A student sits down at their desk to do their homework. Today, it’s just a few chapters of the book they’re reading for English, and yet it seems so daunting. But the assignment is due tomorrow, and they’ve procrastinated all they can. They open the book to the page they were on and start reading the first paragraph. As they’re reading, their mind wanders, and it’s only when they reach the end of the paragraph that they have no idea what they just read. So they start over, but it happens again, and again and again. After 30 minutes, they’ve barely made it through the first page and still have many more to go. This is a common struggle of those with AD/HD, and yet many students remain undiagnosed or untreated. Students may think, “Surely I don’t have AD/HD, or someone would have noticed.” Instead, they blame it on themselves, leading to low self-esteem and negative feelings about school and learning.
Despite many remaining undiagnosed and/or untreated, AD/HD diagnoses have surged in recent years, leading many to question diagnoses’ merit. From 1997 to 2016, the percentage of Americans diagnosed with AD/HD rose from 6.1% to 10.2% according to the National Institute of Health. While this is primarily due to increased awareness and reduced stigma, many are starting to think that “everyone has AD/HD, so students shouldn’t get accommodations for it.” This type of thinking is problematic for many reasons, chief among them being that it invalidates the struggles of those who really do struggle from AD/HD. Not only that, but it is based on false logic. A study published in the Journal of Attention Disorders by researchers at King’s College London found that although diagnoses are rising, the actual prevalence of AD/HD is not. Therefore, the increase reflects more diagnoses matching the actual number of people with AD/HD, not overdiagnosis. Despite this, many students still face difficulties obtaining necessary accommodations.
Getting academic accommodations like extra time on tests often requires an AD/HD diagnosis or other learning disabilities. However, obtaining an accurate diagnosis involves comprehensive testing, where patients perform various mental tasks–such as reading, arithmetic and puzzles–to assess their cognitive abilities. When complete, patients receive a full report on their performance on each test and how it corresponds to the skill it was testing. This report is incredibly useful as it gives one insight into their strengths and weaknesses, which can provide tools to overcome them. This testing allows psychologists to make accurate diagnoses, even when symptoms are more discreet. While the test is very beneficial, it is also very expensive, costing up to thousands of dollars. As a result, many people don’t have access to it and can go undiagnosed for years or even their whole lives.
Because of this, many students who have AD/HD don’t even realize it and attribute their struggles to other things because they don’t present common symptoms and their parents and teachers don’t notice some of the more discreet struggles. In the past few decades, this was especially true for females, as AD/HD presents very differently in females than in males. For example, hyperactivity is a symptom that mainly males display. For females, more common symptoms are internal restlessness and inattentiveness, which are not as obvious and therefore much more overlooked. This represents the problematic trend of AD/HD diagnoses being recommended by teachers based on a student’s disruptiveness. However, AD/HD often doesn’t manifest as outward disruptiveness meaning that those students who have it but are more quiet are less likely to be diagnosed and treated.
AD/HD is also often overlooked in high-achieving students. The common logic is that if a student is doing well in school without accommodations, then they don’t need them. But high-achieving students with AD/HD have just as valid struggles as anyone else with AD/HD, even if they don’t result in bad grades. It often means that the students are working much harder to get those grades and stay on top of their work, though the outside world doesn’t see their adversity.
Some believe that students with extra time accommodations have an advantage over those without them, but this is a misunderstanding. Psychologists often make the analogy to someone who needs glasses: if they have worse eyesight than everyone else, it’s not their fault they can’t see well without them. When given glasses, they can see clearly like all the other students. Like glasses, accommodations don’t give students an advantage; they simply level the playing field.
Ultimately, most experts agree that the underdiagnosis of AD/HD is more damaging than its overdiagnosis. Undiagnosed and/or untreated AD/HD often leads to unhealthy coping mechanisms and is linked with higher rates of other mental health issues, such as depression and anxiety. Because of this, it’s important that all are educated on the symptoms and signs of AD/HD and that comprehensive testing is more accessible. Not only that, but teachers and parents should listen to their students’ struggles instead of dismissing them or blaming them on a lack of hard work.
