Adjusting to college can be difficult for even the most prepared students. But for students who may be struggling with an undiagnosed learning difficulty, the transition can be overwhelming. They may have poor coping skills, increased levels of stress, executive functioning or working memory deficits, low self-esteem, and even significant academic, interpersonal, and psychological difficulties.
The worst part is that many of them don’t know why. According to a National Council on Disability report, as many as 44% of individuals with ADHD were first identified at the postsecondary level.
The Kane Learning Difficulties Assessment (KLDA) is a tool that screens college students for learning difficulties and ADHD in order to give them the answers they need. By screening for learning difficulties and ADHD as well as other issues that affect learning, such as anxiety, memory, and functional problems like organization and procrastination, the KLDA helps to identify those individuals who should seek further assessment so they can get the help they need to succeed in college.
Steven T. Kane, PhD, author of the KLDA took a few minutes to answer some common questions about the product, its development, and the feedback he has received on its impact.
What inspired you to develop the KLDA initially?
Before becoming a professor and researcher, I was employed in a university disability resource center as a psychologist who specialized in learning disabilities and ADHD. I was also previously employed at three of the most diverse community colleges in California. In each of these settings, I saw literally hundreds of students who should have been screened for learning and attentional challenges but never were. I was also shocked, quite frankly, by the number of individuals I saw who clearly suffered from some form of learning or attentional difficulties as adults yet were never screened or tested in the K–12 system.
As most of us are aware, being tested for a learning disability and/or ADHD is very expensive and simply out of reach for the majority of our most at-risk college students. I also found it troubling that almost none of these same students were ever screened for anxiety disorders or memory challenges. Thus, my goal was to develop a screening assessment that was very affordable and easy to take, preferably via the internet.
How does the KLDA differ from competitive measures?
There are actually not a lot of similar measures, which is, again, one of the main reasons why we developed the KLDA. There are two or three other measures that assess study skills, motivation, etc., but not the key academic skills and executive functioning skills the KLDA assesses.
What are some important things clinicians should know about the KLDA?
First, the KLDA was normed on a very large and diverse population from across the U.S. and Canada. Second, the KLDA was completed by more than 5,000 people via the internet for free as we performed factor analyses, perfected item development, etc. Third, the KLDA is very affordable, essentially self-interpreting, and can be administered quickly administered via PARiConnect. Most respondents finish the assessment in about 10 minutes as the items are written at about the fourth through sixth grade reading level. The KLDA can also guide the assessment process and inform which lengthier diagnostic assessments should be administered. Finally, the KLDA is a great discussion prompt to encourage clients to talk about their difficulties across different environments.
What feedback have you received from users on the KLDA and the insight it provides to students?
Thus far, both practitioners and test takers have found the assessment very useful, easy to take, and comment that it leads to very interesting discussions that the respondent has often never had with anyone before.
Anything else you think is important for people to know about the KLDA?
The KLDA is a very flexible product. The assessment can be used by individual clinicians to screen a client before they even meet for the first time. It’s been used by community colleges and universities as part of their orientation process to screen at-risk students before they fail, and study skills and student success instructors have found it extremely useful to administer to a classroom as part of a group assignment. Thanks to PAR’s PARiConnect assessment platform, the assessment can be easily administered to large groups of individuals and at a very low cost.
Learn more about the KLDA
The KLDA is a self-report form that measures academic strengths and weaknesses in key areas, including reading, listening, time management, writing, math, concentration and memory, organization and self-control, oral presentation, and anxiety and pressure. It is useful for all levels of postsecondary education, including vocational schools, technical colleges, community colleges, 4-year colleges and universities, and graduate schools.
Visit the KLDA page to learn more!
