Attention‐Deficit Hyperactivity Disorder (ADHD) is a common, genetically transmitted neurological disorder, with onset in childhood, probably mediated by decreased brain dopaminergic functioning. The first author was one of the earliest to describe the persistence of symptoms into adulthood. Prevalence and natural history data suggest that of the 3 to 10% of children diagnosed with ADHD, one‐ to two‐thirds (somewhere between 1 and 6% of the general population) continue to manifest appreciable ADHD symptoms into adult life. This paper describes how ADHD in adults can be readily diagnosed and treated, despite resembling or coexisting with other psychiatric disorders. The Wender Utah diagnostic criteria address adult characteristics of the disorder. Informant and patient interviews and rating scales are used to determine the psychiatric status of the patient as a child, make a retroactive diagnosis of childhood ADHD, and establish the current diagnosis of the adult. Stringent diagnosis is key to determining effective treatment. Dopamine agonist stimulant medications appear to be the most effective in treating ADHD. About 60% of patients receiving stimulant medication showed moderate‐to‐marked improvement, as compared with 10% of those receiving placebo. The core symptoms of hyperactivity, inattention, mood lability, temper, disorganization, stress sensitivity, and impulsivity have been shown to respond to treatment with stimulant medications. Non‐dopaminergic medications, such as the tricyclic antidepressants and SSRIs have generally not been useful in adults with ADHD in the absence of depression or dysthymia. Pemoline is no longer appoved for use in these patients, despite early favorable reports. Appropriate management of adult patients with ADHD is multimodal. Psychoeducation, counseling, supportive problem‐directed therapy, behavioral intervention, coaching, cognitive remediation, and couples and family therapy are useful adjuncts to medication management. Concurrent supportive psychosocial treatment or polypharmacy may be useful in treating the adult with comorbid ADHD.

Nearly 25 years of special education law have enabled many qualified students with disabilities to graduate from college preparatory high school programs and enter institutes of higher education. The Americans with Disabilities Act enacted by Congress in 1990, the Individuals with Disabilities Education Act of 1975, and Section 504 of the Rehabilition Act of 1973 all mandate special education services for students with disabilities. A parallel nationwide rise is being reported in the numbers of students with disabilities on college campuses. The greatest increase is seen in students with so‐called hidden disabilities such as learning disabilities, ADHD, and psychiatric disabilities. These students face a number of obstacles once they are admitted to college. Many factors, some intrinsic to the student and others extrinsic to the campus, moderate success in higher education. Overlapping or multiple diagnoses, psychological distress, poor social and interpersonal skills, persisting cognitive deficits (especially in the area of executive functioning), and alcohol abuse are important factors that must be understood as institutions of higher education strive to promote access and provide effective support services on their campuses.

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