Simple Changes, Powerful Impact: How to Adjust OST Environments for Neurodiverse Children and Youth
By Meeta Sharma-Holt
3.11.24
In a large multi-service community center, I oversaw afterschool programs for 1st to 5th graders. Most of the children came from a nearby housing project, or their families paid fees on a sliding scale. Every weekday afternoon, about 100 kids would pour into a large multi-purpose room with cinderblock walls, a concrete floor, and bright lights. It was the kind of room where it was always too noisy, no matter how softly you talked to your neighbor. When kids arrived, they would dump their backpacks, hang their coats on the backs of their chairs (mostly), and then wash their hands. After a snack, the kids transitioned to daily activities like arts, music, and science. After an hour, they returned to the lunchroom to do their homework or read quietly. This was also pick-up time, and the quiet was often interrupted by the sound of walkie-talkies as parents asked to pick up their children. This is an all too frequent description of the chaotic sensory atmosphere in which we run programs.
Edwin, a six-year-old, was having none of it. Most days, he didn’t make it through the day’s schedule without being reminded not to push, wait his turn, find his things, or start his homework. Reminders became warnings, and warnings became consequences. All of this made him angry, and when he was mad, he’d throw things, sulk, or pick fights with other kids. (And he could really throw a punch for such a little guy.) We got to know each other well because he was often sent to my office during the afterschool program.
One-on-one, Edwin and I had great conversations. He was funny, insightful, and curious. It became a daily routine for both of us until the fighting became more intense, and we had to find another program for him where he and the other kids could be safe. His family later shared with me that Edwin had been diagnosed with Attention Deficit Disorder (ADD) and Dyslexia after leaving our program.
Years later, I understood more clearly how ADD and learning differences manifest in the children I served because I watched my son and daughter struggle. While my kids have faced academic and social challenges because of the differences in the way they process information, I can’t help thinking about all the other children without the resources mine have. Could our program have helped Edwin succeed if we understood what he needed and adjusted?
It may be overwhelming for a director or program manager to add one more thing to an already full plate: the informal education space, also known as out-of-school time (OST). When I first met Edwin, I had an advanced degree and years of experience but had never run a large or complex program. I had limited power to change the program’s structure and curriculum or to meet the needs of so many kids all at once—or so I thought.
The statistics show that there are more children with learning differences or other forms of neurodivergence in our care than we realize. In the 2021-22 school year, 15% of public school children were diagnosed with a disability.[i] With our help, they can become the next scientist, mechanic, teacher, writer – anything they want to be. Creating inclusive spaces promotes equity and fosters a sense of belonging and self-worth among all participants. Such environments aren’t just good for kids who learn differently; they benefit everyone by encouraging empathy, respect, and diversity. I believe that we not only have the resources, but we also have an obligation to attend to the needs of kids like Edwin – with a few small shifts.
The information provided here can serve as a foundation for ensuring equity in how OST services are provided to neurodivergent children (i.e., children with ADD, dyslexia, and other learning differences.) It does not replace dialogue or more research but is a starting point to get us thinking and acting.
The Breadth of the Issue:
How pervasive are the differences in functioning among school-aged children in the U.S.? How many kids like Edwin are in our public school systems? According to the National Center for Education Statistics, in 2021–22, 7.3 million students ages 3 to 21 received special education and related services under the Individuals with Disabilities Education Act (IDEA). [ii] Among students receiving special education and related services, the most common category of disability was “specific learning disabilities (32%).” The statistics also show that more male students (65%) than female students (34%) received special education and related services under IDEA.[iii] (This may be because females are often underdiagnosed.) Further, diagnoses of disabilities are the greatest for American Indian/Alaska Natives (17%), followed by those who are Black (16%), White (14%), two or more races (13%), Hispanic (12%), and Pacific Islanders and Asians (7%).”[iv]
The signs and symptoms of neurodiversity can also overlap and do not manifest in everyone in the same way. For example, ADD is not classified as a learning disability, but between 30% and 50% of children diagnosed with ADD also have learning disabilities, according to the Learning Disabilities Association of America.[v] Similarly, executive functioning disorder (E.D.) is a prominent symptom of ADD but also shows up in people with learning differences.
