Extended time on Tests and ADHD

[@TashkaGrace]

I think everyone is different in their struggles and also where they are in life. I have just been diagnosed at 54. I have 2 degrees. I didn’t finish school as I wasn’t learning anything I was interested in. Went to university at age 41. I took three times longer than everyone else but got through my exams. However, having completed masters where most things were assignments, I then tried to do my final national registration exam after a couple years internship. I couldn’t even complete the exam. I thought I had early onset dementia. Turns out I have adhd but had been going through menopause. All the struggles I had before were suddenly so much worse.

[@readeral]

Diagnosed as an adult with ADHD, I’ve already completed two university degrees prior to diagnosis, and have a few anecdotal subjective thoughts about this. I certainly don’t feel extra time would have been appropriate accommodation for the struggles I personally recall I had, but sustaining focus for exams that were sometimes 3 hours in length in some cases, breaking the papers into subunits and assessing them in discrete blocks of time would have been a far more appropriate accommodation. Even if it meant sitting alone for 30 minutes between sections, and accepting that each segment only received the discrete allotted time (meaning maybe your best-know section couldn’t claim that little bit more polish time), that would have been a godsend. Time blindness and/or hyper focus meant whole sections of a paper were missed (or given a 15 minute scrawl so it didn’t void the whole paper), and once my attention tapped out, every disturbance, every leaving student, and every opportunity to second guess my chosen essay questions created panic. I wanted to be assessed on what I knew, not how well I survived the unnatural exam environment.

[@readeral]

In that sense it’s extra time because you get a breather, but it’s not extra writing time, and without a knowledge of the next questions, it’s not extra preparation time either.

[@marisalucian9490]

Personally, I had extended time, and it helped a lot. What also helped was the fact that I was allowed to take breaks during long tests.

[@anyone98]

Great idea! Tests broken down into individual components where you're only allowed to see and work on one section at a tme would have been so much better for me. Break times in between I could do without

[@onemillionpercent]

@@marisalucian9490Same here.

[@readeral]

@@marisalucian9490 I can understand that, if I had extended time it _would_ have helped a lot, but that's essentially Russ's point, the longer time clearly helped in an inequitable way when observed in this particular referenced study. I anecdotally felt that extended time wasn't appropriate for _my_ difficulties, but there were some things that would have been equitable accommodations in my case. I'm glad accommodations gave you success!

[@juniper76]

My teen (in high school) has a lot of difficulty getting their thoughts down in writing for essay-type assessments, so it takes them much, much longer to write an essay than their peers (even with 1 to 1 support, which they don't get during exams). This was one of the reasons a teacher last year suggested we seek an ADHD assessment. So, for exams with an essay component, extra time is definitely something that would "level the playing field" rather than giving them an advantage. The support plan we now have at the school specifically says extra time is not needed for maths or short-answer exams. (I had the same difficulties at school and often failed to finish essays during exams; I also got my diagnosis in the last year.)

[@fvsch]

This matches my experience in school (especially high school and college). For sciences and multi-question exams, I almost never finished early, but I was nowhere near as rushed or late than when trying to finish essays. When we had to compose essays, there were many 4-hour exams where I spent one hour reading and thinking, 1.5 hours scribbling notes and trying to come up with ideas and an outline, and a final 1.5 hours of frantically writing the actual essay. Oftentimes I had to merge the third section of my outline and the conclusion into one abridged conclusion in the last 10 minutes, running on pure adrenaline.

[@lilly_koii]

extra time was definitely necessary for me and many others with ADHD in classes like physics and calculus because of issues with word processing speed. i think it would be rash to take away even the option of accommodations based on this alone.

[@hermanmusimbi4337]

Perhaps extra time may be needed for individuals with CDS. You could have that alongside adhd.

[@Baconlessness]

I feel like if this was a common experience across the board, these studies would have picked that up. As someone who went through a physics and maths based degree with untreated and unaccommodated ADHD, I feel that extra time would absolutely have given me an advantage. Would that advantage have compensated for the incredibly inefficient study practices, late assignments and neglect of practice exercises that contributed to my personal underachievement? Probably, but isn't better if those issues themselves are addressed directly rather than handwaving a vague compensatory concession like extra time? I can understand that the conclusions of these studies can really feel invalidating, like you achieved a better grade that you deserved, but I don't that's true. Like I said, extra time probably levels the playing field somewhat by compensating for the main shortcomings of ADHD, but it's too indirect and bodged to be a good solution to our particular set of problems.

[@pavithrarajan178]

What is CDS?​@@hermanmusimbi4337

[@vans4lyf2013]

I completely agree with this. I got diagnosed with ADHD as an adult after completing multiple degrees and never requested extra time during exams because I was a beast at exams, as the adrenaline was high so I could hyperfocus easily on the test. What KILLED me in school and still as an adult was project work. That's where my ADHD comes to shine and destroy me. Having to self regulate and break down projects and do it consistently feels so impossible for me. It destroys my career as I'm in a research oriented field which requires solo project work. That's what led me to diagnosis. The accommodation for this in school was a week extension without penalization, which doesn't help at all as the problem isn't the deadline it's the self-regulation skills to do the work consistently prior to the deadline. A true accommodation would be several smaller deadlines, to help us break up the project and achieve the milestones.

[@bellyfulochelly4222]

You're right. That's the accommodation we need.

