What Students with ADHD and Their Parents Should Know

By Elizabeth C. Hamblet

Published in Attention, December 2013 issue

© Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD), 2013

Available as a downloadable PDF.

When most of today parents were in school, ADHD wasn’t a term that was commonly used. Students who had difficulty paying attention in high school sometimes managed to make it through by working extra hard and self-accommodating(often without recognizing what they were doing). Others were funneled into technical programs where the hands-on nature of the education suited them or, in a worse scenario, they may have dropped out. Improvements in understanding and accommodating students with ADHD over the past few decades and the passage of disability protections have coalesced to dramatically increase the expectation that they will earn a college degree.

Yet still myths abound, because there are no formal mechanisms to disseminate information about the services available at college. Some believe students with ADHD cannot go to college because colleges do not have to make accommodations to help them account for their difficulties. Some who think that accommodations are available at college may think that this is only true of some schools, not the more competitive ones. The encouraging truth is that all colleges- from community colleges through Ivy League schools- have to provide some accommodations for students with ADHD.

The college environment is different from the K -12 environment, however, both with respect to the disability services model and the overall academic expectations and environment. These changes can make the postsecondary environment seem scary, since there are some significant changes there. The good news is that with some basic knowledge and preparation, students can plan to achieve success in college. But it is helpful to have an overview of what students should expect to encounter at the postsecondary level. Here are the answers to some commonly asked questions about college, and suggestions to help families respond to these issues.

Note that the suggestions that follow put the student in the center of the action. They should be the ones driving these procedures as part of their development of the self-advocacy skills they will need in college. Parents of students with disabilities often worry about their ability to be successful outside of the structure and support of home. But what may get lost in these concerns is that all parents have these worries. The best way for parents and students to feel confident about the college experience is to give students the best preparation possible, as outlined in these suggestions.

Can students with ADHD go to college?

As with typical students, any students with ADHD who are ready to handle the academic and self-management responsibilities of the postsecondary environment should be good college candidates. College has not changed in certain respects since their parents' time. College students are considered adults in the eye of the law (even if they are not yet eighteen), and they are responsible for themselves in this atmosphere that lacks structure and supervision. Students are responsible for meeting academic expectations while also managing administrative deadlines for most aspects of college life, such as registering for housing and courses by the deadline.

Some things have changed in the pedagogical style at college. Some professors integrate technology and use teaching methods to make their classes more interactive and accessible to various kinds of learners. Others do not, so their classes take the form of long lectures where professors may not provide visuals to reach students who benefit from multiple modalities. While some classes may evaluate student performance through group projects, many still use two exams or two papers per semester. Professors may assign PDFs of articles or book chapters instead of one large textbook, but the volume of college reading remains the same as when parents were in college. This shift from the high school environment is challenging for most students, but may be even more so for students with ADHD because of their deficits in executive functioning, organization, and impulse control. What is not actually different, but may seem new to parents, is that colleges have to provide services and accommodations to students with disabilities. Colleges all along the competitive spectrum-community colleges through Ivy League schools-have to make certain basic accommodations. So students who feel prepared to handle the college environment with some basic accommodations in place should know that any college they wish to attend will likely offer what they need, such as extended time to take texts, testing in a room where distractions are reduced, and permission to record lectures.

Once students enter high school, parents should increase the amount of responsibility they take for themselves at home. College students have to get up for and get to classes on their own, do their laundry, make their own appointments, and handle a number of day-to-day items. Parents should gradually appoint such responsibilities to their students as they move through their high school years so that they can build their capacity for self-management before they leave for college.

With regard to the academic demands they will face, this is another opportunity for capacity-building. Students with ADHD should get assistance in learning how to break down long-term assignments into chunks and setting interim deadlines to meet them, take some data on how long they can read in one sitting before they lose focus, and work on other skills to help them cope in the college setting.

Do students with ADHD have to meet special requirements for college admissions?

No, students with ADHD apply through the same channels as typical students, and they are expected to meet the same requirements for admission. This is positive, in that it means there are no additional burdens on them to prove their suitability for admission. It also means that students and their families should not expect that colleges will make any special considerations in their admissions process for students with ADHD. The reasons for this are twofold.

