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. Author manuscript; available in PMC: 2022 May 1.
Published in final edited form as: Br J Occup Ther. 2020 Aug 20;84(5):263–270. doi: 10.1177/0308022620937636

(Dis)Ability-informed Mentors Support Occupational Performance for College Students with Learning Disabilities and Attention-Deficit/Hyperactivity Disorders through Problem Solving and a Focus on Strengths

Consuelo M Kreider 1, Sharon Medina 2, Hannah M Koedam 3
PMCID: PMC8297948  NIHMSID: NIHMS1636459  PMID: 34305266

Abstract

Introduction:

Students with learning disabilities (LD) and Attention-Deficit/Hyperactivity Disorder (LD/ADHD) are well-represented on college campuses. However, they experience challenges to meeting occupational and role expectations associated with being in college. Mentors serve as natural supports for young people within college environments. This study investigates the ways in which graduate-student mentors, who were supported in understanding LD/ADHD and their mentee’s strengths and challenges through an occupational lens, provided problem solving supports for undergraduate mentees with LD/ADHD.

Methods:

Thematic qualitative analysis was used to investigate problem solving supports provided by mentors (N = 57) of undergraduate mentees (N = 52) with LD/ADHD.

Results:

Three themes, Executive Functioning, Adult Life Skills, and Academics, represent areas in which mentors worked with mentees in guiding and co-creating strategies to address academic, social, and daily life challenges. Mentors’ understandings of their mentees’ disability-related challenges and strengths within everyday life situations was important for fostering the occupational performance of mentees.

Conclusion:

The inclusion of biopsychosocial approaches is needed in the development of disability-related mentorship interventions where occupational therapists can leverage disciplinary understanding of disabilities and the fostering of occupational performance to support social functioning and participation in college.

Keywords: learning disorders, mentors, problem solving, social support, young adults, qualitative research

Introduction

Students with learning disabilities (LD) and Attention-Deficit/Hyperactivity Disorder (ADHD) are well-represented on college campuses (Newman et. al, 2011). However, while students with LD/ADHD attend college at rates equal to those without disabilities, their college completion remains lower (Cortiella and Horowitz, 2014; Showers and Kinsman, 2017). College students with LD/ADHD experiences challenges in executive functioning and information processing (DuPaul and Volpe, 2009; Johnson, Humphrey, Mellard, Woods, and Swanson, 2010), emotional regulation (Asherson, Manor, and Huss, 2014; Elias, 2004), social performance (Asherson et al., 2014; Kavale and Mostert, 2004), and academic performance (Asherson et al., 2014; DuPaul, Gormley, and Laracy, 2013). These varied behavioral and functional challenges in LD/ADHD can exacerbate difficulties in performance of occupations and participation in current and desired social roles (Kreider, Bendixen, and Lutz, 2015). Development of supports at both the individual and environmental levels is important for improving outcomes of young people with LD/ADHD who are transitioning to adult roles through college pathways (Wolf, 2001; Kreider et al., 2018).

College mentorship has been linked to positive impacts on students’ persistence, academic achievement, and professional development (Coles, 2011). However, sparse research informs as to the specific ways in which mentorship can facilitate the coping strategies, career development, and academic and occupational performance of students with LD/ADHD. The combination of challenges related to (1) executive functioning challenges, (2) managing emerging adult roles, and (3) navigating LD/ADHD symptoms, increases the risk of poor personal, academic, and career outcomes (Gerber, 2012; Kreider et al., 2015).

