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ADHD and the College Experience: Accommodations, Medication, and Other Challenges

 

As an ADHD coach and former college instructor, I frequently reflect on the unique challenges faced by college students with ADHD. Just as students begin to find their stride in high school—leveraging school-provided accommodations and supportive structures—they often encounter a vastly different environment in college. This transition can exacerbate existing challenges.

In college, parental support typically diminishes significantly, coinciding with heightened responsibilities and academic rigor. Students accustomed to consistent routines and previously honed strategies may find these ineffective under these new conditions. Moreover, the accommodations they relied on in high school do not automatically transfer to the college setting. Many students mistakenly believe that the same support will be available, or that accommodations such as flexible deadlines will apply—only to find they do not.


Recently, I’ve heard from parents grappling with these issues. One mother worried about whether to intervene when her brand-new college freshman was about to run out of stimulant medication. She faced a dilemma: allowing her child to experience the consequences of neglecting a medication refill versus stepping in to ensure they had the medication needed to succeed. Another parent expressed frustration over her child’s college requiring a costly and time-consuming round of neuropsychological testing to qualify for accommodations and extended time on the LSAT. She was understandably upset that previous assessments that applied in high school were deemed “out of date,” especially given that ADHD is a lifelong condition.

While these and other college-related ADHD challenges can feel overwhelming, I’d like to offer some general strategies for parents of high school students preparing for college:


1. Gradually Increase Independence

In the last two years of high school, begin scaffolding support to promote self-advocacy. Encourage your student to take responsibility for medication management, attending classes on time, and tracking assignments. This gradual shift can foster independence and confidence.


2. Research Accommodations Early

Encourage your student to investigate the accommodations process at their chosen colleges. Upon acceptance, they should reach out to the office responsible for accommodations—these may be named differently at each institution (e.g., Office of Disability and Access, Disability Services, Student Accessibility Services). It’s crucial to start this process early, as gathering necessary documentation can take time. For various reasons, it is quite common for young adults to resist applying for accommodations at the college level. I highly recommend that you encourage your student to register with the accessibility office and to apply for accommodations even if they don't think they will need them. Students will not be required to use these accommodations, but it's far better to be prepared with the option than to find out mid-semester that they could be helpful and have to go through the application process during a time of stress, especially because the process can often take several weeks.


3. Explore Available Student Resources

In addition to accommodations, have your student research support groups, counseling services, coaching options, and tutoring centers offered by the college. They should also familiarize themselves with important dates and deadlines, like add-drop periods for their first semester. At Thrive ADHD, we provide a workbook designed to help high school students document this information, which is an essential part of our upcoming high-school-to-college transition program launching in 2025.


By gradually reducing parental support and ensuring that students understand the accommodations and services available to them, we can better prepare them for the academic demands of college life. Students with ADHD can navigate this transition successfully and thrive in their new environments. As parents, implementing these strategies can ease their journey.


Remember, the adjustment process may take a bit more time for students with ADHD, but with the right support and resources, they can absolutely succeed!


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