Linda Hecker, Director of Educational Services
- National Institute at Landmark College
(NOTE - At the conclusion of this article
you will find a brief summary of data that my colleagues and I recently collected
on college adjustment in students with ADHD.)
"The road through college was filled with
numerous mountains I had to climb. I discovered the average student had bumps
in the road but my bumps resembled Mt. Everest." -R. Cary Westbrook "Learning
Disabilities and College: Strategies for People that Rock our World"
Troy B and Mike H. are bright,
athletic college freshmen at a state university. They were both diagnosed
with learning disabilities and ADHD in late elementary school, attended the
same public high school where they shared many classes, including time in
resource rooms, and graduated with similar GPA's.
At the end of his first college semester
Troy is facing academic probation in three of his five classes. Troy has
never contacted the university's office of Disability Support Services (DSS):
he's vaguely aware it exists, but he decided to make a "fresh start" in college:
no one at the university would have to know about his LD - he chose to blend
in with his peers.
In contrast, Mike is earning all B's and
B+'s in his classes. He's a regular at the DSS office, taking advantage of
tutoring, study skills seminars, and support groups. He contacted the office
soon after he was accepted at the university, and established a good relationship
with a staff member who helped him select courses with professors who are
empathetic to students with learning disabilities and provided a letter to
Mike's professors suggesting appropriate class accommodations such as extended
time on tests, which he can take in a quiet study area free of distractions.
It's no wonder Mike is having a good freshman
year while Troy is on the brink of suspension, but let's examine what helped
Mike prepare for his positive experience. A successful transition from high
school to college can be summed up succinctly: know yourself; know
the law; know your college; (and prepare accordingly)
Research on successful outcomes
for adults with learning disabilities stresses the importance of well-developed
self-awareness and self-advocacy skills, often referred to as metacognition
(from Greek "thinking about thinking"). This includes a good understanding
of the testing that resulted in a student's diagnosis of LD or ADHD.
* what is the name of the disability?
* what areas of achievement does it affect?
* what are the specific impacts in each
* what are the student's strengths?
* what strategies, interventions, and accommodations
best support learning?
How can students master this information,
especially when test reports are often written in obscure, technical language?
Parents should insist that the evaluator meet with their child after the
testing to explain the results in language, pictures, and examples appropriate
to his/her level of understanding and development Then parents
can reinforce this understanding as their child matures and faces new challenges.
Merely understanding this information isn't
enough, however; students must be able to talk about it knowledgeably and
comfortably with teachers, advisors, and counselors, not an easy task. One
helpful way to build this skill is to have students attend their own IEP
meetings as early as they can participate - by late middle school. Ideally,
students will take an active role in the meetings, preparing questions beforehand
and taking notes to the best of their ability.
KNOW THE LAW
The reason it's so important
for college students to be strong self-advocates is that the laws governing
treatment of individuals with disabilities change radically when students
move from grades K-12 into postsecondary settings. Students who are
not thoroughly familiar with these changes and their implications by the
time they apply to college face a difficult transition.
In grades K-12 the Individuals with Disabilities
Education Act (IDEA) places the burden on schools to identify students with
suspected disabilities, perform evaluations, make specific recommendations
for services in cooperation with parental input, provide special services,
and monitor students' progress, updating testing as necessary.
In contrast, postsecondary institutions,
governed by Section 504 of the Rehabilitation Act and by the Americans with
Disabilities Act (ADA), must ensure that individuals with disabilities have
"reasonable accommodations" that provide equal access to programs, courses,
and resources, but only when students disclose their disability and present
documentation to support their needs. In other words, students in college
are responsible for initiating the process. This means they must 1) choose
to reveal to school officials and instructors that they have a disability
2) discover the procedures for requesting and implementing accommodations
and services and 3) supply testing documents that are current and meet the
Many entering students like Troy fall off
track right at Step 1. They do not want to be identified as "different" when
they go off to school. When I visit postsecondary schools around the country,
talking to DSS staff, their biggest concern is with students with disabilities
who never come into their office, or not until they are in crisis, about
to flunk out. Often this happens too late to make a successful turn around.
On the other hand, successful students like Mike usually connect to the DSS
office soon after being admitted and take advantage of the services they
offer. They have the maturity to recognize the value of good support systems
and to take advantage of what the laws provide.
KNOW YOUR SCHOOL
Although all postsecondary
schools must conform to ADA and most to section 504, schools vary drastically
in the levels and kinds of supports and services they provide students with
learning disabilities, as well as in the campus culture surrounding disabilities.
In some schools, students with learning disabilities-the invisible disabilities-still
meet with skepticism and stigma from some professors or departments; in other
schools, students with learning disabilities are welcomed for their contributions
to campus diversity, and services go well beyond what the law requires.
