Academic Support Needed for High Schoolers With ADHD

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Phil Boorman

Research finds that a little over half of high school students with attention-deficit/hyperactivity disorder (ADHD) are receiving some type of formal school-based service, yet many low achievers with ADHD are not getting the academic supports they need.

One of the most potentially debilitating difficulties students with ADHD often experience is chronic academic underachievement relative to their intellectual abilities. The high school years can be especially challenging for a struggling student with ADHD. Adolescents with ADHD tend to experience even greater levels of academic impairment, with lower grade point averages, placement in lower-level classes (for example, remedial vs honors) and failure in more courses compared to students without ADHD. High school students with ADHD also have significantly higher rates of drop-out, as compared to their peers.

To compound the problem, the struggles teens with ADHD face to focus on and complete work and perform at their abilities are often viewed as a willful lack of motivation rather than related to an academic impairment. Chronic underachievement in the high school years can have negative long-term consequences that can impact adulthood.

There is clearly a need for more effective educational interventions for this age group of students with ADHD. Compared to the resources that are available for younger students with ADHD, there are relatively few evidence-based interventions for ADHD in high school. Research published in the journal School Mental Health (June 2014) aims to increase our understanding by examining the prevalence and characteristics of school-based interventions provided to this age group.

Participants in the study were from the longitudinal follow-up of the Multimodal Treatment study of Children with and without ADHD (MTA) across seven sites. Researchers examined a broad, detailed range of services for 543 high school students participating in the study. Using data collected directly from the schools, rates of school services for both high school students with and without a history of ADHD were analyzed. Services included special education as well as other accommodations and school-based mental health-related interventions.

Study Findings

The study found that over half of the students with a history of ADHD were receiving services through an Individualized Education Plan (IEP) or 504 plan, a rate that is six times as high as for the comparison sample of students without ADHD. 

The average number of interventions for students with ADHD and an IEP/504 plan was five. Common accommodations included extended time, modified assignments, tests or grading standards, and slower-paced instruction, as well as supports such as progress monitoring, behavior management programs, study skills or learning strategy instruction, and self-advocacy training. Almost all were receiving at least one academic intervention while only half were receiving any behavioral intervention or learning strategy. Very few services (except tutoring) were provided to those students without a formal IEP or 504 plan.

"Although school procedures for identifying academic impairment in this population appear to be working for the most part, our results also suggest that 20 to 30 percent of students with academic impairment and ADHD have fallen through the cracks," said Desiree W. Murray, Ph.D., lead author of the study. "There is a need for greater or more effective academic supports for a substantial minority of the students in our sample."

Murray and her colleagues also found that only approximately one-fourth of the interventions being used have evidence of support for ADHD in the literature. The most common supports used—extended time on tests and assignments, progress monitoring, and case management—have no reported evidence of efficacy in improving performance among ADHD students, according to study authors.

Improving Academic Services

The study found specific areas where services could be improved for high school students with ADHD—areas such as teaching self-advocacy and self-management strategies and specific study/organizational skills. These types of strategies may be more helpful in reducing the performance gap between students with and without ADHD.

"Evidence-based practices can help improve long-term outcomes for high school students with ADHD," said Murray. "Providing effective services may contribute to increased graduation rates and successful transitions to adult life."

2 Sources
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  1. Murray DW, Molina BSG, Glew K, et al. Prevalence and Characteristics of School Services for High School Students with Attention-Deficit/Hyperactivity DisorderSchool Mental Health. 2014;6(4):264-278. doi:10.1007/s12310-014-9128-6

  2. Frank Porter Graham Child Development Institute. The University of North Carolina at Chapel Hill. Better Academic Support in High School Crucial for Low Performers with ADHD. 2014.

By Keath Low
 Keath Low, MA, is a therapist and clinical scientist with the Carolina Institute for Developmental Disabilities at the University of North Carolina. She specializes in treatment of ADD/ADHD.