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- [00:01]
A
Welcome back to the Thriving Kids Podcast from the Child Mind Institute, a nonprofit dedicated to transforming the lives of children and families experiencing mental health and learning disorders. I'm your host, Dr. Dave Anderson. This is the third and final episode in our series on the transition from high school to college. In the first two episodes, we explored why this transition can feel so challenging and what's happening beneath the surface when students struggle with skills like organization, time management and follow through. In this episode, you'll hear our clinicians focus on what families and students can do to prepare for college more effectively. We'll cover practical supports, routines, accommodations, and signs that a student may need additional help, along with guidance on how parents can support independence without stepping in too quickly. I'll hand it back to my colleagues, Dr. David Friedlander, Dr. Adam Zamora and Dr. Morgan Eldridge to wrap up the series.
- [00:55]
B
Now that we've kind of covered a lot of information on what makes college in this transition so challenging, I'd love to focus on some actionable preparation. Right. What can parents can students do now to get ready kind of practically and emotionally since we know this is a big transition. So to you Adam, let's start with support. What kind of key academic or kind of campus based resources should families be thinking about or identifying before the their student even leaves for this big transition?
- [01:30]
C
Yeah, well, a couple things. So I think just in general in preparing students for the transition in the first place is the last year of high school. Parents can help their kids by and teachers can also help their students by rewarding and providing more motivation towards doing things on their own. Not, you know, 100% being independent because as we said before, like not even full blown people who are adulting are 100% independent. But I think just getting them more comfortable with making more of their own decisions and reflecting upon what went well about that decision, what didn't, validating those efforts, providing encouragement and positive reinforcement that can really go a long way. And now going back to what we were talking about with students who have mental health or learning challenges, if you've been diagnosed with a learning disorder or ADHD or any other neurodevelopmental challenge, there are supports that you can be and should be utilizing in college. Most schools have some kind of service center called the Office of Disabilities or Accessibility or Learning that can assist with those supports and accommodations. And chances are if you have a pre existing diagnosis, you've had a neuropsych evaluation or some kind of psycho educational evaluation that documents your profile of strengths and weaknesses and the accommodations that you've utilized throughout high school, maybe even earlier. And those are the accommodations that you should still be utilizing in college. Those reports typically spell out, like, exactly the accommodations that you should be entitled to receive, that they're not there to like, give you a leg up on anybody. They're there to help you reach what your potential actually is. Even students in graduate school often continue to utilize accommodations for support. Colleges also have peer tutoring or writing centers or math centers that can support challenges that you might have. The services are often free on campus. If you don't know, if you don't ask, you won't know. And sometimes there's peer tutoring for specific subjects. And if you feel uncomfortable asking a peer or talking to a peer about something that you're struggling with, there are always TA sessions, office hours that the professors hold. Those are actually, like, really important. There are opportunities for the people who are actually grading your assignments to get to know you. And especially in those like, early hundred level classes where depending upon the size of school you're in, they might have 100 kids in them, they might have like 300 students in them. Your professor is not going to know who you are unless you're always raising your hand in class, unless you're showing up during office hours or sitting outside of the professor's office. I always tell my students, like, sit outside the professor's office in whatever, like the academic resource center is for that department during your professor's office hours. And that's the time when you should be doing your homework for that class. Because then you're doing the homework. If you have a question, you can just pop into the professor's office or wait until you know somebody else has come out of it since their office hours and ask that question. And the professor, the professor gets to know who you are. And that can often make the difference between getting an A minus or a B plus or passing or failing a class. Believe it or not, like, professors want to know that their students care about the work that they're doing and the subject that they're learning. For the most part, professors have chosen to specialize in an area because they're passionate about it. So they get excited when their students are passionate about that same kind of work. So I tell students that office hours are. They're mandatory, they're not optional. I also think that, as we were saying earlier, your peers, your classmates can be a really great resource for academic help in the form of putting together study groups, shared notes, and more. You know, obviously not asking your friends to do your work for you. But sometimes if you're doing the work with somebody, like somebody who you know actually does well in the subject, you can learn a lot from them about how they're approaching the topic. And sometimes there's that like one little hurdle that you're having trouble figuring out. And maybe for the kind of kid who doesn't feel comfortable going to a professor and asking them questions, you can just like poke appears brain about a question and that'll unlock your ability to be like, wait, oh, now I know how to do this. That totally makes sense now that so and so explained it to me in a way that my professor couldn't. And also, and David can talk a little more about this, but college campuses usually have counseling centers that offer mental health support weekly or as needed. But at the end of the day, what I, what I want students and their parents to understand is that the, the supports that you relied upon in high school, now's not the time to give them up. Now's the time to make sure that you're going to be getting those supports in college and that the transition from high school to college with the supports is as seamless as it can.
