Paying Attention: Female ADHD Students Learning in Graduate School

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by persistent patterns of impulsivity, difficulty maintaining attention, poor organizational skills, and difficulty completing daily tasks (Lovecky, 2018). ADHD rates have increased globally (Conrad & Bergey, 2014), with the prevalence of ADHD in US adults reaching between 2% and 8% (Kwon et al., 2018). The symptoms of ADHD have a significant impact on adult learners (Kwon et al., 2018) and up to 25% of college students receiving services from university disability offices were diagnosed with ADHD (DuPaul et al., 2009). These learners can have difficulty adjusting to a new learning environment, struggle with regulating their emotions, and have a negative self-concept (Hirsch et al., 2018). They also have lower grade point averages (GPA), are more likely to be on academic probation, and are less likely to graduate than their non-ADHD peers (Kim et al., 2014; Weyandt et al., 2017). As a result, only 15% of adults with ADHD obtained a 4-year degree in comparison to 48% of adults without ADHD, and only 0.06% of adults with ADHD held a graduate degree in comparison to 5.4% of adults without ADHD (Kuriyan et al., 2013).

While some literature presents the impact of ADHD on adult learners as they enter college—underperformance compared to non-ADHD peers (Green & Rabiner, 2012), there is little literature showing the impact ADHD has on adult learners pursuing graduate study. Additionally, adult learning theories and models have not involved adult learners with disabilities, such as ADHD learners. Adult learners with ADHD are increasingly struggling, and graduate education poses additional demands on executive functioning (EF) and self-regulation, both of which are hallmark challenges for adult learners with ADHD. Further, most higher education institutions do not provide services that target EF difficulties in these learners (Meinzer et al., 2021). This lack of research makes it difficult to determine how best to help this population succeed. Thus, it is vital to understand the lived experiences of adult learners with ADHD and help them thrive in graduate school.

A phenomenological research design was applied based on the research question: What is the essence of the lived experiences of graduate students with ADHD as they pursue their graduate education? As all participants who agreed to participate in the study were women, the scope of this article is limited to female ADHD learners’ lived experience in graduate education. Phenomenology was the chosen methodology for this study as the research question sought to understand lived experience. Phenomenology offers a formal and systematic way to access direct human experience (Bakewell, 2016). Using this qualitative approach, our study aims to gain a deeper understanding of lived experience through participants’ own words. In the following sections, we present relevant literature, methodology, findings, discussion, limitations, and a conclusion with future research and implications for adult education.

Literature Review

Adult Learning

Adult learning came to the forefront in the United States in the 1920s, enhancing adult educational practice, along with the formation of the American Association for Adult Education in 1926, and Eduard Lindeman's The Meaning of Adult Education published that same year. Lindeman's book vividly reflected the progress of adult learning and highlighted it as a moral goal to give life meaning (Lindeman, 1926). In 1980, Malcolm Knowles publicized the term andragogy into broader use, defining it as “the art and science of helping adults learn” (p. 43). He distinguished the mission of adult educators as meeting the needs of individuals, institutions, and society (Knowles, 1980). Today, adult learning occurs in a variety of settings. Each year, over 45% of adults participate in formal or nonformal education (Brockett, 2015).

Adult learners are the fastest-growing population in higher education (Shillingford & Karlin, 2013). They are often considered nontraditional students over age 22 (Rogers, 2018), and most graduate students are adult learners with responsibilities and commitments outside of the classroom (Ross-Gordon et al., 2017), including work and family obligations, making it difficult for them to complete their studies (Shillingford & Karlin, 2013). The National Center for Education Statistics (2019) offers a profile of a typical graduate student in the United States: 59.3% are female, 78.4% are over the age of 25 (with 20.9% age 40 or older), 37.5% are married, 32% have dependents, and 12% have some type of disability. These graduate students often bring their own experiences into the learning environment (Owusu-Agyeman, 2019), and are generally viewed as self-directed learners who prefer instructors committed to their success (Phillips et al., 2017).

Previous research on adult learning is usually based on learners without disabilities and rarely takes gender differences into account. In 1984, a study by Pettigrew and Zakrajsek found that female students preferred conceptual-based learning, whereas male students preferred hands-on learning (Pettigrew & Zakrajsek, 1984). Keri (2002) looked at 693 students from a Midwestern community college and found that female students preferred social and conceptual learning (27.1% compared to 13%) whereas male students preferred applied learning (10.7% compared to 3.85%). Other studies have also shown that female graduate students are more participatory in the classroom (Zelazek, 1986).

