ad/hd transition to college passport to success · passport to success patricia o. quinn, md...
TRANSCRIPT
AD/HD Transition to College Passport to Success
Patricia O. Quinn, MD Developmental Pediatrician
Washington, DC
Today we will discuss:
O How AD/HD impacts students at college.
O Factors that may lead to many transition
challenges.
O How to better prepare for college success.
O Where to get the help you need on campus.
O How medication may help.
O Useful accommodations.
GETTING INTO COLLEGE IS ONLY HALF THE BATTLE…
EXPERIENCES OF COLLEGE STUDENTS WITH AD/HD
More likely to:
O Have lower grade point averages.
O Be placed on probation more often.
O Take longer to graduate.
O Graduate at even lower rates
than students with other disabilities.
O Struggle more with necessary coping
and self- management skills.
References: Barkley et al.( 2007);D’Amico, personal communication (January 29, 2008); Heiligenstein, et al. (1999);
Murray, et al.( 2000); NCES (2003); Newman et al. (2009); Rabiner et al.(2008); Reaser et al. (2007); Vogel &
Adelman (1990a, 1990b, 2000); Vogel et al.(1998); Vogel et al. (1999); Wagner et al. ( 2005)
Why is the transition to college challenging?
O College life is dramatically different
from high school.
O Increased academic expectations.
O Different laws/mandates/services (
(504 and IEPs).
O Dealing with impact of AD/HD on
their own (some for the first time!).
Learning Issues for Students with AD/HD
O Unexpected weaknesses in learning even without a formal Learning Disability (LD)
O Less efficient learners
O Problems in short-term and working memory (males>females) and executive functioning
O Difficulty recognizing as well as recalling after a delay
O Slower processing speed (males>females)
Cutting, et.al., (2001) Evidence of unexpected weaknesses in learning in children with attention deficit hyperactivity disorder without
reading disabilities. National Academy of Neuropsychology.
Seidman, et. al., (2005) Impact of gender an age on executive functioning: Do girls and boys with and without attention deficit hyperactivity
disorder differ neuoropsychologically in preteen and teen years? Developmental Neuropsychology.
Learning
Memory Attention
Language Visual-spatial
Sequencing Emotion
(anxiety/depression)
Sensory input
Alertness (sleep issues)
Attention and Working Memory as a Function of Learning
In order to learn new information
we need:
O Attention span
O Working memory
O Time perception
O Rapid information processing
Slide provided by T. Spencer, MD
Progression of Executive Functions from Childhood to Adulthood
Early childhood
O Simple responses to limited demands in a protective environment
Late childhood into adulthood: executive functions become more important
O Juggling competing tasks, independence, organization, and planning
IQ and EF O Students with high IQs (top 9 percent) and AD/HD also suffer
from executive functioning (EF) challenges—difficulty with working memory, processing speed, organization and focus.
O These impairments do not significantly interfere with their ability to perform well until relatively late in their school years.
O Students report that during elementary school they were able to function in ways that lived up to the high expectations for academic success that were held by their parents, their teachers, and themselves.
O It was not until they had to keep track of various assignments for many different teachers, without anyone to help them to prioritize and remember, that AD/HD became apparent in these students.
(Brown, et al., 2011)
Common EF Challenges in College
O Procrastination/meeting deadlines/late
O Chronic stress/ frequently overwhelmed
O Identifying and using existing resources
O Disorganization of materials, space, effort
O Poorly-planned choices (assignments, course selections, majors/careers)
O Saliency: focusing on that which is important
O Using existing skills and knowledge at the “point of performance”
O Reading social niceties/cues
DuPaul, Weyandt, O’Dell, & Varejao (2009); Parker & Boutelle (2009); Ratey, Quinn, & Maitland
(2000)
Field, Parker, Sleeper-Triplett, & Tudisco
(CHADD 2010)
How to better prepare teens with AD/HD for college ?
O Raise awareness of stark differences
between high school and college
O Challenge teens to “stretch and grow”
O Assess student’s readiness for college and
make a personalized readiness plan (at
home and/or at school)
O Total freedom/responsibility
O No adults
O No homework
O No accommodations
O No teachers
High School vs. College
Challenges for AD/HD Teens
O Organization
O Decision-making/Problem-solving
O Time management
O Reminding and remembering
ALL are challenges for AD/HD adults - need to
help them develop these skills earlier.
Strategically work on:
O Important non-academic readiness skills.
Self-determination
Daily living skills
O Learning study skills/strategies that will be necessary
in college.
O Slowly fading reliance on accommodations that are
not likely to be available at college.
O Practicing good decision making/problem-solving.
O Other issues -- If more is going on -- get help now!
Problem-solving
Strategies to shore up EF
O Reduce load on working memory
O Learn in small chunks followed by guided
practice
O Provide scaffolding (visual cues)
O Checklists
O Coaching
“Passport”
O Self-knowledge
O Self-advocacy
O Planning
O Self-care
O Instead of approaching college like a kid in
a candy store, try to set up a program for
success that utilizes and builds on your
strengths and seeks help and
accommodations for the weaker areas.