[@PebblesandMac]

I think it is different for each ADHDer. I had extra time on exams in university, and I didn't really need it for multiple choice, but I did need it for written exams. Any time I need to write, it takes me so long to focus and sort my thoughts, then decide on what to write, all with distractions in between. Then, once I've written a few words, I forget what the rest of the sentence was going to be, so I have to pause and remember... So for myself, I would argue that I genuinely cannot write as quickly as non-ADHDers, and having extra time was truly 'leveling the field' for me in the case of written exams.

[@rosemarymartinez6709]

I agree and relate to this. Multiple choice I’m so impulsive and tend to go by my first gut instinct so I actually complete my quizzes and exams earlier than the original time given to the whole class. But reading and writing takes me longer. I have to reread a few times and then sentence structuring is also time consuming for me. I’m constantly erasing and rewriting.

[@martine5716]

As a mature age uni student I don't have too much trouble with multiple choice or short answer questions so long as I take my time to read the questions properly the first time. Long answer questions are where I fall in a hole because I need time to organise my thoughts and that definitely takes me longer, especially now I'm in perimenopause.

[@JonBrase]

During my academic career, exams saved my grades from the piles of undone homework. I kept hearing my peers freak out about not having time for something called "stuh dee ying" before exams, and never understood what they were talking about.

[@m-yday]

oh my god I FEEL this.

[@voikalternos]

I am not sure if it's due to my ADHD (& might have a factor of CDS), but while I am doing exams, I very frequently forget my trace of thoughts. In that case I would need to go back to the question, re-read everything, and try to pick my thoughts back up from there. Noting things down helps for picking thoughts back up, but doesn't stop myself from completely forget my trace of thoughts. It happens to every question in the exam no matter it's easy for me or not, and even several times during the same question.

[@sfstucco]

I have the same thing. As soon as I think of the next sentence or formula to use in a problem, P O O F !! It’s gone. Back to the question (or prior sentence or my guiding outline I scribbled) & start over again. Round & round & round she goes! Ugh! Some of us have such stunted Working Memories, we can hold less than half of what most people do. If I “raced” to finish a calculus test, e.g., then I would get 30% right. If I took the time I needed, I finished only 30% of the exam (but got those answers right). I could answer all the homework questions that my fellow pre-med, straight-A dorm-mates couldn’t figure out, but I couldn’t pass the tests. Flunked out of a very good university. It was devastating. Many years later, trying to resurrect my attempt to graduate, a teacher allowed class members to take extra time for an exam & take it in the Library or outside (Quantitative Analysis class, oye!,), as she was just learning about Learning Disabilities. I took 4 hours (normally a 1-hour time limit was given). I didn’t even review my answers, and I got my first A ever in this sort of class (that I have major struggles with)! I had never, before, gotten above a C.

[@voikalternos]

@@sfstucco I can relate so hard. I rarely get above C but I am able to solve the hardest questions given time. It is so frustrating going through the loop of forgetting with a tight time limit knowing I’m able to solve everything.

[@sfstucco]

@@voikalternos - I feel you! It IS so frustrating. Have you not arranged for extra time in school for taking tests? That is a mandatory arrangement in the U.S. if requested (or diagnosed??), isn’t it? Or are you in a different country? It’s a new school year. Please, if you haven’t already, get that accommodation for yourself, if it’s available. Perhaps you have to go through some testing, but it will be worth it. I didn’t have that possibility when I was in high school or university, and it could have made a H U G E difference in my life. Confidence builds with being able to perform according to one’s knowledge & ability, and it keeps building, and a person’s ability to manage life builds. In the cases of people like me who flunked, we spend so much energy dealing with the trauma, with all the negative and doubting self-talk that runs endlessly in the head… “if only…”, “can I?”, “I don’t deserve to do what I want,” “I guess I’ll just get a stupid job to get by…,” “what should I do with my life?”, etc. Our personal growth gets stunted. So that’s why I hope you are or will use time accommodation (& any other helpful accommodations).

[@Saintly2]

For my work, there are constant assessments and standardized tests for us to advance. I used to struggle to finish because I’d get stuck on understanding a question or how or what I was supposed to do. One time it took me 30 minutes to figure out how to respond (high level government tests at the levels I’m applying for). I was just about to give up & then remembered they’d granted me 30 extra minutes! I managed not to cry over my frustration and finished that test with a good score. This accommodation HELPS me so much and am grateful for an employer that has a duty to accommodate. For me, it’s not just extra time it’s time that allows me to comprehend fully what’s required so that I can then best show my abilities. Without it… I’ve not been able to finish tests, had to guess what’s needed, guessed at answers, and repeatedly done badly. I’m excellent at my job… and now I can communicate this when I’m tested.

[@amphibien8264]

My experience with extended time is that it’s important for higher level math courses (Calculus) when medication isn’t improving working memory. I needed extended time to neatly show my work, do math that others could do mentally, and avoid mistakes when it comes to working memory. However, once I got on the right medication that addressed those issues, I definitely found extended time to be advantageous and detrimental to my overall learning because it allowed me get away with less studying. I will no longer be using accommodations. It did take me over half a year to get on a medication that addressed my working memory issues. Stimulants did not work for my working memory (co-morbid anxiety), and I had to switch to Straterra to finally move past the need for accommodations for higher level math. Other courses, I did not use extended time nor did I see the need to use them.

[@JonBrase]

Interestingly, my dad is where I got my ADHD from, but his ability to do mental arithmetic is far beyond mine.

[@alexdrockhound9497]

I agree. Helped me a lot with my calc classes and some of my engineering classes.

[@amphibien8264]

@@JonBrase I suspect it might have to do with CDS in my case.

