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.