Teaching Students with ADHD with Cathryn Friel

If you’ve taught in higher education for any length of time, you’ve probably had one or more students with attention deficit hyperactivity disorder, better known as ADHD, in your courses. You might not have known it, however, since some students with ADHD haven’t been diagnosed yet and some choose not to disclose it to their instructors. This type of neurodivergence can be a little invisible to instructors, which is why it’s important we learn more about it and how we can design and teach courses that support these students.

Cathryn Friel knows a lot about teaching students with ADHD. Catt is a senior instructional designer at Missouri Online, and she completed her PhD last year with a qualitative study examining the experiences of students with ADHD in online courses. I reached out to Catt to learn more about her study and her own experiences as a student with ADHD. I learned a lot from our conversation about how students with ADHD experience and cope with college courses and about how instructors can make their courses, especially their online courses, more welcoming to neurodiverse students.

Episode Resources:

·       “Experiences of students with ADHD in online learning environments: A multi-case study,” Cathryn Friel, https://mospace.umsystem.edu/xmlui/handle/10355/91567 

·       “What I wish my instructor knew: How active learning influences the classroom experiences and self-advocacy of STEM majors with ADHD and specific learning disabilities,” Mariel Pfeifer, Julio Cordero, and Julie Dangremond Stanton, https://www.lifescied.org/doi/full/10.1187/cbe.21-12-0329 

·       “Supporting ADHD Learners with Karen Costa,” Teaching in Higher Ed podcast ep. 384, https://teachinginhighered.com/podcast/supporting-adhd-learners/ 

·       Distance Teaching & Learning (DT&L) and Summit for Online Leadership and Administration + Roundtable (SOLA+R), https://conferences.upcea.edu/DTL-SOLAR2023/ 

Transcript

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Derek Bruff 0:11
Welcome to Intentional Teaching, a podcast aimed at educators to help them develop foundational teaching skills and explore new ideas and teaching. I'm your host, Derek Bruff. I hope this podcast helps you be more intentional in how you teach and how you develop as a teacher over time.

If you've taught in higher education for any length of time, you've probably had one or more students with Attention Deficit Hyperactivity Disorder, better known as ADHD. You might not have known it, however, since some students with ADHD haven't been diagnosed yet and some choose not to disclose it to their instructors. This type of neurodivergence can be a little invisible to instructors, which is why it's important we learn more about it and how we can design and teach courses that support these students.

Cathryn Friel knows a lot about teaching students with ADHD. Catt is a senior instructional designer at Missouri Online and she completed her PhD last year with a qualitative study examining the experiences of students with ADHD in online courses. I found out about Catt and her work while looking over the program for UPCEA's summer conference. UPCEA is a professional association that focuses on continuing professional and online education, and they're hosting a conference in July for faculty, staff and administrators who work in these areas. Full disclosure: UPCEA has provided me with a press pass to the virtual components of their summer conference.

Catt will be sharing her study at the UPCEA conference and I reached out to her to learn more about her work and her own experiences as a student with ADHD. I learned a lot from our conversation about how students with ADHD experience and cope with college courses and about how instructors can make their courses, especially their online courses, more welcoming to neurodiverse students. 

Well, Catt, thank you for being on International Teaching. I'm glad to have you on the podcast today and to get to know you and your work a little bit more. Thanks for joining us. 

Cathryn Friel 2:11
Well, thank you for having me on, Derek. I really appreciate it. It's a fun opportunity. 

Derek Bruff 2:16
Oh, good, good. Before we talk about your project, I'm going to ask you my usual opening question. Can you tell us about a time when you realized you wanted to be an educator? 

Cathryn Friel 2:30
Well, it's interesting because way back in grade school, fourth, fifth grade, that long ago, I had a teacher that she would let me and another friend stand at recess and pretend to teach. So way back then. I had a roundabout trip to get here. I did a lot of things in between before I actually settled on being an educator and an instructional designer. So. But the... it was hit early, early. I ignored it. And here I am. 

Derek Bruff 3:08
But here you are. That's great. It's great. Well, we're going to talk about your project, which deals with students who have ADHD and how they experience online courses. And you've disclosed that you were diagnosed with ADHD as an adult, correct? 

