What Schools Get Wrong About ADHD

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We’ve got to stop calling it "defiance" when it’s actually dysregulation.

In this episode, we’re pulling back the curtain on what ADHD really is- and why the strategies we often use in schools aren’t cutting it. You’ll learn:

• Why ADHD isn’t a behavior problem (and what it actually is)
• The critical difference between knowing and doing
• Why worksheets, clip charts, and “just try harder” don’t work
• What school counselors can do instead to actually help

If you’ve ever had a student who “knows the rules” but can’t seem to follow them, this one’s for you.

And if you’re tired of seeing kids punished for things they haven’t learned how to manage yet?

You’re in the right place... Let's go!

Resources:

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

Barkley, R. A. (1997). ADHD and the nature of self-control. New York, NY: Guilford Press.

Barkley, R. A. (2011). Executive functions: What they are, how they work, and why they evolved. New York, NY: Guilford Press.

Brown, T. E. (2013). A new understanding of ADHD in children and adults: Executive function impairments. Routledge.

Centers for Disease Control and Prevention. (2022). Data and statistics about ADHD. https://www.cdc.gov/ncbddd/adhd/data.html

Quinn, P. O., & Madhoo, M. (2014). A review of attention-deficit/hyperactivity disorder in women and girls: uncovering this hidden diagnosis. The primary care companion for CNS disorders, 16(3), 27250.

Shaw, P., Eckstrand, K., Sharp, W., Blumenthal, J., Lerch, J. P., Greenstein, D. E. E. A., ... & Rapoport, J. L. (2007). Attention-deficit/hyperactivity disorder is characterized by a delay in cortical maturation. Proceedings of the national academy of sciences, 104(49), 19649-19654.

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Episode Transcript

Speaker 1 (00:00):
Let me tell you about a student named Mason.
Mason is a fourth grader.
He is very smart and hilarious,he cracks the best jokes and he
loves talking about rocks allthe different kinds of rocks,
you name it.

(00:20):
He knows about them.
Just an overall delightfulstudent, except for one problem.
Every week there's a newbehavior slip, he's out of his
seat, he forgets his homework orhe talks non-stop in the

(00:40):
classroom.
Then the teacher comes to youand says hey, we got a problem
with Mason and I think he mighthave ODD because he just does
not seem to care about theclassroom rules.
But here's the thing that thatteacher wasn't seeing Mason

(01:02):
actually does care.
Mason actually does care and heis trying really hard.
But his problem isn'tmotivation, it's regulation.
And in Mason's case, like somany other students on our
campuses, what looks likedefiance is really dysregulation

(01:23):
.
By mid-year Mason's grades aredropping.
He's getting pulled from hisspecials classes.
He's spending lunch in theoffice almost every week and
something has to change.
And when mom comes up to thecampus to have a meeting, she

(01:46):
says with her eyes full of tearshe used to love school, but now
he cries when it's time to go.
Now Mason is a compilation of alot of students that I've had
over the years, but I'll bet asyou're listening, the story
reminds you of one of your ownstudents.

(02:09):
These kinds of situations hithard because it's not just an
issue of misunderstanding kids.
Kids like Mason get trained inschool to believe that they are
the problem, and that's not okaywith me.

(02:29):
So today I'm really focusing onhow we conceptualize and
understand ADHD in our schools,Because if you've ever wondered
why there's a student that knowsbetter but still struggles to
follow the expectation, or ifyou've ever felt stuck between

(02:52):
what the classroom is expectingand what you know that student
is capable of, this episode isgoing to be for you.
Hey, welcome back to the Schoolfor School Counselors podcast.
I'm Steph Johnson, a full-timeschool counselor, just like you,

(03:14):
on a mission to make schoolcounseling feel more sustainable
and more enjoyable.
I want your career to berewarding.
I want you to feel capable andconfident every day you walk
through those doors and not onlywork hard but enjoy the journey
along the way.
So let's just lay down thegauntlet at the get-go here and

