Policies

1. Table of Contents
2. Acknowledgements
3. Introduction
4. Americans with Disabilities Act and Section 504
5. Accommodations
6. Accommodations Process
7. Enrollment
8. Documentation
9. Instructional Procedures / Methodologies
10. Determining Appropriate Educational Placement
11. Materials and Resources
12. Professional / Staff Development
13. Annual Tracking Form
14. Confidentiality / Privacy Issues
15. Data Necessary for an ADHD Evaluation

Appendices

1. Guide to Disability Rights Laws
2. Accessibility Checklist
3. Sample Release Forms
4. Sample Equal Opportunity Statements
5. Student Record Log
6. Resources
7. Sample Grievance Procedure Form
8. GED Testing Accommodations Attachment / Guidelines for Requesting Documentation for Accommodations on the GED Tests

The development of this policy was prompted by a variety of needs and issues in the field of adult education and literacy as related to adult students who have special learning needs. After many years of workshops and policy committee meetings, the resulting document reflects the growth in awareness for special needs students by both practitioners and administrators. The intent of this policy is to ensure that adult education and literacy programs throughout Arkansas will offer appropriate services to all students.

Special thanks to the dedicated members of the policy committee for their continuing commitment to excellence. Also, the policy committee reviewed several policies regarding students with disabilities and would like to thank the following for sharing their documents: Washington Office of Superintendent of Public Instruction (OSPI), West Virginia Adult Education, Arkansas Rehabilitation Services, and the Arkansas Transition Project.

Finally, our deepest appreciation and gratitude to Nancie Payne, M.S. and Dale R. Jordan, Ph.D., for their indispensable expertise in guiding the committee through the process of establishing policy for adult students with special learning needs. Their vision, knowledge, and dedication kept the committee focused on the goal with special emphasis on “doing what is right”.

In 1993, Arkansas adult educators participated in a pilot project which implemented informally assessing and accommodating learning disabilities in the workplace using the Payne Inventory. Since that year, many changes have occurred in the way adult education and literacy programs serve students with learning disabilities due to the far reaching effects of the training received from Nancie Payne, M.S. and Dale R. Jordan, Ph.D.

The Learning Disabilities Planning and Policy Committee has attempted to cover some points which will be helpful to programs as they serve special needs clients. Also included are some principles that should be followed to allow the system to run as smoothly as possible, not only for the benefit of the programs, but more importantly, the students.

This manual is designed to help adult education and literacy programs in Arkansas understand certain policies and procedures that are mandated by Section 504 of the Rehabilitation Act of 1973 (see Appendix A) and the Americans with Disabilities Act of 1990 (see Appendix A) as they are applied to instructional and testing situations. It is not designed to deal with every situation and the committee reserves the right to modify the application of any of its policies based upon particular circumstances. This manual does not represent legal advice. Each program is responsible for consulting with their designated ADA compliance officer; or if needed, legal counsel.

The Americans with Disabilities Act (ADA, PL 101-336) is a civil rights law that was signed by President George Bush in July of 1990. It is a comprehensive piece of legislation that promotes the rights of people with disabilities. It is similar to, yet more extensive than Section 504 of the Rehabilitation Act of 1973 which prevents discrimination against persons with disabilities by organizations that receive federal funds. Both of these acts are included in this manual in Appendix A. An ADA checklist is also provided in Appendix B.

Federal law (ADA and Section 504) requires that adult education and literacy programs adhere to the following policies to ensure compliance:

1. Ensure that all program services are accessible and barrier-free in accordance with the ADA (see Appendix A)
2. Access to program enrollment and orientation will be in accordance with the ADA (see Appendix A).
3. All adult education and literacy programs are legally responsible for five specific administrative requirements in the ADA:
   1. Each program must have a designated ADA coordinator.
   2. Each program must provide public notice.
   3. Each program must have an established ADA grievance policy. Procedures in this policy should include how, where, and with whom a grievance can be filed, a reasonable time period for filing, reviewing and ruling a grievance, an appeals process, and how each step in the grievance process will be documented. All programs should provide information to all students with disabilities that describes the process for filing a grievance with Disability Rights, Inc. (Phone: 800/482-1174) If the program is part of a larger agency, know the components of that agency’s grievance policy, especially if that agency requires all divisions under its purview to follow them.
   4. Each program must conduct a self-evaluation.
   5. Each program must develop a transition plan regarding accessibility.

