Documentation Guidelines

Documentation is confidential information from an appropriately qualified health or other service professional who is knowledgeable about your condition. This professional might be a therapist, doctor, rehabilitation counselor, audiologist, nurse practitioner, or mobility specialist. The type of professional specialist involved will differ depending on the nature of the diagnosis. However, all professionals must have comprehensive relevant training and must hold a current license in the state in which they practice.

In addition to information you provide on the Request for Accommodations form and in conversation with Disability Resources, documentation from external sources can help Disability Resources better identify impacts in an academic setting and make informed decisions to determine reasonable and appropriate accommodations.

In general, documentation should include a description of the disability, including the diagnosis, assessment and evaluation used to make the diagnosis, history, any treatment, and expected duration. Documentation should also include the current functional limitations of the disability in an educational setting and recommendations for accommodations that are logically related to the specific functional limitations of the disability. Please note that Washington and Lee University does not grant accommodations solely based on the recommendations of evaluators or care providers.  The determination is made based on all information relevant to the documented functional limitations caused by the disability in relation to our program.

The age of acceptable documentation is dependent upon the disability. While older documentation for conditions that are permanent or do not vary may be appropriate, changing conditions and/or changes in how the condition impacts the individual over time may warrant more current documentation. In some cases, if you are in the process of acquiring updated documentation, reasonable provisional accommodations may be granted.

Costs associated with diagnosis, evaluation, and testing are your responsibility, except in cases of severe financial need demonstrated to, and upon recommendation of, the Office of Financial Aid.

The Director of Disability Resources will maintain all documentation received in a confidential file, separate from your academic record, and will disclose the documentation only in accordance with law or your consent.

Below, you will find a description of the recommended documentation for specific conditions.

Neurodevelopmental Disabilities, including learning disabilities and ADHD

These guidelines apply to learning disorders, as well as other disorders that affect neurodevelopmental abilities, except where indicated to relate exclusively to ADHD. W&L reserves the right to request additional documentation as necessary to fully evaluate individual requests for accommodation.

I. A qualified professional must conduct a current evaluation

Professionals conducting assessments and rendering diagnoses of neurodevelopmental disorders must have comprehensive relevant training in differential diagnosis of neurodevelopmental disorders and experience with adults. The following professionals would generally be considered qualified to evaluate and diagnose neurodevelopmental disorders: clinical psychologists, neuropsychologists, and educational psychologists, psychiatrists (ADHD).

Because the provision of reasonable accommodations is based on assessment of the current functional impact of the student's disability on academic performance, it is in a student's best interest to provide documentation of recent testing. This generally means that a comprehensive evaluation should have been conducted within the past three years using the adult version of assessment tools. If documentation is inadequate in scope or content, or does not address the individual's current level of functioning, reevaluation and/or additional testing will be required. If you have had accommodations in your prior school but don't have a current or complete psychological report: send us what you have. We may grant provisional accommodations to allow time to obtain a comprehensive psycho-educational evaluation.

II. Documentation Must Be Comprehensive

A. Evidence of Impairment: A Diagnostic Interview

The report of assessment should include a comprehensive diagnostic interview that includes relevant background information from a variety of sources to support the diagnosis. The report of assessment should include, but not necessarily be limited to, all of the following areas as relevant to the disability and the current request for accommodation(s):

  • a description of the presenting problem(s);
  • a thorough history providing evidence that learning or attentional problems began early, typically in elementary school or before, including objective evidence of ongoing issues that have significantly impaired functioning over time;
  • a developmental history;
  • an academic history, including results of prior standardized testing, reports of classroom performance, behavior, notable trends, and prior accommodations and self-accommodations used in secondary and postsecondary school;
  • family history as relevant to the impairment;
  • psychosocial history;
  • relevant medical and medication history, including (but not limited to) the absence of a medical basis for the present symptoms;
  • history of relevant prior psycho- or other therapy;
  • a discussion of dual diagnoses, alternative or coexisting mood, behavioral, neurological and/or personality disorders, and exploration of possible other mental health problems, such as depression and anxiety, or attentional or academic problems that are not better explained by other mental health conditions.

B. Relevant Testing

The neuropsychological or psychoeducational evaluation for the diagnosis of a neurodevelopmental disorder should provide clear and specific evidence that a neurodevelopmental disorder does or does not exist. The data should logically connect the specific substantial limitation to learning or other major life activity for which the student requests accommodation. The test findings must document both the nature and severity of the neurodevelopmental impairment(s) involved.

Students should refrain from taking medication during testing that might alter their performance on tasks. Students should consult with their evaluator about testing on or off medication. Testing off medication will increase the possibility that the testing will show current functioning more accurately.

It is not acceptable to administer only one test, nor is it acceptable to base a diagnosis on only one of several subtests. The tests used must be reliable, valid, and standardized for use with an adult population.

