Documentation Guidelines

In order to provide reasonable and appropriate academic accommodations to UTHSC students with disabilities, students are required to submit documentation and other supporting evidence of their disability. Documentation must show the current diagnosis, the significant functional limitation in a major life activity being impacted for which an accommodation is being requested, and a rationale for why the accommodation is needed.

The following guidelines are provided to assure that documentation is appropriate to verify eligibility and to support requests for reasonable accommodations, academic adjustments, and/or auxiliary aids. UTHSC adheres to the standards set forth by Educational Testing Services (ETS). It is essential that each student understand their responsibility to look at the information provided for the specific type of disability for which they are asking accommodations and make certain that the documentation adheres to those specific guidelines.

General Guidelines - all documentation must include:

Must be on official letterhead, typed and signed by the appropriate credentialed professional.
Must be current. Generally, this means that documentation for ADHD and Learning Disabilities is determined using assessment tools that have been normed on adult (not children). For mental health disabilities, it is preferable to have documentation from within the 12-months during which the request is being made. We reserve the right to make appropriate modifications to this time frame.
Must include a clear diagnostic statement provided by a properly credentialed professional that establishes the existence of a diagnosis and includes the degree to which the student’s diagnosis substantially limits a major life activity and the manner in which the diagnosis limits the individual’s ability to function in the academic environment.
Must provide a description of the diagnostic methodology,including but not limited to test scores, objective medical data, clinical observations, past academic or professional history, and the student’s actual performance in similar situations.
If recommendations are made, these should include a description of the specific accommodations being recommended and a rationale for each as to why the accommodation(s) may be needed based upon the student’s functional limitation(s).
- Example: A request for extended time should have documentation that demonstrates difficulty taking tests under timed conditions. In most cases, the documentation should include scores from both timed and extended/untimed tests, to demonstrate any differences caused by the timed conditions.
- Please Note: If extended test taking time is suggested, the inability to complete an exam is not a sufficient rationale since this does not address the academic need for the accommodation as related to the student’s functional limitation and disability.

Please Note

It must be understood that evaluation reports themselves do not automatically qualify a student for registration or services. After appropriate consultation with the student and the appropriate medical professionals, we will make a decision as to whether reasonable and appropriate accommodations are needed and can be provided to the student.

It is important to note that a prior history of receiving accommodations in previous academic/testing environments is not a guarantee one will be granted accommodations on a high stakes examination. Prior documentation may have been adequate in determining appropriate services or accommodations in the past. However, a prior history of accommodations without demonstration of a current need does not in itself warrant the provision of similar accommodations.

Disability-Specific Documentation Guidelines

In addition to the general guidelines listed above, documentation for a specific disability must also include the following:

