Recommended Specific Guidelines

St. Lawrence University

-Introduction
-Recommendations for Consumers
-Documentation Guidelines

I. A Qualified Professional Should Conduct the Evaluation
II. Testing Must Be Current
III. Clinical Documentation Necessary to Substantiate the Learning Disability Should be Comprehensive
A. Diagnostic Interview
B. Assessment
1. Cognitive Ability
2. Achievement
3. Information Processing
4. Other Assessment Measures
C. The Documentation Must Include a Specific Diagnosis
D. Actual Test Scores from Standardized Instruments Should be Provide
E. A Clinical Summary Should be Provided
IV. Each Accommodation Recommended by the Evaluator Should Include a Rationale
V. Verification of Attention-deficit Hyperactivity Disorder (ADHD)

Introduction

The following document was developed by a Faculty Ad Hoc Committee on Special Needs established by Faculty Council at the request of Dean Coburn. A major intent of the Faculty Ad Hoc Committee is to develop standard criteria for documenting learning disabilities (LD) and attention-deficit hyperactivity disorders (ADHD) that can be used to determine appropriate accommodations for students with disabilities at St. Lawrence University. This document addresses learning disabilities and guidelines for documentation of ADHD. The guidelines provide students, professional diagnosticians, and service providers with a common understanding and knowledge base on those components of documentation which are necessary to validate a learning disability and the need for accommodation. The information and documentation to be submitted should be comprehensive in order to avoid or reduce unnecessary time delays in decision making related to the provision of services.

The Committee presents guidelines in four distinct areas: 1) qualifications of the evaluator; 2) recency of documentation; 3) appropriate clinical documentation to substantiate the learning disability; and 4) evidence to establish a rationale supporting the need for accommodation(s).

Under the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act of 1973, individuals with learning disabilities are guaranteed certain protections and rights to equal access to programs and services. In order to access these rights, the documentation must indicate that the disability substantially limits some major life activity, including learning. The following guidelines are provided in the interest of assuring that documentation is appropriate to verify eligibility and to support requests for accommodations, academic adjustments, and/or auxiliary aids. Recommendations for the consumer are presented to assist in finding and working with a qualified professional.

Recommendations for Consumers

1. For assistance in finding a qualified professional:

a. contact the Office of Academic Services for Students with Special Needs
b. discuss your future plans with the Director.

2. In selecting a qualified professional:

a. ask what his or her credentials are;
b. ask what experience he or she has had working with adults with learning disabilities;
c. ask if he or she has ever worked with the service provider at your institution or with the agency to whom your are sending material.

3. In working with the professional:

a. take a copy of these guidelines to the professional; encourage him or her to clarify questions with the person who provided you with these guidelines.
b. be prepared to be forthcoming, thorough, and honest with requested information; and
c. know that professionals must maintain confidentiality with respect to your records and testing information.

4. As follow-up to the assessment by the professional:

a. request a written copy of the assessment report;
b. request the opportunity to discuss the results and recommendations;
c. request additional resources if you need them; and
d. maintain a personal file of your records and reports.

Documentation Guidelines

I. A Qualified Professional Should Conduct the Evaluation.
Professionals conducting assessments and rendering diagnoses of specific learning disabilities and making recommendations for appropriate accommodations must be qualified to do so. Comprehensive training and direct experience with an adolescent/adult LD population is essential.

The name, title, and professional credentials of the evaluator, including information about license or certification (e.g., licensed psychologist as well as the area of specialization, employment, and state in which the individual practices should be clearly stated in the documentation. For example, the following professionals would generally be considered qualified to evaluate specific learning disabilities provided that they have additional training and experience in evaluating adolescent/adult learning disabilities: clinical or educational psychologists; school psychologists; neuropsychologists; learning disabilities specialists; medical doctors with training and experience in evaluating adolescent/adult learning disabilities; and other professionals with training and experience in the assessment of learning problems in adolescents/adults. Use of diagnostic terminology indicating a specific learning disability by someone whose training and experience are not in these fields does not meet eligibility requirements. It is not appropriate for professionals to evaluate family members. All reports must be on letterhead, type, dated, signed, and otherwise legible. St. Lawrence University has the responsibility to maintain the confidentiality of the student's records.

