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GUIDELINES FOR DOCUMENTATION OF LEARNING DISABILITY (continued)

Substantiation of the Learning Disability

Documentation should validate the need for services based on the individual's current level of functioning in an educational or employment setting. A school plan such as an individualized educational program (IEP) or 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.

A. Diagnostic Interview

An evaluation report should include the summary of a comprehensive diagnostic interview. Learning disabilities are commonly manifested during childhood, but not always formally diagnosed. Relevant information regarding the individual's academic history and learning processes in elementary, secondary, and post secondary education should be investigated. 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 employment histories; family history (including primary language in the home and the individual's current level of English fluency); and a discussion of dual diagnosis where indicated.

B. Assessment

The neuropsychological and psycho-educational evaluation for the diagnosis of 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 battery, which does not rely on any one test or subject.

Evidence of a substantial limitation to learning or other major life activity must be provided. A list of commonly used tests is attached. Minimally, the domains to be addressed must include the following:

1. Aptitude

   A complete intellectual assessment with all subtests and standard scores reported.

2. 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.

3. 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 more ability) should be assessed.

   Other assessment measures such as non-standard measures and informal assessment procedures or observations may be helpful in determining performance across a variety of domains. Other formal measures may be integrated with the above instruments to help determine a learning disability and differentiate it from co-existing neurological and/or psychiatric disorders (i.e., to establish a differential diagnosis). In addition to standardized tests, it is also useful to include informal observations of the individual during test administration.

4. 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."

   If the data indicate that a learning disability is not present, the evaluator should state that conclusion in the report.

C. Test Scores

Standard scores and/or percentiles should be provided for all normed measures. Grade equivalents are not useful unless standard score and/or percentiles are also included. The data should logically reflect a substantial limitation to learning for which the individual is requesting the accommodation. The particular profile of the individual's strengths and weaknesses must be shown to relate to functional limitations that my necessitate accommodations.

The tests used should be reliable, valid and standardized for use with an adolescent/adult population. The test findings should document both the nature and severity of the learning disability. Informal inventories, surveys and direct observation by a qualified professional may be used in tandem with formal tests in order to further develop a clinical hypothesis.

D. 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 of the evaluator's having ruled out alternative explanations for academic problems as a result of poor education, poor motivation and/or study skills, emotional problems, attentional problems and/or cultural/language differences;
2. Indication of how patterns in the individual'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; and,
4. Indication as to why specific accommodations are needed and how the effects of the specific disability are accommodated.

For further information, consumers may wish to access AHEAD online at www.ahead.org.

AHEAD GUIDELINES FOR DOCUMENTING LEARNING DISABILITIES

Tests for Assessing Adolescents and Adults

When selecting a batter of tests, it is critical to consider the technical adequacy of instru-ments 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 - Revised (WAIS-R)
• Woodcock-Johnson Psychoeducational Battery - Revised: Tests of Cognitive Ability
• 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 which are not comprehensive enough to provide the kinds of information necessary to make accommodation requests.

Academic Achievement

• Scholastic Abilities Test for Adults (SATA)
• Stanford Test of Academic Skills
• Woodcock-Johnson Psychoeducational Battery - Revised: Tests of Achievement
• Wechsler Individual Achievement Test (WIAT)

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 not useful if used as a sole measure of achievement.

Information Processing

Acceptable instruments include:

• Detroit Tests of Learning Aptitude - 3 (DTLA-3)
• Detroit Tests of Learning Aptitude - Adults (DTLA-A)
• Information from sub tests on WAIS-R
• Woodcock-Johnson Psychoeducational Battery - Revised: Tests of Cognitive Ability

as well as other relevant instruments.

DOCUMENTATION GUIDELINES FOR ATTENTION DEFICIT/HYPERACTIVITY DISORDER (ADHD)

Qualifications of the Evaluator

Students requesting accommodations on the basis of a diagnosis of Attention Deficit/Hyperactivity Disorder (ADHD) must submit documentation provided by a professional qualified to conduct assessments and render diagnoses of ADHD. These professionals may include psychiatrists, psychologists, neuropsychologists and other relevantly trained medical providers.

The name, title, and professional credentials of the evaluator, including information about licensure or certification, the area of specialization, and state/province in which the individual practices should be clearly stated. Documentation should be typed, signed, and dated by the professional and appear on letterhead.

Diagnostic Methodology

There is no one test or combination of tests for determining a diagnosis of ADHD. A comprehensive and accurate report requires a multifaceted approach. Thorough documentation includes a description of the diagnostic criteria, evaluation methods, procedures, tests and dates of administration, as well as a clinical narrative, observation and specific results.

Some of the elements necessary to document a diagnosis of ADHD include:

Clinical interview
History
Rating Scales
Response to Medication
Neuropsychological assessment measures
Tests of cognitive ability

These components should include:

Clinical Interview

Symptoms as described in the Diagnostic and
Statistical Manual (DSM) - IV-TR
Treatment modalities
Any differential diagnosis and rationale

Evidence of early impairment
Relevant medical, family and/or academic history

Rating Scales

Brown Attention-Activation Disorder Scale
ADHD Rating Scale (ARS)

Tests of Cognitive Ability

Woodcock-Johnson Tests of Cognitive Ability
WAIS III

Current Functional Impact

Providing information on how the diagnosis of ADHD currently impacts the student's ability to function can be useful to establish the existence of the disability and the recommended reasonable accommodations. Documentation should be thorough and demonstrate the major life activities that are substantially impacted. Severity, frequency and pervasiveness of the condition should be addressed in the documentation.

Typically, testing should be recent, within the last three years. If documentation is inadequate or does not reflect the individual's current level of function, reevaluation may be recommended.

Recommended Accommodations and Rationale

The diagnostic report should include specific recommendations for reasonable accommodations. Requests for accommodations should include:

1. A detailed explanation or rationale as to why each accommodation is recommended with reference to the specific functional limitations of the individual.
2. Current documentation should validate the need for services based on the individual's present level of functioning in an educational setting.

Documentation should include any record of prior accommodations and the setting in which they were implemented. The University will review documentation and evidence of prior accommodations in making a determination about the reasonable accommodations, when necessary.