Disabilities and neurodivergence
ADHD in Higher Education:
A Student Perspective and Practical Strategies
After three years on the ADHD assessment waiting list, a university student shares insights into how ADHD may manifest across academic and daily life and offers practical tips for managing the challenges.
Author: Charlotte Bayley
Submitted: May 2025
Post-covid, the NHS has seen an incredible backlog of referrals for neurodivergence. In 2023, the wait time ranged from four to five years in the Surrey and Sussex area (Bish, 2023). Subsequently, neurodivergent students will be unable to get a diagnosis during their degree and therefore, unable to access the support and resources that this provides (e.g., the Disabled Student’s Allowance (DSA) and Disability and Neurodiversity Support (DNS)). Furthermore, students that are diagnosed, gaining access to the current support in place, continue to struggle in university settings. Students diagnosed with ASD are more likely to drop out of university (North East Autism Society, 2023) and those students diagnosed with ADHD were shown to experience more academic difficulties (DuPau et al., 2018). With this in mind, it is likely that neurodivergent students unable to get the current support available, may struggle even more.
For the past three years, I have been on the waiting list for an ADHD diagnosis/assessment. Throughout this process, I have noticed the limited resources available for students in this position. The DSA and University’s DNS only offer help to those with a formal or working diagnosis, leaving those without struggling. Even when given the support available, these resources fail to acknowledge struggles outside of academia. There are so many facets to student life, (social life, budgeting, food and housing, etc.) and neurodivergence can create unique challenges to each one. Students are expected to simply figure out how to face these struggles on their own, despite the ramifications this can have on their education. For example, adults with ADHD are more likely to be in a poorer financial situation than control groups (Bangma et al., 2019). Qualitative studies on college students found that those with financial stress felt that their academic performance suffered because of this as well as their social life (Moore et al., 2021). These are the experiences of neurodivergent students that in my experience, are often overlooked. This is why I wrote this blog, to share insights into how ADHD may present in a higher education context over various domains, and some tips on how these could be managed.
Executive Function
Executive function has a multitude of definitions but it often refers to a goal-orientated cognitive process that oversees the function of smaller cognitive processes (Doebel, 2020) such as working memory, organisation, attention and emotional regulation. Struggles with executive function – known as executive dysfunction – is a common symptom of ADHD.
Common ways that working memory may impact neurodiverse students’ studying and relationships include: Remembering information (e.g., lectures), equipment, and practical tasks (e.g., something is cooking, replying to people).
Furthermore, working memory also influences organisational skills, such as planning academic work, daily tasks (e.g., cooking) and balancing social and academic life.
Executive Functioning Tips:
There are variety of strategies that can be useful in improving organisation and working memory. This can be particularly difficult for activities that need to be done regularly such as cooking. Batch cooking can be helpful as it allows you to plan one dedicated time to cook for the week rather than cooking multiple times a day, alleviating stress.
Another thing that can be helpful are organisation and task managing apps. There are thousands of these kinds of apps today, and unfortunately in my experience very few of these apps improve organisation long-term as they gradually fall out of use. These apps tend to focus on increasing dopamine levels, allowing you to associate feeling reward with tasks and that feeling motivates you to continue (e.g., completing more tasks). However, ADHD is widely associated with dysregulation of dopamine, and this reward system is not the most effective (Levy & Swanson, 2001). Apps that “gamify” these tasks (e.g., Habitica) can be an effective way of adding an external reward and value to completing tasks, increasing satisfaction and motivation
Trackers to locate your property are also helpful if you struggle with working memory. This is why I have a tracker on my keys and my Bluetooth earphones for example, as they are items that I use daily and lose often.
Attention:
Both hyper-fixation and inattention can adversely impact social relationships and academia. For example, hyper-fixation can take precedence over completing coursework, and inattention can make it difficult to concentrate on lectures or conversations.
Attention Tips:
One tip that can be helpful for when you are struggling to work, is a system called body doubling. This is the idea of working quietly alongside someone to encourage working, concentration, minimising outside distractions and keeping you accountable. This can sometimes cause distractions, particularly if you are working next to a friend. However, I have found getting you and your friend to set an achievable end goal for the session and organising some kind of reward you can both have once you both reached those goals works well (e.g., watching an episode of anime together).
Emotional regulation:
Emotional dysregulation can be confusing to those around you and can cause a strain on relationships.
