Helping the haphazard college student

First-year college students with executive function (EF) difficulties arrive on campus and can be overwhelmed by the independence.

Without someone to remind them to look at a syllabus, they may not remember that there’s a research paper due halfway through the semester, or know that the professor doesn’t accept late work—no exceptions.

These students may plan to study, but starting and prioritizing tasks are especially challenging for them. More often than their peers, they end up playing video games or going out with friends. When faced with writing papers for classes they find boring, they feel so unmotivated that they keep putting it off.

By the time they go to the student academic center to seek help, they’re so far behind that they can’t catch up. During midterms, they pull back-to-back all-nighters, and the sleep deprivation exacerbates their anxiety.

Thanks to the federal Individuals with Disabilities Act, more and more students with disabilities, including executive function deficits, are graduating from high school and attending college.

While about 51 percent of young adults who enter a four-year college graduate within eight years, only about 40 percent of those with learning disabilities or autism spectrum disorders (for which executive dysfunction is common) complete a degree in that period, according to the study.

Part of the problem: They’re not seeking help. The federal laws that pertain to college students—the Americans with Disabilities Act and Section 504—make it the student’s responsibility to report a disability to the institution and seek accommodations.

Only 19 percent of students identified with a disability in high school receive any accommodations or supports in college, and only 28 percent report their disability to the college, according to a National Center for Special Education Research study.

“They don’t want to be identified as disabled,” says Lisa R. Audet, assistant professor of speech pathology and audiology at Kent State University in Ohio. “These are brilliant people who have a lot to offer. If we keep calling them disabled, no wonder they’re resisting our help.”

Colleges have good reason to persist in encouraging support. When students fail, they often consume more administrative time, harm an institution’s reputation and tarnish college rankings.

So as more students with executive function deficits attend college, higher ed institutions are creating and expanding programs to help students with disabilities, including those that go hand-in-hand with executive dysfunction.

Smart, but needing support

Students with executive function deficits face an especially daunting challenge: They tend to be three years behind peers in development of the brain as it relates to the regulation of delayed gratification, self-discipline, time-management, sustained attention and task initiation and completion.

Colleges with older students aren’t off the hook, either; those with EF difficulties struggle throughout their lives (although they do tend to learn to live with it by their mid-30s).

Passing or even excelling in high school was due to extra support from special education teachers, guidance counselors, classroom teachers, administrators and parents.

But in college, students with executive dysfunction are twice as likely to be on academic probation compared to their peers, says Richard Guare, co-author with his son Colin Guare, and Peg Dawson, of Smart but Scattered Teens: The ‘Executive Skills’ Program for Helping Teens Reach their Potential (The Guilford Press, 2012).

They face enormous difficulties in deploying their intelligence, says Thomas E. Brown, associate director of the Yale Clinic for Attention and Related Disorders and assistant professor of psychology at the Yale University School of Medicine.

“They often take a serious nose dive when they get into college. They can’t manage to organize themselves, prioritize their tasks, get themselves a decent night’s sleep. Many of them crash and burn.”

While executive function difficulties are the hallmark of ADHD, students with autism spectrum disorder, traumatic brain injuries, post-traumatic stress disorder, anxiety and learning disabilities often have executive function impairment as well.

The long-term projects and infrequent assessments that embody college work pose a challenge to students with executive function weaknesses.

“They’re expected to show astronomically higher levels of self-management at the same time that all the support systems are being taken away,” says Linda Hecker, an associate professor at Landmark College in Vermont, which specializes in educating students with learning differences.

These students often frustrate faculty. “It’s a cognitive issue, not a character flaw,” Hecker says. “So, many people say the student is lazy. They don’t understand there’s a neuroanatomical basis for all of these issues.”

If these students are able to learn the skills they need to function, they can be extraordinarily successful. Albert Einstein, Thomas Edison and Leonardo da Vinci, for example, are believed to have had ADHD.

But a lot of talent doesn’t get realized, and anxiety and depression are common among students with executive dysfunction, Guare says.

