Documentation Guidelines
In accordance with Section 504 of the Rehabilitation Act of 1973 and with the Americans with Disabilities Act (ADA) of 1990, the Office of Accommodative Services provides equal access to educational programs and safeguards against discrimination for qualified students with disabilities as defined by the ADA. The ADA defines a person with a disability as any person who
• Has a physical or mental impairment that substantially limits one or more major life activities
• Has a record of such an impairment
• Is regarded as having such an impairment
In order for Accommodative Services to determine if a student's condition meets the standard defined by the law, the disability documentation submitted by the student must contain all of the elements detailed below.
• A licensed or credentialed examiner
• A diagnostic statement identifying the disability (note that a condition does not automatically qualify as a disability)
• A description of the diagnostic methodology
• A description of the current functional limitations
• A description of the expected duration and progression of the condition
• A rationale and justification for all requested accommodations
Detailed Guidelines
Clarkson University’s Office of Accommodative Services has established guidelines for documenting conditions that qualify for disability services. These guidelines help provide comprehensive and current information regarding the functional limitations caused by the condition as well as any appropriate and reasonable modifications in an academic setting.
• Attention Deficit Hyperactivity Disorder (ADHD)
• Learning Disabilities
• Physical, Medical and Sensory Disabilities (includes visual and hearing impairments)
• Psychological Disabilities
• Temporary Disabilities
Please note that Clarkson University does not provide comprehensive evaluations.
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ADHD Documentation Guidelines
(available in PDF format: Attention-Deficit/Hyperactivity Disorder Documentation Guidelines)
Clarkson University requires the following information to make informed decision concerning academic accommodations for students with Attention Deficit Hyperactivity Disorder (ADHD or ADD).
Qualifications of the Evaluator
Documentation
Evidence of Early Impairment
Evidence of Current Impairment
Diagnostic Interview
Alternative Diagnoses or Explanations
Specific Diagnoses
Recommendations for Accommodations
Qualifications of the Evaluator
Professionals conducting assessments and rendering diagnoses of ADHD and making recommendations for accommodations must be qualified to do so. Comprehensive training and relevant experience in differential diagnosis and the full range of psychiatric disorders are essential. The name, title, and professional credentials of the evaluator should be clearly stated in the documentation. All reports should be on letterhead, typed, dated, and signed.
Clarkson University requires current documentation of disabilities using well-known diagnostic criteria that are valid for adult populations.
Because ADHD is, by definition in the DSM-IV, first exhibited in childhood (although it may not have been formally diagnosed) and manifests itself in more than one setting, relevant historical information is essential. A comprehensive assessment should include a clinical summary of objective historical information that establishes symptomatology indicative of ADHD throughout childhood, adolescence, and adulthood as garnered from transcripts, report cards, teacher comments, tutoring evaluations, and past psycho-educational testing, and third party interviews when available.
Evidence of Current Impairment
Statement of Presenting Problem - A history of the individual's present attentional symptoms should be provided, including evidence of ongoing impulsive/hyperactive or inattentive behaviors that significantly impair functioning in two or more settings.
The information collected for the summary of the diagnostic interview should consist of more than self-report, as information from third party sources is critical in the diagnosis of ADHD. The diagnostic interview with information from a variety of sources should include, but not necessarily be limited to, the following:
• History of presenting attentional symptoms, including evidence of ongoing impulsive/hyperactive or inattentive behavior that has significantly impaired functioning over time
• Developmental history
• Family history for presence of ADHD and other educational, learning, physical, or psychological difficulties deemed relevant by the examiner
• Relevant medical and medication history, including the absence of a medical basis for the symptoms being evaluated
• Relevant psychosocial history and any relevant interventions
• A thorough academic history of elementary, secondary, and post secondary education
• A review of prior psychoeducational test reports to determine whether a pattern of strengths or weaknesses is supportive of attention or learning problems
• Relevant employment history
• Description of current functional limitations in an educational setting that are a direct result of problems with attention
• Relevant history of prior therapy
Alternative Diagnoses or Explanations
The evaluator must investigate and discuss the possibility of dual diagnoses and alternative or coexisting mood, behavioral, neurological, and/or personality disorders that may confound the diagnosis of ADHD. This process should include exploration of possible alternative diagnoses and medical and psychiatric disorders as well as educational and cultural factors affecting the individual that may result in behaviors mimicking an Attention-Deficit/Hyperactivity Disorder.
