Higher Education: A Survey of Clinicians About Documentation Requirements and Diagnostic Standards

The expansion of the number of students requesting accommodations in postsecondary settings compels clinicians to become knowl-edgeable about the legal definitions and documentation requirements of the Americans with Disabilities Act (ADA). Because the law is relatively new, courts and regulatory agencies have only recently begun to clarify what constitutes a disability. In this study, 147 clini-cians completed a questionnaire developed to assess their understanding of the law and the diagnostic approaches they used to justify claims of learning disability (LD), attention-deficit/hyperactivity disorder (ADHD), and psychiatric disability. Whereas the clinicians agreed on certain points (e.g., the right of institutions to formulate specific policies regarding documentation), they substantially dis-agreed on several fundamental issues. Clinician consensus was lowest on items that asked about the basic intent of the law, the metrics for assessing impairment, and the criteria for assessing ADHD in adulthood. Judged against the legislative history of the ADA and the body of regulatory rulings and legal decisions, many clinicians ’ responses showed a need for clarification regarding the distinction be-tween special education law and the antidiscrimination intent of the ADA. The respondents also expressed a nearly uniform wish for more training in this fast-growing area of clinical practice. Since the passage of Section 504 ofthe Rehabilitation Act in 1973 andlater of the Americans with Dis-abilities Act (ADA; 1990), students iden-tified as having a learning disability (LD) or attention-deficit/hyperactivity disorder (ADHD) have increasingly pursued accommodations for college entrance exams and postsecondary ed