Table 6 Supplementary information: educational interventions for children and adolescents with comorbid ADHD and ASD

Individualised strategy plan

• Assess broader learning needs, including the presence of specific learning difficulties (e.g. dyslexia, dysgraphia, dyscalculia, developmental coordination disorder), sensory processing difficulties and language or communication impairment.

• Tailor a curriculum which emphasises the development of ‘islands of competence’ in areas of relative strength, e.g. promoting learning through special interests and exploiting talents in areas such as mathematics and information and communication technology (ICT [e.g. coding/programming]).

• Introduce small group learning and individualised timetables to support learning.

• Establish academic and pastoral counselling for students.

• Provide specific guidance on homework and revision strategies.

Assistance to aid concentration and reduce anxiety

• Establish provision for supervised breaks at certain intervals during examinations instead of extra time to help sustain concentration and reduce disengagement. Although the practice of allotting extra time to complete an assignment or examination has been used with individuals with various psychological disorders, it is not necessarily the best option for those with ADHD and/or ASD.

• Consider the need for separate accommodation during examinations to reduce sensory overload and exam stress.

• Use an oral language modifier to explain or re-phrase language in an examination paper and clarify the meaning for the candidate (subject to approval from awarding bodies such as the Joint Council for Qualifications [109] or Scottish Qualifications Authority [110]).

• Note learning and teaching opportunities that highlight any difficulty a student may have in sustaining attention and retaining information (short-term working memory).

• Provide immediate feedback and the positive reinforcement of success, given the sensitivity of the reward mechanism in pupils with ADHD.

• Introduce ‘movement breaks’ or similar to allow pupils an opportunity to engage in physical exercise during the school day.

• Use of explicit language when teaching or making task demands of students.

• To reduce anxiety and reinforce expectations, introduce visual timetables that are adapted to the ability level of the student

Personal assistance

• Plan carefully for the dispensing of medication during school hours to reduce stigma

• Use assistive technologies (e.g. voice recognition) when handwriting difficulties arise as a result of poor fine motor skills that are often associated with ASD and ADHD.

• Consider the additional demands being made on some students during field trips, external excursions or any significant changes in routine.

Organisational assistance

• Provide guidance and support on deadlines and late submissions and regularly check on progress during extended tasks.

• Provide regular feedback on performance, progress and likely outcomes.

• Provide support with task prioritisation and time management through the use of task lists, and mind-maps or similar to break down complex topics.

• Provide support to develop self-checking strategies for coursework and examination submissions.

• Provide notes, note-making support or access to online resources to support learning for lectures and classes.

• Provide an executive summary and/or key learning points of lectures and classes.