43rd International Conference of Human & Social Sciences 6-8 December 2024

ADHD: A case study in primary school

Lada Stavroula, Primary school teacher, Med (School Guidance and Mentoring), MPsy (Special Education and
School Psychology), PhD(c), Papalouka Vasiliki, Primary school teacher, Med, Kostikas Vyron, Primary school
ICT teacher, MSc, PhD(c)
Abstract
The effects of Attention Deficit Hyperactivity Disorder (ADHD) of students on their academic performance are
apparent. Children with ADHD often show low academic outcomes and deal with major educational setbacks. This
review aims to gain insight into the challenges a student in primary school copes with, ways of the teacher
approaching such a child, different types of interventions in the classroom, and the results of a structured academic
support. The method of studying the topic is action-research and it has been conducted by the teacher of the 6th grade
in a typical class of 6th grade, in a primary school in Athens, in collaboration with the two other educators in the
school, during the school year 2023-24 from October 2023 to May 2024.
Keywords: ADHD, Intervention, Individualized Education Plan, Differentiation, Inclusive Education
Περίληψη
Οι επιπτώσεις της Διαταραχής Ελλειμματικής Προσοχής και Υπερκινητικότητας (ΔΕΠΥ) των μαθητών στις
ακαδημαϊκές τους επιδόσεις είναι εμφανείς. Τα παιδιά με ΔΕΠΥ εμφανίζουν συχνά χαμηλά ακαδημαϊκά
αποτελέσματα και αντιμετωπίζουν σημαντικές εκπαιδευτικές δυσκεολίες. Η παρούσα ανασκόπηση έχει ως στόχο να
προσφέρει μια σαφή εικόνα για τις προκλήσεις που αντιμετωπίζει ένας μαθητής στο δημοτικό σχολείο, τους
τρόπους προσέγγισης ενός τέτοιου παιδιού από τον εκπαιδευτικό, τους διαφορετικούς τύπους παρεμβάσεων στην
τάξη και τα αποτελέσματα μιας δομημένης ακαδημαϊκής υποστήριξης. Η μέθοδος μελέτης του θέματος είναι η
έρευνα δράσης και διεξήχθη από την εκπαιδευτικό της ΣΤ΄ τάξης σε μια τυπική ΣΤ΄τάξη, σε δημοτικό σχολείο της
Αθήνας, σε συνεργασία με τους άλλους δύο εκπαιδευτικούς του σχολείου, κατά τη διάρκεια του σχολικού έτους
2023-24 από τον Οκτώβριο του 2023 έως τον Μάιο του 2024.
Λέξεις-κλειδιά: ΔΕΠΥ, Παρεμβάσεις, Εξατομικευμένο Εκπαιδευτικό Πρόγραμμα, Διαφοροποίηση, Συμπεριληπτική
Εκπαίδευση
1. Introduction
ADHD is a neurodevelopmental disorder that is becoming more prevalent among children. It is defined by persistent
and pervasive issues with inattention, hyperactivity, and impulsivity1. ADHD impedes academic progress, resulting
in years-long deficits that intensify as a person advance through high school. It usually arises in early childhood2. It
affects 8% of the population, though prevalence estimates vary3.
Critical aspects of executive functioning that affect academic achievement encompass working memory,
organizational abilities, strategic planning, goal formulation, and perseverance. While these core symptoms define
ADHD, individuals with the disorder also show differences in cognition and social functioning compared to
typically developing children, impacting their educational outcomes. Academic performance in students with ADHD
is often poor, not only when compared to their typically developing peers, but also in comparison with other
neurodevelopment disorders. It is common for students with ADHD to face negative perceptions from their peers4.
According to The Salamanca Statement and Framework for Action on Special Needs Education 5 from 1994, the
fundamental principles for inclusion emphasize institutions that accept every student, view diversity as an asset,

1
Wolraich M. L., Hagan J. F., Allan C., Chan E., Davison D., Earls M., et al. (2019). Clinical practice guideline for
the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and
adolescents. Pediatrics 144:e20192528. [Link]
2
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders, 5th Edn.
Washington, DC: American Psychiatric Association. [Link]
3
American Psychiatric Association (2017, July). What is ADHD? [Link]
families/adhd/what-is-adhd
4
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders, 5th Edn.
Washington, DC: American Psychiatric Association. [Link]
5
UNESCO. 1994. The Salamanca Statement and Framework for action on special needs education: Adopted by the
World Conference on Special Needs Education; Access and Quality. Salamanca, Spain, 7–10 June 1994.

