Students showing signs of attention deficits may struggle to maintain focus, follow instructions, and complete tasks, requiring instructional management responsive to their learning needs. This study aims to describe teacher strategies for managing instruction for elementary school students exhibiting signs of attention deficits. A qualitative case study design was employed. Informants—including the school principal, a classroom teacher, a subject teacher, a student, and a parent—were purposively selected. Data were collected through observation, semi-structured interviews, and documentation, then analyzed using the Miles, Huberman, and Saldaña interactive model, involving data condensation, data display, and conclusion drawing/verification. Data validity was reinforced through triangulation of sources, techniques, and time. The results indicate that teachers utilized a variety of instructional methods, concrete and technology-based media, learning environment adjustments, positive reinforcement, individual support, and communication with parents. The most prominent strategies were varied, participatory teaching methods combined with interactive media. During these activities, students were observed following instructions, waiting for their turn, using media, participating in group activities, and completing tasks, although they still required redirection in certain situations. Challenges identified included easily distracted attention, the need for repeated instructions, spontaneous behavior, and distractions caused by a noisy classroom environment. The findings highlight the importance of flexible, context-specific instructional adjustments tailored to students' responses and needs.