This week’s blog was contributed by Jeremy Sharp, PhD, licensed psychologist and clinical director at the Colorado Center for Assessment & Counseling and the host of the Testing Psychologist Podcast. Dr. Sharp earned his undergraduate degree in experimental psychology from the University of South Carolina and earned his master’s degree and doctorate in counseling psychology from Colorado State University. He specializes in psychological and neuropsychological evaluation of children and adolescents and provides private practice consulting for psychologists and other mental health professionals who want to start or grow psychological testing services in their practices. He lives in Fort Collins, Colorado with his wife (also a therapist) and two kids.
The past 18 months have been a rollercoaster for all of us. It seems like a lifetime ago when we got the news that my then-seven and eight-year-old children would NOT be going back to school after spring break in March 2020. I remember thinking, “Okay, we can get through this for a couple of months...things will be back to normal in the fall.” But no! Things were definitely NOT back to normal in the fall for us or for most families in the U.S.
There are many implications for kids being out of school or partially attending school for the better part of a year. I’d like to focus on the implications for practitioners who may be seeing increased referrals for issues like ADHD and learning issues.
Although some data suggest that mental health utilization (both psychotherapy and assessment) went down during the pandemic, this frankly does not match the anecdotal evidence from around the country. It seems like every practitioner I talk to is completely full—with longer waitlists than ever. Our practice has seen a huge increase in referrals for assessment of ADHD and learning disorders, and I think there is a direct link to the pandemic. Here are a few reasons why:
Instability in the environment. Kids do well with stable, consistent environments. Speaking for myself, other parents, and practitioners around the country, there was very little stability or consistency over the past year. Here are just a few examples of environmental changes: kids transitioning from in-school to in-home learning, parents transitioning to working from home, parents transitioning to being an in-home teacher, and cancellation of after-school programs and activities. Many families experienced variation or reduction in income. Marginalized groups and lower-income families may have experienced food insecurity. The list goes on and on. Increased instability = increased anxiety, acting out, distraction, or withdrawal.
Parents getting a firsthand look at kids’ behavior and academic skills. During the pandemic, many parents transitioned into the role of in-home teacher or a facilitator of education. For those parents who previously relied primarily on teacher comments or conferences to gauge their kid’s academic performance, this was an eye-opening experience. Parents suddenly got to see just how distractible, unfocused, fidgety, and (sometimes) disruptive our kids could be throughout the school day. If any parents of kids with ADHD were in denial about their children’s symptoms, those symptoms quickly became clear. Were they likely worsened by the instability mentioned above? Definitely. But many parents acknowledged and sought support once their kids were home all day trying to learn.
Parents being more burned out than usual. Not only were kids under more stress, but parents were also struggling during the pandemic. As mentioned previously, the world was turned upside down for us, too! It was challenging to juggle work (if you were still employed), finances, kids being home, spouses suddenly being home together more than usual, and any number of other things. When parents get stressed, it’s easy to focus on the negative or undesirable aspects of your child’s behavior. These might include not sitting still, interrupting the teacher, not doing their work, blurting things out, and so forth. Even if these behaviors are occurring with typical frequency, a stressed-out parent may notice them more often and perceive them to be more severe.
Increased variability in learning. Again, structure is important. In addition to the big-picture environmental instability discussed earlier, the academic realm itself was quite variable for many kids. Teachers absolutely did their best to develop and implement remote learning options. And yet, many children ended up with multiple platforms or websites to navigate. Many did not have stable internet access, which disrupted video and audio delivery. The remote school day typically looked different than the in-person school day, with many kids completing their work more independently than before. For kids with attention concerns, this was a recipe for disaster.
Related post: Jeremy Sharp on Trauma-Informed Assessment
All of these factors created quite a dilemma. Yes, many clinicians have seen increased referrals for ADHD evaluations, but how does one evaluate ADHD with so many environmental influences? These are just a few strategies that we’ve employed:
Conduct a more thorough intake. Our intakes now include explicit questions to gauge the impact of the pandemic. We ask about changes to the family routine, including parent work schedules, parent involvement in learning, kids’ reactions to the pandemic in general, loss of sports or after-school activities, and the timeline of in-person vs. remote learning.
