The following guidelines are provided in the interest of assuring that evaluation reports are appropriate to document eligibility. The Office of Student Accessibility Services is available to consult with diagnosticians regarding any of these guidelines.
1. Qualified Professional:
Professionals conducting assessments and rendering diagnoses of ADHD must have training in differential diagnosis and the full range of psychiatric disorders. The following professionals would generally be considered qualified to evaluate and diagnose ADHD provided they have comprehensive training in the differential diagnosis of ADHD and direct experience with an adolescent or adult ADHD population:
- clinical psychologists
- neuropsychologists
- psychiatrists
- other relevantly trained medical doctors.
Use of diagnostic terminology indicating ADHD by someone whose training and experience are not in these fields is not acceptable. It is also not appropriate for professionals to evaluate members of their own families.
Reports from a qualified practitioner should be submitted on letterhead and include:
- Name, title, and professional credentials
- Information about license or certification as well as the area of specialization
- State/province in which the individual practices
2. Documentation Should Be Current:
Because the provision of all reasonable accommodations and services is based upon assessment of the current impact of the disability on academic performance, it is in an individual's best interest to provide recent and appropriate documentation. In most cases, this means that a diagnostic evaluation has been completed within the past three years. Flexibility in accepting documentation which exceeds a three-year period may be important under certain conditions if the previous assessment is applicable to the current or anticipated setting. If documentation is inadequate in scope or content, or does not address the individual's current level of functioning and need for accommodation(s), re-evaluation may be warranted. It is the student’s responsibility to pay for costs associated with obtaining sufficient documentation. Funding may be available for students with demonstrated need.
3. Documentation Should Be Comprehensive and include:
A. Specific Diagnosis
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 terms such as "suggests," "is indicative of", or "attention problems". Individuals who report only problems with organization, test anxiety, memory and concentration in selective situations do not fit the prescribed diagnostic criteria for ADHD.
B. Evidence of early impairment
Because ADHD is, by definition, 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. The following should be included in a comprehensive assessment: clinical summary of objective, historical information establishing symptomology indicative of ADHD throughout childhood, adolescence, and adulthood as garnered from transcripts, report cards, teacher comments, tutoring evaluations, past psychoeducational testing, and/or third party interviews.
C. Evidence of current impairment
A history of the individual's presenting attentional symptoms and evidence of current impulsive/hyperactive or inattentive behaviors that significantly impair functioning in two or more settings must be provided. History of full assessment which includes information about the impact of the symptoms on the student’s functioning in and out of the classroom setting. It is important the evaluation addresses the severity and frequency of the symptoms and indicates whether the symptoms constitute an impairment of a major life activity.
D. Alternative Diagnoses
The evaluator must investigate and discuss the possibility of dual diagnoses, and alternative or co-existing mood, behavioral, neurological, and/or personality disorders which may confound the diagnosis of ADHD.
E. Relevant testing
Neuropsychological or psychoeducational assessment are important in determining the current impact of the disorder on the individual's ability to function in academically related settings. The evaluator should objectively review and include with the evaluation report relevant background information to support the diagnosis. If grade equivalents are reported, they must be accompanied by standard scores and/or percentiles. Test scores or subtest scores alone should not be used as a sole measure for the diagnostic decision regarding ADHD. Selected subtest scores from measures of intellectual ability, memory functions tests, attention or tracking tests, or continuous performance tests do not in and of themselves establish the presence, or absence of ADHD. Checklists and/or surveys can serve to supplement the diagnostic profile but in and of themselves are not adequate for the diagnosis of ADHD and do not substitute for clinical observations and sound diagnostic judgment. All data must logically reflect a substantial limitation to learning for which the individual is requesting the accommodation.
F. An interpretative summary
An interpretative summary based on a comprehensive evaluative process is a necessary component of the documentation.
G. Recommended Accommodations
The diagnostic report should include specific recommendations for accommodations that are reasonable and that postsecondary institutions, examining, certifying, and licensing agencies can reasonably provide. A detailed explanation should be provided as to why each accommodation is recommended and should be correlated with specific functional limitations determined through interview, observation, and/or testing.
H. Rationale
Each accommodation recommended by the evaluator should include a rationale. The evaluator(s) should 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.