(03:35):
start with the most importantthought first and I normally
don't do it this way, but I needto make sure this is crystal
clear ADHD is not a behaviordisorder.
Adhd is a disorder of executivefunctioning, and that is a super

(03:57):
important distinction.
Executive function is like thebrain's air traffic control
system it helps us pay attentionto the right things at the
right time.
It helps us tune out thedistractions that might divert
our attention.
It helps us manage our impulses, start, maintain and finish

(04:20):
tasks, regulate our emotions,organize our materials and even
shift from one task to the nextone.
In kids with ADHD, that systemdoesn't develop at the same pace
or in the same ways asneurotypical kids.
So when you have a studentthat's blurting out answers

(04:43):
every 30 seconds or leavingtheir seats 10 times in a class,
or forgetting their folder forthe third time that week, it's
not because they're trying topush anybody's buttons.
It's because the mental systemthat helps them regulate when
and how to do those things isimpaired.
When and how to do those thingsis impaired.

(05:04):
It's like trying to drive yourcar with GPS, but the GPS keeps
cutting in and out.
You know the destination you'reheaded toward, but you're
constantly missing the turns,and then you get disoriented,
you get frustrated and you mighteven give up on the trip
altogether.

(05:25):
That's what ADHD feels like forstudents in school and
unfortunately, even though it'spretty prevalent, it's also
still very widely misunderstoodon our campuses, even when the
adults on those campuses are themost well-meaning, empathetic

(05:45):
people in the world.
When we mistake dysregulationfor defiance, we tend to respond
with discipline instead ofsupport, and then we end up
chasing compliance instead ofteaching capacity.
That's a very importantdistinction.

(06:09):
According to the Centers forDisease Control, about one in 10
children in the US have beendiagnosed with ADHD.
I've seen numbers as high as14%, and if you work on a campus
that's a Title I campus or acampus with limited access to
pediatric care, the actualnumber is probably higher.

(06:29):
And when we're talking aboutgirls, they are historically
underdiagnosed.
What that means to you as aschool counselor is that many of
the kids that you've been askedto see for things like anxiety
or behavior or apathy mayactually be walking around with

(06:51):
undiagnosed ADHD, and the longerwe miss that, the more shame
they begin to internalize,because they begin to decide
that that they're the problemand y'all.
That's why our work matters.

(07:13):
In the DSM-5, which is theDiagnosis Manual for Mental
Health Concerns, adhd iscategorized into three
presentations.
One is the type of presentationthat we normally see and can
identify pretty quickly, andthose are students who are
predominantly hyperactive orimpulsive.

(07:36):
These are the kids that areconstantly moving and fidgeting
and squirming around.
They're leaving their seat whenthey're supposed to be seated.
They talk excessively.
Sometimes they get so excitedthey start blurting out answers
and they have difficulty waitingtheir turn.
They're often interruptingothers.

(07:56):
That's what we generallyconceptualize when we think
about ADHD.
But there are otherpresentations too.
One of them is predominantlyinattentive.
One of them is predominantlyinattentive.
These kiddos often fail to giveclose attention to the details.
They have difficulty sustainingattention in tasks.

(08:21):
They kind of wander off alittle bit.
They don't seem to listen.
When we're speaking to themdirectly, it's almost like
they're in another place.
When we're speaking to themdirectly, it's almost like
they're in another place.
They're easily distracted andoften forgetful in their daily
activities.
This is a type that we oftensee in these undiagnosed girls,

(08:47):
because they are compliant,complacent and they're able to
do just enough to get by.
So they never really sound outthe alarm bells for teachers.
And then the thirdclassification of ADHD in the
DSM-5 is a combined presentation, that's when students meet the
criteria for both kinds thehyperactive, impulsive and

(09:10):
inattentive and they meet thosecriteria for six months.
Now there are other constraintsto the diagnosis of ADHD as
well, and we're not going to getinto those because as school
counselors, we don't diagnosestudents and we shouldn't be
attempting to do that.
But it's important to note thatthis kind of diagnostic

(09:32):
criteria helps standardizedidentification.
People often want a label tothe situations they're seeing,
right, but we also know,especially in our line of work,
that students' symptoms can alsobe heavily influenced by
context, environment andco-occurring conditions.

