Does Extra Time Really Help Your ADHD Child? The Truth About Exam Concessions

Do Exam Concessions Really Help ADHD Children? The Evidence | Dr John Flett
ADHD & School Support

Does Extra Time Really Help Your ADHD Child? The Truth About Exam Concessions

It’s the meeting you fought months to get. The assessment is done. The report is in. And the school has agreed to apply for extra time, maybe a separate venue, perhaps a reader.

You walk out feeling like you’ve finally cracked it. Like you’ve handed your child the key. And mostly, that’s a good thing.

But here’s something almost nobody tells you. The most common concession of all — extra time — might be doing far less for your ADHD child than you think. In some cases, it does nothing at all. And once in a while, it makes things worse.

I know that’s hard to hear. So let me show you what the research actually says, and what helps instead.

The One Question That Decides If a Concession Works

Researchers use a simple test to judge whether a concession is fair and useful. It goes like this.

Does it help your child more than it would help a child without ADHD?

That’s the whole game. A concession is meant to close a gap — to remove a barrier so your child can show what they actually know. If a support lifts everyone’s marks equally, it isn’t levelling the field. It’s just an advantage.

A real concession should close the gap. Not shift the whole class up together.

Hold onto that idea. Because when you point it at extra time and ADHD, the picture gets uncomfortable.

80%+ of children diagnosed with ADHD are given extra time — the single most prescribed concession, and the one with the weakest evidence behind it.

What Extra Time Actually Does to an ADHD Brain

Extra time is the default. It’s quick to grant, cheap to arrange, and it feels like the obvious fix. So it ends up on almost every plan.

But the controlled studies tell a sobering story. When you compare children with ADHD to children without, the extra minutes don’t give your child a special boost. The other kids benefit just as much — sometimes more. One study even found that some younger children with ADHD completed fewer questions when given longer.

Why? Because extra time only helps if you use it well. You have to go back. Check your work. Re-read the question you rushed. And that takes the exact pause button an ADHD brain struggles with. So the minutes sit there, unused.

Take Sipho — a composite of dozens of boys I’ve seen. Eleven years old, bright, granted extra time after his assessment. His mum was thrilled. But his marks didn’t budge. Not because the concession was wrong on paper. Because nobody taught him what to do with the time. His brain wasn’t built to manage it on its own.

A large study from the Kennedy Krieger Institute found exactly this. Across the five most common concessions, none was linked to better marks for children with ADHD. And here’s the kicker — that held true even for the children who also had a learning difficulty alongside their ADHD.

Concession by Concession: What the Evidence Says

So which concessions earn their place? Here’s the honest breakdown — colour-coded, so you can see at a glance.

Weak evidence

Extra Time (ADHD on its own)

No reliable ADHD-specific benefit. It only works if your child is actively taught to use it — to pause, check and re-read. Without that coaching, the extra minutes change very little. Helpful as fair access, not as a magic boost.

Weak evidence

Separate Venue

This one surprised me too. Studies show a quiet separate room doesn’t reliably lift marks — and in some cases children with disabilities scored lower in isolation than they did in the group. A strange, unfamiliar space carries its own costs. Useful for some children, but not the sure thing it seems.

Sound — for the right child

A Reader

The best-evidenced support here. A reader genuinely helps — but only when reading isn’t the skill being tested. Brilliant for a maths or science paper, where the words are just the wrapper. Pointless (and unfair) on a reading-comprehension test, where decoding is the whole point. Works best for younger children.

Sound rationale

Spelling Concession

The least controversial of the lot. The marker ignores spelling as long as the answer is phonetically clear, in non-language subjects. It doesn’t inflate marks — it simply stops your child being punished for a weakness the test was never meant to measure. Quietly fair.

Promising — under-studied

A Prompter

This is the one that fits ADHD best on paper. A prompter gives a quiet cue to refocus a child who has drifted. It targets the actual problem — attention slipping — rather than just adding time your child can’t manage. The hard evidence is thin, but the logic is the soundest of any concession for ADHD.

When There’s a Real Reading Difficulty (Dyslexia)

Everything changes when dyslexia is genuinely present. Now the bottleneck is decoding — the knowledge is in there, stuck behind the words. So extra time and a reader make far more sense. They remove the barrier rather than just adding minutes.

But even here, be careful. Extra time alone rarely fixes things. The child still has to be taught how to use it. The concession opens a door — it doesn’t walk them through it.

ADHD brain

The barrier is attention and self-control. More time = more minutes to lose focus. The support needed is structure and refocusing, not just length.