- [08:05]
B
Thank you. Yeah. And Dr. Zamora, teed you up here, Dr. Friedlander, but we would love to hear kind of for students who may need additional support related to, you know, mental health, what are some on or off campus options that they should be considering or thinking about?
- [08:25]
D
So we'll start with the on campus. Every college that I'm aware of will have an on campus counseling center which will provide individual therapy, group therapy on some campuses, medication management, but not necessarily all. One thing to be aware of with these centers is it really depends on the school how well equipped and well staffed they are. There are some schools that will have a policy of we can do a limited time like brief up to 10 session intervention and then we simply do not have enough staff. They keep seeing you. So if your mental health needs will go beyond 10 weeks, they will likely have to refer you out other campuses. That's not the case at all. They'll see you for four years, no questions asked. But it really does depend entirely on the school and it's not necessarily predictable. Based on this might be a school that has a really great psychology program that they teach and they might not actually have that well staffed or while funded a college counseling center. So if you're thinking you might need to be making use of those resources, do your research before you get to campus and if it turns out that they really aren't the best fit for you. The on campus student counseling services. There's all sorts of resources in the community, right? Private therapists such as myself or Dr. Zamora, people who might label themselves a coach, right? It's a different kind of training, but it can still often be useful to people with mental health or learning challenges. Psychiatrists, physicians, assistants or nurse practitioners to provide medication. Either if you already know from earlier in your life that you take and require psychiatric medication, or if it's something you're thinking you might need for the first time based on challenges that have arisen after your transition to college. If you have a provider back home in many states, there's something that we call the psypact law that allows mental health providers to provide telehealth services across states. Alternatively, if you're going to school in the same state as your at home provider or in another state that they have a professional license in, they still might be able to be your provider while you're off at school. There's also things that I think frankly don't get talked about enough, such as like community supports. Probably most people have heard of things like Alcoholics Anonymous or Al Anon, Narcotics Anonymous. But like there's support groups for everything, right? There's a support group for grief. There's a support group for my parents and I don't get along anymore because I don't participate in the religion the way I used to, right? Like if you have any sort of problem, there's probably a support group because you're probably not the only person who has that problem. And especially if you go to a big enough school or a school in a big enough city, you can probably find a support group for something that you need. And then that's not necessarily something that will have a professional running it. Those are usually volunteer run and peer led, but there is actually great research supporting their efficacy as well. So whatever your problem is, I would say start with this is what I need help with and then just ask the Internet what's out there. You'll probably find something
- [11:52]
B
that's really helpful. And I'm curious, you know, just thinking about like the big social transition which we've alluded to in our time together today. How can families help students connect socially before or right after kind of arriving on campus? Since we know connection is such a big protective factor.
- [12:15]
D
So a lot of that you can sort of let your interests be your guide. There's going to be a club day. Every school I've ever heard of or been aware of has like a club day within the first couple of weeks of school starting. And if you know that you're interested in board games or singing acapella or debate. Right. Like, whatever your interest is, there's a decent chance there's a club that's either directly for it or at least adjacent to it. But you don't have to just like show up to the club fair and hope every college website will have a list of these programs.
- [12:52]
B
That's helpful. Yeah, I remember early on my freshman year just really getting connected to different groups based on what I loved to do. So, so that's an easy way to connect.
- [13:04]
C
I, I think it's also helpful to think of it like you're, you're going to be in a dorm with certain people who you may click with incredibly well, and they might be your friends the whole time you're in college. You may not get along with the people in your dorm, or it may just be that you don't really have a lot in common with them. But joining groups for things that you're passionate about or willing to try and might not even know that you're passionate about yet. That's where you can find some of the people who become your people.
