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EPSTEIN QUARTERLY
Updated October, 2003
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INTRODUCTION
Many ADD students choose to attend college. Making the high school to college
transition is difficult for everyone, and particularly stressful and often overwhelming
for the ADD student. Careful planning will make the transition more successful. Therefore,
this edition of the Epstein Quarterly focuses on planning techniques to help the ADD high
school seniors make a successful transition to college life.
THE INITIAL STEP
The first step in planning is to decide which ADD symptoms need to be addressed.
Remember that the symptoms can vary markedly from individual to individual even though
they all have the diagnosis of ADD. For example, change is hard for many. Some students
have limited organizational skills. Others have spent years mastering the art of
procrastination. Distractibility is a common problem but may be more severe at a specific
time, such as when doing homework.
Take a minute to jot down the particular characteristics of students under your care.
This done, we can move into specific areas.
MEDICATION AT COLLEGE
In high school medication is generally taken before school, at midday and before doing
homework. There is structure to the day and to the use of medication. And Mom is often
around to remind the student to take the pill.
The daily structure of college, of course, is quite different. Classes can start at 9
AM with a second class at 11 AM, a lab at 4 PM and homework from 10 PM to 2 AM. And this
changes from day to day. Medication still needs to be taken before class and before
homework, and doing this can require a great deal of ingenuity.
Clearly, the timing of the medication must be planned in relation to the course
schedule. To work this out, I like to discuss the subject of medication with the student
and parents a few weeks before he/she leaves for college. I ask that they try to get an
idea of the class schedule before we meet. We then work out a program for the medication
use, and plan a review a few months into the school term.
We also talk about helpful techniques. Alarm watches can be of great help. Post It type
notes on mirrors, doors and notebooks can be good reminders. The use of a day planner can
be a good organizer, and can include useful lists of what needs to be done.
I have found ADD students have an easier time in a single room. If this is a
possibility I often suggest applying for a single. Later classes also help. Ten AM is a
good time for the first class, as the extra time seems to make organization and planning
easier.
ACCESS TO MEDICATION
It is, of course, necessary to replenish the supply of medication from time to time.
The general rule is that the student runs out of medication the night before the exam.
Since Ritalin and Dexedrine cannot be ordered by phone, and since a prescription is only
good in the state in which it is written, we need to have a system to get the medication
to the student in short order.
Here’s an idea. Let’s assume the student would usually get a prescription for
100 tablets. Instead of 100, get 125. The extra 25 are kept at home. In an emergency, they
can be sent overnight and this does not involve getting a new prescription.
The student divides the remaining 100 pills into two bottles. One holds about 75, and
the remainder goes into the second bottle. This is like a spare gas tank. When the first
bottle is empty, it is time to call home for another supply. This system works pretty
well. Without it, the supply is almost gone before the student recognizes the need for a
refill. Since it can take a week to get a new supply, this system avoids the problem.
If you have other methods to prevent running out of medication, please let me know.
It is a good idea to remind the student to be very careful of the medication. Stress
that pills should not be left out, as they might be stolen. They are not to be shared at
parties and they are not to be given to friends to "try." If pills are lost or
used up too soon, a new prescription cannot be written at once. These are Federally
controlled drugs, and the pills must be watched carefully and used as prescribed.
SHOULD THE ADD STUDENTS IDENTIFY THEMSELVES?
Ed was a freshman at a good Eastern college. He had been diagnosed with ADD in the 10th
grade, and with the use of medication and with hard work his grades went from C’s to
A’s and B’s. He described his condition in an essay in his application. The
school he chose had a good program for ADD students. They would help him adjust, make it
possible for him to take one less course his first semester, and speak with his teachers
about untimed tests. Ed refused to go to the Center, saying he did not need the special
supports they offered. I urged him to go and make himself known to them in case they could
be helpful at some future date. He refused.
Unfortunately, the pressures of the academic schedule combined with the absence of the
home supportive system caused Ed to have great academic difficulty, and he ended the first
semester on academic probation. Prior to the first set of finals he did go to the Center,
but they could do nothing for him until he was well into the second semester.
I suggest that the ADD student identify themselves to the ADD Center at their school.
There are supports available for ADD students at most schools. Of course, most students
are not known to the ADD Center ahead of time and, therefore, they must introduce
themselves. Occasionally I am asked for a letter confirming the diagnosis and describing
the medication. In my experience, those working in these Centers are anxious to be of
help. The supports vary, but often include some type of assistance with note taking,
helping the student to get untimed tests, and planning a schedule with fewer courses.
There is often a counselor to talk with to get help with ADD or other problems. The
available support can indeed make the first term, if not the whole college experience,
more successful.
Students often resist, saying they don’t need special help. This may be so, but
one can just identify themselves as ADD, and then never use the program. But you
can’t go in the week before finals and expect much help. It is
"preventative" medicine, meaning it is easier to prevent the problem than to
"treat" it later. As I have written in the past, ADD is a bummer, and it is
important to use whatever techniques are available to reduce its effects.
OTHER CHANGES TO THINK ABOUT
One is handling money. A system has to be set up to make money available for numerous
expenses. Credit cards fill part of the need. Generally a bank account is set up, with
checks to be written for routine expenses or cash. Now an account has to be balanced, or
at least not overdrawn, and the checkbook must not be lost. Suddenly there is something
else requiring attention and organization.
Doing laundry is a new problem. If there is a roommate it might mean that clothes
cannot be left scattered on the floor indefinitely. They may have to be washed and put
away. It’s just one more thing to think about.
CONCLUSION
As I have stressed, planning for college is essential if a student has Attention
Deficit Disorder. The student must be aware of the need to be on top of the problems
caused by ADD. It is very helpful if the family can be available for support and guidance.
In addition, I feel it is very important to take advantage of any services offered by the
school.
A helpful book is "ADD and the College Student" edited by Patricia Quinn,
M.D. and published by Magination Press in 1994. I obtained my copy from CACLD in Norwalk.
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