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College Readiness for Individuals with Executive Functioning Deficits

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It was not so long ago that individuals with executive functioning (EF) disorders, such as Attention Deficit/Hyperactivity Disorder (ADHD) and Autism, had a tough time finding a university setting that was a good match. Obstacles such as the traditional high school grading system, college-level entrance exams (e.g., SAT, ACT), college application essays and interviews, and even the process of managing the intricate and complex process of applying for college were enough to stymie many with EF deficits who did not have adequate support.

These days we know much more about EF deficits, and specifically about how to properly support individuals with such deficits so their intelligence and aptitude can be accurately reflected in their applications. In my experience, more and more people with diagnosed EF deficits are entering college than in the past due, at least in part, to higher quality services and supports at the high school level.

Universities, however, seem slower to adapt. The question many of my clients and their families are asking me these days is, “Now that my child got into their top choice school, how will they do once they are there?” Below is a list of some of the questions I ask and information I look for in order to answer this question for families. I do not have a crystal ball, and certainly make no promises for someone else’s successes or failures, but there are some items for families to consider when thinking about the readiness of their child with an EF deficit for college.

Considerations When Thinking about College Readiness for Students with EF Deficits

Academics

Students should self-identify with the college’s students with disabilities (SDS) office. Nearly every credible college institution will have one, but the name of the office will vary by campus. I tell my clients that, once they identify with the office, they are not forced to use the services. However, “It is better to have it and not need it, then need it and not have it.” Consequently, refusing to register with the SDS office for individuals with a diagnosed EF deficit or other learning disability is usually a yellow flag for me. Some students feel they would be too embarrassed, have “grown out” of their disability, want to “see how it goes,” or some other explanation for not taking readily available and legitimate support. While some of these excuses may sound noble or grown up, in most cases they result in avoidable hardships and problems.

Students are sometimes surprised at the level of course rigor or pace, how much is expected to be done outside of class, the fact that their professors do not care if they attend class, or will not initiate interactions with them if there is a problem. Typically by the time the student with an EF deficit suspects there is a problem in the class, it is already too late. The Early Warning System (i.e., my grade is in peril) is usually set way too low, so it is important to have someone else (like an official from the SDS office who does weekly grade-checks with the student) help adjust it. The SDS office usually has highly skilled workers who have a host of highly effective interventions for your child with EF deficits. Registering with the SDS office can usually be done before the semester starts (although they will need to go in person when the semester does start), and must be done by the student (and not the parent) as the university now sees your baby as a legal adult (and cannot talk with you even if they wanted to without your baby’s permission).

Independent Living

Your child probably has little understanding as to how dependent they are on you. This is part of the hubris of adolescence. As opposed to low grades, it is my estimation that poor independent living skills are the reason most people must return home after living on campus their first semester. It is true that your child may choose to have a lower standard of cleanliness when you are not cleaning his or her environment, but some students with EF deficits can have problems remembering to eat or shower—skill deficits that can lead to health problems.

There is no way to take you completely through my checklist of independent living skills in this post. Instead, I would encourage the parent to stop reminding their child to do anything for the six months (or longer) prior to going to college. Stop waking them up, stop reminding them to shower or take their meds, stop cleaning their room or doing their laundry, stop inviting them to the table for dinner. You should keep all of the original expectations in place (e.g., waking up on time, good hygiene, family dinners), but stop reminding them about these expectations and see what falls through the cracks. You may only have to try this experiment for a day or two, or a couple weeks. It is better to find out that your child is dependent on you to remember to eat meals now rather than after they go off to college.

It should be added that children prescribed medication should take the meds as prescribed. If your child misses a dose, or seems like he or she will miss a dose (or fail to engage in any other safety activity), please remind them. This is not about “teaching your child a lesson,” but about seeing where they need to shore up their independent living skills.

I should warn you that, after stopping the reminders, some parents have decided that their child cannot live safely away from home. Again, this is something that is better to discover sooner than later. There are options for students to live away from home in supported environments, so all is not lost for these families.

Self Help Skills

Knowing when to ask for help, and when to work it out (i.e., persevere, problem solve, etc.) is a huge self-help skill. More basic than that, I see individuals with EF deficits have problems asking for help. For some, their reluctance comes from pride in that they do not want to admit they need help. More often than not, most students with EF deficits do not know when they are approaching crisis, and when they figure out they are, what to do about it. Some of this is based on the fact that EF deficits affects a person’s ability to estimate, evaluate based on a standard, and forecast. Some of this is based on the fact that many individuals with EF deficits have not been properly weaned from external support (e.g., teacher’s aide, extended deadlines) as they have aged. Parents and schools find themselves over-committed to their student’s “happiness” and academic success, and fail to let their child benefit from failure. This creates a host of problems, including the most basic skill deficit of not knowing how to locate and ask for appropriate help.

My primary message to parents preparing their child for college is that there is no way you can prepare for every eventuality. Your child will struggle when they go to college, and especially if they choose to live away from home, but when things get really bad you want to make sure they will call you. For this reason, I encourage parents to begin focus on their relationship with their college-bound child the months before going to school. Shift from nagging to encouraging; drills to fun activities. If your child is not using their day planner, now is the time to let that issue go. They will have a crisis, and most parents really do want to be the first ones to know.

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Andrew Schlegelmilch, Ph.D.-profile-picture

Andrew Schlegelmilch, Ph.D. is a clinical psychologist in private practice in San Francisco, and former Head Psychologist of Orion Academy, the nation’s first college preparatory high school for children with Asperger’s and related neurocognitive disorders. Dr. Schlegelmilch recently authored “Parenting ASD Teens: A Guide to Making It Up As You Go.”

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