WHAT DO STUDENTS WITH DYSLEXIA, ADHD, AND AUTISM NEED TO BE SUCCESSFUL? - NORRINE RUSSELL, PH. D.
“That student is impossible—they won’t do anything you
ask.” In a perfect world, all students
with multiple exceptionalities would be well understood
and effectively supported by all members of their
education and treatment team. In reality, that’s rarely the
case, despite the best intentions on the part of school
personnel and medical providers and the children
themselves. All professionals need to understand the
individual complexity of children with
multiple disabilities, meet them where they are at, and
have a variety of personalized strategies for helping
them to learn, grow, and develop. These ten guidelines
provide professionals a road map for what to consider
when working with complex kids with multiple
neurodevelopmental disorders. “Impossible” kids
become kids with remarkable potential when adults
change their lens and their own behaviors.
1. COMPLEX STUDENTS NEED US TO
OBSERVE AND LEARN ABOUT EACH ONE.
Individuate them from other students. All three of
these conditions can look very different in individual
students and when students have a combination of
neurodevelopmental conditions, it’s vitally important to
understand that particular student, their mind, and what
works and doesn’t work for them. Avoid generalizing
and making assumptions about students with dyslexia,
ADHD, and autism. Students with multiple diagnoses
are always complex students and it will take time to get
to know each one. As the saying goes, “If you’ve met
with one person with autism, you’ve met one person
with autism.” That is infinitely more true for students
with autism, dyslexia, and ADHD. A good question to
ask ourselves is, “How does this child’s exceptionalities
affect them? How do they manifest in this child?”
2. UNDERSTAND AND EDUCATE YOURSELF
ABOUT THE STUDENTS DIAGNOSES
AND COMORBIDITIES. AT A MINIMUM,
PROFESSIONALS SHOULD KNOW THE
FORMAL DIAGNOSTIC CRITERIA FOR EACHDISORDER SO THEY CAN DIFFERENTIATE
SYMPTOMS AND BEHAVIORS.
Many times, actions that are undesirable or problematic
are labeled as behaviors or choices when in reality
they are symptoms. For example, when a teacher says,
“If Mason would just settle down in class and focus
better, he wouldn’t have a problem in this class. I know
he’s bright, he’s just not trying.” If adults working with
students like Mason understand that inconsistency in
effort and poor motivation for routine tasks is part of the
ADHD neurology, they would understand that coaching
his executive functioning skills is going to have a bigger
payoff than making assumptions or judgments.
3. KNOW WHAT IS AND IS NOT EVIDENCE
BASED INTERVENTIONS FOR DYSLEXIA,
ADHD, AND AUTISM.
Far too few people understand that there are
interventions that work for each of these disorders and
interventions that have very little scientific backing. It’s
imperative that when interventions are implemented,
the results are tracked. Multi-sensory instruction is
a strategy that should be helpful to students with all
three conditions, as should small group instruction and
manipulatives.
4. IDENTIFY KEY STRENGTHS IN THEIR
EXECUTIVE FUNCTIONING.
The Dawson & Guare model outlined in the Smart but
Scattered series of books is a useful framework for
doing this as it includes assessment questionnaires for
all ages, from young children through adults. In their
model, they identify eleven executive functioning skills in
a developmental order (Fig. 1). Help the student connect
these strengths to their goals and strategies for goal
attainment. “Liam, one of your best strengths is task
initiation. This means you often have an easy time
starting tasks in class or at home. You decided you
wanted to get 100% of your homework done this week–
let’s figure out how to use your ability to get
started to achieve your goal.”
5. IDENTIFY KEY CHALLENGES IN A
COMPLEX STUDENT’S EXECUTIVE
FUNCTIONING.
Identifying key challenges shifts the lens from
motivation or effort to seeing what skills might be
lagging. It’s important to recognize that the goal isn’t
to develop every skill perfectly but to identify the pain
points and provide scaffolding. “Liam, one of the areas
that’s hard for you is task completion (goal-directed
persistence). Let’s find three things to try this week to
help you finish your math homework after your initial
enthusiasm is gone.” A student with dyslexia, autism,
and ADHD may need more scaffolding for a longer
period of time and multiple accommodations. With
sufficient training and practice, education professionals
can coach executive functioning skills using a
multisensory approach, with a clear structure, breaks,
and rewards.
6. SET SPECIFIC, MEASURABLE, ATTAINABLE
GOALS WITH THE STUDENT.
