ADHD and Appreciative Advising

Michael Ormsby, University of South Carolina

Editor's note: This is the sixth in a series of articles written by graduate students enrolled in Jennifer Bloom's student affairs administration course at the University of South Carolina for the fall 2009 semester. As part of her course syllabus, Dr. Bloom required each student in her class to submit an article to The Mentor or other publication for consideration.

Attention Deficit Hyperactivity Disorder (ADHD) affects between 5 and 8 percent of school-aged children. Categorized as a neurobehavioral disorder, it is often diagnosed early in childhood when teachers and parents are instrumental in the student's success. “Teachers and parents can work together to solve problems and plan ways to support a child's learning at home as well as at school” (American Academy of Child and Adolescent Psychiatry [AACAP] and American Psychiatric Association [APA], 2009, p. 13). But what happens when these children get older and enroll in college? Current estimates indicate that around 2 to 4 percent of college students exhibit signs of ADHD, although much more research is needed in this area (“Pharmacological Study,” 2009). One recent study reported “approximately 25 percent of college students that receive Disability Support Services (DSS) receive accommodations for ADHD” (Vance & Weyandt, 2008, ¶1).

In addition to the typical challenges most first-year college students face, students with ADHD face additional hurdles. For example, they must decide whether to seek accommodations for their learning disability, to what extent they self-identify as ADHD, and how they will handle their ADHD medication. Advisers seeking to assist students with ADHD are looking for the best way to work with these students. Appreciative Advising is a powerful advising framework that has positively impacted retention and student satisfaction rates (Bloom, Hutson, & He, 2008). The purpose of this paper is to define ADHD, delineate the challenges that college students with ADHD face, and share how academic advisers can use the Appreciative Advising framework to empower ADHD students.

Defining ADHD

In order to work effectively with ADHD students, it is important to be familiar with the terminology and background of the disorder. Attention Deficit Hyperactivity Disorder is “a neurobehavioral condition characterized by excessive restlessness, inattention, distraction, and impulsivity” (AACAP & APA, 2009, p. 1). Hyperactivity-impulsivity and inattention are the two main symptoms that combine to create ADHD. Another facet to ADHD is that these symptoms are “more frequent and severe than is typical for individuals at comparable levels of development” (Bramer, 1996, p. 6). There are three ADHD subtypes: predominantly hyperactive-impulsive, predominantly inattentive, and combined. Bramer noted that “the diagnosis is not given unless some of the symptoms have been present before age seven ... [and] in at least two settings—home, school, work” (p. 6). Although the disorder has had many names over its years of existence and is sometimes still referred to as ADD (Attention Deficit Disorder), ADHD has now been the proper term designated for the disorder by the American Psychiatric Association.

Challenges Facing College Students with ADHD

Common characteristics associated with ADHD can become even more pronounced for college students. The most frequent problems that ADHD students face in the classroom include their lack of organization and time management skills, tendency to procrastinate, and difficulty with note-taking and studying (Attention Deficit Disorder Resources, 2009). As is the case with most students, personal issues can also influence their performance in the classroom. Personal roadblocks related to ADHD include difficulty sleeping, low self-esteem, and depression. ADHD students may also experience a multitude of relationship issues as the disorder can cause them to act inappropriately in social situations (Attention Deficit Disorder Resources).

The issue of students taking medication to treat ADHD also becomes more complex in the college environment. Just as students need to make major changes in their daily schedules when they come to college, students with ADHD may also need to alter their medication once they arrive on campus. “Doctors prescribing drugs to control ADHD in college students need to make sure the drugs control students' ADHD throughout the day. The drugs need to cover students' active lifestyles” (Medical News Today, 2009, ¶ 3). In addition, if students do not take their medications as prescribed, the side effects may become more severe and the chances of addiction and/or abuse of their medication increase.

