By: 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)
KNOW YOURSELF
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 area?
* 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 college's criteria.
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 climate.
PREPARING
YOURSELF FOR COLLEGE
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 home.
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 do.
CONCLUSION
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.
RESOURCES
(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
STUDY SKILLS
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:
http://www.ldanatl.org/facts/shhet/summer.html
http://www.ldonline.org/ld_indepth/summer/
http://www.ldonline.org/ld_indepth/postsecondary
http://www.petersons.com
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 ADHD.
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 Better Adjustment?
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 attention problems.
* There was no difference in
self-reported hyperactive-impulsive symptoms.
* 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.