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There is often an overlap between clients with PAW and ADD with a set of commonly shared symptoms. Given the growing cost of college and the serious economic problems facing many families, these aborted college experiences create a significant financial burden, not to mention an emotional toll, on both students and parents.
Transition planning, however, can make a big difference in helping teenagers with ADHD be ready for what lies ahead in college. Gaining a fuller understanding of ADHD and its ramifications are important factors in its successful management.
Adolescents with ADHD need to be encouraged to spend the time they have left before going off to college to work on these areas. Only one-third of college students who received special education services in high school seek such formal accommodations in college. Over the last decade, several medications have been approved that make the treatment of ADHD easier and more effective.
Young adults on stimulant medications, particularly those living in dormitory or other communal settings, need to be reminded about several issues regarding these medications. In addition, it is important that patients understand that their medication is a controlled substance. As students with ADHD pursue their college careers, they must do so in environments that are less structured and supportive than the ones they experienced in high school. The overall message of this article is one that urges pediatricians to hold deliberative discussions with college-bound patients with ADHD as early as possible in the college transition process. Subscribe to Contemporary Pediatrics to get monthly clinical advice for today's pediatrician. All comments must follow the ModernMedicine Network community rules and terms of use, and will be moderated. Are you aware of the newly released CDC Guideline for Prescribing Opioids for Chronic Pain?
David Smith reported on study of adolescent substance abusers that seemed to indicate the appropriate medication for severe ADD in adolescents prevents the abuse of other substances for the purpose of medicating ADD symptoms. Students with ADHD often find the transition to college difficult because they were not prepared to advocate for themselves and to meet the increased academic expectations at college.
Parents are now insisting that students maximize the educational opportunities made possible by their financial sacrifice.
Ironically, adolescents’ specific high school experiences may contribute to the difficulty.
The treating pediatrician can play a significant role in assisting patients with ADHD to ensure that this transition goes smoothly. Although the parents of patients with ADHD may have pursued this information for their children in the past, as young adults their children will need to take responsibility for their disorder and find out as much as they can.
The transition from attending high school and living at home to starting college or university studies while living away from home is among the most challenging of transitions for many students; however, it is especially challenging for young adults with ADHD.
Sometimes that means helping their parents see the benefits of letting go and thus allowing their teenagers to learn to function on their own. Students with ADHD have little to no experience in handling the more difficult coursework and the freedom and responsibilities they will encounter at college. If the college they have chosen has a well-established disabilities program, and the staff is aware of and has sensitized the faculty to the needs of students with ADHD, students should have little trouble receiving appropriate accommodations. Difficulties with time management and planning often interfere with the best intentions of college students with ADHD.


Now is the time for pediatricians and their college-bound patients with ADHD to work together to develop a medication regimen that will lead to a practical daily schedule. These newer medications are all longer-acting preparations in a variety of formulations and delivery systems (Table).
First, they should be cautioned not to give or sell any of their ADHD medications to their friends or to others who ask for it.
Under federal law, ADHD medications are schedule II substances, and even giving these medications away can result in a drug distribution charge. This opportunity for growth and maturation is important, leading students with ADHD to work on their own to achieve balance and structure in their lives. These discussions should encourage self-determination and the acquisition of independent living skills. She is a founding board member of the EDGE Foundation and a paid consultant and speaker for Noven and Shire Pharmaceuticals. ModernMedicine reserves the right to use the comments we receive, in whole or in part,in any medium. Students from families who are struggling to make tuition payments cannot afford the luxury of reduced course loads or taking additional semesters to graduate.
Most teenagers today lead structured lives and get very little practice making decisions about how to manage their time and life in general. By having a detailed discussion with their teenaged patients on how ADHD can affect them at college and what they can do about it, pediatricians can help these patients take the first steps on the road to success.
College is dramatically different from high school with no adults to prod a teenager and help structure his or her life. These students will inevitably discover that their last-minute approach to preparing for tests or writing papers will not work at college. By having a discussion that includes questions about each patient’s strengths and weaknesses, preferred learning style, passions, and hopes for the future, pediatricians can help these students assess their capabilities and ascertain where they will need support. As a result of the problems they have with setting and achieving their goals, overall daily living tasks and academic achievement may suffer. Pediatricians of these patients may need to point out that ADHD affects not only the students’ academic performance but also their relationships, emotions, and day-to-day activities such as eating, sleeping, and getting enough exercise.
Encouraging patients to take their medication consistently so that it will be effective for studying and reading assignments is often critical to a successful transition. Such once-a-day preparations provide the individual with ADHD a means of reducing symptoms throughout the day and into the early evening, while eliminating the need for a multiple-dose regimen that is difficult for those with ADHD to remember. Not only does this reduce the amount of medication that they have for their own personal use, but it could also endanger the health of the other person. Further, if patients use up their medication more quickly than prescribed or lose it, they will not be able to receive a new prescription until the end date of the current prescription.
Discussing ways to maintain good emotional and mental health, including how to deal with stress and how to get the emotional support through individual or group therapy or attending peer support groups on campus, is critical. By engaging college-bound students in this process, pediatricians are providing them the greatest opportunity to achieve success in college as well as in life.
Identifying and treating attention deficit hyperactivity disorder: a resource for school and home.
The post-high school outcomes of youth with disabilities up to 4 years after high school: a report from the National Longitudinal Transition Study-2 (NLTS2).
The ADHD Parent Care Package: Support and Encouragement for Parents of Teens and Young Adults with ADHD.


