Common school accommodations for children with attention-deficit/hyperactivity disorder (ADHD), including extra time on assignments, frequent breaks, standing desks, and low-distraction workspaces, do not significantly improve classroom behavior or academic performance, according to a Florida International University study announcement. In contrast, the researchers found that behavioral interventions and stimulant medication significantly improved student conduct and assignment completion in structured summer classrooms.
What Happened
Researchers at FIU's Center for Children and Families evaluated the four accommodations in a randomized clinical trial conducted through the university's Summer Treatment Program, which provides structured classroom and recreational activities for children with ADHD, according to the FIU news release. The study enrolled 255 students in kindergarten through sixth grade between 2022 and 2025, with 235 children completing the trial. While the findings were published in JAMA Pediatrics, the full journal article was not available for independent review beyond the university's release.
None of the four accommodations produced significant gains in classroom behavior or quiz scores, even when paired with behavioral therapy or stimulant medication, the FIU release reported. Some of the accommodations were linked to lower academic productivity. By comparison, behavioral interventions reduced classroom rule violations by 37% relative to a general classroom setting, and stimulant medication reduced rule violations by 61% while increasing the rate of correctly completed assignments by 22% compared with a placebo.
Lead author Gregory Fabiano, a psychology professor at FIU, said in the university announcement that standard accommodations often included in Individualized Education Programs (IEPs) and Section 504 plans fail to build student skills or address motivation. Instead of relying on uniform accommodations, the research team recommended evidence-based behavioral strategies such as daily report cards, clear expectations, consistent feedback, praise, and rewards tied to individual goals. The researchers noted that because the trial took place in structured summer treatment classrooms rather than traditional schools, additional studies are needed to determine whether the results apply to everyday K-12 classrooms.
The Bigger Picture
Earlier research supports the behavioral tools recommended by the FIU team, but also shows their limits. In a review of school-based daily report card interventions, researchers noted that daily report cards work through home-school collaboration: teachers rate a student's daily conduct against specific targets, and parents provide rewards at home. Although teachers generally find the cards easy to use, maintaining adherence over time and avoiding student stigma remain practical challenges.
A meta-analysis of seven group-design studies found that daily behavior report cards significantly reduced teacher-rated ADHD symptoms and produced large improvements in directly observed classroom behavior. Similarly, a randomized controlled trial of 213 students in grades K–7 showed that consultant-supported daily report cards reduced classroom rule violations and functional impairment, particularly for children with lower-quality IEPs. However, that trial found no significant difference between the daily report card group and standard schooling on teacher ratings of academic performance or special education goal attainment.
The new FIU study also builds on work by the late William E. Pelham Jr., founding director of FIU's Center for Children and Families, who helped design the trial before his death, according to the FIU news release. In an earlier randomized crossover trial of 173 children aged 7 to 12 with ADHD, Pelham and colleagues found that daily stimulant medication produced large daily gains in seatwork productivity and classroom behavior, yet children learned the same amount of vocabulary, science, and social studies content whether taking medication or a placebo. A broader meta-analysis of 34 studies on methylphenidate likewise found that while the medication increased math productivity by 7.8%, improved math accuracy by 3.0%, and increased reading speed, it had no effect on reading accuracy and yielded small academic gains overall compared with symptom reductions.