II. Testing Must Be Current.
Because the provision for all reasonable accommodations and services is based upon assessment of the current impact of the student's disabilities on his or her academic performance, it is in a student's best interest to provide recent and appropriate documentation. In most cases, this means that testing has been conducted within the past three years. In some cases, testing within a five-year period may be appropriate if the previous assessment is applicable to the current or anticipated setting. In some instances, documentation may be more than five years old, and/or inadequate in scope and/or content, or it may not address the students current level of functioning and need for accommodation(s). Furthermore, observed changes may have occurred in the student's performance since previous assessment was conducted. In such cases, it may be necessary to update the evaluation report. The update should include detailed professional summary of relevant information, as delineated in Section III. A., as well as the most recent diagnostic report.

III. Clinical Documentation Necessary to Substantiate the Learning Disability Should be Comprehensive.
Prior documentation may have been useful in determining appropriate services in the past. However, documentation should validate the need for services based on the individuals current level of functioning in the educational setting. A school plan such as an individualized education program (IEP) or a 504 plan is insufficient documentation in and of itself but can be included as part of a more comprehensive assessment battery. A comprehensive assessment battery should include the following:

A. Diagnostic Interview
Because learning disabilities are commonly manifested during childhood, though not always formally diagnosed, relevant historical information regarding the student's academic history and learning processes in elementary, secondary, and postsecondary education should be included. An evaluation report should include the summary of a comprehensive diagnostic interview by a qualified evaluator. By using a combination of student self-report, interviews with others, and historical documentation such as transcripts and standardized test scores, the diagnostician should provide a summary of the following:

a description of presenting problem(s);
developmental history;
relevant medical history including the absence of a medical basis for the present symptoms;
academic history including results of prior standardized testing, reports of classroom performance an behaviors including transcripts; study habits and attitudes; and notable trends; relevant family history, including primary language of the home, and current level of fluency of English;
relevant psychosocial history;
relevant employment history;
a discussion of dual diagnosis, alternative or coexisting mood, behavioral, neurological, and/or personality disorders along with any history of relevant medication and current use which may impact the individual's learning; and
exploration of possible alternatives, which may mimic a learning disability when, in fact, one is not present.

B. Assessment
The neuropsychological or psychoeducational evaluation for the diagnosis of a 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 assessment battery, which does not rely on any one test or subtest. Competence in working with culturally and linguistically diverse populations is essential. It is of utmost importance that evaluators are sensitive and respectful of cultural and linguistic differences in adolescents/adults in the assessment process.

Objective evidence of a substantial limitation to learning must be provided. Minimally, the domains to be addressed must include the following:

1. Cognitive Ability

A complete battery with all subtests and standard scores reported is essential. This may include, but is not limited to, the following:

Kaufman Adolescent and Adult Intelligence Test:

Stanford-Binet Intelligence Scale

Wechsler Adult Intelligence Scale-Revised (WAIS-3)

Woodcock-Johnson Psychoeducational Battery-Revised:Tests of Cognitive Ability

The Slosson Intelligence Test-Revised and the Kaufman Brief Intelligence Test are primari;y screening devices which are not comprehensive enough to provide the kinds of information necessary to make accommodatin(s) decisions

2. Achievement

A comprehensive 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. Acceptable instruments include, but are not limited to:

the Scholastic Abilities Test for Adults (SATA)

the Stanford Test of Academic Skills (TASK)

the Wechsler Individual Achievement Test (WIAT)

or specific achievement tests such as:

the Nelson-Denny Reading Skills Test

the Stanford Diagnostic Mathematics Test

the Test of Written Language - 3 (TOWL-3)

the Woodcock Reading Mastery Tests - Revised

Specific achievement tests are useful instruments when administered under standardized conditions and when 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 is not useful if used as the sole measure of achievement.

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; motor ability) should be assessed. Acceptable instruments include, but are not limited to: the Detroit Tests of Learning Aptitude - 3 (DTLA-3); information from subtests on the WAIS-R or the Woodcock-Johnson Psychoeducational Battery - Revised: Tests of Cognitive Ability, as well as other relevant instruments, may be useful when interpreted within the context of other diagnostic information.

4. Other Assessment Measures

Non-standard measures and informal assessment procedures or observations may be helpful in determining performance across a variety of domains. Other formal assessment measures may be integrated with the above instruments to help support a differential diagnosis or to disentangle the learning disability from coexisting neurological and/or psychiatric disorders. In addition to standardized test batteries, it is also very useful to include informal observations of the student during the test administration.

