Attention Deficit Disorder & Attention Deficit and Hyperactivity Disorder
(ADD & ADHD)

     ADD and ADHD are persistent neurodevelopmental disorders: they cannot be outgrown and may interfere with one’s social, academic, and occupational functioning. ADD is mainly characterized by inattention and disorganization. This leads one to have trouble staying focused on a task (i.e., writing an assignment, reading, listening to a lecture or a discussion) and losing or misplacing their material. In addition to the struggles associated with ADD, ADHD is related to hyperactivity and impulsivity. According to the DSM-5, “hyperactivity refers to excessive motor activity […] when it is not appropriate, or excessive fidgeting, tapping, or talkativeness […]. [By contrast,] impulsivity refers to hasty actions that occur in the moment without forethought and that have high potential for harm to the individual […]. Impulsive behaviors may manifest as social intrusiveness (e.g., interrupting others excessively) and/or as making important decisions without consideration of long-term consequences” (American Psychiatric Association, 2013, p.61). 

     For students, having ADD or ADHD translates to a general feeling of having different operating mechanisms in various situations ranging from academic performances to social interactions and passing by sustaining basic needs. Here, it is not meant that a person with ADD or ADHD cannot do those tasks but instead has different needs to navigate them. In university-related situations such as lectures or working on assignments, readings, and examinations, students with ADD and ADHD have trouble focusing and staying still for long periods and need to take active breaks regularly. Moreover, they experience problems in time management, such as planning, prioritizing, and assessing how much time has passed. Thus, a given task may be anticipated to take much longer than needed and vice versa, and it is difficult to keep up with appointments. In addition, students with ADD or ADHD can have trouble regulating their emotions and be easily overruled by them, which, in some cases, can lead to exhaustion and negatively impact their capacity to perform socially or academically.

     A crucial aspect of understanding ADD and ADHD is the understanding of executive dysfunction or executive function deficit. This consists of the alteration of cognitive processes involved in executive functions such as time management (planning, organization), cognitive flexibility, behavioral control, and working memory. This deficit is due to dysfunctional neurocognitive processes, which means that, though it manifests in one’s behavior, it is a biological trait inherent to the individual and not a personality trait that can be outgrown or overcome. Executive dysfunction typically appears in individuals with ADD or ADHD through the struggles of starting tasks, regardless of their significance. For students, this means that they may be physically unable to begin an assignment, however stressed they are about it and however close it is to the deadline. Often, executive dysfunction is confused with indolence, or laziness, which is, despite the ability to do something, a deliberate choice not to do it. 

In class

Situation
What is happening when the issue arises?

Issue
Why is the situation challenging?

Possible accommodation
How can the situation be made more accessible?

- Lectures and in-class exercises with unannounced or no specific structure

- Overtime 

For students with ADD or ADHD, structure is very important in order to stay focused during a certain period of time. If there is no specific structure or if the structure is unannounced, they are more likely to stop paying attention before the end of the lecture’s part or the exercise and miss out on its content.

Note: This applies to classes of all lengths. 

- Announcing the lecture’s structure at its beginning. 

- Avoiding overtime or letting students know that the class will last for longer than usual. 

Lectures with no break

Students with ADD or ADHD have increased difficulty focusing for an extended period of time. If no break is given, they may merely and unwillingly stop paying attention and miss out on the class’ content. 

- Giving a break of 5 to 10 minutes in the middle of the lectures. 

 

- Giving a summary of the lecture’s important points at its end. 

Long lectures (>1h30)

Longer lectures require a longer attention span from students which is challenging for those with ADD or ADHD. 

- Announcing the lecture’s structure at its beginning. 

- Giving a break every 45minutes or every hour. 

Lectures with no PowerPoint or summary 

Students with ADD and ADHD have trouble staying focused during a lecture and may miss out on important information during a lecture. 

A PowerPoint or summary allows students to go through the class’s content again and catch up. 

Note taking

Some students cannot take notes as it causes them to miss part of a discussion or follow the class. This is problematic to study later on. 

- Use of the PowerPoint. 

- If agreed on between with the lecturer, the student can record the class on their phone. 

 

- Online: recording the class

The lecturer asks a question and quickly launches a discussion. 

This also applies in “first come first served” situations (i.e., to pick partners for group work or a date for a presentation). 

Students may not have the time to process the question or gather their thoughts and are unable to contribute on time. 

The students unwillingly end up with the “last pick”. 

- Giving a few minutes for reflection, especially for “first come first served situations” and making sure all students are ready. 

- Online sign-ups introduced in-class with a reminder in canvas announcements. 

- Writing down the question on the board or the PowerPoint.

- Writing down the discussion’s main points on the board.

