AD(H) D in Higher Education:
Making it Work
Dr Kate Esser: Dyslexia Coordinator
Southampton Solent University
ADSHE 21/06/20112
AD(H)D
• You all know what AD(H) D is...however, model
relates to executive functioning disorder of frontal
lobe leading to symptoms such as lack of attention,
distractibility, hyperactivity/restlessness and
impulsivity, or poor time-keeping
• ADD lacks the hyperactive component
• Diagnosed by psychiatrist-observation and self report
linked to report of symptoms
• Treatment-Ritalin/Concerta (Methylphenidate) or
antidepressant (Atomoxetine)
AD(H) D contd...
• Co-presenting conditions-depression, anxiety, mood disorder,
bipolar or borderline personality disorder
• Appears to be hereditary and often co-presents with SpLds
• Behaviours caused can be extreme-overspending, overeating,
gambling, driving offences, addiction, criminal conviction and
sexual addiction
• High proportion of divorce and family estrangement
• Young adults often overlooked in the transition from child to
adult care pathways, or told they are not eligible for
medication
• CBT and counselling also recommended, also mindfulness
AD(H)D and HE
• BDA conference presentation (2008)-AD(H) D
students hardest group to engage and retain, even
with support in place
• Females affected a little differently
• Key areas of difficulty are retention and progression,
likewise employability
• AD(H)D individuals often intelligent (43% IQ of 120 or
over but do not meet potential
• Based on practitioner experience as Dyslexia
Coordinator: agree with all of the above!
Impact on the Individual
• Despite undoubted creative gifts conferred by ADHD,
individuals often have low self-esteem
• History of self-blame and being judged for
behaviours and not being able to control them
• Labile moods and perseverance mean up and down
and fixate on things: VERY INTENSE
• Relative emotional immaturity (30% behind peers)
means friendships/relationships suffer
• They really mean to do it...it just doesn’t happen
AD(H) D and the Degree...
• AD(H) D executive functioning antithetical to the
demands of Higher Education
• Transition to unstructured social environment; new
codes and norms and difficulty adjusting
• Expectation of independent engagement such as
timetabled lectures and scheduled hand in for work
• Boredom with study where this is unsupervised or
self-directed
• Group and social interaction can be an issue
Social Environment
• Inappropriate comments in class can be
misinterpreted by tutors and peers (verbal
aggression/sexual remarks)
• Impulsive behaviour can lead to discipline or
inclusion issues in academic/social settings
• Impulsive spending in effort to self-stimulate or feel
included can lead to money trouble
• Alienation of peers in halls or class, leads to poor
attendance
• Group work-exclusion by other students
Engagement...
• Attending lectures where there is attendance monitoring,
as often oversleep
• Missed hand-ins and incurred penalties due to poor timekeeping
• Not knowing who to contact for advice or support as they
never make contact due to the above
• Not knowing how to find lectures
• Failing to get evidence for extenuating circumstances and
losing out more
• Not taking medication to assist which compounds other
issues
• Either lose good-will or no-one knows they are there until
there is a crisis
Academic Assignments
• Procrastination is the thief of academic success
• Last minute production of assignments and late
hand-in can make individuals stressed
• Academic penalties can be incurred
• Exams may be preferred as they are shorter and
create pressure
• Revision and behaviour issues can arise (don’t do
enough or disrupt other students)
Group Work
• Lack of awareness from other students as to reason
for alienating behaviour
• Inappropriately gauged interactions (excessive
talking, questioning etc or taking over
• How situation is managed by academic staffawareness as to how this feels for everyone
• Impact on learning experience can lead to isolation
or even exclusion
• Modified/alternative provision may be needed
Examples of AD(H)D declarations and
compounding issues
• P (AD(H)D/Autism-impulsive spending and sexual
disinhibition, anger, stress, aggression and family issues
• R(ADHD/Aspergers) impulsive spending and physical risk
• T (ADHD/Aspergers/Bipolar): lack of medication, attendance
and outcomes
• S(ADHD) lack of engagement with learning services, fear of
stigma and suicide attempts
• H (Severe ADHD)-addiction, criminal behaviour and
depression/anxiety/suicidal feelings
• N (ADHD)-work and financial problems lead to course
engagement issues
How to manage complex issues
• Flexible provision which takes AD(H)D issues into account
• Encourage accessing support from DSA if you can
• Close communication, as appropriate, with other
agencies/families/services
• AD(H) D awareness and training for staff and students, as well
as individuals
• Referral for diagnosis/medication when needed
• Supporting intention wherever possible!
• Be patient and separate the individual from the behaviour
(this can be really hard)
• Creative problem solving can help
Links
• ADDISS
http://www.addiss.co.uk/
• ADDCA Skills for Impulsivity - YouTube
http://www.youtube.com/watch?v=ORcbHvHZNA
• ADD Coach Academy - Launching ADHD Success
http://addca.com
• The Mindfulness Prescription for Adult ADHD: An 8-Step Program for
Strengthening Attention, Managing Emotions, and Achieving Your Goals
by Lidia Zylowska (Paperback - 28 Mar 2012)
• http://www.simplywellbeing.com/
• Uncertain Grief
• Short slightly abstract piece based on Kubler-Ross' 5 stages of grief (both
actor and director have ADHD)