Emotion Regulation Tips:
As many people start living with people other than their family for the first time, it can be difficult to navigate these relationships, particularly with ADHD. It is difficult for people who do not have extensive experience/ knowledge of symptoms of ADHD to know exactly what to expect, in terms of how they manifest and how they are manged, vary drastically from person to person. It may be worth having an open discussion about living with ADHD and creating ways to manage these situations. For example, wearing headphones in communal areas to signify you don’t want to talk to anyone now or a code word to signify that you are upset and need some time by yourself.
These are just a few tips which may help university easier for neurodivergent students. If you are interested in more tips about living with neurodiversity in higher education, the weekly “student tip of the week” will now cycle through generic study tips, and tips for living with neurodiversity on a week-by-week basis. If you are interested in sharing some of your own tips then please fill in this Qualtrics form: [https://rhulpsychology.eu.qualtrics.com/jfe/form/SV_1RNO3bl2MJyqiXQ ] or scan this QR code:
References:
North East Autism Society. (2023, March 27).Autistic students most likely to drop out of university: Investigation. https://www.ne-as.org.uk/news/autistic-students-most-likely-to-drop-out-of-university-investigation
Bangma, D. F., Koerts, J., Fuermaier, A. B. M., Mette, C., Zimmermann, M., Toussaint, A. K., Tucha, L., & Tucha, O. (2019). Financial decision-making in adults with ADHD. Neuropsychology, 33(8), 1065–1077. https://doi.org/10.1037/neu0000571
Doebel, S. (2020). Rethinking Executive Function and Its Development. Perspectives on Psychological Science, 15(4), 942–956. https://doi.org/10.1177/1745691620904771
DuPau, G. J., Franklin, M. K., Pollack, B. L., Stack, K. S., Jaffe, A. R., Gormley, M. J., AnastopouIos, A. D., & Weyandt, L. L. (2018). Predictors and Trajectories of Educational Functioning in College Students With and Without Attention-Deficit/Hyperactivity Disorder. Journal of Postsecondary Education and Disability, 31(2), 161.
Bish, A .(2023, March 21). Five-year wait for adult ADHD assessment in the South East. BBC News. https://www.bbc.com/news/uk-england-kent-65020111
Levy, F., & Swanson, J. M. (2001). Timing, Space and ADHD: The Dopamine Theory Revisited. Australian & New Zealand Journal of Psychiatry, 35(4), 504–511. https://doi.org/10.1046/j.1440-1614.2001.00923.x
Moore, A., Nguyen, A., Rivas, S., Bany-Mohammed, A., Majeika, J., & Martinez, L. (2021). A qualitative examination of the impacts of financial stress on college students’ well-being: Insights from a large, private institution. SAGE Open Medicine, 9, 20503121211018122. https://doi.org/10.1177/20503121211018122
Accessibility in Academia: One Disabled Student’s Experience
Isabella Spinelli (They/Them/Theirs)
Submitted September 2024
Now I’m entering my fourth year at Royal Holloway, I reflect on the countless conversations I’ve had with my disabled friends regarding our access arrangements at university, the inequalities and ableism we’ve faced, and the extra degrees of difficulty we’ve tackled in our assessed work. For me, these experiences come from someone who is Autistic, and has ADHD and a chronic pain condition. I’m about to begin my final year of my MSci in Psychology with the hopes of becoming a special educational teacher, a job I already assist with during summer holidays. As a teacher, my main priority has always been to provide flexibility in the accommodations made to my disabled students (or those showing signs of disability). This has opened my eyes to the importance of both systemic and individual care regarding accessibility as educators. Higher Education has a long way to go before meeting the goal of providing an equal experience to all students, regardless of disability, but some of my recent personal experiences have given me hope that individual lecturers are designing their modules and assessments with equality, diversity, and inclusion (EDI) issues in mind.
Access arrangements at the institutional level often lack the flexibility and compassion needed for the institution to truly support their students. I entered university in the midst of receiving my autism diagnosis, and having been referred but still waiting on my ADHD diagnosis. Unfortunately, my lack of confirmed diagnoses meant that regardless of a psychiatrist’s notes for my accommodation needs, systems such as Disability and Neurodiversity Service (DNS) were not able to assist me fully. My mental health was abysmal at the start of my first year for countless reasons all related to my disabilities, and the barriers towards receiving academic support made it difficult to feel confident in my ability to continue my degree. I would also like to note that although I am Latinx, I am racially white and did not experience the vastly greater barriers to diagnosis and accommodations that disabled people of colour do; which is so unbelievably important to acknowledge in discussions about improving systemic issues. I also found that the DNS at Royal Holloway (similarly to most if not all other such services across the UK) are very particular about which accommodations can and cannot be granted. This is especially the case for non-physical disabilities where the solutions may not appear so “clear-cut”. For instance, I once requested to receive a “green marking sticker” concessions for my handwritten exams (only), as my fine motor skills diminish quite quickly while writing exams, and I can often visually skip over words in my head while rereading my work meaning that spelling mistakes/unwritten words go unnoticed. However, upon hearing my reasoning, the DNS officer I spoke to was unable to grant me the accommodation, as it was exclusively for Dyslexic and Dyspraxic students. And so, in my exams this last year I wound up using the five minutes rest time I get for my chronic pain to instead take writing breaks and stretch my hands, still needing to use physiotherapy tape on my wrist afterwards. I have had lovely experiences with the DNS staff as a whole, they truly do seem to care about our wellbeing. It is simply the system and guidelines they have to operate under that are currently failing to meet students’ needs. An interesting source I’d recommend for reading into this further would be Disabled Students UK, who conduct a report each year measuring the experiences of disabled students in universities across England, including Royal Holloway (2023 edition linked here).
