Supporting People with ADHD: A Guide for NDIS Support Workers
This guide brings together current research and the practical experience we have gained supporting people with ADHD across South East Queensland. Our hope is that by sharing what we have learned, more individuals, families and support workers can benefit from support that is respectful, person-centred and evidence-informed.
Registered NDIS Provider · Gold Coast, Logan, Ipswich & Brisbane
ADHD is a different and valid way of experiencing the world. Effective support is not about fixing someone or managing their behaviour. It is about understanding how an individual experiences their environment, reducing unnecessary friction in their daily life, building a genuinely trusted relationship, and creating conditions in which a person can pursue the goals that matter to them.
At Hearts In Action, these principles guide the way we support people every day. This guide combines evidence from the research with practical insights from our work alongside people with ADHD and their families. We hope it encourages thoughtful, compassionate support that helps people build on their strengths, develop confidence and live life on their own terms.
A note before you read on
Every person is unique, including every person with ADHD. The patterns in this guide come from research, but no two people experience ADHD the same way, and no approach here will suit everyone.
Use this guide as a way to build understanding while remaining open, curious and responsive to the person you are supporting. Their experiences, preferences, strengths and communication should always guide the support they receive.
The Relationship Is the Intervention
If there is one finding that cuts across every major study in this field, it is this: the quality of the relationship between a support worker and the person they support is the single most powerful predictor of positive outcomes. Be a consistent, continuous presence rather than one of a rotating cast of workers. A 2025 study of fifteen adults with ADHD found that having one dependable contact person, someone who already knew their story so they never had to start from scratch, was what made people feel safe enough to engage with support at all (Björklund et al., 2025).
It's worth remembering
Be someone they can rely on. Keep your word, arrive when you say you will, and follow up when you say you will. For many people with ADHD, relationships have been complicated by a lifetime of missing their own deadlines, forgetting commitments and feeling misunderstood, so a support worker who is non-judgemental and provides real encouragement can change that experience.
Understand What ADHD Actually Is
ADHD is a neurodevelopmental condition affecting attention regulation, executive function, impulse control and emotional processing, and it affects roughly 5 to 7% of adults globally, though it has historically been significantly underdiagnosed, particularly in women (Ginapp et al., 2022). A rapid review of 35 qualitative studies found the experience is more accurately described as attention dysregulation than attention deficit, not a universal inability to pay attention, but an inability to choose what to direct it toward. One participant described it plainly: "I think that deficit might not be the right word because I have an abundance of attention at times, it's just that I can't direct it. I don't get to choose what I pay attention to." Someone who hyperfocuses on a podcast for three hours and then can't start a practical task is not being lazy. Their attention system works differently, not worse.
It's worth remembering
ADHD is neurological, not motivational. When someone struggles to start a task, loses track of time, or can't shift attention away from something they're absorbed in, these are features of how their brain works, not choices they are making.
Embrace Person-Centred, Autonomy-First Thinking
Research consistently shows that adults with ADHD want to be active participants in their own care, and that genuine involvement directly improves outcomes. Participants in the Björklund et al. study experienced being invited into decisions about their care as profoundly meaningful, while feeling excluded or under-informed led them to withdraw from support entirely (Björklund et al., 2025). A 2026 systematic review of neurodivergent adults' experiences following diagnosis found identity reconstruction involved reconfiguring the self, finding the self through others, and emotional integration, with diagnosis offering validation and a framework for understanding experiences previously attributed to personal failure (Meldrum et al., 2026).
It's worth remembering
Ask what the person wants from the session before you decide what to do. Some people will know exactly what they need, others will need ideas and encouragement, but the starting point is always their priorities, not the plan on the sheet.