These are staggering numbers, for sure. However, the numbers only represent students who have an official clinical diagnosis. Getting a diagnosis is a multi-layered process. It first requires an official request by caregivers for school-based testing or securing private testing. Private testing can cost thousands of dollars and is not often covered by insurance. So, the probability that more children from underserved communities may be undiagnosed is high because of the challenges in getting a diagnosis in public schools.
The Afterschool Alliance estimates that “children with special needs or disabilities represent a higher percentage of afterschool program participants (19%)[vi] compared to public school students overall because they are more likely to participate in our programs. This means that a typical afterschool classroom will likely have about 20% of its students with complex challenges to seemingly routine tasks like packing up a bookbag, starting homework, sitting still to listen to directions, or transitioning from one activity to another. Therefore, in working with neurodiverse children, OST program managers must create an environment where the unique needs of children can be accommodated.
Types of Neurodivergence
How do children and adults process, think, or learn differently, or are they neurodivergent? There are three main categories of neurodivergence, manifesting in a person’s ability to manage their energy, learn, plan, and sometimes function socially.
Attention Deficit Disorder (ADD) – We hear and read so much about ADD, but to be more accurate, it is not one thing. There are multiple types of ADD, and they each manifest differently. Broadly speaking, kids (and adults) with ADD have trouble focusing on tasks and may have difficulty sitting still, organizing assignments, or containing impulses.[vii] Many variations are essential to consider within the ADD diagnosis. Researchers from Johns Hopkins Medicine have identified three types: “combined type, impulsive/hyperactive type, and inattentive type.” According to Johns Hopkins, the most common is the “combined type,” where children are impulsive, have high energy, can be distractable, and have difficulty staying on task.[viii]
Learning Disabilities (L.D.) (or “Learning Differences” preferred term) – Language-based learning differences are defined in several broad categories but can overlap and manifest differently in each person. Under IDEA, the “specific learning disability” category covers specific learning challenges. These conditions affect a child’s ability to read, write, listen, speak, reason, or do math. Examples of the most common learning differences and their overall descriptions include the following:
- Dyslexia involves difficulty reading due to problems identifying speech sounds and learning how they relate to letters and words (decoding). It shows up as school-aged youth struggling to focus on reading because the words blend or letters seem interchangeable. Here is an example of what it feels like to have Dyslexia: https://www.cnn.com/2016/03/05/health/dyslexia-simulation/index.html.
- Dyscalculia affects a person’s ability to understand number-based information and math. As described in this brief video, children with dyscalculia may have trouble reading numbers, whether things are bigger or smaller, or counting out change.
- Dysgraphia is a written expression disorder. With this disorder, children may have trouble writing words or sentences or copying text from a board onto their papers could take a long time. With Dysgraphia, a person can be challenged to write, spell, or both.[ix]
Autism Spectrum Disorder (ASD) – Cognitive differences causing ASD can make social communication and interaction challenging or restricted. ASD can also cause children and youth to exhibit repetitive or hyperfocused behaviors.[x]
Executive Function Disorder (ED) – Everyday activities that require managing time, planning, and remembering multiple tasks to get to a finished product are collectively called “executive functioning.”[xi],[xii] In people with neurodivergent brain functions, the area of the brain that assists with E.D. is impaired, making it challenging to complete schoolwork, be on time for events, or finish a project. In an OST setting, challenges with following a multi-step art project, tracking belongings, or persistently losing track of time (what some call “time blindness“) can frustrate a child or even cause social isolation.[xiii]
Simple Changes, Powerful Impact
Neurodiversity does not mean a child is deficient or will necessarily fail. Knowing how children and youth function helps ensure their unique abilities can be fully supported in an afterschool or summer camp program. By providing appropriate support, accommodations, and personalized learning strategies, OST professionals can empower neurodivergent students to thrive academically, socially, and emotionally.
The good news is that OST learning environments serve more neurodiverse youth and are uniquely positioned to provide support, mainly when serving children and youth from marginalized communities. Moreover, small, low/no-cost shifts can have a powerful and positive impact on supporting youth with learning differences. The following provides ideas for adjustments that can be made from the recruitment stage to program design and staffing.
