Disability Evaluation for Accommodation on Licensing Exams Based on the ADA: Why Do Clinicians Fail to Adopt a Forensic Perspective?
The legal basis for receiving exam accommodation within postsecondary educational environments, on university entrance exams and licensing exams, is the ADA. Even when evaluations are conducted to recommend accommodation on licensing exams, where a clear forensic perspective should be the norm, this perspective is not routinely adopted. To explain why the gap between suggested and actual practice continues to be so wide, these types of accommodation-focused evaluations are contrasted with two other areas of forensic evaluation practice, competency to stand trial and worker’s compensation disability, for which a forensic perspective is the norm. Factors influencing the lack of forensic perspective adopted in accommodation-focused assessments include general problems with current clinical practice, the lack of a set of clearly defined forensic guidelines for performing these evaluations, the ongoing confusion regarding the standard for disability determination under the ADA, and the difficulty of obtaining evidence that would directly support the provision or denial of specific exam accommodations.
KeywordsDisability ADA Exam accommodations
Compliance with Ethical Standards
Conflict of Interest
Both authors currently work as consultants for multiple testing organizations reviewing documentation submitted on behalf of applicants requesting accommodation.
This article involved no human experimentation or need for informed consent.
No animal studies were carried out by the authors for this article.
- AAPL Task Force on Forensic Assessment Guideline. (2015). AAPL practice guideline for the forensic assessment. The Journal of the American Academy of Psychiatry and the Law, 43(2), S3–S53.Google Scholar
- AMA Council on Ethical and Judicial Affairs. (2016). Code of medical ethics. Chicago, IL: American Medical Association.Google Scholar
- Americans with Disabilities Act of 1990, Pub. L. No. 101–336, 104 Stat 329 (1990).Google Scholar
- Americans with Disabilities Act Amendments Act, 42 U.S.C. 12101 et seq. (2008).Google Scholar
- ADA National Network. ADA Overview: an overview of the Americans with disabilities act. https:/ada.org/factsheet/ADA-overview.
- Burgoyne, R. A., & Mew, C. W. (2011). New regulations under titles II and III of the ADA: what has changed relative to the administration of licensing examinations? The Bar Examiner, 80, 642–652.Google Scholar
- Colker, R., Golden, C., Keiser, S., Mather, N. & Ofiesch, N. (2015). Final report of the “best practices panel”; Keiser, S, Minority Report; LSAT Consent Decree.Google Scholar
- Dusky v. United States, 362 U.S. 402 (1960).Google Scholar
- Gordon, M. (2009). ADHD on trial: courtroom clashes over the meaning of “disability”. Westport, CT: Greenwood Publishing.Google Scholar
- Gordon, M., & Keiser, S. (1998). Accommodations in higher education under the Americans: a no-nonsense guide for clinicians, educations, administrators, and lawyers. New York: Guilford Press.Google Scholar
- Gordon, M., Lewandowski, L., & Keiser. (1999). The LD label for relatively well-functioning students: a critical analysis. Journal of Learning Disabilities, 32, 485–490. https://doi.org/10.1177/002221949903200603.
- Government Accountability Office. (2009). Higher education and disability: education needs a coordinated approach to improve its assistance to schools in supporting student, (Report to the Chairman, Committee on Education and Labor, House of Representatives, GAO-10-33. www.gao.gov/newitems/d1033.pdf.
