ADHD in higher education: is digital learning making it worse?

Attention deficit hyperactivity disorder (ADHD) has been around for centuries, but recently the news has been awash with articles reporting significant increases in the number of individuals being diagnosed, treated or suspecting that they have the condition (including the recent Panorama exposé of incorrect diagnoses provided by some private clinics).

Indeed, the Centers for Disease Control and Prevention recently reported that prescriptions for ADHD medications increased 10 per cent during 2020-21, especially among young adults, while the incidence of ADHD in the US is reported to have surged by 123 per cent between 2007 and 2016. This comes alongside reports of UK ADHD services being “swamped”.

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Various explanations for ADHD have been proposed, including genetics, premature birth and imbalances within neurotransmitters, but it has been speculated that this recent increase may be owing to factors as various as social isolation, the Covid-19 pandemic, poor diet and lifestyle factors, internet and gaming addictions, and even TikTok trends.

As recent research has revealed, there is a distinct lack of understanding about the intersection of ADHD and university study, but the main challenges for students centre around inattention, hyper-attentiveness, disorganisation/forgetfulness, hyperactivity, impulsivity and emotional dysregulation. This affects students’ ability to engage in focused, analytical reading, time management, writing and structuring assignments and revising/taking exams.

This obviously presents numerous challenges when studying for a university degree, and increasing numbers of previously undiagnosed and/or undeclared cases of possible ADHD are coming forward to be screened with a view to formal diagnosis by an educational psychologist. Why is this, and is our bid to make education ever more digitally “enabled” making it worse?

It has been suggested that ADHD has only been rising since about 2000, the year the British writer Will Self associates with the inception of the age of bi-directional digital media. For Self, this has led to young people now being “in the larval stage of a new form of human”. While alterations in brain structure resulting from our increasingly digital lives may well be a possibility, it’s striking that the proliferation of bi-directional digital media maps closely to increases in the diagnosis of ADHD.

Smartphones, tablets, laptops and social media interactions mainly revolve around rapid swiping and skim reading – headlines or “clickbait” are the key anchors into our consciousness and long-term memory rather than slow, deep and considered thinking. In an age of rapid knowledge consumption and searching, “fragmented by push notifications and digital dopamine hits”, as Kelli María Korducki has recently asked, “who doesn’t have trouble multitasking or following through with tasks?”

Many institutions seem to be deploying ever greater levels of technology in a bid to be inclusive. Coventry University, for instance, states in its 2030 Group Strategy that it sees the success of its educational offering and delivery of “access, participation and inclusion” as being “underpinned by the development and delivery at scale of blended and fully online learning…and the exploitation of digital connectivity and educational technology”. Similarly, the University of Leeds sees digital education as playing “a leading role in…growing our provision of accessible, inclusive and inspirational digital education opportunities for all”.

Such statements are typical and are often reinforced and perpetuated through the labelling of online platforms, apps or educational software as “assistive”, “enabled” or “enhanced” – especially in respect of how it may help students with neurodiverse conditions such as ADHD. However, research into ADHD shows that there is a significant correlation between frequent use of digital media and the symptoms of ADHD. As such, in a bid to be inclusive, are certain aspects of digital education worsening one of the very conditions it is meant to “assist”?

One of the key issues is working memory. Bi-directional digital media is, by definition, multifaceted – and problems often occur in relation to multitasking or when there are simultaneous cognitive demands that overwhelm the brain’s ability to make connections.

Typical triggers can include unscaffolded, disorganised information overload via file sharing, hopping from one login to another (often on different devices), moving transcripts in recordings and the rapid switching of individuals in meetings without being able to see the class as a whole (on Zoom or Teams, for example). The movement of the video sections at the bottom of recordings (perhaps on Panopto) is also problematic, as is having multiple tabs open, having to switch between tabs as part of a session, chat occurring simultaneously with other inputs, mind mapping or collaborative online tools (for example, Padlet or Miro Board), particularly in cases where panes move around as others contribute.

Additionally, with the advent and increasing promotion/absorption of AI in higher education, students can now access a dizzying plethora of tools (upwards of 130 productivity apps alone) to help with summarising and research through to generative AI such as ChatGPT or scheduling assistants such as Clara.

Hopping between all these apps and platforms, students with ADHD can become not only overwhelmed by trying to make sense of these multiple cognitive burdens, but the speed with which they change and the multifaceted nature of their delivery exacerbates the pre-existing difficulties in concentration and focus whilst feeding the propensity of our students without previously diagnosed ADHD to learn and consume information in heavily fragmented, multifaceted forms.

With the advent of AI to assist with both searching and writing, the ADHD “epidemic” is only likely to get worse as focus and concentration become increasingly unnecessary and outsourced and information becomes ever more pre-digested and summarised for us. We’re obviously yet to witness the full effects of AI, but the evidence in relation to bi-directional digital media suggests a further negative cascade effect in respect of attention spans. In an age of AI, maybe sustained attention and focus are seldom needed, but we can hardly claim to be surprised when we are confronted with increasing numbers of students with ADHD or students pathologising themselves as having ADHD when they come up against tasks requiring deep, sustained concentration.

So where do we go from here? I’m not suggesting that digital technologies cannot enhance, assist or indeed enable learning. Rather, we need to be alert to the negative effects that too much fragmentary, clunky digital multitasking might have in terms of cognitive overload while remaining critical of the propensity of too much outsourcing of tasks to AI to weaken attention spans. To finish, the following suggestions can help us strike the right balance while supporting students with ADHD:

− Scaffold learning activities and inputs: students with neurodiverse conditions such as ADHD need to see the what, the why and the how of the session to orientate themselves.

− Limit the number of different platforms or technologies: this helps avoid unnecessary cognitive overload and/or fragmentary delivery.

− Only use technologies that genuinely “assist” or “enable” learning: don’t deploy them merely as a means of adding variety to your teaching.

− Keep it simple: don’t overcomplicate by using an app or a platform requiring sign-ins and multiple devices when a simple show of hands or a flip chart will do.

− Remember that “thinking is movement confined to the brain”: like a muscle, the brain needs exercise to grow and develop. Tasks involving sustained concentration rather than quick AI fixes or “digital dopamine hits” are pedagogically useful – and can be inclusive if appropriately scaffolded and supported.

Adrian J. Wallbank is a lecturer in educational development at Oxford Brookes University, UK.

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