Quick summary: Students with suspected ADHD showed similar reductions in well-being, belonging and ease of university transitions as those with a formal diagnosis. Higher ADHD symptom levels were associated with lower belonging and more difficult transitions that were not confined to the first year of study. Universities should therefore provide accessible support based on the difficulties students report rather than requiring a diagnostic label first, with implications for student mental health and inclusive practice.
Awareness of ADHD has increased considerably, and more people are beginning to recognise ADHD traits in themselves. But what happens during the period when somebody suspects they may have ADHD but does not have a formal diagnosis?
It can be easy to assume that those without a diagnosis are experiencing fewer difficulties. But findings from my undergraduate research made me question whether diagnostic status alone always tells us who may be struggling.
The space between suspecting and knowing
Receiving an ADHD diagnosis can help someone make sense of difficulties they may have experienced for years. It can also provide a route towards appropriate professional support and, in some circumstances, reasonable adjustments.
However, diagnosis is not necessarily immediate. Some people may recognise ADHD traits in themselves before receiving a professional assessment, while others may not pursue an assessment at all.
This creates a group that can easily be overlooked: people experiencing significant ADHD traits without the formal diagnosis that can sometimes be required to access certain forms of support.
Importantly, suspected ADHD should not be treated as equivalent to a clinical diagnosis. ADHD requires appropriate professional assessment. However, the absence of a diagnosis does not necessarily mean that somebody is not experiencing difficulties that could benefit from support.
What I found in my research
For my final-year psychology dissertation at the University of Leeds, I conducted a quantitative study examining well-being, belonging and university transitions among students with formally diagnosed ADHD, students with suspected ADHD and students without identified neurodivergence.
The study initially recruited 222 participants. Following exclusions and ADHD symptom-screening procedures, the final analysed sample consisted of 162 students: 53 with formally diagnosed ADHD, 45 with suspected ADHD and 64 without identified neurodivergence.
One of the findings I found particularly interesting was the similarity between the diagnosed and suspected ADHD groups.
Students without identified neurodivergence reported the highest well-being and belonging and found university transitions easier. In contrast, the formally diagnosed and suspected ADHD groups showed similar difficulties across these outcomes, with no significant differences between the two ADHD groups.
Higher levels of ADHD symptoms were also associated with lower belonging and more difficult university transitions.
The study additionally found no ADHD-by-year-of-study interaction for university transitions, suggesting that transition-related difficulties were not simply confined to students’ first year.
As this was one undergraduate quantitative study, these findings should not be interpreted as showing that people who suspect ADHD necessarily have the condition. But they raise interesting questions about whether some people may experience significant difficulties before obtaining a formal diagnosis.
Why belonging matters
University involves much more than academic performance. Students are adapting to different routines, expectations, social environments and often a greater level of independence.
Belonging can therefore be an important part of university well-being.
My research found a positive association between belonging and well-being. Easier university transitions were also associated with greater belonging and well-being.
This suggests that when we consider support for students with ADHD-related difficulties, academic outcomes may only be one part of the picture. How connected and supported students feel within their university environment deserves attention too.
For students experiencing ADHD-related difficulties without a formal diagnosis, this may be particularly relevant. If support is perceived as something reserved only for students with documented conditions, some students may be reluctant to seek help with the difficulties they are experiencing.
Does support always have to start with a label?
A formal diagnosis has an important role and cannot be replaced by self-identification or a screening questionnaire. Professional assessment can provide clarity and help determine appropriate treatment and support.
But not every form of support necessarily needs to begin with a diagnostic label.
Universities can provide clear instructions, accessible information, structured transition support and straightforward routes to well-being and academic services. These approaches may help students experiencing difficulties while also benefiting the wider student population.
This is not a replacement for professional assessment or ADHD-specific support. Instead, it means considering whether unnecessary barriers can be reduced before a student reaches the point of having to demonstrate why they are struggling.
Perhaps the first question does not always need to be: “Does this student have a diagnosis?”
Sometimes another useful question might be: “What is this student finding difficult, and what support could help?”
My dissertation left me particularly interested in the gap between suspected and formally diagnosed ADHD. Although the two groups cannot be considered equivalent, the similarity in their measured well-being, belonging and transition outcomes suggests that students without a formal diagnosis should not automatically be assumed to be experiencing fewer difficulties.
If we want to create more inclusive university environments, there may be value in considering the difficulties students report alongside the diagnostic labels they currently hold.
Erin Maria Bonet-Clarke is a first-class BSc psychology graduate from the University of Leeds and a freelance writer focused on ADHD, neurodiversity, and well-being.