The systemic faults of institutions are widely responsible for inaccessible education, yet that does not disregard the individual impact and responsibility of the educator to not only make their content and classroom welcoming, but also to challenge systems within the university that are misaligned with EDI values, and to advocate for their students. In previous years, I’ve found myself losing marks in assessments, sometimes quite significantly, due to misunderstanding the assessment expectations, going “off topic” for the sake of what I thought was a relevant point, or confusion due to formatting. I once wrote an entire half of a report on an unapproved topic because the physical layout of the Moodle page relied on images rather than titles, and I confused two lectures of similar content. Not only did my marks suffer for this error, but my mental health and self-esteem took quite the hit: My otherwise well-written report had achieved such a low mark for what could be classed as a stupid mistake, but rather was a consequence of how I, as a disabled student, had interacted with the learning resources provided. Such situations have also taken place when I’ve not understood how to expand on seemingly simple assignment briefs (such as answering yes-or-no questions), losing me marks due to my inability to stay on topic when I had, in fact, thought I had found an interesting and unique angle towards addressing the subject. The lack of instruction exemplifying what successful work would look like, alongside the inability to receive feedback regarding the specifics of our topic due to anonymity concerns, results in the need to trust that what we believe to be interesting and insightful, but that may simply not reach the brief.
In the third year of my degree, I was reminded that I am an intelligent and capable student, when I achieved an excellent, First Class mark in the assessment for the Psychology of Equality, Diversity, and Inclusion (EDI) module coordinated by Dr James Ravenhill. More specifically, the way the assessment information had been presented to students had so clearly outlined the expectations for our work that I felt none of my usual anxieties about misunderstandings, and instead could pour all my energy into producing my work. I achieved my best mark of my academic career to date in this assessment and I wholeheartedly believe that it is because I knew from the start what was expected of me and what would be appropriate topics for this specific assessment. The factors I found most supportive were the following:
- The lecture slides describing the assessment included an example outline with wordcounts, which clearly highlighted which sections of our reports should be the most focused, while also not requiring students to follow this formatting precisely, thus allowing for some flexibility.
- The Module Co-ordinator recorded a video of himself going through the assessment lecture slides, which not only provided extra context and detail into the expectations, but also meant that anyone who may have missed the lecture for countless reasons (i.e., pain flares, fatigue, or even just illness) wouldn’t be less informed going into their work when compared to their peers. I’d like to note that lectures are recorded to be uploaded at a later date for those who cannot attend, but these are still susceptible to technical difficulties which risk missed content.
- The shared information identified what stronger reports would show for this specific assessment. We very often get referred to the WAKE-guidelines to understand what stronger work may look like (W(riting); A(nswering the question); K(nowledge); E(valuation)), which are technically specified for each individual assignment. However, for this assessment we were further told what particular topics or concepts to touch upon that may expand the value of our work, and subsequently facilitate higher marks. For example, in the case of this report, we were told that stronger papers would address intersectional identities alongside those we had already discussed, even though that was not a requirement for the assignment.
It would be dishonest to claim that I’ve had the picture-perfect academic experience at university. I had always loved learning, but academia as an institution has been simply inaccessible to me. However, my recent experiences of studying at Royal Holloway, and the presence of initiatives such as THESIS (Teaching in Higher Education: Supporting and Inspiring Students) have shown me that many staff members truly are emphasising the importance of improving inclusivity in their classrooms, something I didn’t expect or see to the same extent four years ago. The efforts being made to improve our experiences are truly being felt, and from a student’s perspective I’d like to thank you all. Royal Holloway has felt ever more welcoming because of it, and that is due to the continued efforts of the teaching team.