Cathryn Friel 3:26
Correct. 

Derek Bruff 3:27
So looking back, knowing that about yourself now, looking back on your time as a student, how do you think having ADHD affected your college experience. 

Cathryn Friel 3:43
In in a lot of ways. 

I was and still am a procrastinator. So one of the things about ADHD is we don't produce enough dopamine. And so there are... we have to find other ways to get that dopamine. And unfortunately, procrastination and time crunches dump a lot of dopamine. So, you know, papers and projects and stuff like that were always last minute. I do remember one semester in college where I thought I was going to be brilliant and just take Monday, Wednesday, Friday classes and have Tuesday, Thursday for homework. That was a disaster because I could do the Monday, Wednesday, Friday classes, but I could never get motivated on the Tuesdays and Thursdays to sit down and do those long stretches of homework. 

Being late to class is not uncommon and there is a lot of... there's impulse control issues, and you most often think of that with little kids as, you know, bouncing off the walls, always moving and stuff like that. But for someone in college, a lot of time that translates into speaking out of turn in or talking over people because you've got an idea and you know that if you wait, it's going to be gone and you're not going to get it back. So there is just a lot of things that I look back now.

When I was in my master's program, I was in online and I would always wait until the last minute for my paper and I would always have what I call my pre-paper breakdown. I would just sit in front of my computer and ball.

Derek Bruff
Oh, wow.

Cathryn Friel
And until I got that out of my system, I couldn't I couldn't start on the paper. It was just facing that blank screen. And the subject matter wasn't all that interesting. I just couldn't do it. And so but the dopamine kicked in and we sat down. I also never did drafts ever. So my the first time that I wrote anything, that was what was getting submitted. And so when people say, well, do a draft and then come back later, I have a real hard time doing that because I was always editing and drafting at the same time, because I didn't have time to do a complete draft, step away from it and come back in and refine. 

Derek Bruff 6:38
Because you had procrastinated. Is that why? 

Cathryn Friel 6:41
Yeah. The other reason, even if I didn't procrastinate, I've done it once. Now I'm bored with it. So you know, I can write it the first time. It's a struggle, but I can do it. But the idea of going back and editing something that I've I've been there, done that. I'm ready to move on.  

Derek Bruff 7:04
That's fascinating. Did you did you find yourself I mean, you weren't diagnosed at that time, but were there kind of workarounds you had figured out in your life to kind of manage things? 

Cathryn Friel 7:16
Yes. I needed to be early morning. I have to get up and I have to have some place or something to do. Without that impetus, it's kind of like I will even... before all the multimedia and stuff that's like, Oh, I just got that book looks interesting, or I know I need to write this paper, but my closet, which I haven't cleaned out in six years, just all of a sudden is desperately calling to me. So you, you, you find stuff that interests you in the moment to avoid what you're doing. I like to call it productive avoidance. I'm really good at productive avoidance. 

Derek Bruff 8:07
Gotcha. Not just daydreaming, but doing something else that's maybe less time sensitive, but still useful. 

Cathryn Friel 8:14
Yes, exactly. And having my classes basically back to back, because if I had time between classes, I would waste it. I wouldn't get anything done. Oh, neurotypical students will have an 8 a.m. class and then maybe not have one until ten, and then they'll spend that hour in between, either prepping for the next class or doing homework for the previous class or something. And not me. I have to have it all and then sit down in a block and get it done. And that was another thing is they always say work for half an hour or 45 minutes, take a break, come back, you're refreshed. I can't do that because once I take a break, the focus and the motivation is gone. And it is virtually impossible for me to get back into it now.  

Derek Bruff 9:10
Yeah, that makes sense. Well, let's let's talk about your project. Give us the big picture. What were the questions that you were pursuing and kind of what methods did you use to try to answer those questions? 

Cathryn Friel 9:22
And if you don't mind, I'm going to back you up just a little bit as to why I, I was very interested in this this project 

I have right now a teenage son who was diagnosed with ADHD when he was in the third grade. And that's about the time that I got my diagnosis, because ADHD tends to run in families and they are seeing this a lot more that if one member is diagnosed with ADHD, especially a child, there's probably a parent in there that has it.

