by Patricia O. Quinn, MD
THE TRANSITION FROM HIGH SCHOOL TO COLLEGE AND FROM FAMILY TO SEMI-INDEPENDENT LIVING can be difficult for students with ADHD. Unless ADHD is understood and handled properly, the transition can cause significant stress to both the student and his or her family.
College students with ADHD must understand the impact it has on academic, social, and daily life. Without this knowledge, they cannot perform successfully or be their own best advocate. Making appropriate choices, prioritizing time, solving new challenges and then facing the increased academic demands of college can be much more complicated for them. ADHD may prevent them from performing up to their true potential, staying enrolled, or even graduating.
When the journey toward graduation ends abruptly or is fraught with unexpected difficulty, the emotional and economic costs to families and students can be great. Young adults who expected to excel suffer a huge blow to their egos when they fail because they were not prepared academically, socially, or emotionally for the expectations at college.
Self-determination and success
For several decades, special education experts have been grappling with what causes some individuals with disabilities to have more successful adult lives than others. This important question has led to an understanding of the importance of self-determination skills. Self-determination refers to “a combination of skills, knowledge, and beliefs that enable a person to engage in goal-directed, self-regulated, autonomous behavior.”
A self-determined individual:
- knows who he or she is;
- can set his or her own goals, and make plans to achieve these goals;
- can ask for help when needed;
- can find necessary resources; and,
- can handle conflicts with others.
Most importantly, a self-determined individual can use his or her own thoughts to problem-solve, make decisions, and regulate his or her own behavior.
Success in college and in life requires that young people have the ability to observe themselves, notice when problems are in the early stages or even before they happen, and use their executive functioning skills to manage their emotions, think through their goals and plans for achieving these goals, and problem-solve to overcome any obstacles that stand in the way.
While a number of definitions are used in the special education field, experts would agree that a person who is self-determined has the attitudes and skills needed to set his or her own course for a more meaningful and fulfilling life. While self-determined individuals have meaningful relationships and know when to turn to others for advice or support, they value and accept themselves. They are confident and independent.
Studying coaching as a tool for success in college
A new helping profession known as personal or life coaching has emerged over the past several decades. Borrowing from the field of sports coaching, coaching was first applied in the business world as a way to help professionals become more productive and live more balanced lives. The business world discovered that worker productivity increased when employees were coached versus managed or supervised using traditional methods. It was discovered that, just as sports coaches partner with talented athletes to help them develop their skills and achieve success, life coaches can partner with people to assist them in living the life of their dreams.
Many ADHD experts see coaching as a valuable tool, especially for teens who have deficits in executive functioning skills, or those all-important thinking skills needed for effective day-to-day functioning. Although very few studies have been conducted using the coaching model, the few that have suggest that coaching does help teens improve in many life-management skills.
To address this lack of studies, the Edge Foundation, a national nonprofit organization that provides personal coaching for children and young adults with ADHD, recently completed a $1 million research study to determine the extent of the effectiveness of coaching on the academic and social performance of college students with ADHD.
Led by a faculty team from the Center for Self-Determination and Transition in the College of Education at Wayne State University in Detroit, Michigan, the twenty-seven-month study is considered the first large-scale study to document the effectiveness of coaching for college students with ADHD.
“A primary challenge associated with the use of coaching as a support for students with ADHD is the need for scientific evidence that the approach is effective,” said Sharon Field, EdD, the project’s research director. “There is substantial anecdotal evidence indicating that coaching is perceived by students, parents, and educators as a valuable service that helps students succeed in a variety of settings. However, the value of personal coaching has never been subjected to a rigorous scientific study of its effects on student outcomes.”
One hundred twenty-seven students from eight universities and two community colleges from a variety of geographic regions across the United States participated in the study. Students were randomly assigned to either the treatment group or the comparison group.
Edge Foundation coaches worked with the treatment-group students in seven major areas: scheduling, goal setting, confidence building, organizing, focusing, prioritizing, and persisting at tasks. The coaches helped the students to assess their environments, identify needs, and set goals, and offered suggestions and guidance. They monitored student progress and goals through regular phone or email check-ins. The protocol called for regular daily check-ins to provide more structure and accountability.
