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Featured Doc Blog: 12 Things Every Parent Should Do for Their College-Bound Kids (Part 2)

In part one of this blog, Dr. Mark Thomas with our Focus-MD Tuscaloosa office shared some tips that would help college students help manage their academics and daily life on campus. Below, he discusses ways to help them manage their healthcare and resources.

6. Teach them about navigating the health care system

  • Making and remembering appointments
  • Calling the MD office rather than sitting on a problem
  • When is appropriate time to seek medical care
  • Does this problem need to go to the ER?
  • How, when and where to fill prescriptions (Anecdote: In treating college freshmen in a student health center, I have been asked by the student “What do I do with this prescription?” or “What is this?” (after handing them the prescription) or “How am I going to get my medicine now?”

7.  Let them know about how to use health insurance

  • Ensure they have their own copy of their health insurance card
  • Educate them about co-pays and deductibles
  • Let them know about in-network versus out-of-network coverage
  • Explain to them what pharmacy benefits they have and give them a copy of the pharmacy benefits card if there is a separate one
  • If you have a Health Savings Account, give them a copy of the card and teach them when it should be used

8.  Set up strategy to continue their ADHD medication while away.

  • The worst times for a younger person to try managing ADHD without medication is while making a transition to new level! Starting college may be the absolute worst!!!
  • Discuss with the doctor who manages the ADHD medication at home about her or his policies about continuing to prescribe ADHD medications to students attending a school at a significant distance from home.
  • If the provider at home will continue to oversee the prescription of ADHD medications, they will need to see the student at regular intervals, optimally at least once every 3 months.
  • Ask if the provider would be available to discuss problems or questions about treatment via phone, video calling, or through a secure portal that arise will student is away.
  • It would be best to have a follow-up within the first couple of months after leaving for college to ensure the usual regimen at home works well on new schedule.

9. Usually, it is better to help them find a physician near the school to take over their care. Some of the reasons to consider this include the following:

  • If it is not feasible to return home frequently to be seen by their ADHD provider
  • A provider close to college campus is usually more familiar with the needs of college aged patients.
  • Being able to schedule more frequent visit with the prescribing doctor when medication adjustments are needed is easier  with a doctor close to campus
  • In some states controlled substance prescriptions written by out of state providers cannot be filled.
  • Check with the college or university about the availability of on-campus student health services
    • Some schools will have physicians on staff who can provide care for students with ADHD and other chronic conditions
    • Other schools may have a go-to list of medical providers in the community
    • Help them determine which providers are in-network (If there are no local providers in-network, call the insurance carrier to discuss arrangements for care to be provided while away.)

10. Consider engaging an ADHD Coach

  • ADHD coaches take a very practical approach to helping students overcome executive functioning deficits,
  • Coaches may instruct in skills such as organization, time management, wise use of electronic resources, study skills, interpersonal skills, test taking strategies
  • Coach can provide encouragement, support, and accountability without seeming to nag.

11. Register with the disabilities services office on campus to ensure they receiving accommodations – the earlier the better

  • The documentation requirements from each school may differ. Sometimes additional testing will be needed. The usual requirement is for full psychological and educational testing performed within the past three years.
  • Accommodations found helpful by most students with ADHD include
    • Note-taking services (Even if student can take notes successfully, they often miss important opportunity for the auditory learning experience if they concentrate too hard on getting down what the professor is saying.)
    • Extended-time on tests (Even if students do not typically run out of time on examinations, knowing they have extra time availability may prevent them from rushing through exams and making careless errors.)
    • Test taking with reduced distractions (Large lecture halls with numerous other students taking the same test provide numerous potential distractions such as other students coughing, fidgeting, and finishing their tests early.)
    • Priority in registration (It can be very important to plan class schedules that maximize class time when medication is strongest but avoid too many back to back to back classes in which students will struggle to maintain focus even more than usual. Having a choice of professors can be crucial in finding those who teaching style best fits the student’s learning style. )

12. Maintain the right amount of support.

  • Make your expectations clear about how often the student should check in with family. (Remember how Bear Bryant emphasized to his players the importance for them to regularly “call mama.”)
  • Check in often enough to know when he or she is struggling before things spiral out of control
  • Help them find a support network on campus through meeting professors or student services staff members in advance. Encourage them to becoming involved with the organizations on campus that are right for them individually.
  • Not every student is best suited to pledge the same fraternity or sorority as Mom or Dad. Most students with ADHD would do better waiting until after they have adjusted to campus life for a full semester or year before joining a Greek organization that will place huge demands on their schedule.
  • Students need to be reassured of your UNCONDITIONAL LOVE and support, Provide a sympathetic listening ear whenever they call. DO NOT NAG or SHAME students when they are struggling. They do not need to dread calling you or answering the phone when you call. Keeping open and accepting channels of community is crucial to their success!

