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← Back to blogIf You Had ADHD, You Wouldn't Have Graduated
All 68 students diagnosed with ADHD at one university graduated. Their grade point averages did not differ from those of typical graduates.
"If you had ADHD, you wouldn't have graduated" is not a criterion but an assumption. Diagnosis requires symptoms to impair daily functioning. Not the absence of a diploma.
In a Canadian study of 135 university students diagnosed with ADHD, 67% reported severe impairment in executive functioning. Those same students' grade point averages and standardized test scores were in the average range. Their grades did not capture the difficulties they experienced.
This is not to downplay the risk. A meta-analysis combining 98 studies found that ADHD was associated with failure to complete high school (odds ratio 3.7). But an odds ratio is a group-level measure. Within that same group, some graduate and others do not.
So how do they graduate? Through compensatory strategies developed before diagnosis: establishing routines, managing attention, and making social adjustments. High intelligence does not erase the clinical picture; it masks it. Children with ADHD whose IQ is above 120 perform at the same level on cognitive tests as a control group with average intelligence. Women are diagnosed an average of four years later and are more likely to have previously been diagnosed with anxiety or depression.
In clinical practice, the question to ask is not "Did you graduate?" but "What did it cost you?" Compensatory strategies should be explored. In women, the sequence of diagnoses should be reviewed. And screening is not diagnosis.