Results of the Edge study
Self-determination. The study showed that students who received Edge coaching services demonstrated significant improvement in their ability to organize, direct, and manage cognitive activities, emotional responses, and overt behaviors. They were able to formulate goals more realistically and consistently work toward achieving them, manage their time more effectively, and stick with tasks even when they found them challenging.
Improvement, measured by the difference in gain on total scores on the Learning and Study Strategies Inventory (LASSI) between the coaching group and the comparison group, was statistically significant. The coaching group had a mean gain of 182.67 points pre to post assessment, whereas the comparison group’s mean gain was only 64.05 points. The LASSI is comprised of three cluster scores: self-regulation, skill, and will. There were significant differences between the coaching group and the comparison group, in favor of the treatment group, on all three cluster scores.
Executive functioning skills. The LASSI also measures executive functioning skills as they are applied in academic environments. The coached students with ADHD demonstrated statistically significant, higher executive functioning than students with ADHD who did not receive coaching. “The magnitude of the effect size for self-regulation was more than double the typical educational intervention, and executive functioning was quadruple,” wrote the study authors. “Findings with effect sizes that large are rare.”
Overall well-being. Interviews with students at the end of the study corroborated the findings from the LASSI. Students indicated that Edge coaching services helped them establish more effective goals and pursue those goals in more efficient, less stressful ways. They attributed this outcome to the coaches’ proficiency in helping them reflect on themselves and their goals more often, in more realistic and positive ways, and to regulate their feelings and behaviors more effectively while pursuing those goals.
Results from this study also demonstrated that participation in coaching enhanced the students’ sense of well-being and resulted in more positive emotional states. Students said that coaching helped them feel less stress, greater empowerment, increased confidence, and have more balanced lives. Their overall mean score on the College Well-being Survey was statistically significantly higher than the comparison students’ mean well-being score, when corrected for initial differences in executive functioning.
Approach to learning and academic standing. While the study demonstrated that students who received coaching showed substantial gains in their overall approach to learning, there were no statistically significant differences between the coached students and the comparison students in GPA, the number of credits earned per semester, or eligibility to continue in college. However, the Edge coaching model as currently implemented was not designed to impact GPA when delivered on a short-term basis. It is possible that differences in GPA may be observed in a longitudinal study, or if the model was implemented for a longer duration.
The Edge coaching model made an important difference in the way students approach the learning process, however. It helped them to be more organized and efficient, resulting in increased feelings of control and confidence. Given the difficulty that students with ADHD typically experience in self-regulation and executive functioning, these findings are of high importance to those concerned with factors that contribute to success for students with ADHD.
Overall, the Edge Foundation study offers hope for students with ADHD. The results directly linked coaching to improved self-determination and executive functioning, and improved executive functioning often translates to greater success in school.
Impediments to Success in College
- Poor organization of time and space
- Reading problems resulting from difficulty persevering
- Notetaking may be impossible, as two processing skills are needed simultaneously
- Writing skills which require sustained attention and organization
- Verbal skills—inappropriate word choices or word retrieval problems affect class presentation or conversation skills; may be further compromised by anxiety or attention problems
- High level of frustration/poor self-esteem
- Inappropriate social skills
- Confusion about goals and the future
- Lack of perseverance/need for immediate gratification
For more info: Sharon Field, EdD, David Parker, PhD, Shlomo Sawilowsky, PhD, and Laura Rolands, MA.
Quantifying the Effectiveness of Coaching for College Students with Attention Deficit/Hyperactivity Disorder. College of Education, Wayne State University, Detroit MI. August 31, 2010.
The findings of this study were presented at CHADD’s annual conference in Atlanta in November 2010, and are slated to be published in the Journal of Postsecondary Education and Disability in May 2011. Visit edgefoundation.org for links to the study.
Patricia O. Quinn, MD, is the director of the National Center for Girls and Women with ADHD and the author of Ready for Take-Off: Preparing Your Teen with ADHD or LD for College. She is a founding board member of the Edge Foundation. This article originally appeared in the February 2011 issue of Attention magazine. Copyright © 2011 by Children and Adults with Attention Deficit Hyperactivity Disorder (CHADD). All rights reserved.