Reference Tool — Not an Assessment

Attention-Deficit/Hyperactivity Disorder (ADHD)

Purpose: an educator reference guide covering what staff may see, what may be happening underneath, and what to do next for Attention-Deficit/Hyperactivity Disorder (ADHD). It separates the three recognised presentations — predominantly inattentive, predominantly hyperactive-impulsive and combined — wherever that distinction is useful, while also showing the substantial overlap between them. It is not a diagnostic test, ADHD screener, medication guide, treatment plan or clinical assessment.

Core educator principle. The diagnosis gives useful context, but it does not tell staff why a particular behaviour happened. Observe the task, environment, timing, skill demands, relationships, health factors and consequences before assigning intent or function.

How to read this guide

Evidence category	Meaning in this resource	Examples
Core diagnostic features	Features that define ADHD in diagnostic systems. Outward presentation varies by age, task and setting.	Persistent developmentally inappropriate inattention and/or hyperactivity-impulsivity causing impairment across important areas of functioning.
Presentation-specific patterns	Differences expected when inattentive symptoms, hyperactive-impulsive symptoms, or both are currently prominent.	Losing track of multi-step work may be especially visible in inattentive presentation; excessive movement or interrupting may be especially visible in hyperactive-impulsive presentation.
Common associated differences	Frequently reported in ADHD populations but not required for diagnosis.	Executive-function difficulties, emotional dysregulation, sleep problems, social difficulties, time-processing difficulties.
Co-occurring conditions	Separate conditions that commonly overlap and may alter the school presentation.	Specific learning disorder, autism, anxiety, depression, ODD/conduct problems, tic disorders, language disorder, sleep disorders.
Popular / emerging concepts	Commonly discussed descriptions that may capture real experiences but are not formal diagnostic criteria or have variable evidence.	“Interest-based nervous system”, rejection sensitive dysphoria, sensory-seeking explanations for all movement.
Not safe to infer from behaviour alone	Possible explanations that require assessment rather than assumption.	Medication effect, pain, trauma, bullying, substance use, sleep deprivation, hearing/vision problems, mood disorder, seizure activity.

Start with a presentation

Click the one closest to what you're seeing. Each page covers what it is, what it can look like at school, and what helps.

Foundations

What ADHD is, and the three current presentations.

Attention, memory & task initiation

Attention regulation, working memory, and starting/finishing tasks.

Movement, motivation & reward

Why movement happens, and how task design affects motivation.

Listening, sensory & sleep

Language access, sensory factors, and sleep's effect on the school day.

Presentation across people & time

Girls and missed presentations, developmental change, medication, and co-occurring conditions.

Across the school day

How each presentation looks through the day, and a behaviour translation matrix.

Adult response & practical adjustments

Response principles, adjustments by presentation, and what commonly backfires.

Data & escalation

Useful school data, and when to escalate beyond the classroom.

Quick reference

A fast checklist and phrase swaps for busy moments.

Evidence base

The full reference list, with DOI links where available.

Reference note: this guide is an educational synthesis, not a substitute for formal assessment, diagnosis, safeguarding procedures, or individual clinical advice. Prepared 31 August 2026.

ES tools that may help

ES tools that may help with the classroom patterns you selected. These products do not assess or treat the condition above. They provide practical classroom systems that may help with some of the behaviours, demands, communication needs or regulation patterns you are seeing. Demand/capacity mismatch, sustaining engagement, and translating inattentive/impulsive behaviour into useful classroom responses.

Instructional Demand System

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Engagement System

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Behaviour Translation Guide

A$200

Currently available for Primary settings.

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Predominantly inattentive presentation

Often less externally disruptive, but the functional impact can be substantial.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

Predominantly inattentive ADHD is often less externally disruptive, but the functional impact can be substantial. Students may spend significant effort trying to hold instructions, organise materials, begin tasks, maintain attention and recover after distractions without attracting adult attention.

@What staff may see

Looks out the window, doodles, daydreams or appears mentally elsewhere
Starts after everyone else despite understanding the work
Misses the second or third part of an instruction
Completes some questions and unintentionally skips others
Forgets books, devices, chargers, homework, notes or due dates
Produces work that is inconsistent with verbal knowledge
Needs repeated reminders to return to the current goal
Appears slow because time is lost to drifting, searching, re-reading or restarting
Works well one-to-one but falls apart in independent work
Can focus strongly on interesting material, which may lead adults to question the authenticity of difficulties

✓What may be happening underneath

Observed pattern	Possible mechanism to test	Do not jump straight to
Does not start	Task-initiation difficulty; unclear first step; low salience; working-memory loss; avoidance because the task is hard.	“Lazy” or “does not care”.
Does not finish	Attention drift; weak time monitoring; task too long; lost place; competing stimuli; learning difficulty.	“Refusal”.
Forgets instructions	Working-memory overload; attention was captured elsewhere; instruction too long or delivered while transitioning.	“Wasn't listening on purpose”.
Careless errors	Speed, missed details, weak self-monitoring, attentional lapses.	“Doesn't take pride in work”.
Loses materials	Organisation and prospective-memory difficulty; too many storage locations or transitions.	“Irresponsible”.
Quiet but failing	Low visibility of impairment; shame; compensating; not asking for help.	“No behaviour problem, so no support needed”.

!Keep in mind

Inattentive presentation can be obscured by high ability, strong compliance, structured home support or a teacher who externally organises the student. Problems may become much more visible when workload, independence and timetable complexity increase.

