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Post-secondary program considerations for young adults with ADHD and related conditions

Rob Crawford, M.Ed , for The Life Development Institute
What should I do while they are still in high school?
Taking the first steps into the adult world presents both complex planning challenges and exciting opportunities for youth with ADHD and their families. Most public school programs and private boarding schools tend to focus on the traditional mission of an educational institution- developing academic competency in preparation for college.

Although transition planning for students on an IEP is mandated to begin by age 14, many times it becomes overlooked because of the combined pressures of high stakes testing, lack of school resources, appropriate programming, and adult service participation barriers.

What is transition planning and how can it help my child? The transition planning component of the IEP calls for a coordinated set of activities designed around a "results-oriented" process-promoting the academic and functional achievement of a student- to facilitate successful transition from high school to postsecondary education or employment, and independent living.

There is a requirement that transition services be based on the student's strengths, as well as their preferences and interests. The addition of "strengths" makes it clear that the development of transition goals should focus on and build upon what the student can do - not focus entirely on what the student can't do.

What does student-centered planning do in preparing my child for transition?
The emphasis on student-centered/strength-based planning can be difficult to accomplish when there is a lack of regular and consistent student inclusion by the IEP team during the high school years. There is a general tendency for students with ADHD to not clearly understand the functional limitations the condition potentially places on them, how and when to disclose to others, being able to accept and reframe their experiences into an identity as a resilient person.

Many either don't know/underestimate the value of their personal capabilities, interests and aptitudes are or go to the other extreme of grossly exaggerating the capacity for living on their own, enrolling in higher education, and starting a career. As a result of this lack of involvement in assuming/be given responsibility for their future, students with ADHD struggle to effectively self-advocate as adults who can and do effectively take care of their own affairs.

What are some essential considerations for families and young adults with ADHD to think through and address? The transition to college and independent living is challenging to the typical young adult-period. Once out of high school, it is common to want to "leave the ADHD behind." After all, as a young adult in higher education or beyond, they are unlikely to be recognized as someone with a disability unless they choose to disclose.

There is the possibility and hope that ADHD will not have an adverse impact in college or work. However, for almost all young adults lacking experience in making these "next step" decisions, ADHD in adulthood brings a special set of challenges in postsecondary education, work and home, relationships, and especially feelings about oneself.

College and employment are adult performance-based environments.
While academic preparation and the acquisition of vocational skills are important to success in both educational and employment settings, the consistent and appropriate use of effective social-emotional skills are an absolute must in order to sustain success beyond formal academic /training settings. College and workplace environments require very different skill sets to achieve successful performance.

It is important and expected that the learner/employee sets their own goals and use strategies that promote success in both post-secondary and workplace environments. Unlike school-age special education laws (e.g., IDEA and Section 504), the ADA provides protections only for those willing to accurately and specifically self-disclose their condition and the impact or barrier it presents in completing course or work assignments.

In order to be considered a qualified applicant, each person must be also able to perform the essential functions of the job- with or without accommodations. Knowing how to talk about the ADHD, when to disclose or not to disclose, articulating no cost/low cost accommodation suggestions, and how to appropriately self-advocate can make a profound difference in competitive employment settings in job entry, in performance evaluation, and in job advancement.

Because of these and other factors, it may seem logical to investigate programs that provide these types of transition services specifically tailored for young adults with ADHD and other related disorders.

When considering young adult program options, here are some key factors to consider.

Outcomes: Be clear about personal expectations vs. program focus and ability to deliver these end-results.

Do you want a college-oriented focus with study strategies, academic support that helps matriculation to full time college programming? Is your concern to make headway in enhancing employability and job skills, developing independent living skills, and making better choices about healthy relationships? Are you seeking a program that provides overnight staffing and a "safe" self-contained campus?

A key to having satisfaction and success in achieving these program outcomes can be enhanced by thinking through some pre-determined priorities and mutually agreed upon objectives.

Structure: What is your son/daughter ready for and how much of their freedom can you live with?

At one end of the spectrum, program options are highly structured, personal autonomy is limited in self-contained/segregated residential settings, students are in monitored learning and living environments with 24/7 activities, supervision, and support.

The program philosophy is to provide enough ongoing structure to support the student's transition from the family home or boarding school program into the adult world.

The general view is that young adults coming to this setting have not demonstrated the skills or maturity to function with less than this amount of daily structure.

In the middle, program options would consist of a daily schedule of classes, activities and support with more unstructured free time and an open inclusive community-based adult living environment.

This structure and program support helps young adults with ADHD stay focused and organized by working with them on how to balance their social life with their academic/work life, avoid going overboard with reckless spending, self- isolating from their peers, managing anxiety or depression, and making healthy lifestyle choices.

There is recognition that the young adult with ADHD may struggle with organizing their lives or staying focused on what's important to them, but that these challenges are best addressed through experiential learning and the integration of life coping skills/strategies.

