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Succeeding in College with ADHD

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Obtaining accommodations and support services at college can dramatically improve the odds of success for students with ADHD. However, many transitioning students with ADHD choose not to disclose their disability and seek help. In fact a large-scale study (Newman et al., 2011) found that only 20% of college students with a diagnosis who got accommodations and help in high school informed their universities of their disability status. Of those who did, only 19% used the resources available.

There can be a lot of reasons for this concerning pattern. Unlike in the K–12 system, colleges are not allowed to ask about whether a student has a disability and cannot actively pursue finding students. Colleges require that students, not parents, must disclose their disabilities and seek out supports.

Many high school and transfer students with ADHD who previously did not need help before, may not see a need to access supports when they go to college. They may be totally unaware of the fact that things are likely to be much more difficult for them in this setting. Those that used accommodations and services in high school or at a smaller community college found that everything was magically put in place each semester by their parents, teachers and flexible professors. They naively think that’s how things will continue to work. Consequently, most new college students have little to no practice with understanding their needs and requesting help. Also, disclosing requires that the student accept the fact that they really do have differences caused by their ADHD and that they need resources. Oftentimes, parents have come to this level of acceptance but their teenagers have not.

Prior to going to college, it can be helpful for you to develop an accurate understanding of what your strengths and weaknesses are and how ADHD might impact you in college. If you intend to request accommodations from the disabilities office, you will be asked to produce documentation and be expected to talk about your needs and what accommodations you are requesting. Many colleges ask students to provide an updated ADHD assessment for college accommodations, which usually includes an assessment of intellectual functioning, learning preferences, and academic strengths and weaknesses. However, the Americans with Disabilities Amendments Act of 2008 (ADAA)  encouraged colleges to become more liberal with their documentation requirements by accepting older documentation and student self-report.

The requirements for documentation may vary widely from college to college and it would be important to research this as part of your college search process. Once accepted to the college of your choice, make immediate contact with the disability office and begin the registration process. See if you can set up face-to-face or virtual meetings before classes start to get accommodations in place.

Even if you decide against disclosing your disability and requesting formal support services, an evaluation is still useful in determining the path to take in order to achieve success at the college level. Incoming college students may want to informally review strategies that worked well for them previous schooling. It can be helpful to create a portfolio with formal records and letters from teachers, tutors and coaches as well as your own notes that you can use to guide your meetings with college personnel.


Addressing ADHD Symptoms

Not all college students with ADHD are the same and have the same level of difficulty adjusting to college. Some families and schools have helped students practice many of the daily living and academic skills that will be needed in college. However, some come to college totally unprepared to take charge of themselves. Others have co-existing learning, emotional, physical and social issues that can make transitioning to college more challenging. Some of the common consequences of ADHD at the college level can include the following

  • procrastination or poor organization and time management
  • lack of self-esteem
  • difficulty keeping current with assignments and reading
  • emotional and social problems as students make new friends, have to deal with roommates and independently manage their emotions and stress level
  • distractibility and difficulty focusing leading to problems with reading comprehension, note-taking, and completing assignments and tests in a timely fashion

Many students, even those without ADHD, may have no experience handling all of the freedom that college offers and learning how to parent themselves. However, students with ADHD may have even greater and more serious complications with the nonacademic aspects of college:

  • self-care (managing sleep, independently waking up, forming healthy habits, setting limits on substance use) and achieving balance (using the free time in college wisely to focus on classes and have time for friends and outside activities). Their difficulties with the executive functioning skills that are needed to prioritize, set goals, make and follow plans, and observe and manage themselves with no adult involvement can make being independent very difficult.

Another common pitfall for students with ADHD is the feeling that they are instantly cured upon graduating from high school and no longer require supports and/or treatment at the college level. A young adult with ADHD may not want to be different than their peers and may hope that they can leave their ADHD behind in high school. Unrealistic expectations and lack of acceptance of the reality of ADHD may also lead a new college student with a track record of success to take on a heavy course load at college. They may fail to take into consideration the multiple demands that will suddenly be placed upon their time. This may lead to a “crash and burn syndrome,” with the student staying up all night and sleeping all day after studying or partying or both.

Given the fact that individuals diagnosed with ADHD are at greater risk for developing substance abuse problems, some students have their college experiences totally derailed by the drinking and party scene. Conversely, some students with ADHD are very aware of the potential challenges ahead in college and tighten the reins on themselves and become “all work and no play.” Such students will not allow themselves time for exercise, connection on campus, rest, sleep or down time. The consequences of this approach can lead to a different type of burnout where the student is unhappy and lonely and unable to keep at this pace.

