The following was created to assist psychologists, neuropsychologists, diagnosticians and other individuals qualified to assess and diagnose learning disabilities with a focus on the post-secondary arena. This information was compiled with input from post-secondary disability service providers including universities, community colleges, certification tests and providers of admissions testing (ETS, ACT, SAT). However, each individual entity has the right to establish their own reasonable requirements for such testing; therefore we encourage evaluators to reference the individual institutions prior to finalizing the testing process and providing a diagnosis.
I) What are the essential elements of learning disability documentation for post-secondary education?
At UNT we usually require the following:
- A qualified professional (not related to the student) has completed the evaluation and it is typed, printed on letterhead, dated and signed with the credentials of the evaluator.
- Testing is preferred to have been completed within the last 5 years, but older testing will be considered provided the student was tested as an adult and if it is comprehensive meeting all standards.
- A diagnostic Interview and summary.
- Full test, and subtest scores must be provided and reflect substantial limitations in learning.
- A clear diagnosis in the DSM-IV-TR multiaxial format (note, phrases such as consistent with a diagnosis of; appears to indicate; may have; etc. are discouraged, we need to know if in your professional opinion you feel that the student does or does not have a diagnosable condition).
For full details on UNT documentation requirements visit disability.unt.edu/services/learning-add-adhd
II) What are the preferred and/or most commonly accepted tests to diagnose a learning disability for a college student at UNT?
Intellectual: Most current versions of the Woodcock Johnson Test of Cognitive Abilities or Wechsler Adult Intelligence Scale
Achievement: Most current versions of the Woodcock Johnson Psycho-Educational Battery Tests of Achievement or Wechsler Individual Achievement Test
III) What other tests may be considered?
Almost any test with sound psychometrics can be considered, we list many examples on our web page at disability.unt.edu/services/learning-add-adhd. However, when evaluating specifically for UNT students, it is usually wise to only use tests named at that link and to pay special attention to tests like the Wide Range Achievement Test (WRAT), the Kaufman Brief Intelligence Test (K-BIT), the Test of Non-verbal Intelligence (TONI). For example, the WRAT is a good test for screener purposes; however it is not comprehensive enough to be the sole measure of achievement when providing a diagnosis.
IV) What learning disability diagnostic model is most frequently required in colleges?
DSM-4 TR and DSM 5 defined diagnostic criteria are preferred, others may be considered.
V) I’m a Vocational Rehabilitation Counselor at DARS/VA/Social Security/Private Insurance etc. What should I know to maximize the chances my consumers will qualify for reasonable accommodations at UNT when I sponsor their evaluations?
Other than all the details found herein, often evaluators for agencies like DARS have standard batteries and contracted rates with their evaluators. The testing often is more geared towards vocational rather than diagnostic outcomes, resulting in tests like the WRAT being used to diagnose. When this happens such students often find it difficult to have their testing approved for reasonable accommodation at universities and/or high stakes admissions testing. We recommend DARS and VA counselors ask evaluators to provide full psychoeducational batteries with only comprehensive tests.
VI) I’ve used comprehensive batteries, but there’s no discrepancy however I feel strongly the student will have challenges and cannot succeed without reasonable accommodation what can be done?
In cases like this, it may be possible to look for a pattern of deficiencies in the test results that could at least justify a diagnosis of LD NOS or Cognitive Disorder NOS, which will often suffice (but not always, ETS can be strict on this one). Some evaluators focus on specific, but crucial subtests scores that may be significantly lower such as processing speed, academic fluency, or just a lower IQ. As a final option, evaluators may use different models/scores to diagnose LD provided sound reasoning is used and explained in the report. For example, in some cases the FSIQ may not be the best representation of a student’s intelligence and instead an evaluator chooses to use the VIQ. There may not be a simple discrepancy when the FSIQ is used, but it may be evident with the VIQ. Provided the evaluator provides a statement justifying the use of the VIQ instead of the FSIQ, this student may qualify.
Lastly, we view scores as being important, but certainly not the sole evidence of a diagnosis of LD. A whole person approach is necessary and evaluators can establish credibility by ruling out other diagnosis that may mimic and LD such as depression or anxiety. Medication effects should be noted as well as language proficiency or lack thereof. Ultimately, the professional judgment of the evaluator can overcome a lack of scores when a thorough explanation is provided focusing on the individual.
VII) As a diagnostician, I’m trained to avoid giving potentially harmful labels that often are found on the DSM multiaxial format. Will the student be approved if I simply note the discrepancies and allow you to draw your own conclusions?