Predominantly hyperactive-impulsive presentation

Difficulty stopping an action, delaying a response, or regulating activity to match the setting.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

Hyperactive-impulsive presentation is often more visible because difficulties occur in real time around movement, waiting, inhibition and response speed. The core problem is not simply “too much energy”. Behaviour can reflect difficulty stopping an action, delaying a response, tolerating waiting or regulating activity to match the setting.

@What staff may see

Fidgeting, rocking, tapping, manipulating objects or repeatedly changing posture
Leaving the seat, roaming, standing or finding reasons to move
Talking frequently, calling out, answering before the question is finished
Interrupting, entering games or conversations rapidly, touching others' materials
Difficulty waiting in lines, turn-taking, group games or whole-class discussion
Acting before checking rules, instructions or likely consequences
Rapid escalation during waiting, boredom, restraint or repeated correction
Accidents, rough play or risk-taking that occur faster than reflective decision-making
Apparently “not learning from consequences” when the problem is failure to inhibit in the moment rather than lack of knowledge

✓Useful interpretation

What staff see	Possible mechanism	Helpful adult move
Blurting	Response is released before the stop/check process catches up.	Build a response delay cue; use private visual prompts; allow alternative response channels.
Leaves seat	Movement need, restlessness, low stimulation, task escape, or all of these.	Work out the pattern; provide purposeful movement if it improves access rather than using movement only as a reward.
Interrupts peers	Impulse control + social timing; desire to join before the moment passes.	Pre-correct expected entry; practise one concrete joining strategy; cue privately.
Grabs / touches	Action precedes inhibition.	Reduce tempting clutter; increase proximity; teach and cue the replacement action.
Acts despite knowing rule	Knowledge is present but does not reliably control behaviour at the point of performance.	Bring the cue closer to the moment; reduce delay between cue, action and feedback.

!Do not overgeneralise

Movement is not automatically “sensory seeking”, deliberate disruption or proof that the work is too easy. It can have different functions on different occasions. Observe what changes when movement, task difficulty, stimulation, adult proximity or waiting time changes.

Combined presentation

Clinically significant symptoms from both domains at once.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

Combined presentation includes clinically significant symptoms from both domains. In school, this can create a double load: the student may have difficulty maintaining the goal and organising the task while also having difficulty inhibiting competing actions, speech or movement.

@What makes combined presentation tricky for staff

An adult may successfully reduce movement but the student still cannot organise or sustain the task
A student may understand the instruction but respond before fully processing it
Rapid activity can hide working-memory failures; staff see the movement but miss that the student has also lost the task sequence
Repeated correction can increase emotional load and further reduce working memory and inhibition
Success can vary sharply by lesson, teacher, time of day, interest, structure and fatigue
Different domains may dominate across development: visible hyperactivity may reduce while disorganisation, distractibility or internal restlessness remain

✓How the two components combine

Situation	Inattentive component	Hyperactive-impulsive component	Possible result
Independent worksheet	Loses place / goal	Starts rapidly without checking	Skipped questions, careless errors, incomplete work
Group discussion	Misses part of others' comments	Blurts / interrupts	Peer conflict or being seen as rude
Transition	Forgets items / next location	Moves before instructions finish	Arrives without equipment or in wrong place
Assessment	Attention drifts across long task	Responds too quickly	Knowledge underestimated despite adequate understanding
Conflict	Loses track of verbal detail	Responds before pause	Fast escalation and weak recall of sequence afterward

Executive function and ADHD

Group-level executive-function differences are well supported in ADHD.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

Executive functions are the control processes used to maintain goals, inhibit responses, hold and manipulate information, shift strategies, plan, organise and monitor performance. Group-level executive-function differences are well supported in ADHD, but not every person shows the same profile and executive-function tests do not diagnose ADHD.

@What executive load can look like

Executive demand	Possible classroom expression	Useful support principle
Inhibition	Blurting, touching, acting before reading all instructions.	Move cues closer to the action; reduce unnecessary delay; rehearse the stop/check routine.
Working memory	Forgets multi-step instructions; loses what they were doing.	Externalise information: written steps, visual sequence, checklist, worked example.
Planning	Starts without a sequence; underestimates materials/time.	Show the plan; model backward planning; define the first concrete action.
Organisation	Lost materials; messy digital files; missed submissions.	Reduce locations; consistent naming/storage; end-of-lesson reset routine.
Task initiation	Knows what to do but does not begin.	Make start tiny and visible; prompt the first action rather than repeating the whole demand.
Self-monitoring	Does not notice skipped work/errors.	Build scheduled check points; use brief checklists rather than “check your work”.
Shifting	Gets stuck on current activity or idea.	Give transition warning, finish point and next-step cue; distinguish ADHD shifting from autism-related sameness needs.

Inhibition and impulsivity

Not equivalent to recklessness, disrespect or a lack of values.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

Impulsivity is not equivalent to recklessness, disrespect or lack of values. A student can know the rule, agree with the rule and still have difficulty pausing long enough for that knowledge to control behaviour in the moment.

@High-risk school moments

Competitive games, teasing and fast peer exchanges
Lining up, assemblies, buses and unstructured transitions
Practical subjects with equipment
Online chat, rapid posting or device use
Conflict where verbal exchanges accelerate
Activities that combine excitement, waiting and peer attention

!Safety principle

Where impulsivity creates genuine safety risk, environmental controls and direct supervision may be necessary. Do not rely on repeated verbal reminders as the only control when the student has already shown that inhibition fails under those conditions.