First, colleges are not allowed to ask any disability-related questions on their applications or in their interviews, so they do not actually know who among their applicants has ADHD or any other disability unless these students indicate their disability on their application, in their essay, or in their discussions with an admissions representative. (Students who want to disclose their ADHD in some way during the application process can do so voluntarily, though it is a good idea for them to talk to their college advisor about why and how they want to make the disclosure.) Therefore, it makes no sense for colleges to have different standards if they don't know which of their applicants have disabilities.

The other reason why colleges do not have special admissions standards is that the same laws that require schools to provide accommodations also allow colleges some exceptions in the accommodations they make. One of these concerns schools' essential requirements (including those for admission).  Colleges do not have to have separate entrance requirements for students with disabilities; they are allowed to hold all applying students to the same standards. So if a college requires that all students applying for admission have four years of foreign language and four years of math in high school, this is true for all students who hope to get in.

Suggestion: Before students enter high school, they and their parents should use the Internet and college guides to see what kinds of courses are required for admission at a number of colleges that might be of interest in the future. They should make sure that high school course selections provide them with the classes they will need to apply for admission at a variety of colleges.

If they don't tell colleges that they have ADHD during their admissions process, how do students get their accommodations?

Even when students put something on their application or write their essay about their disability, this information is unlikely to be sent to the disability services office. Instead, students who wish to receive accommodations have to apply for accommodations once they enroll at college. They do this by submitting documentation of their ADHD (such as evaluation reports or letters that show that they have been diagnosed by a qualified professional), often by completing a form specifying what accommodations they want, and sometimes by meeting with a member of the college's disability service staff. It's not a time-consuming or difficult process. Students can do this as soon as they send in their enrollment deposit, which is a good idea because it will start the review process and give them their best chance at having accommodations in place when school starts.

Suggestion: Once students decide which college they want to attend, they should look up the disability services office page on the school's website. There they should be able to find the procedures for applying for services. Students and their parents should review these together. If students have questions, they should call the office to ask questions.

What kind of documentation do students have to provide to prove that they have ADHD and need services?

Parents may be surprised to hear this, but there is no federal regulation that tells colleges what kind of documentation they have to accept.  Postsecondary institutions have the freedom to decide what kind of proof of disability students have to submit in order to be considered eligible. At some colleges, this may mean that a diagnosis described in a detailed letter from a pediatrician or psychologist or an IEP or 504 plan will be sufficient. Some schools might ask that the student's treating professional complete a form instead of providing a letter.

Parents should be aware that some colleges require students with ADHD to undergo a full evaluation involving a variety of tests. These schools remain in the minority, however, so I suggest that parents not schedule their student for such an evaluation until s/he has been accepted to and enrolls in a college that requires such testing, which is costly, time-consuming, and can be exhausting. It is not worth doing this testing until families are absolutely sure the student needs it.  And if the report isn't ready by the time school starts, many colleges will grant temporary accommodations to students who are waiting for their paperwork. Students should not be reluctant to ask for this if they find themselves in that position.

Students should take notes and check with their parents to see what documentation they currently have, so that they can be aware of what they might need to get if they get accepted to and decide to attend a school that requires more documentation than they have. If some of the schools that interest them require a full evaluation, students and their parents can start the search for a good evaluator (see ldadvisory.com/educated_consumer_hs on my website for advice on how to find someone who will provide a high-quality report).

Suggestion: During their college search, students and their parents can learn what documentation is required. Go to the college's home page and type "disability services" into the search window. If those words don't work, try terms such as "access office" or "academic resource center" (some schools have removed the word "disability" from the name of the office). If you still can't find it, call the college's main number and ask to be connected. Once you reach the right office, get the name and plug that into the website's search feature. When you get to the office's page, you will be able to find the documentation requirements. If you still can't find them, call the office to ask about this.

Can't students just submit their high school IEP or 504plan?

Colleges want to know how ADHD affects a student's academic functioning, and these high school plans do not typically provide this information. If parents go through their student's IEP or 504 plan, they'll notice that a lot of the information centers on high school services, including items such as transportation, state testing, etc. Most of what is there will be irrelevant to colleges, so don't spend time photocopying the plan unless the college requires students to submit it.