Actual test scores must be provided. Age norms should be used unless not available for that specific test. In addition to test scores, interpretation of results is required. Test protocol sheets or scores alone are not sufficient.

Domains to be addressed should include the following:

1. Cognitive Ability

A complete aptitude assessment is required with all subtests and standard scores. The preferred instrument is the Wechsler Adult Intelligence Scale - Fourth Edition (WAIS-IV). Other acceptable instruments include, but are not limited to, the Woodcock - Johnson Psychoeducational Battery -IV: Tests of Cognitive Ability; the Stanford-Binet Intelligence Scale: Fifth Edition.

2.  Achievement

A complete achievement battery, with all subtests and standard scores, must be provided. The battery should include current levels of academic functioning in reading (decoding and comprehension), mathematics, and written language. If an accommodation request includes extended time for tests, timed measures of relevant academic skills should be included. Accommodation recommendations based on an ADHD diagnosis require evidence from a full psychoeducational evaluation that the student has deficits directly related to each accommodation request. For instance, if extended time for tests is being requested, testing should include academic fluency measures and other timed measures of academic skills showing that the student is substantially impaired in his/her ability to complete the work in a timely manner.

Recommended instruments include, but are not limited to, the Woodcock - Johnson Psychoeducational Battery-IV: Tests of Achievement; the Nelson - Denny Reading Skills Test; the Gray Oral Reading Test - Fifth Edition; and the Wechsler Individual Achievement Test - III. The Wide Range Achievement Test - 4 (WRAT-4) is not a comprehensive measure of achievement and therefore is not acceptable 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) must be assessed, including the nature and extent of all processing deficits, in addition to other information provided regarding functional impairment.
Acceptable instruments include, but are not limited to, the Detroit Test of Learning Aptitude - 4 (DTLA-4), the Wide Range Assessment of Memory and Learning - 2 (WRAML2), Wisconsin Card Sort, Trails A and B, Rey-Osterrieth Complex Figure Drawing (REY-O). Information from subtests on the WAIS-IV, or the Woodcock - Johnson Psychoeducational Battery-IV; Tests of Cognitive Ability, Wechsler Memory Scale - IV, Luria-Nebraska Neuropsychological Battery, Halstead-Reitan Neuropsychological Battery, as well as other instruments may be used to address these areas. For students with ADHD, computerized assessment of attentional functioning, (e.g., Continuous Performance Test (CPT)), is strongly encouraged. Weaknesses in Processing Speed or Executive Functions do not automatically qualify a student for extended time; rather, an accommodation for extended time must be supported by data that clearly shows work pace deficits on timed measures specifically related to academic skills, such as reading, writing, and/or math.

4.  Other Assessment Measures

Other standard and formal assessment measures (e.g., personality, clinical, or behavior inventories) may be integrated with the above documents to help support a dual diagnosis, or to disentangle the neurodevelopmental disorder from coexisting mood, behavioral, neurological, and/or personality disorders. In addition to standardized test batteries, it is also very helpful to include informal observations of the student during the test administration. Nonstandard measures and informal assessment procedures may be helpful to determine performance across a variety of domains.

C. Evidence of DSM-5 Criteria (ADHD only)

Note: For documentation of LD, all elements of Subparts A and B must be provided. For documentation of ADHD, all elements of Subparts A, B, and C must be provided.

According to the Diagnostic and Statistical Manual of Mental Disorders: (DSM-5) (2013), the essential feature of ADHD is a persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequent and severe than is typically observed in individuals at a comparable level of development. A diagnostic report should include a review and discussion of the DSM-5 criteria for ADHD and specify which symptoms are present from those specified in the criteria.

III. Documentation Must Include a Specific Diagnosis and Demonstrate a Substantial Limitation to a Major Life Activity as Compared to the Average Person in the General Population

The report must include a specific diagnosis of a neurodevelopmental disorder. For example, "individual learning styles," "learning differences," "attention problems," "foreign language disability" and "test anxiety" are not by themselves neurodevelopmental disorders for which accommodations will be granted. The specific diagnosis must be supported by test data, academic history, anecdotal and clinical observations that may include comments about the candidate's level of motivation, study skills, and other non-neurodevelopmental factors. These findings must demonstrate that the candidate's functional limitations are due to the diagnosed disorders.

It is important that the diagnostician demonstrate having ruled out alternative explanations for academic problems, such as emotional, medical, or psychological disorders, or motivational or study skill problems that may interfere with learning or another major life activity, but which do not, in and of themselves, constitute a neurodevelopmental disorder.