Recognise the Masking Tax
Many adults with ADHD spend significant energy concealing their traits to navigate everyday situations, suppressing the urge to fidget, rehearsing conversations, pretending to follow along when they have lost the thread. A 2026 study found over 91% of adult participants reported masking to some extent, and while it helped people fit in, it came at real cost: exhaustion, anxiety, depression, low self-esteem and an eroded sense of identity (Mylett et al., 2026). A related study on rejection sensitivity found a parallel pattern: participants who felt misunderstood began masking their emotional responses too, leading to disconnection from their own feelings. One participant described it: "I think at some point it's not just masking towards others, but you are also masking with yourself… you can't identify if you're bothered or not, because you lose connection" (Rowney-Smith et al., 2026). A person who seems to be coping well in your presence may be running at great personal cost to sustain that impression.
It's worth remembering
Create an environment where the person doesn't feel they have to perform. Accept fidgeting, silence and non-linear conversations. The person who cancelled twice in a row may be depleted, not disinterested.
Emotional Dysregulation Is a Core Feature, Not a Character Flaw
Emotional dysregulation is present in up to 70% of adults with ADHD and is more negatively influential on quality of life than attention difficulties alone, yet it is absent from the formal diagnostic criteria and consistently overlooked in support (Rowney-Smith et al., 2026). Adults with ADHD often experience emotions in an all-or-nothing way, extreme highs and extreme lows with very little in between. One participant described it as feeling like "someone has lit a match and your nerves and your brain are the fuse and something in there is on fire for a while," and not understanding why had led many to years of misdiagnosis as anxiety, depression or personality disorders before their ADHD was identified (Ginapp et al., 2023). Rejection sensitivity is a related dimension: even ambiguous signals, an unanswered message, an offhand comment, can produce intense distress that lasts hours or days, and the anticipation of rejection is often more painful than actual rejection (Sandland, 2025). If a participant goes quiet or withdraws after an interaction that felt neutral to you, it may not have felt neutral to them.
It's worth remembering
Don't read emotional reactions through a neurotypical lens. What looks disproportionate from the outside often makes sense given a nervous system wired for intensity. Give feedback clearly and kindly, and avoid vague phrasing: an ambiguous comment gets interpreted in the least favourable direction possible, every time.
Structure Is Something You Can Offer, Not Impose
Structure significantly reduces the friction of daily life for adults with ADHD, but the most helpful structure is co-created, not handed down. Participants in the Björklund et al. study described structured discussions about everyday situations as among the most practically valuable support they received, with one describing the value of a contact person who helped with "providing a structure for doing some cleaning and things like that, household chores, and helping me apportion my energy for the whole day, so that I can cope" (Björklund et al., 2025). As children, most of that structure was provided by parents, school and routine. In adulthood it disappears, and many people with ADHD are left to build it themselves for the first time. Strategies like scheduling, alarms and supportive relationships help most when someone is genuinely alongside the person, not just handing them a system (Ginapp et al., 2022). This is why our daily living support is delivered consistently by the same workers, at the same times. Predictability is built in by design.
It's worth remembering
Help the person build their own system, not yours. Ask what has worked in the past and what has failed and why, then try things together and adjust. An external reminder the person chose to set up themselves works far better than one you impose.
Support Identity, Not Just Symptoms
Adults with ADHD are not their diagnosis. Many spent years being told they were lazy, careless or dramatic before finally receiving an explanation that reframes those experiences. A 2026 systematic review found receiving a neurodivergent diagnosis as an adult triggered a profound identity reevaluation, grief about years of unnecessary struggle, confusion about who they were without the negative labels, and gradually a more integrated, authentic sense of self, with access to others with similar experiences the most powerful facilitator of that process (Meldrum et al., 2026). Support workers who approach ADHD through a neurodiversity-affirming lens, one that recognises hyperfocus, creativity, spontaneity and enthusiasm as genuine strengths alongside the challenges, contribute meaningfully to this process. Many adults with ADHD describe real, valued parts of who they are: the ability to produce exceptional work in short bursts, resilience built from navigating a world not designed for their neurology, and a capacity for deep connection with the people and topics they care about (Ginapp et al., 2022). It's the same connection our community access support is built around.