Time perception and time management

Externalising time can help when estimation and self-monitoring are weak.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

Meta-analytic evidence indicates that children and adolescents with ADHD, as a group, show differences in time perception and timing accuracy. These effects are variable and do not mean every student has “time blindness”, but externalising time can be useful when time estimation and self-monitoring are weak.

@What staff may see

“Five minutes” seems either immediate or distant rather than proportionate
Underestimates how long setup, writing, packing or transition will take
Does not start because the deadline does not yet feel urgent, then works intensely near the end
Loses substantial time after a small distraction
Cannot explain where the lesson went despite being busy for much of it

✓Useful supports

Visible countdowns or timers
Intermediate deadlines rather than one distant due date
Time estimates paired with actual measured time to build calibration
Clear “start by” and “finish by” markers
Transition cues that specify what must be completed before moving

Social functioning and peer relationships

Group-level difficulties, though the pathway differs between students.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

Children and adolescents with ADHD show group-level difficulties in everyday social functioning, although the pathway differs between students. Attention lapses, impulsive speech, weak inhibition, emotional reactivity and missed social information can all contribute.

@What peers may experience

What peers may experience	Possible ADHD-related contributor	Support focus
“They never listen”	Attention shifts during conversation; working-memory loss.	Brief check-back, teach repair language, reduce competing stimuli.
“They interrupt everything”	Impulsive entry / fear of losing thought.	Visual cue, agreed wait signal, practise joining.
“They go too far”	Difficulty monitoring intensity in fast play.	Pre-correct boundaries; use immediate private feedback.
“They overreact”	Rapid emotional escalation.	De-escalate first; process social meaning after regulation.
“They forget plans”	Prospective-memory / organisation difficulty.	External reminders rather than moralising reliability.
“They dominate”	High verbal output, poor turn timing.	Structured turn-taking and explicit conversational cues.

!Keep in mind

Do not attribute every social difficulty to ADHD. Autism, language disorder, hearing difficulty, anxiety, bullying, trauma and ordinary peer dynamics may need separate consideration.

Emotional regulation

Can contribute substantially to impairment, though not a defining diagnostic criterion.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

Emotional dysregulation is common in ADHD research and can contribute substantially to impairment, but it is not one of the defining diagnostic criteria. It can also arise from anxiety, mood disorder, trauma, autism, sleep loss, learning frustration, peer conflict and many other causes.

@Possible school patterns

Rapid frustration when blocked, corrected or made to wait
Emotional response rises faster than reflective control
Reaction may be intense but relatively brief once the trigger passes
Difficulty shifting away from perceived unfairness or a social mistake
Shame after repeated correction or public failure
Greater dysregulation late in the day, after sustained self-control or poor sleep

!Rejection Sensitive Dysphoria

RSD is widely used in ADHD communities but is not a formal DSM or ICD diagnosis and does not have a settled diagnostic definition. Educators can respond to observable rejection sensitivity, shame, distress and emotional reactivity without labelling those experiences as RSD.

ADHD in plain language

A persistent pattern of inattention and/or hyperactivity-impulsivity.

Reference tool — informs practice, does not diagnose or label.

iADHD in plain language

ADHD is characterised by a persistent pattern of inattention and/or hyperactivity-impulsivity that is inconsistent with developmental expectations and interferes with functioning. Diagnostic systems require that symptoms begin during development, are evident across more than one important setting, and are not better explained by another condition. There is no single classroom behaviour or single test that establishes ADHD.

The term “attention deficit” can be misleading for educators. Many students with ADHD can focus intensely under some conditions. The difficulty is often regulation of attention: directing it, sustaining it, shifting it, resisting competing stimuli, holding the goal in mind and re-engaging after interruption. The same student can therefore appear unable to start routine work but remain absorbed in a preferred activity for a long period. That inconsistency is compatible with ADHD and should not automatically be interpreted as proof that the student could perform the same way under every condition.

@The two diagnostic symptom domains

Inattention	Hyperactivity / impulsivity
Difficulty sustaining attention; errors from missed details; appearing not to listen; incomplete follow-through; organisation difficulty; avoiding sustained mental effort; losing items; distractibility; forgetfulness.	Fidgeting or leaving seat; excessive movement or internal restlessness; difficulty engaging quietly; seeming “on the go”; excessive talking; blurting; difficulty waiting; interrupting or intruding.

!Important

Symptoms must be interpreted developmentally. A highly active 6-year-old and a restless 16-year-old cannot be judged against the same behavioural expectation.

The three ADHD presentations

Inattentive, hyperactive-impulsive, and combined.

Reference tool — informs practice, does not diagnose or label.

@The three ADHD presentations

Presentation	What is currently prominent	Common school visibility	What can be missed
Predominantly inattentive	Clinically significant inattentive symptoms with few or insufficient hyperactive-impulsive symptoms.	Incomplete work, lost materials, drifting, weak follow-through, slow re-entry after interruption, missed instructions, disorganisation.	The student may be quiet, compliant and not disruptive, so impairment can be underestimated.
Predominantly hyperactive-impulsive	Clinically significant hyperactive-impulsive symptoms with few or insufficient inattentive symptoms.	Movement, talking, blurting, touching, leaving seat, rapid responding, waiting difficulty, acting before checking.	Staff may focus on behaviour management and miss genuine inhibition, timing or regulation difficulty.
Combined	Both inattentive and hyperactive-impulsive symptom sets are clinically significant.	A mixture: organisation and attention failures plus movement, impulsivity and behavioural inhibition difficulties.	Different domains may dominate at different times; “combined” does not mean every symptom is equally visible or that the student is necessarily more severe.