1
43rd International Conference of Human & Social Sciences 6-8 December 2024

support learning, and address individual needs. Based on Mezzanotte 6, teachers should break down tasks into
smaller, manageable pieces to make students feel more comfortable and less overwhelmed. The use of teaching
materials is fundamental, emphasizing key points and writing them down to aid concentration, while reducing
scheduled tests can help alleviate exam anxiety. Additionally, asking one question at a time and utilizing Venn
diagrams can significantly enhance concentration and reduce anxiety. These methods, combined with teaching
students to take notes and use tools based on "school success skills," can greatly improve their learning experience.
Enhancing the knowledge about ADHD can significantly improve the implementation of suitable support for
children with the condition in schools. Teachers with extensive ADHD knowledge are more likely to advocate for
and utilize these services7. ADHD training for educators has been proved to boost the use of behavior management
strategies in classrooms by special education teachers8. For these reasons, this review is focused on the ways an
educator can make the appropriate interventions in the classroom so that a student with ADHD may improve
academically.
2. Theoretical part
The symptoms of ADHD begin in childhood. They impact daily life, such as social interactions and performance in
school or work. ADHD is a neurodevelopmental disorder, and it is one of the most commonly diagnosed mental
disorders in children. It cannot be prevented or cured. However, early detention and a well-structured treatment and
educational approaches can assist in managing symptoms for children with ADHD. An understanding of the
epidemiological aspects of ADHD may offer insights and information for beneficial and successful effects and
outcomes. It is essential to make a literature review, and study the causes and the symptoms of ADHD. Moreover, it
is crucial to make an approach of ADHD in association with school performance, before presenting the research
based of a case study of a pupil with ADHD.
2.1 Literature review and Causes of ADHD
DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, a diagnostic tool that was published
by the American Psychiatric Association (APA) and revised in 20229 gives a definition for ADHD. According to
DSM-5, Attention-deficit/hyperactivity disorder is a developmental disorder. It can be classified in three subtypes,
according to the strength of symptoms, predominantly inattentive, predominantly hyperactive-impulsive, and
combined. According to researches, ADHD has a global prevalence of 5.9% to 7.1% in children and 1.2% to 7.3% in
adults10.
ADHD is characterized by ongoing symptoms of inattention and/or hyperactivity and impulsivity. This disorder
interferes with functioning and development of a person. It is characterized by a pattern of extreme pervasive,
persistent and debilitating inattention, overactivity, and impulsivity. Children with ADHD experience educational
underachievement, social isolation, and significant difficulties in the post-school years11.
According to the literature review, the causes of ADHD are connected with a series of environmental factors during
different phases of the development of central nervous system (CNS). These phases are associated with gestational
and perinatal periods. ADHD has a strong family predisposition, with an increased risk in families that have a

6
Mezzanotte, C. (2020). Policy approaches and practices for the inclusion of students with attention- deficit
hyperactivity disorder (ADHD) - OECD Education Working Paper No. 238. [Link]
7
Ohan, J. L., Cormier, N., Hepp, S. L., Visser, T. A. W., & Strain, M. C. (2008). Does knowledge about attention-
deficit/hyperactivity disorder impact teachers’ reported behaviors and perceptions? School Psychology Quarterly,
23(3), 436–449. [Link]
8
Jones, H. A., & Chronis-Tuscano, A. (2008). Efficacy of teacher in-service training for attention-
deficit/hyperactivity disorder: Teacher in-service training for ADHD. Psychology in the Schools, 45(10), 918–929.
[Link]
9
American Psychiatric Association, ed. (2022). Diagnostic and Statistical Manual of Mental Disorders, Fifth
Edition, Text Revision (DSM-5-TR). Washington, DC, USA: American Psychiatric Publishing. ISBN 978-0-89042-
575-6.
10
Huss, M.; Duhan, P.; Gandhi, P.; Chen, C.W.; Spannhuth, C.; Kumar, V. Methylphenidate dose optimization for
ADHD treatment: Review of safety, efficacy, and clinical necessity. Neuropsychiatr. Dis. Treat. 2017,13, 1741–1751.
[Link]
11
Thabet, A.M., Al Ghamdi H., Abdulla T., Elhelou, M.W., Vostanis, P. Psychiatry, 2002, 159:1556–62. Attention
deficit–hyperactivity symptoms among Palestinian children. EMHJ 2010; 16(5):505-10.