Maybe, at UNT we feel qualified enough to look at the test scores and draw these conclusions when we have the full scores and the testing contains all the other aforementioned essentials. It is very helpful when evaluators can at least point out the discrepancies (compuscore at a minimum).
VIII) I’m working with a student who has a very thorough evaluation, but it is more than five years old. I’m being asked to provide updated testing, isn’t there an easier way to do this?
Yes! As mentioned at UNT we will go beyond 5 years if the student was tested as an adult and the testing meets all other standards. But, if the student was not an adult or maybe the testing is significantly beyond five years, then an evaluator may simply provide the documentation update option to UNT as established by ETS at: http://www.ets.org/disabilities/documentation/ld_adhd_update. Again, this may work for UNT but may not suffice everywhere.
IX) Are there some standard referral questions universities would like to see in a report?
What are the student’s strengths and weaknesses in the academic setting?
What are your impressions of the student’s learning style e.g. auditory, visual, and kinesthetic?
What reasonable accommodations would be most helpful for the student and why?
X) Examples of most common, reasonable accommodations
- More time on exams, either time and one half (1.5x) or double time (2x), please provide thorough justification for 2x
- Testing in a distraction reduced environment (small group, semi-private)
- Help acquiring class notes, e.g. voice recorder, copies of professor’s notes, note partner, Smart Pen voice recorder, laptop for notetaking
- Use of calculator on math tests
- No deduction for grammar/spelling when that is not an essential skill
- Use of computer/word processor for exams
- Reserved seat in preferred area of class
- Write answer on tests instead of scantron
- Scribe to write answers for tests, or double check scantron entries
- Reader during exams (computer text to speech)
- Short breaks
Example of reasonable accommodations that should only be suggested with a strong justification and a clear diagnosis.
- Absence leniency (include statement that this would not be counter-therapeutic and why)
- Consideration for oral exam instead of written
- Substitution for math class requirement (note, waivers are not granted substitutions only)
- Substitution for foreign language requirement (substitutions only)
- Provide both written and oral instruction
- Conversion of text books to digital or auditory format
- Allow one on one presentations or video instead of in front of class
- Testing in a private room
If you are considering recommending any of the following, please contact the ODA in advance before suggesting them to the student or listing them on our forms/documentation.
- Vocabulary list
- Formula card
- Change format of essay test to multiple choice or vice versa
- Reduce options on multiple choice tests
- Test time extended beyond double time
- Time extended for work done outside of the classroom (projects, papers, research etc.)
- Comfort animal
XI) Our waiting list is 2-3 months to test students, by then they could fail their classes, isn’t there anything that can be done to help sooner?
Possibly, at many universities (including UNT) we will grant at least one semester of temporary adjustments for students who have at least a minimal history of reasonable accommodation while they are undergoing evaluation, or on a waiting list. These temporary services are typically only the most basic direct modifications (more time on tests, reduced distractions in small group testing room). Refer such students back to the disability office to ask about this option. Temporary adjustments are usually not an option on certification/admission testing.
XII) Are there any special requirements to diagnose ADD/ADHD/Autism/Psychiatric Disabilities?
No, we do not require any standards for these conditions beyond what is suggested in the DSM. However, it is helpful to see continuous performance testing (CPT) for ADD/ADHD, personality testing for psychiatric and other tests specifically for autism.
XIII) Do you require neuropsychological testing for traumatic brain injury, stroke, post concussive syndrome etc.?
No, but it is preferred, especially tests of memory. Typically, a neuropsychological eval will maximize the types of services that can be provided and make student learning strategies more effective.
XIV) I don’t feel like the student I was evaluating was truly putting forth the best effort, what should I do?
We always encourage evaluators to follow their training, ethics, and professional judgment.
XV) Do most disability offices/testing agencies want students to qualify for services or do they see themselves as “gatekeepers” only allowing students to qualify for reasonable accommodations who meet the strictest of standards?
In 2008, congress corrected some problems found in the application of the original Americans with Disabilities Act. The intent of the ADA Amendments Act was clearly to reduce the burdensome process of proving one has a disability and is therefore entitled to protection. This is especially true in light of the fact that other protected groups, e.g. gender, age, race have to do very little or nothing at all to prove they qualify for protections under anti-discrimination laws. Further, the focus on retention and progression of all post-secondary students has led to offices like ours being encouraged to keep that goal in mind. In keeping with these trends, the philosophy of our office is to make the process of documenting a disability as painless as possible for students. Temporary adjustments, removing the age limit of 5 years from documentation of some disabilities, the documentation update option, and disseminating information such as this are all ways we hope to help more students qualify. Our numbers reflect our success in this, with 28% and 20% increases in population for the two Fall semesters which followed the implementation of these new procedures.