Syracuse University has adopted the Association on Higher Education And Disability (AHEAD), the principle professional resource for disability professionals in higher education, guidance on documentation practices.
Guidance on Documentation Practices:
The Association on Higher Education And Disability (AHEAD) presents the following conceptual framework to support appropriate practices in providing seamless access through equal treatment and the provision of academic adjustments and auxiliary aids.[i] This revised guidance is necessitated by changes in society’s understanding of disability[ii], the 2008 amendments to the Americans with Disabilities Act[iii], and the updated regulations and guidance to Titles II and III of the ADA. Although the amendments and regulatory revisions occurred through separate federal processes, together they reflect a more mature understanding of disability that is essential for fostering a positive campus perspective on disability. The concepts described in this document are interrelated components of a comprehensive, professional approach to using disability documentation to make informed decisions. This framework is consistent with the letter and spirit of the law[iv], reflective of legal and judicial thinking[v], and responsive to scholarly understandings of disability[vi] and its role in higher education and society.[vii] This document supersedes AHEAD’s previous guidance on this topic.[viii]
Sources and Forms of Documentation
Acceptable sources of documentation for substantiating a student’s disability and request for particular academic adjustments and auxiliary aids can take a variety of forms:
Primary Documentation: Student’s Self-report
The student is a vital source of information regarding how he or she may be “limited by impairment.”[xi] A student’s narrative of his or her experience of disability, barriers, and effective and ineffective academic adjustments is an important tool which, when structured by interview or questionnaire and interpreted, may be sufficient for establishing disability and a need for academic adjustments and/or auxiliary aids.
Secondary Documentation: Observation and Interaction
The impressions and conclusions formed by higher education disability professionals during interviews and conversations with students or in evaluating the effectiveness of previously implemented or provisional academic adjustments are important forms of documentation. Experienced disability professionals should feel comfortable using their observations of students’ language, performance, and strategies as an appropriate tool in validating student narrative and self-report.
Tertiary documentation: Information From External or Third Parties
Documentation from external sources may include educational or medical records, reports and assessments created by health care providers, school psychologists, teachers, or the educational system. This information is inclusive of documents that reflect education and academic adjustment (accommodation) history, such as Individual Education Program (IEP), Summary Of Performance (SOP), and teacher observations.[xii] External documentation will vary in its relevance and value depending on the original context, credentials of the evaluator, the level of detail provided, and the comprehensiveness of the narrative. However, all forms of documentation are meaningful and should be mined for pertinent information.
Quick Reference: Documentation Guidelines for Providers
Specific to a Learning Disability, Autism Spectrum Disorders (ASD), and Auditory Processing Disorder – Comprehensive evaluation should include:
- History of substantial learning difficulties present since school age. (may not become fully manifest until the demands for those affected academic skills exceed the individual’s capabilities)
- Observational data from the evaluation.
- Test scores from a comprehensive psychoeducational or neuropsychological assessment which provide information on the disability’s present functional impact on cognitive and academic functioning. Such standardized measures may assess cognitive/academic skills, processing speed, fluency, memory, and executive functioning and should include the following:
- Adult cognitive assessment (e.g., WAIS-IV, Stanford-Binet 5, W-J III,TOCA)
- Achievement measures including measures of fluency (e.g., W-J III, WIAT-II)
- Current functional limitations due to the disability, including severity and impact on academic performance.
- Information on previous academic adjustments (accommodations) and how these supported equal access needs.
- Interpretation of results including explanation as to why differential diagnoses were ruled out.
- Specific recommendations and rationale regarding academic adjustments (accommodations) and/or services believed to be necessary for equal access.
- Language indicating individual learning styles or difficulties or the possibility of a disability or diagnosis is not sufficient.
General Guidelines for Documentation Providers
- A diagnostic statement identifying the condition(s).
As appropriate, include ICD or DSM codes, the date of the most recent evaluation, or the dates of evaluation performed by referring professionals. If the most recent evaluation was not a full evaluation indicate when the last full evaluation conducted.
- Current functional impact of the condition(s).
The current functional impact on physical (including mobility, dexterity, and endurance), perceptual, cognitive (including attention, distractibility and communication), and behavioral abilities should be described as clinical narrative and/or through the provision of specific results from the diagnostic procedures. Descriptions should provide a sense of severity, information on variability over time or circumstance and potential environmental triggers.