ADHD and Its Impact

Research shows that 65% of children with ADHD will continue to exhibit symptoms into adulthood (Kim et al., 2014), and up to 80% of adults with ADHD have at least one comorbid disorder (Katzman et al., 2017). Adults with ADHD are at higher risk for adverse outcomes, including higher levels of anxiety, lower levels of self-esteem, difficulties with work, strained relationships with family, sleep disorders, eating disorders, depression, and issues with substance abuse (Kwon et al., 2018). Consequently, they are 11 times more likely to be unemployed, six times more likely to be in a less skilled occupation, 61% more likely to be fired in comparison to 43% of a control group, and earn an average of $2 less per hour (Kuriyan et al., 2013). Adult learners with ADHD tend to worry excessively (Kwon et al., 2018), have difficulty regulating their emotions (Hirsch et al., 2018), report a lower quality of life (Pinho et al., 2019), have significantly lower GPAs in college (DuPaul et al., 2021), and tend to repeat more classes (Jansen et al., 2017).

Diagnosis, Domains, and Functioning

Adults diagnosed with ADHD are typically classified into three subtypes: predominantly inattentive, hyperactive/impulsive, or combined presentation (American Psychiatric Association, 2013). Several theories explain how ADHD impacts neurocognitive functioning. One is the executive deficit model (Barkley, 1997) in which ADHD impacts EF; a set of mental processes that are used for cognitive control, attention, and working memory (WM) (Diamond, 2013). WM is the ability to hold information in the brain after it is no longer immediately present to work with that information (Diamond, 2013). EF, like WM, is necessary for learning. Learners with impaired WM perform worse on tasks requiring significant mental effort (Jansen et al., 2017). This supports research by Miller et al. (2013) that learners with ADHD must spend more cognitive resources on maintaining attention, which leaves them with fewer resources for comprehension. Diamond (2005) suggested that the EF of response inhibition (self-control) stemmed from hyperactive and combined type ADHD domains, whereas issues with WM reflected the inattentive domain. Castellanos et al. (2006) also theorized that processing issues were a deficit of the inattentive domain. Sonuga-Barke and Castellanos’ (2007) model theorized that individuals with ADHD struggle with switching from inactive to active cognitive states, which Pievsky and McGrath's (2018) study on processing speeds found evidence to support. Dekkers et al. (2017) showed a correlation between motivation deficits and impaired EF in adults, suggesting that motivation is also a core part of ADHD's symptomology.

Medicalization of ADHD

ADHD rates are increasing globally due to a variety of factors that include access to pharmaceuticals, more countries adopting Diagnostic and Statistical Manual diagnostic criteria, and information and advocacy available via the internet. Between 2004 and 2014, prescriptions for ADHD medication increased 274% (Conrad & Bergey, 2014). While this medicalization of ADHD may be downplaying the social, cultural, and environmental factors that play into the disorder (Smith, 2017), the history and research on ADHD seems to show universal symptoms experienced worldwide that appear more severe than in the normal population (Singh, 2008).

Women and ADHD

Research shows differences in how ADHD presents in males versus females and in childhood, girls often go underdiagnosed by a ratio of 3:1 (DaSilva et al., 2020). ADHD diagnostic criteria are also biased toward male symptoms (Mowlem et al., 2018), and research primarily uses male participants (Pievsky & McGrath, 2018). Symptoms in females often present as difficulty sustaining attention, and they are more often diagnosed as ADHD inattentive (Nussbaum, 2012). Symptoms in males lead to more disruptive classroom behaviors, and they are more often diagnosed as ADHD hyperactive or combined presentation (Waite, 2010). A study by Klefsjö et al. (2021) found that women were more often referred for psychiatric services for anxiety or depression before an ADHD diagnosis. In a systematic literature review, women with ADHD experienced low self-esteem; struggled with social relationships and emotional reactivity; and developed dysfunctional coping strategies (Attoe & Climie, 2023).

Understanding a Different Impact

Research also presents some positive aspects of ADHD, including hyperfocus and resilience. Weiss (2016) termed ADHD individuals exhibiting resilience as high functioning. Sedgwick et al. (2019) found little previous empirical research on the positive aspects of ADHD, but all six male participants in their phenomenological study reported experiencing hyperfocus, creativity, persistence, social intelligence, and resilience.