We used the Person Environment Occupational Performance (PEOP) model (Baum, Christiansen, and Bass, 2015) as a theoretical lens in conceptualizing how mentors can support college students with LD/ADHD in progressing toward personal and professional goals. The PEOP model includes three essential components: 1) person characteristics (physical, motor, cognitive, etc.), 2) environmental factors (social support, physical environment, cultural aspects etc.) and 3) the characteristics of the activity, task, or role. Within the PEOP model, the interaction between the person, environment, and task demands can facilitate or hinder an individual’s performance towards their desired goals (Baum et al., 2015). Consequently, in order to enhance performance in everyday life activities and contexts, students with LD/ADHD may benefit from supporters that are knowledgeable about 1) LD/ADHD symptoms, strengths, and challenges, 2) career trajectories, and 3) holistic mentorship approaches. Mentors serve as natural supports for young people within college and workplace environments. Mentors are able to provide emotional and social support while offering important understanding through provision of the school or workplace’s cultural or normative framework (Kreider et al., 2018). Mentorship is a dynamic, long-term relationship whereby the primary goal is the professional and personal development of the mentee (Eby, Rhodes, and Allen 2010). While mentorship interventions are typically able to offer supports for academic and career competence and socialization (Coombs-Richardson, 2002), mentors who are also knowledgeable about their mentee’s disability-related challenges are able to provide needed holistic support - support that considers the whole person with a focus on strengths and abilities (Kreider et al., 2018). We refer to this strength-based understanding of the disabling condition as (dis)ability-informed mentorship. This type of support can be considered a biopsychosocial support whereby the mentor is able to offer psychological and social support with regards to the mentee’s disability-related biological considerations.

There exists a gap in the literature about how mentors, especially those who understand about the LD/ADHD conditions, could assist undergraduate students with LD/ADHD in fostering occupational performance needed to progress towards personal, academic, and career goals. This study investigates the ways in which neuro-typical graduate-student mentors, who were (dis)ability-knowledgeable, provided problem solving supports for their undergraduate mentees with the developmental neuropsychological conditions of LD and/or ADHD for the purpose of informing development of a biopsychosocial mentorship interventions that support young peoples’ occupational performance across the broad range of young adult contexts and roles.

Methods

Thematic qualitative analysis was used to investigate problem solving supports provided by mentors. This research was a part of a larger study that tested a multi-component model of holistic support for undergraduate students with LD/ADHD pursuing science-related fields of study, of which LD/ADHD-informed mentorship was one component; details regarding the larger study are published elsewhere (Kreider et. al, 2018). This study reports on a post-hoc analysis of existing data that were collected to inform program development and to monitor mentee and mentor outcomes.

Study procedures were approved by the University’s Health Science Center Institutional Review Board and all participants provided written informed consent prior to engagement in study activities. Participants were 52 undergraduate student mentees with LD/ADHD and 57 graduate student mentors who were matched based on the mentee’s field of study. Graduate student mentors were recruited on campus during a time when the university was encouraging faculty, staff, and students to engage in mentorship activities. The university has several mentoring opportunities, among them are peer, undergraduate research, and first-generation student mentorship programs. Further, as part of the University of Florida Graduate School’s professional development initiatives, a graduate student mentoring award is offered yearly for graduate students who engage in mentorship. The University’s pro-mentorship culture was helpful in graduate student recruitment, which resulted in ample number of students that were interested in study participation. Undergraduate and graduate student participants were compensated for study-related activities.

All study activities took place on the campus of a large research intensive university in the Southern United States. Undergraduates were enrolled for four semesters (i.e. two academic years) and engaged in one-to-one mentorship and monthly group meetings that included focused discussion about student-related experiences. Mentors also met as a group two to three times each semester to receive on-going training regarding LD/ADHD and to engage in discussions regarding their mentorship experiences.

Members of the investigative team included engineering and food science and human nutrition researchers as well as researchers with clinical expertise in occupational therapy (first author), psychology, and health education. The occupational therapy researcher and the health education researcher worked together to lead development of the content delivered in the group meetings during the first two of four years, with the occupational therapy researcher leading content development for the group meetings in the final two years. Discussions during group meetings were primarily led by the occupational therapy researcher with facilitation contributions from all members of the investigative team. Research assistants, who were primarily occupational therapy students or pre-occupational therapy students, were also present during group meetings to assist with note taking and meeting debriefings. To focus the discussions within the mentor and undergraduate group meetings, a combination of techniques were used, which included knowledge sharing (i.e., knowledge articulation) (Toglia, Rodger, and Polatajko, 2012), reflective prompts for bolstering self-awareness of performance (Toglia and Kirk, 2000), and guided discovery probes (Overholser, 2013). Techniques used were selected as useful therapeutic strategies for fostering performance through learning (Babulal et al., 2016) and strategy development (Toglia, Rodger, and Polatajko, 2012).

