Action Research Project: how can I develop the time management tool to help neurodiverse students organise study tasks effectively?
My professional role and workplace at UAL and interest in time management for ADHD students
In 2019 I joined disability services at UAL, supporting neurodiverse students with study skills tutorials. My positionality impacts my role, and is shaped by motherhood, various educational privileges like studying, degrees, teaching, tutoring, as well as belonging to the status quo within heterosexuality and home ownership and as Chan et al. (2018) explain, I bring all of these elements into the tutorials in the form of power and privilege. As the tutorials are one-to-one, it is important for me to be conscious of how the power and privilege manifests, its impact upon the student and the quality of the tutorial.
These one-to-one tutorials can include students with a range of specific learning differences (spld) such as dyslexia, dyspraxia, attention deficit disorder (ADHD), attention deficit disorder (ADD) and autism and it is quite usual for mental health issues to present alongside. This sometimes is referred to as ‘co-morbidity’. For example, a review by neuro-psychiatrists Franke et al. (2018), highlights that ‘both in childhood and adulthood, ADHD is characterised by substantial comorbidity including substance use, depression, anxiety, and accidents’.
Before being ‘eligible’ for tutorials, students must be assessed and receive a diagnosis of their spld in order to qualify for accessing the disabled students’ allowance (DSA) and draw down funding to receive various study support. The process has a ‘medical model’ feel, rather than a social one, but currently, the diagnosis needs to be in place for students to access the support. It is also important for specialist tutors to be aware of how different diagnoses (or conditions) present within this co-morbidity, or intersect, as this will inform study skills strategies and approaches.
To identify that the students’ often ‘hidden’ neuro-divergencies intersect, and further intersect with class, race and faith for example, can also inform tutors’ understanding of students’ unique characters, histories and importantly, learning needs. As we have learned on this course in unit 2 with an introduction to the theory of intersectionality via Crenshaw (1995) whose work focussed specifically on being positioned at the intersection of women and race, a consideration of someone’s intersectionality can promote and foster a more social perspective of the pedagogical experience upon which tutors can build relationships with their students.
Rationale
By 2023, the UAL disability service had experienced a significant increase of ADHD and ADD students, partly forming rationale for my AR project. A recent US medical publication (Abdelmour et al., 2022) outlines reasons for the rising public awareness of the condition, such as previous neglect for ‘underrepresented minorities and women’. ADHD and dyslexia were once referred to as a ‘middle class myth’, writes Morley (2022) for Wellcome Collection, a London Museum that aims to promote connections between the arts, science and health, and this opinion does prevail, but there is increased attention from educationalists and psychologists to attest to the validity of the conditions.
A brief but informative outline from members of the medical community (Abdelmour et al., 2022) emphasises the importance of taking ADHD/ADD seriously, stating: ‘For those who have been struggling with unrecognized ADHD, there are significant impacts to mental health, social life, and work life’. However, Abdelmour et al.’s (2022) article is published in a pharmaceutical journal, which raises questions of drug endorsement. Nonetheless, that quote points to the extra pain or despair that someone feels when experiencing an undiagnosed condition, their struggles both unrecognised and unsupported. Whether or not drugs are appropriately advised is another topic, as is the unprecedented UK national shortage of ADHD medication (ADHD UK, 2023) impacting some of our students.
In addition to growing support and acknowledgement from the medical community, UAL students’ take up of ADHD assessment opportunities at the university is also down to the UAL’s disability services’ promotion of our support for this condition.
Recently, to combat the National Health Service (NHS) waiting lists for ADHD/ADD diagnosis, the DSA put in place an ADHD/ADD assessment for university students, a diagnosis process specifically recognised in the context of higher education. This has also contributed to the rising requests for support from these students, as they are now more able to access the support quickly. The growing population of this HE ADHD diagnosed group further contributed to the rationale for the AR project which asks: how can I develop the time management tool to help neurodiverse students organise study tasks more effectively?