It's worth remembering
Notice what the person does well and name it genuinely. Many people with ADHD have spent years hearing about what they're failing at. Paying consistent attention to strengths plays an active role in rebuilding the confidence that years of misunderstanding can quietly dismantle.
Address the Training Gap
Inadequate training is a structural problem that directly limits support quality. Participants in the Björklund et al. study described experiences with professionals who did not understand ADHD as fundamentally unhelpful: meetings that were "superficial," that left no space for genuine involvement, and that left them feeling more overwhelmed than supported (Björklund et al., 2025). ADHD-specific knowledge is not a bonus. It is the baseline that makes support useful, and without it, even well-intentioned support can increase the shame and sense of failure it was meant to reduce.
It's worth remembering
Seek out ADHD-specific training and resources on your own initiative. Most general disability or mental health training, including the NDIS Commission's worker orientation module, does not cover ADHD in any real depth. The more clearly you understand what someone is actually managing, neurologically, emotionally, socially, the more naturally your support adapts to what they need.
Families Are Partners, Not Peripheral
For many adults with ADHD, family members are a primary source of both support and tension, often carrying real informal load: reminding, organising, advocating, and reducing the cognitive burden of navigating care systems. Participants in the Björklund et al. study specifically valued relatives who helped them remember information from appointments and support decision-making, and found shared psychoeducation with family members both supportive and informative (Björklund et al., 2025). Communicating proactively with families, always with the participant's consent, and coordinating support respectfully directly improves outcomes and extends your impact beyond the hours you are present.
It's worth remembering
Where appropriate and with the participant's consent, keep families informed about what's going well and any changes you've noticed. A brief, clear update can reduce household tension and help everyone provide support that actually fits together. You are not working in isolation, and neither is the family.
References
- Björklund, P., Grensman, A. B., Ranås, M., & Sandlund, J. (2025). On the way to becoming like anyone else: The experiences of being involved in their care — An interview study with adult patients with ADHD. Scandinavian Journal of Caring Sciences. Advance online publication. https://doi.org/10.1080/28324765.2025.2550308
- Ginapp, C. M., Macdonald-Gagnon, G., Angarita, G. A., Bold, K. W., & Potenza, M. N. (2022). The lived experiences of adults with attention-deficit/hyperactivity disorder: A rapid review of qualitative evidence. Frontiers in Psychiatry, 13, Article 949321. https://doi.org/10.3389/fpsyt.2022.949321
- Ginapp, C. M., Greenberg, N. R., MacDonald-Gagnon, G., Angarita, G. A., Bold, K. W., & Potenza, M. N. (2023). "Dysregulated not deficit": A qualitative study on symptomatology of ADHD in young adults. PLOS ONE, 18(10), e0292721. https://doi.org/10.1371/journal.pone.0292721
- Meldrum, P., Johnson, B. P., Lo, B. C. Y., Bedelis, M. L., & Rabba, A. S. (2026). "You become yourself, your full self, the true self": A systematic review of neurodivergent adults' experiences of identity reconstruction following diagnosis of autism and/or ADHD in adulthood. Autism in Adulthood. Advance online publication. https://doi.org/10.1177/25739581261427260
- Mylett, M. L., Boucher, T. Q., & Iarocci, G. (2026). "I wish I could just be myself": Experiences of social camouflaging in adults with ADHD. Research in Neurodiversity. Advance online publication. https://doi.org/10.1016/j.rin.2026.100018
- Rowney-Smith, A., Sutton, B., Quadt, L., & Eccles, J. A. (2026). The lived experience of rejection sensitivity in ADHD: A qualitative exploration. PLOS ONE, 21(1), e0314669. https://doi.org/10.1371/journal.pone.0314669
- Sandland, B. (2025). Neurodivergent experiences of rejection sensitive dysphoria expose the environmental factors too often overlooked. Neurodiversity, 3. https://doi.org/10.1177/27546330251394516