School is often where the characteristics of ADD are first noted as problematic or cause for concern. The school setting often requires the very skills that are difficult for children with ADD--sustained attention to a task, waiting turns, and staying seated.

Problems occurring at school usually prove to be the catalyst for a diagnosis of ADD. Behavioral difficulties may first become evident at school because the child is asked to maintain attention for long periods of time, and sustain a persistent effort.

Children with ADD experience difficulties in many or all of the skills needed for academic success: starting tasks; completing tasks; making transitions; interacting with others; following through on directions; producing work consistently; and organzing multi-step tasks. If the child attends preschool, ADD is often exhibited through excessive activity and an inability to stay with play activities for sustained periods.

In elementary school, demands placed on the child to pay attention increase. Teachers may report the child is fidgety, often out of his seat, talkative and interrupting, usually looking about the classroom instead of at the teacher or chalkboard, bossy, and performing inconsistently.

In middle and high school, these children-turned-adolescents frequently settle down, no longer appearing obviously hyperactive. Instead they may be fidgety, restless, often looking about, and loud. Their poor learning skills cause academic problems and under-developed social skills result in poor peer relations.

Approximately 50% of children with ADD can be taught in the regular classroom. Teachers must be trained to recognize the special needs of these students and to make any appropriate teaching and classroom modifications. The other 50% will require some degree of special education and related services. Of this 50%, about 35-40% will primarily be served in the regular classroom with additional support personnel and/or "pull out" programs that provide special services outside of the classroom. The most severly affected, 10-15%, may require self-contained classrooms.

Researchers have identified classroom characteristics which promote success for many children who have ADD:

- Predictability

- Structure

- Shorter work periods

- Small teacher to pupil ratio

- More individualized instruction

- Interesting curriculum

- Use of positive reinforcers

The research literature also suggests a number of teacher characteristics that will be helpful in teaching children with ADD, including:

- Positive academic expectations

- Frequent monitoring and checking of work

- Clarity in giving directions

- Warmth, patience and humor

- Consistency and firmness

- Knowledge of different behavioral interventions

- Willingness to work with a special eduction teacher

Behavior management techniques must often be used in the school. By examining a child's specific problem behavior, understanding its antecedents and consequences, educators can help children with ADD develop behaviors that lead to academic and social success.