Textual data were drawn from (1) transcripts from the group meetings held with undergraduates (n = 30 undergraduate group meetings) and mentors (n = 20 mentor group meetings); (2) written responses to focused questions posed within mentee and mentor group meetings; (3) mentors’ open-ended responses on end-of-semester surveys; and (4) mentor logs, which were short surveys completed every two weeks by the mentors, and reported on the one-to-one mentorship meetings.

Thematic analysis was used to identify and describe conceptual areas of problem-solving topics provided by mentors (Sandelowski and Barroso, 2003). Data were structurally coded to identify passages containing information regarding communication and interaction between mentors and mentees (Saldana, 2013). Structural codes were then topically coded to categorize problem-solving topics covered. Data were reduced to conceptual themes around problem solving (Sandelowski et al., 2003).

Themes were developed through use of constant comparison of the data to emerging conceptualizations. Researchers’ prolonged engagement with participants supported the credibility of the analysis. Weekly meetings among the coding team and the senior researcher involved discussion and verification of codes and developing conceptualizations, which contributed to the dependability of findings.

Results

Three themes were identified regarding problem solving support provided by mentors, which include the themes of (1) Executive Functioning, (2) Adult Life Skills, and (3) Academics. Mentors provided supports for problem solving that ranged from facilitating the development of specific academic skills, such as organizing class notes, to fostering the mentee’s personal development, such as problem-solving social situations. Mentors often co-created strategies and solutions for problems that mentees experienced across their various life contexts, which included academics, daily life, career, and social situations. Supports went beyond academic and professional enculturation within the mentor-mentee’s shared fields of study to include holistic supports. Holistic supports fostered the undergraduate mentee’s transition to college and adult roles and contexts, which also included learning how to understand and manage one’s LD/ADHD.

Mentors worked with their mentees in guiding and co-creating strategies for overcoming challenges experienced by mentees in areas of academics, social situations, and daily life. Mentors provided direct suggestions of solutions, prompting of the mentee to create their own solutions, and discussions with the mentee whereby the mentor and mentee together talked through strategies for problem solving challenges experienced and/or anticipated.

Executive functioning

Problem solving supports were carried out in the context of the mentee’s capacity to evaluate, synthesize and critically think about the demands of a multifaceted college setting; as well as mentee’s capacity to make adjustments when faced with difficult situations. Problem solving supports are delineated by six subthemes, which are detailed in Table 1. Sub-themes include: (1) big picture thinking, (2) breaking things down, (3) LD/ADHD-specific coping strategies, (4) organization, (5) stress management, and (6) time management. Discussions regarding challenges related to executive functioning necessitated problem-solving supports related to academics, personal life, and the mentees’ general responsibilities.

Table 1.

Topical categories representing types of problem solving assistance provided by mentors, category definitions, and representative quotations.