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43rd International Conference of Human & Social Sciences 6-8 December 2024

history of attention disorders12. Within the biological factors, the neurobiology of ADHD involves imbalances in
neurotransmitters, such as dopamine and norepinephrine, which affect the ability to concentrate and self-regulate13.
Nutrient intake during pregnancy is crucial for proper brain development14. Factors such as exposure to toxins
during pregnancy and poor diet can contribute to the development of ADHD15. Malnutrition or immune activation in
the expectant mother is a risk factor for ADHD and other Neurodevelopmental disorders. Premature birth is also a
crucial risk factor16. Perinatal hypoxia is another environmental aspect of causes of ADHD17. Studies suggest that
increased cell phone use may be associated with attention problems and hyperactivity. Another risk factor for ADHD
is the exposure to neurotoxic heavy metals18. According to Hale and Guan (2015), excessive screen use can be
distracting and hinder the development of basic self-regulation skills19.
2.2 Symptoms
Symptoms of ADHD usually appear in childhood. According to the DSM-5, several symptoms should be present
before the age of 12. Many parents report excessive motor activity during infancy, but symptoms of ADHD are
difficult to distinguish from the impulsivity and energy typical of children under four. For diagnosis, children must
have six or more symptoms of the disorder, while adolescents 17 and more and adults must have at least five
symptoms. The DSM-5 can provide a series of criteria that help diagnose ADHD. These criteria are based in
symptoms of ADHD and are categorized in three groups. These main groups are:
• inattentiveness, where a person cannot focus
• hyperactivity is the case of a person who is extremely active
• impulsivity is the category of symptoms of uncontrollable behavior20.
The symptoms for each of these types are summarized below.
ADHD dominated by inattention:
• Does not pay attention to details or makes careless mistakes
• Has difficulty maintaining attention
• Seems not to hear
• Tires easily when called upon to perform activities that require attention
• Has difficulty following instructions
• Has difficulty in organizing, mainly space and tasks
• Has time management problems
• Avoids or dislikes activities that require constant effort
• Loses items
• Easily distracted
• Forgets daily activities

12
Faraone, S. V., & Biederman, J. (2005). "Genetics of Attention-Deficit Hyperactivity Disorder." Psychiatric
Clinics of North America. [Link]
13
Biederman, J., & Faraone, S. V. (2005). "Attention-deficit hyperactivity disorder." The Lancet.
[Link]
14
Gharami, K.; Das, M.; Das, S. Essential role of docosahexaenoic acid towards development of a smarter brain.
Neurochem. Int.2015,89, 51–62. [Link]
15
Barker, G., Nascimento, M., Deva, M.P., Talukder, K., Kirumira, E., Kanaan, N. (2005). "Adolescents, social
support and help-seeking." Journal of Youth Studies.
16
Aylward, G.P. Neurodevelopmental outcomes of infants born prematurely. J. Dev. Behav. Pediatr. 2005,26, 427–
440. [Link]
17
Giannopoulou, I.; Pagida, M.A.; Briana, D.D.; Panayotacopoulou, M.T. Perinatal hypoxia as a risk factor for
psychopathology later in life: The role of dopamine and neurotrophins. Hormones 2018,17, 25–32.
[Link]
18
Nuñez-Jaramillo, Luis & Herrera Solís, Andrea & Herrera-Morales, Wendy. (2021). ADHD: Reviewing the
Causes and Evaluating Solutions. Journal of Personalized Medicine. [Link]
19
Hale, L., & Guan, L. (2015). "Screen time and children's psychological well-being: Evidence from a population-
based study." Child Development. [Link]
20
Nuñez-Jaramillo, Luis & Herrera Solís, Andrea & Herrera-Morales, Wendy. (2021). ADHD: Reviewing the
Causes and Evaluating Solutions. Journal of Personalized Medicine. [Link]

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43rd International Conference of Human & Social Sciences 6-8 December 2024

ADHD dominated by Hyperactivity and Impulsivity:

• Moves his arms or legs or twists in place
• Has difficulty staying seated
• Running or climbing excessively (in children); intense restlessness (in adults)
• Has difficulty participating quietly in activities
• Displays behavioral immaturity
• Behaves as if he is "driven by a machine"
• Speaks excessively
• Interrupts the other before finishing the question
• Has difficulty waiting for his turn
• Interferes or interrupts others
Combination type of ADHD:
The combination formula meets the criteria for both divided attention and hyperactivity-impulsivity. Symptoms can
change over time, so children can belong to different types as they get older.
2.3 Therapeutic approaches of ADHD
Treatment recommendations are tailored to the specific needs of the person with ADHD. This disorder is treated
through various approaches, depending on the type of disorder and the intensity of symptoms. The most prevalent
approaches are behavioral therapy programs that help develop attention skills and self-control. Both stimulant and
non-stimulant therapies have demonstrated effectiveness in reducing ADHD symptoms in children and teenagers.

