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ADHD Associated With Lower Academic Performance Among College Students
College students with attention-deficit/hyperactivity disorder (ADHD) obtain significantly lower grade-point averages than their peers without ADHD, and the difference persists throughout their college years, a large-scale, multisite longitudinal study found.
The research also found few students with ADHD utilized support services at their colleges. Here, the three principal investigators on the project, Arthur D. Anastopoulos, PhD, Lisa L. Weyandt, PhD, and George J. DuPaul, PhD, explain the study method, surprising outcomes, and real-world implications of their findings.
Q: What was the impetus for your study on ADHD and the academic trajectories of college students?
A: Up until about 20 years ago, there was very little research or clinical attention paid to the population of college students with ADHD. However, with growing numbers of students being identified as having ADHD on college campuses, the need for research specifically focused on their needs was heightened. We had all been involved in consulting with our college disability service offices and other campus personnel working with students with ADHD. So we all saw a glaring need to study this group in more detail, particularly regarding their functioning in important areas (ie, academic, psychological, social) across semesters.
Q: Please briefly describe how the study was conducted.
A: With support from a National Institute of Mental Health research grant (R01MH094435), we were able to recruit first-year college students with and without ADHD in 2 cohorts across successive years from multiple 4-year colleges in North Carolina, Pennsylvania, and Rhode Island. Participants were recruited through several means (eg, referral from student disabilities, campus flyers, summer orientation sessions, advertisements on social media and in campus newspapers).
Student participants then went through a rigorous psychological evaluation to determine ADHD diagnostic status (present or absent) and presence of comorbid disorders. They completed multiple questionnaires about their functioning and also completed direct assessment of their cognitive ability, academic achievement skills, and attention/impulse control. Assessments were repeated on an annual basis across the succeeding 3 years. We also obtained each student’s college record regarding course grades, withdrawals, and disciplinary actions.
Q: Were any of the outcomes you reached particularly surprising or unexpected?
A: We expected students with ADHD to have academic problems and for those difficulties to be associated with executive functioning; however, we didn’t expect the magnitude of differences in grades between those with and without ADHD, nor did we expect those grades to be so different across essentially their entire college experience. After all, the students with ADHD had performed successfully enough in high school to be admitted to these universities, so we had expected grade differences to be of smaller magnitude.
Another unexpected finding was that most college students with ADHD do not seek or receive support from campus academic or disability services. Whether that is due to lack of awareness, fear of stigma, or a desire to be completely independent, this indicates a significant gap between what this population needs to succeed and what they are receiving to address those needs.
Q: What are the possible near-term applications of these findings in clinical practice?
A: One of the main take-away points is the need to help students with ADHD with self-advocacy before and during college matriculation. That is, to help them be aware of potential challenges they may face when living and studying independently, as well as help them be cognizant of connecting with campus disability, counseling, and student health services before they experience academic difficulties.
Another primary take-away is the need for students with ADHD to receive support in executive functioning and study strategies while in high school, with continued support in these areas during their college years. Finally, it is important to note that although receipt of ADHD medication helped with student persistence in enrollment across semesters, medication did little to address their academic difficulties. Thus, the need for ongoing support that directly addresses academic and organizational skills.
Q: What support services do you see as most important for students with ADHD before and during their college years?
A: As per the response to the prior question, students with ADHD need support in organizational and study skills while in high school and during college. They also need help in advocating for themselves to receive necessary counseling, disability support, and academic tutoring before they experience significant difficulties. This also may include consultation with a medical professional to determine the need for medication.
Q: Are you doing any more research on this topic, and are there any other studies you feel are needed?
A: All of us continue to be interested in research with this population, including additional analyses of outcomes from the Trajectories Related to ADHD in College (TRAC) study. One of us (Dr. Anastopoulos) is conducting research on psychosocial treatment of college students with ADHD; specifically, the development and evaluation of intervention that directly addresses the gaps identified in our TRAC study. We should note that 2 efficacy trial papers have been published from Dr. Anastopoulos’s psychoeducational treatment study.
Reference
Arthur D. Anastopoulos, PhD, received his doctorate in clinical psychology from Purdue University and currently holds the position of Professor in the Department of Human Development and Family Studies at the University of North Carolina Greensboro, where he also directs an ADHD Clinic. Throughout his career, Dr. Anastopoulos has maintained clinical and research interests in the assessment and treatment of ADHD across the life span, with a current focus on emerging adults with ADHD attending college.
Lisa L. Weyandt, PhD, is a professor of psychology at the University of Rhode Island and the Director of the Interdisciplinary Neuroscience Program. Her primary areas of research concerns the assessment and treatment of ADHD and various facets of clinical neuroscience. She is recognized nationally and internationally for her work concerning ADHD in college students. Dr. Weyandt and her research team have published numerous articles concerning the appropriate use and misuse of prescription stimulants among college students in the United States and abroad.
George J. DuPaul, PhD, is professor of school psychology and associate dean for research in the College of Education at Lehigh University in Bethlehem, Pennsylvania. Dr. DuPaul has published extensively on the assessment and treatment of children, adolescents, and young adults with ADHD. His current research activity is focused on evaluation of early intervention for young children at risk for ADHD.