Themes and subthemes Description Representative quotation
Executive Functioning Problem solving supports for helping mentees manage tasks and expectations, these supports were needed related to mentees’ challenges with higher level thinking related to their LD/ADHD
Big Picture Thinking Discussion of strategies useful to people whose preferred cognitive style is more wholist, some strategies helped mentee take a more holistic approach to resolving a conflict/challenge “We tend to have alotta discussions about just overall perspective and trying to come back around to what that bigger picture is. I mean, I think it might have something to do with her LD…I think sometimes she gets these gaps and then gets stuck in all the muddy details instead of pulling herself out” [M95]
Breaking Things Down Discussion of cognitive strategies targeted at breaking down the mentee’s responsibilities into workable chunks in order to make them less overwhelming “She was like, I feel overwhelmed and if I try to do any of this type of research… So then we spent about a half hour like breaking down like what kind of troubles you’re having with DOIng that” [M61]
LD/ADHD-specific Coping Strategies Discussion targeted at relieving symptoms specific to the mentee’s LD/ADHD-related anxiety “We talked about his struggles in the classroom and what he has done to help himself. For instance, he likes sitting in the front of the classroom in order to focus better. We talked about always being able to get a front seat and if he cannot, he should talk to his teacher.” [M80]
Organization Discussion of organizational challenges and solutions “Created outline chart for organizing application” [M68]
Stress Management Discussion of stress related challenges and strategies to manage stress “Apparently, he felt so burnt-out last week he felt he had to leave town, so we discussed more healthy stress management strategies” [M94]
Time Management Discussion of time related challenges and strategies for more efficient allocation of time “We are very focused on scheduling going over time management what do you have planned, how are you going to lay it out, how are you going to manage …so just letting her know like to pace yourself don’t get overwhelmed” [Y2MM4]
Adult Life Skills Problem solving supports pertaining to mentees’ emerging adult responsibilities in the college setting
Communication with Others Discussion regarding initiating communication, tools for more effective communication, and practicing for interactions with professors, TAs, bosses and other students “I would discuss with my scholar how comfortable they are approaching professors or bosses to discuss problems. I would help my scholar role play why she needed more time. I would help her come up with different ways to say, “slow at processing”. I would discuss how she could discuss this without sound[-ing] like she was trying to make excuses or just did not do the task.” [M68]
Employment Discussion of challenges and strategies related to undergraduate’s current employment “Talk about the part time job she worked and give some suggestion for future” [M107]
Finances Discussion of financial issues faced by the mentee “Emailed mentee information regarding student financial management strategy workshops offered through UF. Plan to attend the biweekly workshops with mentee once she registers.” [M102]
Life Skills Discussion regarding challenges faced by mentee in balancing and carrying out day-to-day activities “I think there’s a lot of overlap in that her academics seem very effective but outside factors and life skills of like going to bed at a reasonable hour so that you can wake up and get to class and conflicts …and how they are effecting or hampering her succeeding in classwork” [Y2MM5]
Academics Problem solving supports pertaining to education, academic performance, course-related responsibilities, and/or plan of study.
Academic Support Discussion of challenges related to general academics and course work, such as difficulty with comprehension of the course material and challenges with assignments and exams “One thing I encouraged her to do was to break things down as much as possible… and after a few weeks she noticed some improvement in her abilities to solve such problems [in Calculus class].” [M103]
Accountability Discussion of mentors checking-in on their mentee’s progress in order to make them feel accountable to remain on task with their school related responsibilities “So I’m sure her asking me and sending me texts asking how it was going made me actually, like, gave me some incentive to actually go do it.” [U33]
Campus Resources and Accommodations Discussion of difficulty obtaining necessary resources from the university to support disability related academic challenges “My mentee is a freshman and hasn’t declared a major and feels like she’s floundering a little bit not knowing which direction she wants to go. I suggested she go to you know the career resource center” [M3]
Course Load Discussion of problem solving around challenges faced by the mentee based on their course load or combination of courses “Discussed decisions to limit the number of classes taken in order to do better in each class.” [M78]
Graduation Discussion of and strategies to manage graduation concerns, requirements and timeline “… look at the course catalog of the other universities and then work through the petition process within the department to make sure that course will count as the same credit as it’s taught here at …. I think to everyone else’s point, graduating and sequencing out classes to take when and where.” [M57]
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LD/ADHD = Learning disabilities/Attention-Deficit/Hyperactivity Disorder

Mentors fostered development of skills that worked to address challenges in executive functioning. Mentors used the ongoing support provided in the mentor group meetings to (1) discuss and gain deeper understanding of their mentee’s LD/ADHD-related challenges, (2) gain ideas for how to support and strategize with their mentee about their challenges, and to (3) discuss experiences in working with their mentee to identify mentee’s strengths and the situations and contexts that may match strengths.

Occupational performance in the area of adult life skills

Supports involved undergraduate mentees’ abilities to handle additional challenges associated with living with new adult responsibilities within the college context. Discussions around these challenges were not as closely related to the student’s disability, but rather, dealt with skills that young people need as they transition to the college environment. Adult Life Skills included problem solving supports in four areas (i.e., sub-themes), which are detailed in Table 1. Sub-themes include: (1) communication with others (2) employment, (3) finances, and (4) balancing life and responsibilities. Graduate student mentors, as older students who had likely experienced similar challenges in their transition to adult and college-based roles and contexts, were able to provide guidance and support for problem solving across the wide range of situations experienced by their mentees.

