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Policies and Guidelines

Attention-Deficit Disorders

Guidelines for Documentation of Attention-Deficit Disorders

Please provide these guidelines to your diagnosing/treating professional provider. Your provider will need to ensure that the documentation submitted in support of your request for disability accommodation includes all pertinent information as set forth in these guidelines.

Note that a diagnosis of an attention-deficit disorder does not in and of itself automatically mean you have a disability under the ADA or that you qualify for reasonable accommodations under the ADA. While an attention-deficit disorder may be a source of discomfort or stress, an impairment only constitutes a disability when it prevents an individual from performing a major life activity that the average person in the general population can perform or when the individual is substantially limited as to the condition, manner or duration they can perform a particular major life activity as compared to the average person in the general population, not the average college student at MICA.

You should consult with your testing provider about testing on or off medication.

Note that an Individualized Education Plan (IEP) and/or 504 Plan can be included as part of a comprehensive report, but it is insufficient by itself to establish the rationale for recommended accommodations.

Students with attention-deficit disorders requesting disability accommodations through the Learning Resource Center must furnish documentation that includes:

1. Current Evaluation – Because the provision of reasonable accommodations is based on the assessment of the current functional impact of the student’s disability on academic performance, it is in the student’s best interest to provide documentation of recent testing. This generally means that a comprehensive evaluation should have been conducted within the past three years using the adult version of assessment tools. If the documentation is inadequate in scope or content, or does not address the student’s current level of functioning, retesting or additional testing will be required. Note a psychiatric evaluation without the relevant testing is not acceptable.

2. Qualified Professional – Professionals conducting assessments and rendering diagnoses of attention-deficit disorders must have comprehensive relevant training and experience in the differential diagnosis of neurodevelopmental disorders in adults. The following professionals would generally be considered qualified to evaluate and diagnose attention-deficit disorders: clinical psychologists, neuropsychologists, educational psychologists, and psychiatrists.

3. Comprehensive Documentation – Documentation should consist of 2 components: (1) a diagnostic interview; and (2) relevant testing.

Diagnostic Interview: The diagnostic interview should include relevant background from a variety of sources to support the diagnosis. The report of assessment should include a description of the presenting problem; a thorough history providing evidence of attention problems including objective evidence of ongoing issues that have significantly impaired functioning over time; a developmental history; an academic history; any relevant family history; psychosocial history; relevant medical and medication history; and a discussion of dual diagnoses, alternative or coexisting mood, behavioral, neurological and/or personality disorders, and exploration of other mental health problems, such as depression and anxiety, or academic problems that are not better explained by other mental health conditions.

Relevant Testing: The psychological or psychoeducational evaluation for the diagnosis of an attention-deficit disorder should provide clear and specific evidence that an attention-deficit disorder does or does not exist. The data should logically connect the specific substantial limitation to learning or other major life activity for which the student requests accommodation. The test findings must document both the nature and severity of the attention-deficit impairment. It is not acceptable to administer only one test or to base a diagnosis on only one of several subtests. The tests used must be reliable, valid and standardized for use with an adult population. Actual test scores must be provided. In addition to test scores, interpretation of results is required.

Cognitive Ability – A complete aptitude assessment is required with all subtests and standard scores. The preferred instrument is the Wechsler Adult Intelligence Scale – Fourth edition (WAIS-IV). Other acceptable instruments include, but are not limited to, the Woodcock- Johnson IV: Tests of Cognitive Ability; the Stanford-Binet Intelligence Scale – Fifth edition.

Achievement – A complete achievement battery, with all subtests and standard scores, must be provided. The battery should include current levels of academic functioning in reading (decoding and comprehension), mathematics, and written language. If an accommodation request includes extended time for tests, timed measures of relevant academic skills should be included. Recommended instruments include, but are not limited to, the Woodcock-Johnson IV Tests of Achievement, the Kaufman Test of Educational Achievement-3, or the Wechsler Individual Achievement Test-III. Tests such as the Nelson-Denny Reading Test and timed reading, writing, and math subtests of the Scholastic Abilities Test for Adults may be used to supplement more current and comprehensive measures. Note the Wide Range Achievement Test – 5 (WRAT-5) is not a comprehensive measure of achievement and is not acceptable if used as the sole measure of achievement.

Information Processing – Specific areas of information processing (e.g. short and long term memory, sequential memory, auditory and visual perception/processing, processing speed, executive functioning) should be assessed as relevant/needed for specific deficit areas.

Acceptable instruments include, but are not limited to, the Detroit Test of Learning Aptitude – 4 (DTLA-4), the Wide Range Assessment of Memory and Learning – 2 (WRAML2), Wisconsin Card Sort, Trails A and B, Rey Complex Figure Test. Information from subtests on the WAIS-IV, Woodcock-Johnson Psychoeducational Battery – IV: Tests of Cognitive Ability, Wechsler Memory Scale – IV, as well as other instruments, may be used to address these areas.

Other standard and formal assessment measures (personality, clinical, or behavior inventories) may be integrated with the above documents to help support a dual diagnosis, or to disentangle the attention-deficit disorder from coexisting mood, behavioral, neurological, and/or personality disorders. In addition to standardized test batteries, it is also helpful to include informal observations of the student during the test administration.

4. Identification of DSM-5 Criteria (Attention-Deficit/Hyperactivity Disorder (ADHD) only) – According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the essential feature of ADHD is a persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequent and severe than is typically observed in individuals at a comparable level of development. A diagnostic report should include a review and discussion of the DSM-5 criteria for ADHD and specify which symptoms are present from those specified in the criteria. The report should also include the relevant DSM-5 code designation based on presentation.

5. Specific Diagnosis – The report should include a specific diagnosis of an attention-deficit disorder. The specific diagnosis must be supported by test data, academic history, anecdotal and clinical observations that may include comments about the student’s level of motivation, study skills, and other learning factors. Findings must demonstrate that the student’s functional limitations are due to the diagnosed disorder. It is important the testing provider demonstrate having ruled out alternative explanations for academic problems, such as emotional, medical or psychological disorders or motivational or study skills problems that may interfere with learning or another major life activity, but which do not by themselves constitute an attention-deficit disorder.

6. Recommended Accommodations – The comprehensive report must recommend specific accommodations. The testing provider must include a detailed explanation as to why each recommended accommodation is necessary and must reference specific current functional limitations (determined through test results and clinical observations) that support the need for accommodation. The report must also include an explanation of current treatments, medications, or self-accommodations, including any student-reported information on effectiveness of such measures.

 

MICA reserves the right to request additional documentation as necessary to fully evaluate individual requests for disability accommodations.