I knew that I struggled with my online classes with with my ADHD, and that is a trend where higher education is going. So I was really concerned about my son, who will be going to college in a few years. And I wanted to be able to advise instructors on things that they can do within the course site that would support students with ADHD.

A lot of times you don't know that you have a student with ADHD. They don't go to disability services and they don't disclose it to an instructor. And so if you can put in support systems that are going to help neurodiverse students like students with ADHD, you're actually going to end up helping everybody. So I wanted to see what those things were. My goal has always been to do an application dissertation, not a theoretical one. So that's where that's how I got into this in the first place.

So I wanted to know how students with ADHD experience online courses. What challenges do they have? Do they see any benefits in it? What types of things do they think would support them and what strategies are they currently using in their online courses to get them through? So that's how this got started. And that's what I was interested in.

Going through high school, in grade school, if you're diagnosed with ADHD, you have a lot of support systems. Even if you're not diagnosed, there are a lot of students with ADHD that have parents that are very supportive. They're on them. Did you get your homework done? Don't forget, you've got this paper due next week. Where are you on the paper? We got to get you to school. You got to get up, you have to eat. So there's people there that are guiding and supporting them.

When they hit college is when quite a few people are getting official diagnoses because those support systems are gone. They now have to get up on their own. They have to get to class on their own. They have to know they have to sit down because that paper is due tomorrow. So then they start getting stressed and anxiety that takes them to the health services on campus. And then that starts the ball rolling for ADHD diagnosis. 

Derek Bruff 12:39
That makes sense. So it's it's maybe students who were not diagnosed in high school, but had that support structure to do well, then they get to college and then then the ADHD starts to cause this kind of snowball effect. 

Cathryn Friel 12:57
Yeah, right. And you know, years ago there was a common perception that you outgrew your ADHD, that as you got older, you outgrew it. You don't outgrow ADHD, your symptomology changes. And over the years, whether you realize it, whether it's conscious or not, you have started establishing coping mechanisms and strategies and put them in place. So, you know, by the time that you're 16, 17 and in high school, you can't jump out of your seat and run over and look at the squirrels that are playing in the courtyard. 

Derek Bruff 13:39
Right. 

Cathryn Friel 13:39
So you sit there, you might do other things, but you know, it it shifts,m the symptoms shift because you have grown and you've been forced to find mechanisms and strategies to help you through the day.

Derek Bruff 14:01
And so your approach was to to talk with students who were taking online courses, students who had ADHD, right? 

Cathryn Friel 14:11
So, yeah, I wanted to talk to students. So I decided on a multi case study. So I had four individual students that I looked at or talked to, and each one of those students was my case. And then once I got... talked to all of them and I coded and analyzed their data, then I pulled all the data together and did it across all of the cases. So I have experiences of four different students. We talked for between 60 and 90 minutes an interview, and I had three interviews per participant. So we spent a lot of time together talking and really got to know them and and what they're doing. 

Derek Bruff 15:05
So let's talk about what you found in your study. What what were some of the challenges that the students you talk to experienced, particularly in the online course setting? 

Cathryn Friel 15:16
Well, this is a no surprise, but there were a lot more challenges than there were benefits. [laughter]

So some of the challenges that they had had to do with the instructors themselves. So the relationship with the instructor, the design of the course, and then quite a few of the challenges were more personal. They were challenges... There wasn't an outside intervention that could help, let's put it that way.

So all students need a connection with their instructors. But for students with ADHD, it's super important. If they establish a relationship and a connection with that instructor, they are more likely to (one) disclose because they feel safe and comfortable with them and (two) ask for help and get the support that they actually need. So that's that's one of the things that instructors can do.