ADHD

A qualified diagnostician must conduct the evaluation.
- Professionals conducting assessments and rendering diagnoses of ADHD must be qualified to do so.
- Comprehensive training in the differential diagnosis of ADHD and direct experience in diagnosis and treatment of adolescents and adults with ADHD is necessary.
Evaluation report must include specific information:
- Date(s) of assessment;
- Clear diagnosis utilizing the appropriate DSM-5 or ICD code(s);
- A description of the exact symptoms and criteria met for the diagnosis as well as absence of specific diagnostic criteria for ADHD;
- Identification of tools used for diagnostic purposes;
- Clinical observations;
- Relevant pharmacological history, explanation of the extent to which the medication(s) currently benefit and effect the student;
- Testing results using adult norms and reporting as percentiles or stanines, along with standard scores;
- Description of the functional impact as it pertains to the learning environment;
- Details about the typical progression or prognosis of the condition.
Evidence to support a childhood onset of symptoms and associated impairment.
- Historical information regarding the individual's developmental, academic and behavioral functioning in elementary and secondary education, including difficulties and/or use of accommodations in kindergarten through high school and college;
- Review of relevant educational records; early psycho-educational testing reports; documentation from tutors or learning specialists; and disciplinary records.
Documentation should build a case for and provide a rationale for the ADHD diagnosis.
- In-depth history reflecting a chronic and pervasive history of ADHD symptoms and associated impairment beginning during childhood and persisting to the present day;
- Description and emphasis on how ADHD symptoms have manifested across various settings over time, how the student has coped with the problems and what success the student has had in their coping efforts;
- All co-morbid issues should be addressed and the manner in which they impact the diagnosis or need for accommodations should also be discussed;
- A thorough explanation of the significant functional limitation(s) to major life activities (e.g. learning, concentrating, thinking) posed by the disability;
- Description of the degree to which the functional limitations apply to the life activity for which accommodations are being requested.
Comprehensive testing battery and diagnostic report with specific assessment data must be included.
- Summary of the assessment procedures and evaluation instruments used to make the diagnosis.
- An intellectual assessment including sub-test scores, standard scores and percentiles or stanines:
  - Examples of acceptable IQ Tests:
    - Kaufman Adolescent and Adult Intelligence Test
    - Reynolds Intellectual Assessment Scales (RIAS)
    - Stanford Binet – 5^th Edition
    - Wechsler Adult Intelligence Score-IV (WAIS-IV)
    - Woodcock-Johnson III, Tests of Cognitive Abilities, General Intellectual Ability (WJ-III)
  - Please check with SASSI if you are unsure if an assessment tool is acceptable by our standards.
- A comprehensive academic achievement battery with all sub-test scores, standard scores and percentiles or stanines reported, and should include current levels of academic functioning in such relevant areas as reading (decoding and comprehension), mathematics, and oral and written language.
  - Examples of acceptable Achievement Tests:
    - Scholastic Abilities Test for Adults (SATA)
    - Stanford Test of Academic Skills (TASK)
    - Wechsler Individual Achievement Test – III (WIAT-III)
    - Woodcock-Johnson III Psycho-educational Battery: Test of Achievement (WJ-III)
    - Woodcock Reading Mastery Tests – Revised
    - Nelson-Denny Reading Testing (to be used as supplemental test)
  - NOT Acceptable Achievement Tests:
    - Wide Range Achievement Test– 4 (WRAT-4)
- Test data should logically reflect a substantial limitation to learning for which the student is requesting the accommodation.
- The particular profile of the student's strengths and weaknesses must be shown to relate to functional limitations that may necessitate accommodations.
- Checklists and/or ADHD symptom rating scales can be a helpful supplement in the diagnostic process, but by themselves are not adequate to establish a diagnosis of ADHD.
- Test scores or sub-test scores alone should not be used as a sole measure for the diagnostic decision regarding ADHD as they do not in and of themselves establish the presence or absence of ADHD.

Each accommodation recommended must include a rationale.
- Accommodations are not granted on the basis of a diagnostic label; instead, accommodation requests need to be tied to evidence of current functional limitation that supports their use.
- Each recommendation should be tailored to the individual and tied to specific test results and clinical observations.

Deaf and Hard-of-Hearing

Report from an audiologist or otolaryngologist that includes the following:

- Clear statement of deafness or hearing loss;
- Current audiogram and interpretation that reflects the degree of hearing loss and current
  impacts the deafness or hearing loss has on the student’s functioning, specifically within an
  academic and clinical setting;
- The student’s history with and managing hearing loss;
- The type of hearing loss (conductive or sensorineural);
- The status of the individual’s hearing in regards to whether the hearing loss is temporary or
  permanent, and if it is stable or progressive;
- Whether the condition is mitigated by hearing aids or medication;
- Recommendations and rationales for reasonable academic accommodations are appreciated.