Attention regulation: more than “pay attention”

Attention is not one skill — several processes can each be affected differently.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

Attention is not one skill. School requires selective attention, sustained attention, shifting, divided attention, resistance to distraction and re-engagement after interruption. ADHD can affect these processes differently across people and tasks.

@Why performance can look inconsistent

Novelty, urgency, immediate feedback, personal interest or close adult interaction can temporarily improve engagement
Long delay, repetitive work, unclear payoff, low stimulation or competing stimuli can expose difficulties
A student may attend to a preferred detail while missing the teacher's broader goal
After distraction, the main cost may be re-orienting to the goal rather than the distraction itself
Fatigue, stress, sleep loss and emotional arousal can further reduce attention control

!Popular phrase vs evidence

“Interest-based attention” is a useful shorthand for some lived experiences, but it is not a diagnostic criterion and should not be treated as a complete neurobiological explanation. The safer educator conclusion is that attention in ADHD is often highly context-sensitive, and task salience, immediacy and feedback can matter.

Working memory and instruction load

Taxed when students listen, remember a sequence and inhibit distractions.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

Working memory is the capacity to hold information active while using it. In school, this is taxed when students listen, remember a sequence, inhibit distractions and begin before the instruction disappears from active memory. Working-memory difficulty can look like defiance when a student repeatedly asks “what am I doing?” or starts only the final part of a direction.

✓Reduce memory load without reducing the learning goal

Give shorter instruction chunks, then check the student can identify the first action
Pair spoken directions with visible steps
Leave key information available rather than requiring the student to remember it while working
Avoid adding corrective language while the student is trying to hold the original instruction
For multi-stage tasks, use completion markers so the student does not need to mentally track the whole sequence
When possible, assess the intended curriculum skill rather than memory for procedural directions

Task initiation, persistence and completion

ADHD can affect the transition from intention to action.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

“Can do” and “can reliably start and complete under current conditions” are different questions. ADHD can affect the transition from intention to action, especially when tasks are long, delayed in payoff, repetitive, vaguely defined or require several self-generated steps.

@Barriers and what to test

Barrier	What it can look like	Adjustment to test
Unclear start point	Stares, chats, sharpens pencil, opens unrelated tabs.	Define one visible first action.
Task too large	Avoidance until deadline; gives up early.	Chunk into short units with clear finish points.
Delayed payoff	Chooses immediate competing activity.	Increase immediacy of feedback; make progress visible.
Weak time monitoring	Works too slowly or leaves everything until late.	Use external timer/visual timeline and intermediate check points.
Low confidence / learning difficulty	Avoidance labelled as ADHD.	Check actual skill level; provide scaffold or learning assessment.
Repeated failure history	Protective disengagement or “I don't care”.	Use achievable entry point and feedback tied to process, not moral judgement.

Movement, restlessness and arousal regulation

Movement can serve several different functions.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

Hyperactivity can be overt — running, climbing, leaving the seat — or more subtle, such as constant fidgeting, object manipulation, rapid talking or an internal sense of restlessness. The form often changes with age and social expectations.

@Movement can have different functions

Possible function	Clues	What to test
Regulating arousal / alertness	Movement increases during low-stimulation work and may improve engagement.	Allow low-disruption movement and compare work access.
Escaping task difficulty	Movement appears when a particular demand is presented.	Check skill, clarity and task size; do not assume movement need alone.
Seeking stimulation	Touching objects, talking, novelty seeking during repetitive periods.	Increase active responding, variation and immediate feedback.
Habit / motor restlessness	Movement occurs across preferred and non-preferred tasks.	Use acceptable movement options without making stillness the main success criterion.
Social attention	Movement reliably produces peer/adult reaction.	Alter attention contingencies and teach alternative access to interaction.

Motivation, reward, delay and task salience

Altered reward and delay-related processes are part of some ADHD models.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

Research supports altered reward and delay-related processes as part of some ADHD models, but motivation should not be simplified to “ADHD brains only work for dopamine” or “they can only do interesting things”. Those claims go beyond what educators can safely infer.

@Practical interpretation

When the task has…	ADHD difficulty may be more visible because…	Educational design response
Distant outcome	The consequence is temporally remote.	Add nearer milestones and feedback.
Low novelty / repetition	Attention and arousal may drift.	Increase active responding or vary practice while keeping the learning goal.
Unclear success criteria	The student cannot see progress.	Make completion and quality criteria visible.
High competing reward	Peer talk/device/activity offers immediate payoff.	Reduce competing access during the task and make progress feedback more immediate.
All-or-nothing workload	Reward arrives only after a long effort.	Chunk and acknowledge completion of meaningful stages.

Listening, language and processing demands

Attention and working-memory demands can make spoken language less accessible.

Reference tool — informs practice, does not diagnose or label.

@Watch for the difference

Pattern	Possible interpretation
Cannot repeat the instruction but can do it when shown	Attention/working-memory load may be important.
Consistently misunderstands vocabulary, grammar or inference	Consider language or learning difficulties rather than assuming ADHD.
Appears not to listen during eye contact demands but follows the task	Do not make eye contact the test of listening.
Talks excessively yet struggles to organise written responses	Verbal output and written executive demands are different skills.

