dieter baeyens & lotte van dyck

Supporting students with ADHD:

Indications for and effectiveness of teaching and exam accommodations

Dieter Baeyens & Lotte Van Dyck

http://www.lessius.eu/code

2Supporting students with ADHD

Attention Deficit Hyperactivity Disorder

July 2011

Inattention Hyperactivity/ Impulsivity

ADHD-IA ADHD-COM ADHD-HI


• Worldwide prevalence in children +/- 7% • Between 2 and 4% of university students

More students with ADHD in higher education because of increased screening at earlier age and better diagnosis at primary school age

With increasing demands in secondary and postsecondary education, this group is primarily facing increasing problems with attention, planning and organization.

ADHD

July 2011

(Weyandt & DuPaul, 2006)


ADHD

July 2011

If I really want to study efficiently, I get on the train. The ongoing noise seems to block all other stimuli. I don’t get distracted anymore and there is only me and my books.


ADHD

July 2011

This is the third key of the house, the seventh key of my bike and my second mobile since January.

I loose everything because I am not able to pay attention.


ADHD

July 2011

My mother knows the telephone number of the bus company by heart to claim objects I have lost. They are

really friendly people.


• Important to know that− ADHD is best described in terms of “not being

able” rather than “not wanting” understanding

− Symptoms are present in all settings it is not personal

− ADHD in childhood ≠ ADHD in adulthood many people outgrow the typical DSM-IV symptoms but still show impairment

ADHD

July 2011


• Important to know that− At the basis of the disorder lies a genetic

vulnerability that can be positively or negatively affected by environmental factors through these factors we have a moderate impact on the disorder

ADHD

July 2011

Need for evidence based diagnostics, treatment and support for each age group


Evidence based diagnostics

July 2011

Diagnostics of ADHD

Classification Assessment

“Universal” “Age and person specific”



July 2011

Diagnostic process of ADHD

• Number and peristence: ≥ 6 symptoms of inattention and/or ≥ 6 symptoms of hyperactivity/impulsivity

• Age of onset: 7 years

• Pervasiveness: present in ≥ 2 settings

Classification (1)

HeterogeneityDevelopmental

perspective



July 2011

Diagnostic process of ADHD

• Impairment: social, academic/occupational

• Not only during the course of/better accounted for by other disorders

Classification (2)

Interpersonal variation

Comorbidities



July 2011

Diagnostic process of ADHDAssessment (1)

Heterogeneity

Interpersonal variation

Comorbidities

Recent, comprehensive

assessment

Developmental perspective



July 2011

Diagnostic process of ADHDAssessment (2)

• Identify the current cognitive processes responsible for the impairment

• Clear indications of student’s strengths and weaknesses


• Psycho-education− For the student with ADHD− For the context

• Psychopharmacology

• Cognitive behavioral therapy/techniques− For the student with ADHD− For the context

Evidence based treatment

July 2011


• ADHD – students− Lower grade point averages− More academic problems− Higher chance of dropping out− …

• As a result students with ADHD are encouraged to advocate for teaching and exam accommodations provided by Disability Services Offices (DSO).

Evidence based support

July 2011

(Barkley et al., 2008)


• Students with ADHD could potentially benefit from teaching and exams accommodations (Harrison & Rosenblum, 2010)

• However, little research available on effectiveness of accommodations in secondary education (SE) and postsecondary education (PE)


July 2011


• This study: − Overview of accommodations for students with

ADHD in SE and PE quantitative approach

− Exploring indications for and effectiveness of accommodations qualitative approach

Aims

July 2011

Survey

Interviews


• Quantitative study A survey on accommodations in 91 settings of PE (n=49) and SE (n=42)

Qualtrics (www.qualtrics.com)

• Qualitative study 23 semi-structured interviews: − Students in PE and SE − DSO in PE and SE Nvivo8 (QSR International, 2008)

Methods

July 2011


1. Comparison ADHD – Learning Disorders2. Teaching accommodations3. Exam accommodations4. Needs

Outline results

July 2011


• Significantly more accommodations for learning disorders (LD) than for ADHD (χ²(1)=3.82, p<0.05)

Results – comparison

July 2011

SE PE

LD 100 % 100 %

ADHD 75.5 % 90.2 %

Survey


• Possible hypotheses:


Are students with LD applying more often than students with ADHD?More acceptance for

impairments caused by LD than ADHD?

