Jansen, D., Petry, K., Ceulemans, E., Van der Oord, S., Noens, I., & Baeyens, D. (2017). Functioning and participation problems of students with ADHD in higher education: Which reasonable accommodations are effective ? European Journal of Special Needs Education , 32 (1), 35–53. https://doi.org/10.1080/08856257.2016.1254965

Downloadable online at https://ppw.kuleuven.be/okp/_pdf/Jansen2017ADHD.pdf

The experiences and perceptions of postsecondary students with ADHD were investigated, including comparing them to students without disabilities, and with the additional perspectives of postsecondary professionals. A set of 12 reasonable accommodations was examined including at least seven provided during course exams: alternative format, computer-based exam, deferral of exam, designated seat location, extended time, small group administration, and visual time indication; exam accommodations were emphasized in this summary.

Eighty six (86) postsecondary students with attention-deficit hyperactivity disorder (ADHD) were matched with 86 students without disabilities; all students responded to a student survey. Respondents with and without ADHD were matched by gender—51 female and 35 male students—and by year of enrollment, with both groups having mostly students in their second or third year. Efforts were also made to match students by academic or professional program, which was completed by broader categories: 68% were in humanities and social sciences; about 25% were in science, engineering, and technology; and the remainder were in biomedical sciences. Forty two (42) university counselors who were supporting students with ADHD responded to an educator survey. The counselors were mostly women (n=35) and had 1–22 years of work experience in the role. All survey respondents attended or were employed at one of seven postsecondary institutions, either colleges or universities, in Flanders, Belgium.

A survey developed by the research team and vetted by experts was used to capture data from the three groups of respondents. It consisted of three sections: (Part A) a list of 17 difficulties in functioning and participation for students with ADHD in postsecondary education (Emmers et al., 2016), (Part B) a list of 14 different teaching and evaluation methods drawn from the European Credit Transfer System, and (Part C) a set of reasonable accommodations used by students with ADHD (Harrison et al., 2013). Academic assessment or evaluation methods were emphasized in the Findings section. All three groups responded to Part A, the list of functioning and participation difficulties, with the students rating the extent to which each difficulty applied to themselves, and the counselors endorsing the extent to which they have observed each difficulty being characteristic of students with ADHD. Only postsecondary students with ADHD responded to Part B, as to whether they have encountered each difficulty from Part A while each teaching and evaluation method were used. Only the group of students with ADHD responded to Part C by indicating whether they have been provided each of the accommodations, then to rate the degree of effectiveness when using each, or the perceived effectiveness in the case that they were not provided them. Responses from students without disabilities were used as comparison data and responses from counselors were used to gain additional perspectives on the functioning of students with ADHD.

Large proportions of postsecondary students reported that their difficulties in postsecondary education included sustaining and focusing attention (96%), frequent daydreaming (80%), difficulty completing tasks (71%), and difficulty planning and organizing (71%); additional data from large proportions of counselors (75–95%) confirmed these distinguishing features or problems. Comparative data showed lower proportions of students without disabilities experienced these difficulties (39–54%). Larger proportions of counselors than students with ADHD endorsed impulsive behavior (75% vs. 56%) and difficulty sitting still (53% vs. 30%). The researchers grouped the 17 functioning and participation difficulties into four clusters: attention problems, inefficient study skills, regulation problems, and social problems; the four most frequently encountered difficulties were components of the first two clusters. Students with ADHD experienced relatively high incidence of experiencing attention problems (0.69) and inefficient study skills (0.65) associated with exams employing classical evaluation methods—such as writing a term paper, completing a closed-book or open-book exam, or completing a selected-response (multiple-choice) exam. However, when taking exams employing alternative evaluation methods such as oral or practical exams or portfolio-based evaluations, these incidences were decreased: attention problems (0.49) and inefficient study skills (0.48). The specific exam accommodation, extended time, addressed three of the four difficulties in the attention problems cluster and all four of the difficulties in the inefficient study skills cluster; in fact, 93% of participants indicated successfully using extended time for exams. Frequent daydreaming was not addressed by exam accommodations. Participants with the forgetfulness difficulty—in the attention problems cluster—indicated that changing exam response format such as from written to oral response was the most effective option. Participants with the planning and organizing difficulty—in the inefficient study skills cluster— indicated that exam deferral was the most effective accommodation. Students with ADHD each indicated at least one accommodation was effective in addressing all or nearly all of their particular difficulties. However, for students who had not used various specific accommodations to address attention or study skills problems, their expectations that they would be effective were significantly lower, including for extended time, designated seating, exam deferral, small group administration, and visible time remaining indication. The researchers concluded that these results indicated the need to take highly individualized approaches to providing supports, particularly exam accommodations, to postsecondary students with ADHD.