- Treatments, medications, assistive devices/services currently prescribed or in use.
A description of treatments, medications, assistive devices, academic adjustments (accommodations) and/or assistive services in current use and their estimated effectiveness in ameliorating the impact of the condition(s) is helpful. Include any significant side effects that may impact physical, perceptual, behavioral or cognitive performance.
- The expected progression or stability of the impacts described over time.
This description should provide an estimate of the change in the functional impacts of the condition(s) over time and/or recommendations concerning the predictable needs for reevaluation of the condition(s). If the condition is variable (based on known cycles or environmental triggers) are they under self‐care for flair‐ups or episodes?
- Recommended academic adjustments (accommodations) and services.
Recommendations should be logically connected to the impact of the condition. When connections are not obvious they should be explained. Recommendations will be deferred to whenever possible but will be evaluated in the context of the course or program. Not all documentation will contain all of these elements, but the more information we have, the easier it is to determine which academic adjustments (accommodations) are appropriate and beneficial.
For convenience, The Office of Disability Services provides a “Disability Verification Form” for medical, sensory and mental health providers.
Rational Regarding the Documentation Process
The rationale for seeking information about a student’s condition is to support the higher education professional in establishing disability, understanding how disability may impact a student, and making informed decisions about academic adjustments (accommodations). Professional judgment is an essential component of this process.
Ensuring that “academic adjustments” provide effective access requires a deliberative and collaborative process that is responsive to the unique experience of each individual, as advised by the ADA. The disability resource professional should engage in a structured exchange with the student to explore previous educational experiences, past use of academic adjustments, and what has been effective and ineffective in providing access. The weight given to the individual’s description will be influenced by its clarity, internal consistency, and congruency with the professional’s observations and available external documentation. It is often possible to evaluate whether a requested academic adjustment is reasonable or not with minimal reliance on external documentation. This is true even if the student has never received formal academic adjustments or recently acquired a disability and is seeking guidance to determine academic adjustments that might be effective.[xiii] However, if the student is unable to clearly describe how the disability is connected to a barrier and how the academic adjustments would provide access, the institution may need to request third party documentation focused on illustrating that connection.[xiv] Finally, the documentation process must be accessible: if a student’s disability impacts his or her ability to clearly describe the need for academic adjustments, the office must consider flexibility in its processes.
Each situation must be considered individually to understand if and how the student is impacted by the described condition. Disability is defined by the ADA as “a physical or mental impairment that substantially limits one or more of the major life activities, a record of such an impairment or being regarded as having such an impairment.” There is no listing of covered impairments. Therefore, the salient question is not whether a given condition is a “disability,” but how the condition impacts the student. This determination is to be liberally construed to the maximum extent possible.[xv]
There is no one-to-one correspondence of disability to accommodation. Institutions should consider the student’s disability, history, experience, request, and the unique characteristics of the course, program, or requirement in order to determine whether or not a specific academic adjustment is reasonable. A clear understanding of how disability impacts the individual establishes the reasonableness of the academic adjustment for the individual. However, to determine whether the academic adjustment is reasonable in context requires an evaluation of the unique attributes and requirements of the course, program, or activity. Course modifications or auxiliary aids or services that are ineffective or constitute a fundamental alteration will not be reasonable[xvi] and therefore will not meet the ADA and Section 504’s minimal standards. The ADA establishes the “floor” not the “ceiling” of protection. The ceiling is established when a proposed academic adjustment would result in a fundamental alteration to a course or the program of study.[xvii]
Disability and academic adjustment requests should be evaluated using a commonsense standard, without the need for specific language or extensive diagnostic evidence.[xviii] Using diagnostic information as a tool in reviewing requests for academic adjustment is different than using it for treatment. Determining academic adjustments requires a more limited range, level, and type of information. These two processes should not be conflated.
No third party information may be necessary to confirm disability or evaluate requests for academic adjustments when the condition and its impact are readily apparent or comprehensively described. No specific language, tests, or diagnostic labels are required. Clinicians’ training or philosophical approach may result in the use of euphemistic phrases rather than specific diagnostic labels. Therefore, reports that do not include a specific diagnosis should not be interpreted to suggest that a disability does not exist. The question is “Would an informed and reasonable person conclude from the available evidence that a disability is likely and the requested academic adjustment is warranted?”
