Attention Magazine June 2024

What do emerging adults with ADHD experience as they navigate postsecondary education? What types of supports are available to them? More research exists on ADHD in childhood, and there is a pressing need to understand the perspectives of older adolescents and adults with ADHD. This research brief reviews two studies that pertain to the experiences of students with ADHD in postsecondary education.

The first study examined the lived experiences of students with ADHD in college. Participants noted having mixed feelings related to receiving an ADHD diagnosis, experiencing ADHD-related challenges in the postsecondary environment, and having complex relationships regarding pursuing ADHD interventions and accommodations.

The second study reviewed the supportive services available to university students with ADHD. A number of on-campus supports were identified, within the broad categories of academic services, student life services, and career services.

Taken together, the studies underscore the need to make accommodations and interventions for ADHD more accessible in the postsecondary context. Students with ADHD may be more likely to encounter significant challenges, and more research is necessary to understand how to improve the services offered to ultimately enhance their experiences and outcomes.

What is the lived experience of college students with ADHD?

The period of emerging adulthood includes the range of ages between eighteen to twenty-five, the transition years from adolescence to adulthood. This period of life involves a variety of challenges such as consideration of postsecondary education, navigating independence from caregivers, and potentially more serious romantic relationships. Within higher education, students with ADHD may have more difficulty than students without ADHD in terms of paying attention during classes, completing less interesting tasks that involve significant cognitive demands, and thinking through consequences before acting. This study investigated the lived experiences of college students with ADHD by asking what it is like to be a college student with ADHD, and what resources are utilized by college students with ADHD.

Thirty-six students with ADHD who were registered in college full-time participated in this study. Fifty-five percent of them had co-occurring anxiety disorders, and twenty percent had co-occurring depression. Eight focus-group interviews with four to five participants per interview occurred. The predetermined list of ADHD-related topics discussed within each focus group were: age of diagnosis or the effect of the age of diagnosis, feelings about the diagnosis, childhood experiences with the diagnosis, ADHD impairment in the past and the present, educational accommodations in the past and present, psychosocial therapy in the past and present, medication use in the past and present, and best treatment options or accommodations for college.

A number of themes came up during these group discussions. In the broad thematic category of consequences of diagnosis, participants discussed the benefits of the diagnosis, awareness of the problem, and on the other hand, stigma or embarrassment related to the diagnosis. Related to the topic of Impairment, participants discussed their experiences of life skills and choices, academic skills, and low motivation or underachievement. For the theme of treatment management, participants described academic accommodations, psychosocial treatment, and medication.

Overall, the participants reported positive impacts of having an ADHD diagnosis, such as relief and self-understanding as well as negative consequences, that is, experiences of stigma and embarrassment. In addition, participants described the ways in which they experienced problems related to ADHD symptoms and impairment. Participants also noted feeling hesitant about receiving treatment for ADHD. In particular, they reported experiencing challenges with stigma and personalized accommodations in their college contexts.

This study highlights the need to increase attention to understanding how to enhance the accessibility of ADHD programs and services on campus, improve attitudes toward ADHD, and individualize academic accommodations so as to improve the experiences of postsecondary students with ADHD.

Lefler EK, Sacchetti GM, & Del Carlo DI. (2016). ADHD in college: A qualitative analysis. ADHD Attention Deficit and Hyperactivity Disorders, 8, 79-93. https://doi.org/10.1007/s12402-016-0190-9

What services are available to college students with ADHD?

The university environment represents a new social context for emerging adults, with increased independence and distractions as well as fewer parental supports. ADHD is associated with increased risk for lower academic performance and higher risk of dropout. Students with ADHD may be less likely to receive as much support in the postsecondary environment compared to prior school contexts.

This study reviewed twenty-four studies in the literature to determine the types of services available to college students with ADHD. One hundred percent of these studies described universities providing academic services, thirty-one percent of these studies described the provision of personal student life services, and eight percent described career services.

Academic services available on campus included the following: (1) helping students with ADHD with academic-related documentation (e.g., sending text messages to students with information on resources, providing accommodations letters), (2) providing coaching (e.g., meeting with students to improve self-efficacy and organization), (3) academic advising (e.g., helping students set goals and reflect on academic progress with an advisor), (4) providing assistance in class (e.g., providing exam and classroom accommodations), and (5) providing individual and small group tutoring. Personal student life services found on campus included peer mentoring programs, counselling services, and social support services. Career services included support in job searches and navigating the transition to the workplace.

In addition to these on-campus services, intervention programs not necessarily found on campus but that have been examined with college students with ADHD include (1) cognitive behavioral therapy (in which the connections between thoughts, behavior, and feelings are focused on to reduce distress and improve functioning), (2) organizational, time management, and planning (in which organizational, planning, and time management skills are specifically worked on), (3) coping skills development (in which helpful coping skills are worked on), (4) cognitive training (in which cognitive games are played with the goal of improved executive functions), (5) mindfulness and device-guided slow breathing (which involves paying attention in the present as well as learning paced breathing), and (6) coaching and neurofeedback (receiving brain-based feedback to improve self-regulation).

The studies reviewed outline various interventions for college students with ADHD, with a great proportion of on-campus services being academic services. Although research is emerging, psychosocial interventions for ADHD are being examined with college student populations. Given that students with ADHD are at risk for difficult outcomes during college, more research on how to improve the accessibility and effectiveness of ADHD programs in this context is essential.

Álvarez-Godos M, & Ferreira C. (2023). A systematic review of actions aimed at university students with ADHD. Frontiers in Psychology, 14, 1-13. https://doi.org/10.3389/fpsyg.2023.1216692

Yuanyuan Jiang, PhD, CPsych, is an assistant professor in school and applied child psychology at the University of British Columbia and a registered clinical psychologist. She directs the Attention, Behaviour, and Cognitions Lab, which focuses on studying how attention, behavior, and cognitions interact to improve assessments and interventions for children with inattentiveness and/or hyperactivity/impulsivity.