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The Baddeley and Hitch [107] conceptual model of working memory (WM) in Fig. 3, proposes that WM is a core EF for storing and manipulating information, and with a central role in attention, allocating data to its slave systems (phonological loop and visuo-spatial sketchpad), performing task switching, mental arithmetic, problem solving and interfacing with long-term memory through the episodic buffer. The episodic buffer acts as a temporary store for the phonological loop, which processes spoken and written information, whilst the visuo-spatial sketchpad processes visual imagery. Although this model can be used to understand the importance of WM in academic tasks such as reading, comprehension, verbal reasoning (phonological loop), navigation (visuo-spatial processing) and problem-solving (central executive) [107,108,109,110,111], the model can also be used to understand how deficits in WM might occur in both ADHD and reading disorder [93]. Reading disorder (e.g., dyslexia) is defined by deficits in decoding the speech sounds of words and structure of language (phonological weakness), fluency (an inability to ready quickly with appropriate expression) and processing speed [11, 91, 93, 102].
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The expert group recommends multimodal interventions for university students with ADHD, that comprise a variety of interventions including environmental modifications, psychoeducation, medication, academic coaching, DBT, CBT, counselling and/or mindfulness-based interventions. University counselling and disability services do tend to offer a range of psychosocial interventions for students, whether delivered online, face-to-face or in a group.
In summary, UKAAN convened an expert consensus meeting to provide an informed understanding about the impact of ADHD on the educational (or academic) outcomes of university students and to highlight an urgent need for timely access to treatment and management. An overview of key issues, as well as expert advice and guidance has been offered. In Table 10 below, the main recommendations of the expert group are summarised. There is little doubt that university students with ADHD are struggling with long delays in accessing a diagnostic assessment, treatment, and personalised educational support. The provision of rapid access treatment and care pathways can be challenging for clinicians working in specialist NHS ADHD clinics, but examples of good practice are also beginning to emerge, with some university disability services drawing on their own budgets to support their students. Further work is needed to develop and evaluate efficient and cost-effective treatment and care pathways for university students with ADHD (for example see Fig. 4), and to adopt models of best practice across the sector. University students, including those with ADHD, are at a crucial transitioning stage in life and their success at university is likely to determine their success in highly competitive employment markets. This strengthens the argument to support all university students in an inclusive manner. Methods for inclusive teaching and learning are also likely to cater to disabled students, including university students with ADHD.
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