The purpose of this qualitative study is to explore the systems, structures, and on-going professional development that leaders of elementary schools in New York State provide to support students who struggle with ADHD and executive functioning skills. The study used interviews as a data collection tool. Sixteen participants, including principals and directors of special education, took part in the study to help understand the support plans their schools have implemented for students who struggle with ADHD and executive functioning and the ways in which their schools collaborate with parents of children diagnosed with ADHD. The study found that all school systems surveyed use a team approach to implement a tiered system of interventions through the MTSS/RTI process. A second finding was that neither school principals nor teachers are receiving professional development focused on either ADHD or executive functioning. Instead, the study found that school districts generally rely on other staff members to provide individual coaching to teachers of students with ADHD. A third finding was that teacher self-efficacy varies with the individual teacher's background, perceptions, and training. Additionally, the study found that parents' lack of knowledge, perceptions about ADHD, tension around medicine management, and lack of trust in the school system are all barriers to supporting students with ADHD. The study therefore recommends that education certification programs require training in ADHD and executive functioning, provide systemic support for teachers of students diagnosed with ADHD, and help to better educate parents of children with ADHD.Keywords: ADHD, executive functioning, professional development, self-efficacy. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com.bibliotheek.ehb.be/en-US/products/dissertations/individuals.shtml.]