The implementation gap in inclusive higher education: an exploratory case study of reasonable adjustments, assessment design, service–teaching coordination, and wellbeing for a student with ADHD

The formal availability of support does not necessarily produce lived inclusion in higher education. This exploratory instrumental case study examined how one first-year undergraduate student with a disability-related support need – specifically attention-deficit/hyperactivity disorder (ADHD) – described reasonable adjustments, teaching and assessment practices, participation, and wellbeing during her first semester. Data comprised one approximately 22-minute face-to-face semi-structured interview, immediate post-interview field notes, and an anonymised support-service document confirming registration and additional examination time. A contextualist reflexive thematic analysis constructed four themes: early access to support and adjustments; teaching clarity and assessment design; wellbeing described through belonging, self-efficacy, and motivation; and selective disclosure with calls for consistent institutional practice. In her account, the participant discussed formal adjustment, accessible design, relational access to help, and service–teaching coordination alongside one another rather than as stages in a sequential pathway. The study therefore presents a case-informed heuristic summary of the four themes. The findings offer exploratory, situated insights into one student’s account and case-informed considerations for practice that require examination in larger, longitudinal, and multi-perspective studies.