This paper presents a study on how instructional practices impact the academic adjustment of engineering college students with Attention-Deficit/Hyperactivity Disorder (ADHD). While ADHD brings unique cognitive strengths, traditional academic environments—especially in engineering—can pose challenges. Existing research highlights the difficulties faced by students with ADHD during the transition to college, but few studies explore how specific instruction affects their adjustment. This study addresses that gap by examining how lecture-based and active learning approaches support or hinder students' academic adjustment, including academic transition and study skills. Guided by our conceptual framework, we address the question: How do specific instructional practices impact the academic adjustment of engineering students with ADHD? Through thematic analysis of interviews with engineering students with ADHD, we found that both lecture-based and active learning instructional settings present challenges to students' academic adjustment and that students' study skills (one element of academic adjustment) are especially affected by type of instruction.