2.3.1 Pharmacological Therapies

In various countries of America and Europe, medication is administered as part of the treatment. Stimulant drugs,
such as methylphenidate and amphetamines, are often first-line options for treating ADHD21. Substances commonly
used in the treatment of ADHD are methylphenidate and atomoxetine. A systematic review for the use of these
substances has shown that it is important to identify subgroups of patients in order to reduce adverse effects22.
2.3.2 Non-Pharmacological Therapies
The etiology of ADHD can vary significantly from one person to another, meaning the psychological changes
causing ADHD symptoms may differ slightly in each case. This variability can impact the effectiveness of the
selected treatment and might explain why the same treatment has different effects on different persons. Cognitive
behavioral therapy (CBT) is a form of behavioral intervention which aims at reducing ADHD behaviors or
associated problems by enhancing positive behaviors and creating situations in which desired behaviors may occur.
In the context of Special Education and Teaching, individualized and differentiated educational intervention
programs are essential for addressing the specific needs of students with ADHD. These programs focus on tailored
teaching practices that promote academic, behavioral, and social development. An Individualized Educational
Program (IEP) is central, setting specific academic goals, such as using visual aids in mathematics, and behavioral
objectives, like task completion with minimal prompts. Differentiated teaching strategies include multi-sensory
learning, flexible grouping, and structured behavioral interventions, such as positive reinforcement systems and
visual schedules, which help maintain focus and organization23. Mindfulness training and physical activity appear to
have beneficial effects on ADHD behavior24. Family therapy supports parents and creates a positive family
environment25 and general educational support. Educational support for students with ADHD is critical to enhancing

21
MTA Cooperative Group. (1999). "A 14-month randomized clinical trial of treatment strategies for attention-
deficit/hyperactivity disorder." Archives of General Psychiatry. [Link]
22
Nuñez-Jaramillo, Luis & Herrera Solís, Andrea & Herrera-Morales, Wendy. (2021). ADHD: Reviewing the
Causes and Evaluating Solutions. Journal of Personalized Medicine. [Link]
23
Cho, S.-J., & Blair, K.-S. C. (2017). Using a multicomponent function-based intervention to support students with
attention deficit hyperactivity disorder. The Journal of Special Education, 50(4), 227–238.
[Link]
24
Drechsler, R., Brem, S., Brandeis, D., Grünblatt, [Link], G., & Walitza, S. (2020). ADHD: Current Concepts
and Treatments in Children and Adolescents. Neuropediatrics. [Link]
25
Weisz, J. R., Jensen-Doss, A., Hawley, K. M. (2006). "Evidence-based youth psychosocial interventions." Annual
Review of Clinical Psychology. [Link]

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43rd International Conference of Human & Social Sciences 6-8 December 2024