[@bluebasset8738]

My thoughts on this after looking at both articles as a college student with severe adhd: The first study you showed, while it did show higher test scores for individuals with adhd even at standard time, the sample was 76 individuals from a private university, which I feel might increase the odds of people being incorrectly diagnosed with adhd being admitted as there is no shortage of college admissions scandals where children with rich parents at private schools fake symptoms in order to receive increased test time. Another limitation, with both the first study and the meta-analysis you showed after is that even the meta-analysis mostly only looked at scores on reading comprehension, with very few looking at writing, math, or more complicated exams. I feel like for me personally the problem is more with my ability to use long-term recall of things I already know and to hold multiple things in my head at once, examples: I read a lot, and have a fairly high vocabulary, if you were to show me a word and ask me what it means I would be able tell you the correct answer nine times out of ten but if you were to ask me to recall a specific word when writing a long essay it would either take me a significant amount of time or I would have to use a thesaurus. Math in particular is a nightmare for me, as it requires me to juggle multiple parts of the problem inside my head at once, and I will frequently understand how to do the problem and end up getting it wrong on the exam anyway due to one piece or another of the problem falling out of my head as I do it, resulting in me getting the wrong answer. In addition, while the first article used the interaction hypothesis (which assumes the person with disability scores lower with regular time and will “catch up” to his non-disabled peers) the meta-analysis hardly mentioned this and seemed to go with a rationale which states that accommodations are reasonable so long as disabled peers benefit more from extra time than do non-disabled peers, i.e. they receive a “differential boost” as the article put it. This rationale seems flawed from the get-go IMO, it would seem logical to assume that if you give them both extra time the non-disabled peer would still do better, their brain works better on a default level, so of course given the same amount of time they would do better. A better question to ask would be “what level of extra time given to disabled peers normalizes their test scores relative to the level of non-disabled peers” which is what the interaction hypothesis tested. Another thought I had was about some of the info in the meta-analysis which stated that people with adhd actually used less time for their exams than typical individuals. It might be true that they “used” less time but that’s not the same as “needing” less time. It could be that their decision to use less time was a hasty, poorly thought out decision brought on by lack of emotional control from adhd, and that had they actually used it they would have scored better, would be interesting to see statistics on those who use their full allotted time and if it allowed them to score better, as well as on different populations other than the 18-24 demographic, perhaps older individuals with adhd would have more wisdom and patience to use the extra time allotted and it would benefit them more. It’s not like I’m completely opposed to this being true, for example if many repeated studies found that 25% extra time was the amount required to normalize test scores for the population I would be fine with that, I just would like broader studies which include things like scores for the entire SAT rather than just a reading comprehension test with bigger swathes of the population studied before this was used as evidence to remove additional testing time completely. For me personally, it’s the ability to delay taking the test a couple days rather than additional test time that really helps since my brain for whatever reason refuses to cooperate and study except in the last few days before a test. I think the ability to get extra time for late assignments would probably be the biggest boon for me as that can mean the difference between getting a 0 or getting a full grade. The suggestion in one of those studies to have a proctor sit by you as you do the test, or even extending this to include having them watch you do your homework in front of them I think would help boost people with adhd’s gpa tremendously. I wonder if focusing on accommodations for homework/assignments would have a better impact on gpa than accommodations for tests, would be an interesting thing to have people study.

[@CloroxBleach-rq3me]

I'm a student with ADHD and I never liked the idea of extra time accommodations, nor did I seek it out. I'm glad that the scientific literature supports this.

[@MaryMcKeown-it4kn]

I was finally diagnosed with ADHD at age 40 when I was in nursing school BECAUSE I had difficulty getting all of the reading done. I had to read everything two or three times, so for me, more time would have helped.

[@unnotabelle]

When I applied for accommodations from my university, I wanted two things - to be allowed 'time off the clock'/rest time and to hand-write my exams. I got extra time and the ""special"" permission to type my exam (when the default mode of completion was already typing). I actually fought with my disability coordinator to NOT give me extra time and allow me breaks instead but my school refused to allow it. Frustrated me to no end that I wasn't trusted to reliably convey what was actually an accommodation I needed.

[@Robert.Marshall]

Recently diagnosed last month at 54. I started college(for the 4th time in 35 years) a little over a year ago part time while also working. I was always running out of time on math tests. I did get an accomidation for adhd extended time on tests for this and future semesters. But that is also based on my undiadnosed/treated study retention of the past. Im anxious for this semester to progress to see if treatment is going to help with attention and focus, and the extended teats times are there if i need it.

[@Handle8844]

I think you mentioned in one of your books -- I cannot remember which -- that a "movement break" in the middle of a test is a more appropriate accomodation for ADHD students than is extra time. I am glad that you bring attention to these studies that show extra time as an ADVANTAGe rather than simply as a levelling of playing field. I hear a lot people who are skeptical of ADHD suggest that we only have our children assessed/ diagnosed because we want all sorts of financial benefits and extra advantages to help give them a "leg up" over other students. I, and most of the parents of ADHD children I know, receive ZERO financial benefits (unless you count ADHD medication, since any and all medication for children is "free" in my country) and only want accommodations that are fair, not those that give unfair advantage. By being honest about which accommodations do no more and no less than level the field, we can show that we are trying to do right by our children, not "game the system. Another great video, Dr. B. Thank you. 💙

[@relaxedanchored]

dang, this vid hit hard! Been messin with ADHD stuff for a minute, and it’s wild how we all got different struggles. Big ups for breaking it down like this, makes me feel like I ain't alone in this mess. Keep doin’ what you do, fam

[@wilaustu]

I didn't need more time on multiple-choice tests, but I did for exams that involved writing in response to a single essay prompt. In French high schools, there are several written exams of this nature. Some allow up to 4 hours to write your essay. Most of my classmates would be done after 1-2 hours, but I would always use the full time just to write 3-4 pages.

