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9 Survival Strategies for Your College-Bound Teen with ADHD

A crash course in managing meds, staying organized, and keeping it together in college. Essential reading for parents and teens alike.

Students with ADHD walking on a college campus, learning survival strategies
Bird's eye view of college students with ADHD walking on campus

Time flies. Your teen will soon be graduating from high school and heading off to college. Finding the right school — not to mention the means to pay for it — will be tough enough. If your adolescent has ADHD, you need to address other challenges as well.

Have you made sure that your college-bound teen understands ADHD and how it affects him? Have you explained how medication helps and how to use it, and slowly shifted the responsibility for taking and managing it to him? If so, you are ahead of the game. If not, you have work to do.

What resources or school accommodations might your soon-to-be-freshman need at college? Does she know what services she is entitled to, and what to do if they are not provided? If she is struggling academically, or has an emotional meltdown, where can she go for support? If she feels confused, what should she do?

Finally, is your teen disorganized, or finding it hard to plan his day, never mind a week’s worth of classes and homework? If your child runs into these problems at college, he should know that he can call or text you for help. But this approach is a short-term solution. At college, he should know what to do and talk with you only as a last resort.

Here are the key challenges most students with ADHD will face, along with strategies to meet them. Thinking ahead will ensure that your teen’s debut in college will be calm and successful.

> Keep the supply flowing. Your college student must be able to monitor his supply of ADHD medication and plan to get refills on time. He has two options: working with your family physician or using Student Health Services (SHS) at college.

If you decide to use your family physician, discuss it in advance with him. If your son will be attending college locally, he should be able to get refills during winter and spring breaks and during summer vacation. If he will be going to school out of state, check to see whether the prescription written in your home state can be filled in the state where he is attending school. If it can’t, you will have to fill the prescription locally and mail the refill to him.

Using your family doctor will require logistics. Talk it over with your teen and decide how and when he will alert you that refills are needed in time to fill the prescription and ship it off.

If you and your teen go with Student Health Services to manage the medication, your family physician will need to write a letter to SHS. Present this letter in the spring or over the summer before school starts, and make sure that SHS confirms, in writing, that it will handle the medication for your student before he heads to campus. Most college SHS departments require meeting with the student briefly when picking up a refill, so your student will have to make an appointment to get his medication.

> Manage and adjust the dose. Taking medication was easy in high school: An eight-hour capsule in the morning would cover classes, and a four-hour tablet in the afternoon would cover homework. This model won’t work in college. If your son is hyperactive and impulsive, he may need to be on medication all day, every day. If he is trying to manage distractibility, inattentiveness, and executive function problems only during classes, his medication schedule will probably vary each day.

For example, your teen may have classes on Monday, Wednesday, and Friday between 9 a.m. and 4 p.m., while on Tuesdays and Thursdays, his classes may go only from 11:30 to 2:30. If medication is primarily needed for class time and study time, he might take an eight-hour dose at 8:30 a.m. on Mondays, Wednesdays, and Fridays. If he wants to relax, exercise, or socialize after class and start to study at 7 p.m., he should take a four-hour dose at about 6:30 p.m. However, on Tuesdays and Thursdays, taking a four-hour tablet at 10:30 a.m. may be adequate. Then he should plan on coverage for study time.

Be sure that your son or daughter understands how medication helps, how long it takes to start working, and how long it lasts.

> Watch for side effects. Has your prescribing physician explained possible side effects, and what to do if they occur? If not, arrange for a meeting with your doctor. If your teen experiences side effects, have him call you first to discuss what to do. You can decide with him whether he needs to call your family physician or go to Student Health Services.

> Limit alcohol. Stimulant medications amplify the effects of alcohol. The bottom line? You get intoxicated sooner. Instead of telling your teen not to drink — partying is part of college, after all — explain to him that he should drink less, because he will get buzzed sooner when he is drinking and taking ADHD medication.

For some teens, the best advice is not to take medication when they plan to imbibe. For others, though, being off medication leads to problems — impulsive decisions or out-of-control behavior. Arrange a chat with your doctor to determine the best strategy for your teen.

> Deal with stealing. It is fairly common for students without ADHD to steal medication from those who are taking it. This is especially true for Adderall. Your teen should keep his medication safely locked in his room and never give it to anyone. If someone steals his medication, he should alert college security immediately.

Has your son or daughter needed accommodations or special services in high school? Do these services address ADHD (often listed as Other Health Impairment)? Does he also need help for Learning Disabilities?

> Seek out accommodating schools. Choose a college that offers a full range of services and accommodations. When you make your first visit to the college, to see if your son likes it, meet with someone in the Office of Disability Services and discuss the accommodations, in class and out, he will need. This will indicate whether the college can provide the services.

> Get services in writing. After your son is accepted, plan a longer visit with someone in disability services. Bring all of the necessary documentation — your teen’s IEP or 504 Plan, as well as any psycho-educational testing results. Determine what your child needs and get it in writing that the school can and will provide it. If services in high school worked well, try to get the same kinds of help in college.

> Make sure accommodations are implemented. Talk with your daughter about what she should do if one of her professors doesn’t implement the agreed-upon services. If your daughter misses a tutoring session or other remedial help that has been scheduled, decide how you will handle it. You can ask the disability office to contact your teen if she doesn’t show up. You can be notified as well, as long as your daughter signs a release form. If the disability office is understaffed and can’t track your daughter’s schedule, work out a plan with her, so that you know what’s happening before her grades begin to plummet.

> Manage coexisting conditions. Many students with ADHD also have social or emotional problems, such as anxiety disorder or depression. Your teen may be in therapy or taking medication for one of these conditions. Discuss with him what kind of help he will need at college. Should he see someone regularly at Student Mental Health Services, or follow up during holiday breaks with his doctor or therapist at home? He may be able to arrange phone sessions with his therapist at home, as well.

Is a coach or tutor helping your teen stay organized in high school? If so, can he get the same kind of assistance in college? The Office of Disability Services can possibly work with him on assignments, especially projects and term papers.

But what about getting up on time, doing laundry, or socializing? There’s no easy answer. Start by discussing your concerns with someone at the Office of Disability Services. What can they do? Whom would they suggest to help? Some students rely on Resident Assistants in dormitories to create structure for them.

Talk about possible problems with your teen. If he oversleeps, how will he deal with this? If you wake him up to go to high school, have him take over this job in his senior year, not in the fall of his freshman year at college. Until you are sure that he has solved the problem, ask if he will let you call to wake him up. While you’re at it, ask him if it would be OK to nag him about laundry.

Preparing your teen for college is the most effective way you can help him succeed when he gets there.

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