He returned home from college for the holiday break recently and told his parents he doesn't want to go back. He's in his 3rd year at an out-of-state college. He really wants to return, but he struggles so much with academics that, despite his best efforts, he's getting mediocre grades. He's on academic probation.
He had an IEP, an Individualized Education Plan, in high school, but he wasn't re-evaluated before going to college.
What's next for him? Does he leave college? Does he transfer somewhere else? And, he is still unconvinced as to what he wants his life's work to be.
This is why many, if not most, colleges won't award a student accommodations without an assessment that is no older than 3 years.
The university is responsible for crafting an appropriate plan to determine his academic and social/emotional needs and we haven't got a clue because we have no recent data to reflect the reality of how he learns.
This is what he needs, in the correct sequence...
1. Consider pulling him out of school for this next semester. He needs to "re-tool" his life, get some direction, have confidence in his path, get an assessment and for heaven's sake, get some rest.
Contact his university to ask for a single semester leave of absence and explain the reasons. You've got valid reasons for this request.
2. He needs to undergo a comprehensive psychoeducational evaluation that follows the AHEAD guidelines as well as the guidelines from his university.
AHEAD is the organization that is at the forefront of making sure that students with all kinds of disabilities can access post-secondary education of all kinds.
3. If you were satisfied with the clinician who conducted the assessment in the 3rd grade and they're still in practice, reach out and ask them if they're familiar with post-secondary assessments and scheduled an interview for your son. If not, use your "go-to" resources to generate a list of 3 psychologists and start the exploration process.
This is an extremely important relationship, so don't rush it. If you're unsure, go to your county's or nearest city's psychological association website and check out the clinician profiles to see who's a good fit. Does he want a female evaluator? A male evaluator?
(By the way, I use "psychologist, clinician and evaluator synonymously".)
Choose one and get started. It was my practice to never test clients for more than 1.5 hours at a setting. The intense attentional and cognitive (thinking) demands are so intense that both effort and motivation can wane after 1.5 hours. Those clients with ADHD are much more vulnerable to cognitive fatigue than are "neuro-typical" students. And no, breaks are not a substitute for stopping and getting a full night's rest.
Below represents the assessment plan that I used when I was in practice from 1993 to 2018 conducting evaluations in Los Angeles. This is for parent use only.
It's not appropriate to tell your clinician that you want him/her to use my assessment plan. They know which instruments to use to give the information they need.
Wechsler Adult Intelligence Scale-4 Edition
The Leiter International Performance Scale-3rd Edition
*if the student has a history of language processing disorders. This test is also untimed.
Achievement (the curricular/academic information they have learned)
Woodcock-Johnson Tests of Achievement-4th Edition
Subtests related to reading, math and written expression
Fluency subtests (measuring speed which is frequently an area of deficit for those with ADHD)
Nelson-Denny Reading Test (required for many universities as it measures reading speed, comprehension and ability to recall the information)
Processing (these skills are related to memory, working speed, visual motor skills, as well as attention and executive functioning)
Wechsler Memory Scales-4th Edition
Rey Complex Figure and Recognition Trial (motor skills as well as immediate, short- and long-term memory)
Conners Adult ADHD self-report and parent/other reporters
Behavior Rating Inventory of Executive Functioning or other tests of executive functioning
There are a number of valid and reliable measures to use in this area. If there were no concerns about a client's functioning in this area, I used the Behavior Assessment System for Children-3rd Edition to get an overview of strengths and weaknesses.
However, when clients were showing distress, I would more fully assess their social-emotional status using specialized instruments to evaluate behavioral problems, depression, anxiety, and social deficits.
The report should present an overview of the client's developmental, educational and social-emotional history and present the information in ways that are clearly understandable to the client.
Recommendations should be reflective of the data and offer a rationale for each one.
Typically, my recommendations would include accommodations for:
2. Extra time on tests in a low-distraction environment.
3. Priority registration (which is critical for scheduling classes so that they could finish their tests using extra time without missing their next class.)
4. Being allowed to review notes before taking a test (if memory issues are evidence).
5. If possible, being assigned to those professors who have a reputation or working cooperatively with those students with disabilities. (I could regale you with stories about inhumane professors who do their best to gut the spirit of students with disabilities...and yes, you're paying for this!)
The recommendations are driven by the test results.
Once the assessment is complete, consider working with a career counselor.
They will look at the level of disabling conditions (sorry, that sounds harsh!), evaluate his interests and abilities, do a lot of interviewing and offer him options for careers.
It is likely that the clinician who conducts the assessment can give you guidance, but, if you have no resources, career counselors have a national association and you can get a referral source through their website.
You're also likely to find resources by doing an online search for "career counselors near me" if you're in an urban area.
If your young man needs individualized educational support when he's at his university, he's likely to benefit from working with an educational therapist. The Association of Educational Therapists can help you locate such a professional to help him learn how to get the job done.
Yes, all of this seems like a lot because it is.
Your young man, like many other students, has not received the "learning how to learn" education that he's needed all along.
Yes, he has ADHD and its primary symptoms are being treated, but what about all of those issues, such as executive functioning problems, that likely are hiding underneath and sabotage his ability to "produce work" which, by the way, is the essence of having a job?
This resource right here will give you an understanding of executive functioning and how they can make or break a life. No exaggeration here.
College, indeed, imitates the demands he'll find in the workplace. He's no longer just surviving to get from one class to another, he's learning the skills he need to both get and maintain a job. This is not a rehearsal...this is life.
If your young man doesn't take a break from college and get the knowledge, skills and guidance he needs to benefit from his education and have a plan for his life, he will continue to struggle.
Thanks for the call. You've helped a lot of families!
For the caller looking for a resource for adult ADHD, here ya go! Check out the Attention-Deficit Disorder Association.
See you next week on the radio!
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