Postsecondary institutions cannot create documentation processes that are burdensome or have the effect of discouraging students from seeking protections and academic adjustments to which they are entitled. This was clear even prior to the amendments to the ADA.[xix] The non-burdensome standard is applicable to initially establishing a relationship with the disability resource office and to setting up individual academic adjustments from institutional personnel, including course instructors. Students should not be required to bear responsibility for achieving access through cumbersome, time consuming processes.
Current and Relevant Information
Disability documentation should be current and relevant but not necessarily “recent.”[xx] Disabilities are typically stable lifelong conditions. Therefore, historic information, supplemented by interview or self-report, is often sufficient to describe how the condition impacts the student at the current time and in the current circumstances. Institutions should not establish blanket statements that limit the age of acceptable external documentation. Determining academic adjustments in distinctly new contexts may require more focused information to illustrate a connection between the impact of the disability, the described barrier, and the requested academic adjustment.
[i] As is common in practice, the term “academic adjustment or accommodation” is used throughout this document as synonymous with the modification of policies, practices, and procedures; the provision of auxiliary aids and services; academic adjustments and modifications to the environment intended to remove barriers to equivalent access.
[ii] As a social construct, there are hundreds of definitions of disability that inform the process of providing equity for disabled individuals. The U.N. Nations Convention on the Rights of Persons with Disabilities provides a broad and appropriate context for higher education professionals as they work to ensure access: “The loss or limitation of opportunities to take part in the life of the community on an equal level with others due to physical, social, attitudinal and cultural barriers encountered by persons having physical, sensory, psychological, developmental, learning, neurological or other impairments (including the presence in the body of an organism or agent causing malfunction or disease), which may be permanent, temporary, episodic or transitory in nature.”
[v] Colloquy between Representatives George Miller and Fortney Stark on the floor of the House; Congressional Record 9/17/2008, Page: H8286
[vi] Scholarship in the relatively new academic discipline of disability studies seeks to shed light on the experiences of disabled people and explore disability from social, political, cultural, and economic perspectives. The Society for Disability Studies (SDS) (http://disstudies.org ) promotes this multidisciplinary scholarship through its professional network, journal (http://dsq-sds.org ), and conferences. While disability studies research and writings are abundant, a foundational work for the higher education professional is Linton, S. (1998). Claiming Disability: Knowledge and Identity. New York, NY: New York University Press.
[vii] “The emergence of disability studies in the academy has created a new analytic space to examine disability and normalcy from a critical lens. Disability studies scholars illustrate how the ‘border’ between ability/disability is constructed, artificial and arbitrary, yet made to appear natural and static across time and place through the interconnected and pathologizing diagnostic, medical, and legal discourses.” Ferri, B. (2008). Teaching to Trouble. In S. Danforth & S.L. Gabel (Eds.), Vital questions facing disability studies in education (pp. 289-290). New York, New York: Peter Lang Publishing, Inc.
[viii] This document should not be considered legal advice; Institutions should consult with legal counsel before implementing policies. Disability resource offices should follow institutional practices and are encouraged to include the full range of stakeholders and experts when reviewing and developing policy. As with other policies, documentation policies and practices should be reviewed every 3-5 years to ensure that they stay consistent with accepted practices and changes in the legal landscape.
[x] 28 CFR 36.309(iv) states that “Any request for documentation, if such documentation is required, is reasonable and limited to the need for the modification, academic adjustment, or auxiliary aid or service requested” indicating that entities can require documentation though they are not obligated to do so.