What kinds of accommodations can students with ADHD expect at college?

Colleges offer many of the same accommodations students receive in high school-extended (but not unlimited) time to take exams, testing in a setting where distractions are reduced, and preferential seating. Students may be eligible for copies of a classmates' notes and priority registration (so they can select classes that occur when their medication will be in effect and are not too late so that they don't have to take a late dose of their stimulant that might interfere with sleep onset). In addition, colleges may offer students accommodations that they have not previously tried - use of a smartpen or digital recorder to supplement their notes, or electronic texts and software so that students can have their texts and handouts read aloud by the computer. All these accommodations are provided free of charge, though students typically have to give a deposit for any technology tools they borrow in case they lose or break them.

Although colleges often do offer students many of the accommodations they received at high school, they are not obligated to do so. Students who attend college are protected by Section 504 of the Rehabilitation Act of 1973 and subsection E of the Americans with Disabilities Act (ADA). Since IDEA and Section 504, Subsection D (which is the section that applies to K-12) are not in effect at college, the plans that are written under them (IEPs and 504 plans) expire when students graduate from high school, and they therefore have no legal bearing afterward. This doesn't mean that students won't receive the same accommodations at college; it just means that there is no guarantee that they will.

In addition, parents and teachers can make sure that students know how classes and assignments are likely to be different at college. Ask siblings or friends who are already at college what kinds of difficulties they have had, and how they handle them. Or contact the disability services office at local colleges to ask whether a student who utilizes their services who might be willing to speak with them about what things are like at college and what strategies or technology tools they find helpful.

Investigate the kinds of technological tools that might be useful at college. Call the disability services office of a local college or the school the student hopes to attend and ask what kinds of software and other devices their students with ADHD find helpful. Consider purchasing these tools (if students' high school does not have them) so the student can get accustomed to using them before they transition to college.

Suggestion: Students should try to utilize in high school only the kinds of accommodations they are likely to have access to in college. If students, their parents, and the IEP team or case manager think that this may be risky when students first transition to high school, they can start freshman students with the supports they used in middle school, but they should plan to start scaling these back as students move up through the grades. It is important that while their services are scaled back, teachers, coaches, or tutors also teach them strategies they can use to compensate for their weaknesses. For students to be able to work independently, which is what they will have to do at college, they have to know techniques to help them organize their materials, take effective notes from lectures and readings, organize notes from sources into papers, etc. They should work consistently with someone, in or out of school, to learn strategies that help them to approach their work without assistance. This will be the best preparation for the changes in the academic environment at college.

What about other accommodations, such as extended deadlines for assignments or someone to help students with ADHD refocus. Are these available?

Some accommodations may not be available because of the exceptions the law allows colleges to make if a student's request would constitute a fundamental alteration to their programs. This applies to admission as well as graduation requirements. Just as colleges do not have to waive foreign language requirements for admission, they may require a foreign language for completion of the college degree. If schools require students to take a certain number of credits in a subject in order for students to graduate, this holds true for all students regardless of their disability. Colleges can choose to allow students to take substitute courses (such as logic instead of calculus or a Spanish culture course instead of Spanish), but they do not have to do so.

Within some programs or majors, accommodations may not be available depending upon the skills being measured. An engineering major may be allowed use of a calculator in her classes but be required to pass calculus. A political science major may not be allowed a calculator if he's taking a developmental math class where calculation is a skill being measured, but he might not have to pass calculus. Students who can't meet their department's requirements risk not completing their degree in that field, and those who can't complete their school's core requirements risk not completing their degree at that college (meaning they'll have to transfer elsewhere in order to finish school).

It is important to keep this in mind as students choose their college and their major. For these reasons, students should research the graduation requirements of colleges they are considering and the requirements for any major they want to choose.

