Randomized Controlled Trial of a Technology-Based Intervention to Enhance Academic Organization and Planning in College Students with ASD and ADHD
Adults with autism spectrum disorder (ASD) and/or attention deficit hyperactivity disorder (ADHD) are less likely to attend or graduate from college than peers with other disabilities or typical development (Shattuck et al., 2012, Dvorsky & Langberg, 2014). Simonoff et al. (2008) found that ADHD was the second most common comorbid disorder in individuals diagnosed with ASD. Further, ADHD symptoms have been found to negatively correlate with study habits and academic adjustment in the college population (Norwalk et al., 2008), suggesting that ADHD symptoms (e.g., monitoring, organization, planning, prioritizing) may contribute to poor academic outcomes in college students with ASD and ADHD.
To examine the novel application of tablet technology, using an academic e-planner app, to help college students with ASD and/or ADHD monitor their assignment and exam due dates, prioritize and plan time for homework, and stay academically organized. The study included an active control group, which used an app that monitored daily water consumption rather than academics, to control for general tablet use and motivation.
Participants consisted of 38 undergraduate college students, 28 with ADHD (19 male; 9 female) and 10 with ASD (7 male; 3 female) ranging in age from 18-50 years (M=23.90, SD=6.56). Participants were eligible for the study if they had provided medical documentation of their ASD and/or ADHD diagnosis to the UC Davis Student Disability Center (SDC) and were currently receiving academic accommodations through the SDC. All participants were loaned an iPad tablet for a term and, using stratified randomization based on diagnosis and gender, were assigned either the academic e-planner app or the hydration tracker app. Thirty-eight were randomized and 6 were lost to follow-up (2 with ASD; 1 in treatment and 1 in control), so 32 were included in the primary analyses. The primary outcomes were the subscales (Academic Organization/Monitoring and Hydration Monitoring) of a 15-item instrument developed by the research team.
For the Organization scale, the improvement at follow-up from baseline was significantly higher (p-value = .04) in the treatment group (follow-up vs. baseline difference = 0.43, 95% CI -0.06 to 0.92) than in the control group (follow-up vs. baseline difference = -0.20, 95% CI -0.60 to 0.20). There were no significant treatment vs. control differences in improvement at follow-up in Hydration Monitoring (p-value ≥ .15), although, as expected, the control group tended to have better improvement in Hydration (follow-up vs. baseline difference = 0.52, 95% CI 0.21 to 0.83) than the treatment group (follow-up vs. baseline difference = 0.14, 95% CI -0.32 to 0.61). The size of the ASD group was too small to allow formal subgroup comparisons, but 3 of the 4 ASD participants in the treatment group showed improvement in Organization that was consistent with the overall treatment group.
Our study provides evidence that specifically using an app to monitor academics enables students to manage their school workload better. Future research should assess the effectiveness of an academic e-planner app in a broader college community of students with ASD and/or ADHD.