Why the Move From High School to College Is So Hard for Many Neurodivergent Students

Nov 5

For some families, the hardest years comes later than expected. Your student made it through high school, maybe with good grades, a full schedule, and teachers who said lovely things at conferences. They got into college, packed up, and seemed ready. Then somewhere in the first semester, the texts got shorter. Classes started slipping. A grade came back that didn't make sense. You might be hearing "I'm fine, I'm just tired," or "Everyone else seems to know how to do this," or not hearing much at all.

If this sounds familiar, you're far from alone, and it rarely means your student isn't capable or didn't try. For many young people, especially those with ADHD, autism, learning differences, or anxiety (diagnosed or not), doing well in high school rested on support that was easy to overlook: a parent keeping track of the calendar, teachers who checked in, a schedule that held the day together, and a home to come back to each night. Many of these students have also spent years working hard to look like they're keeping up. When all of that changes at once, the effort that carried them this far often stops being enough.

Every student is different, but a few things are worth knowing from the start:

The support often disappears all at once. Structure, reminders, routines, and the people who noticed when something was off tend to fall away in the same few weeks.
High school success can hide how much help was there. A student who did well with support may not have had a chance to find out what they need without it.
Students who mask often run out of energy faster in college. Everything is new, and there may be nowhere to fully let their guard down, not even their own room.
College accommodations work differently than an IEP or 504 plan. Your student has to ask for them, and many students who qualify never do.
It's rarely just one thing, and it isn't too late. ADHD, autism, anxiety, depression, learning differences, and sleep can all play a part. Understanding how they fit together helps at any age, and so does the right support, whether that's an evaluation, therapy, or both.

The rest of this post looks at each of these more closely, along with what can help, whether your student is still in high school or already partway through a hard first year.

What changes between high school and college?

So much of what helped your student in high school was built into daily life that it was easy to miss. Here's some of what tends to change:

The schedule. High school days run on bells and look about the same every day. College might mean two classes on Tuesday, nothing until 2 p.m. on Wednesday, and long stretches of open time that are up to the student to fill.
Reminders. High school teachers repeat due dates, post assignments, and often notice when work is missing. A college syllabus may list every deadline for the term on the first day and never mention them again.
How work is graded. Instead of regular homework and quizzes, a grade might rest on a midterm, a final, and one big paper. There's less feedback along the way, so a problem can grow for weeks before anyone sees it.
Reading and independent work. Reading loads often jump, which matters most for students with dyslexia or slower processing speed.
Daily living. Waking up, meals, laundry, sleep, money, and medication refills all land on the student, often for the first time.
The people who noticed. At home, someone usually saw when things started to slip. In college, a student can miss a week of classes before anyone knows.

Each of these leans on executive function, the set of skills that help us plan, get started on tasks, keep track of time, and juggle several things at once. These skills keep developing well into the twenties for everyone. For students with ADHD, and for many autistic students, they're often an area of real difficulty to begin with. In high school, the people and structure around them filled in many of the gaps. In college, students are expected to fill those gaps on their own, usually right away.

Why it can be hard, even for students who previously excelled in school.

Some of the students who struggle most in college are the ones no one worried about in high school. Many neurodivergent young people learn to mask, which means working hard, often without realizing it, to hide or make up for the things that are harder for them. That can look like copying how classmates act socially, over-preparing for everything, staying up late to make up for slow starts, or carefully tracking every detail so nothing slips. It works, sometimes for years. It also takes a great deal of energy, and that cost doesn't always show.

College tends to make masking harder. Everything is new at once, and new people, places, and routines all take extra energy to figure out. For many students, home was where they could finally let their guard down each evening, and a shared dorm room, shared bathrooms, and a busy hallway don't offer that. The noise and activity of dorm life can be hard on their own. Friendships that took years to build are suddenly far away, and making new ones in loud, unstructured settings can be exhausting, especially for autistic students. Working twice as long as everyone else may have gotten them through high school, but it's much harder to keep up when the workload grows and the support goes away.

When masking stops working, it can look like a sudden change, even though the difficulty may have been there all along. Some students reach burnout: deep exhaustion, pulling away from people, struggling with things they used to manage, and shutting down. Over the phone, that can sound like a student who stopped caring, when far more often they've been working very hard for a long time and have nothing left.

It's rarely just one thing.

Students who struggle in college rarely have only one thing going on. ADHD and anxiety often show up together. Many autistic students also have ADHD, anxiety, or depression. A learning difference like dyslexia can go unnoticed for years in a bright student and suddenly matter when the reading load doubles. Sleep often falls apart in the first year, and poor sleep makes attention, mood, and memory harder for anyone.