Pay more attention to history. With a neurodevelopmental disorder like ADHD, history is always important. It should not just emerge out of nowhere. But with many parents now seeing longstanding or acute symptoms of ADHD firsthand, this factor is more important. In the past, we may have gotten by with documenting symptoms within the last year and going on our way with a diagnosis. Now, we must look further back. Were these symptoms present prior to the pandemic? Are they only happening during academic times? Do they vary based on in-person vs. remote learning?
Be less confident. Principle 5 of the American Psychological Association’s guidance on psychological teleassessment during the COVID-19 crisis explicitly states that we should widen our confidence intervals when making conclusions and clinical decisions. This is incredibly important. Most evaluations over the past 18 months have a big, metaphorical asterisk beside the results that says, “We are not as confident in these results as we typically are. Here’s our best guess.” We’ve gotten over the fear of saying, “This is unclear right now,” and have no shame about asking families to come back in 6–12 months for a brief, updated assessment.
In summary, there are many things for us to consider as we see increased referrals for ADHD testing. We must take environmental factors into account, acknowledge that parents and kids are more stressed out than usual, know that certain groups have less access to resources than others, and generally be more diligent and less confident in diagnostic results. It’s a thrilling time, as my colleague Dr. A. Jordan Wright says, to “be brave” with our work as we navigate challenging circumstances to do our best in helping these families.
Catch up with the Testing Psychologist podcast online, via Apple Podcasts, Google Podcasts, or on Spotify.
Do you see students or clients with symptoms like restlessness, excessive talking, or difficulty staying on task? Sometimes, it can be difficult to know if the behaviors are age-appropriate and typical or if they might be signs of ADHD–the primary developmental disorder of executive function.
Find out quickly with the new BRIEF2 ADHD Form.
Using results from the BRIEF2, the gold-standard instrument for assessing executive function, the BRIEF2 ADHD Form takes a three-step approach to predict the likelihood of an ADHD diagnosis. This knowledge helps parents, clinicians, and educators get children and adolescents ages 5 to 18 years the supports they need—both in and out of the classroom.
Scoring is quick and straightforward, and existing BRIEF2 scores (or PARiConnect results) can be used–there’s no need to retest. Scores are first plotted alongside skylines of scores from children and adolescents known to have ADHD to help evaluators get an at-a-glance view of how their clients’ and students’ ratings compare. Next, using classification statistics and an evidence-based approach, scores from the BRIEF2 Working Memory and Inhibit scales are used to predict the likelihood of ADHD and determine likely subtype. Finally, specific responses on individual BRIEF2 items are compared to DSM-5™ ADHD criteria.
Results from the BRIEF2 ADHD Form can help professionals develop Individual Education Plans and provide academic interventions and accommodations and help get students on the path to success.
Coming to PARiConnect this summer!
Though several sources agree that attention deficit/hyperactivity disorder (ADHD) is is on the rise, new numbers question how much. According to a recent study published in JAMA Pediatrics, diagnoses of ADHD increased 24 percent in Southern California over the past 10 years, bringing to issue previous estimates.
As part of the study, doctors reviewed the charts of children treated at the Kaiser Permanante Southern California physician’s group from 2001 to 2010 – 842,830 children in all. They found that in 2001, 2.5 percent of children age 5 to 11 were diagnosed with ADHD, but that number increased to 3.1 percent in 2010.
The Centers for Disease Control and Prevention (CDC) estimates that about 9.5 percent of children age 4 to 17 have ADHD. Researchers in the California study believe their estimate gives a more accurate picture of the rate of ADHD in Southern California because they reviewed actual medical records, rather than relying on parents to respond to telephone surveys, which is how the CDC got its number. Furthermore, the majority of ADHD diagnoses in the California study were made by specialists using strict Diagnostic and Statistic Manual of Mental Disorders (DSM-IV) diagnoses. This complicates previous estimates, as new research found that only 38 percent of primary care physicians actually use the DSM-IV for diagnosing ADHD.