their attention span and participation in the classroom. Here are more examples of strategies and techniques that can
be applied26 27:
• Create a Structured Schedule: Having a clear and predictable routine can help students understand what is
expected of them and reduce their anxiety. Daily programs with visual elements (such as tables or icons) can
make it easier to understand.
• Use of Visual Amplifiers: The use of visual tools, such as thought maps, graphs and tables, can help students
organize their thoughts and better understand the material.
• Periodic Pauses: Incorporating short pauses during lessons can help students refresh their attention. Activities
such as light exercise or breathing can be especially beneficial.
• Create Support Zones: Setting up quiet areas in the classroom where students can disconnect and concentrate
when they need it can provide much-needed peace of mind.
• Flexible Furnishings: The use of special furniture, such as rubber chairs or basketball seats, allows students to
move while participating in the learning process, which can reduce hyperactivity. Tires can help students with
ADHD maintain physical mobility without distracting themselves or their classmates.
• Repetitive Learning Strategies: Repetition of material through games or activities that require interaction can
enhance memory and comprehension, making the learning process more fun.
• Goal Setting: Creating small, achievable goals that students can achieve gradually can help them stay motivated
and develop a sense of accomplishment.
• Working with Specialists: Working with psychologists, speech therapists and other specialists can provide
tailored support strategies, depending on the needs of each student.
• Assessment of Progress: Regular assessment of student performance can help teachers adjust teaching
strategies and identify areas where students need extra help.
• Technology Integration: Use of educational applications and tools that promote interaction and attention, such
as interactive whiteboards and educational platforms.
3. Research
This paper uses case study and action research methods to obtain research data and evidence. The researchers used
the method of action research to obtain as many relevant findings and information regarding a case study of an 11
years old student with ADHD. The research took place in a primary school in Athens in Greece, and lasted 9 months,
during the school year 2023-2024.
Action research is a qualitative method. It focuses on simultaneously taking action and developing knowledge or
theory about the action as it occurs. It begins with every day experiences and emphasizes the growth of practical
knowledge28. Action research involves identification and intervention to a problem. It generates ideas and
investigates the issue, by collecting data29. Data analysis follows, with recognition of consistent themes and patterns
throughout the data. The findings lead to the creation of research questions and test the initial hypothesis about the
case study30. The research questions in this case study are: 1) What are the teacher’s educational support initiatives
to provide a student with ADHD a more positive educational environment and 2) how this support system may be
implemented? The researchers created a plan of an educational intervention. According to the results of the findings,
after the intervention, the researchers made all the alterations needed and re-created strategies and necessary actions
for the obtainment of the research objectives31. It is a cyclical process, which is accomplished with the achievement
of the researchers’ goals.

26
DuPaul, G. J., Weyandt, L. L., & Janusis, G. M. (2011). ADHD in the classroom: Effective interventions
strategies. Theory into Practice, 50(1), 35-42. [Link]
27
Creelman, K. (2021). A literature review of understanding and supporting children with attention deficit
hyperactivity disorder in the classroom. Northwest Journal of Teacher Education, 16(1), Article3.
[Link]
28
Coghlan, D. (2022). Action Research. In: Glăveanu, V.P. (eds) The Palgrave Encyclopedia of the Possible.
Palgrave Macmillan, Cham. [Link]
29
Oranga, J. & Gisore, B. (2023). Action Research in Education. OALib.1-10. [Link]
30
Burns, A. (2015) The Action Research in ELICOS Program: Refining the Development of a National Model.
Cambridge English: Research Notes, No. 60, 4-8.
31
Carr, W. & Kemmis, S. (2005). Staying Critical. Educational Action Research, 13 (3), 347-
[Link]

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43rd International Conference of Human & Social Sciences 6-8 December 2024

3.1 Collecting data

In the first steps of the study, the researchers investigated the profile and the needs of the student with ADHD. The
data were collected by different means. One main way of gathering information was the daily journal of the
researchers. Notes about the student’s actions, behavior and feelings were written down in details. Note taking is a
common approach in action research 32. Moreover, the researchers took daily and detailed notes of the strategies used
for intervention. In parallel, regular discussions about the process took place among the three educators who
conducted the instructional initiative. Another way of collecting data were structured self-administered
questionnaires, adapted from various sources. The researchers developed structured self-administered questionnaires
and implemented them on the student. These questionnaires were integral to the observational methodology,
providing detailed insights into the student's basic skills and behaviors. They were able to systematically assess and
monitor the progress and specific needs of the student.
According to the case in study, the student, a 12-year-old male child was a sixth-grader who had been diagnosed
with Attention Deficit/Hyperactivity Disorder (ADHD). The diagnostic evaluation was conducted by the Center for
Interdisciplinary Assessment and Counseling Support, a public sector center in Greece. For the student, a tailored
Individualized Intervention Plan was devised, which educators thoroughly considered to ensure a synchronized and
effective intervention approach. This plan was instrumental in guiding the educators' efforts to address the student's
unique needs through a coordinated strategy. The student, despite his abilities, he faced significant challenges in his
daily life at school. In teaching, the student often found it difficult to keep track of and lost pieces of information, as
he was easily distracted by external noise or activities. This forced him to ask his classmates to better understand the
lesson, or very often not to know what subject he had to work on.
His organization and time management were also problematic. He often forgot to bring the necessary books or
assignments to school and found it difficult to prepare for exams as he could not draw up a study plan. At the same
time, the student’s hyperactivity led him to not be able to sit quietly in his chair, which distracted his classmates. He
often got up from his seat without permission. He spoke at times when they were not appropriate, causing
misunderstandings with teachers who taught specials.
His social life was also not easy. He had challenging relationships with his classmates, as his excessive energy and
loss of attention made it difficult for him to participate in group activities. He often felt isolated and did not fully
understand social cues, which led to conflict.
In lessons, he encountered difficulties especially in mathematics, where he missed instructions and failed to
understand complex concepts. In language lessons, he had difficulty reading and understanding texts, while his
writing was cluttered and omitted. Despite his hyperactivity, he had problems coordinating certain physical
activities, which affected his self-esteem.
3.2 Analysis
“N” exhibits classic symptoms of both inattention and hyperactivity/impulsivity as defined in the DSM-533.
According to these criteria, inattentive ADHD manifests as difficulty sustaining attention, organizational problems,
and forgetfulness. “N” frequently loses his materials, struggles to follow instructions, and is easily distracted in the
classroom, which aligns with descriptions of inattentive ADHD found in existing research 34. The student frequently
expressed a need for further explanations regarding the lesson activities. In terms of hyperactivity/impulsivity,
“N’s” behaviors, such as an inability to remain seated, talking out of turn, and engaging in excessive movement, are
common challenges among students with ADHD35. His difficulties in waiting for his turn or controlling impulses are
noted as symptoms that disrupt classroom learning and social interactions. The hyperactive behaviors observed in