[@GoezTo11]

I never had difficulty with tests. I usually excelled at high pressure difficult tests. The challenge and restricted time made it easier to focus. If I had difficulty with a particular test, it was more likely due to having difficulty studying. I had the most difficulty getting homework assignments and papers done. I often used tests to save my grade from poor marks in homework assignments. (I've only been diagnosed recently and didn't know I had ADHD at the time.)

[@JonBrase]

What is this "stuh dee ying" you speak of? 😂 Seriously, though, I generally aced my tests in half the allotted time with no studying.

[@alexdrockhound9497]

Depends on the complexity of the test. Extra time definitely helped me in some of my engineering classes.

[@readeral]

Similar for me. The effect of late submission penalties on my paper grades often pushed me further away from a high-distinction result than my actual base assessment did. (i.e. I might've scored a 76, but with a late submission, would only end up with 65)

[@HowndsOfDoom]

Wow! I've been tuning in to the best source for reliabilie info on adhd for over a year!! Pirate day already? Wow!

[@Chriztina97]

I wrote a 2.5 hour exam last week. A different chair would have been ideal. I tend to change positions a lot and the chair had a curved up seat on the sides which basically forced me to keep my legs together and forward which was not comfortable and I got restless. I've worn foam ear plugs for my last 3 exams and I'm convinced they would have made a big difference for me in high school and earlier college and university tests.

[@omalou42]

Love your videos! It takes so much longer for my brain to download the information, that when I was in college, I would just skip the questions I didn’t know the answer immediately. I would finish before everyone thinking, that if I did go back to look over the skipped questions, I still wouldn’t know is the answer. I wish I knew then what I know now, things would have been better. I would have graduated, I would have went on to finish all of my dreams and graduate with a PhD. Now I have to be ok with the “some college”. lol

[@mrguysnailz4907]

Seems like one of those cases where an ADHD - CDS differential diagnosis is important. I'm diagnosed with ADHD-PI (I think "subtypes" are still standard practice in Portugal, I might be wrong) and I didn't finish most of my tests in university. In fact, in the Portuguese end of high school exams (user for university admission), I got 100% on all questions except for one that was worth 5/20 points and I didn't manage to write more than a third of it. I ended up scoring 16.2/20 - a decent, yet unremarkable B - if I had been allowed an extra 10 minutes, I would likely be within the top 3 test takers in the country.

[@sfstucco]

Painful, isn’t it? I flunked out of a good university(back in 1981, before there was any talk of giving extra time - that would be 10 years later) because I needed about 2-3 times (more for essay answers) the normal time to finish many exams types*. I didn’t know how intelligent I was (so much over-compensation, just to “survive” must have really stretched my brain!), because I had so many failures. But over time I added up all the signals, and I realized I could have been just as successful as the top students became (had I been given the time I needed to complete exams). Once, when I later tried going back to university, my Quantitative Analysis professor allowed students to take as much time as they needed on an exam that I didn’t study much for. It took me 3 hours instead of 1, and I got my first “A” ever in that *category of exams. I never got above a “C” before. It was gratifying. But by then my psyche was too damaged and life has been a big struggle, though not a total failure ☺️. (*Exam types like formula-based/problem-solving types, like Calculus, Physics, Statistics; and essay questions.)

[@floveslondon]

I can imagine that the extra time doesn't really help a lot to increase the acquired result. When I do get extra time on an exam, I do feel so much more at ease because if needed I do have more time, and no I almost never actually use it. But, it does make me feel heard with the professors and counsellors, instead of just being thrown for the wolves. And even with that extra time, I still have 3 resits this year and I had 3 resits last year, 2 of which I had to completely redo this year. So maybe it would be better to give us more time or other tools during the year, and then give us the same time for the actual exam. I'd rather be heard in other ways during the year, by them making decent lessons, give good instructions and to tell us what they expect form us during the exam. Most of the time I only know what they really want after I've done and failed the exam 😅.

[@GreenSharpieScience]

I’m really not convinced by the first studies logic. They are presumably sampling a college group from the same college. The college admissions etc have already selected the cohort based on having a similar aptitude for standardized tests/grades/academic function. In doing so it has preselected adhd students who already fair as well as their neurotypical peers on such tests. I’m sure extra time benefits both groups, but it’s definitely not a sound rationale to remove extra time from students w adhd.

[@Imperial_Squid]

I half disagree, they don't have a _similar_ aptitude for tests, more that it's they both meet the _minimum requirement_ in such tests (eg no test ever has passed an ADHD student for getting a B but failed a non ADHD student for getting an A), this is a weaker statement than actual (or near) equality in aptitudes. It also should be noted that both papers explicitly state that the results are about college students, in the titles no less, so they should be used in regards to that setting. Extrapolating it out to the whole population would be a mistake I'd expect of a non-researcher journalist type looking for quick clicks with poorly supported arguments.