There are several ways that a student with ADHD may address these issues. Some of the most effective include seeking accommodations; practicing good self-care (getting enough rest and exercise and learning ways to reduce stress); establishing supportive systems (working with a coach or a peer study group); taking medication for ADHD; and setting appropriate goals and priorities. Success is much more likely when a team of professionals including a physician, counselor or coach is available to assist in addressing needs, setting goals and priorities and developing a plan to carry them out. This process should lead to a new way of thinking and dealing with ADHD symptoms with the student eventually taking responsibility for his or her medication and other daily life activities.


Medication for ADHD

Consistent use and careful monitoring of medication is integral in helping college students with ADHD achieve both personal and academic success. Students will need to work with their physicians to establish a treatment regime that reduces symptoms of ADHD and optimizes functioning, while minimizing any side effects. Oftentimes, the dose and the dosage schedule that worked in high school need to be altered given the reality of a college student’s day. A new medication plan may be needed that lasts longer into the evening, given the heavy demands for learning that happens outside of class.

If a student needs to rely on local doctors to take over medication management, immediately contact the campus health center or counseling office to find out what options exist. Some campus physicians and psychiatrists will write prescriptions for medication, but only if the student has a recent, comprehensive evaluation for ADHD. If students lack comprehensive documentation, they can ask if there are doctors in the nearby community who may take over managing a prescription. Knowing this in advance and setting up appointments for medication management can avoid problems later.

Before transitioning to college, it is critical for students with ADHD to know what medication they take, understand the impact of the medication and assess whether it is of help to them. It would also be important for college-bound students to practice remembering to take their own medication, refilling their own prescriptions and making their doctor’s appointment while in high school. When this step is postponed until college, it can lead to increased stress for the transitioning students, and their use of medication might stop or be inconsistent at this critical time.

Finally, all college students with ADHD using medication should have a fail-proof plan for storing their medication so it doesn’t get lost or stolen. Stimulant misuse and abuse is a real problem on college campuses. Decide whether to let anyone know you have ADHD medication and if so, whom. It isn’t unusual for the word to get out and for students with ADHD to be approached by acquaintances, strangers and even close friends who want some pills to use during midterms or final exams. Sharing a pill with someone who is not diagnosed with ADHD is a criminal act as well as a potential honor code violation at college. Rehearsing how to say “No,” even to a close friend, will allow a student to be prepared to deal with this awkward situation if it arises.


Use of a Coach or Other Academic Supports

As mentioned previously, many colleges have supports for all first-year students and/or all students on campus. Make sure to use all available services proactively as you transition. There are orientation experiences that are designed to connect students to campus and with each other and to make them aware of campus resources and organizations.

Having an individual act as a coach for transitioning college students can be very helpful. Sometimes family members or friends can act as a coach or mentor as students are adjusting to their new setting. There are also coaches who specialize in working with college students with ADHD. Coaching can be done virtually or by phone as well as in person. Find out if coaching is available at your institution or whether you can get a referral to an ADHD coach within the community. It can be helpful to set up weekly meetings with a coach or learning specialist or an advisor during the first semester at school rather than wait to see if you need any help.

Given how different college is from high school, transition challenges are to be expected for any new student and may be even more likely for students with ADHD. Having a consistent connection with a professional can help you head off problems, get you to the right resource people and make sure you are developing the academic and self-management skills to succeed at college. A wait-and-see approach to using resources is likely to backfire given how quickly the college curriculum moves.


Apps, Technology and Digital Tools

We live in a time when everyone is using technology to make daily life and learning easier. At one point text reading and voice recognition software was very expensive and only available to individuals with disabilities. Now cell phones, tablets and laptops have built in programs that can allow anyone to have an audio version of their text or let them dictate a draft to a paper or an email. What a perfect time to be a student with ADHD, who may need reminders for appointments, to take medication, to refill prescriptions and assignments as well as ways to better manage time and be aware of time passing. Become as familiar as you can with all the ways your phone can be of use for helping you be successful at college. Many colleges have staff members in their computer departments or in their learning centers who help students figure out which technology might help them with their time management, daily living or academic learning challenges.


Mental Health Counseling

Having the right supports and tools can help make your college experience more successful.  Still, there may be issues that are more emotional or relational that can also interfere with your success.  These can include adjusting to college, peer relationships, self-esteem, motivation, anger management, and social skills, along with co-existing conditions such as anxiety or depression.  Short or long term weekly therapy sessions with someone who is trained to work with those with ADHD can provide much needed support and understanding, strategies for dealing with difficult situations and new skills to enhance coping and functioning with daily life and school stress.  Most therapists work from a “strengths-based perspective” that involves not only assessing your problems but also maximizing your skills and potential.

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