Adult education and literacy programs must understand the difference between accommodations and interventions as part of establishing a foundation for ADA/Section 504 compliance. An intervention is a strategy or technique that can enhance a student’s learning process, such as color coding, card markers, colored overlays, etc. An accommodation changes or augments the environment to enable individuals to compete or perform at an equal level. Accommodations approved for the GED are: extended time (amount of time must be specified); audio cassette version; private room for testing; supervised frequent breaks (time must be specified); calculator; scribe; and “other” (this category is used when there may be an extreme disability where motor functions are limited). According to the ADA and Section 504, adult education/literacy providers must provide logical and reasonable accommodations to students with disabilities.

1. Accommodations should be provided to students when:
   1. They have disclosed that they have a disability that has been documented by a qualified professional and are eligible for accommodations under the provisions of the ADA/Section 504.
   2. Informal assessment has been administered (see “Enrollment” section for guidelines on when to administer an informal assessment screening), and it is determined that accommodations are warranted.
2. The process of choosing accommodations will be conducted by the accommodation team, which must include the student, the student’s immediate instructor(s), and the person who administered the informal assessment if that person is not the student’s instructor. Any professional that has formally evaluated the student may be included in the accommodation process. If there is a confidential issue (see “Confidentiality” section), staff members must be granted permission by the student’s signature on a signed release form (see Appendix C) before they can assist with the accommodation process.
3. Documentation of a learning disability from a qualified professional must be submitted before accommodations can be applied to the official GED examination.
4. All accommodations implemented must be documented, including the subsequent success or failure of the accommodations. The accommodations must be applied in the instructional setting as well as in any testing situation.
5. If a student declares ADA/Section 504 eligibility, it is the program’s responsibility to cover costs associated with requested accommodations.
6. It is the program’s responsibility to determine if a requested accommodation is reasonable. Accommodations are determined by examining:
   1. the barriers resulting from the interaction between the documented disability and the program environment;
   2. the possible accommodations that might remove the barriers but do not negate safety standards;
   3. whether or not the student has access to the program, service, activity, or facility without accommodations; and
   4. whether or not essential elements of the program, service, activity, or facility are compromised by the accommodations.
7. If the request is denied, the student has the right to file a complaint following the guidelines set forth in that program’s grievance policy. If the student is simultaneously involved in two programs, the federal program’s grievance policy takes precedence.
8. If a state-mandated assessment is administered as part of a program’s enrollment process, then that program must administer an alternative test which allows for the requested accommodations and assesses for the same or similar data. The selected alternative test would be used as a substitute with students who declare ADA/Section 504 eligibility (see “Resources” in Appendix F).
9. It is the responsibility of each adult education program to have an audiocassette version of the General Educational Development (GED) Practice Tests.
10. All forms, letters, brochures, publicity, etc. produced for the program must include a statement that the program is ADA accessible, EEOC compliant, and disability accommodations are available upon request. (See Appendix D for sample statements.)
11. Interventions allowed during GED testing without a request for accommodation are:
    1. use of large-print version of the test;
    2. use of a straight-edge (no markings) or guide to facilitate the reading of the text;
    3. use of colored overlays for reading;
    4. request to sit near a window, away from flourescent lights, etc. when possible;
    5. use of graph paper for working out math problems;
    6. taking individual tests on different days (at the discretion of the center and available personnel);
    7. use of clear, transparent overlays with highlighers;
    8. earplugs;
    9. magnifying device;
    10. priority seating.