[@imthinkingthoughts]

I am likely going to die sooner, have to pay more in medical bills, get emotionally affected more than others, ruminate more than my peers, struggle to plan etc. ill take a couple extra points to make up for it bahahahaha

[@connorhillen]

But this is here to challenge those exact circumstances. Students with ADHD, at the same level and with the same entrance requirements, can receive as much as double test time with accommodations as peers in the same class, and this is stating that this gives them an advantage, not just equalizing. That also means that someone of lower academic function without ADHD, if given the extra time, gains the same advantage when provided with more time. Additionally, as an instructor in a department with very high highschool grade entrance requirements, I can certainly say that there can still be a vast difference in general academic skill/test taking capabilities for sure.

[@weirdo3116]

​@@connorhillen I'd assume the main rational for giving extra time for ADHD students is that they are more likely to have lower academic function than non-ADHD students. Specifically because of their ADHD. Granted they should probably instead be put on medication and then be given some amount of time to increase their academic function while on meds. Instead of just being given extra time. But if for whatever reason the student isn't able to get onto medication then I would assume extra time would be warranted.

[@BrothireStrangLuve]

@green pseudo science you are the abuser who calls students with adhd "crap people". never forget, never forgive. We know who you really are.

[@Luminon87]

I think the idea of extra time on tests being a good accommodation for ADHD goes back to misconception that ADHD is about inability to focus. If you frame it as a problem with executive functioning and emotional regulation instead you'll realize that ADHD students are going to struggle with self-directed studying, keeping up with reading and coursework etc.. Extra time on an exam isn't going to help you if you struggled to do the prep work, and in fact I suspect that a lot of students who struggle with this will drop out, perhaps confounding research results.

[@vans4lyf2013]

Exactly! Those difficulties are the things that should be targeted for accommodations not exams.

[@rebeccat9389]

Fascinating! I homeschool, and when offering my ADHD son extra time on tests, he has never needed it. We tend to mostly do untimed tests, though, but he flies through them lightning fast anyway. Which I guess makes a certain sense, doesn't it?

[@blamedthegnome]

I have found that whilst the time pressure and challenge of an exam are typically sufficient reward motivation for me to be able to focus more easily, for longer questions and questions that require a structured or planned answer I do tend to struggle towards the end of the exam to the extent that I have run out of time before on these types of exams. Perhaps a break where no progress on the exam can be made - i.e. a chance to step outside the exam hall - would be more appropriate an adjustment. I wonder if more time on the exam could be viewed reasonable accommodation for people with ADHD who find the studying for the exam more difficult. It is reasonable to assume that lengthy planned study is challenging, and so whilst not a specific reasonable adjustment, it could do a little to offset the additional difficulties ADHDers likely encountered during studying normalising the expected exam performance based on the ability of the individual.

[@ab.122]

Inner perception of time meaning internal clock got better for me after adding ssri to my concerta. I used to blink and time flies .

[@Abbie.Normal]

My curiosity has to do with this: I am adhd and I find when I'm under the wire, I can activate a lot of buttons. That doesn't mean I'm thinking about the buttons. How do we know the adhd students didn't breeze through without paying enough attention? I would be curious to see a study that tested the scores of adhd students under time limits, verses shorter ones. With a control group too of course. How many questions you can answer doesn't seem like the only metric of 'access'.

[@FriendofWigner]

I've never understood extra test time. I never had a problem with tests, it was always homework. If I have four weeks to complete a report and presentation, I am going to flail wildly at the last minute. If I have three weeks of discrete assignments that culminate into a report and presentation in the fourth week, I will do well. I think it is more like outsourcing the chunking and organization. Tests were sort of a do or die situation; I figured I would pass or fail, so I go in do my thing for an hour with no stress.

[@jonistidham4278]

Depends on the type of test for me- if there is a lot of reading or writing involved, I need the extra time. I have to re-read questions so many times 😫

[@JonBrase]

When I was assesed for autism, my (already known) ADHD was also assessed and a "severe" qualifier was added. The diagnostic report recommended "extra time on tests" as an accommodation. This was a complete joke for two reasons: 1) I've been out of college for almost a decade and a half. 2) My ADHD actually supercharged my academic career: I spent much of my time in school reading ahead in my textbooks instead of listening to the teacher, so I was years ahead of my peers before I was even out of elementary school. This allowed me to ace exams without any studying (having generally "studied" years prior), which meant I only had to average a C on my homework to keep up a B-ish GPA, which generally kept the adults off my back. This allowed me to leave a good chunk of my homework half done in favor of having more free time at home.

[@banditabout9749]

I believe that I would have benefited from being allowed to enter the exam room early rather than giving me extra time to do the exam. Allowing me to read the exam paper (for the exams that I would be writing an essay for), would allow me to focus while reading it because I do struggle with reading when other people are around. This would then give me time to write my own notes to refer to while writing the essay. Once the rest of the students were allowed in I could then start the exam with everyone else and not been one of the last to finish, which in itself can cause additional problems in concentration due to anxiety kicking in.

[@JohnNumber5]

Reading on a computer during tests has proven challenging for me. I need the extra time. I can’t tell you why but it is real. ADHD and digital content don’t mix in my case. I don’t think giving extra time on tests is an advantage as we need it to try and organize our responses so they look more normal to aleviate bias.

[@helenavascouto6875]

Do you use some medicine for ADHD?

[@nickm2677]

I completely disagree with the studies recommendations/conclusions. As someone who provides students with disabilities accommodations, I’ve seen a tremendous amount of success by providing extra time for adhd, LD & even mental health diagnosis. I think what makes it unfair is when the students take advantage of it but that’s where institutions need to have strict guidelines and procedures to help support this accommodation. So having an adequate assessment centre.

[@ladyoftheflowers9781]

Agreed! Studies like these prevent the academic support for students with ADHD.

