This section contains information on the best ways to support a student who has disclosed Attention Deficit (Hyperactivity) Disorder (ADHD).
If you're looking for information regarding students seeking a diagnosis, email the Accessibility and Disability Resource Centre (ADRC) disability@admin.cam.ac.uk with the subject ‘Diagnostic assessment’.
Key support actions
- Permit recording of lectures.
- Provide handouts in advance of lectures.
- Provide directed reading lists.
- Extend loan periods for books.
- Facilitate examination access arrangements (such as extra time, use of a word processor, rest breaks and marking advice to examiners)
What is ADHD?
ADHD is one of the conditions that is sometimes described as a 'Specific Learning Difficulty' (SpLD), however, it is a separate diagnosis in its own right with its own unique features.
It is characterised by inattention, hyperactivity and impulsiveness. This affects the student’s ability to maintain focus and concentration, to sustain or shift attention and a student often tends to be easily distracted. As a result, students can find it difficult to manage their time, avoid distractions, prioritise tasks, reduce procrastination and make productive use of their time.
A major difficulty can be sustaining their attention in ‘passive’ learning situations such as lectures or larger group tutorials. Students with ADHD can have excellent verbal and abstract reasoning skills, which act as a compensatory strength.
Students with ADHD have difficulties that are exacerbated by timed conditions. Generally, they will benefit from a multi-sensory approach to learning for example, demonstrations, discussions, associated visual information and hands-on practice where possible.
Students with ADHD require additional time and effort to process and comprehend verbal information, particularly when listening. When writing they find it hard to organise and prioritise ideas and have a tendency to overlook accuracy mistakes, such as missing punctuation.
These difficulties with attention also make other multi-processing tasks challenging, such as simultaneously listening and taking notes in lectures.
This diagnosis can negatively affect this student’s ability to complete tasks within a given timeframe, and thus makes deadlines difficult to meet and exam situations particularly stressful, due to the following reasons:
- Difficulties concentrating or focusing for a sustained period
- Problems organising ideas in essays
- Problems with note taking as they easily lose focus unless the content is stimulating
- Tends to be easily distracted by external noise, visual surroundings, movement and by own thoughts
- Due to the concentration, focusing or distractibility difficulties, students need to re-read frequently to absorb information, takes longer to complete note-taking activities and may miss information in lectures (makes reading and note-taking a lengthy process)
- Tendency to be easily distracted by minor aspects of a topic (at the cost of accomplishing the more important aspects)
- Difficulties presenting their knowledge in the given timeframe in a manner that accurately reflects their ability
- Problems limiting themself to the specific question being researched, when writing academic papers or thesis
- Difficulty with time management and organisation (causing problems meeting deadlines)
- Difficulties prioritising and inefficient use of time and tends to procrastinate
- Difficulties selecting key information in lectures and from texts, thus finding it particularly difficult to listen in lectures and engage in discussion during larger group tutorials
- Difficulty with sleeping patterns
- Problems with organisation, punctuality, time management and short-term memory
- Finding it difficult to organise their thoughts in a cohesive order and to follow a linear structure when writing
- Being very easily distracted when studying and working
- Being 'unable to tune out random thoughts'
There are common aspects and characteristics that are shared with other specific learning difficulty diagnoses and ADHD (it is common for there to be overlaps with the other Specific Learning Difficulties).
It is also quite common for an individual to have co-occurring SpLDs or to have ADHD that co-occurs with other impairments such as dyslexia, dyspraxia, dyscalculia, and/or autism spectrum conditions.
How does ADHD impact on study?
The impact of ADHD will vary from individual to individual and will depend upon a range of factors including the time since diagnosis, the range of strategies that have already been developed, and the support that is available.
In general, it may take students with ADHD significantly longer to read material than their peers due to slow speed of processing and distractibility. It may similarly take them substantially longer to write essays.
