There is a discrepancy in attention deficit/hyperactivity disorder (ADHD) services between students who receive a 504 plan and those found eligible under the Individuals with Disabilities Education Improvement Act for special education services under the other health impairment category (Spiel et al., 2014). As school-based administrators are responsible for ensuring students with ADHD are provided free appropriate public education, equal access, and appropriate accommodations in the least restrictive environment, there is a need to include the administrator lens in the body of ADHD research (Esposito et al., 2019). Therefore, this study sought to explore the perceptions of school-based administrators regarding access (use of a 504) versus accommodation (use of an individualized education plan[IEP]) as each relates to service and support for students with ADHD in a secondary school setting. It also sought to explore views on best practices for identification and subsequent service provision for students with ADHD, interpretations of the impact the eligibility process has on minority and socioeconomically disadvantaged students with ADHD, and the role that processes and procedures play in determining the use of a 504 plan or an IEP for students with ADHD. The study was conducted with a constructivist grounded theory approach and involved interviews with 14 school-based administrators. This research leveraged the coherence framework of Fullan et al. (2017) and emphasized social justice, critical policy analysis, and educational neuroscience to discover the underlying meaning through a critical lens and theory that was originated from data, gathered in a strategic and purposeful manner, and analyzed as part of the research (Chun et al., 2019). As a result of the data collection and analysis processes, five themes emerged: (1) academic supports for students with ADHD should be addressed through a continuum of services--with the continuum student centered, not district driven; (2) students with ADHD require accommodations, and accommodations are more robust in IEPs than 504 plans; (3) transitions are based on the individual affective and effective needs of the students with ADHD, with IEPs more comprehensive than 504 plans; (4) administrator efficacy is proportional to training, district process clarity, and teamwork, and communication and accountability are lacking in the determination process; and (5) all students with ADHD should be afforded the opportunity to participate in the eligibility process for special education services; 504 plans are the district opt-out for IEPs. The findings were used to develop theoretical framework: "The Integrated Leadership Framework of 504 Plan and Special Education Eligibility Processes for Students with ADHD." This framework provides a model for school-based educational leaders to lead the process for students with ADHD to access appropriate accommodations through the intervention process. Recommendations are provided related to overall practice, policy, specific transformative research-based practices, and future research. [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.]