The prevalence of ADHD symptoms among adult learners and staff influences the measurement of success in the higher education system. There’s no reason adults with ADHD shouldn’t have a comparable academic experience when the right support is available. We propose five evidence-based proposals to improve the student experience at universities by supporting better understanding and structures for ADHD adults.
Adult ADHD and the student experience
ADHD in adults is a complex, heritable neurodevelopmental disorder that sits somewhere between disorder and neurodiversity. ADHD presents as a complex and individual mix of inattention, hyperactivity, and impulsivity, and has an estimated prevalence of about 2 to 4 percent in adults, with a broadly equal gender distribution. There is strong evidence that adult ADHD is related to underachievement in school and work.
Since the pandemic, the waiting list for an ADHD diagnosis in the UK has shifted from months to several years, according to BBC Freedom of Information requests to several NHS trusts in 2020. This means students can start their studies with a referral and then graduate before a diagnosis can be made.
ADHD presents many challenges to higher education. ADHD adults are less likely to achieve post-secondary education, and those who do have been shown in a number of studies to achieve lower overall grades across all years. Worryingly, they are also more likely to withdraw from their program and need more support before and during college. Academic support is often unavailable or not evidence-based. Support for postgraduate and academic staff with ADHD is also important, but there are few studies on these groups in the literature.
Why is this? Aside from hyperactivity and impulsivity, ADHD adults also have a reduced capacity for many elements of executive functioning important to success in our neurotypical college culture. Examples are planning, long-term goal setting and time awareness. There are general reactions outside the diagnostic criteria, such as B. Inappropriate emotional responses to stimuli and extreme sensitivity to rejection, which can lead to serious negative outcomes in higher education. Examples include responding to “surprising” feedback, responding to academic failure, and emotionally understanding social rules in conversational spaces.
Universities are expected to take positive steps to remove the barriers faced by people with disabilities under the Equality Act 2010. This is to ensure that, as far as is reasonably possible, they have access to the same services as someone without that disability. The exact type of support – e.g. B. Wheelchair ramps or dictation software – depends on the specific and agreed needs of the individual. While some universities have Reasonable Adjustment Processes (RAPs) for students with ADHD, a formal diagnosis is often required. Additionally, because of the executive dysfunction challenges faced by students with ADHD, fewer than half of qualifying students resort to this support. Of concern, these RAPs often include interventions without strong evidence of their effectiveness, such as B. Extended examination times and separate rooms.
Through our work as academics with ADHD and as founders of the ADHDadultUK charity, we propose the following five recommendations that could be used to improve the experience of students and staff with ADHD:
Recommendations for improving the ADHD student and staff experience
1. Better education about ADHD as a recognized neurological disorder and how to treat the symptoms at all levels of the higher education sector. This effort should target students and staff with ADHD to help them learn how to manage their own symptoms in a university setting and to demonstrate the support available to them. Efforts must also be made to train teaching staff and support teams so that they are better equipped to work with ADHD adults. Identifying and appointing an on-site champion with lived experience or a deep understanding of neurodiversity would be ideal to support this.
2. Provide support without diagnosis. In view of the difficult diagnosis, it would make sense to allow an RAP to be carried out on the basis of self-disclosure in partnership with the university support service.
3. Design instruction and support to take executive dysfunction into account like a disturbed perception of time. Consider these challenges when planning seminars, exams, and lectures, setting time goals, and other deadlines. Typically, shorter, clearer milestones and appointment reminders are helpful.
4. Empower and enable staff with ADHD, and students, wherever possible, within their learning goals, through identification of strengths, self-authored goal setting, and providing only solicited feedback. Coaching can be a very useful platform for these conversations.
5. Include a broad awareness of commonly coexisting conditions in discussions about available support and work adjustments. ADHD is often found in combination with mental health issues such as anxiety, Tourette’s and depression. Psychiatric and non-psychiatric comorbidities can lead to severe impairments in mental health, quality of life, and psychosocial adjustment.
The biggest barrier to adult ADHD services is the lack of awareness and stigma associated with the disorder. Supporting students and staff with adult ADHD would almost certainly improve metrics of success in higher education. ADHD is a mix of disorder and neurodiversity. When the disruptive side of ADHD is supported by evidence-based and staff-authored appropriate adaptations, the resulting neurodivergence can be creative, dynamic, and a fantastic resource for success throughout higher education.
Alex Conner is Lecturer in Biomedical Science Communication and National Teaching Fellow in the College of Medical and Dental Sciences, University of Birmingham.
James Brown is Associate Professor of Biomedicine at Aston University’s College of Health and Life Sciences.
Alex and James co-founded the charity ADHDadultUK in 2021 to improve the lives of adults with ADHD through psychoeducation, advocacy and peer support.
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