Experts recommend considering allowing students with executive function challenges to bypass general education courses, which may be boring to most freshmen but can completely derail this group.

Often these students can focus intently on a subject that interests them, but lack the skills to force themselves to do work they find boring.

These students may need prescription stimulants, such as Adderall and Ritalin, to focus.

Yet sometimes an institution’s attorneys discourage campus health centers from filling these prescriptions, says psychologist Ari Tuckman, author of Understand Your Brain, Get More Done: ADHD Executive Functions Workbook (Specialty Press, 2012).

The concerns involve the risks of drug dealing and addiction, says Brown from Yale. On “almost any college campus, you can buy stimulant medication to help you do your work.”

Also, administrators will read stories about the dangers of medication and overuse, and not understand what a difference some medications can make. “It looks like a problem with willpower when it’s not,” he says.

Faculty and administrator attitudes are crucial in creating an environment in which these kids can thrive, he adds. Plus, students’ rights to take stimulant medication for which they have a prescription are protected under the ADA.

Success building

Research shows that the ability to self-advocate is the most crucial factor in college success for students with executive function deficits, says Allison Lombardi, an assistant professor in the Department of Educational Psychology at the Neag School of Education at the University of Connecticut.

Peer mentoring programs and weekly check-ins with an executive function coach have been shown to improve these students’ chances of success.

At Kent State University, a mentoring program connects neurotypical speech and language students with classmates who have EF challenges.

Both students receive academic credit, and they spend about four hours together a week, with the goal of educating each other and working on a mutually agreed upon task, Audet says.

Greenfield Community College in Massachusetts uses a paid peer tutor model. Support program students are trained to provide study strategy guidance, time management plans and goal-setting—a service that’s free to other students.

In an effort to replicate the support students received in high school, Greenfield pairs students who have executive dysfunction with a peer; that peer models the kind of organization that results in success, says Colleen Caffery, disabilities services coordinator.

Academic coaches—who help students plan their week, break down large tasks and hold students accountable—provide a bridge between the structure of high school and the complete freedom of college.

“The single accommodation that I think is most effective is having a once-a-week, 30-minute check-in with somebody,” says Tuckman. It could be a faculty advisor or someone from the disabilities office or counselling center—someone to serve as an “external executive function.”

Since this is a service students need in order to be on a level playing field with their peers, support is typically offered at no extra charge. (In fact, under ADA, when students have a documented disability, institutions can’t charge extra for accommodating it.)

Landmark College creates an integrated support system for each student, with an advisor as the communication center. This system tracks attendance, work completion and test scores. Weekly meetings are designed to prevent small slips from snowballing, and to help students set and write goals and be held accountable.

The need to take a full course load, especially the first semester, causes issues for many students with EF difficulties.

UConn, for one, addresses this on a case-by-case basis, allowing some students with disabilities to take three courses, rather than the standard five, and still live on campus, says Lorri Comeau, disability specialist.

Also, students with disabilities can petition the school to be exempt from taking some required classes (e.g., foreign language or math) that pose a significant challenge in learning. Students may also be permitted to spread out general education courses over multiple years.

As a rule, Landmark structures its courses to meet the needs of students with executive function challenges, Hecker says. For example, rather than basing the grade on a midterm and final, the college gives incremental assessments. “We know students are going to learn more the more often they’re tested,” she says.

Students with executive function challenges thrive in an organized environment, so engagement in school activities such as clubs, sports or a part-time job can help provide structure. Research also shows that students involved in student organizations are more apt to stay engaged and graduate.

The difficulties lie in helping students find the balance. When these students feel overloaded by responsibilities, they can shut down and escape into distractions—typically video games.

But with supports, the outcomes can be positive. As Greenfield’s Caffery says, “Students with these kinds of challenges can be extraordinarily successful once they figure out what supports they need and are willing to utilize them.”

Theresa Sullivan Barger is a Hartford, Connecticut-based writer.