(09:55):
That's why our observations andcollaborative abilities as
school counselors are soimportant to our schools.
Studies suggest that childrenwith ADHD may experience up to a
30 percent delay in thedevelopment of the prefrontal
cortex and if you remember fromall your counseling courses,

(10:19):
that's the part of the brainthat is responsible for these
executive functions that we'vebeen talking about.
That means a 10 year old mightbe functioning more like a 7 or
8-year-old when it comes toorganization, impulse control
and time management.
Let's put that in perspectivefor a minute.
10 years old is the start ofthe fifth grade.

(10:42):
7 years old is the start of thesecond grade.
If we take a student withsecond grade organizational
skills or impulse control skillsand put them in a fifth grade
environment, they're gonna havesome significant challenges
right and when we're asking themto sit still, take notes,

(11:05):
complete multi-step tasks andeven manage their materials
independently.
If we do that withoutscaffolding, we are setting them
up to fail, and I would betthat's a lot of what you're
seeing with a lot of yourso-called behavior problems on
your campus right now.

(11:25):
So let's talk about how studentsperform in school versus what
they know they're supposed to bedoing, because that's one of
the biggest misconceptions thatyou're going to find on a school
campus that ADHD is about notknowing what to do.
And the reality is that's justnot true.
It's not about notunderstanding the expectation.

(11:49):
True, it's not about notunderstanding the expectation.
It's about legitimately notbeing able to perform to that
expectation.
Dr Russell Barkley says ADHD isnot a disorder of not knowing
what to do.
It's a disorder of not doingwhat you know.
Think about that for a minute.
What you know.

(12:14):
Think about that for a minuteBecause that reframes almost
every ADHD conversation that'shappening in schools right now.
We have to understand that ADHDis a performance disorder, not a
knowledge problem and not abehavior problem, and once we
understand that that it is aperformance disorder.
We stop asking things like whyare they doing this?

(12:35):
I already told them what to do.
And we start thinking what'sgetting in the way of them doing
that right now?
And what's usually missing isworking memory inhibition or
emotional regulation.
It's not about motivation,friend.

(12:55):
It's about timing and pressureand capacity, and it's a lot
like the stories we often tellour students in our school
counseling offices when we'reexplaining how the brain works
and about how fight, flight andfreeze work.
We've probably all shown ourstudents the hand model of the
brain, all shown our studentsthe hand model of the brain, and

(13:20):
we've probably all asked if Iwalked out in the hallway right
now and saw a tiger or a beargetting ready to come after me,
what would I do?
Right, I know, I know you'vehad these conversations with
your students, but turn itaround on yourself.
If I asked you to do a mathproblem while you're being
chased by a bear, you might knowhow to do that math problem,

(13:41):
but your brain isn't built toaccess that skill in a moment of
high stress, and that's whatADHD feels like.
If that classroom gets too fastor too loud or too unstructured
, students cannot access theskills they need and really that

(14:02):
kind of speaks to where thingsfall apart in schools.
Because as adults we tend toassume that once we've taught
the skill to the student, oncewe've explained the rule, handed
out the worksheet, reviewed theposter even talked about coping
skills or provided a worksheetabout organization that students

(14:23):
should now be able todemonstrate that behavior on
demand.
But when executive functioningis involved, that's not how
learning works.
Putting a kid in a counselingsmall group and talking about
setting goals is not the same asremembering how to set those