[@ukirichuful]

I was diagnosed in med school (with autism too, a 2 for 1 deal 😂), and although I did apply for accommodations to get extra time, I never needed it. The times I did dip into extra time were because I rushed through the exam and needed a break. I’ve always been a fast test taker, for better or for worse.

[@jeffwheatley5291]

Key points: 1) This is a paper about College students, not high school or younger. Until we see research addressing the difference between these groups, I wouldn’t apply this to anyone younger than college. 2) I agree with Dr Barkley’s comments from other videos where he asserts that it is more important to give ADHD students breaks rather than more testing time. 3) I also agree with some other commenters who say that the pressure of testing seemed to help with paying attention and being able to complete a test… as long as it was mostly multiple choice or short answer.

[@Tamperkele]

What I thought was helpful was having the test split in two parts you did on two different days. But in future I'll certainly ask for extra time if I ever need to take a test for something.

[@sfstucco]

IF THIS IS really TRUE (that ADHDers don’t need extra time), then a * LOT * of us NEED to be CLASSIFIED as LEARNING DISABILITY peeps. I suspect this concept needs re-studying to separate us WM-deficit people out from other ADHDers if others don’t need extra time. I definitely have a big deficit with Working Memory. It’s my main problem. Not just that it “doesn’t work,” but that there is a big difference in how much I can hold. I figured on my own before seeing a research paper producing the same numbers: That I can “hold” about 3.2-3.3 mental task “units” when cognitive processes other than pretty simple ones (e.g., decisions, analysis, hearing someone speak and holding on to a novel thought, etc.) require about 7 units. Most people can handle 7 units. Exactly how Executive Function figures into this, I haven’t pinned down. Maybe there’s no room in the WM for it. But it feels a like it’s a little more than that (like it’s separate but connected, and definitely not functioning).

[@connorhillen]

Late diagnosed, and now a lecturer; I would be curious to see if extra time explicitly for a break would be more valuable. Being able to take a few minutes to stand up, walk around, and get back to it would have surely made a huge impact on my focus during lengthy exams, though the transition between stopping and starting would also take time. What I'm most curious about is if even this would have the same impact on a non-ADHD student - sitting and writing a 3-hour exam seems like plenty challenge of focus for anyone.

[@leilaschafernak-perez8814]

Started first day junior year University today. Already feel like I’m overwhelmed and idk how to handle life. Meds often feel like they don’t even help. Being a woman especially (cuz hormone fluctuations = even worse functioning) w ADHD really really sucks.

[@stoneneils]

OH MY GOD. I 100% completely forgot about this symptom cuz i"m in my fifties but OH BOY...i'd start out like a champ then lose interest in the test and space out for an hour..then the warning bell would ring and I'd be guaranteed my faithful 62% pass rate lol...i always just made it by the skin of my teeth.

[@anyone98]

What kinds of tests were considered? Different test formats present different degrees of planning and organisation challenges. eg. write 5 essays vs answer 100 short answer questions - in many cases the essays might require more planning and structuring and editing on the fly. Also does the topic lend itself more to recall and application or integration of concepts? Challenges of a physics vs philosophy paper are different. And intuitively a test that has multiple questions that are open-ended, novel and require integrating multiple concepts (perhaps rare for a college course...) would be easier to lose track of time in as it's harder to estimate. Would likely be true for all students but I wonder how the 2 populations would compare for specific tests that challenge these skills

[@johnny1iron]

I just asked for extra time on law school exams. I never needed it for other undergrad or high school, but, for reasons I don’t understand, law school exams consistently take me longer than the time limits.

[@buikadjos3495]

People with CDS are slower in tests! So if there are accommodations for other conditions, there should also be accommodations for people with CDS.

[@zecchinoroni]

I needed extra time on certain types of tests only, and it was only indirectly tied to ADHD. It was actually because of checking-rechecking OCD I developed as a coping mechanism for my lack of attention to details.

[@jeremybird5739]

Personal experience of someone with ADHD and maybe a learning disability (I was always thrown in with the remedial group) I run out of dopamine before the end of the exam time. After an hour I'm thinking as much about getting out of there and moving around then taking a nap to reset than I am on the exam. I never once used extra exam time when it was offered.

[@DarthKrafter]

As a Current student at univerisity, I have never struggled with reading and comprehension, but where I truly find my ADHD impairing is for Math, History, Or any class that requires active recall/working memory and studying. Also, if more time does not level the playing field, what accomidation would?

[@cheryll993]

I think these studies fail to account for both exam types and situations that may disproportionally impact the scores of ADHD students * working memory - for example, if struggling to access the same level of working memory "slots", someone with ADHD completing an essay exam where structure and making points in correct linear order is required for full marks, extra time and paper to plan before execution to make sure they have gathered all points may be leveling the playing field against someone who otherwise has enough "slots" to store all information at once to get it in order. * working memory and context switching - where an exam has many topics and may chop and change, students with difficulty switching trains of thought may struggle switching between questions on different topics, where extra time may give processing time for this, or the student could be accomodated with either a better segmented exam (questions 1 - 10 on topic A, 11 - 22 on topic B), I know you've mentioned movement breaks before and that could be helpful too, as could providing the questions one at a time * stress response - obviously not ADHD specific, but with discussions of emotional disregulation, ADHD or others with emotional regulation issues may be more impacted by a stressful exam, which wouldn't be accounted for in a "mock exam" environment * distractions - those with extra time often were in a room on their own or with a few others, where commonly exams were in giant sports halls, which can be very distracting even in exam conditions Personally, I've always been sluggish at completing things as I have to mentally convert to something that will be generally understood and struggle to write to a generic "audience" or remember the required buzzwords of common exam scoring, combined with the stress of exams, while I was taught well how to approach them (skim the questions, answer the easy ones, work through and manage time), I frequently missed things through sheer oversight. I'd love to see more suggestions on reasonable accommodations for different ADHD struggles, and similar studies extended to those not in further education, as one would assume those with ADHD in college are able to strategise and manage tests well enough they are not disadvantaged by testing conditions - maybe with those who failed to get into college, extra time would have levelled their playing field.