32
Góral, A., Jałocha, B., Mazurkiewicz, G., Zawadzki, M. (2021). Action Research: A Handbook for Students.
November 2021 edition. ISBN 978-83-65688-76-7.
33
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders, 5th Edn.
Washington, DC: American Psychiatric Association. [Link]
34
Wolraich M. L., Hagan J. F., Allan C., Chan E., Davison D., Earls M., et al. (2019). Clinical practice guideline for
the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and
adolescents. Pediatrics 144:e20192528. [Link]
35
Wolraich M. L., Hagan J. F., Allan C., Chan E., Davison D., Earls M., et al. (2019). Clinical practice guideline for
the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and
adolescents. Pediatrics 144:e20192528. [Link]

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43rd International Conference of Human & Social Sciences 6-8 December 2024

“N” are well-supported by the research, which finds that such traits can hinder both academic and social
development36 .
The targeted intervention support included:
Tailored therapeutic approaches for ADHD management Structured Routine and Visual Support: Εstablishing a
structured daily routine supported by visual aids has proven effective for managing ADHD symptoms in students
like “N” 37. Visual tools, such as schedules and thought maps, help reinforce instructions and reduce distractions,
aiding students in organizing their tasks. By using these aids, “N” can focus on his assignments more effectively, an
approach supported by DuPaul et al. (2011) 38, which highlights the importance of structured interventions in the
classroom.
Movement Breaks: Allowing “N” periodic breaks addresses his need for movement and reduces classroom
disruptions39. Research suggests that students with ADHD benefit from brief physical activities that channel their
energy in a constructive way, which minimizes their disruptive behavior without limiting their engagement with the
lesson40.
Quiet Zone and Specialized Seating: A designated quiet space within the classroom and the use of flexible seating
options, such as chairs with rubber bands for fidgeting, help reduce the stimuli that can overwhelm students with
ADHD. Such sensory support tools are consistent with findings by Ohan et al. (2008) 41, which indicate that these
environments can significantly reduce hyperactivity and increase focus for students with ADHD.
Goal Setting and Behavioral Reinforcement: Establishing small, achievable goals and incorporating positive
reinforcement aligns with behavioral interventions recommended for ADHD management42. This approach provides
“N” with a sense of accomplishment, thus motivating him to continue focusing on tasks. Collaborative Support from
Specialists: In “N”’s case, collaboration with specialists such as psychologists and speech therapists enables the
provision of individualized support strategies that address his unique learning needs. This multidisciplinary support
network ensures that both educational and emotional aspects of ADHD are addressed, which aligns with established
treatment guidelines43.
Educational Technology: Integrating interactive technology, such as educational apps, can help “N” remain engaged
with his learning materials. Research by Nuñez-Jaramillo et al. (2021) 44 supports the use of technological tools that
promote interaction, which is particularly beneficial for students with ADHD by making learning more dynamic and
engaging.