1. All enrollment information should state the steps for enrollment and that accommodations can be provided (Section 504 of the Rehabilitation Act of 1973, 34 CFR 104.8). Include the name of the ADA Specialist/Person trained in the LD process. (See Appendices A and D for Section 504 and sample statements.)
2. All staff personnel who are involved in the intake process must receive training and information in appropriate in-house referral process when a new student discloses ADA/ Section 504 eligibility, with release form (see “Definitions” in Section 504), or meets any one of the following criteria for administering an informal assessment screening:
1. Ask the questions listed below. Note: These criteria must be documented separately from the standard intake form. If the student meets any of the above criteria, this document must be considered confidential and filed in accordance with confidentiality policies.
   1. Have you ever had any special help/classes in school/training? What? Where? Why?
   2. Do you think that you have trouble learning?
   3. Have you ever had any accommodations in school/training situations (e.g., extra time, oral test, calculator, etc.)?
3. Disclosure of learning disabilities by the student or organization with a release form
4. State-mandated assessment results show 3.9 or below in any one area (reading, math, writing, or spelling).
5. Student states that he or she thinks they may have a learning disability.
6. Teacher observes significant difficulty in learning or failure to make progress.
7. The student’s family member or employer states that he or she thinks the student may have a learning disability.
8. Each program will designate at least one instructor or staff person who is responsible for administering the appropriate screening tool(s) during the process of enrollment when the new student discloses ADA/ Section 504 eligibility or meets any one of the criteria listed above. The designated screener must have completed the entire training(s) mandated for use of the screening tool(s); e.g., Payne-Jordan Learning Inventory, Washington State LD Screening, or PowerPath to Adult Basic Learning
9. All learning disabilities screenings are confidential and will be conducted in a private and secluded environment.
10. The Payne-Jordan Learning Inventory for Adult Education and Literacy will be used in adult education centers and literacy councils only; the Payne-Jordan Workplace Inventory will be used for students in adult workplace programs only.
11. “Transition Services” means a coordinated set of activities for a student, designed within an outcome-oriented process, that promotes movement from school to post-school activities, including post secondary education, vocational training, integrated employment (including supported employment), continuing and adult education, adult services, independent living, or community participation (Arkansas Transition Project, 1995). Transition services are mandated by the Individuals with Disabilities Education Act (IDEA), Section 300.18, which applies to all students under the age of 22. Each adult education/literacy designated learning disabilities screener (person) is encouraged to work with the local public school’s transition team to ensure appropriate coordinating services and enrollment procedures with adult education centers and/or literacy councils.
12. Transition exit interviews include information about both individual rights and program responsibilities regarding the ADA and Section 504.

1. Each program will be responsible for documenting the implementation of special needs accessibility/accommodations procedures by completing Checklist #1 in Appendix B that ensures ADA/Section 504 compliance.
2. The documentation process will be included in the Arkansas Adult Education Program Review process.
3. Each program will be responsible for processing a student’s request for accommodations within a reasonable amount of time according to the reasonableness of the accommodation(s), but should not exceed 90 days. Furthermore, each program will be responsible for documenting the time required to process each student’s request for accommodation(s).
4. No program will have the right to deny services to any student without provision of sufficient, dated documentation that demonstrates that every reasonable effort was made to accommodate the student’s disability.

Methodologies will:

1. be designed to meet the needs of the individual student (i.e., student-centered);
2. be based on the student’s strengths;
3. include and be appropriate for the suggested or identified individual’s accommodation(s);
4. be flexible;
5. include real-life experiences in the classroom;
6. be jointly agreed to between student and instructor prior to implementation;
7. be reviewed with the student at regular, appropriate intervals of instruction (10-20 instructional hours) to discuss impact on learning and progress.

1. Each student must be appropriately evaluated by the local adult education or literacy program (LEA) in accordance with IDEA/ADA/ Section 504 before a decision is made which concludes that the adult education or literacy program is an inappropriate service.
2. If a program does not comply with ADA/Section 504 in its evaluation of student learning capacity, and the student is not provided with the appropriate services and/or accommodations, the program is liable for any resulting litigation procedures that may occur as a result of inappropriate evaluation.
3. If the student is evaluated or provides appropriate documentation that indicates mental retardation/deficiencies, developmental disabilities, or other limited intellectual capacity, then the program must evaluate, implement, and document one of the following procedures:
   1. If the student described above is referred to the program by another agency, school, or organization, that agency/school/organization must include a set of prescribed attainable, educational goals with the student referral. The program will be responsible for reviewing those goals and then will decide if they can provide services towards meeting those goals with the student. If the goals are not in accordance with program service policies, the referring agency/school/organization will be required to seek other, more appropriate referrals.
   2. If the student described above is not referred to the program by another agency or organization; i.e., the student comes to the program of his own accord, then the student and/or the student’s parent or guardian (when applicable) is responsible for developing the attainable, educational goals. The program will be responsible for reviewing those goals and then will decide if they can provide services towards meeting those goals with the student. If the goals are not in accordance with program service policies, the student will be required to seek other, more appropriate services.

