What Happens When ADHD Goes to College?

A group of colleagues in the UK Adult ADHD Network (UKAAN) recently published a consensus statement about supporting college students with ADHD.¹ The author list for the consensus statement is comprised mostly, if not completely, of researchers who also provide clinical services, and thus they know what university students with ADHD (and other young adults with ADHD) are up against as they assume adult roles.

Recalling the early days of the University of Pennsylvania Adult ADHD Treatment and Research Program, I’d estimate that college students comprised two-thirds of our initial cohort of clients. These were students who were only identified with ADHD after facing significant difficulties in college far and above any typical adjustment issues. They often reported simmering difficulties in earlier levels of school that were masked by intelligence (combined with less demanding work), support of family who ensured homework completion, more structure at home and school, or simply doing enough in high school to get by. Once they got to college, however, many of these students faced newfound levels of stress and difficulty that shed light on these heretofore veiled difficulties that could now be understood as undiagnosed ADHD. (There were some other students with ADHD who had been diagnosed before college but sought services as part of their continuity of care in college.)

College life offers students a lot of options—maybe too many if you have ADHD.

Source: Pixabay/Pexels

General Recommendations from the College Students with ADHD Consensus Statement

The main takeaways from the UKAAN review and recommendations are:

• ADHD should be a separate category for disability determination, not as a learning or other difference.
• Screenings for ADHD should be performed for students presenting for disability services with specific learning differences or autistic spectrum issues or who seek help for depression and/or anxiety with learning problems.
• Staff training about the nature of ADHD and its assessment, treatment, and effects on learning is needed to heighten awareness and reduce stigma.
• Rapid access to services is a serious issue in terms of long waits for ADHD-related services via the NHS that needs to be addressed.
• Higher-education specialists also need training on the screen and diagnostic assessment of ADHD in college-aged adults in order to facilitate identification and referral for specialized treatments.
• The use of evidence-supported, multimodal treatment options, including psychoeducation, environmental adjustments/academic accommodations, medication treatments, academic coaching, psychosocial treatments and counseling (cognitive-behavior/dialectical-behavior therapies), and mindful interventions are helpful for young adults.

Facing College With ADHD: It Is More Than Just the Classroom

Our program’s early experiences with college students with ADHD also shed light on the college transition being as much if not more of a test of students’ time management and organizational skills as it was about knowledge and intellect. Unfortunately, difficulties with the former often undermine abilities in the latter. What’s more, most college students move away from home to attend college and must take on many more roles and responsibilities for managing their affairs and dealing with various distractions, temptations, and the stress of emerging adulthood at the same time they face a new level of education.

Help for College Students With ADHD

Encouragingly, there has been increased awareness of the effects of ADHD in college students, as well as other learning and mental health issues. Ever more treatments for ADHD are being adapted to the unique needs of college students with ADHD. As always with ADHD, medications can be highly effective. To date, I don’t think there is a medication that will make you want to read Beowulf, though. Psychosocial treatments, such as cognitive-behavior therapy (CBT), are helpful for the implementation of coping strategies as well as dealing with stress and other emotional aspects of adjusting to and handling college. ADHD coaching is another option well-suited to supporting college students.

On-campus learning centers often offer support in the form of organization and time management strategies and other, more specific learning strategies in both group and individual settings. Targeted tutoring for particular subjects can also be helpful. Specific psychoeducation evaluations are required to petition campus disability services offices for formal academic accommodations based on documented learning disabilities, as the diagnosis of ADHD alone is not deemed sufficient justification, at least for schools that strictly follow Americans with Disabilities Act guidelines for postsecondary education. Nonetheless, there are informal coping steps that students can take, such as sitting near the front in large lectures, making use of instructor and teaching assistant office hours, and resources and regular meetings at the campus learning center.

In addition to an evidence-based CBT program for college students², rumor has it that several other respected clinician-researchers in the ADHD community are developing materials designed to support college students with ADHD. A benefit of addressing ADHD in college is that every day provides an opportunity to implement and practice the coping strategies with academics, but that generalizes to other areas of life. As I had said about our program’s clinical experience with college students with ADHD, we provided early intervention for adult ADHD.