While some accommodations don't rise to the level of being a fundamental alteration, they may not be granted because they are simply considered inappropriate at the college level, where students are expected to be independent, or they may simply be unrealistic. Extended time for assignments is one request I often see that can be hard to get at many schools. The argument disability services providers often give for rejecting this accommodation is that extending deadlines leads to students getting behind in their classes, as they are still trying to finish up work on old topics while the class moves forward. After working with students for almost two decades, my experience is that students who do get their deadlines extended-either by official approval from disability services or by asking the professors themselves-often fail to meet that extended deadline, too, because the pace of work does not stop, and they simply have more to do after the initial deadline passes. Then their anxiety increases, which makes completing the work even more difficult. This is why some schools will instead recommend that students take fewer classes at a time, so that they have more time to handle assignments from fewer classes.

Some students request copies of professors' notes in advance. Schools cannot guarantee that professors will plan their lectures in enough time for disability services to get copies, so this is not a realistic accommodation schools can make. Also, professors' notes may be very informal (or illegible to others), and colleges are not required to make professors prepare notes to be used by anyone else. Some professors post notes or outlines before class so that student can see what will be discussed before class. When students have this opportunity, they should print the documents and bring them to class.

Personal services (such as tutoring and aides) and aids (technology) are another category of accommodations that colleges do not have to make. Parents and students may find it surprising that colleges do not have to provide any kind of specialized help at all for students with ADHD or other disabilities. Students simply have access to the same tutoring that is available to all students at the college, often provided by other undergraduates. While high schools must have qualified special educators on staff to help students with disabilities learn strategies and other skills, colleges do not have such an obligation and most do not offer such help. Colleges do not typically modify the conditions of their tutoring services---either allowing students with ADHD or other disabilities to have more tutoring sessions than other students, specifying that students get tutored one-on-one if tutoring is typically done in small groups, or requiring that it be done by someone majoring or specializing in that subject.

In essence, colleges do not have to provide students with any extra assistance, and this includes in-class aides. Students who cannot focus in class without someone to help them with this can be granted permission to have such a person accompany them to class, but colleges do not hire or pay these people. Instead, students have to find such help on their own (typically through the Division of Vocational Rehabilitation). A parent or family member can take this role, as long as the interaction between the student and the relative does not become a distraction in the class and no questions are raised about who is doing the student's work.

Colleges do not have to provide students with their own copies of software or certain devices for their personal study. If students find it helpful to use Inspiration software to plan their papers, their college does not have to provide them a copy of that software for their personal computer (though some colleges have licenses that allow them to do so). Instead, students will have to use the software while the disability services office is open (and they do not have to stay open later or allow access earlier to accommodate student schedules).

Again, the best preparation for the college setting is for high-school students to utilize only those accommodations and supports that they are likely to find there, and making sure students have skills and strategies to help them work independently. For a student whose attention wanes in long lectures, use of medication or a special vibrating watch may be appropriate.

What if students want to have more support than might be offered in schools' basic services?

Students who to hope to receive ADHD coaching or specialized help will find that some colleges have special programs designed for them. The fees can run from $1,000 to $3,000 a semester. Students who want to apply to such a program typically have to get in to the college first and then apply separately to the program once they enroll. Unlike in elementary or secondary schools, there are no legal requirements regarding who can be employed by such programs, and wise consumers will ask some questions to make sure that the specialists or coaches have the qualifications they would expect them to have.

When looking at these programs, ask probing questions about their staff and their educational and professional background requirements. Ask whether the fee will be refunded if students decide at some point during the semester that they do not want to continue with the program. You may also wish to ask whether a member of the staff will follow up with students if students stop coming in for their scheduled sessions without formally withdrawing from the program (if mid-semester cancellation is allowed). You should also ask how many sessions students receive every week and whether students can scale back if they need fewer meetings or can have more sessions if they want additional help (and what this would cost).

Students and parents might decide that hiring an independent ADHD coach or tutor is a better idea. Ask the disability services office whether it keeps a list of referrals, or ask the local CHADD chapter whether it maintains a list of professionals in the area.  What if students don't apply for accommodations when they get to college? Can parents complete the paperwork for them?  It is not uncommon for students to either delay applying for accommodations or not apply at all. There may be several reasons why students make these choices. The research shows that some students do not apply for accommodations because they wish to "shed" their disability identity when they get to college. Some students do not believe they have ADHD because no one has ever explained it to them.

