For many families, this time of year is defined by familiar rituals: new schedules, new classes, new roommates, packed cars, and one last trip to the store for something that was inevitably forgotten.
But for young adults with ADHD, the transition back to school can represent something much bigger.
For some, this fall will be their first time living away from home. Others may be starting college, beginning a trade program, returning to campus with greater independence, or balancing school with work for the first time. With that independence comes opportunity, but also a growing list of responsibilities that may once have been shared with parents, schools, or other support systems.
During our recent Thriving in Transition Summer Summit series, we spent a great deal of time talking about this moment. One message came through clearly: we often expect young adults to become independent before the systems around them are prepared to help them get there.
A student who previously had a parent scheduling appointments may now need to find a new clinician near campus. Someone who had medication refills coordinated at home may suddenly be navigating a new pharmacy, insurance plan, or state prescribing requirements. Academic accommodations that were familiar in high school may now require a young adult to identify the appropriate office, understand the process, and advocate for themselves.
These tasks require planning, organization, follow-through, and self-advocacy, precisely the executive functioning skills that can be challenging for someone with ADHD.
And when something goes wrong, the consequences can extend well beyond a missed appointment.
A change in insurance can trigger a new prior authorization requirement. A move across state lines can disrupt an established treatment plan. A young adult who has been successfully treated for years may suddenly find themselves having to explain their diagnosis and treatment history to a clinician with limited training in adult ADHD.
That is why back-to-school season should also remind us that successful transitions cannot depend entirely on how well an individual learns to navigate a complicated system.
We need systems that work better, too.
That means strengthening clinician education so primary care and other adult providers are equipped to recognize, diagnose, and manage ADHD across the lifespan. It means improving the tools available to clinicians to support accurate diagnosis. It means examining administrative barriers, including prior authorization, that can unintentionally interrupt access to an established and clinically appropriate treatment.
It also means recognizing that ADHD care is not one-size-fits-all.
Medication may be an important part of treatment for many young adults, and medication decisions should remain individualized, including consideration of the formulation that best meets a patient’s clinical needs and circumstances. But our Summit conversations also reinforced that young adults may benefit from a much broader toolkit: behavioral therapy, executive function coaching, sleep, nutrition, exercise, mindfulness, family support, and other strategies that help build the skills necessary for long-term independence.
We need more research into these approaches and better access to the interventions that evidence shows can help.
Perhaps most importantly, we need to rethink what we mean when we say a young adult is “ready” to transition.
Independence does not have to mean navigating everything alone.
As students settle into a new academic year, there is an opportunity for families, clinicians, educators, policymakers, and young adults themselves to ask a different question: What structures can we put in place now that will make independence more sustainable later?
That is a question worth carrying with us long after back-to-school season ends.
Jakara Eason
Executive Director