Sensory factors: associated, not diagnostic

Not a core diagnostic criterion, though it may still affect attention or regulation.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

Sensory differences are reported in some people with ADHD, but sensory hyperreactivity or hyporeactivity is not a core ADHD diagnostic criterion. Noise, visual movement, tactile access and crowded environments may nevertheless affect attention or regulation for an individual student. Autism, anxiety and other co-occurring conditions can also contribute.

!Educator rule

Describe the sensory condition and the observed effect before assigning a mechanism. “Stops writing and covers ears when chairs scrape” is useful data. “Has sensory processing disorder because they have ADHD” is not.

Sleep, fatigue and the school day

Can worsen attention, inhibition, mood and daytime functioning.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

Sleep problems are common in children with ADHD and can worsen attention, inhibition, mood and daytime functioning. Recent meta-analytic work has found group-level differences in sleep continuity and efficiency, while Australian guidance recommends that sleep be considered in ADHD care.

@School clues worth documenting

Major difference between first and last lessons
Dozing, headaches, repeated lateness or difficulty waking reported by family
Marked day-to-day variability linked to sleep
Sudden worsening after a previously stable period
Increased irritability, movement or disengagement that is not explained by task changes

!Do not diagnose sleep problems from school

Record the pattern and communicate concern through the appropriate pathway. Sleep-disordered breathing, insomnia, medication timing and other medical issues require clinical assessment.

Girls and commonly missed presentations

Girls are often diagnosed later than boys.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

Girls are less likely to receive an ADHD diagnosis in childhood and are often diagnosed later. Evidence suggests that lower clinical suspicion, more prominent inattentive symptoms in some girls, compensatory behaviours and diagnostic overshadowing by anxiety or depression may contribute. This is a detection problem, not evidence that girls “have a different disorder”.

@Patterns that may be easier to miss

Quiet inattention rather than obvious disruption
High effort to appear organised followed by exhaustion or collapse at home
Perfectionism or anxiety masking task-initiation and executive-function difficulty
Friendship problems interpreted only as emotional sensitivity
Good grades achieved through disproportionate time, parental scaffolding or crisis-driven work
Rapid deterioration when secondary-school workload requires more independent planning

!Keep in mind

These patterns can occur in any gender. They should increase curiosity, not be used as a separate diagnostic checklist.

Developmental change and why presentation can shift

The form of ADHD often changes as developmental expectations change.

Reference tool — informs practice, does not diagnose or label.

@Presentation across development

Stage	Demands that commonly increase	What may become more visible
Early primary	Sitting, turn-taking, early routines, basic inhibition.	Movement, blurting, waiting difficulty, incomplete directions.
Upper primary	Longer independent work, materials, homework, peer complexity.	Organisation, sustained attention, emotional/social consequences.
Secondary	Multiple teachers, deadlines, device management, self-directed study.	Time management, missing work, lateness, sleep interaction, internal restlessness.
Post-school / tertiary	Self-generated structure and distant deadlines.	Planning, initiation, attendance, sustained independent workload.

Medication and what educators can observe

School observations can provide useful functional information when shared appropriately.

Reference tool — informs practice, does not diagnose or label.

iWhat it is

Medication is a clinical treatment decision. Educators should not recommend dose changes, tell a student to stop medication, or interpret a single good or bad lesson as evidence that a medication “works” or “does not work”. School observations can, however, provide useful functional information to families and clinicians when shared appropriately.

✓Useful observations

Specific time of day and task
Observable attention, movement, impulse control, work completion and emotional regulation
Changes from the student's usual baseline
Appetite, fatigue, headache or other reported symptoms if the student raises them
Whether changes occur consistently across several days and settings

!Avoid

Diagnosing side effects; commenting that a child “needs more medication”; withholding ordinary support because medication is prescribed; assuming worsening behaviour is medication-related without considering sleep, health, environment, learning, relationships and other causes.

Co-occurring conditions and differential explanations

Frequently co-occurs with other conditions that can change the presentation.

Reference tool — informs practice, does not diagnose or label.

@If staff see… also consider

If staff see…	ADHD may contribute, but also consider…
Persistent reading, spelling or maths failure	Specific learning disorder, instruction gaps, attendance, language difficulty.
Social-communication differences, restricted interests, marked sameness needs	Autism or another communication/developmental condition.
Constant worry, avoidance, reassurance seeking	Anxiety.
Low mood, withdrawal, loss of interest, hopelessness	Depression or other mental-health concerns.
Defiance / conflict	Task difficulty, coercive interaction, ODD/conduct problems, trauma, peer dynamics.
Motor clumsiness / handwriting difficulty	Developmental coordination disorder or other motor issue.
New inattention / hyperactivity with abrupt onset	Sleep loss, medical issue, substance use, acute mental-health change or environmental stressor.
Staring / unusual episodes	Medical/neurological assessment may be needed; do not assume “zoning out”.

What ADHD can look like across the school day

Each presentation shows up differently at each point in the day.

Reference tool — informs practice, does not diagnose or label.