IV. Recommended Accommodations with Rationale

The comprehensive report must recommend specific accommodations. The diagnostician must include a detailed explanation as to why each recommended accommodation is necessary and must reference specific current functional limitations (determined through test results and clinical observations) that support the need for the accommodation. The report may also include an explanation of current treatments, medications, or other accommodations and/or self-accommodations, including any patient-reported information on effectiveness of such measures. An Individualized Education Program and/or 504 Plan can be included as part of a comprehensive report, but is insufficient by itself to establish the rationale for a recommended accommodation.

Psychiatric/Psychological Disabilities

All documentation must be provided by a professional who is qualified and appropriately licensed to diagnose such disorders. W&L reserves the right to request additional documentation as necessary to fully evaluate individual requests for accommodation. Documentation should be current. For mental health conditions the diagnostic evaluation should be generally be within the last six months

Appropriate professionals can fill out the Disability Documentation Form or provide on official letterhead the following information:

  • Credentials of the Evaluator: Documentation should include name, credentials, licensing, area of specialization, address and contact information
  • Statement of Diagnosis and Description of Diagnostic Methodology: Provide a clear diagnostic statement. The statement should identify the nature and extent of the impairment(s), the assessment or evaluation procedures/tests used to make the diagnosis, the date of the current diagnostic evaluation.
  • Description of current functional limitations: A detailed description of the current functional impact of the impairment(s) in the unmitigated state (in other words, the current functional impact of the impairment(s) without any mitigating treatment, medication, etc) as relevant to the current need for accommodations. This should include severity, frequency, and pervasiveness. The documentation should describe if/how the impairment(s) limit(s) one or more major life activities.
  • Description of the expected progression or stability of the impact of the impairment(s): Include information about the expected progression or stability over time, along with a recommendation concerning the predictable need for reevaluation. If applicable, information on the cyclical or episodic nature of the impairment(s) and any known or suspected environmental triggers is recommended.
  • Treatment Plan: Describe any other current treatments,medications, or assistive devices with an explanation of their effectiveness in accommodating the functional impact of the impairment(s), any significant side effects that may impact functional abilities, and whether/how any such current treatments, medications, or assistive devices bear on the specific accommodations being requested of W&L
  • Description of current and past accommodations: Discuss any prior accommodations, including information about the impact on the student.
  • Recommendations for accommodations to provide equal access to a University program or service: A description of specific accommodations recommended with a detailed explanation of why each recommended accommodation is necessary due to specific current functional limitations. Support recommendations with specific test results or clinical observations. Accommodations must be necessary to provide a student an equal opportunity to participate in a University program or service by addressing a substantially-limiting impairment. Accommodations are not granted to ensure better academic performance or to maximize a student's ability to succeed.

Medical/Physical Disabilities

All documentation must be provided by a professional who is qualified and appropriately licensed to diagnose such disorders. W&L reserves the right to request additional documentation as necessary to fully evaluate individual requests for accommodation.

Documentation should be current. For medical/physical conditions the currency required will vary depending on the condition, but generally, a diagnostic evaluation should be within the last year.

Appropriate professionals can fill out the Disability Documentation Form or provide on letterhead the following information:

  • Credentials of the Evaluator: Documentation should include name, credentials, licensing, area of specialization, address and contact information
  • Statement of Diagnosis and Description of Diagnostic Methodology: Provide a clear diagnostic statement. The statement should identify the nature and extent of the impairment(s), the assessment or evaluation procedures/tests used to make the diagnosis, the date of the current diagnostic evaluation.
  • Description of current functional limitations: A detailed description of the current functional impact of the impairment(s) in the unmitigated state (in other words, the current functional impact of the impairment(s) without any mitigating treatment, medication, etc) as relevant to the current need for accommodations. This should include severity, frequency, and pervasiveness. The documentation should describe if/how the impairment(s) limit(s) one or more major life activities.
  • Description of the expected progression or stability of the impact of the impairment(s): Include information about the expected progression or stability over time, along with a recommendation concerning the predictable need for reevaluation. If applicable, information on the cyclical or episodic nature of the impairment(s) and any known or suspected environmental triggers is recommended.
  • Treatment Plan: Any other current treatments, medications, or assistive devices should also be referenced, with an explanation of their effectiveness in accommodating the functional impact of the impairment(s), any significant side effects that may impact functional abilities, and whether/how any such current treatments, medications, or assistive devices bear on the specific accommodations being requested of W&L
  • Description of current and past accommodations: Any prior accommodations should be referenced, including information about the impact on the student.
  • Recommendations for accommodations to provide equal access to a University program or service: A description of specific accommodations recommended with a detailed explanation of why each recommended accommodation is necessary due to specific current functional limitations. Support recommendations with specific test results or clinical observations. Accommodations must be necessary to provide a student an equal opportunity to participate in a University program or service by addressing a substantially-limiting impairment. Accommodations are not granted to ensure better academic performance or to maximize a student's ability to succeed.