Efficacy of Extended Time on Exams for College Students and Applicants With Attention-Deficit/Hyperactivity Disorder: Protocol for a Randomized, Counterbalanced Crossover and Within-Subject Trial

AI Summary

Extended time is commonly granted for students with ADHD yet lacks robust empirical evidence of effectiveness in college populations.
Randomized, counterbalanced crossover within subject design using three versions of a test modelled on the Brazilian National High School Exam.
First such trial outside the United States assessing dosage effects and predictors; 103 participants enrolled and data analysis began March 2026.

JMIR Res Protoc. 2026 Jun 3;15:e80271. doi: 10.2196/80271.

ABSTRACT

BACKGROUND: Extended time on academic exams is one of the most frequently granted accommodations for students with attention-deficit/hyperactivity disorder. However, there is a lack of empirical evidence supporting its effectiveness, particularly in the college population.

OBJECTIVE: This study aimed to assess the efficacy and specificity of extended test time as an accommodation for college and college-prospective students with attention-deficit/hyperactivity disorder.

METHODS: This study will use a randomized, counterbalanced crossover and within-subject experimental design, using convenience sampling to recruit participants. All participants will undergo clinical and neuropsychological assessments to confirm their diagnostic status and cognitive performance. Following these assessments, participants will be randomized to sequentially complete 3 versions of a test modeled on the Brazilian National High School Exam under standard time conditions, with 25% extra time and with 50% extra time.

RESULTS: The study was funded in February 2023. Data collection started in August 2023. As of March 2026, we have enrolled 103 participants. Data analysis was initiated in March 2026, and no projected timeline for the publication of results is currently available.

CONCLUSIONS: The study will be the first of its kind outside the United States and one of the first to investigate the effectiveness of extended testing time at different dosages in the college population. Findings will provide insights into the impact of extended time accommodations in a distinct academic system, addressing gaps in previous research, such as different intervention doses and predictors of effectiveness.

TRIAL REGISTRATION: ClinicalTrials.gov NCT06063382; https://clinicaltrials.gov/study/NCT06063382.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/80271.

PMID:42235056 | DOI:10.2196/80271

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