By: Lucas Jerusalimiec
As teaching assistants (TAs), many of us have experience in assisting students with Attention Deficit Hyperactivity Disorder (ADHD). These students are often highly engaged in tutorials and demonstrate intelligence during class discussions. Those who are in the upper years of their undergraduate degrees are most likely aware of the test-taking accommodations offered by the Paul Menton Centre in conjunction with the Carleton University Testing Centre. Even when they choose to take advantage of these services, however, students with ADHD still struggle with translating in-class and one-on-one assistance into reasonable grade outcomes. In my own tutorials, I have also observed a similar dynamic at play when students with ADHD approach writing their final papers or projects, which suggests that this is a problem they experience with their coursework in general.
Performance anxiety is the mediating factor between the natural intelligence and motivation of students with ADHD and the inconsistency of their marked work. Since the role of TAs is not to serve as educational counsellors, I argue that our role in helping these students to succeed should involve promoting early assessment of their academic work before the end of a course. This may serve to combat the self-doubt many of these students experience, and to reinforce effective learning strategies that they can carry over into other courses. I will begin with a review of the evidence on students with ADHD and performance anxiety before discussing the link between this anxiety and poor grade outcomes. I will close with my recommendations for practice.
ADHD university students are not intelligence-impaired. Reaser et al. remark that “[d]espite problems in academia for some students with ADHD, it does not appear that students with ADHD lack the intellectual ability to learn”; however, “their hyperactivity, impulsivity, and/or inattention make concentration difficult and negatively affect their performance” (627). The authors of this study on the learning strategies and outcomes of students with ADHD found that they scored equivalently to non-disabled students in their knowledge of and access to instructional resources (635). In my experience, I have found that students with ADHD were often willing to approach me for guidance in completing coursework, but that this did not seem to translate into success. This accords with Reaser et al. when they note that while students with ADHD have a positive outlook on the benefits of university and a reasonable level of interest in their chosen subject-matter, their level of intrinsic motivation can be inconsistent (635).
One area where students with ADHD struggle acutely is test-taking anxiety. These students are at a high risk for test anxiety in general, but especially for its worry aspect (Nelson, Lindstrom, and Foels, 553). Worrying inhibits the ability of students with ADHD to perform successfully because of their propensity to expend mental resources on non-task relevant cognitions, thus crowding their short-term memory (Nelson, Lindstrom, and Foels, 553). Nelson et al. remark that special testing accommodations can indirectly reduce test anxiety as they mitigate the cognitive difficulties students with ADHD experience, but it is not clear whether these measures address the cause of anxiety (555). The theoretical models of the effects of ADHD suggest that the expectations and self-assessments of students with ADHD are key to their development of a sense of inadequacy in comparison with their peers (Nelson, Lindstrom, and Foels, 549).
In a study designed to measure the actual test-taking skills of students with ADHD, Lewandowski et al. hypothesized that their weakness in test-taking strategies and their poor self-assessments would lead to comparably worse results in reading speed, vocabulary, word recognition, and comprehension (42). What they actually found was that students with ADHD demonstrated test-taking skills comparable to that of their non-disabled peers, put in similar levels of effort on each question for the same amount of time, and utilized the same comprehension strategies. Students with ADHD, however, “perceived themselves as having more difficulty in reading under timed conditions and reported more test-related anxiety than their peers” (Lewandowski et al., 48). Thus, it seems that while students with ADHD had developed the same skill-sets as their non-disabled peers and can demonstrate these skills under neutral testing conditions, they self-perceived as being less well equipped than their peers and were thus more anxious about tests (Lewandowski, et al., 49).
Lewandowski et al. make a suggestion similar to that of Trainin and Swanson, which is that students with ADHD have a lower sense of self-efficacy because of past negative feedback. In reference to learning disabled students generally, Trainin and Swanson claim that “adverse physical and psychological reaction to a testing situation is more a result of past experiences than a disproportional reaction. […] [F]or students with [learning disabilities], normal test anxiety is not associated with actual performance” (270). The history of failure and negative feedback many students with ADHD experience may serve to de-link anxiety from a realistic assessment of their academic skills and relate it instead to a fear of repeating past experiences. Such a process might cause a generalized condition of academic anxiety that inhibits sufficient preparation or application of learning strategies on the part of students with ADHD. Nelson et al. correctly suggest that preventive strategies are best, since interventions at the moment of an exam or a paper submission deadline will be less effective (555); for these strategies to be effective, however, students with ADHD must have some expectation of success.
Adams and Crews write that learning disabled students in general are often inhibited by poor self-perception, a history of failure, and “a way of life incorporating a concept of being unable to learn, which thus mitigates against the effects of any remedial efforts” (44). They suggest that one of the key elements in an intervention strategy directed toward learning disabled students is the “informed TA who is familiar with the nature of learning disabilities,” since “T[A]s can be principal reinforcers to LD students, offering encouragement and positive appraisal” (45).
