When we think about ADD/ADHD in a college student, we can easily imagine how impulsivity, distractibility, short attention span, problems with following through with directions, poor organizational skills, weak task/time management and procrastination, can wreak havoc on her success. What may not come to mind, however, is one of the most common attentional weaknesses that contribute to college failure – low arousal level.
So what is low arousal level anyway?
Well, at a very basic level, we must maintain a certain level of alertness in order to pay attention and regulate our behavior. Arousal level refers to how awake and alert we are at any point in time. Based upon our clinical experience with thousands of patients, we have found that many individuals with ADD/ADHD have a low arousal level; they are not alert and sufficiently awake to pay optimal attention. This statement can be confusing to some people who presume that because some individuals with ADD/ADHD are “hyperactive” that they are hyperaroused when, in reality, the opposite is probably true!
A student with low arousal level can demonstrate a wide range of behaviors. She may become fatigued during mundane activities (like listening to lecture or completing a 60-page reading assignment), yawn excessively, have a glazed look in her eyes, or actually fall asleep at her desk. Commonly, ADD/ADHD students blame these behaviors on the task, the subject matter or the professor . . . “too boring.” On the other hand, some ADD/ADHD students who are under-aroused demonstrate “hyperactivity” ranging from leg bouncing, wiggling in the chair, fidgeting, aimlessly playing with materials, and stretching or actually getting out of their seat and wandering around. Our clinical experience suggests that these “hyperactive behaviors” are actually unconscious attempts by the ADD/ADHD student to self-stimulate herself in order to increase or sustain her arousal in a learning (or should we say “boring”) situation.
Other conditions or co-morbidities can magnify an ADD/ADHD student’s struggle with alertness or arousal including sleep deprivation, obstructive sleep apnea, iron deficiency anemia, poor nutritional habits (like skipping meals, pigging out, or self medicating with carbohydrates), depression and certain temperamental extremes (such as low frustration tolerance or short persistence) to name a few. All of these conditions are very common in students with ADD/ADHD. Sometimes these conditions even mimic ADD/ADHD in students who don’t have the diagnosis.
Commonly, low arousal can signal the possible need for medication treatment in a student with ADD/ADHD. In those students already taking medication, it can indicate the need to refine the dosage level (generally it means there is a need for more) or dosage regimen (adding medication dosage(s) to provide all-day coverage into the evening when most students study and read those “boring” text books!)
At the very least, the tendency toward low arousal suggests the need to establish and maintain healthy daily routines for sleeping, eating, exercise and relaxation.
It should be obvious that unmanaged low arousal can be a major risk factor for college failure. Dealing with it means getting a comprehensive evaluation to determine all the possible contributors and then developing a targeted, individual treatment plan to address each contributing factor. That’s what we do at the BWC! Contact us today so we can help your child “wake up” and start experiencing the success he or she is capable of!