AD/HD Transition to College Passport to Success Patricia O. Quinn, MD Developmental Pediatrician Washington, DC
Today we will discuss: O How AD/HD impacts students at college. O Factors that may lead to many transition challenges. O How to better prepare for college success. O Where to get the help you need on campus. O How medication may help. O Useful accommodations.
GETTING INTO COLLEGE IS ONLY HALF THE BATTLE…
EXPERIENCES OF COLLEGE STUDENTS WITH AD/HD More likely to: O Have lower grade point averages. O Be placed on probation more often. O Take longer to graduate. O Graduate at even lower rates than students with other disabilities. O Struggle more with necessary coping and self- management skills. References: Barkley et al.( 2007);D’Amico, personal communication (January 29, 2008); Heiligenstein, et al. (1999); Murray, et al.( 2000); NCES (2003); Newman et al. (2009); Rabiner et al.(2008); Reaser et al. (2007); Vogel & Adelman (1990a, 1990b, 2000); Vogel et al.(1998); Vogel et al. (1999); Wagner et al. ( 2005)
Why is the transition to college challenging? O College life is dramatically different from high school. O Increased academic expectations. O Different laws/mandates/services ( (504 and IEPs). O Dealing with impact of AD/HD on their own (some for the first time!).
Learning Issues for Students with AD/HD O Unexpected weaknesses in learning even without a formal Learning Disability (LD) O Less efficient learners O Problems in short-term and working memory (males>females) and executive functioning O Difficulty recognizing as well as recalling after a delay O Slower processing speed (males>females) Cutting, et.al., (2001) Evidence of unexpected weaknesses in learning in children with attention deficit hyperactivity disorder without reading disabilities. National Academy of Neuropsychology. Seidman, et. al., (2005) Impact of gender an age on executive functioning: Do girls and boys with and without attention deficit hyperactivity disorder differ neuoropsychologically in preteen and teen years? Developmental Neuropsychology.
Learning Memory Attention Language Visual-spatial Sequencing Emotion (anxiety/depression) Sensory input Alertness (sleep issues)
Attention and Working Memory as a Function of Learning In order to learn new information we need: O Attention span O Working memory O Time perception O Rapid information processing
Progression of Executive Functions from Childhood to Adulthood Early childhood Simple responses to limited demands in a O protective environment Late childhood into adulthood: executive functions become more important Juggling competing tasks, independence, O organization, and planning Slide provided by T. Spencer, MD
IQ and EF O Students with high IQs (top 9 percent) and AD/HD also suffer from executive functioning (EF) challenges — difficulty with working memory, processing speed, organization and focus. O These impairments do not significantly interfere with their ability to perform well until relatively late in their school years. O Students report that during elementary school they were able to function in ways that lived up to the high expectations for academic success that were held by their parents, their teachers, and themselves. O It was not until they had to keep track of various assignments for many different teachers, without anyone to help them to prioritize and remember, that AD/HD became apparent in these students. (Brown, et al., 2011)
Common EF Challenges in College O Procrastination/meeting deadlines/late O Chronic stress/ frequently overwhelmed O Identifying and using existing resources O Disorganization of materials, space, effort O Poorly-planned choices (assignments, course selections, majors/careers) O Saliency: focusing on that which is important O Using existing skills and knowledge at the “point of performance” O Reading social niceties/cues DuPaul, Weyandt , O’Dell, & Varejao (2009); Parker & Boutelle (2009); Ratey, Quinn, & Maitland (2000) Field, Parker, Sleeper-Triplett, & Tudisco (CHADD 2010)
How to better prepare teens with AD/HD for college ? O Raise awareness of stark differences between high school and college O Challenge teens to “stretch and grow” O Assess student’s readiness for college and make a personalized readiness plan (at home and/or at school)
High School vs. College O Total freedom/responsibility O No adults O No homework O No accommodations O No teachers
Challenges for AD/HD Teens O Organization O Decision-making/Problem-solving O Time management O Reminding and remembering ALL are challenges for AD/HD adults - need to help them develop these skills earlier.
Strategically work on: O Important non-academic readiness skills. Self-determination Daily living skills O Learning study skills/strategies that will be necessary in college. O Slowly fading reliance on accommodations that are not likely to be available at college. O Practicing good decision making/problem-solving. O Other issues -- If more is going on -- get help now!
Problem-solving
Strategies to shore up EF O Reduce load on working memory O Learn in small chunks followed by guided practice O Provide scaffolding (visual cues) O Checklists O Coaching
“ P assport” O Self-knowledge O Self-advocacy O Planning O Self-care
O Instead of approaching college like a kid in a candy store, try to set up a program for success that utilizes and builds on your strengths and seeks help and accommodations for the weaker areas. O You ou are responsible for making success happen!
College and AD/HD O Late diagnosis in college common. O Medication treatment may be complicated due to anxiety and/or depression. O Essential to develop habits, structure, patterns. O Coaching may provide essential lifeline in this transitional period. O Self-advocacy skills are critical. O Under- and over-commitment is hazardous.
Differences in Academic Coping Strategies O Equal gender representation (46% women). O College women seek and experience a greater level of social support than men. O Women reported significantly more time- management behavior. O Men tended to procrastinate.
COLLEGE STUDENTS WITH DISABILITIES… Many don’t access support! O Only a third (1/3) of the college students who received special education services in high school sought formal accommodations in college O Not all of these student used available resources References: NLTS2: Newman et al. (2009)
IF YOU PLAN TO LEARN, YOU MUST LEARN TO PLAN!
Issues that must be addressed O Self-care. O Time management. O Developing strategies and routines. O Anxiety and depression may need to be treated ALONG WITH AD/HD. O Eating problems may be intensified. O Substance abuse and high-risk behaviors must be addressed.
Some suggestions for success O Study groups O No days off -- more scheduled -- more get done O 8 am classes ?????? O Discussion classes O Advisor/coach O Disability services O Healthy habits: eating/ sleeping/ exercise O Technology O Be proactive
NOT SO GOOD NEWS FOR ALL COLLEGE STUDENTS… Many college students struggle emotionally • 50% may need to seek help for emotional/social issues; • Freshmen reported all time lows for emotional health on national survey; • 48.1% rated their emotional health as below average. Kadison, R. , and DiGeronimo, T. (2004), Sieben, L. (2011) )
College of the Overwhelmed
Students: Working with your parents O How involved should they be? O Establish regular check-ins. O Set up guidelines for calls. O Use them as a resource on your AD/HD.
O Take responsibility for your health and medication. O Let them know what you are doing. O Discuss financial responsibilities. O Try to see it their way!
Parents: Working with your student O How much to keep in touch? O Send money? O Roommate problems? O Struggling academically? O 4 vs. 5-6 years? O Discuss giving college permission to share grades and to contact you?
GOOD NEWS FOR COLLEGE STUDENTS WITH AD/HD… If If they access support, their graduation rates are the same as their non-disabled peers
Places to find help on campus O Emotional problems – Counseling Center; staff in dorm or living center; the university health center, local mental health provider; clergy and campus chaplains. O Academic program or individual course – proactively visit professor during office hours; academic advisor; mentor/tutoring program; for more general or serious problems contact the DSS Office or Office of the Dean of Students. O Adjustment issues – connect with others on campus; RA on floor or dorms.
AD/HD Coaching O How does coaching work? O How can I find a coach? O Setting goals and working to achieve them. O Adding structure and achieving balance.
Academic Accommodations O Documentation and recent assessments? O Types of accommodations that have worked in the past? O Types of accommodations you anticipate needing? O How has AD/HD contributed to academic issues? O How has it affected your capacity to learn?
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