ADHD in Higher Education: Making it Work

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)