O You are responsible for making success
happen!
College and AD/HD O Late diagnosis in college common.
O Medication treatment may be complicated due
to anxiety and/or depression.
O Essential to develop habits, structure, patterns.
O Coaching may provide essential lifeline in this
transitional period.
O Self-advocacy skills are critical.
O Under- and over-commitment is hazardous.
Differences in Academic Coping Strategies
O Equal gender representation (46% women).
O College women seek and experience a
greater level of social support than men.
O Women reported significantly more time-
management behavior.
O Men tended to procrastinate.
COLLEGE STUDENTS WITH DISABILITIES…
Many don’t access support!
O Only a third (1/3) of the college students who received special education services in high school sought formal accommodations in college
O Not all of these student used available resources
References: NLTS2: Newman et al. (2009)
IF YOU PLAN TO
LEARN,
YOU MUST LEARN
TO PLAN!
Issues that must be addressed
O Self-care.
O Time management.
O Developing strategies and routines.
O Anxiety and depression may need to be treated ALONG WITH AD/HD.
O Eating problems may be intensified.
O Substance abuse and high-risk behaviors must be addressed.
Some suggestions for success O Study groups
O No days off -- more scheduled -- more get done
O 8 am classes ??????
O Discussion classes
O Advisor/coach
O Disability services
O Healthy habits: eating/ sleeping/ exercise
O Technology
O Be proactive
NOT SO GOOD NEWS FOR ALL COLLEGE STUDENTS…
Many college students struggle emotionally • 50% may need to seek help for emotional/social issues; • Freshmen reported all time lows for emotional health on national survey; • 48.1% rated their emotional health as below average.
Kadison, R. , and DiGeronimo, T. (2004), Sieben, L. (2011)
)
College of the Overwhelmed
Students: Working with your parents
O How involved should they be?
O Establish regular check-ins.
O Set up guidelines for calls.
O Use them as a resource on your AD/HD.
O Take responsibility for your health
and medication.
O Let them know what you are doing.
O Discuss financial responsibilities.
O Try to see it their way!
Parents: Working with your student
O How much to keep in touch?
O Send money?
O Roommate problems?
O Struggling academically?
O 4 vs. 5-6 years?
O Discuss giving college permission to share grades and to contact you?
GOOD NEWS FOR COLLEGE STUDENTS WITH AD/HD…
If they access support, their graduation
rates are the same as their non-disabled
peers
References: Vogel and Adelman (1990, 2000)Vogel et al. (1998, 1999); : Jorgenson et
al.(2003)
Places to find help on campus
O Emotional problems – Counseling Center; staff in dorm or living center; the university health center, local mental health provider; clergy and campus chaplains.
O Academic program or individual course – proactively visit professor during office hours; academic advisor; mentor/tutoring program; for more general or serious problems contact the DSS Office or Office of the Dean of Students.
O Adjustment issues – connect with others on campus; RA on floor or dorms.
AD/HD Coaching
O How does coaching work?
O How can I find a coach?
O Setting goals and working to achieve them.
O Adding structure and achieving balance.
Academic Accommodations
O Documentation and recent assessments?
O Types of accommodations that have worked
in the past?
O Types of accommodations you anticipate
needing?
O How has AD/HD contributed to academic
issues?
O How has it affected your capacity to learn?
O What if you didn’t have accommodations in
high school?
O Who will tell your professors?
O Are graduation requirements ever waived?
O Should I speak directly with my professor
about what I need?
O Can I apply for early registration?
• Extended time
• Note takers
• Customized schedule
• Alternate forms of exams
• Sanctioned movement breaks
Useful Accommodations
Medications for AD/HD at College
O Stimulants treatment of choice and highly
effective to reduce symptoms and improve
cognitive functioning if taken consistently.
O Learn how your medication works and when
you need to take it.
O Does not necessarily improve academic
performance and emotional issues.
O Proactively discuss your needs and set up a
schedule with your prescribing physician.
O Be sure to discuss the newer longer-acting medications.
O Where do you go on campus for prescription refills?
O What to do if its not working one you are experiencing side effects.
O What about sharing meds with others?
Deciding Whether to Stay or Drop Out
O Take an honest look at why things aren’t
working out for you.
O Find the best possible match.
O Take a leave of absence.
O Consider taking a gap year.
O Transfer out.
Should I drop out?
O Reframe your situation.
O Look at your options.
O Make a plan.
O Talk to someone and look at your options for a solution.
O Would a withdrawal or a reduced course load be the better option?
Some Final Thoughts
O “Find your inspiration! And renew it regularly!
O Make sure you seek out contact with people who are inspiring about living and succeeding with AD/HD, who understand that it's a difference, not a disease, and who can help you find your own ways to develop yourself.
O Remember, there are two sides of the disability coin. One makes it harder to learn but the other gives you special strengths and allows you to see the world from a different perspective. Embrace it and run with it.
O Believe that you can be successful in college (if you address your AD/HD) and you will be!”
Question & Answer Session