Attention-Deficit/Hyperactivity Disorder

University of California Practices for the Documentation and Academic Accommodation of Students with Attention-Deficit/Hyperactivity Disorder1

Federal and State law2 and University of California policies3 require the University to provide reasonable accommodation in its academic programs to qualified4 students with disabilities, including students with psychological disabilities.

The University is committed to providing reasonable accommodations appropriate to the nature and severity of the individual's documented psychological disability in all academic programs, services, and activities. In defining a disability as primarily psychological in nature, these practices consider the definition of mental disorders as described in the most current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).5

Definition of Attention-Deficit/Hyperactivity Disorder

The University of California subscribes to the DSM-5 definition of Attention- Deficit/Hyperactivity Disorder and the diagnostic criteria in the most current edition of the Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition (DSM- 5), published in 2013. DSM- 5 names the disorder, "Attention-Deficit/ Hyperactivity Disorder" (AD/HD) and specifies the following presentations:

314.00 (F90.0) Predominantly inattentive presentation

This subtype should be used if six (or more) symptoms of inattention for children, and five for adults, (but fewer than six symptoms for children and five for adults of hyperactivity-impulsivity) have persisted for at least six months.

314.01 (F90.1) Predominantly hyperactive-impulsive presentation

This should be used if six (or more) symptoms of hyperactivity-impulsivity for children, and five for adults (but fewer than six symptoms for children and five for adults of inattention) have persisted for at least six months.

314.01 (F90.2) Combined presentation

This subtype should be used if six (or more) symptoms of inattention for children, and five for adults, and six (or more) symptoms of hyperactivity-impulsivity for children, and five for adults, have persisted for at least six months.

Clinician may indicate other ADHD presentations if applicable:

314.01 (F90.8) Other Specified Attention-Deficit/Hyperactivity Disorder

This category applies to presentations in which symptoms characteristic of ADHD that cause clinically significant distress or impairment in social, occupational or other important areas of functioning predominate but do not meet the full criteria for ADHD or any of the disorders in the neurodevelopmental disorders diagnostic class.

314.01 (F90.9) Unspecified Attention-Deficit/Hyperactivity Disorder

This category applied to presentations in which symptoms characteristic of ADHD that cause clinically significant distress or impairment in social, occupational, or other important areas of functioning predominate but do not meet the full criteria for ADHD or any of the disorders in the neurodevelopmental disorders diagnostic class. The unspecified ADHD category is used in situations in which the clinician chooses not to specify the reason that the criteria are not met for the ADHD or for a specific neurodevelopmental disorder and includes presentation in which there is insufficient information to make a more specific diagnosis.

Documentation of Attention-Deficit/Hyperactivity Disorder

Professionals conducting assessments, rendering diagnoses of AD/HD, and making recommendations for accommodations must be qualified to do so. Comprehensive training and relevant experience in differential diagnosis and the full range of mental disorders are essential.

The following professionals would generally be considered qualified to evaluate and diagnose AD/HD, provided that they have comprehensive training in the differential diagnosis of AD/HD and direct experience with an adolescent and/or adult AD/HD population: licensed doctoral-level clinical, educational, or neuro-psychologists, psychiatrists, or other professional with training and expertise in the diagnosis of mental disorders. Also appropriate may be diagnoses using a clinical team approach consisting of a variety of educational, medical, and counseling professionals with training in the evaluation of AD/HD in adolescents and adults.

The name, title, and professional credentials of the evaluator, including information about license or certification, employment, and state or province in which the individual practices should be clearly stated in the documentation. All reports should be on letterhead, typed, dated, signed, and otherwise legible.