- Adjustments at the Enrollment Stage
How participants are enrolled can set the stage for what accommodations are needed in OST programs. Adding questions to enrollment forms about enrollees’ unique needs and asking whether the child has an IEP or 504 plan can be very helpful. But first, program directors need to ensure the information received is kept confidential and that staff who can view it are fully trained in managing what is disclosed. Consider adding a section to your staff orientation and having staff sign an agreement to keep individual student information confidential. This is true for all participant information, including any special needs.
If families provide information about their child’s needs, following up to find out more is essential. This first conversation with a caregiver is a great place to create trust and gain a deeper understanding of the extent of each child’s needs. It is also the right time to share your program’s structure and staff’s adjustability. Some questions to ask may include:
- What kinds of environments help the child feel calm? What are their biggest triggers?
- What are the effects if the child takes medications, and when does the medication wane?
- How does the child learn best? Does the child need extra time, or do they prefer not to be called on to read aloud? Does the child need access to technology like speech or text to complete homework?
- How can you and the caregivers check in regularly to ensure they meet the child’s needs?
Initial meetings are also helpful in managing caregivers’ expectations about what the program can and cannot do. Not all programs can meet each child’s needs, depending on the depth of a child’s needs and available resources.
- Adjustments to the Program Space and Design
The physical space, materials, and instructional approaches can significantly impact neurodivergent children’s learning engagement and overall well-being. The following are ideas for creating an inclusive environment for neurodivergent children and youth in our afterschool programs:
● Equitable Group Sizes: Enabling staff to support neurodivergent participants’ needs successfully can be as simple as reducing the staff-to-student ratio. OST programs already operate at a much-reduced staffing ratio compared to the traditional school day and could consider adjusting group sizes based on the composition of its members. Changing group composition can include creating a mixture of learning styles or placing children with more intensive needs with instructors who can better support them. This is a more equitable approach than placing children in groups based on their school-day grade or a standard ratio number. OST managers should also consider the expertise of group leaders when assigning them to groups with more neurodiverse participants.
● Flexible Learning Spaces: Many OST programs use traditional school buildings where seating is not generally designed to allow children to lie down, move, or change positions. Allowing children to be on the floor, in the hallway, or in a corner to finish homework can be essential to their functioning, especially after an entire school day. Of course, allowing children to use spaces differently may create chaos and require staff to supervise the group differently or work with children to establish community rules. Ideas for rules include limiting the time for lounging or using hand or word signals to guide the group.
● Supporting Executive Functioning Skills: Helping a child learn to complete a task or adhere to a program schedule in OST can significantly benefit academic achievement and job and career success.[xiv] OST is uniquely positioned because our work is based on building relationships and encouraging experimentation without fear of grading or other school-day consequences. There are built-in opportunities for children to experiment with impulse control through board games or manage multiple art project elements. Experts in ED are needed to build specific learning and organizational skills. Strategies recommend using visual aids to support a child’s understanding of content, so “showing” or “modeling” more than just telling or reading aloud is recommended. OST staff can also teach children how to organize their work using color-coded materials and break large project due dates into smaller tasks with interim check-in dates.[xv] Neurodiverse children respond well to immediate reinforcement like stickers or positive check marks.
● Multisensory Learning: Introducing multisensory learning experiences can benefit all participants, especially youth with learning differences. Incorporating hands-on activities, interactive technologies, and manipulatives can engage different senses, deepen understanding, and improve retention of information. The key here is to create an external cue for the learning process. This can be in the form of physical objects to count instead of a number on a page. Another idea is to offer speech-to-text software to help children complete their homework or download audiobooks from the local library to support Dyslexic readers. Playing background music while children are working or singing the information could be helpful. Using drawings or toys to describe something can work better than relying on reading, writing, or words to complete a project.
● Manage Time: Consider whether your afternoon program or camp schedule is structured to help diverse learners. Since neurodivergent children may be “time blind,” they may not anticipate transitions or keep track of time running out on a task. Could you add more time for transitions or reduce the number of times children move from one place to another? Increasing the time from 45 minutes to one hour for an activity can enable neurodiverse children to transition more calmly. Coupling extended time with visual or auditory reminders can also help.
On the other hand, hyperactive children may need more constant stimulation so that a task can be broken down into its parts. After each component is completed, the child can get up and check off on a chart that it’s completed. Visual timers show how much time has elapsed to finish a task or move to another one. Staff can also provide small toys, stickers, or points for the number of items checked off.