Some colleges are now setting firmer time limits on how long a student may take to complete a degree. With this goal in mind, it is useful to discuss the following areas with teenaged patients with ADHD. Although many students with ADHD may relish this initial taste of freedom, many quickly find themselves floundering and experience great difficulty managing their daily routines. This is a lot to consider for such patients, but to foster success at the college level, these teenagers with ADHD will need to address their disorder and begin to take charge of their own care. It may take some time to get a new prescription and have it filled, so students should be reminded to plan accordingly, especially around exam time.
Given the trusting relationship that exists with these patients, pediatricians are likely in the best position to impart the critical information needed to ensure their successful transition to college. Beginning postsecondary students in 2001 by disability status and learning disability status [CD-ROM]. Instead of encouraging the 5-year plan that a number of students have adopted, some colleges are pushing for the 4-year, 8-semester plan, an approach not allowing for as many stops and starts as in the past.
Most teenagers have well-meaning parents who have established rules for what needs to happen when. These differences are at odds with the core symptoms seen in students with ADHD, particularly poor executive functioning, which affects both time management and organizational skills. In addition to lacking the important time management and study skills needed at college, these students have no experience needing or asking for help. The latter includes the use of medication, meaning that they need to become more knowledgeable about their medication and its effects. Finally, pediatricians should remind patients that, by law, these medications need to be kept in the original bottles and suggest that students carry their medications with them at all times to prevent theft. Pediatricians can take this opportunity to reinforce the need for maintaining healthy habits.
The protectiveness and anxiety of these parents may have led them at times to take over their child’s responsibilities and make things happen in an effort to have their teenager avoid stress and failure. College students face unlimited possibilities for how to spend their time, and may experience increased academic demands that most have not had in high school, even if they have taken advanced placement classes.
They often view these first academic problems as a sign of personal failure and end up in a cycle of hiding their mistakes from family members and friends. It is also important to discuss how taking medication might improve other aspects of daily life such as organization, time management, and relationships, in addition to academics. Add to this mix an irregular class schedule, professors who do not take attendance or assign and grade daily homework, only a few tests during the semester that cover hundreds of pages of reading, and complex long-term assignments that the student must have the self-discipline to complete. Daily assignments, weekly tests, manageable reading assignments, few independent long-range assignments, and teachers who may encourage, direct, control, remind, prod, and sometimes even nag their students to perform all foster dependence. By highlighting the need for good executive functioning skills at college, the pediatrician can call attention to an area that has been found to be critical to academic success.
It is, therefore, not surprising that succeeding on their own at college is so challenging for adolescents. In advising these young patients with ADHD, the idea of working with a coach or academic or peer tutor can also be suggested, emphasizing how such personal support can help them achieve their goals.



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