focus on what is being said.
  • Buddying – they may also benefit from working closely with another student who can help them to develop their cooperation skills or, if space permits, work in separate learning areas, away from other students.

Strategies – Attention Skills

  • Arrange the learning environment in order to minimise distractions, e.g. seat students with ADHD away from windows, and take care during group work as students can become over-stimulated.
  • Use frequent eye contact.
  • Identify times and places where the student is more focused.
  • Give frequent reminders about how much time is left to complete tasks both short-term (examinations) and long-term (assignments and coursework).
  • Use large fonts on handouts and provide only one or two main points to a page. Avoid the use of illustrations that are not directly relevant to the task.
  • Use checklists for each assignment and outline the tasks to be completed.
  • Ensure student attention before giving an instruction and encourage students to verbalise tasks and instruction – first to the tutor and then silently to themselves. Emphasise critical pieces of information.

Strategies – Organisational Skills and Memory

  • Work with student support to explore options of additional specialist tutoring or mentoring for the student
  • Agree more frequent personal academic tutoring sessions with the student
  • Focus on tangible, short-term steps rather than long-term plans.
  • Agree on a concrete starting point to help with prioritisation and avoid procrastination.
  • Provide structure and routine.
  • Encourage the use of colour-coded ring-binders or notebooks for each subject area.
  • Encourage the use of daily reminder schedules or to do lists and highlight priority tasks.

Strategies – Raising Self-Esteem

  • Try to adopt positive descriptions for students, e.g. instead of saying a student is easily distracted say they have a high level of awareness.
  • Use assertive and positive communication, e.g. tell students what is required instead of what is not required.
  • Encourage positive self-talk and internal control.
  • Students may benefit from having a mentor to help them to develop their academic and social skills. This could be a peer mentor (i.e. another student) or a professional study skills tutor (as provided via the Disabled Students Allowance (DSA) programme in the UK).

Strategies – study skills

  • Research and reading – encourage the student to access additional support with planning and organising research. Library services, peer mentors, specialist tutors and personal academic tutors may all provide support in this area. Text to Speech software solutions on Microsoft and Apple platforms and more specialist programmes such as TextHelp and ClaroRead can all support students with reading and comprehension tasks. 
  • Composition, referencing and proof reading – Planning, structuring, writing and proof-reading can be supported by provision of clear guidance, additional opportunities to clarify instructions, additional professional support (see above) and use of software solutions such as talk to text and mind-mapping and planning software.
  • Exams and timed assessments – extra time and rest breaks enable students with impaired working memory and processing speed to ensure they understand tasks and have time to get their ideas on paper as other students are able to. There is no advantage to students getting extra time as “if you don’t know it, you just don’t know it for longer”. However, this is one of the most effective ways of levelling the playing field for students with specific learning difficulties, including ADHD.

In addition to extra time, students with ADHD may benefit from use of a keyboard (PC/Laptop) and the opportunity to take exams and tests in a separate room or smaller group environment to reduce opportunities for distraction.  

  • Placement, work experience and field trips - every student will be different but in selecting placements it will be important for the student and the placement provider to discuss how they might be accommodated within a workplace setting. Students are likely to have concerns about levels of support and guidance and how they may be perceived. 
  • In class
    • Lectures – Clear timetables and advance notice of changes. These may need to be clarified directly with students with ADHD. Send advance notice of group activities and tasks so that students can fully understand what is expected of them before the lesson. Encourage use of recording devices and software solutions such as AudioNotetaker and NoteTalker.   
    • Seminars/Tutorials – As above.
    • Group work – Allow the student or their peers to select groups to work with. Or purposively select groups for the student. Clear ground rules and expectations for group working. Offer additional facilitation of required.
    • Lab work – Arrange for peer support in these sessions.
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