Engaging the student at the very beginning of the
process is essential for success. Whether you create
the goals together or choose goals from a set of
possibilities (this can work better for some students with
autism), the student has to have voice and agency in
determining how their efforts will be directed. Use multi-
sensory methods to create checklists, prompts,
reminders, and progress reports. Goals should be
reviewed weekly, with the student reflecting or reporting
first and the professional adding their feedback after
listening and guiding the student’s input. For example,
“What went well this week, Nathan? Which goals did
you make progress on? How did you achieve that?”
From there, the discussion can shift toward questions
like, “What do you wish you had been able to do this
week that you didn’t? What got in the way?”
7. BASE YOUR GOALS ON DEVELOPMENTAL
AGE, NOT CHRONOLOGICAL AGE.
Students with ADHD can be delayed three years or even
30% of their chronological age in certain areas of
development. Furthermore, development tends to
be uneven across domains of development—that is,
one child could have verbal skills above most of their
peers, but have emotional development more akin to a
student three grades younger. However, we can’t simply
assume a developmental age—assessment is needed
in the domains of physical, cognitive, social, emotional,
and speech/language. Knowing the areas of strength
versus relative weakness is vital to understanding and
supporting that individual child. For example, Ethan,
a fifteen year old who has attended school and been
home schooled, has speech and language skills that
are off the charts. In terms of physical development, he
can’t print all of his letters, tie his shoes, or use eating
utensils. What does Ethan need? Praise and respect for
the skills he does have and slow, methodical practice of
fine motor tasks.
8. PLAN A SYSTEM OF REWARDS WITH THE
STUDENT.
As a general principle, rewards are anything of value
that reinforces the desired behavior. Rewards are far
more powerful than punishment and are especially
important for neurodiverse students. When students
with ADHD are being asked to do tasks that are non-
preferred or students with autism are being asked to
step outside their comfort zone, it’s important that their
efforts are rewarded in a way that is significant and
meaningful to them. These are some of the most difficult
tasks for students and their brain alone may not send
them a strong enough positive message. This is where
having designed a system of rewards with the student
becomes so valuable. The desired, highly valuable
reward helps the student overcome their anxiety,
rigidness, or lack of internal motivation. It’s important to
stress that the student must be involved in choosing
their rewards and setting up the milestones for earning
them.
9. USE BREAKS WISELY. USE ROUTINE
WISELY.
Students with multiple exceptionalities, even those
with above average intelligence or giftedness, can find
themselves more easily fatigued during school or when
completing academic work. Dyslexia is creating a higher
demand for cognitive processing, ADHD is distracting,
and autism can create sensory overload. When Daniel is
at school, he finds himself in need of more frequent
breaks to just allow his brain a time to rest. The five
minutes between classes is almost never enough for him, “I’m still thinking and rushing during that time to
get to my next class and be prepared while trying to
remember all the last minute directions from the last
class that I didn’t have time to write down.” Breaks allow
all people to have a sufficient pause, atypical students
may need a longer chronological period of time for
an effective pause. Routine also decreases stress in
that it lessens cognitive overload. When students know
what to expect and what will be expected of them, they
need less executive functioning skills and can harness
their cognition toward learning and analyzing content.
Sharise says, “My biology teacher is great! She always
starts class with a brief recap of the day before, tells us
the three major topics for the day, and ends with a short
five question quiz.” Because Sharise knows how class
is likely to flow, she can focus on learning biology not
figuring out what’s going to happen next. Breaks and
routines are equally important for complex students
and need to be individualized for maximum benefit. This
doesn’t have to mean an individualized schedule, simply
individual accommodations that work for that student.
10. CELEBRATE.
Sharing genuine joy and respect for a student’s
achievement is one of the best feelings in the world.
Avoid phrases like, “I knew you could do it” or “That’s
what happens when you work hard.” Instead use
phrases that develop the student’s own self-respect and
pride, such as, “How does it feel to achieve your goal?
When did you realize you were going to be successful?”
These types of questions also build the most important
executive functioning skill–metacognition.
These guidelines are not complicated to implement.
They require a shift in perspective, careful observation,
and flexibility on the part of professionals and parents.
The time spent understanding the individual child and
their unique profile of strengths and weaknesses pays
off significantly in helping students to create focus,
engagement, and connection. Remember, “If you’ve
met one child with autism, dyslexia, and ADHD, you’ve
met one child with autism, dyslexia, and ADHD.” They’re
not all the same.