Learning Disability

A qualified diagnostician must conduct the evaluation.
- Professionals conducting assessments and rendering diagnoses of a LD must be qualified to do
- Comprehensive training and direct experience in diagnosis and treatment of adolescents and
  adults with LD is necessary.
Documentation must be current.
- Although a LD is normally viewed as lifelong, the severity and manifestations of the condition
  may change over time.
- The provision of reasonable accommodations and services is based upon assessment of the
  current impact of the disability on the activity in question;
- Therefore, it is necessary to provide "current,” relevant, and appropriate documentation.
Evaluation report must include specific information:
- Date(s) of assessment;
- A clear diagnosis utilizing the appropriate DSM-5 or ICD code(s);
- Identification of tools used for diagnostic purposes;
- Diagnostic interview and clinical observations;
- Testing results using adult norms and reporting as percentiles or stanines, along with standard
  scores;
- Description of the functional impact and severity of the disorder as it pertains to the learning
Historical information that might support a childhood onset of symptoms and associated impairment.
- Historical information regarding the individual's developmental, academic, and behavioral
  functioning in elementary and secondary education, including difficulties and/or use of
  accommodations in kindergarten through high school and college;
- Review of relevant educational records, early psycho-educational reports, documentation from tutors or learning specialists, parental reports, self-report, and disciplinary records;
Rule Out.
- All co-morbid issues should be addressed and the manner in which they impact the diagnosis or
  need for accommodations should also be discussed;
- A thorough explanation of the significant functional limitation(s) to major life activities (e.g.
  learning, concentrating, thinking) posed by the disability;
- Description of the degree to which the functional limitations apply to the life activity for which
  accommodations are being requested;
Comprehensive evaluation and diagnostic report with specific assessment data must be provided.
- Summary of the assessment procedures and evaluation instruments used to make the diagnosis;
- An intellectual assessment including sub-test, standard scores and percentiles or stanines:
  - Examples of acceptable IQ Tests:
    - Kaufman Adolescent and Adult Intelligence Test
    - Reynolds Intellectual Assessment Scales (RIAS)
    - Stanford Binet – 5^th Edition
    - Wechsler Adult Intelligence Score-IV (WAIS-IV)
    - Woodcock-Johnson III, Tests of Cognitive Ability (WJ-III)
  - Please check with SASSI if you are unsure if an assessment tool is acceptable by our standards.
- A comprehensive academic achievement battery with all sub-test, standard scores and
  percentiles or stanines reported, and should include current levels of academic functioning in
  such relevant areas as reading (decoding and comprehension), mathematics, and oral and
  written language:
  - Examples of acceptable Achievement Tests:
    - Scholastic Abilities Test for Adults (SATA)
    - Stanford Test of Academic Skills (TASK)
    - Wechsler Individual Achievement Test – III (WIAT-III)
    - Woodcock-Johnson III, Tests of Achievement (WJ-III)
    - Woodcock Reading Mastery Tests – Revised
    - Nelson-Denny Reading Testing (to be used as supplemental test)
  - NOT Acceptable Achievement Tests:
    - Wide Range Achievement Test– 4 (WRAT-4)
- Test data should logically reflect a substantial limitation to learning for which the student is
  requesting the accommodation.
- The particular profile of the student's strengths and weaknesses must be shown to relate to
  functional limitations that may necessitate accommodations.

Each accommodation recommended must include a rationale.
- If recommendations are made, information that supports the need for each requested
  accommodation must be provided. The rationale should explain why the specific accommodation is needed based upon functional limitations established through the evaluation process.

Medical or Physical disability

Letter or report from a physician in an appropriate medical specialization that includes the following:

The specific medical condition which causes the disability;
Whether the condition is temporary or permanent, and if it is stable or progressive;
Information about current prescribed medications used to treat the disability and possible side
effects;
A description of the functionally limiting manifestations of the condition(s) for which
accommodations are being requested;
Recommendations and rationales for reasonable academic/clinical accommodations.

Mental Health disability

Psychological or neuropsychological evaluation or report from a psychiatrist or licensed psychologist that includes the following:

Clear statement of the condition with the DSM-5 or ICD-10 diagnosis;
Clear description of the specific symptoms experienced by the student which meet the criteria for the diagnosis;
A summary of the assessment procedures and evaluation instruments which were used to make the diagnosis;
Information about current prescribed medications used to treat the disability and possible side effects;
Description of the functional limitation(s) caused by the disability that would impact the academic/clinical/residential context for which accommodations are being requested;
If recommendations are being made, rationales for reasonable academic accommodations should be included.

Speech-Related disability

Report or letter from a speech pathologist or physician that includes the following:

The specific disabling condition;
Whether the condition is temporary or permanent, and if it is stable or progressive;
A description of the functional limitation(s) caused by the disability on student’s performance in
an academic and/or clinical setting;
If recommendations are being made for reasonable academic accommodations, rationales
should be provided.

Visual Impairment

Report or letter from an ophthalmologist or optometrist that includes the following:

The specific medical condition which causes the visual impairment and how long the student has
experienced the condition;
The degree of visual acuity, including with corrective lenses;
The extent of the visual fields;
Whether the condition is temporary or permanent, and if it is stable or progressive;
Whether the condition is mitigated by corrective lenses or medication;
A description of the functional limitation(s) caused by the disability;
Recommendations for reasonable academic accommodations including any visual aids.

Documentation Guidelines

General Guidelines - all documentation must include:

Please Note

Disability-Specific Documentation Guidelines

Contact Us

Section Links

Share