- Grisso, T. (2014). Competence to stand trial evaluations: just the basics. Sarasota, FL: Professional Resource Press.Google Scholar
- Grote, C. L., & Pyykkonen, B. A. (2012). Ethical practice of forensic neuropsychology. In G. J. Larrabee (Ed.), Forensic neuropsychology: a scientific approach. New York: Oxford University Press.Google Scholar
- Harrison, A. G. (2017). Clinical, ethical, and forensic implications of a flexible threshold for LD and ADHD in postsecondary settings. Psychological Injury and Law, 10(2), 138–150.Google Scholar
- Harrison, A. G. (2006). Adults faking ADHD: you must be kidding! ADHD Report, 9, 402–412.Google Scholar
- Harrison, A. G., Holmes, A., & Harrison, K. A. (2018). Medically confirmed functional impairment as proof of accommodation need in postsecondary education: are Ontario’s campuses the bellwether of an inequitable decision-making paradigm? The Canadian Journal of Educational Administration and Policy, 187, 48–60.Google Scholar
- Jasinski, L. J., & Ranseen, J. D. (2011). Malingered ADHD evaluations: a further complication for accommodation reviews. The Bar Examiner, 80, 6–16.Google Scholar
- Joy, J., Julius, R. J., Akter, R., & Baron, D. (2010). Assessment of attention deficit hyperactivity disorder (ADHD) documentation from candidates requesting Americans with Disabilities Act (ADA) accommodations for the National Board of Osteopathic Medical Examiners COMLEX exam. Journal of Attention Disorders, 14, 104–108. https://doi.org/10.1177/1087054710365056.CrossRefGoogle Scholar
- Keiser, S. (1998). Test accommodations: an administrator’s view. In M. Gordon & S. Keiser (Eds.), Accommodations in higher education under the Americans: a no-nonsense guide for clinicians, educations, administrators, and lawyers. New York: Guilford Press.Google Scholar
- Keiser, S. (2015), Best practices panel: minority report. LSAT Consent Decree.Google Scholar
- Larrabee, G. J. (2012). Assessment of malingering. In G. J. Larrabee (Ed.), Forensic neuropsychology: a scientific approach. New York: Oxford U. Press.Google Scholar
- Lewandowski, L. J., & Lovett, B. J. (2014). The new diagnostic and statistical manual of mental disorders, DSM-V: Implications for accommodation requests. The Bar Examiner, 83, 42–54.Google Scholar
- Love v. Law School Admission Coucil, Inc., 513 F Supp.2d 206 (E.D. Pa 2007).Google Scholar
- Medina v. California, 505 U.S. 437, 1992.Google Scholar
- Melton, G. B., Petrila, J., Poythress, N. G., & Slobogin, C. (2007). Psychological evaluation for the courts: a handbook for mental health professionals and lawyers (3rd ed.). New York: Guilford Press.Google Scholar
- Murphy, K., & Gordon, M. (1996). ADHD as a basis for test accommodations: a primer for clinicians. The ADHD Report, 5, 10–11.Google Scholar
- Murphy, K., & Gordon, M. (2006). Assessment of adults with ADHD. In R. A. Barkley (Ed.), Attention-deficit hyperactivity disorder: a handbook for diagnosis and treatment (3rd ed., pp. 425–452). New York, NY: Guilford Press.Google Scholar
- Nelson, J. M., Whipple, B., Lindstrom, W., & Foels, P. A. (2014). How is ADHD assessed and documented? Examination of psychological reports submitted to determine eligibility for postsecondary disability. Journal of Attention Disorders, 18, 1–12. https://doi.org/10.1177/108754714561860.Google Scholar
- Price, Singleton, & Morris v. National Board of Medical Examiners, 966 F. Supp. 419 (S.D.W.V. 1997).Google Scholar
- Ranseen, J. D. (2000). Reviewing ADHD accommodation requests: an update. The Bar Examiner, 69, 6–19.Google Scholar
- Ranseen, J. D. (2016). Reviewing ADHD accommodation requests for the bar exam: what has and has not changed in 20 years. The Bar Examiner, 85, 10–27.Google Scholar
- Rehabilitation Act of 1973, Section 504 Regulations, 34 C.F.R. & 104.1 et seq.Google Scholar
- Rodinelli, RD, (ed.). (2008). Guides to the evaluation of permanent impairment 6th Ed. USA, American Medical Association.Google Scholar
- Searcy, C. A., Dowd, K. W., Hughes, M. G., Baldwin, S., & Pigg, T. (2015). Association of MCAT scores obtained with standard versus extra administration time with medical school admission, medical student performance and time to graduation. Journal of the American Medical Association, 313, 2253–2262. https://doi.org/10.1001/jama2015.5511. CrossRefGoogle Scholar
- Sutton v. United Air Lines, Inc., 527 U.S. 491 (1990).Google Scholar
- Toyota Manufacturing, Kentucky, Inc. v. Williams, 534 U.S. 184 (2002).Google Scholar
- U.S. Department of Justice, Civil Rights Division, ADA Requirements, Testing Accommodations, www.ada.gov/regs2014/testing_accommodations.Google Scholar
- Willingham, W., Ragosta, M., Bennett, R., Braun, H., Rock, D., & Powers, D. (1988). Testing handicapped people. Boston: Allyn & Bacon.Google Scholar