● Cultivating a Supportive and Inclusive Culture: Creating an inclusive learning environment goes beyond physical changes. Fostering a supportive and inclusive culture within the program is equally important. Staff should encourage open communication, empathy, and understanding among staff and participants. Group leaders should promote a sense of belonging by celebrating individual strengths and differences. By creating a safe and accepting atmosphere, youth with learning differences will feel empowered and motivated to participate and engage actively in their learning journey.
- Adjusting Staffing and Staff Training
The most essential element of creating an equitable learning environment is staff. As discussed earlier, staff must be fully equipped to support neurodiverse learners from the point of their enrollment. If assigned children need special support, staff should be notified, and a plan should be in place. Also, a standard procedure for advising anyone substituting for the day is necessary to ensure consistency, which is essential for neurodiverse children. If program and organization leaders spend time cultivating an environment of acceptance and support, identifying children with diverse needs will not translate into stigma or exclusionary practices. Additional practices that can enable staff to create an inclusive environment in their OST group include the following:
- Training on Neurodiversity: A 2012 study of 331 OST program staff in New Jersey found that staff who participated in more professional development on topics about inclusivity were more likely to have positive attitudes about neurodiversity and created an inclusive group environment, regardless of the staff’s educational background or position.[xvi] What are the core topics for training direct-line staff and their supervisors? First, managers must clarify the organization’s confidentiality policy and how to maintain it. Next, staff should understand positive youth development, neurodiversity, and examples of each type. Staff should also brainstorm scenarios about adjusting activity schedules, creating calm learning spaces, and creating agreement among members or their groups about embracing inclusivity. Finally, seasonal or periodic training will work best if coupled with ongoing observation and coaching. Individual or small group follow-up in the context of specific examples can reinforce theoretical concepts and help staff apply what they were taught.
- External Resources to Support Staff Expertise: While OST programs must train their direct service staff to support all types of learners, the unique needs of neurodiverse children and youth may be outside a manager’s and trainer’s expertise. OST leaders can augment in-house training by scheduling conversations with school-day teachers, observing how special education teachers manage children in the lunchroom, or inviting speakers from groups specializing in learning differences, such as the national network, Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), or via web conference with specialists across the country. Organizations may also petition their local OST intermediary (found through the Statewide Afterschool Network) to connect with other providers or provide workshops at conferences to equip middle managers.
Conclusion:
Edwin would be about 20 years old now, and I still think about him. How could we have helped him succeed if we had provided a space for him and all the kids like him who showed me that they needed things to be set up differently? Imagine how many children are left behind on our daily watch without the proper environment to encourage learning and academic skills.
After Edwin left our program, I noticed similar behaviors in other kids. I started making small but meaningful changes to our program structure, and it worked. For example, we grouped kids according to developmental levels, not just grades. We kept groups small or added more helpers, even teens, to provide more personal support. We dimmed the lights and changed how pick-up happened to keep spaces quiet. Participants’ behavior improved overall, and we seldom asked children to leave our programs. Later, I worked for a national youth-serving organization. We paid great attention to class sizes, curriculum, and staff training. Quite simply, we were emphatic about creating equitable learning environments – spaces where a girl like Ada, who we knew was on the Autism Spectrum, said, “…at [this] program, I can be whoever I want to be! I feel safe. I can make mistakes, and it’s OK.” That was a STEM[1] program. Ada, a middle schooler in our program, went on to one of the best STEM public high schools in Wahington, DC.
Creating an inclusive and equitable learning environment for school-aged youth with learning differences or ADD is necessary and achievable, and it turns out that it is suitable for ALL the children in our care. OST programs can create spaces that empower and uplift all participants by making simple changes to the learning environment and fostering a supportive culture. Let us embrace the power of inclusion, recognizing that every child has unique potential and deserves a chance to thrive. Together, we can positively impact and create transformative experiences for youth with learning differences in afterschool programs and summer camps. I challenge you today to think of just one small change you can make in your programs.
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About the Author: Meeta Sharma-Holt, MSW
Meeta believes in the power of out-of-school time programs to support youth from underserved communities in reaching their best selves. She has designed, monitored, and created high-quality systems of out-of-school time programs for over 30 years, first in New York City, Washington, DC, and nationally. She is now an independent consultant who supports nonprofits and system builders in advancing equity and quality in out-of-school time programming.