Dyslexic brain

The barrier is decoding. The thinking is intact behind it. Extra time and a reader let that thinking finally show. A far better fit.

And when ADHD and dyslexia travel together? This is the trap. The ADHD can cancel out the very concessions that would have helped the dyslexia. The child can’t make use of the support, so the marks stay flat. It’s not the concession failing — it’s the untreated attention difficulty getting in the way.

What About Anxiety?

Here the evidence is thinnest of all. There’s surprisingly little proof that anxiety directly blocks test access the way dyslexia does. Extra time may ease the pressure for some anxious children — but it doesn’t treat the anxiety. If anxiety is the real driver, manage the anxiety. Don’t expect a concession to do that job.

What to ask at your next school meeting

“Which barrier is each concession actually removing for my child?”

“Who’s going to teach them how to use the extra time or the reader?”

“Are we treating the ADHD itself — or just working around it?”

5–15mintypical extra time per hour granted in SA exams
<50%of eligible ADHD pupils actually use their extra time
0of 5 common concessions linked to higher marks in one major study

One practical note for South African parents. Whether your child is on CAPS, IEB, SACAI or Cambridge, concessions are granted on documented need — not on proof that they work. Apply early, well before Grade 12. And remember the report is the foundation for all of it.

Quick Win Tonight

  1. 10 minAsk your child to talk you through how they actually use extra time in a test. Do they go back and check — or just sit and wait? Their answer tells you everything.
  2. 15 minPractise one simple “go back and check” routine on a worksheet. Teach the strategy out loud. Don’t assume they know how.
  3. 5 minList your child’s subjects as either reading-heavy or content-heavy. That single list shows you where a reader genuinely helps — and where it doesn’t.

Remember This

A concession is a key to the door — not the room beyond it. It can give your child fair access to show what they know. But it can’t teach the skills, calm the brain, or do the work for them. Access opens the door. Understanding walks your child through it.

Where to Read More

Want to check this for yourself — or hand something to your child’s school? Here are the sources behind this article. Start with the easy ones.

Easy reading for parents

  • International Dyslexia Association — Accommodations for Students with Dyslexia (fact sheet). dyslexiaida.org
  • Yale Center for Dyslexia & Creativity — The Truth About Accommodations. dyslexia.yale.edu
  • Education Week (2025) — Does Extended Time on Tests Actually Help Students With ADHD? edweek.org
  • Exam concessions in South Africa (CAPS, IEB & Cambridge) — a plain-language guide. edupsychologist.co.za

The studies behind this article

  • Lovett, B. J., & Nelson, J. M. (2021). Systematic review: Educational accommodations for children and adolescents with attention-deficit/hyperactivity disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 60(4), 448–457. doi.org/10.1016/j.jaac.2020.07.891
  • Pritchard, A. E., Koriakin, T., Carey, L., Bellows, A., Jacobson, L., & Mahone, E. M. (2016). Academic testing accommodations for ADHD: Do they help? Learning Disabilities (Pittsburgh), 21(2), 67–78. (Free to read via PMC.)
  • Weis, R., & Beauchemin, E. L. (2020). Are separate room test accommodations effective for college students with disabilities? Assessment & Evaluation in Higher Education, 45(5), 794–809. doi.org/10.1080/02602938.2019.1702922
  • Lovett, B. J., & Leja, A. M. (2015). ADHD symptoms and benefit from extended time testing accommodations. Journal of Attention Disorders, 19(2), 167–172. doi.org/10.1177/1087054713510560
  • Pariseau, M. E., Fabiano, G. A., Massetti, G. M., Hart, K. C., & Pelham, W. E. (2010). Extended time on academic assignments: Does increased time lead to improved performance for children with ADHD? School Psychology Quarterly, 25(4), 236. doi.org/10.1037/a0022045
  • Li, H. (2014). The effects of read-aloud accommodations for students with and without disabilities: A meta-analysis. Educational Measurement: Issues and Practice, 33(3), 3–16. doi.org/10.1111/emip.12027

Want to Understand Your Child’s Brain Better?

Ready to move past guesswork and see what your child actually needs? Dr Flett offers compassionate ADHD assessments and support at The Assessment Centre, 8 Village Road, Kloof, Durban.

Call 031 1000 474

Zoom consultations available for families across South Africa.

Disclaimer: The information is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content and information contained in this article is for general information purposes only and does not replace a consultation with your own doctor/health professional. Information about mental health topics and treatments can change rapidly and we cannot guarantee the content’s currentness. For the most up-to-date information, please consult your doctor or qualified healthcare professional.

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