@Across the school day

School context	Inattentive presentation	Hyperactive-impulsive presentation	Combined presentation
Arrival	Forgets materials; slow to organise.	Rushes in; touches/talks before settling.	Arrives fast but without needed items; misses setup.
Teacher instruction	Drifts; misses later steps.	Calls out; starts before instruction ends.	Misses part then acts quickly on incomplete information.
Independent work	Late start; loses place; incomplete.	Leaves seat; seeks stimulation.	Both poor persistence and movement/impulse problems.
Group work	Loses thread; forgets role.	Interrupts; dominates; acts before group agrees.	Misses information while also entering impulsively.
Transition	Forgets next task/items.	Moves before cue; runs/talks.	Moves early and leaves required items behind.
Lunch / recess	May miss social cues through inattention.	Impulsive play, waiting problems.	Social information missed + rapid reaction.
End of day	Unfinished work; packing errors.	Restlessness after sustained control.	Fatigue amplifies both disorganisation and inhibition difficulty.

Behaviour translation matrix

A possible explanation, other checks, and a useful first response.

Reference tool — informs practice, does not diagnose or label.

iHow to use this

The following table maps common staff observations to a possible ADHD-related explanation, other explanations worth checking, and a useful first response.

@Behaviour translation matrix

What staff see	Possible ADHD-related explanation	Other explanations to check	Useful first response
“Won't start”	Initiation / low task salience / working-memory loss.	Skill gap, anxiety, unclear demand, avoidance.	Show first step; reduce task ambiguity; check skill.
“Doesn't listen”	Attention captured elsewhere / working-memory loss.	Language/hearing issue, relationship, deliberate disengagement.	Gain attention, give short instruction, ask for first action.
“Constantly interrupts”	Response inhibition / social timing.	Anxiety, excitement, learned interaction pattern.	Private cue + planned turn-taking alternative.
“Never sits still”	Hyperactivity / arousal regulation.	Task escape, pain, sensory issue, habit.	Test purposeful movement and task variables.
“Doesn't care about deadlines”	Time monitoring / distant consequence.	Low value, overwhelm, learning difficulty.	Create nearer milestones and visible time.
“Explodes over nothing”	Rapid emotional dysregulation / inhibition.	Anxiety, trauma, bullying, mood, sleep, pain.	De-escalate, then analyse trigger and load.
“Knows better but does it anyway”	Performance-control gap in the moment.	Peer reinforcement, rule disagreement, deliberate risk.	Bring cue/consequence closer; teach replacement; analyse function.
“Only works when interested”	Context-sensitive attention / salience.	Skill level, relationship, task design, avoidance.	Compare task conditions; increase structure/feedback without assuming inability.
“Always loses stuff”	Organisation / prospective memory.	Too many storage systems, rushing, environmental chaos.	One storage location + visual pack-up routine.

Adult response principles

Putting support at the point of performance, not just explaining the rule.

Reference tool — informs practice, does not diagnose or label.

iAdult response principles

1. Make the next action clearer before increasing pressure: Repeatedly saying “get on with it” adds demand without supplying the missing executive information. Identify the first observable action and the finish point.
2. Put supports at the point of performance: A rule explained yesterday may not control an impulse today. Use brief cues, environmental design and immediate feedback where the behaviour occurs.
3. Do not confuse inconsistency with dishonesty: A student can perform well under one combination of interest, structure, fatigue and adult support and poorly under another. Compare conditions before concluding that the student is choosing when to “have ADHD”.
4. Reduce public correction: Students with visible hyperactive-impulsive symptoms can accumulate many corrections. Private cues usually preserve attention, dignity and peer status better than repeated public commentary.
5. Separate skill teaching from moral judgement: Organisation, inhibition, planning, turn-taking and self-monitoring can be explicitly taught and scaffolded. Labels such as lazy, rude and careless do not identify a teachable skill.
6. Keep expectations meaningful: Adjustment does not mean removing all demands. It means changing unnecessary barriers so the student can access the intended learning, behaviour or participation goal.

Practical classroom adjustments by presentation

Matched to inattentive, hyperactive-impulsive, or combined presentation.

Reference tool — informs practice, does not diagnose or label.

@Practical classroom adjustments by presentation

Need / context	Predominantly inattentive	Predominantly hyperactive-impulsive	Combined
Instructions	Short chunks; written/visual steps; check first action.	Brief direction before movement begins; response-delay cue.	Visual steps + inhibition cue; avoid long verbal sequences.
Seating	Reduce high-value distractions; easy teacher check-in.	Allow low-disruption movement; plan space around materials/peers.	Low distraction + movement option.
Independent work	Chunk, visible progress, timed check-ins.	Active response opportunities, shorter work bouts if needed.	Chunking + movement/response structure.
Organisation	Single storage system; checklists; pack-up routine.	Reduce rushed transitions; cue before moving.	External organisation + transition cue.
Discussion	Give processing time; written participation option.	Planned turn signal; private interrupt cue.	Both response time and turn-control supports.
Assessment	Quiet setting if distraction is a barrier; clear sections.	Breaks / movement where permitted; cue to check before submit.	Quiet structure, breaks, visible time and check routine.
Feedback	Specific feedback close to task; avoid vague “focus”.	Immediate, brief, private feedback.	Frequent brief feedback on both task goal and inhibition.
Deadlines	Intermediate milestones; calendar reminders.	Avoid relying on distant consequence alone.	Milestones + immediate progress feedback.

These are examples, not a prescription. Individual learning support planning and reasonable adjustments should be based on functional need, including consideration of co-occurring conditions.

What commonly makes things worse

Some ordinary responses can backfire for students with ADHD.