Group work in class. There is a lot of sensory input (i.e., movements, loud discussion / noises)

Students with ADD or ADHD can be easily distracted or overwhelmed and then cannot contribute to their group’s work. Some might think they are taking the position of a free rider.  

- The group of the student can go work in a project room. 

- Ideally, the lecturer booked a room prior to the class so that there is no time loss looking for one or moving to the room because it is far from the classroom. 

Coping behaviours from students that seem distracting (e.g. doodling while listening) but in fact helps paying attention because it prevents intrusive thoughts. 

Some lecturers may be upset with this kind of behaviour and interpret it as a sign of disrespect or disinterest. This can sour the relationship between a student and the professor. 

- If one’s behaviour seems not to be in line with participating in class, a discussion between the lecturer and the student is helpful to find common ground or alternatives. 

Discussing with the student also allows professors to identify behaviour that is not ‘coping’ (like doodling) but distracting (like texting). 

Guest lecture

The new lecturer is not aware of the student’s disability and might not be considerate enough during their lecture. 

- Letting the lecturer know about the student’s disability in advance. 

- Giving time to the student with a disability to introduce themselves. 

The student is late for class. 

The student may miss out on some of the lecture’s content. 

Perceived judgement from others is energy draining as well as the need to explain themselves. 

When the lecturer closes the door and does not let anyone come in anymore, the student misses the whole class and absences can become an issue. 

- This is an ambiguous issue as very strict lecturers may force students to be on time but also increase their level of stress and drained energy from the situation. On the other hand, more accommodating teachers partially solve the stress aspect but may decrease the incentive to be on time.

In any case, the lecturer should not take the issue personally: this is not due to students’ carelessness. 

- Avoiding calling out students on why they are late in front of the whole class. 

Deadlines & Assignments

Situation
What is happening when the issue arises?

Issue
Why is the situation challenging?

Possible accommodation
How can the situation be made more accessible?

- Students are required to plan their work and assignments in advance. 

- Many deadlines in the same week.

Students with ADD or ADHD struggle with time management and long term planning. This induces stress and may cause downgrading because the assignments were handed in late. 

Clarity from lecturers is essential:

- Mentioning whether the time of the deadline is essential.

- Mentioning leniency (i.e., handing in an assignment an hour after the deadline is OK) (if applicable).

- Clarifying in which situations an extension would be possible/what is required to request it.

 

- Avoiding vagueness as much as possible: phrasing such as ‘if you hand it in a day late you’ll probably be fine” takes away the pressure that helps meeting deadlines without taking away the stress that makes deadlines like this mentally taxing. 

 

- Option to move deadlines at the beginning of the semester (to avoid overlap with other classes).

Executive dysfunction-related tasks required for university-associated matters (i.e., sending e-mails, signing up for things).

Some of the ‘smaller’ tasks take up a lot of mental space/energy and time because it is difficult to start them or because students forget them. This can also cause problems with registration for internships and courses. 

- Support from tutors.

- Mentioning explicitly the policy regarding contact with students (i.e., email, canvas messages, through the class’ student mediator).

Written form  

For some students, writing is much more difficult than expressing themselves vocally.  

- Some assessments such as weekly responses, or less substantial essays can be completed in a non-written form (completely or partially), such as audio or video recordings.

Examinations

Situation
What is happening when the issue arises?

Issue
Why is the situation challenging?

Possible accommodation
How can the situation be made more accessible?

Examinations – Distractions & Time loss 

Beside the examination students are supposed to complete, there are a lot of sources of distraction in one’s environment (in-class and at home) which lead them to unwillingly lose time. This adds stress to a situation that is already challenging and may negatively impact their performance in cases where they are not given proper accommodations. 

- Extra time

- Use of noise-canceling headphones.

Long exams (>1h30)

Staying focused for a long time is difficult, sitting still, and staying quiet to complete the exam is problematic.

- Extra time may give students time to refocus.  

- Being able to walk out of the classroom for a few minutes (accompanied if required). 

Miscellaneous

Situation
What is happening when the issue arises?

Issue
Why is the situation challenging?

Possible accommodation
How can the situation be made more accessible?

Studying at home 

Students are confronted with numerous sources of distraction. They also struggle with starting a task due to executive dysfunction. 

- Option to study at the AB or library. Being in a studying and less familiar environment is an encouragement to get started and reduces the number of potential distractions. 

- Study sessions with peers.

Students are required to plan their curriculum by themselves. 

Long term planning can be difficult for students with ADD or ADHD and might lead them to miss opportunities that could benefit them (i.e., off-campus courses, exchange).

- Clear communication about which courses will be available over a given period and explicitly mention if courses are prone to being cancelled or oversubscribed.

- Pro-active support from tutors in planning the curriculum: if a person with AD(H)D says they ‘made a plan’ (even if they believe that) often simply just does not mean they have the same awareness of this planning as the average student.