[xi] Disability is defined by the ADA as “a physical or mental impairment that substantially limits one or more of the major life activities, a record of such an impairment or being regarded as having such an impairment.” 42 U.S.C 126 §12102
[xii] Revisions to Title III regulations provide, “When considering requests for modifications, academic adjustment, or auxiliary aids or services, the entity gives considerable weight to documentation of past modifications, academic adjustments, or auxiliary aids or services received in similar testing situations, as well as such modifications, academic adjustments, or related aids and services provided in response to an Individualized Education Program (IEP) provided under IDEA or a plan describing services provided pursuant to section 504 of the Rehabilitation Act of 1973” (28 C.F.R. § 36.309(b)(1)(v))
Guidance and Section-by-Section Analysis provides these examples of types of information to consider: “recommendations of qualified professionals familiar with the individual, results of psycho-educational or other professional evaluations, an applicant’s history of diagnosis, participation in a special education program, observations by educators, or the applicant’s past use of testing academic adjustments.” 28 CFR Part 36 (2010)
[xiii] Department of Justice guidance advises “that the inclusion of this weight (referenced in note xii above) does not suggest that individuals without IEPs or Section 504 Plans are not also entitled to receive testing academic adjustments. Indeed, it is recommended that . . . entities must consider the entirety of an applicant’s history to determine whether that history, even without the context of an IEP or Section 504 Plan, indicates a need for academic adjustments. In addition, many students with learning disabilities have made use of informal, but effective academic adjustments. For example, such students often receive undocumented academic adjustments such as time to complete tests after school or at lunchtime or being graded on content and not form or spelling in written work. Finally, [one should] consider that because private schools are not subject to the IDEA, students at private schools may have a history of receiving academic adjustments in similar settings that are not pursuant to an IEP or Section 504 Plan. 28 C.F.R. Part 36, Appendix A.
[xiv] See note xiii above.
Congress rejected cases holding that “substantial limitation” required a “significant restriction” 42 USC 12101(A)(8) and mandated that the EEOC revise it regulations accordingly (42 USC 12101 (b)(6)) See, 29 CFR 1630.2 (j)(10(i) (“Substantially limits shall be construed broadly in favor of expansive coverage, to the maximum extent permitted”) .
[xvi] See US Airways v. Barnett, “An ineffective modification or adjustment will not accommodate a disabled individual’s limitations.” 535 U.S. 391, 400 (2002).
[xviii] “The threshold issue of whether an impairment ’substantially limits’ a major life activity should not demand extensive analysis. The comparison of an individual’s performance of a major life activity to the performance of the same major life activity by most people in the general population usually will not require scientific, medical, or statistical analysis.” “The ADA Amendments Act”; the Honorable Chair Feldblum and the Honorable Victoria A. Lipnic, Commissioners, U.S. Equal Opportunity Employment Commission. May 2011
[xix] “A university is prevented from employing unnecessarily burdensome proof-of-disability criteria that preclude or unnecessarily discourage individuals with disabilities from establishing that they are entitled to reasonable academic adjustment.” Guckenberger v. Boston University, 974 F Supp 106, 135-136 (D. Mass. 1997)
[xx] Medical, sensory, cognitive, and other types of disabilities are persistent. An impairment that is episodic or in remission is a disability if it would substantially limit a major life activity when active. While students may develop compensatory strategies that reduce their use of academic adjustment naturally, the underlying impairment is still present. Such coping strategies do not typically translate 100% to a new context. The amended ADA clarifies that students with episodic conditions or disabilities that are in remission and those who have developed compensatory skills are protected by the law.
The concept of “recency” of documentation has, for some, taken on meaning that is not supported by science or law, but is more an outgrowth of assumptions within the special education field, which has required that students be reevaluated on a regular basis to establish the continued eligibility for special education. When the IDEA was first enacted, school systems wanted to be assured that if a child no longer required special education, she would not remain classified for no reason, increasing school district costs unnecessarily. The rule was not meant to reflect that declassifying a child for special education meant that the child no longer had a disability, only that such child might no longer need special education – which can be quite extensive and in-depth. The ADA and Section 504 are civil rights protections, generally providing a less intensive level of benefit or intervention than special education, but to a larger group of individuals. Recent informal guidance from the U.S. Department of Education indicates that children with disabilities who may not be in need of special education are still protected against discrimination by the ADA See “Dear Colleague Letter”, dated January 19, 2012, http://www2.ed.gov/about/offices/list/ocr/letters/colleague-201109.html and “Questions and Answers on the ADA Amendments Act of 2008 for Students with Disabilities Attending Public Elementary and Secondary Schools,” http://www2.ed.gov/about/offices/list/ocr/docs/dcl-504faq-201109.html.
The Association on Higher Education And Disability (AHEAD)
107 Commerce Center Drive, Suite 204 Huntersville North Carolina 28078 USA
t/v: 704.947.7779 f: 704-948-7779 e:email@example.com w:ahead.org