Anxiety and depression are common among college students in general. In the 2024–2025 Healthy Minds Study, which surveyed more than 84,000 college students, about 37% reported moderate to severe symptoms of depression and 32% reported moderate to severe anxiety. Those numbers have improved for three years in a row, but they're still high, and a student who is struggling with attention or learning is often carrying anxiety or depression too.

This is part of why we find comprehensive evaluations so helpful at this age. Looking only at attention, or only at anxiety, can leave out a piece that matters. A fuller look at thinking, learning, attention, emotional health, and social development helps make sense of how everything fits together, and points toward support that fits the whole student.

What struggling can look like from home.

From a distance, it can be hard to tell a normal adjustment from something more, and every student has some rough weeks. A few patterns deserve a closer look:

Missing classes, assignments, or meetings, sometimes for weeks before you hear about it
Shorter texts, fewer calls, or plenty of "I'm fine"
Sleep that has flipped, with very late nights and missed mornings
Skipping meals or falling behind on basic care
Dropping classes, falling behind on a big project, or grades that don't match how capable they are
Pulling away from friends or activities they used to enjoy
Talking about coming home, or saying everyone else seems to have it figured out
Harsh self-talk, like "I'm lazy" or "I'm not cut out for this"

Any one of these can be part of a normal first semester. It's when several show up together, or keep going past the first month or two, that they're worth paying attention to.

If you're ever worried about your student's safety, reach out right away. You can call or text 988, the Suicide & Crisis Lifeline, at any hour, and most campuses also have after-hours counseling support.

How college accommodations work, and how they're different from high school

In high school, the school is responsible for identifying students who need support and building a plan, through an IEP or a 504 plan. In college, support is still protected by law, mainly the Americans with Disabilities Act and Section 504, but the college won't come looking for your student. Your student has to reach out, ask for accommodations, and keep using them. Here's what that means in practice:

An IEP or 504 plan doesn't carry over automatically. It can still be useful as documentation, but your student will need to register with their college's disability services office. Every school has one, though the name varies. At Portland State it's the Disability Resource Center, and at WSU Vancouver it's Student Accommodations & Disability Resources.
Your student is the one who asks. Once they're in college, schools generally won't share records with parents without the student's written consent. You can help them prepare, but they'll need to make the request.
Many students who qualify never ask. In one large national study, only about 37% of college students with disabilities had told their school. And in a 2021 study of college students with ADHD, more than half received no academic support at all, even though services were available on campus.
What counts as documentation varies. National guidance for disability offices says a student's own description of how their disability affects them can carry real weight, and that records like an IEP can help. Some schools still ask for a recent evaluation, especially if the last one was done in childhood or no longer reflects how things look. Check your student's school guidelines early, ideally before the first term.
Accommodations can cover more than tests. Depending on the student and the school, they might include extra time on exams, a quieter testing room, note-taking support, a reduced course load, priority registration, or housing accommodations such as a single room.

When an evaluation or therapy can help

Not every student who has a hard first year needs an evaluation or ongoing support. Sometimes a lighter schedule, better sleep, a campus counselor, or more time to adjust is enough. When it isn't, an evaluation, therapy, or both can help.

When an evaluation helps most:

An evaluation tends to be most helpful when your student has never been evaluated and you're starting to wonder whether ADHD, autism, or a learning difference has been there all along. It can also help when an evaluation from childhood no longer matches what they need, when their college asks for more current or detailed documentation, or when anxiety or depression is being treated but something still doesn't add up. Some young adults want to understand how their own mind works, for themselves.

At this age, an evaluation looks a little different. A young adult's own account of what's hard, what they've tried, and what happens when they sit down to start a task is some of the most useful information we get, and it's often the first time anyone has asked. With their permission, we also gather information from parents, since you can describe their early years in a way no one else can. When the results are ready, we walk through them with the young adult directly, so they leave with an explanation that makes sense to them and recommendations they can use at school and beyond.

For many students, the biggest relief is finally understanding why things have been so hard, in a way that has nothing to do with being lazy or not smart enough.

When therapy helps most:

Therapy can help when your student mainly needs support through the change itself. That might mean building routines and executive functioning tools that fit college life, managing stress, anxiety, or perfectionism, working through a hard adjustment or a semester at home, or rebuilding confidence after a rough start. Our therapy for teens and young adultsdraws on CBT and other research-backed approaches, with practical tools for stress and overwhelm, and adjusting to college life is one of the areas we focus on. Sessions are at our Camas and Tigard offices [confirm telehealth], so therapy works best for students who live nearby, whether they're at a local college, living at home, or taking a semester off.

Not sure which comes first?

