New study shows what does and doesn't work for ADHD kids

A new study says giving kids with ADHD extra time for tasks and more frequent breaks while in class may not affect their behaviour.

Researchers from Florida International University got more than 200 primary school children at summer camps in the US to switch between taking and not taking medication and different classroom environments.

The study, published in the Jama Pediatrics medical journal found medication improved the kids' rule-following and test results but the adaptations in the classroom, including extended time for tasks, frequent breaks, using a standing desk and having a low distraction space, didn't affect their behaviour or achievement.

Clinical psychologist Giselle Bahr said there's been no specific research about what happens when children with ADHD are offered structured classroom changes, and while the study showed they did not make a difference to behaviour in this instance, it was food for thought.

"It's like, of course it would make sense to give a child more time if they're struggling, but it looks like it's not as simple as that," she said.

"What we already know is that behavioural strategies help children and they don't have any adverse effects, there's no risks associated with them. We already know that methylphenidate changes children's behaviour in the short term, but over the long term it leads to worse outcomes."

Bahr said the study had not been done in a normal classroom setting, but at a summer camp during one-hour class periods, and the adjustments were randomised.

"The rest of the hours of the day they were doing fun activities and the classes were small. They only had 15 to 18 students in them and there were two adults in each of those classrooms. It's not an exact match with how a classroom generally run, so we have to be careful about what we extrapolate from that.

"It doesn't look like they matched a child's kind of need for what's going to help them learn better in a classroom, they just kind of trailed these adaptations."

She said the researchers, Fabiano and Pelham, had authored papers about children and ADHD for decades and said behavioural interventions remained an important, low-risk strategy for supporting children with ADHD.

"Some of their previous work looked at the best order for interventions. They found that starting with behavioural strategies was more effective than starting with medication. Also, that ADHD medication made things worse for children in the long term, even if it produced improvements in the short-term."

Bahr said ADHD medication came with serious risks, including reduced growth, a risk of psychotic symptoms, and cardiovascular problems.

Bahr said the findings challenged the common-sense assumptions that adaptations like extra time or low distraction spaces would always improve outcomes, but more research was needed to determine how classroom adjustments could benefit kids with ADHD.