Reference tool — informs practice, does not diagnose or label.

!What commonly makes things worse

Adult / environment pattern	Why it can backfire	Better direction
Long verbal lectures after an error	Adds working-memory and attention load after the key moment.	Brief correction, clear replacement, revisit later if teaching is needed.
Public correction all day	Increases shame, peer attention and conflict.	Private cue system and targeted feedback.
Taking away all movement	May worsen restlessness or attention for some students.	Define movement that is safe and compatible with learning.
“You did it yesterday, so you can do it today”	Ignores context-sensitive performance and changing load.	Identify what differed: structure, sleep, task, support, time, environment.
Vague commands: “focus”, “behave”, “try harder”	Do not specify the action to perform.	State the next observable behaviour.
Huge delayed consequences	Weak connection to the immediate decision point; can create hopelessness.	Use proportionate, predictable and closer feedback/consequences.
Removing support after one good day	Confuses successful scaffolding with absence of need.	Fade supports based on repeated independent performance.
Attributing every problem to ADHD	Misses learning, health, social or mental-health causes.	Reassess when the pattern changes or does not respond as expected.

What useful school data looks like

More valuable than global ratings such as “good day” or “hyper”.

Reference tool — informs practice, does not diagnose or label.

@Capture

Presentation context: subject, task type, group size, time of day and adult
What the student was expected to do and how instructions were given
Latency to start, length of sustained engagement, completion, accuracy or number of prompts where relevant
Movement, interrupting or leaving patterns using observable definitions rather than judgement labels
What happened immediately before and after the difficulty
Adjustments in place and whether they changed access or independence
Student report: what felt difficult, boring, confusing, overwhelming or easy
Changes from baseline, especially sudden deterioration

✓Questions worth asking

Where does this student perform better, and what is different there?
Is the barrier attention, inhibition, memory, organisation, time, skill, emotional load, social context or something else?
Does the same problem occur during preferred activities?
What happens when one variable is changed?
Are we measuring the target skill, or the student's ability to self-organise the conditions for showing it?

When the pattern needs more than a classroom adjustment

Significant change from baseline, or acute risk, warrants broader response.

Reference tool — informs practice, does not diagnose or label.

!Escalate through appropriate school, family, health or emergency pathways when there is…

Concern	Why it needs broader assessment / response
Sudden major change in attention, behaviour or activity level	ADHD is developmental; abrupt change may reflect medical, neurological, substance, sleep or mental-health causes.
Persistent low mood, hopelessness, self-harm or suicidal statements	Requires mental-health and safety response; do not attribute to frustration or ADHD.
New hallucinations, severe confusion or marked behavioural disorganisation	Requires urgent clinical assessment.
Significant weight/appetite change, fainting, chest symptoms or concerning physical complaints	Medical assessment is needed.
Severe school refusal / attendance deterioration	Consider anxiety, bullying, depression, learning difficulty, sleep, family/contextual factors and broader support.
Repeated academic failure despite ADHD adjustments	Assess curriculum access, specific learning disorder, language, intellectual/adaptive functioning, attendance and teaching factors.
Serious aggression or dangerous impulsivity	Requires risk management and functional assessment; diagnosis alone does not determine function or safety plan.

What not to automatically attribute to ADHD

Other explanations worth checking before attributing a change to ADHD.

Reference tool — informs practice, does not diagnose or label.

@What not to automatically attribute to ADHD

Observed change / concern	Other explanations that may need consideration
New aggression or irritability	Pain, sleep loss, anxiety/depression, bullying, trauma, medication/health effects, peer conflict.
Sudden inattention or “zoning out”	Sleep, anxiety, depression, seizures/neurological issue, substance use, hearing/vision, acute stress.
Poor academic progress	Specific learning disorder, language disorder, intellectual disability, attendance, inaccessible instruction, vision/hearing.
School refusal	Anxiety, bullying, learning failure, depression, sensory/environmental load, relationship problems.
Social withdrawal	Depression, anxiety, bullying, fatigue, autism, preferred solitude, peer exclusion.
Repetitive questioning / reassurance	Anxiety, OCD symptoms, language/processing difficulty, memory, uncertainty.
Constant movement	Pain/discomfort, task escape, sensory factors, habit, environmental reinforcement, other neurodevelopmental issues.
Forgetfulness after a head injury or acute illness	Medical assessment rather than assuming baseline ADHD.

Teacher rapid guide

An order to check through when a student isn't doing what you expected.

Reference tool — informs practice, does not diagnose or label.

✓Check in this order

Safety and health: Is there immediate risk, illness, pain, severe sleep loss, bullying or a major change from baseline?
Understanding: Does the student know exactly what is expected right now?
Skill: Can the student actually do the academic, organisational or social task?
Memory: Is the instruction still available, or are they expected to hold too much in mind?
Start: Is there a clear first action?
Attention environment: What is competing for attention?
Inhibition: Is the problem knowing the rule, or stopping long enough to use it?
Time: Can the student see how long they have and what progress should look like?
Load: What emotional, social, learning and executive demands are stacked together?
Adult response: Are repeated prompts, public correction or escalating consequences making performance worse?
Pattern: Where and when does this go better, and what is different there?

