From the issue dated September 26, 2003
|
|
|
Paying Attention to Students Who Can'tSome colleges make accommodations for attention deficit hyperactivity disorder; others balkBy ELIZABETH F. FARRELL Sean P. Gallagher thought he had perfected the art of deception. Since his earliest days in school, he remembers
His smoke and mirrors didn't work for long: report cards with assessments like "doesn't apply himself" and "never hands in assignments on time" piled up. His parents' initial assumption was that he was just lazy and careless. Then one day his mother, a medical secretary, attended a seminar on attention deficit hyperactivity disorder, or ADHD, which can lead to excessive impulsiveness and difficulty in concentrating. At age 12, Mr. Gallagher was diagnosed with the disorder and began taking Ritalin, a stimulant commonly used to treat ADHD. The medication made it easier for him to concentrate, he says, and he did more schoolwork. But Mr. Gallagher says his study habits never really improved -- even though he managed to maintain a B average in high school, scored a 1250 on the SAT, and was admitted to Kent State University. He began his first semester with plans to major in archaeology, but ended it with a 0.28 grade-point average, failing every class except tennis. After an equally unsuccessful second semester, he left Kent State. Researchers are not sure how many college students have ADHD -- estimates range from 0.5 to 5 percent, or 65,000 to 650,000 students -- but the number has increased steeply in recent years, as more children have been diagnosed with the disorder. In elementary and secondary schools, teachers and school psychologists typically work together to develop appropriate learning plans for ADHD students, based on the severity of their disorder. Many ADHD students come to college already accustomed to special services and exceptions, like taking tests in separate rooms or having their medication dispensed by the school nurse. Colleges have responded to the influx by offering a variety of accommodations for students with the disorder, like note-taking services, personal tutors, and policies that allow extended time for taking tests. Despite those efforts, both the anecdotal and the slim statistical evidence available suggest that institutions of higher education are still unsure how to best help these students. And some mental-health experts even doubt the effectiveness of popular accommodations. "The biggest problem for me and my colleagues is that there's a real disconnect between the K-12 system and the collegiate system," says Ross Pollack, director of the student-resource center at Manhattan College in Riverdale, N.Y. "We see students who do well before they get to college, and then barely bump along when they get there." Dealing with time management, lengthy lecture classes, and professors who don't do hand-holding forces every college freshman to rely more on internal self-discipline than on imposed rules and deadlines. 'No Exceptions, No Excuses' For students with ADHD, the autonomy and the big blocks of free time can exacerbate some of their bad habits. Distractions abound in dormitories and in lecture classes full of other students. Classes scheduled for varying times throw off a regular sleep schedule. "When I got to Kent, I basically just fell apart, because what little structure I had was from my parents, and a regular schedule was gone," says Mr. Gallagher. The social environment at college can also be an issue for students with ADHD. "They're a bit impulsive when it comes to alcohol and drugs," says Carol E. Watkins, a Chicago psychiatrist who specializes in treating college students with the condition. "Statistically, they have an increased incidence of drug and alcohol abuse -- and if they do indeed end up with problems, the recovery process is a bit more difficult." Mr. Gallagher says that he doesn't think he became an alcoholic, but that he "got into the partying and drinking very heavily as a way of taking my mind off things," and had a hard time breaking those habits. But the jury is still out on how far colleges should go in accommodating ADHD students. Most colleges supply services or make exceptions on the basis of requests made by students' doctors. What they are required to do legally, however, is ambiguous. The federal Rehabilitation Act requires colleges to provide academic adjustments for students with ADHD. But some institutions, like Boston University, have successfully fought high-profile legal battles challenging the requirement on the grounds that it sometimes compromises their academic mission. "The challenge is to determine the fundamental requirements of the program and communicate that information to the student," says Lorraine E. Wolf, clinical director of disability services at Boston University. "If they are enrolled as a journalism major, for instance, it doesn't really make much sense to give them extended time for assignments, because they won't be allowed that in a journalism career." At the university, academic deans are invited to weigh in on the applicability of modifications for ADHD and learning disabilities to their programs. Dr. Wolf says that is an essential approach for making sure students are not excessively coddled. At times, the "no exceptions, no excuses" approach can seem harsh, but some ADHD students acknowledge that they often need stringent rules to thrive, even if they stumble initially. Corey Williams, who attended Sarah Lawrence College, acknowledges that one professor's tough-love approach helped him. Mr. Williams did not officially report his ADHD, but mentioned it to a professor to explain why he was floundering academically. The professor's response? "She said that regardless of how my mind works, I have to take care of myself," says Mr. Williams. "It was somewhat discouraging to hear, but I wasn't on a positive plan anyway. I was going to bed at 3 a.m. and was sleeping through classes." He says the professor's words were just the push he needed. After making a concerted effort to follow a more normal sleep schedule, Mr. Williams saw his academic performance and his health improve, and he graduated last year. No Proven Solutions Although special services for students with the disorder are becoming the norm, there is little evidence that they actually help. "When it comes to the treatment of ADHD on college campuses, many of the more controversial issues stem from us not knowing what happens to [these students] once they arrive," says Lisa L. Weyandt, a psychology professor at Central Washington University. "We don't know empirically if the interventions offered help