Will Lindstrom

Documenting Hidden Disabilities in Higher Education Analysis of Recent Guidance From the Association on Higher Education and Disability (AHEAD)

Once students with disabilities leave high school, they must take proactive steps to document their disabilities to educational institutions or employers when requesting accommodations. The Association on Higher Education and Disability (AHEAD) has been the principal organization offering suggestions on documentation requirements, and AHEAD’s recently revised guidance involves radical changes to the suggested requirements. AHEAD now recommends that students’ self-reports and disability services professionals’ impressions take precedence over external, objective records. This article reviews the relevant research to evaluate the evidence base for the revised guidance, finding it lacking in important ways as it applies to hidden disabilities (learning, cognitive, and psychiatric disabilities). The evidence supporting various sources of disability documentation is reviewed, and implications for policy and practice are discussed.

How Is ADHD Assessed and Documented? Examination of Psychological Reports Submitted to Determine Eligibility for Postsecondary Disability:

Objective: To examine how ADHD evaluations are documented for postsecondary students requesting disability eligibility. Method: A total of 100 psychological reports submitted for eligibility determination were coded for documentation of Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria, methods and instruments used in the evaluations, and recommended academic accommodations. Results: Results showed that a minimal number of reports (≤1%) documented that students met all DSM criteria for ADHD. Psychologists rarely documented childhood impairment, symptoms across settings, or the use of rule-outs. Symptom severity was emphasized over current impairment. The majority of psychologists utilized a multi-informant, multi-method evaluation approach, but certain methods (e.g., symptom validity tests, record reviews) were limited in use. Most reports included recommendations for academic accommodations, with extended time being the most common (72%). Conclusion: This study raises awareness to the aspects of adequate ADHD evaluation and subsequent documentation that can be improved by psychologists. Recommendations are made regarding valid documentation of ADHD for disability determination purposes.

The Structure of Phonological Processing and Its Relationship to Basic Reading

We investigated various structural models of phonological processing and the relationship of phonological processing abilities to basic reading. Data were collected on 116 kindergarten and first grade students. The specific ability model, which included phonological awareness, phonological memory, and rapid automatized naming as separate abilities, had the strongest fit to the data. Of the specific phonological processing abilities, rapid automatized naming was least associated with a second-order factor. Phonological awareness and rapid automatized naming accounted for variance in word reading, although the latter demonstrated limited practical utility. Theoretical and practical implications are discussed.

Test Anxiety Among College Students With Specific Reading Disability (Dyslexia): Nonverbal Ability and Working Memory as Predictors

Test anxiety and its correlates were examined with college students with and without specific reading disability (RD; n = 50 in each group). Results indicated that college students with RD reported higher test anxiety than did those without RD, and the magnitude of these differences was in the medium range on two test anxiety scales. Relative to college students without RD, up to 5 times as many college students with RD reported clinically significant test anxiety. College students with RD reported significantly higher cognitively based test anxiety than physically based test anxiety. Reading skills, verbal ability, and processing speed were not correlated with test anxiety. General intelligence, nonverbal ability, and working memory were negatively correlated with test anxiety, and the magnitude of these correlations was medium to large. When these three cognitive constructs were considered together in multiple regression analyses, only working memory and nonverbal ability emerged as significant predictors and varied based on the test anxiety measure. Implications for assessment and intervention are discussed.

Test Anxiety and College Students With Attention Deficit Hyperactivity Disorder

Test anxiety was examined in college students with and without attention deficit hyperactivity disorder (ADHD). Results indicated that, relative to college students without ADHD, college students with ADHD reported higher total test anxiety as well as specific aspects of test anxiety, including worry (i.e., cognitive aspects of test anxiety) and emotionality (i.e., physiological aspects of test anxiety). Effect sizes were large for total test anxiety and the worry aspect of test anxiety. Nearly half of college students with ADHD reported clinically significant levels of the worry aspect of test anxiety. Females with ADHD reported higher levels of the emotionality aspect of test anxiety than did males with ADHD. Those with combined type and inattentive type ADHD did not differ on any aspect of test anxiety. Implications for assessment and intervention are discussed.

Simulated Dyslexia in Postsecondary Students: Description and Detection Using Embedded Validity Indicators

The current investigation identified characteristics that discriminated authentic dyslexia from its simulation using measures common to postsecondary learning disability evaluations. Analyses revealed accurate simulation on most achievement measures but inaccurate feigning on neurolinguistic processing measures, speed on timed tasks, and error quantity. The largest group separations were on rapid naming, speeded orthographic, and reading fluency tasks. Simulators accurately feigned dyslexia profiles on cut-score and discrepancy diagnostic models but not on the more complex aspects of the clinical judgment model. Regarding simulation detection, a multivariate rule exhibited the greatest classification accuracy, followed by univariate indices developed from rapid naming tasks. The findings of the current study suggest that aspects of a comprehensive evaluation may aid in the detection of simulated dyslexia.

Postsecondary ADHD Documentation Requirements: Common Practices in the Context of Clinical Issues, Legal Standards, and Empirical Findings

Objective: To evaluate the information postsecondary institutions require when determining disability service eligibility for students with reported ADHD. Method: ADHD documentation requirements of 200 U.S. institutions were surveyed by reviewing guidelines posted on disability services websites. Results: Whereas virtually all institutions required documentation, findings revealed significant variability in requirements across institutions. Required variables most often included a qualified evaluator (80%), diagnostic statement (75%), and identification of substantial limitations (73%), but only 5 of 46 evaluated variables were required by at least 50% of institutions. Supportive data such as diagnostic criteria, standardized assessment results, and rationale for accommodations were rarely required. Conclusion: The majority of institutions required little to verify ADHD as a disability. Furthermore, there was little agreement on what components are essential for verification. When integrated with research, a large portion of guidelines failed to address identified weaknesses in ADHD diagnosis and disability determination.

College Admissions Tests and LD and ADHD Documentation Guidelines: Consistency With Emerging Legal Guidance

Testing agencies request documentation to verify a test-taker’s disability status under the Americans With Disabilities Act of 2008 and Section 504 of the Rehabilitation Act of 1973. A number of recent legal developments, culminating in technical assistance from the U.S. Department of Justice, suggest changes in enforcement of relevant laws are imminent. This article reviews the legal developments and presents results of a survey of the learning disability and Attention-Deficit/Hyperactivity Disorder documentation guidelines of 10 standardized tests commonly used to aid admissions decisions for undergraduate and graduate programs. Consistent with the recent guidance, virtually all guidelines requested documentation from a qualified evaluator, a diagnosis, and accommodation recommendations and rationale. In contrast, agencies were less likely to request the information necessary to grant accommodations based on history of accommodation use. Few agencies had policies allowing submission of reduced amounts of documentation for students with lengthy histories of disabling conditions. Finally, guidelines frequently neglected to provide the guidance that evaluators need to generate useful documentation. Benefits and limitations of the recent legal guidance are discussed, and recommendations for testing and enforcement agencies, as well as secondary schools, are provided.