College Students and ADHD
 

     The prevalence of ADHD among college students is estimated to be 2-8% and 50% of students receiving accommodative services have a diagnosis of ADHD. Transitioning to college can be challenging for students with ADHD. In addition to the challenges an average student faces, students with ADHD also have to work to find and access medical/mental health services, organize their schedule and obtain services to help them succeed academically. Some students struggle when parents and teachers aren’t present to offer additional support, and may have difficulty adapting to the less structured environment and increased academic demands.

     Pediatricians can help college-bound patients with ADHD prepare for this transition by having deliberative discussions as early as possible in the college transition process. These discussions may focus on encouraging self-determination and preparing patients to acquire independent living skills. Treatment issues such as continuing or beginning medication therapy, determining whether their current medication regimen is effective, and discussing the importance of taking medications consistently are also important. Most colleges and universities have a counseling center on campus and oftentimes will have a psychiatrist available to meet with students. Pediatricians should encourage college-bound students to seek out these services prior to the start of the academic year.

     Most individuals with ADHD are diagnosed as a child; however, some people may not begin to experience impairment from their symptoms until they are faced with the academic demands of higher education.  If a college aged student is struggling with symptoms of inattention it is important to also screen for other etiologies, such as anxiety (very common), depression or substance abuse. Psychological testing can be a very useful tool in diagnosing ADHD in this population, especially if they have not had testing previously.

     In treating this population, an additional concern is stimulant misuse. Reports of 5 to 30% of college students misuse or divert their ADHD medication and those with a history of substance abuse or conduct disorder may be at greater risk. Eighteen to 25 year olds are at higher risk for stimulant misuse than any other age group. So what can physicians do? It’s important to educate patients of prescribed stimulants, and remain vigilant for misuse among high-risk individuals. Additionally, physicians should explain the adverse effects associated with the drug, as many college students view stimulants as harmless study aids.
If a student has had prior services in high school, such as an Individualized Education Program (IEP) they will likely benefit from accommodations in college.

Tips for attaining accommodations in college:

• The student should apply for accommodations as soon as they are accepted to college. The student should contact the Office for Student Disabilities Services (OSDS) at their school who can provide guidance on the process.
• Accommodations commonly given to college students with ADHD are extended time on tests, testing in a quiet or separate location, having a designated note-taker in class, getting priority registration, a reduced course load, permission to record lectures, and altered test formats.
• If a student is not granted accommodations, he/she has the right to appeal the decision.

-Dr. Nicole Gloff, BHIPP Consultant
 
References:
Easton, A. (2016). Colleges are welcoming students with ADHD. Observer. http://observer.com/2016/04/extra-help/

Johns Hopkins Bloomberg School of Public Health. (2016, February 16). Adderall misuse rising among young adults. News Releases. Retrieved from http://www.jhsph.edu/news/news-releases/2016/adderall-misuse-rising-among-young-adults.html

Quinn, P.O. (2013). Ensuring college success for students with ADHD. Contemporary Pediatrics. http://contemporarypediatrics.modernmedicine.com/contemporary-pediatrics/content/tags/adhd-medication/ensuring-college-success-students-adhd

Sarkis, S. (2014, June 26). Why you need ADHD accommodations in college. Psychology Today. Retrieved from https://www.psychologytoday.com/blog/here-there-and-everywhere/201406/why-you-need-adhd-accommodations-in-college

Unwin, B.K., Goodie, J., Reamy, B.V., & Quinlan, J. (2013). Care of the college student. American Family Physician, 88(9), 596-604. http://www.aafp.org/afp/2013/1101/p596.html

Weintraub, K. (2012). Heading to college with ADHD brings extra challenges. USA Today. http://usatoday30.usatoday.com/news/nation/story/2012/09/22/when-students-with-adhd-go-to-college-they-may-flounder-parents-can-help-them-succeed/57825092/1


For additional information and resources for parents:

• American Academy of Child and Adolescent Psychiatry - Facts for Families Guide, College Students with ADHD 
• U.S. Department of Education - Students with Disabilities Preparing for Postsecondary Education: Know Your Rights and Responsibilities
• Greatschools.org - College Resources for Students with LD or ADHD: Resource List
   

Educational Event and Leffler Lecture/Awards Luncheon
September 10, 2016
8:00 am - 2:00 pm
MedChi Building, Baltimore, MD

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