Occupational performance in the context of academics

When strategizing about academics, mentor-mentee pairs collaborated to identify strategies that fostered the mentee’s abilities to manage courses, improve performance within the courses, and to plan future coursework. Problem-solving supports for occupational performance related to academics are categorized into five sub-themes, which are detailed in Table 1 and include: (1) academic support, (2) accountability, (3) course load, (4) campus resources and accommodations, and (5) graduation. While academically focused guidance and problem solving were largely informed by the mentors’ understanding of the mentee’s LD/ADHD, some discussions relied on the mentor’s experiences in recently overcoming challenges related to being on a similar academic path.

Discussion

This study delineates key areas of challenge experienced by undergraduate student mentees with LD/ADHD and the resultant problem solving supports that were provided by mentors. We found that mentor and mentee dyads often worked together to co-create strategies for overcoming difficulties and heading off potential and future anticipated challenges. Within this study, whole-student (dis)ability informed mentorship entailed mentors understanding their mentee’s strengths while also supporting the mentee’s engagement in occupations across varied contexts and social role expectations; it involved support for mentees’ academics, career-development, psychosocial, and disability-related needs and challenges. These findings are consistent with mentorship programs within higher education that identified problem solving as a major emphasis of the mentorship relationship (Kilcullen, 2007; Komaratat and Oumtanee, 2009)

Problem solving supports from mentors were important for learning how to navigate new adult expectations and contexts and balance the multiple roles that college students engage in. This finding elucidates the ways in which mentors provided supports that extended beyond academic and professional development to the supports that aided in the young persons’ transition to college life and adult responsibilities. Moreover, because problem-solving and executive functions underpin abilities to meet occupational challenges that arise with current and future anticipated social contexts, mentorship can be an important strategy for supporting the social functioning of young people as they transition to new adult roles and contexts.

Problem solving within the context of the mentees’ LD/ADHD symptomatology and everyday life challenges required the mentors to develop a depth in understanding about mentees’ strengths, interests, and disability-related challenges. This understanding was supported by mentors’ ongoing engagement in the group mentor meetings that focused on supporting their understanding of LD/ADHD-related challenges and strengths through an occupational lens. This strength-based (dis)ability-informed mentorship provided a framework for supporting the whole student, which is consistent with positive psychology literature and strength-based therapeutic practices (Smith, 2006; Mills and Kreutzer 2016). Through use of a (dis)ability-informed frame of reference, mentors’ were able to provide needed guidance and problem solving across the breadth of young adult roles and contexts, including their mentee’s disability context, which we refer to as Whole-student Mentorship.

Study mentees needed guidance from mentors across a broad range of areas. As such, our (dis)ability-informed mentors were able to provide problem solving support that was important for facilitation their mentee’s occupational performance and participation in current and future anticipated roles (Kreider, et al., 2018). We found that mentors were able to provide problem-solving supports within the context of the mentee’s everyday life experiences. The provision of ongoing support that focused on mentors’ application of an occupational lens when supporting their mentees was an important aspect of the mentorship.

The mentor-mentee relationships that developed among study participants were consistent with published descriptions of successful mentor-mentee relationships; relationships that are long term, dynamic, and have the shared goal of the holistic development of the mentee though the provision of advice, counseling and social support (Eby et al., 2010; Coombs-Richardson, 2002). Notably, we found that some of the areas of problem solving supports that were provided by our mentors resulted from the mentor being able to take on an additional role beyond the roles typically described in the mentorship literature (i.e., advisor, provide counsel, social support).

Because mentor-mentee matches were based on field of study, our mentors were also able to provide problem-solving support for their mentee’s academic challenges. This was an important aspect of the mentor selection as interventions that provide academic problem solving strategies are effective for improving educational outcomes of students with LD/ADHD across educational age-ranges (Hutchinson, 1993), including in higher education (Zawaiza and Gerber, 1993).