- [13:41]
B
Yeah. Yeah, I love that leaning in finding your people super helpful. And I'm curious. Adam, I know we've talked some today about, like, accommodations and, you know, different, different like services that students should be thinking about ahead of time. Can you touch on just preparing documentation or accommodations ahead of getting to college?
- [14:06]
C
Yeah, I mean, I, I don't want to sound like a broken record, but at the end of the day, if you benefited from testing accommodations or mental health support in high school, college is not the time to set those aside. Completing assignments or tests without accommodations can often result in your work underrepresenting what you're actually capable of doing. And college is also a time, as we've been saying earlier, when latent mental health symptoms can resurface or grow more intense than they have before. So I would recommend reaching out to the disabilities office or office of accessibility or learning support, whatever it's called at the college. And as soon as you confirm your enrollment in that school, and if your most recent evaluation, like your most recent neuropsych, is recent enough, submit that to them and you'll generally be set. If they say, oh yeah, this evaluation was like four or five years old, we need something more recent, then immediately reach out to the person who did your last neuropsych or, you know, if you had a Bad experience with them, maybe like reach out to somebody new and get an updated evaluation. Because also, chances are over the last four plus years, your strengths have changed. Maybe some of the supports that you can receive in college need to be updated. So it's a really good time. And chances are your previous evaluations happened before you're 18. So maybe you never even read your neuropsych and now's your opportunity as an adult to get your own neuropsych, to read your own report and to really fully understand yourself and everything that comes with, like, how you think, how you learn, how you solve problems. I think that that's super exciting. On the mental health side of things, though, I would say, as David was saying earlier, find out if you're in the same state that your current provider is licensed in, and if not, maybe they can help guide you through the process of finding a new provider on your new campus in whatever state it's going to be.
- [16:22]
B
That's helpful. Thank you. And wanting to make sure, you know, we have adequate time for questions and want to move into kind of our last piece before that. But I would love to kind of wrap up with the toolkit with a few, few kind of key themes, you know, for students themselves. So back to you a little bit. Adam, I'm curious. How can students learn to advocate for themselves and handle common college stressors, right? Like roommates, conflicts, or maybe academic setbacks?
- [16:58]
C
So college is really the time to learn how to think for yourself, how to recognize what success can and should look like for you as an individual. You probably have an idea of like what your parents envision for you and maybe what you think they want for you. Maybe that's not the reality of things. But ultimately, as you're learning about yourself, you learn about what makes you successful, what gets in the way, what you need to meet your own needs and solve your own problems. You don't need to do everything on your own to be independent. You just need to recognize what's realistic for you to do yourself, what something you can resource out to somebody else or talk to somebody and collaborate with them so the two of you can get it done together as a team. In general, if you notice that you keep encountering the same problems without them getting better, maybe it's time to ask somebody else if they can chip in and help you out. There are professionals with expertise who are willing to provide aid. But sometimes a friend or a family member is a great resource and someone who's always willing to help too. Like around my house, I Can do, like, very simple, fix it. Things like if a screw's loose on a door hinge, I can fix that. But if the toilet's overflowing and there are plumbing problems, I'm not going to try and fix that myself, even with YouTube. So there are things that I'm designed for that are. That prey to my strengths and things that not so much. And at the end of the day, you're going to make mistakes in college, you're going to make decisions that don't work out how you expect them to. That's life. That's being an adult. And maybe before this, someone else has always made those decisions for you or helped you fix them. Building resilience and grit and success for yourself are all about knowing that the mistakes or the prototyping of things from mistakes to success are just inevitable, unavoidable, part of the process. The more you lean into that and reflect upon the process and focus on what you alone can control, not what's outside of your control, the more you're going to feel confident about being an adult when college is over.
- [19:27]
B
Yeah. Thank you. And David, anything you would add to what routines or support systems might help students stay grounded and really know when they need to seek additional support or help?
