Matthew J. Gormley

Comorbidity of LD and ADHD Implications of DSM-5 for Assessment and Treatment

Attention-deficit/hyperactivity disorder (ADHD) and learning disability (LD) can co-occur for a significant minority of children with each disorder. A total of 17 studies (2001–2011) examining ADHD-LD comorbidity were reviewed, revealing a higher mean comorbidity rate (45.1%) than has been obtained previously. Higher comorbidity may be the result of including students with writing disorders, not just reading and/or math disabilities. Proposed DSM-5 criteria for both disorders will likely affect comorbidity rates; however, it is unclear whether such rates will increase or decrease. Regardless of the specific impact of DSM revisions, academic skill and/or performance deficits should be assessed for students with ADHD as part of screening, comprehensive evaluation, and treatment monitoring. Comprehensive intervention services for students with comorbid ADHD and LD will require empirically supported treatment strategies that address both disorders and that are implemented across school and home settings.

Rates and Patterns of Comorbidity Among First-Year College Students With ADHD

The purpose of this study was to examine rates and patterns of non–attention-deficit/hyperactivity disorder (non-ADHD) psychiatric diagnoses among a large group of 1st-year college students with and without ADHD. A total of 443 participants, including 214 men and 229 women ranging in age from 18 to 22 years of age (M = 18.2), were recruited from 9 colleges involved in a large-scale, multisite longitudinal investigation. Non-Hispanic Caucasian students represented 67.5% of the total sample. A comprehensive multimethod assessment approach was used in conjunction with expert panel review to determine both ADHD and comorbidity status. Significantly higher rates of overall comorbidity were found among college students with well-defined ADHD, with 55.0% exhibiting at least one comorbid diagnosis and 31.8% displaying two or more, relative to the corresponding rates of non-ADHD diagnoses among Comparison students, which were 11.2% and 4.0%, respectively. These differences in overall comorbidity rates were, in large part, attributable to the increased presence of depressive and anxiety disorders, especially major depressive disorder (active or in partial remission) and generalized anxiety disorder, among the students with ADHD. Within the ADHD group, differential comorbidity rates were observed as a function of ADHD presentation type and gender but not ethnic/racial diversity status. The current findings fill a gap in the literature and shed new light on the rates and patterns of comorbidity among emerging adults with ADHD in their 1st year of college. Implications for providing clinical and support services to college students with ADHD are discussed.

School-Based Interventions for Elementary School Students with ADHD

Children with attention-deficit/hyperactivity disorder (ADHD) experience significant difficulties with behavior, social functioning, and academic performance in elementary school classrooms. Although psychotropic medication may enhance classroom behavior, pharmacologic treatment is rarely sufficient in addressing the many challenges encountered by individuals with ADHD in school settings. This article describes 3 evidence-based strategies including behavioral, academic, and self-regulation interventions. Future directions for research on school-based interventions are discussed.

Impact of Study Skills and Parent Education on First-Year GPA Among College Students With and Without ADHD: A Moderated Mediation Model:

Objective: To test if the relationship between ADHD and academic achievement is mediated by service utilization and/or study skills, and if these mediation effects are moderated by parental education level. Method: A bootstrapping method within structural equation modeling was used with data from 355 first year college students meeting strict criteria for ADHD or clearly without ADHD to test the mediation and moderation effects. Results: Study skills, but not service utilization, significantly mediated the relationship between ADHD status and GPA; however, this relationship was not significant among students with at least one parent holding a master’s degree or higher. Conclusion: Among first year college students study skills may be a more salient predictor of educational outcomes relative to ADHD status. Additional research into support services for college students with ADHD is needed, however, results suggest interventions targeting study skills may hold particular promise for these students.

First-Year GPA and Academic Service Use Among College Students With and Without ADHD.

Objective: ADHD is a chronic neurodevelopmental disorder that typically results in persistent academic difficulties over time. Although most colleges offer support services, students often do not use the available services or those to which they are entitled. The present study examined predictors of academic performance among college students with and without ADHD. In addition, the rate, predictors, and outcomes of academic service use were explored. Methods: A series of multivariate analyses of variance (MANOVAs) and regression analyses were conducted using SPSS v. 21 ® software. Results: First year college students with ADHD earned significantly lower grade point averages (GPAs) relative to students without ADHD. Additionally, ADHD combined with other disorders, but not ADHD alone, predicted higher rates of service use relative to students without ADHD. Finally, the findings suggest that typically available academic services are not independently related to GPA among first-year college students with or without ADHD. Conclusion: This study replicates previous work demonstrating significantly lower GPAs among a rigorously defined sample of students with ADHD relative to students without ADHD. Second, this study indicates that traditional predictors of college success may be less meaningful for students with ADHD relative to those without ADHD. Finally, additional research needs to be conducted regarding the use and effectiveness of academic services on college campuses.

First-Year College Students with ADHD And/or LD: Differences in Engagement, Positive Core Self-Evaluation, School Preparation, and College Expectations.

Students with attention-deficit/hyperactivity disorder (ADHD) and/or learning disabilities (LD) experience significant challenges in making the transition from high school to college. This study examined the ways first-year college students with ADHD, LD, ADHD+LD, and comparison peers differ in engagement, core self-evaluation, high school preparation behaviors, and goals/expectations. Participants were from the 2010 Cooperative Institutional Research Program Freshman Survey, including students with ADHD (n = 5,511), LD (n = 2,626), ADHD+LD (n = 1,399), or neither disability (n = 5,737). Controlling for SAT/ACT scores, family income, and parent education, students with ADHD, LD, or ADHD+LD differed from peers on self-ratings of academic and creative abilities and psychosocial functioning; school disengagement, substance use, and emotional difficulties during their last year of high school; reasons for attending college; and expectations for college activities. Several differences were found between disability groups. Implications for college support services and future research are discussed.

College Students With ADHD and LD: Effects of Support Services on Academic Performance

Two relatively common disabilities reported by college students are attentiondeficit/hyperactivity disorder (ADHD) and learning disabilities (LD). Many questions remain regarding how best to support these students and whether services such as advising, coaching, and tutoring lead to significant academic gains. The current study examined the effect of support services on the GPA of students with LD and/or ADHD at a campus that specifically serves this population by tracking students’ support service usage and GPAs over a 5-year period. Results indicate that although most students who choose to receive coaching support experience academic gains, it is students with ADHD who obtain the greatest gains in GPA as a result of this support. Additionally, although tutoring can be of benefit to all students, significant GPA gains were obtained only for students with an LD diagnosis. Thus, there is a need to provide targeted supports aimed at addressing students’ specific areas of challenge.

Evidence-Based Assessment and Intervention for ADHD in School Psychology

Children and adolescents with attention-deficit/hyperactivity disorder (ADHD) exhibit significant difficulties with sustained attention, impulse control, and/or high frequency of motor activity along with academic and/or social impairment. Thus, students with ADHD need to be identified in a reliable and valid fashion in order to obtain intervention and support services to enhance school functioning. Assessment of ADHD includes clinical interview, standardised questionnaires, direct assessment of student skills, and classroom observation. Multimodal intervention typically is necessary including pharmacotherapy, community-based services, parent training in behaviour management, classroom behavioural strategies, home–school communication system, and academic skill support. This treatment protocol may be supplemented with training in attention, executive functioning, and social skills in some cases. Possible roles of the school psychologist, variables that may impact referral and diagnosis, and assessment and promotion of treatment integrity are discussed in detail. A case example of assessment and intervention for a student with ADHD is provided.