Hopefully, both students and parents will find these tips helpful as they embark on their college careers.  At Focus-MD, our mission is to support the whole patient and his or her family as they go from frustration to focus.

Featured Doc Blog: 12 Things Every Parent Should Do for Their College-Bound Kids (Part 1)

As you can imagine, Dr. Mark Thomas in our Focus-MD Tuscaloosa office has a lot of experience helping college students. In this two-part blog, he discusses things that parents can do to make the transition to college easier. 

I have been treating college-aged young persons with ADHD for over twenty years. In that time, I have witnessed numerous students struggle with getting away from the support structure in place for them at home and adjusting to the new demands of college life and independence. Many of the things that I have observed providing them difficulties could be greatly helped when parents know what things are most beneficial for them to do and what things they should avoid.

Things parents should know and do for their college-bound daughters and sons –

  1. Know that each student is individual in their needs and level of development of executive functioning skills
    1. Some students will need more assistance from home than others.
    2. Parents need to balance between becoming a “helicopter parent” versus having a student who suffers without the support system to which they are accustomed.
    3. Almost all students with ADHD will have some Executive Functioning Deficits that will pose challenges for them when entering college life. Some of these executive functioning areas that are difficult for these younger persons include:
      • schedule planning and time management
      • keeping up with needed personal items
      • physical organizational skills
      • prioritizing use of time and money, and connecting the dots between their personal choices and consequences
      • keeping a long-term view and making decisions that are best for their future
      • monitoring their own performance and making needed corrections in personal habits
      • avoiding impulsive choices and emotional over-reaction
  2. Discuss with them setting up a weekly schedule using either a paper or electronic planner
    1. Many students are so accustomed to close support of parents and teachers that they do not have experience in organizing time for themselves.
    2. Stress the importance of not skipping classes, even when attendance is not required.
    3. Instruct them to set aside adequate time in the schedule for regular studying (not just before a test is imminent.)
    4. Break big projects and assignments in smaller steps to avoid becoming overwhelmed.
  3. Teach them how to manage money wisely through planning and budgeting
    1. Have them get accustomed to paying for their own expenses on a weekly or monthly allowance before they go away
    2. If they have the maturity to manage a credit card, teach them to use it wisely. Make it clear what expenses you expect them to pay with the card
    3. Consider a low-limit credit card in their name with a parent as co-signer that they are responsible for paying. (This will not only give them experience but also help build their credit score.
  4. Give guidance about meal planning and nutrition
    1. Discuss with them the importance of proper nutrition for best performance cognitively, emotionally, and physically. (Protein in the morning is a must!)
    2. Develop habits of not skipping meals, especially breakfast! Eating a hearty breakfast helps to reduce any side effects of stimulants medication such as diminished appetite and upset stomach.
    3. If they have difficulty remembering to eat, have them set an alarm on phone or wearable electronic device to remind themselves.
    4. Often freshmen will live on-campus and rely upon the cafeteria for most meals, but will still need to know about planning and preparing their own meals
    5. Teach them how to shop for groceries wisely
    6. Give them experience in fixing meals at home with simple recipes low in time and ingredients needed.
  5. Make sure students have safe transportation
    1. Bad News: Untreated ADHD increases risk of young adult driver becoming involved in a motor vehicle collision by 300-400%.
    2. Good News: Studies have shown that optimized medical treatment may reduce this risk by up to 50%
    3. If the student will have a car, make sure they know to drive only when medication is in effect.
    4. Discuss who is safe for them to ride with and when they should use alternate means of transportation
    5. Do not assume they know better than to drive after drinking (even a little) or to ride with someone who has had any alcohol or other substances that could impair driving!
    6. In urban environments, students need to be familiar with accessing public transportation.

In the second part of this series, Dr. Thomas will share insight on how to help manage the student’s healthcare while he or she is away at college.