Accommodations

Available accommodations for adult learners with ADHD include extended time on tests, but there is little evidence to show the effectiveness of that approach (Jansen et al., 2017; Meinzer et al., 2021). Additionally, students with ADHD may make more errors in the extra time given (Jansen et al., 2019). DuPaul et al. (2021) found that college students with ADHD did not make sufficient use of study strategies and suggested that EF and comorbid disorder support is needed before entry to college. Meinzer et al. (2021) found that college students showed improvement in their anxiety and depression symptoms and their organizational skills upon implementation of a semester long program to address their EF deficits.

Methodology

We applied the phenomenological method defined by Thomas and Pollio (2002), which is based on the philosophy of Maurice Merleau-Ponty and looks at participant experience through the philosophical lenses of world, body, others, and time. Phenomenology uses rich descriptions to uncover the essence of lived experience. Important to Merleau-Ponty's phenomenology is the concept of the figure and the ground. The ground is the background from which things stand out. Both the ground (background) and the figure (that which stands out) are necessary to see each other. The grounds for Merleau-Ponty are world, body, others, and time, and it is through these philosophical lenses that we understand female ADHD adult learners’ lived experiences in graduate school.

The phenomenological method defined by Thomas and Pollio (2002) includes:

analysis of a bracketing interview prior to data collection;

analysis of interview transcripts using a phenomenology research group;

uncovering meaning units in the transcripts;

determining what is thematic in nature;

refining the thematic structure;

looking for lived experience patterns across all transcripts;

and identifying emerging global themes (p. 45).

Bracketing involves a phenomenological interview of researchers to help heighten their awareness of assumptions and biases so that they may suspend, or bracket out, their preconceptions before data collection. Even though we as researchers have not experienced or been diagnosed with ADHD, it was important for the primary investigator to undergo a bracketing interview before data collection. A pilot interview was also conducted.

The criteria used to identify the research participants in this study included adult learners—age 22 and older (Rogers, 2018), currently enrolled in a graduate degree program in the United States, self-identified as having ADHD, and interested in talking openly about their lived experiences of having ADHD while pursuing a graduate degree. After IRB approval, participants were purposefully selected for data collection (Creswell & Creswell, 2018), using maximum variation sampling to seek out participants from diverse backgrounds, institutions, and majors. This was done to increase confidence that the essence of the phenomenon being studied was captured (Glesne, 2016). Nine female students elected to participate in the study.

Data collection methods included open-ended interviews for rich lived experience descriptions, researcher memos, and video recordings. The opening interview question was: When you think about your experiences as a graduate student with ADHD, what really stands out to you? Phenomenological prompts followed in response to participant answers. Interviews lasting 45–60 min for each participant were conducted by Zoom and then transcribed. Repeated themes were achieved after seven participant interviews, and two additional interviews were conducted to ensure saturation. Data analysis began during transcription and was managed using NVivo 1.0. All interview transcripts were uploaded as cases, and meaning units were entered as codes. Commonalities and insights were captured as researcher memos and served an important function in synthesizing the lived experience accounts. Data was further analyzed via Thomas and Pollio's (2002) phenomenological method. Analysis was handled through the process of coding, re-coding, and organizing meaning units into higher-level global themes and subthemes across all transcripts by finding commonalities in the descriptions of the phenomenon between participants, using their own words. To ensure trustworthiness, we applied member-checking, which allowed participants to review the themes emerging and verify that those themes accurately represented their lived experience. All nine participants chose to engage in member checking, and two provided feedback on study themes.

Findings

Nine female participants, aged 22 to 38, from five universities across the United States, participated in this study. They represented master's and doctoral programs with concentrations in Clinical Mental Health Counseling, Environmental Science and Management, Psychology, School Counseling, and School Psychology. All participants were clinically diagnosed with ADHD by a doctor, psychiatrist, or psychological testing performed by qualified personnel. Pseudonyms were used in this study to protect participant identities and Appendix A offers a glimpse into their lived experiences. Findings revealed three global themes—using participants’ own words: “Just a little bit extra” (ADHD), “I always felt I was going to fail” (Graduate School), and “They don’t understand” (Others). Appendix B provides an overview of the Global Themes and subthemes that emerged from this study.