Literature and secondary research
Some ADHD people may identify with the UK’s government definition which considers that, ‘You’re disabled under the Equality Act 2010 if you have a physical or mental impairment that has a ‘substantial’ and ‘long-term’ negative effect on your ability to do normal daily activities’ (GOV.UK, 2023). This definition emphasises the substantial and long-term effect which people experience throughout their day to day lives, that sets a criterion for disability labelling.
Some people may find the medical model labelling helpful to understand their physiology and identify with having a type of impairment that impacts their daily lives in a way that puts them at a disadvantage. The impact can manifest as the stress that comes with ADHD, which is defined as, ‘A persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development’ (American Psychiatric Association, 2023).
In contrast, other people experiencing disability may take the position that the social model assists their perspectives of what it’s like to function in society when society is more conveniently arranged for normatives. The below diagram (figure 1) from the Parliamentary and Health Service Ombudsman that I stumbled across outlines the 2 contrasting models.
Models and theories of disability continue to emerge, and like most models, some are more relevant to individuals or particular situations than others. Concerning critical disability studies (CDS), Shildrick (2019) writes that,
‘In the most recent years, the powerful emergence of what has come to be called critical disability studies has added new force to the theoretical impetus already at the heart of the social model to take it in new directions that challenge not simply existing doxa about the nature of disability, but questions of embodiment, identity and agency as they affect all living beings’.
Shildrick’s (2019) description of CDS points to the intersectionality of people’s identities and agencies, a theoretical perspective valuing a detailed and in-depth acknowledgement of individuals’ unique localities. Disability theorists Meekosha and Shuttleworth (2009, p.50) also highlight that ‘the term ‘CDS’ is a move away from the preoccupation with binary understandings — social v medical model, British v American disability studies, disability v impairment’.
Meekosha and Suttleworth (2009, p.50) continue with that, ‘The social model of disability argued for a conceptual distinction between ‘impairment’ as a functional limitation and ‘disability’ as a socially generated system of discrimination’ (Meekosha and Shuttleworth, 2009), and that the emerged CDS is less binary and open to a range of complex perspectives. These writers highlight that an underpinning principle of CDS is ‘the irreducibility of social life to objective facts’ (p.47). This highlights the complexities and nuances of experiencing life in the context of ever-changing social landscapes. They put forth another main principle that emphasises CDS’s aim to work towards a participatory and autonomous society, fighting against discrimination of ableism, as outlined by disability theorist Dan Goodley (2014), whose publications have made an extensive contribution to the field.
I have to emphasise the hidden challenges for people with ADHD to participating in society, as their processing of information (thoughts and feelings) and sensory integration (putting together messages from their senses) often overwhelm them. Their slower processing leaving them struggling to organise their responses to stimuli and in a state of stress. Their diagnosed or undiagnosed ADHD can make every single thing they do in the day difficult.
Whether or not an ADHD person considers themselves struggling with an impairment, facing discrimination of ableism, living in a neurodivergent mind, disadvantaged by their surrounding social structures or uniquely placed at the point of their intersecting realities, some elements of their condition remain the same (see Shaldrick’s (2019) footnote 1 in the appendix, outlining brief debate on varied disability language and identities). The element that takes the focus of my AR project is their stress, the stress they feel in how they experience the measurement of time, their temporal reality. Thus, my research asks, ‘how can I develop the time management tool to help neurodiverse students organise study tasks more effectively?