More knowledge about accommodations in case of LD?

More students with LD than ADHD in SE/PE?

July 2011

More need for accommodations in case of LD?


• DSO:

− Knowledge about the disorder in adolescents/young adults: LD > ADHD

− Guidelines about effective accommodations: LD > ADHD


July 2011

Interviews


• Students:

− Fear social stigma− Refuse to accept support− Positive effect of accommodations unknown− Option of applying for accommodations

unknown


July 2011

Interviews


Top 3 reported teaching accommodations:

1. Teaching staff receives information on ADHD 66%

2. Developing strategies to coach the student 41%

3. Supporting self-management in students 40%

Results – Teaching

July 2011

Survey



July 2011

information strategies selfmanagement0102030405060708090

100

SEPE

Survey

* **** = p<.05

*** = p<.005


• DSO:

− Little is known about ADHD in adolescence and young adulthood

− Psycho-education for the teaching staff could increase awareness of ADHD symptomatology

− The teaching staff fears the additional effort


July 2011

Interviews


• Students:

− Fear a lack of understanding by making use of accommodations - this is less the case for LD

− Fear social stigma− Open communication between the student

with ADHD, peers, teaching staff and DSO is needed


July 2011

Interviews


Top 3 reported exam accommodations:

1. Students receives more time 73%

2. Option of (at least partial) oral exams 40%

3. Option of taking breaks during exams 13%

Results – Exams

July 2011

Survey


Results – Exams

July 2011

more time breaks oral explanations0

102030405060708090

100

SEPE

Survey

*

*

**

* = p<.05** = p<.01


• DSO:

− No guarantee that the accommodation is effective

− The teaching staff fears the additional effort− The teaching staff fears doing ‘too much’ for

students with ADHD

Results – Exams

July 2011

Interviews


• Students:

− Most accommodations are not effective − Taking exams in a separate room is perceived

as the most effective exam accommodation− Medication is perceived as the most effective

treatment− A single typical accommodation profile for ‘the

student with ADHD’ does not exist− Fear social stigma

Results – Exams

July 2011

Interviews


• Needs according to DSO:

1. More information on coaching student 71%

2. A national policy on accommodations 50%

3. Help from external specialists 37%

Results – Needs

July 2011

Survey


• There are no clear guidelines from the government:

− The selection of accommodations is made locally and on intuitive basis

Results – Needs

July 2011

Interviews


• Because of the heterogeneity in ADHD, a recent, comprehensive assessment is needed:

− To identify the current cognitive processes responsible for the impairment on which to base accommodations

− Reports from qualified specialists should provide clear indications of students’ strengths and weaknesses

Results – Needs

July 2011

Interviews


• Extra effort, motivation and creativity often insufficient to deal with school and academic impairments of ADHD

• If some specific conditions are met, teaching and exam accommodations are potentially effective to alleviate these impairments:

Conclusions

July 2011


• Accommodations should be individually designed by the DSO based on recent comprehensive assessment of the students’ strengths and weaknessess, reported by a qualified specialist

• Open communication and a better knowledge of ADHD will result in more goodwill on the part of the teaching staff, as is already the case for students with learning disorders.

Conclusions

July 2011


• A clear (national) policy on accommodations for disabilities should guarantee sufficient and effective support for students with ADHD as well as adequate resources for SE and PE settings to organize these accommodations.

Conclusions

July 2011

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dieter baeyens & lotte van dyck

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