Community colleges can be especially good
initial environments for students whose academic skills are still a little
shaky. They often provide developmental or remedial courses and knowledgeable,
empathetic support, as well as much lower tuition fees. In some cases,
students may not earn college credit for these skills-based courses, but
the extra preparation will pay off in improved GPA's and retention once students
are eligible for credit.
Students can get some guidance about which
campuses are most LD-friendly from sources such as Peterson's Guide to Colleges
for Students with Learning Disabilities, and from online resources, but for
authentic, updated information it's best to visit the campus, scheduling
an appointment at the office of DSS soon after being admitted. While visiting,
take time to talk to other students with LD to hear their views about campus
Students should use their
time in high school to develop academic and self-management skills to the
highest level possible, taking the most challenging courses that they qualify
for. This will encourage them to develop the independent skills they'll need
in college, such as organizing and maintaining notebooks.
For example, students should learn how
to take notes efficiently, using note-takers only to supplement their own
efforts. This is because students who actively engage in note-taking
and note-revision learn to process and synthesize information, rather than
passively digesting someone else's notes, trying to commit the information
to rote memory.
Similarly, students need to develop strong
active reading, discussion, and math skills. If your high school doesn't
provide support in developing these skills, it may be worthwhile seeking
a tutor or academic therapist who can.
While still in high school, students should
explore the potential benefits of Assistive Technology. Learn how text-to-speech
software like Kurzweil 3000 or voice recognition software like Dragon Naturally
Speaking can make academic work less labor intensive. If possible,
select, purchase, and learn to use the appropriate software before going
to college, unless you know for sure that the college can provide it when
and where it's needed (like at 1 a.m. on Friday when a paper is due at 8
a.m.). If a student hasn't yet learned efficient keyboarding and word processing
skills, now is the time. Don't let your child go off to college disadvantaged
relative to other students in these critical areas.
Be aware of the many ways college environments
tax executive functioning skills such as managing time and organizing tasks.
The college day is quite unstructured compared to that of high school - students
may have only 1 or 2 classes a day, with lots of "free time" in between.
There are more long-range assignments, and no study halls or hovering parents
making sure students are on track. Therefore, in high school students
must learn how to keep accurate records of assignments, daily and weekly calendars,
and how to manage a long-range planning process. For some students,
all these functions can be combined efficiently in a Personal Digital Assistant,
like a Palm or Pocket PC, but select one and learn how to use it before leaving
Similarly, high school is the best time
to investigate whether medication will play a role in regulating a student's
ADHD. It can take weeks or months to find the ideal medication and dosage.
Freshmen should start their college experience with a stabilized regime,
and not be experimenting with meds while coping with the other challenges
of campus life.
Finally, self-management looms large in
the life of a college freshman. If students have been relying on parents
to awaken them in the morning and make sure they have everything needed for
the day, parents should start handing these responsibilities to their children
no later than their senior year of high school. Students should also
learn to manage money for themselves, with a bank account, checkbook or credit
card for which they are responsible. It may be hard for parents to relinquish
their close monitoring of students for fear of having them fall on their face,
but it's better to have a few slip ups during high school than to completely
fall off track at college, as so many students, with and without ADHD, commonly
While all this preparation
may seem daunting, acquiring these skills, habits, and knowledge can be spread
over several years, ideally starting in middle school. There are many
helpful resources (some of them detailed in the references). There's no substitute
for actually "doing it", however, so one final recommendation is to take
advantage of the many summer programs designed by colleges to help students
experience campus life with a little extra support. Landmark College,
for example, offers 3- week summer programs for high school students after
their junior year, and 6- week summer courses for students already accepted
to college who want to refine their skills. The key to successful transition
from high school to college is to prepare well in advance, like Mike H.,
by knowing yourself, the laws, and your college.
(Note - A brief summary of data that my colleagues and I have
collected recently on the adjustment to college in students with ADHD follows
this list of resources.)
Brinckerhoff, Loring C., McGuire,
Joan M., Shaw, Stan F. (2002). Postsecondary education and transitions for
students with learning disabilities, Austin, TX: Pro-Ed
Frank, K., & Wade, P. (1993). Disabled
student services in postsecondary education: Who's responsible for what?
Journal of College Student Development, 34 (1), 26-30
Nadeau, Kathleen. (1998).Help4ADD@HighSchool.
Silver Spring, MD: Advantage
Reiff, Henry B., Gerber, Paul, Ginsberg,
Rick (1997). Exceeding expectations: successful adults with learning disabilities.
Austin, TX: Pro-Ed
Westbrook, R.Cary (2003). The journey begins.