The report must include a specific diagnosis of ADHD based on the DSM-IV diagnostic criteria. The diagnostician should use direct language in the diagnosis of ADHD, avoiding the use of such terms as "suggests," "is indicative of," or "attention problems." Individuals who report only problems with organization, test anxiety, memory or concentration in selective situations do not fit the prescribed diagnostic criteria for ADHD. Given that many individuals benefit from prescribed medications and therapies, a positive response to medication by itself does not confirm a diagnosis, nor does the use of medication in and of itself either support or negate the need for accommodation.
Recommendations for Accommodations
The evaluator must describe the impact, if any, of the diagnosed ADHD on a specific major life activity as well as the degree of impact on the individual. The diagnostic report must include specific recommendations for accommodations that are realistic at post secondary institutions. A detailed explanation as to why each accommodation is recommended must be provided and should be correlated with specific functional limitations determined through interview, observation, and/or testing.
Although prior documentation may have been useful in determining appropriate services in the past, current documentation must validate the need for services based on the individual's present level of functioning in the educational setting. A school plan such as an Individualized Education Program (IEP) or a 504 plan is insufficient documentation in and of itself but can be included as part of a more comprehensive evaluative report. The documentation must include any record of prior accommodations or auxiliary aids, including information about specific conditions under which the accommodations were used (e.g., standardized testing, final exams, licensing or certification examinations) and whether or not they benefited the individual. However, a prior history of accommodations without demonstration of a current need does not in itself warrant the provision of like accommodations.
If no prior accommodations were provided, the qualified professional and/or the candidate must include a detailed explanation of why no accommodations were needed in the past and why accommodations are needed at this time. Because of the challenge of distinguishing normal behaviors and developmental patterns of adolescents and adults (e.g., procrastination, disorganization, distractibility, restlessness, boredom, academic under-achievement or failure, low self-esteem, chronic tardiness or nonattendance) from clinically significant impairment, a multifaceted evaluation should address the intensity and frequency of the symptoms and whether these behaviors constitute an impairment in a major life activity.
If the requested accommodations are not clearly identified in the diagnostic report, the Office of Accommodative Services will seek clarification, and, if necessary, more information. The Office of Accommodative Services will make final determination of whether appropriate and reasonable accommodations are warranted and can be provided to the individual.
Learning Disability Documentation Guidelines
(available in PDF format: Learning Disability Documentation Guidelines)
The definition of a learning disability used by Clarkson University was written by the National Joint Committee on Learning Disabilities. Learning Disability is a general term that refers to a heterogeneous group of disorders manifested by significant difficulties in the acquisition and the use of listening, spelling, reading, writing, reasoning, or mathematical ability.
These disorders are intrinsic to the individual, presumed to be due to central nervous system dysfunction and may occur across the life span. Problems in self-regulatory behaviors, social perceptions, and social integration may exist with learning disabilities but do not, by themselves, constitute a learning disability. Although learning disabilities may occur concomitantly with other disabilities, they are not the result of those conditions or influences.
Qualifications of the Evaluator
Documentation
Substantiation of the Learning Disability
Diagnostic Interview
Tests for Assessing Adults with Learning Disabilities
Confidentiality
For additional information on Learning Disability resources, visit the Association on Higher Education and Disability web site at http://www.ahead.org/
Qualifications of the Evaluator
Professionals conducting assessments, rendering diagnoses of learning disabilities, and making recommendations for appropriate accommodations must be qualified to do so. Comprehensive training and direct experience with the college-age learning disability (LD) population is essential.
Documentation
Clarkson University requires current documentation of a learning disability using well-known psychometric instruments that are normed on adult populations.