In her work, Meeta brings a positive youth development guiding framework, as well as her background in social work and commitment to social justice. As an immigrant and granddaughter of freedom fighters in India, Meeta is compelled to bring about change. Most recently, Meeta helped grow and scale STEM programs for BIPOC girls from three to 18 states at Techbridge Girls. Before Techbridge Girls, Meeta established the system of afterschool programs for Washington, DC. She also developed and supervised large, multi-site, community-based afterschool and summer programs in Washington, DC, and New York City. Additionally, she expanded corporate mentoring programs with 20 Fortune 500 companies through Big Brothers Big Sisters.
Meeta holds a BS in Marketing and Management from Penn State University and an MSW from Columbia University in New York City.
[1] Science, Technology, Engineering, and Math
[i] National Center for Education Statistics. (2023). Students With Disabilities. Condition of Education. U.S. Department of Education, Institute of Education Sciences. Retrieved on November 1, 2023, from https://nces.ed.gov/programs/coe/indicator/cgg.
[ii] Ibid.
[iii] Schaeffer, K. What Federal Education Data Shows About Students with Disabilities in the US. Pew Research Center. July 24, 3033. Retrieved on March 10, 2024, from https://www.pewresearch.org/short-reads/2023/07/24/what-federal-education-data-shows-about-students-with-disabilities-in-the-us
[iv] National Center for Education Statistics. (2023). Students With Disabilities. Condition of Education. U.S. Department of Education, Institute of Education Sciences. Retrieved on November 1, 2023, from https://nces.ed.gov/programs/coe/indicator/cgg.
[v] Clouser, L. (2022). What is ADHD? Retrieved on November 15, 2023, from https://ldaamerica.org/what-is-adhd.
[vi] The Afterschool Alliance (n.d.). America After 3 PM for Children with Special Needs or Disabilities. Retrieved November 1, 2023, from https://afterschoolalliance.org/documents/AA3PM-2020/AA3PM-Special-Needs-2021-Brief.pdf.
V Berninger, V. W., Ph.D. (n.d.). Understanding Dysgraphia. Retrieved on November 1, 2023, from https://dyslexiaida.org/understanding-dysgraphia
vi Oskarrson, A. (2019, October 1). Executive Dysfunction and MCI. Retrieved on December 11, 2023, from https://connect.mayoclinic.org/blog/living-with-mild-cognitive-impairment-mci/newsfeed-post/executive-dysfunction-and-mci
[x] Centers for Disease Control (n.d.). Autism Spectrum Disorder. Retrieved March 11, 2024, from: https://www.cdc.gov/ncbddd/autism/index.html
viii Ptacek, R., Weissenberger, S., Braaten, E., Klicperova-Baker, M., Goetz, M., Raboch, J., Vnukova, M., & Stefano, G. B. (2019). Clinical Implications of the Perception of Time in Attention Deficit Hyperactivity Disorder (ADHD): A Review. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 25, 3918–3924. https://doi.org/10.12659/MSM.914225.
i[xii] Learning Disabilities Association of America (n.d.). ADHD: Affects focus, attention, and behavior and can make learning challenging. Retrieved on December 11, 2023, from https://ldaamerica.org/disabilities/adhd
x Brock, L. L., Murrah, W. M., Cottone, E. A., Mashburn, A. J., & Grissmer, D. W. (2018). An afterschool intervention targeting executive function and visuospatial skills also improves classroom behavior. International Journal of Behavioral Development. Retrieved November 1, 2023 from,https://doi.org/10.1177/0165025417738057
xi Center on the Developing Child at Harvard University (2014). Enhancing and Practicing Executive Function Skills with Children from Infancy to Adolescence. Retrieved on December 11, 2023, from www.developingchild.harvard.edu.
xii Sharp, J., Rivera Rodas, E., & Sadovnik, A. R. Supporting youth with special needs in out-of-school time: A Study of OST Providers in New Jersey. Afterschool Matters, (ASM_2012_16_fall_4), 31-41. https://www.niost.org/pdf/afterschoolmatters/asm_2012_16_fall/ASM_2012_16_fall_4.pdf