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Six ways to support students without a formal ADHD diagnosis

Only recognised in UK adults since 2008, attention deficit hyperactivity disorder (ADHD) is highly under-diagnosed. Children whose symptoms manifest internally often fly under the radar, and factors including years-long waiting lists for assessment mean many are living without knowing they have it. That means their parents and teachers struggle to provide them with the support they need.

ADHD is a neurodevelopmental condition. Those with it fundamentally think differently to those without. This can result in significant difficulties in standardised environments like schools and exams.

ADHD doesn’t just impact those who may be visibly struggling, but also those who appear to be excelling. I got top marks in my exams but suffered significantly from not knowing that I had the condition. It put me under an enormous amount of pressure and caused me to believe I was stupid.

Spotting children with undiagnosed ADHD is crucial to enabling them to thrive. Here’s how to do this, through the lens of the 30 per cent developmental delay in executive functioning skills associated with ADHD.


ADHD symptoms can manifest differently in everybody, and may be difficult to spot. This is especially so for children who are ‘inattentive’ or who struggle to concentrate without disrupting the class. Children who seem unable to identify or discuss their challenges or needs may be struggling with undiagnosed ADHD.

Learning more about ADHD and its varied symptoms is central to supporting children effectively. Then, collaborating with children (and their parents) to identify and discuss challenges can help with implementing effective support.


Rather than a deficit, ADHD can present challenges in regulating our attention. It’s linked to an ‘interest-based nervous system’, meaning children may be able to ‘hyper-focus’ in certain situations, such as those involving adrenaline or topics of interest.

Conversely, ADHD can also present severe challenges in concentration, procrastination and overwhelm in other areas. Those with undiagnosed ADHD may seem as though they are not listening or trying to concentrate, when in reality it’s likely that they simply can’t.

I can focus best when listening to music, using a fidget toy or writing notes. Often, minor adaptations can make a big impact. Listen to each child about what those might be, and believe them.


Children who struggle significantly with staying on task and time management may have undiagnosed ADHD.

Breaking education down from marathons into a series of sprints can be highly effective. Similarly, incorporating regular breaks can aid focus.

Having ADHD means we may experience time as ‘now or not now’, and struggle to think about the future. Incorporating artificial deadlines and accountability, especially for longer-term projects, can help.

Emotional regulation

Rejection Sensitive Dysphoria is extreme emotional pain at real or perceived rejection, commonly associated with ADHD. Children who display unusual emotional reactions such as repeated crying or excessive anger may be struggling with undiagnosed ADHD.

Research estimates that children with ADHD receive 20,000 more negative messages than their peers by age 12. Providing positive feedback and reinforcement can significantly help to build confidence and engagement with learning.

Having curious conversations about ‘naughtiness’ instead of simply telling a child off can uncover hidden challenges and result in collaborative solutions.

Problem solving

Children struggling with undiagnosed ADHD may not benefit from solutions that help others, or repeatedly struggle with challenges.

As ADHD means we think differently, we sometimes struggle to prioritise and process instructions. Providing clear instructions and template answers helps everybody, not just those with ADHD.

Reinforcing priorities and expectations provides clarity and understanding. This can be especially helpful for situations such as exams, helping children to understand how to revise effectively.


ADHD is commonly linked with audio processing disorder, meaning we may struggle to process and remember verbal information. Providing written instructions and information can help children to remember what they need to learn.

Children with undiagnosed ADHD may also struggle to remember necessary belongings, so reminders and additional copies of materials such as books can prove helpful.

A formal ADHD diagnosis isn’t an excuse; it’s an explanation. In the meantime, it benefits everybody to adapt your teaching to meet individuals’ needs – and recognising these is a fantastic first step.

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