Although I have considered myself well-versed in ADHD/ADD in the past having experienced the living reality of raising an ADHD child, I recently realised I didn’t know enough to help the students whom I support with their time management, which required more than me suggesting they buy a weekly planner. I actively searched from my colleagues and from literature more information to improve my study support and help students approach their study tasks more effectively. From speaking to colleagues and reading, I learned that some people’s limited time horizon, how far into the distance they can perceive things happening, means they are often caught off guard (Green, 2023), and are unprepared for the deadlines that appear very suddenly in their life (see Tuckman’s (2022) article for ADHD ADDitude magazine for such an excellent description of what it’s like to have a short time horizon and experience ‘temporal discounting’). Lernia et al. (2018, also cited in Green, 2023) explain how ‘scalar expectancy theory (SET).1 SET describes time perception as a kind of internal clock where time is measured out in pulse rate’. ADHD people sometimes cannot integrate this internal clock with information from other senses, such as light and sound (Green, 2023), a type of sensory integration issue.
Research Question and Research Aims
Research question: how can I develop the time management tool to help neurodiverse students organise study tasks effectively?
My new knowledge gained in 2022 around some ADHD people’s limited time horizon and its impact on learning and all aspects of living further initiated rationale for the AR project and also focused it along the journey. Although there are many other ways ADHD/ADD students are affected by their relationship with the passing of time and how they use their time, this intervention’s research aim is narrowed to help students understand ‘how long things take to do’, and how ‘important’ those things are.
In July 2023 I continued to research the subject and drew on a little of Zimbardo and Boyd’s (2008) time theory. This work is focused on how people’s perspectives on their past, present and future, their orientation, affects their outlook, productivity and mental state. A positive regard for your time is important, I believe, to enhance your productivity but I was looking to focus the AR on something more specific, that could specifically make a difference to students’ productivity.
Around the same time, I discovered the Eisenhower matrix, seen below, and showed this template to a friend and a peer at UAL. Both their responses to the matrix helped initiate the research question.
Here is an Eisenhower matrix, which I wanted to change/adapt/improve and use it as an intervention in my practice. There are quite a few versions already, but I couldn’t find one focusing on the research aim noted above, ‘how long things take to do’.
The Eisenhower Matrix (Slab Blog, 2023)
Ethics
By September 2023, I had a research question and in Oct 2023 I pursued ethical approval to show the improved time management model to the students I support.
This departmental approval I could not get due to concerns over power dynamics within the tutorial due to my privileged role of the expert in the tutorial space, my seniority, researcher status, comfort in my role, all in contrast to the students’ status as novice, learner as well as neurodiversity challenges. Chan et al.’s (2018) article outlines how individuals’ practice cannot be separated from the powers and privilges that prevail from their identities. The disability department fed back to me that the students we support are already considered vulnerable in relation to their Spld or disabilities and have enough things to cope with, without having to take a position of either consenting to participating in research or not. Fair enough.
Methodology
In November 2023 I developed a questionnaire for my staff peers for their feedback. We also made time to have a discussion for me to gain more feedback on the intervention, the newly developed time management model (see further blog on methods for details).
METHODS are outlined in another blog – Methodology Rationale
Conclusion
This contextual review has aimed to set the scene of my AR project that seeks to answer the question: how can I develop the time management tool to help neurodiverse students organise study tasks effectively? It has focused on the condition ADHD, one of the main target population group that I support in my role who struggle with time management. It has explored some disability positionalities and highlighted the stress that people with ADHD experience, all of which has provided some rationale for the project, alongside the growing group of UAL ADHD students who come to study skills for support.
References
Abdelnour, E., Jansen, M. O., and Gold, J. A. (2022). ADHD Diagnostic Trends: Increased Recognition or Overdiagnosis?. Missouri medicine, 119(5), 467–473.
ADHD UK (2023) REPORT: THE ADHD MEDICATION CRISIS. Available at: https://adhduk.co.uk/adhd-medication-crisis-report/ (accessed 5.12.2023)
Chan, C. D., Cor, D. and Band., M. P. (2018) Privilege and Oppression in Counselor Education: An Intersectionality Framework. In Counselor Education: Portland and State University.
