Neurodiversity in practice: building inclusive higher education

• Due to weak global information processing it can be difficult to:
  • link new information to existing knowledge and see coherence in information;
  • distinguish main from side issues, reducing the chance of absorbing important aspects of the lesson;
  • convert theory to new or practical situations, meaning big and long assignments can quickly feel overwhelming;
  • formulate answers clearly and in a structured manner, with a tendency to interpret information too literally without enough context.
• Because of a strong focus on local information processing:
  • strong analytical and detail-oriented work, but as a result tasks often take longer, and deadlines are harder to meet.
  • strong focus on details: when studying the subject content, this can cause a loss of logical structure and the big picture
  • a good memory for facts.
  • a strong ability to delve into specific subjects, meaning learning material within the area of interest often receives relatively too much attention.
• A strong sensitivity to sensory stimuli, which can cause overstimulation and concentration difficulties.
• Difficulty asking questions directly to the teacher or correctly judging good moments for this.
• Contact with fellow students is often difficult, which, among other things, makes group work challenging.
• Difficulty getting a clear overview of all study activities with negative implications for efficient time management and sometimes even procrastination.
• Abstract concepts or theoretical applications may be more difficult because of the literal interpretation of information.
• Self-testing strategies are sometimes less developed.
• Difficulty in understanding assignments/exam questions correctly and knowing exactly what is expected.
• Group tasks and presentations usually cause extra stress, both because of working with others and speaking in front of a group. Oral exams can also cause additional stress.
• Adjusting to a new environment and new expectations, such as during an internship, can take a lot of effort. This applies both to the tasks themselves and to dealing with new colleagues and working procedures.
• Reflecting and looking at a situation from different perspectives can be challenging.

According to Baeyens and Jansen (2017), students with ADHD experience numerous difficulties, such as attention and regulation problems and inefficient study skills, especially in classical teaching and assessment formats. Alternative evaluations can make things easier, but attention remains a challenge. During activating education (see also ECHO teaching tips, section 'Activating students'), these students typically experience the fewest functioning and participation problems (Baeyens & Jansen, 2017; Jansen et al., 2017).

Specific challenges for students with ADHD are (SIHO, n.d. b):

• Difficulty with punctuality due to impulsiveness or problems with time management and planning.
• Concentration problems and easily distracted by external stimuli or own thoughts. Periods of hyperfocus alternate with periods of high distractibility.
• Due to attention problems, difficulty in grasping the essence of the lesson, often leading to incomplete or untidy notes. Instructions are also not always correctly understood, remembered or properly followed.
• Impulsivity can cause thoughtless responses, sometimes leading to an answer being formulated before the teacher has even fully asked the question. It can also be difficult to wait for a turn or sit still for a long time.
• Keeping a clear overview of all study activities can be difficult, as can creating and following up on a study schedule.
• Meeting deadlines is hampered by setting the wrong priorities and poor time management.
• Losing study materials, meaning, for example, additional time pressure.
• Procrastination is common because students with ADHD cannot sufficiently motivate themselves to study.
• Difficulty distinguishing main issues from side issues and understanding the core of the subject matter.
• Difficulty holding attention for longer periods. Topics that match personal interests or seem new often get more focus at the expense of other learning material.
• Self-testing strategies are often less well developed.
• Correctly understanding a task or instruction can be difficult because the task is started impulsively or because of a greater likelihood of distraction. Completing assignments and exams on time and formulating well-structured answers can be difficult.
• With larger tasks, it is often difficult to keep an overview, which regularly leads to procrastination and failure to meet deadlines.
• The transfer from theory to practice can be difficult.
• Instructions and feedback are sometimes less well understood, especially when they are vaguely worded.
  

Make sure students know what is expected and how to meet those expectations. This helps prevent numerous misunderstandings and misinterpretations.

• Plain and transparent language.
• Explicitly formulated feedback: clearly and concisely formulated points for learning help create greater learning opportunities.
• Clear agreements on, for example, deadlines, submission of assignments, as well as teacher accessibility for questions.
• Clear instructions on evaluation with explicit expectations. Providing example questions with answer keys in advance is a great advantage here.
• Besides oral instructions for assignments, it makes sense to also provide a written version for students to reread in their own time.

Incorporating predictability and structure addresses the need for clarity regarding expectations and provides students with an overview of all study activities. This helps ensure good planning and efficient time management. 

• Predictable lessons with a clear structure.
• Making presentations and well-structured course material available in advance, allowing students to keep focus and follow the lessons smoothly.
• Providing an overview of all assignments and study tasks, perhaps through a study guide. In lengthy assignments, intermediate deadlines are useful, and especially valuable if accompanied by a moment of feedback.
• Regularly making the link between theory and practice (e.g. in preparation for practical applications or internships) in order to meet students' own difficulties with this, while demonstrating the expectations. 
• Bringing along clearly formulated learning objectives and sample questions gives students insight into evaluation expectations.

Ensure a predictable and low-stimulus/low-sensory-conscious learning environment. This lowers barriers, giving students every opportunity to participate in learning and demonstrate their capabilities without losing extra energy dealing with ambiguity or over-stimulation.

For example, you can consider:

• Possibly choosing a location with less distracting stimuli.
• Using sound-reducing tools during lessons or exercises is recommended.
• In group work (see also ECHO teaching tip 'What makes a group assignment successful', 2022) as teacher, you should compose the groups yourself. It is often useful to give some roles/tasks with a clearly defined interpretation.

Regularly test whether things are going well, whether students are on board. By doing so, you show yourself to be involved and students feel respected. Moreover, you provide a learning environment where students can ask questions and mistakes are allowed to be made. 

Making a lesson recording available (ECHO teaching tip, 2023) gives students peace of mind. A recorded presentation or a knowledge clip can be a good alternative. Through an interactive way of teaching and the use of activating teaching methods (see also ECHO teaching tips, section 'Activating students) you meet the challenge of ADHD students to keep attention in the lesson. 

Refer to a study coach when the student has serious problems with making proper study plans or organising study time efficiently. This coach can help students learn study techniques and address fear of failure, procrastination and emotional problems.