Cited in www.ldonline.org/ first_person/westbrook.html
Mooney, Jonathan & Cole, David.
(2000). Learning outside the lines: two Ivy League students with learning
disabilities and ADHD give you the tools for academic success and educational
revolution. New York, NY: Fireside (Simon & Schuster)
Williams, Jamie, ed. (2003) Perspectives:
special issue on study and organization skills: practical suggestions and
sensible plans. International Dyslexia Association. 29 (4), 4 - 35
Strothman, Stuart, ed. (2001) Promoting
academic success for students with learning disabilities: a Landmark College
guide. Putney, VT: Landmark College
Guides to Colleges and Summer Programs
(websites offer the most up to date information)
Kravets, Marybeth. (1999) K & W guide
to colleges for the learning disabled. Princeton, NJ: Princeton Review
Mangrum, Charles T. & Strichart, Stephen
S., eds. (1992) Peterson's colleges with programs for students with learning
disabilities. Princeton, NJ: Peterson's Guides
Useful web sites:
New Data on the Adjustment
to College in Students with ADHD
Recently, my colleagues and
I have collected survey data from freshmen at Duke University and UNC Greensboro
to examine adjustment to college in students with ADHD. Surprisingly,
there are relatively few published studies on this topic, results from prior
studies are mixed, and prior work with college students dealt with non-traditional
students, e.g., older students, commuter students, students with ADHD who
did not have any comorbid disorders, that may not be representative of the
general population of college students with ADHD.
In our study, students were invited to
complete an anonymous survey via the Internet in which the focus was on the
misuse and abuse of ADHD medications by college students. We also asked
students about their academic concerns, social satisfaction, and depressive
symptoms so that we could examine how students who reported an ADHD diagnosis
were handling the transition to college in relation to their peers.
This was the first wave of an ongoing longitudinal study, and all students
were about 10 weeks into their first semester when the data were collected.
We were not really sure what to expect.
On the one hand, it would not be surprising if students with ADHD were experiencing
a more difficult transition, which would be evident in concerns about academic
performance, depressive symptoms, and higher rates of social dissatisfication.
On the other hand, students with ADHD who
enroll in college - especially in a highly competitive college
like Duke - have a history of solid achievement behind them and are likely
to be a better functioning group overall than the general population of older
adolescents with ADHD. For this reason, it is possible that their college
transition would be less problematic than one might first expect.
Survey responses were received from 1648
students, which represented a 46% response rate. Although lower than
desired, this response rate is consistent with what has been reported in
other web-based survey studies of college students. Sixty-seven of
these students - about 4% - reported that they were currently diagnosed with
Compared to students without ADHD, those
with a current ADHD diagnosis:
* reported significantly concerns about
their ability to succeed academically;
* reported significantly higher rates of
depressive symptoms at UNC-Greensboro but not at Duke. The reasons
for this difference are unclear.
On a positive note, students with ADHD
did not differ from peers in their satisfaction with social relationships
in college, nor were they more likely to be using alcohol or marijuana.
Is Medication Treatment Associated with
Of the 67 students reporting
an ADHD diagnosis, 46 were receiving medication treatment and 21 were not.
We wondered whether those on medication were doing better. Comparing
students in these groups revealed the following:
* There was no difference in self-reported
* There was no difference in self-reported
* There was no difference in academic concerns,
depressive symptoms, or social satisfaction.
On all these variables, the average scores
for students in the treated and non-treated groups were remarkably similar.
Thus, there was essentially no indication that medication treatment was being
helpful. Given that a number of controlled trials have documented the
benefits of ADHD medication treatment in adolescents and young adults, how
could this be?
It is possible that students treated with
medication had more severe ADHD to begin with, which could explain why they
were not doing better than non-treated students.
It is also worth noting, however, that
the transition to college may be an especially difficult one for students
with ADHD. Relative to what most students would have experienced in
high school, the typical college freshman has substantially increased amounts
of unstructured time and confronts a new set of academic demands where the
steps to success are likely to be less straightforward.
This places a premium on executive and
organizational skills that may pose particular challenges for students with
ADHD who are confronting this new set of challenges without the structure
and support that parents and teachers who knew them well may have provided.
In this environment, it is not surprising that benefits provided by medication
treatment might be reduced, and that particularly careful treatment monitoring
may be needed in order for students to derive significant benefit.
These results point to the need for controlled studies to determine the efficacy
of medication treatment in college student populations specifically.
To date, I am not aware of any such studies having been conducted.
We will be collecting a second wave of
data on these students towards the end of their sophomore year and it will
be interesting to see how they are faring. I will share these results
with you when they become available.