[@SebastianMicalizzi-t4q]

Hi Dr. Barkley, I am curious to know if there is any scientific literature addressing extended time for homework and projects. From my experience in college, exams were less of an issue than meeting deadlines. Regardless of the exam time, I either knew the material or didn't. As I progressed in my degree, assignments and projects had increasing complexity; dealing with issues such as time blindness, low working memory and executive dysfunction made these deadlines especially difficult to meet. Having a couple extra days was a godsend at times, but I understand that applies to anyone missing a deadline, regardless of ADHD! If extended time for non-exam assignments has been looked at, I would be curious to know how that compares as an accommodation versus an advantage. Thank you for all you do!

[@zecchinoroni]

I really think this should be taken on a case by case basis. Some students may need it.

[@ytmndan]

I have always wondered what my SAT score would have been if I had been given more time, or had I been diagnosed and treated in childhood. I got an 1150 out of a possible 1600 (71%) at the time, but only answered about 75% of the questions in each section before time ran out. I know the questions get harder as you get closer to the end, but I wasn't even struggling with the questions themselves yet. I felt like I was flying through them easily, and then suddenly the time disappeared out from under me.

[@lemoorian4549]

Hi Dr. Can you do a video about adhd and smartpen/recording or note taker accomodations?

[@goktugdemiralp]

So this begs the question, how do we accomodate for suspected students with ADHD and do not have access to medication due to financial constraints?

[@elizabethhenning778]

(1) What about breaks during exams as an accommodation? (2) Is there differential performance with extra time for exams in mathematics or other subjects which require particular attention to precision?

[@jordanwhittle8713]

Wouldn’t there be a difference in how this could affect different individuals with ADHD? It sounds like it would be difficult to truly answer this question broadly without going deeper into how individuals are affected by their ADHD. As I understand it, some people with ADHD will spend far too long on certain tasks because they are trying very hard to avoid careless mistakes or missing important information but this is not the case for everyone with ADHD. I think it’s linked to anxiety stemming from past experiences making careless mistakes and such. An example might be spending hours iterating over multiple versions of an email until they are certain they haven’t made any mistakes or missed anything important out. Then they find something important they forgot to include and rewrite another version to accommodate the change, reinforcing that behaviour. I might have misunderstood something and maybe that kind test would show the same results regardless but I’m wondering: Could extra time be an advantage for those with ADHD who *don’t* have this behaviour and a reasonable accommodation for those with ADHD who do? Both may be capable of getting through all the questions on a first pass since that’s how school teaches you to approach tests/exams. Someone with ADHD might know to read and answer questions quickly to ensure they’ve tried to answer all questions but later upon rereading discover that they’d missed key words in the question and have to rewrite their answer. Anecdotal story time: I had a test once where there were four long-form questions each worth a lot of marks. I knew I had to work quickly and I managed to answer all questions with plenty of text suitable for the time I was given. At the end of the test time, I found out that the instructions said to *choose two of the four questions to answer* and those two would be the only ones I’d get credit for. I got a terrible overall score because I’d effectively wasted half the time answering two questions worthless questions instead of giving more detailed answers to the others 😁

[@ADHDResourceSpecialist]

My son is at RPI, nuclear engineering. While extended test time really doesn’t help him all that much, what would be critical for him is to be able to take LESS classes(same content, info, and intensity) at one time but to keep his full time status. To be able to self regulate, motivate and self evaluate is virtually impossible when he’s bombarded with so much intense, loaded work and information. RPI says that “they don’t do that” which was shocking to me, as this has always been his answer to success. When you put too much bulk in front of him at once to organize and ingest, his executive skills peter out quickly and throw him onto major anxiety . I’m curious if it’s even legal for them to say no without exploring the question with us. Does anyone know or have any ADA links to this answer?

[@publius9350]

Exams are the only time I do well. Give me stress. I want more understanding when I have lost track in the middle of a couse - what happened last week that this week is based on? I thought I could take a break and things went past me.

[@lemoorian4549]

I'm assuming the second study's mention of other mental health conditions would mean that students with major depression (whether or not comorbid with adhd) are not accomodated by extra time either?

[@drgillykahn]

This could be totally off, but two thoughts: (1) how would this look on a math test, (2) how would the results look if they compared difference/change scores between ADHDers performance (ext time - std time) and the controls groups performance? That is, did the degree of their performance significantly differ when compared to controls?

[@HowndsOfDoom]

Actually, I sort of get it with accommodations for ADHD, I'm UK based, here ADHD while impairing for many of us with plenty of negative impact in the eyes of the law/social services etc it is not a deemed disability but a statutory one.

[@kstetson]

I have slow processesing speed and Dyslexia as well as inattentive type ADHD. If I don't have extra time, I usually can't finish the exam before the time limit due to it taking me longer to read and process the information. Is slow processesing something that most people with ADHD don't struggle with then? I feel like that would make a difference when taking tests. I usually do great on projects, and barely finish/pass exams when not given extra (1.5x time).

