Choosing a School for a Child With ADHD

On school open days, parents generally look at the same things: the building, the yard, the foreign language hours, the high schools the graduates go on to. For the parent of a child with ADHD, the order of this list changes. The yard still matters, but the classroom, the teacher and what the school does when the child struggles come first.

My short answer is this: there is no single "best school" for a child with ADHD. There are a few criteria that change with the child's age, where they struggle and the options at hand. Behind some of these criteria there is solid research, and some are reasoning I draw from general principles. I will write clearly which is which.

First, how wide are your options

In Türkiye, primary school registration often depends on the address where you live. A private school requires a budget, and at a state school the address is decisive. So the question "which school?" is not a completely open question for many families. The conditions for transfer need to be learned in their current form from the school administration and the provincial directorate of national education.

For this reason I suggest changing the shape of the question: look not at the school but at the class and the teacher inside that school. Two different sections in the same building can give a child two different years. Section assignment does not work the same way in every school, and not everywhere is the parent given a say. But if you can ask, ask: "Which section will we be registered to, who is the teacher of that section, can I talk to them for ten minutes before registration?"

Class size: what is known, what is not

Everyone intuitively wants a small class, and for a child with ADHD the reason makes sense: the less noise and movement in the class, the fewer doors for attention to scatter through, and the longer the time the teacher can give the child. But I cannot say I know of a solid study that directly compares how class size changes the outcome in children with ADHD. The weight of the evidence we have is elsewhere. There are analyses combining school-based interventions that show accommodations applied in the classroom (seating place, breaking down instructions, frequent feedback, a reward system) give benefit on behavior and academic measures (DuPaul et al., 2012).

This does not mean that class size is unimportant. A small class makes it easier to apply these accommodations, but it does not take their place.

Think concretely. Say there are two options. One has twenty children, but its teacher always gives instructions verbally and reprimands the child who fidgets. The other has thirty children, but the teacher seats the child at the front, gives the work in pieces and writes two lines on the board. If it were up to me, I would choose the second. If the teacher is the same, the smaller one is good, but the number alone is not a measure to decide on.

Teacher approach: the most decisive, the hardest to measure

A child's relationship with school is mostly built by the class teacher. The difference between a teacher who calls the same behavior "laziness" and one who says "this child cannot do this right now" decides how a year will go for a child with ADHD. I cannot measure this distinction with a number, so I suggest observing it.

Instead of an open day, say that you want, if possible, to see the class while a lesson is going on. Look at how the teacher addresses a child whose attention has drifted. Then in the meeting ask these:

• What do you do for a child who needs to fidget? Is there something like permission to stand up, a short task, working standing?
• How do you give instructions? Are they written on the board or on paper?
• Is the child who does not do homework or who talks kept in from break?
• What happens when the child forgets to write the homework in the notebook?
• When do you call the parent other than with bad news?
• Have you worked with a student with ADHD before, and what did you see work?

The break question is, I think, the most important question on the list. In a small study, children with ADHD were reported to perform better on tasks requiring attention after a short period of movement (Pontifex et al., 2013). That is a single small study and does not count as evidence for "do not abolish school break." Still, I see no reason to think that taking movement away as a punishment will help a child with ADHD.

The answer to the last question also gives a clue. A teacher who says "it hasn't happened before, but I am open to learning" is a much better start than one who says "in our class there is no such child." The first is a wish to learn, the second is closing the door.

Support: support that is not written is ignored

The school's capacity to give support is the thing least understood from the brochure. Look at three places: is there a school counselor and how many students do they look after, does the support education room work at the school, how does the BEP (Individualized Education Program) preparation process run in practice.

None of these services comes automatically with a diagnosis. Support at school depends on the educational assessment by the RAM (the Guidance and Research Center) and then on the program prepared at the school. I laid out the order of the process in the article on the roadmap for ADHD in children in Türkiye, and the RAM side in the article on the RAM report. What you need to know when choosing a school is this: a school that promises support on paper and a school that really applies the support are not the same. Asking "For a student with a RAM decision, who runs the BEP, and in which term was the latest example?" is enough to show how familiar the answer is.

Whether to state the diagnosis in the registration meeting or leave it for later is up to you. I think that if support is going to be planned, stating it from the start makes the job easier, because information that comes later carries the air of "a problem came up and now it is being said." This is not evidence, it is my preference.

What to look at by age

Preschool. At this age the diagnosis is often not yet settled, and I explained this in the article on ADHD in the preschool years. The things I would look at in kindergarten: the number of adults relative to the number of children in the group, whether the day has a predictable flow, the time spent outside and in free play, and whether, under the name of "school readiness," there is too much sitting and pencil-and-paper pressure for the age. I know of no tested criterion for choosing a kindergarten for children with ADHD; these come from general child development principles.

Primary school grades 1 and 2. These are the years of learning to read and write, and most of the day is spent at a desk. Since the class teacher is a single person, fit with the teacher comes before everything. At this age also look separately at break length and seating arrangement.

Primary school grades 3 and 4. The homework load begins, and the child is now counted as someone expected to work independently. Look at how much homework the school gives and how it is given. I described how homework spreads across the evening hours in the homework tracking article.

Middle school. Each lesson has a separate teacher, each hour a different expectation. Notebooks, books, changing classrooms and homework tracking suddenly pile onto the child. The question to ask here is whether the school counselor carries the information to all the subject teachers. I took up study routines in middle school in the middle school article. At this age take the child along for a visit too, and ask how they feel. For many families the move from primary school to middle school is a hard period.

On the decision to start school a year early or late too, the evidence is weak. The age limits are set by regulation, and consulting the school guidance service and the doctor who follows the child is enough.

After choosing, the first term is a trial

Experiencing the school choice as a final decision creates unnecessary pressure in the family. I would count the first term as an observation period. Signs to look at: does the child go willingly in the mornings, how does he talk about the teacher, is the homework time getting longer, is the writing in the notebook getting more orderly.

If problems arise, changing school is a heavy decision. First talking to the teacher, classroom accommodations and the BEP are tried. If the child is constantly blamed, does not want to go to school and the written accommodations are not carried out, then a change of section or school comes onto the agenda. If medication is used, talking to the doctor about its effect during school hours is enough.

What I am left with

When choosing a school, I would look not at the score, the name and the building but at this question: when my child makes a mistake here, what happens? A child with ADHD will make mistakes, will forget, will be late. A good school is the one that meets these with accommodation, not punishment. You cannot read this from a brochure, you need to see it in the classroom.

Most of the criteria in this article do not come from studies comparing schools for children with ADHD. I know of no such study. Solid evidence exists for classroom accommodations and behavioral approaches (DuPaul et al., 2012; Daley et al., 2018). My questions about school choice are reasoning I draw from this knowledge. So use the list not like a rule but like questions to ask at the school. You are the one who knows your child best; let the answers be material for you when deciding.

There is no flawless school. A teacher who understands your child and a small support plan put into writing often do more work than a shining school. As I see it, even after the school is chosen, what will carry the most value is the relationship you build with that teacher.