Guidelines for Documentation of Attention-Deficit/Hyperactivity Disorder (ADHD)
Introduction
In order to establish that an individual is covered under the Americans
with Disability Act (ADA) and Section 504 of the Rehabilitation Act of 1973,
documentation must be provided that indicates that a disability substantially
limits some major life activity, including learning. The following documentation
guidelines are provided to assure that documentation of ADHD demonstrates
a significant impact on a major life activity and supports the request for
accommodations.
It is the responsibility of the student to obtain the documentation and
present a copy to the Disability Services Office. Any correspondence regarding
the adequacy of the submitted documentation will be sent to the student.
It is the student's responsibility to obtain additional information or clarification.
Qualifications of the Evaluator
The name, title, and license/certification credentials of the evaluator
must be stated in the documentation. The following professionals are considered
qualified provided they have training in the differential diagnosis of ADHD
and direct experience with an adolescent or adult ADHD population: A licensed/certified
psychologist (e.g., clinical or school psychologist) or a member of a medical
specialty (e.g. psychiatrist, neuropsychiatrist. neurologist or relevantly
trained medical doctor) who has expertise in evaluating the impact of ADHD
on an individual's educational performance. A diagnosis of ADHD by someone
whose training is not in these fields is not acceptable. All reports must
be on letterhead, dated, and signed.
Documentation Should Be Current
Evaluation should be no more than three years old; however older documentation
may be considered under appropriate circumstances, and on case-by-case basis.
Current documentation is particularly important because reasonable accommodations
an d services are based on the assessment of the current impact of the disability
on academic performance. If the documentation is not adequate in content
or does not address the individual's current level of functioning and need
for accommodation(s), a reevaluation may be requested by Disability Services.
In some cases changes may have occurred in the student's performance since
a previous diagnosis or new medication may have been prescribed or discontinued.
In such cases it may be necessary to have a reevaluation. The update should
include a detailed assessment of current impact of the ADHD. The examiner
should also include an interpretive summary of relevant information from
the previous diagnostic report. Documentation must specifically address and
substantiate the need for accommodations based on the student’s current
functioning in an educational setting.
Documentation must be comprehensive
A comprehensive evaluation must include a clinical interview, evidence of
early impairment, statement of presenting problems, evidence of current impairment,
rule out of alternative diagnoses, assessment of attention difficulties,
and a diagnosis of ADHD using all DSM-IV-TR criteria.
A school plan such as an Individualized Education Plan (IEP) or a Section
504 Accommodation Plan is insufficient documentation to support a student's
eligibility for accommodations but may be included as part of a more comprehensive
report.
Clinical Interview
ADHD is by definition first exhibited in childhood and manifests itself
in m ore than one setting; as such. relevant historical information is essential.
A student's academic history should be included. Medical, developmental,
and social histories should be investigated and reported, along with any
family history of educational medical or psychosocial difficulties. A description
of the individual’s presenting attentional symptoms should be provided
as well as any history of such symptoms. A family history of ADHD and the
student's medication history also are important.
Statement of Presenting Problems and Evidence of Current Impact
A statement of the presenting problem as well as a history of the individual's
presenting attentional symptoms should be provided. This should include evidence
of ongoing impulsive/hyperactive or inattentive behaviors that significantly
impair functioning in two or more life activities.
Rule out alternative diagnosis
The evaluator should include any assessment data that supports or refutes
a diagnosis of ADHD. It is imperative that the evaluators investigate and
discuss the possibility of a dual diagnosis. This process should include
exploration of alterative diagnoses and medical and psychiatric: disorders
as well as educational and cultural factors affecting the individual, which
may result in symptoms that mimic ADHD.
Assessment of ADHD
Assessments such as checklists and rating scales are very important, but
checklists, surveys, or subtest scores should not be used as the SOLE criterion
for a diagnosis of ADHD
Diagnosis of ADHD Using DSM-IV-TR Criteria
Individuals who exhibit general problems with organization, test anxiety,
memory and concentration alone do not fit the diagnostic criteria for ADHD.
Likewise. a positive response to medication by itself does not confirm a
diagnosis of ADHD. 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". A specific statement
that the student is diagnosed as having ADHD, with the sub-type and the accompanying
DSM-IV-TR criteria, are required for services and accommodations.
It is important to determine the current impact of the disorder on the individual's
ability to function in multiple settings. As such, the evaluator must describe
the substantial limitation(s) to academic learning, emotional and psychological
functioning, interpersonal relationships, and independent living skills.
All data must logically reflect a substantial limitation to learning for
which the individual is requesting accommodation.
Recommendations for Accommodations
The diagnostic report should include specific recommendations for academic
accommodations. It Is important to reflect upon the functional impact and
limitations of the disorder on the student's ability to learn in the classroom.
A history of accommodations does not in itself warrant the provision of similar
accommodations. If accommodations are not identified specifically in the
diagnostic report, the Disability Services Office must request and receive
this information before services can be provided. The final determination
of appropriate and reasonable accommodation rests with the Disability Services
Office.
A summary of diagnostic findings is a valuable component of the report.
The summary might include an indication of how patterns of inattentiveness
and/or hyperactivity validate the presence of ADHD, elimination of alternative
explanations for academic problems (e.g., poor study habits, lack of motivation,
psychosocial or medical problems), and a rationale for the academic accommodations
requested.
These guidelines; have been developed with the assistance of The University
of North Carolina at Greensboro Psychology Clinic and adapted from The Consortium
Guidelines for Documentation of Attention-Deficit Hyperactivity Disorder
in Adolescents and Adults. (1998).
All submitted documentation will be kept confidential.
Please submit documentation and/or inquiries to:
Jennifer Williams-Cannon, M.A.
Counselor / Coordinator of Special Populations and Disability Services
Mitchell Community College
500 W. Broad Street
Statesville, NC 28677
Phone - 704-878-3364
E-mail - jwilliamscannon@mithcellcc.edu
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