(14:44):
goals in the middle of sixthperiod, especially when that
class is going bonkers.
It's the same with our behaviorcharts, our sticker charts, our
token economies or our calmdown corners.
We're giving zero instructionregarding those and we're
expecting kids to catch on, butwithout coaching or guided

(15:07):
practice.
These tools don't teachregulation Really, they just
track dysregulation.
And if we're getting real aboutthis, they can also cause a lot
of harm.
Because if I'm a student withADHD and I keep getting the same
organization worksheet or I'mbeing admonished about, why

(15:30):
didn't you go to the calm downcorner?
Why didn't you use your copingskills?
What I start internalizing isI'm the problem.
I already know what to do, butI keep messing it up.
Something is wrong with me andover time that turns into shame

(15:53):
and y'all.
We cannot shame kids into betterexecutive functioning, we just
can't do it.
But we can scaffold them intoit and lucky for us.
This is where school counselorscan really shine, because if
ADHD students don't need thewhat to do as much as they need

(16:17):
the how to do it, we can walk inand model how to use a
checklist in the realenvironment.
We can push into that classroomto support.
We can assist the student inpracticing emotional regulation
before the blow-up happens.
Or we can implement and supportvisual prompts or specific

(16:38):
language or consistency inapproach long enough that they
can build the habit in all theirclassrooms.
Let me see if I can explain whatI mean.
Say we have a student who couldexplain the entire process for
turning in their homework.
This may or may not be my ownchild.

(17:00):
She knows exactly where to turnthis paper into.
She can tell me exactly whenshe's supposed to go, where it's
supposed to be turned in andhow she's supposed to make it
happen.
She even had a reminder notetaped to her folder, but every
day, day after day, that paperstayed in her backpack because

(17:23):
she just could not plan it outto make it happen.
So we had to practice, we hadto act out how that was going to
go down.
I had to really work on thepraise part of the equation
instead of the pressure, and wehad to loop the teacher in so
everybody was having the sameconversation and after a couple

(17:44):
weeks of doing that, not onlyhas she turned in that one paper
, but she was turning in all ofher work, not because she
finally cared more about it, butbecause she got a bridge from
knowing to doing, but becauseshe got a bridge from knowing to
doing.
And that is what schoolcounselors are best at.
We should not be the perpetualbehavior managers on campus.

(18:06):
We're not the SEL worksheetteam, but we are connectors and
we can connect betweenunderstanding and application.
And we can connect betweenunderstanding and application
and we can connect betweenstudent need and the capacity of
the adult in the room.
So if you've ever had a studentthat seemed like they should

(18:28):
know better, stop and ask dothey actually have the skills to
do better or are they stuck inthat gap between knowledge and
execution?
And if it's a gap, then yourjob is not to remind and nag.
It's to support and model andcoach.

(18:53):
In our School for SchoolCounselors Mastermind, that's
exactly what we're working onright now.
We're working on building Tier2 interventions that go beyond
behavior plans, collaboratingwith teachers in a way that does
not alienate them and creatingsystems that support skill
building, not just the trackingof the symptoms.

(19:16):
Building, not just the trackingof the symptoms.
We just held our ADHD supportsand solutions masterclass and
that replay is already in ourmastermind classroom.
So if that's what you're needing, come join us, because I don't
want you to have to figure thisout alone.
For your sake and for yourstudents, this is too important

(19:39):
to let it go.
Hey, I'm so glad that youjoined me in this episode.
In the next one, I'm going tobe talking about ADHD through a
completely different lens and itmight actually change the way
you approach behavior.
We're going to be talking abouthow this one thing hijacks

(19:59):
behavior and how to helpstudents that live in a
perpetual fight-flight-freezeloop.
You are not going to want tomiss it and spoiler it's related
to ADHD.
If you enjoyed this episode,make sure you hit subscribe in
your podcast player so you canget the next episode, lickety

(20:20):
split, and until then, I hopeyou have the best week.
Take care.