We found that mentors’ role in the co-creation of strategies for problem solving around mentees’ executive dysfunctions and LD/ADHD-related challenges had similarities to existing models of executive functioning coaching. Coaching for executive functioning provides tailored supports for improving skills and strategies for regulating executive functioning, such as complex problem solving and sustaining effort across time (Parker and Boutelle, 2009). While similarities existed, the problem-solving discussions among dyads in our study were less goal-oriented than supports provided within coaching models for support.

Our mentorship was disability focused, which is not uncommon on college campuses. However, campus-based disability-focused mentorships are often provided by mentors with a disability or with expertise in disability; these disability-focused mentorships provide assistance with advice, campus resources, academics, approaching authority figures, and self-advocacy (Harris, Ho, Markle, and Wessel, 2011; Patrick and Wessel, 2013; Zwart and Kallemeyn, 2001). Our selection of mentors based on field of study rather than on disability experience necessitated the provision of ongoing supports for the mentors in understanding LD/ADHD, which were integral in fostering the mentors’ abilities to provide supports for problem solving the breadth of their mentee’s challenges.

Limitations

Although three conceptual themes emerged from the data, these themes may not represent the full range of areas of problem solving needed within the (dis)ability-informed LD/ADHD mentorship relationships. Additional investigation as to the process and efficacy (dis)ability-informed mentorship interventions that support the whole student with LD/ADHD is warranted.

Implications for Future Studies

Within occupational therapy and rehabilitation fields, problem solving interventions are effective in improving the functioning and performance within everyday life situations of individuals from clinical populations (e.g., traumatic brain injury; Dawson, et al., 2009) whose symptomatology include executive functioning difficulties (Cogan, 2014). Mentorship interventions supporting the occupational performance of young people with LD/ADHD should test incorporation of evidence-based strategies from clinical problem-solving interventions, such as the use of guided discovery for strategy generation and adaptation.

Conclusion

Mentors are supports commonly found on college campuses. Mentors, whose mentorship training included supports for understanding the LD/ADHD conditions, were able to provide problem-solving supports for the challenges experienced by the undergraduate mentees within their everyday lives and the college context. Mentors’ ability to understand their mentees’ disability-related challenges within the broad range of situations and contexts experienced by the mentees was important for supporting mentees’ multifaceted needs through the mentorship. Occupational therapists can leverage disciplinary understanding of disabilities and the fostering of occupational performance to advance mentorship interventions that support the whole person. The inclusion of biopsychosocial approaches is needed in the development of disability-related mentorship interventions; such interventions can support social functioning and may improve the college experience and persistence of young people with LD/ADHD pursuing higher education.

Key findings.

Mentors, whose mentorship training included focus on understanding LD/ADHD, were able to provide problem-solving supports for challenges experienced by mentees within their everyday lives and the college context.

What the study has added.

Occupational therapists can leverage disciplinary understanding of disabilities and foster occupational performance to advance mentorship interventions that support the whole young person transitioning to adult roles and context through college.

Acknowledgments

Funding: This research is based upon work supported by the U. S. National Science Foundation under Grant Number (HRD-1246587). This work is also supported in part the National Institutes of Health, National Center Medical Rehabilitation Research (NICHD) (K12 HD055929). Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the National Science Foundation or the National Institutes of Health.

Footnotes

Research Ethics: This research was approved by the University of Florida Health Science Center Institutional Review Board. Written informed consent was obtained prior to study participation. This study was initially approved on August 20, 2012; continued approval obtained December 2, 2019.

Declaration of Conflicting Interests: Authors report no conflict of interest.

Contributor Information

Consuelo M. Kreider, Department of Occupational Therapy, University of Florida. PO Box 100164, Gainesville, FL USA 32610-0164

Sharon Medina, Department of Occupational Therapy, University of Florida. PO Box 100164, Gainesville, FL USA 32610-0164.

Hannah M. Koedam, Department of Occupational Therapy, University of Florida. PO Box 100164, Gainesville, FL USA 32610-0164

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