36
Thabet, A.M., Al Ghamdi H., Abdulla T., Elhelou, M.W., Vostanis, P. Psychiatry, 2002, 159:1556–62. Attention
deficit–hyperactivity symptoms among Palestinian children. EMHJ 2010; 16(5):505-10.
37
Creelman, K. (2021). A literature review of understanding and supporting children with attention deficit
hyperactivity disorder in the classroom. Northwest Journal of Teacher Education, 16(1), Article3.
[Link]
38
DuPaul, G. J., Weyandt, L. L., & Janusis, G. M. (2011). ADHD in the classroom: Effective interventions
strategies. Theory into Practice, 50(1), 35-42. [Link]
39
Jones, H. A., & Chronis-Tuscano, A. (2008). Efficacy of teacher in-service training for attention-
deficit/hyperactivity disorder: Teacher in-service training for ADHD. Psychology in the Schools, 45(10), 918–929.
[Link]
40
Nuñez-Jaramillo, Luis & Herrera Solís, Andrea & Herrera-Morales, Wendy. (2021). ADHD: Reviewing the
Causes and Evaluating Solutions. Journal of Personalized Medicine. [Link]
41
Ohan, J. L., Cormier, N., Hepp, S. L., Visser, T. A. W., & Strain, M. C. (2008). Does knowledge about attention-
deficit/hyperactivity disorder impact teachers’ reported behaviors and perceptions? School Psychology Quarterly,
23(3), 436–449. [Link]
42
Huss, M.; Duhan, P.; Gandhi, P.; Chen, C.W.; Spannhuth, C.; Kumar, V. Methylphenidate dose optimization for
ADHD treatment: Review of safety, efficacy, and clinical necessity. Neuropsychiatr. Dis. Treat. 2017,13, 1741–1751.
[Link]
43
Wolraich M. L., Hagan J. F., Allan C., Chan E., Davison D., Earls M., et al. (2019). Clinical practice guideline for
the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and
adolescents. Pediatrics 144:e20192528. [Link]
44
Nuñez-Jaramillo, Luis & Herrera Solís, Andrea & Herrera-Morales, Wendy. (2021). ADHD: Reviewing the
Causes and Evaluating Solutions. Journal of Personalized Medicine. [Link]

7
43rd International Conference of Human & Social Sciences 6-8 December 2024

3.3 Interventions
The intervention was designed by the researchers. It encompassed a comprehensive series of instructional
interventions and in-class activities, designed to enhance student engagement and learning outcomes. These
interventions were meticulously planned to cater to the student’s learning style and foster an inclusive educational
environment. The intervention strategy for the student included creating a structured curriculum with visual
elements, which informed him daily about the routine. Visual tools, such as thought maps and notebooks, were used
so that he could organize his ideas. Periodic pauses every 30 minutes, during which he was able to move around the
classroom (either to erase the blackboard or hand out a handout), proved particularly beneficial. In addition, a quiet
corner was created in the classroom where he could disconnect when he felt hyperactive. The use of a chair with
elastic bands allowed him to move freely during the lesson. Learning games and group activities were incorporated
for the repetition of the material, and together with him small, specific goals were set for each lesson, which he
attended through his personalized whiteboard. Working with the school psychologist and his parents provided
additional supportive strategies, while regular assessment every two weeks allowed strategies to be adjusted where
needed. Finally, the use of educational applications, such as Kahoot, enhanced interaction and kept the student’s
interest high. This holistic approach has yielded positive results in his education and participation in the classroom.
3.4 Results
The results of the ADHD case study showed significant improvements in the student’s organization and focus. The
use of structured routines and visual aids contributed to better task management and sustained attention. Scheduled
movement breaks and flexible seating options helped reduce hyperactivity, resulting in fewer classroom disruptions.
The integration of interactive technology and the setting of small goals increased the student’s engagement and
interest in the learning process. Additionally, quiet zones and positive reinforcement improved his social
interactions, helping him interact more positively with his peers. Overall, these individualized interventions led to
notable progress in his academic performance and classroom participation, highlighting the benefits of applying
targeted support strategies to manage ADHD symptoms in a school setting.
4. Discussion
First of all, enhancing ADHD knowledge can positively influence the implementation of appropriate support for
students with ADHD in education. Educators with elevated ADHD knowledge were more likely to recognize the
benefits of educational support services compared to those with low knowledge45.
4.1 Limitations
This study of ADHD in a primary school shows some limits, which match issues often seen in research. First, the
one-case study way, while giving deep, quality views into personal intervention methods, holds back general use46.
The results here are just for one student in a certain school place, and so wider claims about ADHD intervention
success across many groups and learning settings can’t be proven. One-case studies usually look closely at single
answers to intervention47, but they miss the side-by-side data needed to see changes across other ADHD types and
school places.
A second limitation is in the trust on action research, which is naturally personal, as the teachers in it are both
observers and participants. This can bring in bias, as teachers might knowingly or unknowingly see actions and
results based on hopes or past knowledge about ADHD48. While daily logs and arranged self-checks were used to
keep fairness, such self-told measures can be biased and may not show all details of a student behavior.
Moreover the study time, limited to a single school year, makes it hard to see the lasting effects of intervention on
the student’s school and social results. ADHD signs can change with time, and a longer follow-up would let