This is because students with ADHD may experience difficulties in the following areas, particularly under time pressure:
- Absorbing information quickly from reading material
- Writing concisely
- Fluency of written composition
- Speed and legibility of handwriting
- Planning, organising, ordering, and structuring writing and ideas
- Retaining and manipulating long lists of orally given instructions
- Formulating and retaining ideas both for speech and in writing
- Proofreading (ability to recognise own errors)
- Sentence structure, grammar and punctuation
- Listening and taking notes simultaneously and selecting essential information
- Summarising from source material or paraphrasing
- Scanning and skimming information rapidly
- Maintaining focus and focusing accurately on the text for a sustained period
- Task and time management - including planning and structuring time
It is important to note, however, that not all students will experience all the difficulties listed and the range of areas of difficulty experienced will vary from individual to individual.
Some students with ADHD will have developed a range of compensatory strategies. However, these strategies may come under pressure in different environments including during times of increased stress and may begin to break down.
Therefore, the difficulties may become more noticeable when under time pressure (such as in examinations), where there is an increased burden on memory and the rapid retrieval and organisation of information and/or if a student is overwhelmed as a result of poor time management and organisation.
Supporting and teaching students with ADHD
Inclusive teaching
Supervisions
- Allow extra time and flexibility over deadlines where possible
- Provide help with defining the scope and limit of the work, monitoring of progress, and establishing clearly defined academic goals
- Texts placed on Moodle should be in Word document form if possible (rather than PDF) so that students can use assistive technology to read texts
- Provide clear guidance with reading lists, directed reading tasks or modified reading lists
- Email any supervision discussion materials to students in advance
- Provide assignment deadlines well in advance
- Provide the reading list for the term ahead as early as possible so that students can organise and start the reading during the vacation. When providing the reading list, please indicate the order in which books or works will be set for assignments
- Academic goals and timelines should be clearly defined
- Rephrasing or repetition of information may be necessary
- ‘Signposting’ essential information will assist this student in determining salient information from non-essential details.
- Instructions and feedback should be provided in clear written form
- Permission to record where possible
- Avoid asking the student to read aloud from unseen texts without prior agreement
- Offer additional supervisions to discuss subject-specific areas and identify knowledge gaps due to speed of processing difficulties
- Extend library loans
Lectures
- Texts placed on Moodle should be in Word document form if possible (rather than PDF) so that this student can use assistive technology to read texts
- A synopsis at the start of the lecture and effective signposting throughout. At the conclusion of each lecture, review major points.
- Reading lists provided in advance
- Permission to record
- This student may need to take notes using a laptop computer
- Information should be left on the board to allow adequate copying time
- Copies of PowerPoints, handouts, and discussion documents, in advance
- Introduce new vocabulary in context with concepts explained
- Label diagrams in handouts. If this is not possible, make labelled diagrams available afterwards
Practicals
- Give permission to record instructions
- Break lengthy tasks into stages
- Repeat information when necessary
- Provide instructions, processes, and protocols in written and verbal form
- Extend time available
- Give clear information in advance about field work and years abroad and offer discussions about ensuring access
Remote teaching & learning
- Provide adequate time for the student to assimilate or process questions and make notes or sequence ideas before being required to respond to a question. Answering on the spot can be challenging as it can place a burden on the working memory, sequencing, speed of processing and concentration of a student with ADHD.
- Repetition may be required
- Allow recording, where possible
Diagnosing ADHD
To get a diagnosis of ADHD, a student must meet several criteria that are defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the UK NICE 87 Guideline.
Diagnoses are normally made via a medical route and sometimes via a referral from an educational provider. Both involve specialists who have training and experiencing in diagnosing ADHD, and include specialist psychiatrists, paediatricians, clinical and/or some educational psychologists.
Waiting times for a diagnosis can be lengthy and students are advised to speak to the ADRC for more information and guidance.
Reasonable adjustments
In addition to the reasonable adjustments mentioned above, additional adjustments which should be available if required to students with ADHD include:
- Mentoring and study skills support - to enable good planning and efficient working, and to facilitate appropriate coping strategies
- Allow use of assistive technology
- Regular meetings with Tutor or Director of Studies - to keep everyone informed of issues and to enable difficulties to be addressed prior to them reaching a crisis
The Equality Act (2010)
The Equality Act protects people with a diagnosed Specific Learning Difficulty, including ADHD. There will be a legal obligation to make reasonable adjustments and not to treat these individuals less favourably.