C. The Documentation Must Include a 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 of a learning disability, avoiding the use of terms such as "suggests" or "is indicative of."

D. Actual Test Scores from Standardized Instruments Should be Provided.

Standard scores and/or percentiles should be provided for all normed measures. Grade equivalents are not useful unless standard scores and/or percentiles are also included. The date 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 necessitate the requested 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 disabilities. Informal inventories, surveys, and direct observation by a qualified professional may be use in tandem with formal tests in order to further develop a clinical hypothesis.

E. A Clinical Summary Should be Provided.

A well-written diagnostic summary based on a comprehensive evaluative process is a necessary component of the assessment. Assessment instruments and the data they provide do not diagnose; rather, they provide important elements that must be integrated 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 cultural/language differences;

2. indication of how patterns in cognitive ability, achievement, and information processing are used to determine the presence of a learning disability;

3. indication of the substantial limitation to learning 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 mediated by the accommodation.

IV. Each Accommodation Recommended by the Evaluator Should Include a Rationale.

The evaluator(s) should describe the impact the diagnosed learning disability (if one exists) has on a specific major life activity as well as the degree of significance of this impact on the individual. The diagnostic report should include specific recommendations for accommodations. A detailed explanation must be provided as to why each accommodation is recommended and should be correlated with specific test results or clinical observations. The documentation should include any record of prior accommodation or auxiliary aids, including any information about specific conditions under which the accommodations were used (e.g., standardized testing, final exams, licensing or certification examinations) and whether or not they benefited the student. However, a prior history of accommodation, without demonstration of a current need, does not in itself warrant the provision of a like accommodation. If no prior accommodation(s) has been provided, the qualified profession and/or the students should include a detailed explanation as to why no accommodation(s) was used in the past and why accommodation(s) is needed at this time.

When accommodation(s) are warranted, the determination for accommodation(s) rests with the Office of Academic Services for Students with Special Needs working in collaboration with the student with the disability. St. Lawrence University has a responsibility to maintain confidentiality of the evaluation and may not release any part of the documentation without the student's informed consent.

V. Verification of Attention Deficit Disorder

Students being evaluated for Attention Deficit Disorder, or those previously diagnosed, are required to submit documentation verifying eligibility for accommodations under Section 504 of the Rehabilitation Act of 1973. Students diagnosed by a physician or psychologist must submit the attached form signed by the diagnostician. When appropriate, extended time testing and an alternate test site will be offered.

Students requesting accommodations other than extended time on tests and an alternate test site must provide additional documentation addressing those areas of cognitive functioning requiring consideration. The additional documentation, performed by a qualified evaluator, must include a list of tests administered, test scores, a narrative report analyzing and summarizing the data, and a clearly stated diagnosis of the problem. The diagnosis must be based on statistically significant intra-individual discrepancies. In the case of previously diagnosed students, evaluation should be administered within three years of the date of enrollment. The evaluation must include the following:

1. A measure of Intellectual, Aptitude of Cognitive functioning. Examples of such tests include one of the following:

Wechsler Adult Intelligence Scale-Revised (WAIS-3)

Stanford Binet Intelligence Scale: Fourth Edition

Woodcock Johnson Psycho-Educational Battery-R: Tests of Cognitive Ability

Kaufman Adolescent and Adult Intelligence TestÂ

2. A measure of Achievement in reading comprehension, written langauge, and mathematics such as:

Woodcock-Johnson Psycho-Educational Battery R: Tests of Achievement

Wechsler Individual AchievementTest

Scholastic Ability Test for Adults

Test of Written Languag-2 (TOWL)

Nelson-Denny ReadingTest

Woodcock Reading Mastery Tests-R

Stanford Diagnostic Mathematics Test

Stanford Test of Academic Skills

3. A measure of Information Processing in one or more of the following areas:

visual and/or auditory processing

memory

processing speed

attention and concentration

perceptual motor skills

other cognitive areas

4. Other Assessment Measures

Nonstandard measures and informal assessment procedures or observations may be helpful in determining performance across a variety of domains. Other formal assessment measures may be integrated with the above instruments to help support a differential diagnosis or to disentangle the learning disability from coexisting neurological and/or psychiatric disorders. In addition to standardized test batteries, it is also very useful to include informal observations of the student during the test administration.