Global Theme 1: “Just a Little Bit Extra” (ADHD)

From extreme emotional reactions to difficulties with inattentiveness or hyperactivity, the symptoms of ADHD set participants apart from others. Each experienced ADHD symptoms in childhood, but many did not realize they had ADHD until adulthood. Most were quiet, inattentive perfectionists. They were often forgetful, had difficulty developing peer relationships, and were told by others that they were too sensitive. They often took much longer to complete homework compared to their peers. As Jetta said, “It seems like people with ADHD are just a little bit extra.”

Every participant mentioned that their experience as women with ADHD was fundamentally different than what some practitioners consider to be ADHD. Kaya believed that most practitioners would diagnose women with anxiety before they would diagnose them with ADHD, “girls get anxiety diagnoses instead of ADHD.” Gaya believed that the way her symptoms presented impacted how she as a woman was diagnosed, “a lot of times they don’t believe it…I’m not like super hyperactive or anything, but I get distracted really easily” Jetta didn’t even know that women could have ADHD, and Gemma thought that ADHD was a thing that young boys experience. Ruri's doctor told her that ADHD in women is under researched. For Jasper, “the way we view ADHD in children is just so male centric…you have these well behaved, intellectually gifted children who, you know, aren’t struggling in the way you know a kid who can’t sit still long enough to read is.”

Many participants described experiences where their ADHD brought about big emotions. They lacked confidence in themselves and their abilities, and emotions tended to come when they felt overwhelmed. For Gemma, “it always ended up with me crying…” For Jade, “It goes back to like as a child, like, you’re too emotional…this is why you should not have said anything or brought up your feelings in this class.” Jetta described her emotions as being more intense than others and that people often think she is too emotional and can’t handle her feelings, “people even have the reaction like, that's too much. You know, you’re too much.” For Kaya, “I definitely will have, I think, more emotional reactions”

Each participant had at least one comorbid disorder, including anxiety, depression, eating disorders, sleeping disorders, Post Traumatic Stress Disorder (PTSD), chronic pain, panic attacks, and trauma. After diagnosis, participants battled whether to accept ADHD as part of their identity, but all participants were relieved to have a reason for their struggle, “there was a name for it…I’m not just bad…” (Jetta). “There's always some grief of like, had I known sooner would I have struggled this much” (Gemma). “they saw what I saw, what my mom saw…I just needed some extra support” (Jasper). “it's also nice to have a name for it…” (Gaya). “the sense of relief that I now feel because there was an explanation for why things were so challenging” (Ruri).

Participants struggled when it came to ADHD medication use. Some had family members who disagreed with the use of stimulant medication, while others faced criticism from peers who thought they had an unfair advantage due to the medication. Moreover, participants had to cope with issues such as timing their medication and the cost. Jetta shared a profound realization she had the first time she took ADHD medication, “It was like I had been dreaming for my whole life and then finally, that was the first time I woke up.” Mica described her experience with members of her cohort who would comment that students got good grades because of their medication, “the irony of these psychology students…they should understand like, fundamentally it doesn’t work like that.”

Global Theme 2: “I Always Felt I was Going to Fail” (Graduate School)

Graduate school brought up a lot of insecurities for participants. They felt extremely overwhelmed and believed that many coping mechanisms they had used previously were no longer working. Often, they questioned their decision to go to graduate school or felt lost in the process, “sometimes I’m like, why am I here…I always felt I was going to fail” (Gemma). “I feel like I’m just standing in like the middle of this very busy intersection, just kind of looking around like what street do I go down first” (Jasper). “it's still such like a big crush to my ego and self-esteem…like, this is who I am” (Jade). “every deadline is an emergency…they kind of like come to rule my life in a way” (Jetta).

Participants felt that it was expected that by graduate school, they would have figured themselves out. The problem, in their experience, is that everything fell on them, which is difficult when they have an EF disorder like ADHD. For Gaya, “It seems like they throw everything at you at once and expect you to be able to organize it and just know where to start”. Most participants were also afraid to disclose their ADHD to professors or others in their program, even though they needed help. They worried that disclosing would impact how they were seen and graded and whether professors believed they could work in their professions. Further, even with working up the courage to disclose, they were not always supported. Gemma recounted, “I just like poured my heart out to her in this email…and she just sent me like one sentence…maybe grad school isn’t for you.” Jasper explained that much of the advocacy had to be taken on by her, “it's all on you, and that's not something that people talk about.” Kaya wanted disability protections in cases where she might misinterpret assignments and would like protected time on tests, “just having that kind of official backing.”