- [19:40]
D
So the most important thing to know is your baseline, right? So if you were perhaps on a sports team in high school and perhaps not a NCAA athlete anymore, that was an amount of exercise you were probably getting multiple days a week that you're not getting anymore, your body might notice that change, right? If you were eating three square meals a day because you were living at home with your parents and they were making sure it was happening, and now you're sleeping till 11 in the morning, running off the class, getting back to your dorm at 3, and you're eating one big meal in the evening, your body's going to notice that change, right? So what's your baseline? And when you start deviating from it, are you starting to notice that maybe your concentration is going? Maybe your mood's not what it used to be, Maybe your energy level is not what it used to be. When those routines start to slip and you start to see a change in your attitude, your personality, personality or behavior, that's definitely a red flag. Conversely, trying to keep those things consistent, right? If you tended to have a pretty regular sleep cycle when you were at home for the first 18 years of your life, trying to keep a regular sleep cycle in college is going to be a protective factor for mental health changes. Keeping some sort of exercise in your routine, keeping some amount of social connection in your routine, all of those things, they were working for you for a certain length of time in your life. As Dr. Zamora has been alluding to. Now is not the time to make big changes in terms of what's been working. But because of the freedom that tends to come with living independently, sometimes young adults start to think that they can make some sacrifices in those areas. And I'll be fine, right? Like, I got into this awesome college. I can not sleep enough and not eat three balanced meals. And I'm sure I'll just be able to figure it out later. Your brain and your body actually would very much appreciate it if you kept sleeping eight hours a night and eating healthy, regular meals. And so I guess I would also say for parents, it's tricky because your teens and young adults are going to want independence from you and they definitely don't want to feel like you're like, parenting them just as strongly as you were when they were living with you.
- [21:57]
B
Because.
- [21:57]
D
But if you're getting a very clear sense that your kid is not sleeping enough, not eating regularly, not moving their body as much as they used to, that would be a time for you to maybe start having some conversations about it.
- [22:12]
B
Thank you. That's really helpful. And now we're going to open up to questions from the audience. I know many people have already placed their questions in the chat, so thank you all so much. And we're going to take as many questions as we have time for to start us off. One question that was put in the chat was when should you disclose the need for accommodations before or after acceptance to college?
- [22:43]
C
You technically can do it at any time, but I would say there's no reason to ask for accommodations before you've even gotten into the school. I think really what you should do is research. Does the school actually provide support for kids who have accommodations historically? Do they have a learning center? Do they have peer tutoring, or maybe even like executive functioning supports on campus? And then after you get into the school, you submit the report that outlines what the accommodations are that you need. I think that's probably the standard way to go about it, and that's what I would probably recommend.
- [23:28]
B
Yeah. Relatedly, another question put in the chat was just curious about, as experts, what your experience has been with colleges honoring accommodations for students that have had 504 plans in high school. This person indicated that they believe they don't always carry over, but are just curious what you all have experienced or seen.
- [23:54]
C
Well, it probably depends upon the accommodation and it varies from school to school. Whereas 504 plans or IEPs are government mandated documents where they ultimately like, you need to follow these recommendations. Colleges have a little more freedom to do what they want to do. However, the. The more standard accommodations like extended time, maybe being able to take a test in a separate location, being able to type versus handwrite, although that's not so much an issue anymore. Most schools won't make you handwrite long exams. I just am scarred from the days of writing in blue books when I myself had like a writing disability. So I didn't get those accommodations, but I also wasn't evaluated back then. So I think that colleges, at the end of the day, they want their students to succeed. So if you are requesting accommodations in advance, you're more likely to get them. The times when they're less likely to honor them are when halfway through a semester, you're all of a sudden reaching out to your professor and saying, I need extended time. And they're like, wait a second, there's no documentation of this. Then it becomes harder to get it in time for when you need it.
- [25:24]
B
Got it. That's helpful. And relatedly, I think to your kind of personal anecdote of not having been assessed, then one question early in the chat was, if attention has been an issue since middle school, is it possible to get assessed or diagnosed in college? Or does a lack of childhood diagnosis negate that?
- [25:49]
C
I can say that for me, when whenever I evaluate somebody, I take anything that has or hasn't happened in the past with a grain of salt. Obviously, prior history can inform a lot of what's going on now. But if I see somebody with attention, challenges, and their high school students are about to go to college, I don't assume that they were never diagnosed because it never was an issue. Very often there are really, really bright, capable individuals who are able to get by despite having a learning disorder, despite having adhd. That doesn't mean that. I like to think of the analogy of the duck swimming in the pond where it looks calm and collected on top, but it's really like kicking its legs feverishly underneath the surface of the water. A lot of these students, they got by and they might have done really well, but chances are their support system for getting their work done was pretty slipshod. Or maybe they, yeah, maybe they were just struggling and doing work much later into the night than some of their peers were and they could have used an evaluation earlier. So I think like high school college aged even as an adult. If you Always suspected, like, hey, I struggled with X, Y, and Z, but I never got diagnosed or whatever. It's never too late to understand yourself.
