This article is based on an extensive study of teaching-learning processes in special educational settings organised for children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). There is a general assumption that children's learning will be supported through placement in a special class with few students and one or more teachers present. The issues explored concern what educational practices unfold in these settings, i.e. what are the children learning, and how do they participate in the activities? The empirical study is based on video-recorded classroom interaction in eight ADHD-classes during a period of seven years, in total about 200 h. The results show that the interactional format dominating is characterised by one teacher instructing one child at a time. These situations usually seem to follow the well-known Initiative-Response-Feedback (I-R-F) structure. The contributions from the children are generally minimal, and there is no indication that the student's role in such dyads is more active. Thus, there is little evidence that children's learning will improve and that they become more focussed and assume a more participatory role in the interactional formats offered in special classes. Also, it is not obvious how experiences of this kind will prepare children for a return to regular classroom or develop towards becoming active citizens.