And some do not have a sufficient understanding of the impact of ADHD on their academic functioning or recognize how the changes in the college environment may stress their areas of weakness.  Students who don't apply for accommodations don't receive them. As already noted, they must apply for services they want.  If students do not ask for accommodations and do poorly on their first set of exams or papers, they can apply for accommodations at that point (or any time during their education), but they have to keep in mind that colleges are not required to expunge those bad grades from their records or let them retake exams or resubmit the papers. if they don't apply for accommodations upon entering, but panic just before their first exams, they can apply for services at the time, but the reality is that- even if they are approved for accommodations right away-disability services staff will likely be unable to accommodate them on those exams because it takes a number of days to make all the necessary arrangements.

Parents nervous about the choices their student will make will also find that they are not allowed to complete the application for services for their student. To be very technical, no one at a college is allowed to talk to anyone but the student (not parents, doctors, therapists, etc.) until the student signs a waiver giving them permission to do. Parents will find that disability services staff cannot even communicate with them unless their student allows it. And even then, if students won't ask for accommodations, colleges will not arrange them on the basis of parents' requests. This makes sense - why would they make arrangements for students to take their exams in a separate room with extra time if they students have made no indication that they want this and will show up?

Knowledge is the key to all of these worries.  First, students must have a good understanding of their ADHD, what their particular symptoms are, how these affect their academic functioning, and how the accommodations and supports they receive are intended to help level the playing field for them. It is very important that students are aware of what their accommodations are. (Research shows that some students did not realize when they were in high school that they were being given extra time for tests or that this adjustment was an accommodation given only to students with a disability.) Case managers, special education teachers, diagnosing professionals, tutors, and others should help to educate students about these topics.

I strongly recommend that, when students are high-school seniors, they sit down with their case manager and compose a list of accommodations they hope to request in college. These should focus on those accommodations they are likely to receive at college. If students want to ask for accommodations that they are not likely to get (such as having someone create study guides for them), they can certainly ask for them, as they may be pleasantly surprised. The case manager should discuss such a likelihood and also ask what image they would like to project to their new school, and whether asking for certain supports will show disability services staff that they are prepared for the college environment. It is important that the case manager also makes sure that students know how to explain to someone what particular area of weakness the accommodations are meant to help.

Students need this self-knowledge in order to self-advocate. A discussion of the disability services system should also be part of the college search and application process. Students should be informed that they can wait to apply for accommodations, but they face the real-life possibilities - the risk of not receiving the accommodations if they apply right before exams or having to live with their poor grades if they apply after exams occur.

Parents should tell students that they can register for services when they first enroll but that they are not obligated to use the accommodations they are granted. They might want to consider offering students a reward for registering (students can alert parents to their registration by signing a release with disability services and then alerting their parents that they can call the office and speak with someone there). If students don't want to sign the release, they can ask for an extra copy of the letter that disability services writes outlining their approved accommodations so that they can send it to their parents.

Elizabeth C. Hamblet is a learning specialist at Columbia University. She has worked at the college level for over fifteen years after starting her career in the field as a high school special education teacher and case manager. Since 2008, she has been making presentations at high schools throughout the region and at national conferences to educate professionals, parents, and students about the changes students will find at college and how to best prepare them {or success there. In addition to her book, 7 Steps for Success: High School to College Transition Strategies for Students with Disabilities (Council for Exceptional Children, 2011), she has published numerous articles on this topic. Hamblet's website, LDadvisory.com, offers advice and resources for students, parents, and professionals.

ADDITIONAL RESOURCES

7 Steps for Success: High School to College Transition Strategies for Students with Disabilities (Council for Exceptional Children)

HEATH Resource Center at the National Youth Transitions Center (heath.gwu.edu)

Information from Patricia Quinn and Kathleen Nadeau for college students (addvance.com)

Information from the U.S. Department of Education (ed.gov/)

An open letter to a college disability services professional (and mother of a child with a disability) to other parents (ahead.org/affiliates/ohio/lettertoparents)

Guides listing special programs

• Peterson's Colleges for Students with Learning Disabilities or AD/HD

The K&W Guide to College Programs & Services for Students with Learning Disabilities or Attention Deficit/ Hyperactivity Disorder, 17th Edition