Substantiation of the Learning Disability
Documentation should validate the need for services based on the individual's current level of functioning in the educational setting. A school plan such as an individualized education program (IEP) or a 504 plan is insufficient documentation, but it can be included as part of a more comprehensive assessment battery. A comprehensive assessment battery and the resulting diagnostic report should include a diagnostic interview, assessment of aptitude, academic achievement, information processing, and a diagnosis.
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Diagnostic Interview
The diagnostician, using professional judgment as to which areas are relevant, should conduct a diagnostic interview which may include: a description of the presenting problem(s); developmental, medical, psychosocial, and educational history; family history (including primary language of the home and the student's current level of English fluency); and a discussion of dual diagnosis where indicated.
The neuropsychological or psycho-educational evaluation for the diagnosis of a specific learning disability must provide clear and specific evidence that a learning disability does or does not exist. Assessment, and any resulting diagnosis, should consist of and be based on a comprehensive assessment battery, which does not rely on any one test or subtest. Evidence of a substantial limitation to learning or other major life activity must be provided. A list of commonly used tests is found below. Minimally, the domains to be addressed must include the following:
Aptitude
A complete intellectual assessment using adult-normed instruments with all subtests and standard scores reported.
Academic Achievement
A comprehensive academic achievement battery is essential with all subtests and standard scores reported for those subtests administered. The battery should include current levels of academic functioning in relevant areas such as reading (decoding and comprehension), mathematics, and oral and written language.
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, and motor ability) should be assessed.
Specific Diagnosis
Individual "learning styles," "learning differences," "academic problems" and "test difficulty or anxiety," in and of themselves, do not constitute a learning disability. It is important to rule out alternative explanations for problems in learning such as emotional, attentional or motivational problems that may be interfering with learning but do not constitute a learning disability. The diagnostician is encouraged to use direct language in the diagnosis and documentation of a learning disability, avoiding the use of terms such as "suggests" or "is indicative of."
Test Scores
Standard scores and/or percentiles should be provided for all normed measures. Grade equivalents are not useful unless standard scores and/or percentiles are also included. The data should logically reflect a substantial limitation to learning for which the student is requesting the accommodation. The particular profile of the student's strengths and weaknesses must be shown to relate to functional limitations that may necessitate accommodations. The tests used should be reliable, valid and standardized for use with an adult population. The test findings should document both the nature and severity of the learning disability.
Clinical Summary
A well-written diagnostic summary based on a comprehensive evaluation process is a necessary component of the report. Assessment instruments and the data they provide do not diagnose; rather, they provide important elements that must be integrated by the evaluator with background information, observations of the client during the testing situation, and the current context. It is essential, therefore, that professional judgment be utilized in the development of a clinical summary. The clinical summary should include:
1. Demonstration that the evaluator has ruled out alternative explanations for academic problems as a result of poor education, poor motivation and/or study skills, emotional problems, attentional problems or cultural/language differences.
2. Indication of how patterns in the student's cognitive ability, achievement, and information processing reflect the presence of a learning disability.
3. Indication of the substantial limitation to learning or other major life activity presented by the learning disability and the degree to which it impacts the individual in the learning context for which accommodations are being requested.
4. Indication as to why specific accommodations are needed and how the effects of the specific disability are accommodated.
The summary should also include any record of prior accommodation or auxiliary aids, including any information about specific conditions under which the accommodations were used (e.g., standardized testing, final exams, licensing or certification examinations).
Recommendations for Accommodations
It is important to recognize that accommodation needs can change over time and are not always identified through the initial diagnostic process. Conversely, a prior history of accommodation does not, in and of itself, warrant the provision of a similar accommodation. The diagnostic report should include specific recommendations for accommodations as well as an explanation as to why each accommodation is recommended. The evaluators should describe the impact the diagnosed learning disability has on a specific major life activity as well as the degree of significance of this impact on the individual. The evaluator should support recommendations with specific test results or clinical observations.
