Documenting the Accommodation Needs of Students with ADHD

Requirements for Professional Reports

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Under Section 504 of the Rehabilitation Act of 1973 and the Americans with Disabilities Act (ADA), Student Disability Services (SDS) protects qualified students enrolled at The University of Iowa from discrimination on the basis of disability and assures provision of reasonable accommodations.

To determine that a student is protected by the two laws, SDS requires documentation that diagnoses a disability and describes how the condition directly and substantially limits a major life function such as learning.

The following documentation requirements establish that a student is eligible for protection and services on the basis of a disability, demonstrates that the disability produces a significant, functional impact on a major life activity, and supports the student’s request for accommodations.

All reports must be typed on professional letterhead and include name, title, and professional credentials of the evaluator, including license or certification, area of specialization, employment, affiliation, and the state or province of practice.

Please note that IEP’s and 504 plans will not be considered documentation, but should be integrated by the professional evaluator into the final report.

Components I-IV must be included in the professional report.

I. Qualifications of the Evaluator Professionals

Qualifications of the Evaluator Professionals conducting assessments and rendering diagnoses of ADHD and making recommendations for accommodations must have comprehensive training and relevant experience in differential diagnosis and the full range of psychiatric disorders. Examples of such professionals are psychologists, neuropsychologists, psychiatrists, and other relevantly trained medical doctors.

II. Recency of Documentation

Because the provision of all reasonable accommodations and services is based upon SDS’s assessment of the current impact of the disability on academic performance, it is in a student's best interest to provide recent and appropriate documentation. This means that a comprehensive evaluation must have been completed within the past three years

III. Comprehensive Information that Verifies the Existence of the Condition

A comprehensive evaluation should provide information about the history of the condition and verify the existence of a current condition. The report should include the following:

1. Evidence of early impairment

• Childhood diagnosis (or retrospective diagnosis): The report must contain evidence to establish that symptoms of the disorder were present in childhood and manifested in more than one setting.
• Developmental and educational history: The summary should include information substantiated in medical and educational records. It should also describe the student’s diagnostic history of ADHD and any family history of physical or psychological problems deemed relevant by the examiner (historical educational impact). Accommodation history should be discussed.

2. Evidence of current impairment:

• Presenting concerns: The report must describe the student’s presenting attentional symptoms, including evidence of ongoing impulsive/hyperactive or inattentive behaviors that significantly impair functioning in two or more settings at the time he or she was referred for the current evaluation.
• DSM-IV symptoms: Documentation must include a summary of objective historical information substantiating the individual’s manifestations of DSM-IV ADHD throughout childhood, adolescence, and adulthood (to the present) in two or more settings, and how patterns of inattentiveness, impulsivity, and/or hyperactivity have been used to determine the presence of ADHD.
• Medical treatment: Relevant current medical information must be included. The report should indicate whether or not the individual was evaluated while on medication prescribed for the treatment of ADHD, and whether or not the prescribed treatment consistently produces a positive response.

3. Alternative causes ruled out:

The report must demonstrate that the evaluator(s) has investigated and ruled out alternative psychological, medical, educational, and/or cultural explanations for inattentiveness, impulsivity, and/or hyperactivity.

4. Relevant testing must be provided:

The WISC-III or the WAIS-III should be administered to establish average to above average intelligence and, in addition to self-report, observation, information from third parties and historical information, the current diagnosis must be based on objective tests of sustained attention. Examples: Ruff 2 & 7 Selective Attention Test, Brief Test of Attention, d2 Test of Attention, Continuous Performance Test (CPT).

5. An interpretative summary must be provided:

An interpretative summary of testing results that support the diagnosis and the need for accommodations must be included in the report.

6. Definitive Diagnostic statement:

The summary must contain a specific diagnosis of ADHD based on the DSM-IV diagnostic criteria. The diagnosis must be stated directly and should not use such terms as suggests, appears to, is consistent with, is indicative of, a history of or attention problems.

IV. Evidence that Supports the Necessity of Accommodations

In addition to the above information and in order for a student to receive disability accommodations, the report must also include the following information to support the need for accommodations.

1. Current educational impact:

The report must describe the current and significant impact of the ADHD on the individual’s academic functioning. Please note that accommodations are provided for a condition only when it imposes a substantial limitation as compared to the average population. Accommodations are not provided for (relative) weaknesses, areas needing improvement, below expectancy performance, or mild disabilities.

2. Accommodation recommendations and justifications:

The report should contain specific recommendations for academic accommodations and state why they are needed and how they mitigate the effects of the individual’s manifestations of ADHD symptoms (as designated by the DSM-IV). Each recommendation should be correlated with specific functional limitations that have been documented in the assessment. All data must logically reflect the substantial limitation(s) to learning for which the individual is requesting accommodation.

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