them. ... It's an area where we need more research." For instance, many colleges offer ADHD students the opportunity to take exams separately from their peers, or give them extended time for the tests. But some ADHD students say that such accommodations often don't help, and that the pressure to finish a test quickly is what gives them the stimulation they need to focus. One institution that challenges the conventional wisdom about supplemental help is Landmark College, a private two-year institution in Putney, Vt., that specializes in helping students with ADHD learn to manage their time and to study effectively. The college's policy on test-taking, for instance, is to consider giving extra time on a case-by-case basis. While many colleges offer ADHD students a note-taking service to compensate for their shorter attention spans, Landmark frowns upon that accommodation, arguing that it can reinforce a student's impulse to let his or her mind wander during class. "The initial theory is that taking notes distracts them from paying attention during the lecture," says John A. Capriotti, director of admissions. An alumnus of the college, he has ADHD. "But note-taking is a skill that can help them pay attention because they have to record what the professor is saying." The college has developed a system in which students are taught to take their own notes in a way that holds their attention, he says. They are asked to divide each notebook page into two columns. On the left side, they are to draw diagrams that might help them remember things they hear, and to take "meta notes," recording broad ideas and themes from the lecture. The right-hand column is for conventional notes. Mr. Capriotti argues that many of the ADHD-related services offered by conventional colleges are based on a "deficiency model," which operates on the assumption that because affected students lack the ability to do something, the institution should provide compensatory services, like class notes. But what many ADHD students lack, he argues, is not ability but drive. So, he says, colleges' accommodations should emphasize keeping students focused on their work. Need to 'Self-Advocate' Some students who could benefit from accommodations do not get them because they shy away from informing their professors of their disorder. It does not help that some professors view ADHD diagnoses with skepticism, especially when they see such students display moments of high ability. "They're consistently inconsistent, and that drives professors crazy," says George J. DuPaul, coordinator of the psychology program at Lehigh University. "They'll wonder, 'If they can do it on Tuesday, why can't they do it on Wednesday?' It's because their behavior isn't controlled by the things that control normal people's behavior." Many of his colleagues, he says, "vehemently believe ADHD isn't real" because of this inconsistent behavior, which creates the impression that students are simply lazy. Mr. Gallagher did not tell his professors at Kent State that he had ADHD. "I still didn't really understand what it was," he says. "I felt like asking for help would be a sign of weakness. And besides, my smallest class had about 300 students in it, so I didn't think the professors would even remember who I was." For students with ADHD, some experts on the disorder say, it is crucial to "self advocate" -- to tell professors of their condition and explain the type of help they need. "The ability of the student to self-advocate, to be articulate about the modifications they need, is more important in determining their success than their IQ," says Sheldon H. Horowitz, director of professional services at the National Center for Learning Disabilities, a nonprofit advocacy group. "But they aren't accustomed to doing that, because it was the school's responsibility [to provide them with services] in high school." Legally, college students are considered adults, and their colleges are not required to provide any accommodations to a student who does not disclose that he or she has ADHD. Campus student-support offices can advise students on how to approach professors, but actually doing so is up to the students -- and with little experience fending for themselves and a tendency toward poor time-management skills, they might not ask for help until it is too late for the professors to help them without giving them an unfair benefit. A national expert on ADHD, who asked not to be named, says that some students can be their own worst enemies, and that he will not help them unless they take the first step. He sees it as their responsibility as adults. "I had a student who called me on the phone after adding my class late and told me he had ADHD," says the professor, who teaches about learning disabilities. "He said he came to the class, got overwhelmed, and left and just sat in his car. He wanted me to help him, but he never made an effort to meet with me ahead of time, didn't do the reading, and never went to special services. Now he's off to a very bad start, and I'm probably going to suggest to him that he doesn't take my class, because he's not proactive about his disability." Ms. Weyandt, of Central Washington, says colleges might need to take some of the first steps. "Maybe we need to develop better interventions to help students move forward," says the psychology professor, who has conducted one of the few surveys of existing research on college students with the disorder. "One of the hallmark traits [of the ADHD student] is an inability to follow through on things." Lessons From Failure Mr. Gallagher, who now attends Landmark College, says he looks forward to going to classes now. But he does not believe that he would have been able to learn so many new study skills, or be willing to apply them to his academic career, if he had not first hit rock bottom at Kent State. He plans to graduate next spring with an associate degree and is looking to transfer to a college in the Boston area with a strong photojournalism department. Landmark does not have data on how successful its students are after graduation. Mr. Gallagher says he is confident that he will do well at his next college, but even he is not sure how more-traditional colleges could improve their services for students with ADHD. "I did learn a lot by failing out of Kent State, but I guess that's not something I would recommend as an approach," he says. "I don't really know what could be done. ... I guess nobody really has an answer to that."
http://chronicle.com Section: Students Volume 50, Issue 5, Page A50
| ||||||||||||||||||||||||||||||
Copyright © 2003 by The Chronicle of Higher Education