ADHD in College

The College Transition Program That Is Changing Lives

A new program tailored for college students with ADHD improves their chances of thriving on campus.

A college transition plan for students with ADHD

For many teens diagnosed with attention deficit disorder (ADHD or ADD), the transition to college is a bridge too far. About 9 percent of students with ADHD graduate from college, compared to 60 percent of students without the condition.

“When students with ADHD go to college, they experience a perfect storm of circumstances that present some big challenges,” says Arthur D. Anastopoulos, Ph.D., professor and director of the ADHD Clinic at the University of North Carolina at Greensboro. “There is support in high school that may include an IEP and parent involvement. In college, they lose this support and have to deal with the stresses of adjusting to college life alone. There isn’t anyone there to act as their executive function.”

Without support from teachers and parents, students with ADHD often have trouble concentrating in class or during exams, or they miss assignments and classes. This translates into lower grades and a higher probability of changing majors. Many college students with ADHD take longer to finish college — if they finish at all.

Adding to these challenges is the fact that many teens don’t understand or accept their ADHD. They are reluctant to seek out campus support services, because they do not want to seem different from their peers.

“These students are good enough to get into college, but they have trouble staying in and doing well,” says Anastopoulos, who developed a program called ACCESS (Accessing Campus Connections and Empowering Student Success) to change that.

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In her freshman year at college, Sarah had trouble balancing her social life with academic demands. “I was impulsive, hanging out with friends instead of studying for upcoming tests or starting a big assignment.” In her sophomore year, Sarah signed up for the ACCESS program. Mentors and counselors made her aware of the consequences of her impulsivity and her negative thought patterns. The program helped her become aware of her ADHD habits and taught her to troubleshoot when those habits led her down the wrong road.

A Program with Promise for ADHD Students

ACCESS is a structured program, using a special type of cognitive behavioral therapy intervention to address ADHD problems. The program showed encouraging results in a small pilot study involving 88 UNC Greensboro students who ranged in age from 17 to 29. The program is in its fourth year of a four-year trial.

The ACCESS program is divided into two phases — the active phase and the maintenance phase, each lasting one semester. The active phase is designed to increase knowledge about ADHD and awareness of campus resources, and to improve planning, organization, and time-management skills. During the active phase, students also learn to identify and manage unproductive thinking patterns and how to adhere to a treatment plan.

According to Anastopoulos, many students have a limited understanding of ADHD. Others are reluctant to accept their diagnosis. Laura Eddy, one of the team leaders of the program, explains that during the active phase team leaders and mentors help students understand why they are struggling. Students need accurate information about how their symptoms affect their performance.

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Eddy says that many students view taking medication as a short-cut that gives them an unfair advantage over non-ADHD students. “We explain to them that medication is a corrective for people with ADHD, helping their brain function like the brains of neurotypical people.”

In the active phase, students meet weekly for 90 minutes of group cognitive behavioral therapy, and also receive eight 30-minute individual mentoring sessions. In the group session, students are encouraged to support each other. More experienced students share strategies that have worked for them.

A large part of the program is learning about the support resources available on campus. Team leaders and mentors inform students about services they can take advantage of, available in the disability office and the counseling, health, and tutoring centers.

“Many students in the program have been labeled ‘crazy’ or ‘stupid,’” says Erin Spence, a counselor in the ACCESS program. “It was eye-opening for them to realize that there was a reason for their struggles. Many of them had anxiety and/or depression, but had never tried therapy. Learning that the campus offered psychotherapy inspired them to seek help.”

During the second part of the program, the maintenance phase, the frequency of sessions tapers off. Some of the students maintain friendships formed in the group sessions, and continue to find support and help.

Improvement Across the Board

Students who completed the ACCESS program saw improvement in behavior regulation, medication management, and social adjustment, gains that lasted through the maintenance phase. Students’ GPAs were largely unchanged throughout the study, but the subjects took on more credit hours on average, indicating an improved ability to manage a college-level workload.

“We view college as a critical period to flip the switch to try to get students on a more positive trajectory,” says Anastopoulos. “We have an opportunity to help a competent college student be successful. We know there’s a path that leads to successful outcomes. We know there’s a path that leads to negative outcomes. We have a chance to affect that trajectory.”

A Three-Part Plan for College Success

The ACCESS program has three components:

  • Education about ADHD — how it affects learning and executive functions, and strategies that can help
  • Awareness of campus resources — including disability accommodations, psychotherapy, tutoring, and access to medication
  • Cognitive behavioral therapy strategies — targeting unhealthy thinking patterns related to academics, social interaction, emotional issues, and treatment adherence