Students with ADHD are often hesitant to share their diagnosis with their college instructors. It can be awkward for college students to make professors aware of their condition. Vance and Weyandt (2008) found that high numbers of college faculty are not aware that students with ADHD are afforded the legal right to reasonable accommodations under the Americans with Disabilities Act. Some students decide to pretend that they no longer have ADHD when they go to college. “A common pitfall for students with ADHD is the feeling that they are instantly cured upon graduating high school” (Attention Deficit Disorder Resources, 2009, ¶ 14). Although it is understandable that students with ADHD might want to disregard their ADHD, it may not be the best choice for them academically or personally. Academic advisers who meet with students individually are poised to help students with ADHD consider their options as well as the resources that are available to them.

Appreciative Advising Overview and Application to Students with ADHD

Appreciative Advising is “the intentional collaborative practice of asking positive, open-ended questions that help students optimize their educational experiences and achieve their dreams, goals, and potentials” (Appreciative Advising, 2009). The six phases are: Disarm, Discover, Dream, Design, Deliver, and Don't Settle (Bloom, Hutson, & He, 2008). The Disarm phase involves creating an environment in which students feel comfortable and welcome. In the Discover phase, advisers search for strengths and passions by using open-ended questions and active listening techniques. Advisers encourage students in the Dream phase to explore their potentials and help them create life and occupational goals. The Design phase allows students to set goals for achieving those dreams with the help of the adviser. The Deliver phase is when the student works toward achieving his or her goals while the adviser periodically checks in for progress updates and provides support after mistakes are made. Finally, Don't Settle challenges students to build on their successes.

Disarm

ADHD students may appear to be very nervous and fidgety when meeting with academic advisers and other institutional representatives. Therefore, the goal of the Disarm phase—putting students at ease—is especially important with ADHD students. One thing academic advisers can do to help alleviate ADHD students' impulsive tendencies is to have something available for them to hold in their hands, such as a stress ball or a Rubik's Cube. This can help alleviate students' anxiety and allow them to better focus on the discussion with the adviser. Advisers can also ease students' anxiety by warmly greeting them, smiling, and engaging in limited small talk (Bloom, Hutson, & He, 2008). These steps can help to engage students from the start.

Discover

A common characteristic among ADHD students is low self-esteem. They may tend to focus on their past academic struggles and be very critical of themselves. Therefore, the Discover phase, which focuses on advisers asking positive, open-ended questions, can help ADHD students reflect on their academic and personal accomplishments. Sample Discover questions include: After discovering students' interests, it may be helpful to briefly describe classes and/or majors that are congruent with those interests. This can help to give students a new, positive view of academics. In addition, advisers can also suggest extracurricular opportunities that match these interests, which can help them become engaged on campus.

Dream

Encouraging ADHD students to dream big may take some additional effort. Advisers may want to remind students of famous celebrities like Terry Bradshaw and Bill Cosby, who were diagnosed with ADHD. Historical figures like Albert Einstein, Thomas Edison, and Winston Churchill were all suspected of having the disorder as well. Sharing this information up front may result in students being more willing to share their hopes and dreams for their future. Effective questions for ADHD students include: Design

The Design phase involves coming up with a plan to accomplish the goals that students shared in the Dream phase (Bloom, Hutson, & He, 2008). Advisers working with ADHD students need to realize that ADHD students “do not appear to work well for long-term rewards. They appear to need brief, repeated payoffs instead of a single, delayed reward” (Goldstein, 1996, p. 41). Thus, helping ADHD students create small, concrete, and realistic goals is important. ADHD students should be encouraged to use a daily planner that allows them to track their daily, weekly, and monthly “to do” lists. This will help them meet their class requirements as well as any goals that the adviser and student have created during the advising session. Advisers should ensure that students are aware of and utilizing the services available to them through the disability services office. ADHD students may need to be convinced by advisers of the value of registering with the disability services office. Advisers can reassure students that by going through the registration process that the disability services office may be able to provide appropriate accommodations to students with ADHD, such as extended testing time and separate, quiet testing rooms.

Advisers can also refer ADHD students to other campus resources as appropriate. Once they have registered with the student disability services office, students may also need encouragement to speak to their instructors about their condition as well as the accommodations. Another resource available to ADHD students who may be struggling with depression is the counseling center. If students are displaying erratic behavior, the adviser may want to thoughtfully refer students to the physician who prescribed any medication to see if an adjustment may be in order.