The other thing that that a lot of students with ADHD find is that they hear a lot of negative. They have their whole life. You're lazy, just focus. You just need to do is concentrate. Why can't you get here on time? And all of these things, while they seem that they're in control, that the student with ADHD has control, they don't. And so they start feeling really bad about themselves. And so, you know, it's... you're really smart I know you are, why are you getting D's? Well, they can't get the homework in and stuff like that. So having an instructor who will reach out to a student with ADHD and say, Hey, I noticed that you've got a B or above on the last three assignments. That's really good. You're doing great. Or I see your improvement. That really... that small little motivation is huge. And they they don't get that very often.

And as far as the course design itself goes, the fewer links that they have to navigate and have to make decisions on, the better off they are. Having everything that they need for a particular unit, module, chapter, whatever you want to call it, within that course site so that they don't have to go looking around for it is crucial. One of my participants actually mentioned his frustration several times that it's ridiculous for me to have to search around in the web the course site to find what I need to do, the resources that I need to do it and get the instructions; I need to spend that time on the assignment, not finding it and the resources. So they were all very... they all mentioned that the way that the course is set up and where stuff is located was key. 

Derek Bruff 18:41
So let me let me follow up on that. So like I'm thinking of the podcast assignment that I gave my students and I would have a handout, both print and digital, and it had the assignment description, the assignment expectations. It had links to resources, things that they would need. So if they're focused on that assignment, all of the things that they might need are can be found from that document. I'm imagining another model where I have a very cleverly designed course where I have resources over here. I have examples over here. I have, you know, lecture slides over here and I might... to do the podcast assignment I might need stuff from all of those buckets. But if I have to go kind of clicking around all over the course to find that, that's going to be a lot harder for me. Is that, is that kind of what you're saying? 

Cathryn Friel 19:33
That's exactly what I'm saying. Yeah. The learning management system that I'm most familiar with is Canvas. So within Canvas you can have like a quizzes link on the side and you can click on that and there's a list of all of the quizzes. So as an ADHD student, if I click on those quizzes and I look at all the quizzes I have to do for this semester, I start getting overwhelmed. Also, you're depending on me to be focused enough on the details of something that they may not be very interested in and finding the right quizz to take at the right time. Whereas if you hide that and you put that quiz with the rest of the materials for that unit together, then there's no question. And on my part, I go to the unit I know that we're working on. I know these are my readings. I know this is the video that relates to it. This is my homework and this is the quiz I have to take.  

Derek Bruff 20:35
So for this week, this is my starting point. Everything I'm going to need for this week can be found right here. Yeah, that makes a lot of sense. Well, yeah. What were some of the other challenges that you you saw. 

Cathryn Friel 20:47
And a lot of the challenges... Another one of the challenges was that when they have a question, they can't answer, they can't ask it immediately. And so if they have to remember, like I'm watching a lecture video and I have a question, I don't quite understand this, if I have to stop the video and write the question down or send the email to my instructor, at that point, the chances of me coming back to the video have just diminished. If I wait until the video is over, I might not even remember the question. Or I'll send the question, I think it's really important, because I've waited until the last minute to start my project and I have to... and the instructor doesn't get back to me in what I consider a timely manner.

So a couple of things that instructors can do in that case is, you know, outline expectations and stuff like that for when they're going to get feedback back. So if I know I'm going to have to wait at least 24 hours when I send that email 6 hours before the due date. I know that's probably not going to be very effective. 

Some of the other things is just detailed instructions. Students with ADHD have trouble extrapolating information and if you give them too much information that isn't strongly connected, they have a hard time organizing that information, prioritizing it, and then moving forward. So vague descriptions or expectations for assignments and stuff are really paralyzing for students with ADHD. 

Derek Bruff 22:52
Or it sounds like maybe even including too much information can be problematic. Or if the information is not organized well. 

Cathryn Friel 22:59
Correct. Yes, the extraneous information. 

Derek Bruff 23:04
I'm thinking of a paper I read. I think it came out last year. I'll have to find the citation and put it in the show notes. But it was looking at the experiences of students with ADHD in physical classrooms during kind of active learning activities. Group work and pulling questions and things like that. And I found it pretty fascinating because, for instance, one of the recommendations was you're going to do a polling question with your students, a multiple choice format is a lot easier for someone with ADHD to both answer and then to look at the bar graph and kind of parse the results. Whereas if you have a free response question where students can just put a whole bunch of different answers up on the on the screen. That's a, that's a lot of very different information to make sense of. And it would it would take someone with ADHD more time to kind of process and pass that. And so it sounds like there's something similar happening there. If I've got like pages of information about this assignment that's not kind of differentiated or organized in a way, it's going to be hard to to kind of pull that into something actionable. 