Participants struggled with overthinking and doing too many things at one time. Distractions were also problematic for some participants, especially during exams. They felt easily sidetracked. Organizing things became difficult, and they tended to set over-ambitious expectations and then needed help with how to prioritize. For Gemma, she felt her, “brain is just sort of all over the place” Gaya described how her mind was always on a million things at once, “my mind's not just purely on what I’m doing. It's on everything…I didn’t know it was weird for me to start on one paper and end up doing research for a whole different topic.” “I’m hearing the person tap their pencils, eat a granola bar, shift around in their seat” (Jasper). “I’ll start something and then I’ll move on to another thing…I’ll have 100 tabs open, and my computer is running slowly” (Ruby). “It just seems like everything kind of gets bigger, faster than I’m expecting it to” (Kaya).

Global Theme 3: “They Don’t Understand” (Others)

Every participant recalled experiences where they struggled with being understood by others. For many, support or a lack thereof was directly proportional to their chance of success. Kaya felt her professors knew all about ADHD, but because they had not experienced it, they didn’t truly know what it was like for her. After Mica shared her diagnosis with her professors, she still felt their informal ways of evaluating student performance left her at a disadvantage, “It's affected how I came across to faculty…and the others, they seem more interactive” For Gemma, “not having people understand me, as someone with these issues, including my advisor…it's been really isolating.” Gaya explained, “I reached out once because I was confused about the topic, but they didn’t help” For Ruri, “now that I’m finally starting to get treatment…the first communication I get is, tick-tock tick-tock” Jade explained, “yeah, we’re mental health professionals, but they’re not at all well-informed.”

Participants found it difficult being compared to their peers. Mica realized that even though she had good grades, she couldn’t spend as much time getting clinical hours as her peers and didn’t choose to participate in as many research projects. Her professors told her that she had the lowest case count in her cohort, “to have it like formally stated, like, we’re comparing you to your peers…what would it be like if I didn’t have ADHD and I could at least compare myself with others?” Kaya explained, “I don’t know if I’ve ever had like, this intense of a comparison to other people and other people's work habits before.” For Ruby, “It's always been kind of like there in my life, which makes it harder to see that it's not like something that everyone else deals with.” For Gemma, her process looked different, “Mine's messy and like, I sort of have to jump all over the board to figure out where I am”

Every participant explained that their experiences with ADHD directly impacted their career choices to help others. For Ruby, ADHD drove her to understand more and to put that knowledge to practice, “I’m reliving some of the things I went through…but I’m going to do something more in it.” Jasper imagined, “I think it will make me a good psychologist in a lot of ways because I think there will be an air of relatability” For Kaya, “I like working with those kids…the kids who are like, you know, extra challenging” For Mica, “because of my struggle…that makes me feel a little more on the same level as the kids that I’m working with.” Gemma wanted to use her knowledge to help the homeless have access to clean water, “I felt like I had more to offer the world with my passion and experiences”

Discussion

The World of Graduate School for Adult Learners With ADHD

Perception is active engagement with the world around us. The body lives in and through the world, not as an onlooker, but as a part of the world (Merleau-Ponty, 1945/2014). These participants experienced the world of graduate school through their ADHD symptoms and all the large and small impacts that had on their learning. They struggled with insecurities, constantly felt behind, dealt with comorbid disorders, and generally lacked support. In their world, ADHD was less understood, and further, because they are women—they were often perceived as being too sensitive and emotional. Thus, they learned to look to themselves for ways to mitigate their symptoms and stressors. With the added pressure of increased readings, academic research, writing, internships, comprehensive exams, and dissertation research, the world of graduate school was overwhelming. The need to process so much information strained their coping mechanisms. As this study's findings show, graduate school explicitly overloaded participants’ ability to cope. They were exhausted from trying to maintain a graduate school/life balance which made it difficult to prioritize self-care.

Participants felt that it was expected of them in graduate school to know how to organize their assignments and their time, and they felt the lack of help in this area made it harder for them to persevere. They wanted to be somewhat autonomous in their learning, but they also needed help with organizing their work. While research shows that adults are encouraged to bring their experiences into the learning processes (Merriam & Baumgartner, 2020), our findings indicate that educators need to become more conscious about adults with ADHD needing assistance in structuring their learning. Additionally, graduate school makes participants’ ADHD even more pronounced, and this added pressure makes it even harder for them to concentrate only on their graduate studies, which echoes research by Shillingford and Karlin (2013).