Deliver

In the Deliver phase, students are charged with following through on the plans made during the Design phase (Bloom, Hutson, & He, 2008). The Deliver phase may be the most frustrating of all phases for ADHD students and their advisers, yet it also may be the most important phase. Students with ADHD symptoms may find it difficult to carry out their plans. Thus, it is imperative for advisers to express their confidence in ADHD students' abilities to carry out the plan and follow up with them to check their progress and evaluate the effectiveness of their plans. With advisers' assistance, students may need to make alterations and perhaps divide goals into more manageable chunks. However, it also important for advisers to discourage students from solely blaming any lack of progress on their ADHD condition. It may be helpful in the Deliver phase to ask the following questions during roadblocks with ADHD students: If students stumble in this phase, it can be particularly challenging for advisers to focus on the positive. Advisers can accomplish this by focusing on even the smallest of efforts that students engage in toward completing their goals, especially early in the process. In addition, advisers can remind students about their answers to Discover questions that highlighted past successes and the skills they have already acquired. Rather than reviewing what the student has done wrong, reviewing what they did right in the past will encourage them to use those positive assets and build on them to accomplish their goals.

Don't Settle Phase

This final phase of Appreciative Advising may be a step ADHD students have rarely experienced. Due to previous academic struggles, they may not have been challenged to push themselves beyond their initial goals. Provided they reach their intended goals, advisers should encourage students to not settle and to devise and achieve additional goals. For example, if they reach their goals of completing 80 percent of their homework on time, students should be encouraged to complete 90 percent of their homework in the upcoming week.

Conclusion

Attention Deficit Hyperactivity Disorder (ADHD) is becoming increasingly prevalent on college campuses. In addition to the typical growing pains that come with adjusting to college, ADHD students face issues of identity, medication, and seeking accommodations during their college careers. Advisers who are familiar with ADHD and understand the symptoms and challenges that ADHD students face have a major advantage in working effectively with this student population. By combining Appreciative Advising and a basic understanding of ADHD, it is possible for advisers to aid ADHD students in making their college journey a success. This article highlighted how the six phases of Appreciative Advising can be adapted to empower ADHD students to fulfill their potentials.

References

American Academy of Child and Adolescent Psychiatry and American Psychiatric Association. (2009, August 25). ADHD parents medication guide: Attention-deficit/hyperactivity disorder. Retrieved from http://www.psych.org/Share/Parents-Med-Guide/Medication-Guides/ParentsMedGuide-ADHD-English.aspx

Appreciative Advising. (2009). What is appreciative advising? Retrieved from http://www.appreciativeadvising.net

Attention Deficit Disorder Resources. (2009, August 8). College issues for students with ADHD. Retrieved from http://www.addresources.org/article_adhd_college_chadd.php

Bloom, J. L., Hutson, B. L., & He, Y. (2008). The appreciative advising revolution. Champaign, IL: Stipes.

Bramer, J. S. (1996). Succeeding in college with attention deficit disorders: Issues and strategies for students, counselors and educators. Plantation, FL: Specialty Press.

Goldstein, S. (1996). Managing attention and learning disorders in late adolescence and adulthood: A guide for practitioners. New York, NY: John Wiley and Sons.

Medical News Today. (2009, January 25). Treating college students with ADHD poses challenges, UA researcher says. Retrieved from http://www.medicalnewstoday.com/articles/136453.php

Pharmacological study for ADHD treatment amongst college students. (2009, September 24). The Medical News. Retrieved from http://www.news-medical.net/news/20090924/Pharmacological-study-for-ADHD-treatment-amongst-college-students.aspx

Vance, T. A., & Weyandt, L. (2008). Professor perceptions of college students with attention deficit hyperactivity disorder. Journal of American College Health, 57(3), 303–308. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed

About the Author

Michael Ormsby is a graduate student in the University of South Carolina's Higher Education and Student Affairs program. He is also a graduate assistant in the university's Office of Sexual Health and Violence. He can be reached at ormsby@mailbox.sc.edu.

Published in The Mentor on March 17, 2010, by Penn State's Division of Undergraduate Studies
Available online at dus.psu.edu/mentor
Privacy and Legal Statements | Copyright | © The Pennsylvania State University | All rights reserved