It often doesn't have to be one or the other. An evaluation can explain why things have been so hard, and therapy can help your student put what they learn into practice. Sometimes therapy is the better place to start, especially when a student is overwhelmed and needs support right away. We wrote more about how to decide in Assessment or Therapy First?, and it's something we're glad to talk through on a free consultation.

If your student is already struggling

If you're reading this in the middle of a hard semester, a few things can help right now:

Start with connection. Before trying to solve anything, let your student know you're on their side. Many students hide how hard things are because they're afraid of letting you down.
Help them contact disability services now, even partway through a term. Accommodations usually don't apply to work that's already been graded, so the sooner they're in place, the more useful they are.
Look into campus support. Counseling centers, tutoring, writing centers, and academic coaching are often free and underused. If your student lives nearby, we also offer therapy for teens and young adults.
Ask about options for the course load. Dropping a class, taking an incomplete, or in some cases a medical withdrawal can protect a student's record. Deadlines matter, so ask an advisor soon.
Keep an eye on the basics. Sleep, regular meals, and medication refills are often the first things to go, and small fixes there go a long way.
Coming home isn't a failure. A semester at home, a lighter schedule, or a few classes at a community college can be a thoughtful next step, and many students go on to do well after one.

If your student is still in high school

If your teen is a junior or senior, there's plenty you can do now to make the move easier:

Let them practice running their own week. Senior year is a good time to slowly hand over the calendar, appointments, emails to teachers, and medication refills, while you're still close by if something slips.
Ask for a Summary of Performance. Students with an IEP should receive one when they leave high school. It describes their strengths, needs, and what has helped, and it can be useful to a college disability office.
Visit the disability services office on college tours. Ask what documentation they need and what support looks like day to day.
Think about housing. For students who need quiet or time to recharge, ask about a single room or a smaller residence hall.
Think about support for the move itself. For a teen who's anxious about leaving home or still building independence skills, therapy during senior year or the summer before college can give them time to practice the routines and coping tools they'll lean on later.
Get school supports in place if they aren't already. A history of accommodations in high school can help when your student asks for them in college. Our posts on requesting school accommodations and choosing between an IEP and a 504 plan can help you get started.
Consider an evaluation before they leave. If there's an open question about attention, learning, autism, or anxiety, it's often easier to answer while they're still living at home. A current report can also support accommodations for college and for tests like the SAT or ACT. We wrote more about that in Does My Child Need a Psychoeducational Evaluation for SAT/ACT Accommodations?, and our testing accommodations page covers how we help.

Frequently Asked Questions

Does an IEP or 504 plan transfer to college? Not automatically. Colleges don't follow high school IEPs or 504 plans, but many accept them as part of the documentation for accommodations. Your student will need to register with the college's disability services office and make the request themselves.

Does my student need a new evaluation for college accommodations? It depends on the school. Many colleges accept a student's own description of how their disability affects them along with existing records. Others want more current or detailed documentation, especially if an earlier evaluation was done in childhood.

Why do some students who did well in high school struggle so much in college? High school often provides structure and support that's easy to miss: steady schedules, frequent reminders, teachers who notice, and family at home. When all of that changes at once, students with ADHD, autism, learning differences, or anxiety, especially those who have been masking, can find that the strategies that worked before aren't enough anymore.

Is it too late to get evaluated in college? No. An evaluation in young adulthood can still lead to accommodations, help guide treatment, and give a student a clearer understanding of how their mind works. For many, it's the first explanation that has made sense.

Should my student start with therapy or an evaluation? It depends on what's getting in the way. If the big question is why things are so hard, an evaluation can help answer it. If your student mainly needs support getting through a stressful transition, therapy may be the better first step. Many students benefit from both. Our post Assessment or Therapy First? walks through how to decide.

Can my student be evaluated over a school break? Often, yes. The intake meeting is virtual, and testing happens in person at our Camas or Tigard office, so students who go to school farther away can often schedule testing during winter, spring, or summer break. Times around breaks tend to fill up, so it helps to reach out early. Winter break can be an especially good time, since first-semester grades show where things stand.

If you're not sure what your student needs yet, we’d love to hear from you!

A hard first year can feel scary from both ends of the phone. For your student, it can feel like proof of something they've worried about for years. For you, it can be hard to know how much to step in. Most of the families we talk with are somewhere in that middle.

You don't need to have it figured out before you call. A consultation with Dr. Webb is free and takes about fifteen minutes. You can share what's been happening, ask whatever's on your mind, and get an honest sense of whether an evaluation, therapy, or both make sense right now. If something else would help more first, we'll tell you that too. Young adults are welcome to reach out on their own.

Reach out today to see if an evaluation is the right next step for your student. We see teens and young adults at our offices in Camas, WA and Tigard, OR, and work with families across the Portland and Vancouver area, including students home on break.

Schedule a free consultation