What Challenges Do Children with ADHD Combined Type Face in School Settings? 

Children with Combined Type ADHD face a dual challenge; they struggle with both inattention and hyperactivity. This often leads to frustration in structured school settings where calm focus and self-regulation are expected. The issue lies in executive functioning, not intelligence or capability. This includes planning, memory, focus, and emotional regulation. The good news is that with the right support and informed teaching, children with ADHD can thrive. Understanding the link between executive functioning and classroom behaviour is the first step towards effective ADHD treatment. 

How ADHD Affects School Performance 

In school, ADHD symptoms can appear in many different forms: 

• Rushed or unfinished classwork 

• Interrupting or shouting out during lessons 

• Intense emotional reactions to correction or feedback 

• Trouble working in groups or staying focused on independent tasks 

These behaviours are not signs of defiance. They reflect executive function challenges that make it difficult for children to meet typical classroom expectations. 

Specific Challenges Faced by Children with Combined Type 

Focus and Memory 

Children with ADHD often struggle to maintain focus throughout an entire lesson. They may lose their reading materials, forget instructions, or drift off during tasks. This is due to executive function difficulties, rather than typical forgetfulness. 

Behaviour and Impulsivity 

Sitting still or staying quiet can be very difficult for children with hyperactive traits. They may struggle to wait their turn, leave their seat without permission, or interrupt others. This isn’t deliberate disruption   it is a reflection of poor impulse control due to ADHD. 

Emotional Regulation 

Minor issues may trigger tears, outbursts, or emotional shutdowns. Routine changes can be particularly difficult to manage. Many children with Combined Type ADHD are especially sensitive to perceived criticism, often reacting strongly due to rejection sensitivity rather than overreaction. 

What Helps? Classroom and Behavioural Supports 

A range of classroom strategies can help make learning more accessible for children with ADHD: 

• Visual schedules to provide structure throughout the day 

• Dividing tasks into smaller, manageable steps 

• Incorporating movement breaks into the daily routine 

• Regular emotional check-ins to support regulation 

• Peer support schemes to provide positive role models and assistance 

CBT (Cognitive Behavioural Therapy) techniques can also build emotional resilience and improve self-monitoring skills. 

Role of ADHD Treatment in the School Context 

ADHD treatment, particularly stimulant medication, can be transformative. It supports focus, reduces impulsivity, and enables children to engage more fully with learning. However, it is not a complete solution. The medication effects can differ from child to child. Some children may experience reduced appetite or irritability as the medication wears off known as “rebound effects”. An overly high dose may cause children to feel emotionally flat or withdrawn. That’s why collaboration between families, schools, and healthcare professionals is essential. 

Medication can reduce the mental “noise” that hinders learning, but without emotional support and practical strategies, its benefits may be limited. Teachers should be aware if a child is on medication and understand how it may impact behaviour and energy throughout the school day. Even with medication, consistent support and understanding in the classroom remain crucial. 

Final Thoughts 

Children with ADHD are not “difficult” learners; they simply need learning environments that suit how their brains work.  Early intervention, strong collaboration between home and school, and tailored ADHD treatment can make a significant difference. When educators and parents work together, they can help children with Combined Type ADHD develop resilience, confidence, and lifelong skills.  For trusted practitioner insights and training, you can also explore resources from ADHD Certify offering evidence-based guidance for parents, educators, and professionals.