Cathryn Friel 24:13
Exactly. The tldr (too long; didn't read), those little synposes were made for students with ADHD because... It's true, you give someone with ADHD a long block of text and they're going to balk against reading that. And a lot of white space is your friend as an instructor on your pages. I know that if I was formally writing this, this paragraph is just a single paragraph, I shouldn't break it out, but go ahead and put in extra spaces and extra breaks in the paragraph when you're changing slightly topics. Okay, This project is we're going to be looking at the effect of water on plants and it will be important that you get native plants. So put that in a separate... or a a bullet points. Bullet points are great, right? Because yeah, it's really hard to... too much information, they don't know what to focus on, they you can't prioritize, you can't organize. And so when a student with ADHD comes up to you and says, Hey, I'm having a hard time prioritizing what I need to be doing or where I am. Responding, you're in college and you need to figure it out-- that is not helpful. And that same person with ADHD is going to go to their boss and say the exact same thing. So you're not teaching them to be a professional or getting them ready for the workforce if you're sitting there saying, Hey, you're an adult now, you're in college, you need to figure it out. I gave you all the information. 

Derek Bruff 26:10
Yeah, yeah. And what that does is, you know, if you're taking a chemistry class, that student is in struggling with that assignment not because of the chemistry, but because of the instructions for the assignment. Right. Like you said, they're spending all this time figuring out what they need to be doing. They're not spending that time doing the things that are actually on topic and relevant for the course, correct? 

Cathryn Friel 26:34
Yeah, They're expend a lot of energy. And let's not forget that they're spending a lot of energy in this class, whether it's an online class or a face to face class. That's just one small pocket of their life that they are expending extra energy to get basic things done, you know. So take it outside of the classroom. They're still running. It's not just in the classroom that they struggle with these things. And so, you know, we can't get the dishes done. We can't can't get the laundry done. We you know, there's all of those things. I'm always late for a doctor's appointments. There's a phrase that a lot of people with ADHD use, and that's called the "ADHD tax" because it's very expensive having ADHD from both a financial position and emotional and energy. You know, I forgot to feed the meter. Okay, there's another $15 fine. I locked my keys in the car again. I got to call the locksmith. There's another ADHD tax of $75 to have them come and get my keys out of the car. It's a constant struggle all day long from the time they wake up until the time they go to bed. 

Derek Bruff 28:10
Are there things that instructors might do from a kind of well-meaning standpoint that are actually not as helpful as they think they might be. 

Cathryn Friel 28:23
But some of them are the ideas that I am preparing you for the job. 

One of the things that I struggle with getting some instructors to relax on is a no-late-work policy, okay? And they're saying, well, when you're in the business world, you know, you can't be late with that report. And it's like, but really? Really? So you work on those report for your manager and you've got it three quarters of the way done and you're not going to make the deadline, typically your manager doesn't say, no, I'm not going to accept that now. You put all that work in but, nope, not going to do it. You negotiate with your manager a new due date or... you know there will be consequences. I'm not saying no consequences, but so negotiating due dates is a life skill that is handy to have. Let your ADHD students well, any students but students with ADHD let them negotiate and accept late work again. Penalties are fine, but accept the late work because if you don't accept late work and it's the start of the fall semester.

ADHD students... Students with ADHD typically take about a month or so to start getting back into the groove of being in the academic setting after being out for all summer. So they're really going to struggle that first six weeks or so. There's going to be later assignments just because they haven't gotten things figured out yet. And if you start the semester with three zeros, depending on the course, there's no coming back from it. 

Derek Bruff 30:31
So you start those with a 75, right, instead of a zero because you turned it in and you took a penalty and it wasn't perfect, but it's a 75 and not a zero. That's a big difference. That's a big difference. 