The Mind-Body and ADHD

Merleau-Ponty's philosophy of phenomenology focuses on the holistic view of embodiment. Humans are not separate from the world in which they live. They feel the world in them and around them (Merleau-Ponty, 1945/2014). Our study shows that participants constantly dealt with ADHD symptoms that impacted their mind and bodies. Even though they appeared to show normal intellectual functioning, they struggled with tasks that demanded more of their WM and had difficulty sustaining their attention on tasks that were not interesting to them. This is reflected in previous research (Jansen et al., 2017; Weyandt et al., 2017) that considers motivation deficits as a core part of ADHD. Earlier studies indicated that ADHD symptoms include difficulty completing everyday tasks, issues with time management, inability to meet deadlines, inattention, and procrastination (Turgay et al., 2012), which were all experienced by our study participants.

Most participants had at least two comorbid disorders including anxiety, depression, PTSD, sleeping disorders, and eating disorders, confirming previous research (Katzman et al., 2017). Most also stated that their ADHD became apparent when they started graduate school, as also noted by Meinzer et al. (2021), which found that a graduate education poses additional demands on EF and self-regulation, both hallmark challenges of adult learners with ADHD. All participants described their experiences with emotional distress, significant impairment, and poor quality of life while trying to complete their degrees, echoing Pinho et al.'s (2019) and Weyandt et al.'s (2013) findings. Participants also struggled with extreme emotional reactivity which is in line with research by Hirsch et al. (2018) and Kwon et al. (2018).

Our study shows the weight participants gave to the emotional experience of ADHD in graduate study and how the latter triggered their ADHD symptoms and emotional reactivity. Our study also shows that their ADHD presents differently as women and that their differing symptoms are not well represented in ADHD research. Further, several participants in our study changed degree programs or sought out classes of interest to them to increase their motivation and ability to complete their graduate programs. This extends Dvorsky and Langberg's (2019) research that motivational impairment could predict students’ future academic achievement.

Recent research on ADHD medication found that college students tend to forget 50% of their doses (Meinzer et al., 2021). Participants in this study, however, did not struggle with forgetting medication but did have issues with timing medication to make sure they were alert and focused on their classes which could stretch from morning to night. They would often have to choose which classes to be alert for, which meant some professors only experienced an unmedicated version of them. Rationing was also a problem for several participants due to the high cost of the medication. Participants chose which days to take or skip their medication to spread out their doses.

The Experience of Others

We are not alone in the world and as such, we exist in the world with others and the experiences of others color our own experiences. Merleau-Ponty (1945/2014) explains that while the natural world around us impacts and interweaves its way into our lives, we too impact and interweave into the natural world. Participants needed to be understood by others, especially their professors, from whom they needed support. Our findings suggest that support or lack thereof may be directly proportional to participants’ chance of success. Several participants reported high GPAs, yet they were evaluated based on their caseloads or classroom engagement level. This is an important finding in that graduate students with ADHD may, on the surface, appear to be academically successful. However, they have hidden struggles due to being misunderstood by their professors and compared to peers emotionally, socially, and psychologically, significantly impacting their learning capabilities and wellbeing.

Participants reported that their professors did not understand their emotional reactivity. They were perceived as being unprepared to complete their programs. Professors who are not well informed about ADHD symptoms may easily mistake ADHD learners’ frustration for an unwillingness to follow instructions when that frustration stems from a fear of initiating the work. Instead of reaching out for help, these learners may shut down. This makes it appear to their professors that learners with ADHD are not as invested in their classes as their peers.

Participants also stated that part of the reason they did not disclose their ADHD to disability services was that they did not know what accommodations would work for them. Participants in our study wanted protection for submitting late assignments or needing more instructions from professors to help prepare their assignments. This finding is critical to inform and adjust currently available accommodations, as the existing support system may not sufficiently accommodate this population.

An interesting finding is that all participants chose their current degree and future career paths toward giving back and helping others. ADHD has impacted their lives so profoundly that they decided to choose or change majors leading to careers that enable them to support others struggling as they have. This finding adds a new understanding of graduate learners with ADHD, and their learning motivation and professional contribution toward society and others.

