Screening for ADHD and Dyslexia in undergraduate university students Dr Debbie J. Pope Learning and Literacy Research Unit Department of Psychology UCLAN PLAT2006

Dr Helen Whiteley Dr Chris Smith Ms Rachel Lever Dr Debbie Pope Dr Delia Wakelin Dr Helen Dudiak Dr Hazel Dewart Supported by the Higher Education Academy Psychology Network Contributors

Aims To gain a broader picture of the incidence of dyslexia and ADHD characteristics in Psychology undergraduates To consider links between ADHD and dyslexia screening scores and academic achievement To explore when/why undergraduates do/do not seek help and to identify outcomes from support or lack of it To consider the implications for retention and progression

Definitions Dyslexia can be described as a combination of abilities and difficulties that affect the learning process in one or more of reading, spelling, writing. Accompanying weaknesses may occur in areas of speed of processing, short-term memory, sequencing and organisation, auditory and/or visual perception, spoken language and motor skills. ADHD is a common developmental and behavioural disorder characterized by poor concentration, distractibility, hyperactivity, and impulsiveness

Measures - Dyslexia 1. British Dyslexia Association (BDA) Adult Dyslexia Checklist  20-items  5 minutes to complete  9 or more YES answers indicates potential ‘difficulty’

Measures - ADHD 2. Connors’ Adult ADHD Rating Scales – Self- Report: Screening Version (CAARS)  30 items  10 minutes to complete  3 DSM-IV symptom measures (inattentive, hyperactive/impulsive, total ADHD)+ ADHD Index score  Age and gender are taken into account  A score of 66+ indicates 95 th percentile or above, which indicates the possibility of a significant problem

1 st Year nd Year 541 Total1,184

Male 246 Female 938 Total1,184

Incidence of Dyslexia and ADHD Characteristics

Results – Dyslexia Characteristics 144 (12.1%) students scored ‘at risk’ 12 students (1%) scored very highly (15+) 30 students had previously indicated that they were dyslexic - 21 (70%) of these scored 9 or above

Results – ADHD Characteristics 174 (14.5%) students scored highly on inattentive scale 82 (6.9%) students scored highly on hyperactive/impulsive scale 140 (11.8%) students scored highly on ADHD total scale 82 (6.9%) students scored highly on ADHD Index scale No student had previously indicated that they had been diagnosed with ADD/ADHD

Results 110 (9.2%) students scored ‘at risk’ on BDA checklist and at least one of the CAARS ADHD scales Strong significant positive correlation between BDA checklist scores and 4 ADHD rating scores

Links between Screening Scores and Academic Achievement

Academic Achievement Data for the student academic year 2004/5 was collected An average mark for the year was calculated Overall mark comprised of marks from a range of modules and types of assessment – differences between universities (exams - essay, MCQ, practicals, essays, etc.)

Results No relationship between academic achievement and dyslexia checklist Overall, a highly significant negative relationship was found between academic achievement and each of the four ADHD rating scales Results indicate that those who score higher on the ADHD scales, are performing more poorly than their peers who score lower on the ADHD scales Similar trend across three universities (UCLan, Teeside, Northumbria) but no relationship between achievement and screening scores at Westminster

PS2700 Methods (n=238) Assessment – coursework only Assignment 1 Assignment 2 Assignment 3 Assignment 4 Final Mark Dyslexia ***-** Inattentive **---- Hyperactive **---- ADHD **---- * p < 0.05 ** p < 0.01

PS2200 Developmental Psychology (n=185) Assessment – coursework (essay, practical), exam (essay) EssayPracticalExam EssayFinal Mark Dyslexia ---- Inattentive *--- Hyperactive ---- ADHD *--- * p < 0.05 ** p < 0.01

PS2400 Cognitive Psychology (n=213) Assessment – coursework (practical) and exam (essay and MCQ) PracticalExam EssayMCQOverall Mark Dyslexia --** Inattentive --** Hyperactive --**- ADHD --*** * p < 0.05 ** p < 0.01

Support and Guidance

Existing Provision Students declare learning difficulty on entrance to university Student may be reassessed by psychologist in Learning Support Unit Individual provision provided as necessary CLaSS Project

Learning Difficulty among Sample? Question – “Have you ever been diagnosed with a learning difficulty” – 47 replied “Yes” 30 = dyslexia 17 = other (deafness, dyspraxia, scotopic sensitivity, non-specific learning difficulties) No student mentioned ADD/ADHD or difficulties of an attentional nature

General Difficulties at University Exams – can’t concentrate, unable to write fast enough, anxiety beforehand, poor memory and short attention span Lectures – concentration problems, short attention span, easily distracted Time management – too many deadlines Organisation problems Poor study skills Literacy problems Lack of motivation Memory problems – poor short term memory, slow learner

Why not sought help? Discrimination – don’t want to jeopardise career by being judged or labelled Asked but didn’t receive help Don’t know where to get help from Embarrassed, lack confidence Feel others will laugh or see as laziness It can’t be helped – need to try harder, work faster, do more practice, pay more attention Thought it was my problem that no one would be interested in helping with

Summary and Conclusions

Summary 1 High incidence of undiagnosed students in ‘at risk’ categories for both dyslexia and ADHD characteristics No correlations between achievement data and dyslexia scores Strong negative association between CAARS scores and academic grades UCLan 2 nd Year module results indicate that specific modes of assessment (MCQs) may pose particular problems for high inattentive / ADHD scorers

Summary 2 Suggests a need to focus on the identification and provision of support for students with problems related to ADHD characteristics – implications for organisation, note-taking, focusing in lengthy lectures, etc. Indicates that many students, other than those who ‘declare’ learning difficulties would benefit from further support Concerns from student comments regarding their reluctance to seek help and the response when help was actively sought

Future Directions 1 Continue to analyse different assessment measures in relation to dyslexia/ADHD screening results e.g. exams, MCQs, coursework Determine whether departmental differences exist – i.e. whether results dependent on subject/course specific areas Look at feasibility of incorporating results into existing systems (e.g. CLaSS Project) and improvement of other existing student support mechanisms

Future Directions 2 Incorporate findings into staff development programmes Identify students who perform well academically and who score highly on the rating scales in order to identify strategies that may be of use to other students (mentoring, incorporation into CLaSS Project, etc.)