Cathryn Friel 30:44
Huge difference. Huge. 

Derek Bruff 30:47
You had said earlier that the the challenges in the online environment outweigh the benefits. But but are there some benefits? Are there some some benefits of kind of taking online courses that students with ADHD can experience? 

Cathryn Friel 31:03
Yes, there are, but there's also caveats with those benefits. It's not a straight up "It's a benefit." Dome of the biggest benefits that they had 
were one, online lectures, not synchronous lectures, but recorded lectures. 

Half of the participants really liked it because they could pause it, they could write notes, they could listen to it at their speed. One of the participants, the only way that he could get through online lectures or recorded lectures was by doing it at double speed because he really had to focus to catch everything. And he wanted it to get going because he thought that his instructors talked way too slow on their recorded lectures, so that was a benefit. If it was a synchronous class and the instructor allowed cameras off, I had one participant who would have the lecture going but cleaning their room or brushing the dog or doing something like that. And that was a focus mechanism for her. And so she was actually paying attention and focusing more than if she was sitting there, sitting in front of a camera. 

And they liked it because they could sit and draw and doodle and they wouldn't get in trouble for it, because they got used to teachers walking around and they saw that they were doodling or they were drawing something and not taking notes. But a student with ADHD, that was the way that they could focus on what was being said. Students with ADHD are notoriously horrendous note takers, so that student was getting more information by doodling and focusing and listening than they would have if they were trying to take notes because they can't... their brain isn't going to allow them to listen, pick out the important things for notes and put it on the paper. If you give them guided notes, it helps tremendously. But having an a student with ADHD to try and discern from your 50 minute lecture the important parts that need to be written down is difficult. It's a it's a stressor. 

Derek Bruff 33:52
And that's and again, you know, that's challenging for a lot of students to kind of pick out what's important and what's not important. This is something that novices in any field encounter is like. There's just so many things, what things are important, but because of the ADHD, it might be more challenging for some students than for others. That makes sense. 

Cathryn Friel 34:14
Yeah. 

Derek Bruff 34:15
Well, Catt, thank you so much. I appreciate you sharing your work here and giving us a little insight into some of our students who might not, as you said, might not identify themselves as in this category. But I know we have a lot of thoughtful instructors who listen to the podcast and who want to do right by their students.

I had on the podcast a little while ago Robert Eaton and Bonnie Moon, who've written a book about kind of teaching for mental health of students and and I remember Rob saying, you know, not all difficulties are desirable. We know there are desirable difficulties that we want our students to encounter and grow from. But sometimes we build our courses or teach in ways where we have undesirable difficulties. And if we can make a few small steps to kind of move those out of the way, we can have more students shine. So thanks for giving us some great ideas for doing that with our online courses. 

Cathryn Friel 35:08
Thank you. And again, it was a pleasure talking to you. I love talking about this, this topic and could talk about it all day long. And so I appreciate the opportunity. 

Derek Bruff 35:19
That was Catherine Friel, senior instructional designer at Missouri Online, sharing results from her doctoral study of students with ADHD and how they experience online courses. In the show notes, you'll find a link to Catt's full study as well as that article I mentioned about the experiences of students with ADHD and active learning classes. Thanks so much to Catt for taking the time to come on the podcast and share her experiences and her research. 

As I noted at the top, Catt is presenting at UPCEA's summer conference, which is actually two conferences combined. The Summit for Online Leadership and Administration and Roundtable, SOLAR, is intended for leaders of online education initiatives, while the Distance Teaching and Learning Conference (DT&L) is aimed at practitioners, including online instructors, instructional technologists and educational technology researchers. The conferences will be held July 25th through 27th 2023 in Madison, Wisconsin, and also online. See the show notes for a link for more information. 

This episode of Intentional Teaching was produced and edited by me, Derek Bruff. See the show notes for links to my website, the sign up form for the Intentional Teaching newsletter. and my Patreon, which helps support the show for just a few bucks a month. You get access to the occasional bonus episode, Patreon-only teaching resources, the archive of past newsletters, and a community of Intentional Educators. As always, thanks for listening.