- [27:24]
D
I just want to add to that quickly that depending on the college counseling center or the psychology department at your school, you may even be able to get that evaluation at your school. So they're definitely, like, equipped for it in some cases. In other cases they won't be. So it is case by case and you need to do that research. But yeah, if they have a neuropsychologist at the their college counseling center, or if they have a department of neuropsychology in their psychology or psychiatry department, there's actually a decent chance you can get that evaluation at your school. And then they'll know exactly how to navigate the systems of getting the accommodations applied. There may also be a very long wait for those services, in which case you might need to look out and find somebody like Dr. Zamora.
- [28:11]
B
Yeah, that's really helpful. Along these kind of similar lines, I've seen a couple of questions that are related in the chat. One asking, you know, are there activities that can help behaviorally. Right. Without prescription medications? And also, like, what are some top two to three skills that high school students should learn or be taught before trying to make that big transition to college?
- [28:41]
D
So, I mean, narrowing it down to just two to three, when I could come up with a list, that might be tricky. But some of this stuff is maybe things that you actually already know, but you just don't realize how important it is. Getting enough sleep really is one of the most important things you can do for your mental health, for your attention, for your social functioning, putting yourself out there. Right? Like, if you stay in your dorm when everybody else is doing things, you're not going to make connections with people. Right. This one, I feel like I'm gonna really get all the parents on my side with this and maybe alienate some of the teens. But put your phone down. When you're in the first few weeks of school and you're in a common area in your dorm room and you're in the same room as a bunch of other people that you don't do know that well, maybe honestly even leave your phone in your room, right. It's just so easy when you're stressed to pick it up and lean in on a comfort behavior. But you're not going to make the connections with people if you're not available to them. So I would say those are some really easy ones that might sound like, well, oh, that's just Common sense. That doesn't seem like a real big deal. They're actually huge deals. And it can really be that easy. Getting enough sleep, putting yourself out there, and really being available to make those connections can really be a decisive difference between a lonely and really, like, not confident teen and somebody who feels like college is just super easy.
- [30:17]
B
Okay, that's helpful. I think we're going to move to our last question, and then we will wrap up. Someone had asked. Where's the question I wanted to ask? Here it is. Someone had asked just related questions of how do you get your student to initiate kind of going to disability services? If that's maybe something they're not really interested in or like, what encouragement would you offer students when their requests for accommodations are met with maybe resistance from faculty or staff?
- [30:56]
C
Well, I think talking, what I try and do for the students I evaluate, and in general, what I think most neuropsychologists do is they help students to understand why they need the accommodations. So I think students who are more resisting the accommodations, it's a combination of, as we were saying earlier, like, the drive to be more independent, feel like I can do everything on my own. And I think a lot of it is not fully understanding what is the diagnosis or diagnoses at play that are making it so that this accommodation is really what's going to help me, you know, be the best, most successful student that I can be. So having those conversations earlier rather than later, Like, I've also worked with families where the kid didn't even know that they had ADHD when they went to college, and it was a diagnosis that their parents had just kept from them for a long time. And I understand the reasons why that is, but sometimes it's not always helpful in the long run to shield kids from what is information that helps them ultimately to understand themselves. And when schools are resisting providing, you know, these kinds of accommodations, sometimes that happens at the individual professor level. Sometimes it happens at the level of the dean or office of disabilities. So there's. There's always multiple people that you can talk to. Certainly if you submit your neuropsych and your accommodations are approved and a professor is saying, well, I don't give those accommodations. Go back to where they were approved and get them to talk to the professor. There are always a lot of other resources, and certainly if your therapist or your neuropsychologist is available, have them talk to whomever is in charge of approving those services. Because sometimes it just, just a quick phone call can help them to understand why your young adult actually needs that support.
- [33:13]
B
Wonderful. That's helpful. Well, I know we're at our time, so I just wanted to thank everyone who was here with us tonight for joining us.