The least structured program options are typically higher education oriented, and provide "supportive" services for students presumed to have minimal issues making sound decisions, have reasonable expectations to succeed academically and are generally ready to advocate for him/herself as an adult learner.

There is more emphasis on mastering the intricacies of the college world and academic achievement, and far less on specific life skill acquisition. Study labs, tutorials, test taking strategies, accommodation support, and course advisement leading to matriculation of a chosen university or completion of an Associate's degree are the main program objective.

Student behavioral choices and social/emotional regulation are expected to be handled responsibly by the student with minimal support and involvement by program staff. Residential support, supervision and social/recreational activities may be offered, but are not central to this level of programming.

Location and community resources: Think about the trade off's between rural, urban or suburban program settings.

Depending on your objectives and program emphasis, look for the types, supply and range of employment options available as well as higher education and postsecondary training programs.

If students are not licensed drivers or allowed to bring personal vehicles that there is adequate public mass transit or program transportation by staff that provides rides for essential needs.

Make sure you are comfortable with the kind of neighborhood the program is located in. Some programs are in charming country settings while others can be in the virtual center of a large urban area- each has unique benefits as well as potential limitations that could impact overall service provision.

This includes the residential side of programming too. Some programs have their own self-contained independent living arrangements where only members of the program reside. Others rent apartments within an adult community complex and offer varying levels of residential support and supervision. This could mean anything from onsite overnight staff, alarmed and remote- surveillance apartment monitoring to once a week check-in with itinerate staff support.

Another obvious consequence of the location factor is to see how easy to fly into or how long a drive it is in order to get to the program. Some families and young adults may also have a preference for ready access to shopping, entertainment, or recreational options while this in not important to others.

For medication management, psychotherapy or other health-related considerations, look for referral options to local medical and professional provider's, as well as availability and expertise in your child's specific circumstances.

Get updated testing with adult scale measurements:

Because of the increasing demands that adult living, higher education, and employment place on people with ADHD, getting a complete, accurate and age-appropriate diagnostic picture helps in making the best informed decision about program options, structure, medication management, and other supports that would be needed.

It is critical to have an unbroken chain of documentation that shows the evidence, persistence, and chronicity of attention, learning, or other disorders for eligibility of reasonable accommodations in adult settings.

Most testing for secondary age students is used for educational placement category purposes only. The data, age level or type of testing usually falls short of meeting standards for higher education, postsecondary training, and employment criteria which require documentation of specific functional limitations in major adult life areas in order to be considered as a person who has a disability.

It is common for a significant number of adults with ADHD to have co-occurring conditions such as learning, mood, or neurodiversity issues that impact their overall abilities for peak performance in a given environment.

Find diagnosticians who have experience working with adults and are able to conduct comprehensive evaluations that yield the type and scope of specific recommendations relative to these major adult life domains and required by education, employment, and adult service providers to qualify for provision of reasonable accommodations.

The results of comprehensive psycho educational, neuropsychological, and/or vocational assessments can yield valuable information about what resources and support are needed to best determined next-step considerations for placement as well as inform outside professionals and providers with the situation-specific information they need to implement appropriate accommodations.

One size does not fit all: there is no ideal or perfect program, try to balance out the most important, immediate or ultimate priorities through joint family determination, the young adult's buy in and agreement to sustain commitment.

For some, it means making sure program philosophy and level of communication focuses on their child first and the parents second. They are able to risk placing trust in their child to either make good choices or learn from them when they are not so good. This means that the young adult and program staff work through the issues, and parents are advised/consulted of the process and outcomes. Other parents need to continue to play a central advocacy role in their adult child's life, expecting to assume a parallel decision-making role with the program and will look for a program that allows this level of access.

For both parents and the young adult with ADHD, finding out how much and how often parental involvement is expected or welcomed is critical. While intellectually understanding that it is time for emancipation and allowing greater autonomy, many parents still emotionally expect an integral, ongoing role in decision making.

Difficulties with parents or their adult child in "letting go" are understandably normal as part of the transition process. But left unchecked can complicate or inhibit the desired outcome of independence, responsible adult behavior, and emotional development of the child. Make sure you understand and are comfortable with program policies/procedures related to communication between parties and expected performance responsibilities of all concerned.

Growing up is a process and young adult transition program success is really more of an art than it is a science. For young adults with ADHD, using a transition program gives them multiple opportunities to be successful exploring new and different experiences, travel, work, self-reliance, and developing adult relationships. For parents, it allows them to confidently work with others in helping their child take those next meaningful first steps into the adult world that they would not otherwise do on their own.


Rob Crawford, M.Ed is the director of The Life Development Institute, for The Life Development Institute, A Transition Program that creates a practical and inclusive bridge between the secondary and higher education/career development aspirations of under-prepared young adults with learning and neurodiversity challenges. .



Disclaimer: Internet Special Education Resources (ISER) provides this information in an effort to help parents find local special education professionals and resources. ISER does not recommend or endorse any particular special education referral source, special educational methodological bias, type of special education professional, or specific special education professional.
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