Reopening Time

Humans exist in time and their experiences and interactions are from within that point in time. Perhaps one of the more profound statements Merleau-Ponty (1945/2014) makes about phenomenology is that when looking at lived experience in the past, one can “reopen time” (p. 439). Participants’ experience of their ADHD appeared to be strongly influenced by time and the idea that whatever they were dealing with, they would grow out of it. By the time they got to graduate school, they had to come to terms with not only how their ADHD symptoms had evolved, but all the psychological impacts ADHD had on them from childhood into adulthood. After struggling with science as a child, one participant decided to study science during her undergrad in large part to prove that she could. One participant wondered why she did well academically as a child but began failing her classes when she started college. Others questioned how no one noticed previously how much they were struggling. In short, participants’ experience of their ADHD as adults was heavily shaped by their experiences with ADHD, both diagnosed and undiagnosed, as children.

Our study shows that participants can reopen time during their lived experience accounts which can help them understand how their ADHD symptoms evolved. As children, they felt they had more support during the learning process and with managing their symptoms, but once they reached adulthood, it was hard to get needed accommodations when the expectation was entirely on them to do so. They reported that the accommodations available to them were insufficient for their success. This understanding is supported by Gormley et al.'s (2019) research, in which only 40% of college students with ADHD reported that accommodations were appropriate for their needs. Our findings indicate that the issue of how to support, and with what accommodations, remains a critical issue.

Limitations

Due to the sensitive nature of an ADHD diagnosis and possible concern over universities or employers discovering a participant's diagnosis, confidentiality in this study was heavily emphasized during the informed consent process. This additional emphasis on confidentiality may have caused some participants to be uncomfortable with participating. This study is limited to those participants who chose to participate, which happened to be all female graduate students with ADHD. As only female graduate students participated, the lived experiences presented may differ from those of male graduate students. Given the difference in time commitments and types of assignments intrinsic to graduate study, our findings may not reflect the experience of female and male undergraduate students with ADHD.

Conclusion, Implications, and Future Research

Looking at the figural (that which stood out) from Merleau-Ponty's philosophical grounds of world, body, others, and time, a picture emerged of both pain and resilience for these participants with ADHD. While the ADHD literature found that adult college students with ADHD had lower GPAs (DuPaul et al., 2021), our study shows most participants maintained high GPAs throughout their graduate school careers. This new finding is meaningful in that GPA may not show the full picture of how adults with ADHD are faring in graduate school. This study provides implications for adult educators’ facilitation of adult learners with ADHD, as well as policy and social implications.

First, adult educators must become informed and prepared when working with this group of learners. Universities may consider providing training and workshops as a part of continuing professional development for faculty, staff, and administrators. Moreover, faculty can consider alternatives when designing assignments and learning activities to provide ADHD-friendly approaches and methods (smaller learning units, emotional support and tolerance for multiple deadlines, options for revision, and resubmission after feedback).

Second, our study helps inform policymakers and administrators in adult and higher education settings with a clearer picture of the learning experiences of adult learners with ADHD in graduate school. At the university level, participants seek policy changes to protect them from being placed on academic probation or dismissed from their programs due to their ADHD symptoms. Our study indicates a critical need for disability services offices to reach out to this learning population to offer support since current accommodations may be insufficient to meet their needs.

Third, our findings present social implications. Adult learners with ADHD who feel unsupported have a more challenging time in their graduate studies. Even when they succeed, the damage to their psychological health can be considerable. Several participants have changed degree programs or sought more interesting courses to increase their motivation to complete their programs. This finding suggests that future research could explore diverse approaches for ADHD learners to navigate their academic journeys.

Finally, findings also indicate that participants have a deep fear of disclosing their ADHD, which may partially imply that the learning environment may not be welcoming and accepting of ADHD learners. Therefore, publicly addressing the needs of this learning population and encouraging learners to share and educate their faculty, administrators, and peers openly about their situations, and honoring their needs, must be the established steps at all levels.

An interesting finding from this study is that a variation in symptomology may have a differing impact on women's learning, their ability to obtain an ADHD diagnosis, and their access to support and accommodations in graduate school. This finding contributes to the literature with new research areas for future studies to determine what can be done for women with ADHD in graduate school. More research can also be conducted at the policy level to de-stigmatize ADHD and to offer proper, evidence-based support to this learning population. Research in the areas of motivation and identity development would be of benefit. Certainly, additional research utilizing different methods and larger, more diverse samples in both the U.S. and internationally is necessary to confirm these findings and support efforts to implement changes in policy and practice. For adult learners with ADHD, we hope our study serves as a call to higher education to pay attention.