Mental Wellbeing

Education for Mental Health Toolkit - Inclusivity ADHD

Students with ADHD can experience difficulties with inattentiveness, distractibility and with executive functioning, restlessness and motivation (1).

Inclusivity ADHD

Summary

Students with ADHD can experience difficulties with inattentiveness, distractibility and with executive functioning, restlessness and motivation (1). They may often experience difficulties with study skills, study strategies, problem solving skills, and social integration (1). Students with ADHD are also more likely to experience feelings of loneliness, poor sleep quality, difficulties in self-management, low self-efficacy and feeling overwhelmed, stressed, and anxious (2). Consequently, academic demands as well as the conditions imposed in Higher Education (HE) can exacerbate their difficulties, leading to poor performance and an increased possibility of drop out (2-5). However, literature also shows that academic outcomes tend to ameliorate when students are supported with individually tailored accommodations that meet their specific needs (2).

Education for Mental Health

Download a digital copy of the full toolkit, the staff development toolkit and case studies.

 Download the report

Students with ADHD require a more structured approach to learning, and may benefit from accommodations targeted at improving executive functioning, such as learning how to organise tasks and properly manage time (6-9). Additionally, strength-based approaches addressing self-determination and regulation skills can help empower students when dealing with academic demands (2). Individualised teaching activities as well as the presence of support can help students thrive in the learning environment (5). Close working relationships between academics and student services can often help to provide these accommodations and support.

Alternatively, if teaching academics discourage the use of accommodations and additional support, this can make students with ADHD feel excluded (10). In fact, some of the main barriers to inclusivity highlighted in research entail academics' negative attitudes, lack of understanding of specific needs, lack of knowledge on how to make content accessible, and lack of willingness and/or time to provide reasonable adjustments (5). In turn, this can lead to students not disclosing their disability (11). Recognising ADHD simply as a type of student diversity can help foster inclusivity (12) and improve the classroom and learning experience for all. However, to achieve this academic staff may require additional staff development.

Research highlighted the importance of training opportunities for educators to increase awareness and support for students dealing with different types of disabilities, as training positively influenced instructors' attitudes (13, 14). Training in inclusive practice and learning aids the development of a clear and coherent educational programme for all students (15). Academics educated in the Universal Design for Learning (UDL) reported being more understanding, open-minded and flexible in their instructions (16, 17). UDL is particularly helpful for students and lecturers as the strategies are simple to implement, can have a positive impact on the learning experience of all students and could help against labelling and segregation of differently abled neurodiverse students (2). See inclusivity.

Key lessons

  • Students with ADHD can experience difficulties with inattentiveness, distractibility and executive functioning (e.g., emotion regulation, working memory deficits), restlessness and lack of motivation. Consequently, they often display issues with study skills, study strategies, problems solving skills, social functioning, and social behaviours.
  • They may also experience feeling overwhelmed, stressed, and anxious, and academic demands, as well as the conditions imposed in higher education, can exacerbate mental health comorbidities.
  • Academic outcomes tend to improve when students are supported with individually tailored accommodations that meet their specific needs.
  • The attitudes, knowledge and understanding of academic staff are key in whether or not students with ADHD can access the support they need, feel a sense of belonging and achieve academically. Considering ADHD simply as a type of student diversity can help foster inclusivity.
  • Adoption of UDL strategies is particularly well suited for this population as students with ADHD often struggle to disclose their diagnosis and to discuss their disability and accommodations needed; these strategies can significantly benefit all students independently of them being neurotypical or not.

Top tips

  • Convert course material in multi-sensory and accessible formats (e.g., audio recordings, adoption of different colours) in an easy to navigate setup. Provide reading lists and course material as early as possible as well as lecture notes before class.
  • Teach organisational and study skills (e.g., how to break down tasks into parts, estimating time needed for completion of tasks) and outlining skills (e.g., words needed for note-taking) as part of the curriculum.
  • Use active learning and group work help to improve learning, and design assignments and tasks to be broken up into smaller parts. Remember to highlight, emphasise and repeat important information.
  • Encourage students to sit away from noise and in front of the class to minimise distractions and allow for periodical short breaks.
  • Close working relationships between academics and student services can ensure students receive the adjustments and support that they need and that work well with the nature of the course.

