An estimated 8% of students on US college campuses have ADHD, accounting for 25% of students with
disabilities. College students with ADHD experience significant academic impairment, including lower grade
point averages (GPA's); increased frequency of probation, medical leave, and required withdrawal; and lower
graduation rates. These adverse experiences likely contribute to the higher rates of depression and anxiety
among college students with ADHD, as well as long-term occupational impairment. Poor executive self-
management is increasingly recognized as a central characteristic of ADHD and a major cause of functional
impairment at school and at work. Executive dysfunction in ADHD is typically manifested as deficient self-
management with respect to time, organization, and planning, and correlates with worse academic
performance in children with ADHD, and greater occupational impairment in adults. Although cognitive-
behavioral therapy (CBT) is efficacious in treating executive dysfunction in adults with ADHD, efforts to adapt
this intervention for the needs of college students have been sparse. The Specific Aims of this application are
therefore: (1) to adapt our successful adult group CBT to address impaired executive self-management in
college students with ADHD; (2) to train campus learning disability specialists to deliver the intervention (3) to
examine the feasibility, acceptability, and effectiveness of the optimized intervention vis-à-vis ADHD
symptoms, executive self-management, academic performance, and emotional outcomes and (4) to examine
change in executive self-management as a critical mediator between proximal behavioral/cognitive changes
and the therapeutic outcomes of interest. CBT will be delivered to rigorously evaluated and diagnosed students
with ADHD at our collaborating site - the Weingarten Learning Resources Center (WLRC) for students at the U
of PA. The first half of the project will be a Development phase, during which the 10-week group program (6-8
students) will be adapted and refined and during which three WLRC staff will be trained to deliver the
intervention. During the Pilot Study, 84 eligible students will be randomized to receive either CBT or Treatment
as Usual. The final manualized CBT protocol will be delivered in six 10-week treatment series, each led
independently by one of the trainees. Pre- to post-treatment change will be assessed on measures of: (1)
academic performance; (2) ADHD DSM-5 inattentive symptoms (3) executive self-management; and (4)
depression, anxiety, and self-esteem. Information concerning the acceptability, feasibility, and scalability of this
program on college campuses will be collected from 3 sets of stakeholders: 1) the student-participants 2) the
WLRC trainees and Advisory Board and 3) the Investigators. We will also survey counseling/disability centers
concerning the potential feasibility and utility of implementing the intervention with respect to resources,
staffing, and training. Compiling this information is expected to facilitate interim projections about the feasibility
of a full-scale multi-site trial of the intervention, and its scalability to college campuses generally.
