Learning strategies for female students with ADHD

Around 2.5% of adults have ADHD - so there is a high chance the disorder impacts a significant number of your students - but what exactly is ADHD?

The National Institute of Mental Health defines ADHD as: "a disorder marked by an ongoing pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development." According to The American Psychiatric Association, these symptoms are best described as inattention (unable to maintain focus), hyperactivity (excessive movement inappropriate for the setting) and impulsivity (acting hastily in the moment without thought).

Asked to think of ADHD, many people immediately picture a disruptive schoolboy. But this is far from the whole picture.

While research has typically found ADHD is more common in males, an emerging school of thought thinks many females are being overlooked. Many experts on the matter have found that signs of ADHD in girls bear little resemblance to those in boys, meaning many simply aren’t diagnosed.

This isn’t helped by ADHD girls remaining an under-researched topic. It wasn’t until 2002 that a long-term study, created for better understanding girls with ADHD, was published. And even now, females represent just 2% of ADHD research, despite making up 50% of the population.

Inattentive ADHD in girls is more common than in boys (who often exhibit the more readily observable impulsive traits), which leads to females all too often being dismissed as quirky or sensitive or daydreamers, rather than receiving an actual diagnosis. Consequently, it’s estimated that as many as 50% – 75% cases of ADHD in females are missed.

One of the most common symptoms associated with ADHD is hyperactivity, but ADHD symptoms in girls can look quite different. Here are a few examples of behaviours that may indicate ADHD in teenage girls and women:

• Talking a lot (even when asked to stop)
• Often crying over minor disappointments
• Interrupting conversations and activities
• Difficulty paying attention
• Daydreaming
• A messy home or workspace
• Difficulty finishing assigned work

Because of the varied nature, often these symptoms are overlooked as immaturity or associated with another disorder, such as anxiety or depression.

Without a diagnosis, or adequate support, young girls and women dealing with ADHD may struggle to function in everyday situations. Left untreated, ADHD can lead to poor mental health outcomes such as low self-esteem which is associated with depression, anxiety, and eating disorders.

Recent research has found that young women with ADHD are two to three times more likely to engage in self-harm and three to four times more likely to attempt suicide. And while supporting students with ADHD is always important, a recent survey found 64.7% of adults with ADHD have reported increased anxiety since the start of the pandemic, which highlights the importance of taking action now.

Poor executive function can make life at university incredibly challenging for female students dealing with ADHD. Everyday tasks like being organised, prioritizing, meeting deadlines on time, juggling multiple assignments, and arriving on time can all be difficult to achieve.

Fortunately, the problem often isn’t knowing what to do, it’s getting it done. So, with the right strategies and support in place it becomes manageable. Here are a few ways you could better support female students with ADHD throughout their time at university.

1. Make a diagnosis accessible

Women often don’t get diagnosed until adulthood, meaning there could be undiagnosed female students at your university struggling to cope. Yet research has found that receiving a diagnosis helps women feel more in control of their lives.

You can encourage more women to get the help they need by making sure the mental health provisions at your institute are clearly communicated and easily accessible. It may also prove useful to educate academic staff on how ADHD presents differently in females so they can spot any warning signs.

2. To do lists and schedules

Managing time is a challenge for many female students with ADHD, so it makes sense that the next logical step would be to help them devise a system for staying organised. While many can hyperfocus – stay on one task for a long time – oftentimes it can be done at the expense of other, more important, projects which can lead to overwhelm and frustration. A simple to do list can help for many, but others many benefit from an hour-by-hour schedule set out at the start of each morning.

3. Factor in extra time

Some people who experience ADHD have difficulty grasping timings, so where possible you should advise them to add a ‘cushion’ to compensate. It’s tempting to cram tasks in in a bid to be as productive as possible, but that isn’t always achievable or advisable.

4. Use timers

It’s all well and good having a time plan to follow, but how do students who are easily distracted actually stick to it? A timer can be a tangible tool that indicates when it is time to move on to the next thing and stops them from losing track of the time.

5. Empower them to find individual solutions

Of course, everyone studies and learns in a unique way and that’s no different for students dealing with ADHD; there is no one size fits all approach. Research shows that multimodal learning helps people to learn and remember, so thinking outside the box is key. Strategies might include:

• Highlighting with coloured pens
• Audio note taking software like Glean
• Listening to audio notes while doing other activities e.g., exercising or commuting to campus
• Studying in different positions e.g., standing, rather than the traditional desk set-up
• Reading notes aloud
• Working alongside a peer
• Studying in a public place e.g., coffee shop or library

6. Outline the benefits of exercise

Research has found that exercise can improve cognitive performance in students with ADHD, so reinforcing the benefits to students dealing with the condition may be useful. This could be done by signposting them to available resources on campus such as team sports, gym access and exercise classes.

7. Invest in an ADHD coach

Depending on your budget, it could be worth referring students to a specialist ADHD coach that has experience with females with the condition. There is a growing body of evidence that suggests ADHD coaching can help students better learn to plan and prioritise, which can result in less overwhelm and more confidence.

8. Communicate specialist help available

Ensure any available academic support, such as tutoring or increase time allowances, are clearly communicated.

With 2.5% of the adult population estimated to be affected by the condition, learning how to better support students with ADHD is a key issue for all universities. It’s particularly important when it comes to females, with many girls and women missing out on a diagnosis as the condition presents differently in them.

Given how many women are estimated to be missing a diagnosis, an obvious first step is making sure there is adequate mental health provision in place. This can help the right people get a diagnosis first and foremost and then provide them with ongoing support.

In terms of practical learning strategies, developing a schedule that builds in extra time 'cushions' can make staying organised more achievable. Meanwhile, the use of to do lists and physical timers can help keep students stay on track. Exercise is a useful tool for improving health in general, but it's cognitive performance boost may be particularly helpful for students with ADHD.

Any available specialist help should be made clearly available and, where budgets allow, students may benefit from further investment such as an ADHD coach or specialist software. Ultimately though, the most effective tools will vary, so working with them to find an approach that best meets their needs is the best pathway.