Crenshaw, K. (1991). Mapping the Margins: Intersectionality, Identity Politics, and Violence against Women of Color. Stanford Law Review, 43(6), 1241–1299. https://doi.org/10.2307/1229039
Franke, B., Michelini, G., Asherson, P., Banaschewski, T., Bilbow, A., Buitelaar, J. K., Cormand, B., Faraone, S. V., Ginsberg, Y., Haavik, J., Kuntsi, J., Larsson, H., Lesch, K. P., Ramos-Quiroga, J. A., Réthelyi, J. M., Ribases, M., & Reif, A. (2018). Live fast, die young? A review on the developmental trajectories of ADHD across the lifespan. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology, 28(10), 1059–1088. https://doi.org/10.1016/j.euroneuro.2018.08.001
Goodley, Dan. (2014). Dis/ability Studies: Theorising disablism and ableism. Routledge
GOV.UK (2023) Definition of disability under the Equality Act 2010. Available at: https://www.gov.uk/definition-of-disability-under-equality-act-2010 (accessed 1/12/2023)
Greene, R. (2023) Time blindedness and ADHD. Available at: https://www.verywellmind.com/causes-and-symptoms-of-time-blindness-in-adhd-5216523 [accessed 8/05/2023]
Morely, M. (2022) Dyslexia and its misconceptions. In Wellcome Collection. Available at: https://wellcomecollection.org/articles/Yfv_thEAACEALrqh (accessed 22.11.2023)
Parliamentary and Health Service Ombudsman (2023) Introduction to the Social and Medical Models of Disability. Available at: https://www.ombudsman.org.uk/sites/default/files/FDN-218144_Introduction_to_the_Social_and_Medical_Models_of_Disability.pdf (accessed 1/12/2023)
Ptacek R, Weissenberger S, Braaten E, Klicperova-Baker M, Goetz M, Raboch J, Vnukova M, Stefano GB (2019). Clinical Implications of the Perception of Time in Attention Deficit Hyperactivity Disorder (ADHD): A Review. Med Sci Monit. 2019 May 26;25:3918-3924. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6556068/#b37-medscimonit-25-3918 [accessed 24/05/23]
Shildrick, M. (2019) Critical disability studies: Rethinking the conventions for the age of postmodernity. In Routledge handbook of disability studies (pp. 32-44). Routledge.
Tuckman, A. (2022) ADHD Adults -TIME & PRODUCTIVITY: Why Deadlines Pounce and Long-Term Plans Never Happen. Available at: https://www.additudemag.com/how-to-plan-ahead-when-you-have-adhd-understand-time/ [accessed 6/07/23]
Victorino, R.C. (2023) The Eisenhower Matrix: Prioritize Your Time on What Matters Most. In Slab Blog. Available at: https://slab.com/blog/eisenhower-matrix/ (accessed 1/12/2023)
Zimbardo, P.G. and Boyd, J. (2008) The Time Paradox: The New Psychology of Time That Will Change Your Life. Atria Books.
Appendix
‘The terminology around disability is highly contested, not least around the naming of those who putatively occupy the category. The current preference within both CDS, and some but no means all activists circles, is for ‘disabled people‘ rather than ‘people with disabilities‘, although even then, practice may vary between the UK and US. The term, people with disabilities, was initially promoted to signal a break with older and more evidently stigmatising terms such as handicapped, retarded, cripples, and so on. Other supposedly more positive designations such as differently-abled, physically challenged, or special needs have fallen from favour, and the use of so-called people-first language forms is now seen as a failing to encompass the significance of disability (Overboe 1999, Titchkosky 2006), treating it as more a contingent add-on than a fundamental element in the production of identities. Nonetheless, people with disabilities remains in widespread use among disabled and non-disabled people alike, and some academic journals make it mandatory. On either side such policing seems unnecessarily divisive, and in any case chases after the illusion of perfect terminology that will not in time become marked by ongoing prejudices and anxieties. Accordingly, although I prefer ’disabled person‘ as more adequate to denoting the process of embodiment, I use its alternative wherever it seems contextually more appropriate’.
Footnote 1, Shaldrik (2019, p.10)