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Tests for Assessing Adults with Learning Disabilities
When selecting a battery of tests, it is critical to consider the technical adequacy of instruments including their reliability, validity and standardization on an appropriate norm group. The professional judgment of an evaluator in choosing tests is important. The following list is provided as a helpful resource, but it is not intended to be definitive or exhaustive.
Aptitude
• Wechsler Adult Intelligence Scale III (WAIS-III)
• Kaufman Adolescent and Adult Intelligence Test
• Stanford-Binet Intelligence Scale (4th ed.)
The Slosson Intelligence Test-Revised and the Kaufman Brief Intelligence Test are primarily screening devices that are not comprehensive enough to provide the kinds of information necessary to make accommodation decisions.
Academic Achievement
• Stanford Test of Academic Skills
• Woodcock-Johnson Psychoeducational Battery-Revised: Tests of Achievement
• Wechsler Individual Achievement Test (WIAT)
and/or specific achievement tests such as:
• Nelson-Denny Reading Skills Test
• Stanford Diagnostic Mathematics Test
• Test of Written Language-3 (TOWL-3)
• Woodcock Reading Mastery Tests-Revised
Specific achievement tests are useful instruments when administered under standardized conditions and interpreted within the context of other diagnostic information. The Wide Range Achievement Test - 3 (WRAT-3) is not a comprehensive measure of achievement and therefore is not useful if used as the sole measure of achievement.
Information Processing
Acceptable instruments include:
• Detroit Tests of Learning Aptitude-3 (DTLA-3)
• Detroit Tests of Learning Aptitude-Adult (DTLA-A)
• information from subtests on the WAIS-III
• Woodcock-Johnson Psychoeducational Battery-Revised: Tests of Cognitive Ability
• as well as other relevant instruments
Confidentiality
The receiving institution has a responsibility to maintain confidentiality of the evaluation and may not release any part of the documentation without the student's informed and written consent.
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Physical, Medical and Sensory Disabilities Documentation Guidelines
(available in PDF format: Physical, Medical and Sensory Disabilities Documentation Guidelines)
Students with sensory impairments (e.g., vision, hearing), physical impairments or chronic medical conditions must have their physician or certified diagnostician complete and submit the Verification of Physical, Medical or Sensory Disabilities Form. In order to identify appropriate reasonable accommodations, the Director of Accommodative Services may need to discuss the student's disability with physicians or other qualified professionals, and may require updated documentation at the time services are requested and/or during the course of an academic career. The Verification Form may not be completed by a relative or family member. This form can be requested from the Office of Accommodative Services in print or as a PDF file. This form MAY NOT be used to document Learning Disabilities, ADD/ADHD, Psychological or other cognitive disorders.
Verification of a Disability for Medical, Physical or Sensory Disabilities Form (PDF File)
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Psychological Disabilities Documentation Guidelines
(available in PDF format: Psychological Disabilities Documentation Guidelines)
Clarkson University recognizes that "psychiatric disabilities" is a generic term used to refer to a variety of conditions involving psychological, emotional, and behavioral disorders and syndromes. The two official sources designed to outline the criteria used in making these diagnoses are the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and the International Classification of Diseases Manual, Tenth Revision (ICD-10). For the purpose of determining eligibility for accommodation, the symptoms must meet the Americans with Disabilities Act (ADA) definition of a disability.
Qualifications of Evaluator
Current Documentation
Comprehensive Evaluation
Historical Evaluation
Specific Diagnosis
Alternative Diagnoses or Explanations
Recommendations for Accommodations
Adults with Psychological Disabilities
Qualifications of Evaluator
Professionals conducting assessments, rendering diagnoses of psychiatric disabilities, and making recommendations for accommodations must be qualified to do so. It is essential that professional qualifications include:
1. comprehensive training and relevant expertise in differential diagnosis of psychiatric disorders
2. appropriate licensure/certification
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Current Documentation
Due to the changing nature of psychiatric disabilities, it is essential that a student provide recent and appropriate documentation from a qualified evaluator. Since reasonable accommodations are based upon the current impact of the disability, the documentation must address the individual's current level of functioning and the need for accommodations (e.g., due to observed changes in performance or medication changes since previous assessment). If the diagnostic report is more than one academic year old the test taker must also submit a letter from a qualified professional that provides an update of the diagnosis, a description of the student's current level of functioning during the preceding twelve months, and a rationale for the requested academic accommodations.