TAs require two things if they are to provide this positive reinforcement to students with ADHD: first, an opportunity to provide this encouragement, and second, a piece of academic work that actually merited this assessment. If past negative experiences with time-constrained assessments, such as final papers or exams, induce a distracting and de-motivating anxiety in students with ADHD, then perhaps assessments in a more neutral environment would better display their real academic potential. TAs may not have a great deal of influence in course design, but when they do, it would be helpful to suggest more frequent, less heavily weighted assessments as an option. Even in this case, the fact that a course component is marked may produce de-motivating anxiety for students with ADHD. A truly neutral assessment would be one that is not conducted for marks at all, as in the Lewandowski study. It is always difficult to persuade students to actually do work without this incentive, even when they are proactively approaching their TA for guidance. The ideal situation is one where students with ADHD follow through with non-marked assessments and receive realistic and positive feedback on their work.
Students with ADHD struggle with motivation in general, however, so TAs need to have recourse to additional techniques that can help instill confidence in students with ADHD before the end of term crunch arrives. One suggestion I received is that TAs can be very intentional in fostering relationships with students who appear to be struggling with anxiety and motivation. This does not require TAs to know whether a student has been diagnosed with ADHD or another learning disability, but rather leaves the door open for those students to approach their TA earlier in the term when they start to feel the effects of performance anxiety. One key indicator that TAs can pay attention to is tutorial attendance and participation, since anxiety or motivation issues will often manifest themselves in the relatively formal environment of structured class discussions. TAs may be able to engage with these students after regular class or tutorial hours before they disappear entirely. E-mail communications are not likely to be very successful, however, since they are often anxiety-inducing in and of themselves. This approach will not solve the academic problems of students with ADHD but it will provide the beginning of a different narrative in which instructors can be viewed as proactively helpful rather than passively judgmental.
One-on-one interactions with anxious students also provide TAs with an opportunity to provide feedback to these students as they present their ideas orally in a low-pressure environment. Although this may not allow us to build the confidence of these students in their written work specifically, TAs can use these conversations to reinforce students’ positive views of their own intellectual and academic capacity generally. Any interaction between TAs and students with negative past experiences is an opportunity to counteract those impressions by displaying interest and understanding. Students approach TAs as authority figures, and are often looking for some kind of relief from academic stress. In the case of students with an unjustifiably low assessment of their capabilities, TAs can provide this relief simply by engaging with them on equal footing in an informal academic setting.
My interactions with fellow Carleton TAs have taught me that none of us enjoy giving students marks that fall below the potential we see in them, and that students who fail or drop out of courses always give us pause for thought about the efficacy of our teaching methods. We cannot bear the full responsibility for responding to the difficulties of students with ADHD in seeking out or integrating our help, since much of this is determined by their past academic history. We are responsible, however, for managing our classrooms and one-on-one interactions with students so that they always provide the opportunity for learning and improvement, on the part of TAs as well as students. Our jobs as TAs expose us to differences in learning styles, as well as the tragedy of unrealized potential. We should remember that we ourselves have succeeded academically because professors and TAs took an interest in our potential and encouraged us to overcome our educational hurdles. We can continue this process by finding ways to motivate students who may have different histories and learning profiles than we do, but whose desire to make the most of a university education drives them to participate in this project in spite of their individual challenges.
Adams, Murray C., and W. Bee Crews. “Teaching Strategies in Introductory Sociology for College Students with Learning Disabilities.” Teaching Sociology vol., 19, no. 1, 1991, pp. 42-47. http://www.jstor.org/stable/1317572. Accessed February 20, 2017.
Lewandowski, Lawrence, Rebecca A. Gathje, Benjamin J. Lovett, and Michael Gordon. “Test-Taking Skills in College Students With and Without ADHD.” Journal of Psychoeducational Assessment vol. 31, no. 1, 2013, pp. 41-52. doi:10.1177/0734282912446304. Accessed February 20, 2017.
Nelson, Jason M., Will Lindstrom, and Patricia A. Foels. “Test Anxiety and College Students with Attention Deficit Hyperactivity Disorder.” Journal of Psychoeducational Assessment vol. 32, no. 6, 2014, pp,548-57. doi:10.1177/0734282914521978. Accessed February 20, 2017.
Reaser, Abigail, Frances Prevatt, Yaacov Petscher, and Briley Proctor. “The Learning and Study Strategies of College Students with ADHD.” Psychology in the Schools vol. 44, no. 6, 2007, pp. 627-38. doi:10.1002/pits.20252. Accessed February 20, 2017.
Trainin, Guy, and H. Lee Swanson. “Cognition, Metacognition, and Achievement of College Students with Learning Disabilities.” Learning Disability Quarterly vol. 28, no. 4, 2005, pp. 261-72. http://www.jstor.org/stable/4126965. Accessed February 20, 2017.