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

Nelson, Jason M.; Whipple, Brittany; Lindstrom, Will; Foels, Patricia

doi:10.1177/1087054714561860

Cited by 48 publications

(37 citation statements)

References 44 publications

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“…Furthermore, only 14% of students had documentation meeting all diagnostic criteria when we expanded our analyses to include data based exclusively on students' self-reports. Our findings are consistent with the results of previous studies that also showed a low percentage of college students with documentation supporting their ADHD diagnoses (Joy et al, 2010;Nelson et al, 2014). Altogether, these results yield converging data that clinicians should provide more thorough evidence supporting their diagnostic decisions and recommendations for treatment.…”

Section: Discussionsupporting

confidence: 91%

“…In the second study, researchers reviewed 100 psychological reports submitted by college students seeking academic accommodations (Nelson, Whipple, Lindstrom, & Foels, 2014). In contrast to the previous study, the researchers only included students with an ADHD diagnosis and excluded students with comorbid learning disabilities.…”

Section: Clinician's Adherence To Best Practicesmentioning

confidence: 99%

“…On the surface, there seems to be a discrepancy between clinicians' self-reports and their actual assessment practices. However, this discrepancy could be due to a deficiency in documentation rather than to a lack of adherence to diagnostic criteria (Nelson et al, 2014). It is possible that psychologists' self-reports are accurate; clinicians may assess all diagnostic criteria but simply fail to document their methods and findings in their reports.…”

Section: The Current Studymentioning

confidence: 99%

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ADHD Assessment in College Students: Psychologists’ Adherence to DSM-5 Criteria and Multi-Method/Multi-Informant Assessment

Weis

Till

Erickson

2017

Journal of Psychoeducational Assessment

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The evidence-based assessment of attention-deficit/hyperactivity disorder (ADHD) depends on adherence to Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) diagnostic criteria and reliance on multi-method/multi-informant data. Although nearly all psychologists endorse these practices, college students with ADHD may lack documentation supporting their diagnoses. We reviewed the documentation submitted by 214 undergraduates diagnosed with ADHD and receiving academic accommodations for this condition. Their clinicians also completed a checklist that described their assessment procedures. Relatively few psychologists assessed all DSM-5 criteria, based on either the psychologist’s self-reported assessment procedures (23.4%), written documentation (14.0%), or multi-method/multi-informant data (10.3%) such as educational/medical records, results of rating scales, or interviews with other informants. Psychologists were least likely to assess students’ areas of impairment or to rule out alternative causes for students’ self-reported symptoms. This lack of adherence to DSM-5 criteria and overreliance on students’ self-reports can threaten the reliability of diagnosis and the appropriateness of medication and accommodations that follow.

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Section: Discussionsupporting

confidence: 91%

Section: Clinician's Adherence To Best Practicesmentioning

confidence: 99%

Section: The Current Studymentioning

confidence: 99%

See 1 more Smart Citation

ADHD Assessment in College Students: Psychologists’ Adherence to DSM-5 Criteria and Multi-Method/Multi-Informant Assessment

Weis

Till

Erickson

2017

Journal of Psychoeducational Assessment

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“…Both the DSM-5 and the ADA Title I Regulations require additional information regarding functioning to determine the presence of a disability. Testing agencies are often asked to make accommodation decisions based on documentation verifying a clinical disorder but lacking information verifying the impairment severity necessary for a disability determination (Nelson et al, 2014).…”

Section: The Challenges Of Accommodation Determinationsmentioning

confidence: 99%

“…Although collateral report is essential to the detection of ADHD (Molina & Sibley, 2014), only one set of guidelines requested it. All agencies requested evidence of functional limitations, addressing a frequent omission in the reports of qualified evaluators (Nelson et al, 2014).…”

Section: Guidance For Evaluatorsmentioning

confidence: 99%

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

Lindstrom

2017

Journal of Disability Policy Studies

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Test-takers with disabilities access academic accommodations on standardized college admissions tests under the auspices of the Americans With Disabilities Act (ADA; 2008) and Section 504 of the Rehabilitation Act (1973). Also under these laws, testing agencies request documentation to verify a test-taker's disability status and need for accommodations to equally access an examination (Banerjee & Shaw, 2007). Historically, relevant laws, regulations, and guidance have provided little information regarding the content or scope of the documentation allowed to be requested, leading to variability in documentation policies across testing agencies (Banerjee & Shaw, 2007). More recently, technical assistance provided by the U.S. Department of Justice (2015) has provided increased guidance regarding what constitutes sufficient documentation, as well as what might constitute overly burdensome requests. Some of the guidance has been controversial (Lovett, 2014). This has particularly been the case for the documentation of learning disabilities (LDs) and Attention-Deficit/Hyperactivity Disorder (ADHD), hidden disabilities that account for the majority of accommodation requests (U.S. Government Accountability Office [GAO], 2011). Given these developments, the current study sought to (a) investigate LD and ADHD disability documentation guidelines across testing agencies and (b) evaluate the guidelines within the context of the new DOJ technical assistance. Applicable Law The ADA (2008) and its Title III Regulations (2010) prevent discrimination during admissions tests. To be eligible for protections, LD and/or ADHD must represent a mental impairment that substantially limits one or more major life activities relative to most people in the general population. For qualifying test-takers, testing agencies must ensure that examinations are administered in an accessible manner.

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Students with Disabilities in Higher Education: A Review of the Literature and an Agenda for Future Research

Kimball

Wells

Ostiguy

et al. 2016

Higher Education: Handbook of Theory and Research

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

Abstract: 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.

Cited by 48 publications

References 44 publications

ADHD Assessment in College Students: Psychologists’ Adherence to DSM-5 Criteria and Multi-Method/Multi-Informant Assessment

ADHD Assessment in College Students: Psychologists’ Adherence to DSM-5 Criteria and Multi-Method/Multi-Informant Assessment

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

Students with Disabilities in Higher Education: A Review of the Literature and an Agenda for Future Research

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