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Comprehensive Evaluation
In most cases, documentation should be based on a comprehensive diagnostic/clinical evaluation that adheres to the guidelines outlined in this document.
The diagnostic report should include the following components:
• a specific diagnosis
• a description of current functional limitations in the academic environment as well as across other settings
• relevant information regarding medications
• relevant information regarding current treatment
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Historical Information
The information collected for the summary of the diagnostic interview should include, but is not limited to, the following:
• history of presenting symptoms
• duration and severity of the disorder
• relevant developmental, historical, and familial data
• relevant medical and medication history, including the individual's current medication regimen compliance, side effects (if relevant), and response to medication
• a description of current functional limitations in different settings with the understanding that a psychological disorder usually presents itself across a variety of settings other than just the academic domain and that its expression is often influenced by context-specific variables (e.g., school-based performance)
• if relevant, a description of the expected progression or stability of the impact of the condition over time
• if relevant, information regarding kind of treatment and duration/consistency of the therapeutic relationship
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Specific Diagnosis
The report must include a specific diagnosis based on the DSM-IV or ICD-10 diagnostic criteria and include the specific diagnostic section in the report with a numerical and nominal diagnosis from DSM-IV or ICD-10. Evaluators are encouraged to cite the specific objective measures used to help substantiate the diagnosis. The evaluator should use definitive language in the diagnosis of a psychiatric disorder, avoiding such wording as "suggests," "has problems with," or "may have emotional problems."
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Alternative Diagnoses or Explanations
The evaluator must also investigate and rule out the possibility of other potential diagnoses involving neurological and/or medical conditions or substance abuse, as well as educational, linguistic, sensorimotor, and cross-cultural factors that may result in symptoms mimicking the purported psychiatric disability.
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Recommendations for Accommodations
The evaluator must describe the degree of impact of the diagnosed psychiatric disorder on a specific major life activity, as well as the degree of impact on the individual. A link must be established between the requested accommodations and the functional limitations of the individual that are pertinent to the anticipated academic setting. Accommodations will be provided only when a clear and convincing rationale is made for the necessity of the accommodation. A diagnosis in and of itself does not automatically warrant approval of requested accommodations. A prior history of accommodations, without demonstration of current need, does not in and of itself warrant the provision of accommodations. If there is no prior history of accommodations, the evaluator must include a detailed explanation of why accommodations were not needed in the past, and why they are now currently being requested. Psychoeducational or neuropsychological testing may help to support the need for accommodations based on the potential for psychiatric disorders to interfere with cognitive performance.
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Adults with Psychological Disorders
If psychological instruments are used, all tests used should be current and have sufficient reliability, validity, and utility for the specific purposes for which they are being employed. All tests should also be normed on relevant populations, and the results should be reported in standard scores and/or percentile ranks. Tests that have built-in validity scales or indicators are preferred over those that do not. No single test or subtest should be used solely to substantiate a diagnosis.
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Temporary Disabilities
(available in PDF format: Temporary Disabilities Documentation Guidelines)
Services are available to students with temporary disabilities to provide access to campus academic programs and services.
Assistance cannot be provided for tasks of a personal nature such as typing homework or assisting with home-health care.
Students must submit documentation of their condition by using The Verification of Physical, Medical or Sensory Disabilities Form. This form can be requested from the Office of Accommodative Services in print or as a PDF file. This form MAY NOT be used to document temporary disabilities of a psychological nature.
Verification of a Disability for Medical, Physical or Sensory Disabilities Form (PDF File)
Please call the Office of Accommodative Services with your questions and concerns related to a temporary disability and we will discuss resources and assistance that can be provided by Clarkson during this difficult time.
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