An assessment for ADHD must be current. In most cases, this means that a diagnostic evaluation must have been completed within the past three years. If documentation is inadequate in scope or content or does not address the individual's current level of functioning and need for accommodations, reevaluation may be required. Campus Disability Services professional staff reserve the right to request updated or supplemental documentation on a case-by-case basis and may consult with other professionals, as appropriate, regarding the adequacy of a student's documentation. An assessment for AD/HD may include the following:

  • Interviews and questionnaires which permit the student to describe current concerns and past problems;

  • Interviews with significant people in the student's life (for example, parents, spouse, partner, or friends) and/or questionnaires filled out by these people;

  • Observations of the student's behavior;

  • Complete developmental, educational, and medical histories including specific statements concerning the effects of the student's diagnosed AD/HD in the past and any current functional limitations;

  • The exact diagnosis (including secondary diagnoses and medical condition information), date of diagnosis, and specification of the diagnostic criteria on which the diagnosis was based (for example, DSM- 5);

  • An evaluation of the effectiveness of past and current medications prescribed for the ADD/ADHD symptoms.

  • An evaluation of the effectiveness of behavioral interventions and its effect on that student that must include any medication used by the student during the assessment process;

  • A summary of assessment findings. If the student is found to have a disabling condition, the assessment summary must include a description of the current limitation (s) imposed by the disorder.

(Note that tests of intelligence, cognition/ information-processing, and academic achievement, which may not be part of the diagnostic process itself, may be needed by a disabilities specialist to determine appropriate accommodations and services for a student with ADD/ADHD. Therefore, it is recommended that educational testing be part of the evaluation process.)

Accommodations and Services

Each student with ADD/ADHD should be provided with accommodations and services that are appropriate to the student's disability-related academic needs. It is the responsibility of the campus Disabled Students' Program office to determine whether the student is eligible for services and, if so, provide appropriate accommodations and services based on the documentation provided and in consultation with the student and other professionals, as appropriate. |6| It is the responsibility of students who seek accommodations and services from the University of California to provide comprehensive written documentation of their disabilities. With the informed consent of each student, an appropriate and qualified member of the Disability Students' Program may contact the professional(s) who made the diagnosis, requesting further information in order to determine the most appropriate and reasonable accommodations.

University accommodations and support services for a student with ADD/ADHD should be designed to minimize the limitations imposed by the student's disability, thus providing an equal opportunity to learn and to demonstrate what the student has learned in an academic setting. Academic accommodations should be provided in the most integrated setting possible and designed to meet the disability-related needs of qualified individuals without fundamentally altering the nature of the instructional programs or any licensing requirements specified by the student's intended profession.

Each campus has procedures for resolving complaints or grievances regarding the provision of academic accommodations and services.

January 2014

Notes:

  1. The syndrome commonly called "attention deficit disorder" has been variously explained and defined. Even its name has changed with different editions of the Diagnostic and Statistical Manual of Mental Disorders. To avoid confusion, these Practices use the term "Attention-Deficit/Hyperactivity Disorder" or the initials (AD/HD) to refer to the specific diagnosis which is based on the diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders: Fifth Edition (DSM-5).

    The purpose of these "Practices" is to describe the standards for documentation and provision of services for students at the University of California with AD/HD to faculty, staff and students with this disorder and their parents. Guidelines for Students with ADD were developed in December, 1995 and revised in February, 2001 as the current "Practices for the Documentation and Accommodation for Students with Attention-Deficit/Hyperactivity Disorder."

  2. Section 504 of the Rehabilitation Act of 1973, the Americans with Disabilities Act of 1990, and the ADA Amendments Act of 2008 are the pertinent Federal laws. For pertinent State law, see Chapter 14.2, Section 67310 of the California State Education Code.

  3. University of California Policies Applying to Campus Activities, Organizations, and Students, Section 140.00: Guidelines Applying to Non-discrimination on the Basis of Disability.

  4. "Qualified" with respect to post-secondary educational services, means "a person who meets the academic and technical standards requisite to admission or participation in the education program or activity, with or without reasonable modifications to rules, polices, or practices."

  5. Diagnostic and Statistical Manual of Mental Disorders 5, Washington D.C.: American Psychiatric Association, 2013

  6. Section 143.34 of the University's Guidelines Applying to Nondiscrimination on the Basis of Disability specifies that: "…in attempting to provide any type of academic adjustment, faculty, disability-management staff, and students with disabilities should work in concert to formulate accommodations that meet the individual educational needs of qualified students with disabilities while maintaining the academic integrity of the program, service, or activity to be modified."