Tutoring College Students with Ad(h)d

We have all heard of the schoolboy who doesn't know how to stay in his seat at school; instead he climbs furniture and makes noise during work time. We have also all known a schoolgirl who looks out the window quietly daydreaming instead of paying attention to the teacher. We now know that the hyperactive boy has a neurological disorder called attention deficit hyperactive disorder (ADHD) (Hallowell & Ratey, 1994; Latham, 2000). Experts recently have agreed that the daydreaming girl also has ADHD - sometimes called ADD because it occurs without hyperactivity (Hallowell & Ratey, 1994). But what happens when the child with AD(H)D grows up? How can tutors work with college students who have AD(H)D?

What AD(H)D Is

College tutors need to understand what AD(H)D is before learning how to accommodate this condition. The three most important symptoms of AD(H)D are inattentiveness, impulsivity, and hyperactivity (DSM-IV, 1994; Hallowell & Ratey, 1994; Latham, 2000). The Diagnostic Statistical Manual of Mental Health (DSM-IV) explains that simply having these symptoms is not enough to diagnose AD(H)D because everyone sometimes has the same symptoms. These symptoms must be "persistent" and they must be "more frequent and severe" than they are for other people at about the same level of development (DSM-IV, p. 78).

It is possible to diagnose AD(H)D later in life, but only if the symptoms began before age 7. Also, symptoms should cause problems in two or more settings, for example at both work and home. Furthermore, AD(H)D can only be diagnosed if the symptoms make it hard for the person to learn how to function well socially, academically, and at work (DSM-IV, p. 78). Symptoms might not show up if the person is under "very strict control," is in a new

place, or is doing "especially interesting" activities, or is working with only one other person (p. 79).

AD(H)D is not a single condition; instead, there are three subtypes. People with the predominantly inattentive type have trouble paying attention. Those with the predominantly hyperactive-impulsive type are hyperactive and impulsive. The combined type includes all three major symptoms (DSM-IV, p. 80). Perhaps the most well known symptom of AD(H)D is hyperactivity, but Hallowell and Ratey (1994) emphasize that not all people with AD(H)D are hyperactive. Indeed, they say that many people with ADD-mostly girls and women-are quiet daydreamers (p. 153). Robertson (2000) notes that children with AD(H)D are "consistently inconsistent." That means the same student could do very well in school one month then very poorly the next (Hallowell & Ratey, p. 65). Hallowell and Ratey also point out that people with AD(H)D are sometime able to hyper focus. That means they may focus very well on one thing for a long time and will have trouble stopping when it is time to finish.

What exactly does it mean to be inattentive, impulsive, or hyperactive? Some specific symptoms of inattentiveness can include overlooking details, making careless mistakes, doing messy work, having trouble paying attention, changing from one activity to another without finishing anything, and being easily distracted. Some examples of impulsivity include impatience, frequently interrupting other people, talking at the wrong time, clowning around, and doing dangerous things without thinking about what will happen. Hyperactivity in children can include fidgeting and squirming, leaving one's seat when one isn't supposed to, running and climbing at the wrong time, having trouble playing quietly, and talking too much (DSM-IV, pp. 78-79).

AD(H)D in Adults

Research into AD(H)D among adults is still new (Hallowell & Ratey, 1994). People used to believe that AD(H)D was a childhood disorder that could be outgrown. However, researchers now understand that they were wrong-AD(H)D can continue through college age and the rest of one's life (Latham, 2000). Up to two-thirds of AD(H)D children become AD(H)D adults (Hallowell & Ratey, p. 6).

College students who have AD(H)D may have trouble organizing, prioritizing, and finishing their work on time, doing long assignments, doing tasks that have many steps, writing papers, handling math requirements, interacting with faculty and students in an appropriate way, meeting expectations, and following rules (Latham, 2000). AD(H)D adults in general often feel they are underachievers, are disorganized, procrastinate, do many projects at the same time without finishing anything, can't stand boredom, can't focus, have low tolerance for frustration, are impulsive, worry a lot, and have mood swings. Hyperactive adults are not as hyper as children, but they are often restless and may pace a lot, drum their fingers, or fidget (Hallowell & Ratey, p. 73).

Tips for Working with AD(H)D Students

There is very little literature on how to tutor college students with AD(H)D. However, many authors have shared ideas on how teachers can help children in their classroom who have AD(H)D. Other authors have shared ideas on how people with AD(H)D can help themselves become more organized. Some of these ideas may be useful for tutors who work with college students.

Booth (1998) emphasizes that