(2, 6, 10, 18)

Resources
Buff line
References
  1. Emmers E, Jansen D, Petry K, Van der Oord S, Baeyens D. Functioning and participation of students with ADHD in higher education according to the ICF-framework. Journal of Further and Higher Education. 2017 Jul 4;41(4):435-47.
  2. Clouder L, Karakus M, Cinotti A, Ferreyra MV, Fierros GA, Rojo P. Neurodiversity in higher education: A narrative synthesis. Higher Education. 2020 Oct;80(4):757-78.
  3. Arnold LE, Hodgkins P, Kahle J, Madhoo M, Kewley G. Long-term outcomes of ADHD: academic achievement and performance. Journal of attention disorders. 2020 Jan;24(1):73-85. Available from: doi: 10.1177/1087054714566076
  4. Sedgwick JA. University students with attention deficit hyperactivity disorder (ADHD): A literature review. Irish journal of psychological medicine. 2018 Sep;35(3):221-35.
  5. Taneja-Johansson S. Facilitators and barriers along pathways to higher education in Sweden: a disability lens. International Journal of Inclusive Education. 2021 Jun 17:1-5.
  6. Bender WN, Mathes MY. Students with ADHD in the inclusive classroom: A hierarchical approach to strategy selection. Intervention in school and clinic. 1995 Mar;30(4):226-34.
  7. Budd J, Fichten CS, Jorgensen M, Havel A, Flanagan T. Postsecondary Students with Specific Learning Disabilities and with Attention Deficit Hyperactivity Disorder Should Not Be Considered as a Unified Group for Research or Practice. Journal of Education and Training Studies. 2016 Apr;4(4):206-16. Available from: doi: 10.11114/jets.v4i4.1255
  8. Jansen D, Petry K, Ceulemans E, Van der Oord S, Noens I, Baeyens D. Functioning and participation problems of students with ADHD in higher education: which reasonable accommodations are effective? European Journal of Special Needs Education. 2017 Jan 2;32(1):35-53.
  9. Terras K, Anderson S, Grave S. Comparing Disability Accommodations in Online Courses: A Cross-Classification. Journal of Educators Online. 2020 Jul;17(2):n2.
  10. Pfeifer MA, Reiter EM, Cordero JJ, Stanton JD. Inside and out: Factors that support and hinder the self-advocacy of undergraduates with ADHD and/or specific learning disabilities in STEM. CBE—Life Sciences Education. 2021;20(2):ar17.
  11. Lister K, Coughlan T, Owen N. Learning needs, barriers, differences and study requirements: How students identify as 'disabled' in higher education. Widening Participation and Lifelong Learning. 2020 Apr 1;22(1):95-111.
  12. Dewsbury B, Brame CJ. Inclusive teaching. CBE—Life Sciences Education. 2019;18(2):fe2. doi: 10.1187/cbe.19-01-0021
  13. Bussing R, Gary FA, Leon CE, Garvan CW, Reid R. General classroom teachers’ information and perceptions of attention deficit hyperactivity disorder. Behavioral Disorders. 2002 Aug;27(4):327-39.
  14. Lombardi A, Murray C, Dallas B. University faculty attitudes toward disability and inclusive instruction: Comparing two institutions. Journal of Postsecondary Education and Disability. 2013;26(3):221-32.
  15. Svendby R. Lecturers’ Teaching Experiences with Invisibly Disabled Students in Higher Education: Connecting and Aiming at Inclusion. Scandinavian journal of disability research. 2020;22(1):275-84.
  16. Allen AG, & Anderson DSC. Universal Design for Learning and Instruction: Overcoming Barriers Facing Students with Disabilities in Colleges and Universities. 2020. Available from: http://jespnet.com/journals/Vol_7_No_4_December_2020/10.pdf
  17. Hsiao F, Burgstahler S, Johnson T, Nuss D, Doherty M. Promoting an Accessible Learning Environment for Students with Disabilities via Faculty Development (Practice Brief). Journal of Postsecondary Education and Disability. 2019;32(1):91-9.
  18. Vickers MZ. Accommodating College Students with Learning Disabilities: ADD, ADHD, and Dyslexia. John William Pope Center for Higher Education Policy (NJ1). 2010 Mar.
  19. Duke Learning Innovation. How to support your students with ADHD [Internet]. Durham: Duke University; 11 Sept 2020. Available from: https://learninginnovation.duke.edu/blog/2020/09/how-to-support-your-students-with-adhd/