45
Ohan, J. L., Cormier, N., Hepp, S. L., Visser, T. A. W., & Strain, M. C. (2008). Does knowledge about attention-
deficit/hyperactivity disorder impact teachers’ reported behaviors and perceptions? School Psychology Quarterly,
23(3), 436–449. [Link]
46
Kazdin, A. E. (2019). Single-case experimental designs: Characteristics, changes, and challenges. Journal of the
Experimental Analysis of Behavior, 111(3), 359-378. [Link]
47
Kratochwill, T. R., & Levin, J. R. (2010). Enhancing the scientific credibility of single-case intervention research:
Randomization to the rescue. Psychological Methods, 15(2), 124-144. [Link]
48
Faraone, S. V., Biederman, J., & Mick, E., (2006). The age-dependent decline of ADHD: A meta-analysis of
follow-up studies. Psycological Medicine, 36(2), 159-165. [Link]

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43rd International Conference of Human & Social Sciences 6-8 December 2024

researchers grasp better how well intervention works over time49. Similar studies show the need for long-term data
to check the steadiness of behavior and school gains in students with ADHD as time passes.
At last, while working together with a psychologist and using helpful tools made the intervention better, the options
for resources changed a lot between schools. This was especially true in areas with few funds for special learning
services. Such differences limit how well the study can be used in places with similar resources. Previous research
emphasizes the need for many site studies50 to think about different resource levels and nearby factors in ADHD
intervention, which could make future research stronger by giving more representative findings51.
4.2 Future Research
Future research should look at the few limits found in this case study to widen the knowledge and success of ADHD
intervention in schools. Because of the difficulties with generalization found in single-case studies, it would be good
to do multi-site research that includes different school environments. Such research would catch the differences in
how ADHD shows up across many settings and make the findings useful for various groups and school systems.
Research that focuses on a larger group of students with ADHD in many schools could give info on how resources
available and support from schools affect results of interventions, helping build a more complete system for
managing ADHD.
Also, long-term studies are suggested to check the lasting effects of actions taken in primary school. ADHD signs
can change as kids develop, and observing the student’s school work, friends, and behavior over a longer time may
give clues about how well these methods work. Following students with ADHD into higher education could show
trends in grades and social mixing, along with whether there is a need for changing interventions later on.
Looking deeper into how families help in making interventions work would be helpful. Since family support can be
very important for handling ADHD, looking at how family-focused methods affect student’s school and social
results could be useful. Checking ways to make the link between home and school stronger might give good things
for students and teachers.
5. Conclusion
This case study highlights the significant challenges that ADHD poses to academic performance and social
interactions in primary school students, as well as the benefits of individualized intervention strategies. By
implementing structured routines, visual aids, scheduled movement breaks, and flexible seating, educators can
effectively address core ADHD symptoms, enhancing students' focus, organization, and engagement. The case
further demonstrates that collaboration with specialists and the use of positive reinforcement can contribute
positively to the student's academic and social development. However, the single-case approach limits
generalizability, underscoring the need for broader research to explore the efficacy of similar interventions across
diverse educational contexts. Overall, this study supports the importance of targeted, holistic strategies to better
integrate students with ADHD into the classroom environment and maximize their educational potential.
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CVs of authors
Lada Stavroula is a primary school teacher in Athens and holds Master’s degrees in Special Education & School
Psychology and in School Counseling & Mentoring. She's an active researcher and has presented at conferences and
integrates European projects into her teaching. She’s a PhD candidate at the University of Alicante and her research
focuses on educational technology.

Vasiliki Papalouka is a primary school teacher in Athens and teaches Greek language, Math, Science, History,
Social and Environmental Studies. She holds an MSc in Special Education. She has been taught Braille writing and
has completed two training programs, one in intercultural education and one in autism. She is involved in research
and programs aimed at fostering innovation in education

Vyron Kostikas, an IT teacher in a primary school in Athens, holds an MSc in Computer Science and is a certified
adult educator. He teaches IT courses at vocational institutes and is an undergraduate in Management Science and
Technology. He’s a PhD candidate at the University of Thessaly and his research focuses on machine learning
algorithms.

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