@High-value phrases for staff

Instead of	Try
“Focus.”	“Your first job is question 1. I'll check back in three minutes.”
“I already told you.”	“The steps are here. Show me which one you're on.”
“Sit still.”	“You can stand here or sit there. The job stays the same.”
“Stop interrupting.”	“Hold that thought. Use this cue and I'll come to you next.”
“You know better.”	“You know the rule. We need a cue that helps you use it before you act.”
“You're just not trying.”	“Something is blocking the start. Is it the first step, the task, the time, or something else?”
“Why didn't you do it?”	“Show me where it stopped working.”

Evidence base & references

The full reference list from the source document.

Reference tool — informs practice, does not diagnose or label.

iSelected references

Australian ADHD Guideline Development Group. (2022). Australian Evidence-Based Clinical Practice Guideline for ADHD. Australasian ADHD Professionals Association. adhdguideline.aadpa.com.au
Australasian ADHD Professionals Association. (2023). ADHD Factsheet for Educators. AADPA. adhdguideline.aadpa.com.au — ADHD for Educators
Australasian ADHD Professionals Association. (2023). Educational adjustments for people with ADHD. AADPA. adhdguideline.aadpa.com.au — Educational Adjustments
Faraone, S. V. et al. (2019). Emotional dysregulation in attention-deficit/hyperactivity disorder. Journal of Child Psychology and Psychiatry, 60(2), 133-150. doi.org/10.1111/jcpp.12899
Haza, B., Gosling, C. J., Ciminaghi, F., Conty, L., & Pinabiaux, C. (2024). Social cognition and everyday social skills in children and adolescents with ADHD. Journal of Child Psychology and Psychiatry, 65(9), 1245-1254. https://doi.org/10.1111/jcpp.14006
Martin, J. (2024). Why are females less likely to be diagnosed with ADHD in childhood than males? The Lancet Psychiatry, 11(4), 303-310. https://doi.org/10.1016/S2215-0366(24)00010-5
Metcalfe, K. B., McFeaters, C. D., & Voyer, D. (2024). Time-perception deficits in ADHD: A systematic review and meta-analysis. Applied Neuropsychology: Child. https://doi.org/10.1080/87565641.2023.2293712
Sadozai, A. K. et al. (2024). Executive function in children with neurodevelopmental conditions: a systematic review and meta-analysis. Nature Human Behaviour, 8(12), 2357-2366. https://doi.org/10.1038/s41562-024-02000-9
Wolraich, M. L. et al. (2019). Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of ADHD. Pediatrics, 144(4), e20192528. https://doi.org/10.1542/peds.2019-2528
World Health Organization. (2024). Clinical descriptions and diagnostic requirements for ICD-11: ADHD (6A05). WHO. icd.who.int — ICD-11 browser
Xian, P., Sheng, X., Liu, S., Liu, Z., & Guo, X. (2025). Sleep dysregulation in ADHD children: a systematic review and meta-analysis. Psychological Medicine, 55, e321. https://doi.org/10.1017/S0033291725102158
Zheng, Q., Wang, X., Chiu, K. Y., & Shum, K. K. M. (2022). Time perception deficits in children and adolescents with ADHD: a meta-analysis. Journal of Attention Disorders, 26(2), 267-281. https://doi.org/10.1177/1087054720978557
Ceruti, C., Mingozzi, A., Scionti, N., & Marzocchi, G. M. (2024). Comparing executive functions in children and adolescents with autism and ADHD. Children, 11(4), 473. https://doi.org/10.3390/children11040473

All 13 citations verified against original sources; all links now confirmed live.

Attention-Deficit/Hyperactivity Disorder (ADHD)

How to read this guide

Predominantly Inattentive Presentation

Predominantly Hyperactive-Impulsive Presentation

Combined Presentation

Executive Function & ADHD

Inhibition & Impulsivity

Time Perception & Time Management

Social Functioning & Peer Relationships

Emotional Regulation

Instructional Demand System

Engagement System

Behaviour Translation Guide

Predominantly inattentive presentation

iWhat it is

@What staff may see

✓What may be happening underneath

!Keep in mind

Predominantly hyperactive-impulsive presentation

iWhat it is

@What staff may see

✓Useful interpretation

!Do not overgeneralise

Combined presentation

iWhat it is

@What makes combined presentation tricky for staff

✓How the two components combine

Executive function and ADHD

iWhat it is

@What executive load can look like

Inhibition and impulsivity

iWhat it is

@High-risk school moments

!Safety principle

Time perception and time management

iWhat it is

@What staff may see

✓Useful supports

Social functioning and peer relationships

iWhat it is

@What peers may experience

!Keep in mind

Emotional regulation

iWhat it is

@Possible school patterns

!Rejection Sensitive Dysphoria

ADHD in plain language

iADHD in plain language

@The two diagnostic symptom domains

!Important

The three ADHD presentations

@The three ADHD presentations

Attention regulation: more than “pay attention”

iWhat it is

@Why performance can look inconsistent

!Popular phrase vs evidence

Working memory and instruction load

iWhat it is

✓Reduce memory load without reducing the learning goal

Task initiation, persistence and completion

iWhat it is

@Barriers and what to test

Movement, restlessness and arousal regulation

iWhat it is

@Movement can have different functions

Motivation, reward, delay and task salience

iWhat it is

@Practical interpretation

Listening, language and processing demands

@Watch for the difference

Sensory factors: associated, not diagnostic

iWhat it is

!Educator rule

Sleep, fatigue and the school day

iWhat it is

@School clues worth documenting

!Do not diagnose sleep problems from school

Girls and commonly missed presentations

iWhat it is

@Patterns that may be easier to miss