Excessive squirming and fidgeting. Difficulty paying attention. A tendency to act impulsively and make careless mistakes. Trouble acting cooperatively. These hallmark symptoms of childhood ADHD run counter to behavior that teachers welcome in their classrooms.
It’s perhaps unsurprising, then, that the estimated 11% of the nation’s children who have the common developmental disorder tend to get punished far more than their classmates. High school students with attention-deficit/hyperactivity disorder are twice as likely to get suspended, and five times as likely to be expelled from school, compared to their classmates without ADHD, according to a study of students from nine high schools.
Younger students with ADHD feel the effects of school discipline disproportionately, too. One national survey of parents whose children had ADHD, conducted in 2014, found that nearly 6% of boys and 1.5% of girls with the disorder were expelled from preschool.
A lack of training for teachers on the best practices for classroom management for students with ADHD is partly to blame, say experts. In a study that surveyed elementary teachers 20 years apart, in 1999 and 2019, just 10% of respondents in the initial survey and 30% in the later one reported feeling appropriately trained to manage behaviors of students with ADHD.
Teachers who lack effective training tend to resort to punitive measures in response to behaviors associated with ADHD, like inattention or impulsivity, said Gregory Fabiano, a professor of psychology at Florida International University whose research focuses on effective assessments and interventions for children with ADHD.
But meting out punishments—especially exclusionary discipline, like suspensions—rarely works in the short or long term to address the challenges that students with ADHD face, he argues.
Students with ADHD too often get trapped in a negative feedback loop
The school experience of students with ADHD often looks far different than that of their peers, Fabiano observes.
Students without behavioral challenges typically have the privilege of positive interactions with adults, he said. Nobody groans when they come into the room or automatically expects them to misbehave.. On the contrary, the school experience of someone with ADHD can feel lonely and discouraging.
“The sort of kids that I often work with as a clinical child psychologist, the ones with behavioral challenges, their entire day is often commands, demands, reprimands, corrective feedback, criticism, getting in trouble,” Fabiano said. “You can imagine how that approach wears thin for both the adult and the child really quickly. It’s just repeating the same kind of approach over and over again until the student drops out or disengages from school.”
One study from 2010 estimated that 32% of students with ADHD drop out of high school, compared to 15% of teens that don’t have a psychiatric disorder.
By the time a student with ADHD is in middle or high school, they’re likely to have accumulated a history of negative interactions with adults in the school setting, Fabiano points out.
“They’re often only seen or heard when they’ve been misbehaving, and oftentimes the adults miss opportunities to engage with them when things are going the right way,” he said.
The daily report card can reinforce positive behavior for students with ADHD
Receiving positive affirmation is critical to the success of all students. But forms of positive reinforcement that motivate most students, like quarterly or semester report cards, don’t necessarily have the same effect on kids with ADHD, said Fabiano.
“Traditional report cards don’t do enough to make a difference for children who are prone to outbursts or other challenging behaviors,” he said. But daily report cards can, especially for elementary and middle school students.
The tool sets specific, daily goals to which the classroom teacher, student, and his or her parents or guardians agree in advance. When those goals are met, the student—with parents’ buy-in—receives a specific and previously agreed upon home-based reward, like a slightly later-than-usual bedtime or screen time privileges.
Fabiano offers advice on how to make the daily report card effective, starting with making sure the goals are clear and objective.
“It’s not just, ‘I had a good day.’ It’s ‘I completed my work within the time given,’ or ‘I had no more than three reminders for calling out during the lesson,’” he said.
Providing feedback in real time, throughout the day, also helps, said Fabiano, as it gives the child an opportunity to course correct if needed.
“The daily report card gives the opportunity for the child to have a great day and positive attention,” he said. “But also, if they have a rocky day, they have a clean slate the next day. That’s what’s often missing in interventions for kids with ADHD.”
A 2025 study by Fabiano and colleagues found the use of these daily report cards effective. The study included 213 students ages 5 through 13, all of whom had ADHD and an individualized education program in special education classes. One group of students received daily report cards tailored to their specific needs. The other group did not.
Diligent use of the strategy resulted in significantly improved classroom behavior and fewer incidents of disruptive or rule-breaking behavior for students compared to those who received standard special education support, the researchers found.
For older students with ADHD, individualized support can keep them on track
High school students with ADHD may not respond well to the idea of a daily report card, but they can still benefit from the positive reinforcement of trusted adults.
Bryan Rotella, the principal of Niagara Falls High School in New York, has adopted a system that focuses on providing individualized support from assigned staff members to students with behavioral challenges. PASS, which stands for Positive Approaches to Student Success, aims to improve students’ attendance, behavior and coursework through regular touchpoints—from helping students build class schedules or agendas, offering support on coursework, making sure they’re coming to school on time, or helping with whatever aspect of school that presents a struggle.
The program enrolls about 100 of its estimated 2,150 students; about 75% of students who participate have been diagnosed with ADHD or exhibit symptoms of the disorder. Staff members assigned to support them may be a teacher, paraprofessional, or other educator. The primary criteria for staff members, Rotella said, includes “people who have developed great relationships with the student body as a whole.”
As for the students, he said, “they don’t necessarily have IEPs, but they are on the cusp of falling off the fence.”
These supportive staff members understand how overwhelming high school can feel for a student with attention issues, Rotella said.
“Think about a school schedule where you have seven or eight classes in a day, and they almost never align with one another,” he said. “It’s like a champion reassuring these students that they’re not in this alone.”
Rotella believes that program, which has been active for the past five years, has had a significant impact on the school’s graduation rate. In 2019, the school’s graduation rate was 66%. In 2024, the most recent year for which data are available, the graduation rate reached 82%—an increase that included students with symptoms of ADHD.
Effort on the front end pays off in the long run
Fabiano emphasized that he does not place blame on teachers for the poor outcomes of students with ADHD.
“I have empathy for educators. It’s hard work to manage a whole classroom of children,” he said.
So too, he acknowledges, is effectively addressing students’ behavioral challenges, whether that entails developing daily report cards for students in elementary school or assigning individual trusted adults to provide ongoing support to struggling high schoolers. But he sees the value in putting in the effort up front.
“If there is any child in the class that’s taking up most of a teacher’s time already, it’s probably the child with the disruptive behaviors,” Fabiano said. “And if you can figure out an approach that helps that child be more successful and promote your ability to do what you really want to do, which is to educate the students in your class, that investment is probably worthwhile because of the long-term dividends it’s going to pay.”