[@lemoorian4549]

What if the test is a homework quiz that has short answer sections or higher levels on the bloom's taxonomy?

[@barzinlotfabadi]

Yes, but that's assuming under standard test conditions, and if you have ADHD and confounding factors like plain prejudice, adverse childhood experiences, a society that has all sorts of problems in a world that has all sorts of problems, run by people who don't even want to acknowledge those problems or that they're responsible for creating those problems - that's a whole other issue. ADHD is comorbid with anxiety and depression, and this study makes the mistake of isolating the ADHD from the person.

[@m-yday]

is there any literature that recommends any specific accommodations? I have ADHD & Autism and suspected CDS. I'm absolutely struggling with course work in my degree, since consistently getting myself to work, time blindness, and other issues make it extremely hard for me to keep going. I notice I keep falling into a pattern of burnout and recovery. There has got to be something I can do to manage these things better. It's been incredibly difficult and despite trying so many different medications, I have felt no difference. Hopefully trying non-stimulants, as I have recently, will be different. But I would honestly take any inkling of something I could pursue to make things better. Accommodations or not.

[@therabbithat]

Sometimes I need extended time because I have to read the question over and over to make sure I haven't misinterpreted it. It depends on the type of test. With multiple choice I usually need extended time because it's all reading, I might be only half way through at the end. I usually get below 70 on IQ tests because they are multiple choice and I can never finish them in the time. If my IQ was below 70 I wouldn't be able to write this post. It sounds like everyone needs extended time. If it's an advantage to everyone, give it to everyone. Honestly usually that's the only accommodation available, they aren't willing to grant anything else to anybody for any reason.

[@jameswhipp3256]

I have ADHD and dyslexia, I wonder if these co-mingle at all to make it harder to focus and move swiftly through a multi-hour exam? As opposed to just dyslexia

[@LawtherJude]

Hello professor Russell，I'm a ADHD student from China，Recently I‘ve watch the video of your speech about"30 Essential Ideas you should know about ADHD",and it really helps me a lot. I do a lot of notes about that series of video and try to understand and use those knowledge into my life. But there are some of the content didn't show in the video cause it on the ppt and no camera for the ppt, So I am wondering if I could ask for the ppt of that speech, I will really appreciate it. And please forgive my poor English and grammar issue.

[@russellbarkleyphd2023]

Sorry. I don’t have those slides any longer. They were 12+ years old and morphed into other presentations you can find on my channel. Be well

[@LawtherJude]

@@russellbarkleyphd2023 Thank you so much for your response! I'll continue learning from your upcoming videos and I really appreciate all the knowledge and insights you’ve shared, it has been incredibly valuable to me. Wishing you all the best!

[@VGatorS]

I find this interesting and not terribly surprising. However, I wonder if the results are skewed because the population is made up of individuals who are at least somewhat academically inclined, as they've made it to college or are considering college, despite how ADHD hinders them. What I notice as someone who works primarily with children is that extra time is not usually that helpful. Rather, it's breaking the standard testing time over multiple periods with breals in between that actually works. I can only imagine what college entrance exam scores would have been had I been diagnosed and given that accommodation. I had a tendency to fall asleep or daydream during standardized testing, but I somehow pulled off high scores every time. You could always tell based on subscores which parts of the test were closer to the end.

[@asims9145]

I wonder if the ADHD students in the study were medicated, unmedicated, or both. Do you think that would make a difference?

[@JLJ7802]

I'd argue the study is flawed... On tests for which I was given extra time. I was typically able to attempt answering all of the questions on the test. On tests where I was only allowed the "standard" amount of time. I rarely made it past the first 3/4's before running out of time. Leaving 25% of a test blank. Definitely results in lower test scores.

[@RenanGallinari1]

Hi Johnny!

[@durschfalltv7505]

In school i always didn't do anythint until the lasts minutes of the tests where i ran overclocked. So i did a 2 hour test in 1 hour. Performance was shit. If i got 30' minutes more to correct them that would have me 2 grades better. But it i knew beforehand i would start 30 minutes later ahahhaaha

[@cornchip07]

bro don’t let ETS hear this i need that advantage on the GRE 🤣 /s

[@ladyoftheflowers9781]

Exams are inherently a poor measure of true understanding. If anything, they measure recall. Inattentive ADHD results in a greater proportion of mistakes due to misreading questions. But inattentive students thrive in tasks that require divergent thinking. I wonder if the PIs for this study are trained in educational theories? It would be worthwhile to study the mistake patterns during timed exams which require quick responses (e.g. standardized tests). ADHD PI certainly causes deficits in understanding the questions asked, and would result in struggles during intense time limits. This kind of research makes it difficult for those who need accommodations on standardized tests to enter professions.

[@advocate1533]

This is a ridiculous study. And it is likely correlational, rather than causation. Often people with ADHD are far more analytical and logical than others. Plus, they may have undiagnosed learning disabilities. If their minds wander or their working memory fails them, they have to go back and reread the content. They also tend to be time blind so they may not realize they are off task. However, when the are on task and/or hyper-focused they typically perform better than those without ADHD. So...is extra time really an advantage...or is it a reflection of their ability to analyze the material that allows them to perform better with the extra time. Why not give everyone the extended time? On the other hand, in the real world none of the groups described will be provided with extra time to perform their roles, so perhaps extra time should not be provided at all. My vote is to eliminate the timing of tests and allow students to show what they know without the anxiety that can interfere with performance as a result of time limits.