Study Finds Common ADHD Classroom Accommodations Fall Short
Extra time, breaks, a standing desk and a quiet place to work are everyday supports for children with ADHD. A new US trial found that none of them brought a significant gain in behaviour or schoolwork.
How many children have ADHD
The US Centers for Disease Control and Prevention estimates that about 7.1 million children aged 3 to 17, nearly 12%, had a current ADHD diagnosis in 2024. Many of them receive extra school support through individualised education programmes (IEPs) and Section 504 plans.
What the trial tested
The trial, published in JAMA Pediatrics, drew on 255 children with ADHD, from kindergarten through sixth grade. All had attended Florida International University's Summer Treatment Program between 2022 and 2025.
Researchers at the university's Center for Children and Families examined four supports: extra time to finish assignments, frequent pauses, standing while working, and a setting with few distractions.
Under varying conditions, the team counted rule violations in class and checked how many assignments children completed and how they scored on quizzes.
None of the supports made a significant difference, even when paired with behavioural interventions or medication. "We were surprised that none of the accommodations we tested had a significant effect," said lead author Gregory Fabiano, a professor of psychology at the university.
What did help
Behavioural interventions and stimulant medication did make a measurable difference. Rule violations during independent work fell 37% with behavioural interventions and 61% with medication, measured against children who got neither. Children on medication also finished more work and scored higher on quizzes.
The write-up draws a line between the two kinds of help. An accommodation alters the setting in which a child works. A behavioural intervention aims at the child's own skills, rewarding the behaviours that support learning.
Extra time shows the problem. Extra time is a good example: a longer deadline may do little for a child who struggles to settle to the task at all.
Fabiano says many accommodations target symptoms such as trouble paying attention or staying seated. Easing those, he says, does not necessarily solve what stops a child from learning and finishing schoolwork. He also says these approaches do not build skills or address motivation.
None of this makes accommodations useless. Some children may benefit from specific supports, and the findings challenge the idea that one set of them suits every student with ADHD.
Classroom alternatives
Daily report cards are one option. A teacher sets individual goals for a child, tracks progress and gives feedback. Meeting a goal brings positive reinforcement, and parents see how their child is doing at school.
Fabiano recommends more emphasis on positive behavioural supports that teachers can build into daily routines. Simple examples are praise for appropriate behaviour, clear expectations and steady feedback, which show children what is expected of them.
A teacher might instead give a child a clear target for the work and check in often along the way.
He also argues that behavioural interventions belong more in ordinary classrooms. Most children with ADHD spend a large part of their day there, including those receiving special education services.
Parents can work with teachers to check that a child's plan includes strategies that make a real difference. The results also raise questions about the accommodations written into IEPs and Section 504 plans.
A research legacy
The study builds on the work of William E. Pelham Jr., the late founding director of the centre, who helped design and carry it out.
Earlier work of his showed behavioural interventions were the more cost-effective place to begin, compared with medication. A 2022 study by Pelham and colleagues found that stimulant medication lifted classroom behaviour and productivity, yet did not significantly add to how much new material children learned.
Fabiano said: "We need to rethink how we're supporting these students". He wants more emphasis on effective treatments in everyday classrooms and less reliance on accommodations.
Source: Florida International University