1. Appropriate materials and resources for students with special learning needs will be provided in the classroom. Program personnel may obtain those materials and resources on a lending basis from the Arkansas Adult Learning Resource Center (AALRC) if they are not available on-site (see AALRC catalog, available at program site).
2. Each program will establish set-aside funding to purchase appropriate materials and resources for students with special learning needs.

The AALRC will:

1. Provide training in the use of screening tools for students with special learning needs, instructional strategies, accommodations, referrals, and resources for administrators, instructors, tutors, and staff who work with students who have special learning needs and/or learning disabilities.
2. Provide consultation by request for:
   1. appropriate interpretation/application of screening tools;
   2. appropriate accommodations, resources, and referrals.
3. Provide consultation in resource and referral development as new or updated information is available. All AALRC consultation will be considered as part of the follow-up/sustaining procedures for professional/staff development.
4. Conduct all workshops in facilities that meet ADA/Sect. 504 requirements.
5. Provide formal training in the use of screening tools for paid adult education and literacy staff only, due to liability issues and length of training.
6. Provide one-on-one, on-site follow-up training for participants in the learning disabilities-related workshops when the participant requests assistance in implementation of training or when the program director requests assistance based on an observation of no training implementation.

Local programs will:

1. Report all implementation of disabilities workshops to the AALRC on the Annual Report (see next page).
2. Share screening expertise and resources with other regional LEAs.

Tracking Participants will:

1. Attend all training sessions and demonstrate required competencies. In case of an emergency conflict, the participant is required to make up the missed session.

1. According to the Family Educational Rights and Privacy Act of 1974, enacted as Section 438 of the General Education Provisions Act, student information that is considered “private” can not be shared with anyone who is not designated on a release of confidential information form that has been signed by the student. Examples of confidential information disclosures include disabilities, recovering substance abuse condition, AIDS/HIV, or other medical information. If the student discloses any condition or disability that falls under the Privacy Act, the disclosed information can not be shared with anyone without a release of confidential information form, including all appropriate signatures.
2. Each LEA must adhere to their affiliated institution’s policy for directory information, which must be in accordance with DOE 34 CFR, Part 99 (Family Education Rights and Privacy). Furthermore, each student must sign a form that verifies their knowledge that the institution can release directory information.
   Information that can be released is “directory information”, and is regarded as information contained in an education record of a student which would not generally be considered harmful or an invasion of privacy if disclosed. It includes, but is not limited to, the student’s name, address, telephone listing, date and place of birth, dates of attendance, and the most recent previous educational agency or institution attended.
3. Every LEA receiving state or federal adult education funds will have proper release forms for release and/or transferral of confidential information. (Samples of release forms are in Appendix C.)
4. No confidential information or any other assessment information regarding a student can be shared externally (outside the center or council) for referrals or recommended testing without a signed release of information form specifying the agency representative or diagnostician to whom the information is to be released.
5. Standards for release forms:
   1. Release forms must be on agency letterhead.
   2. Information to be released must be specified.
   3. Individuals/organizations to whom information is to be released must be specified.
   4. A validation statement must be included on the release form. For example, “This release of confidential information is only valid from the date of signature to (specify ending date) or until canceled by the undersigned in writing. I understand the information will be kept confidential and will not be shared with any other agency without my consent. This release form has been read/reviewed with me and I understand its content.”
6. No student information will be transferred unless appropriate release forms have been completed and are on file. Faxing and other electronic transfer methods (e.g., E-mail, Internet, telephone) are not permissible for transfer of confidential information.
7. No confidential information regarding a student can be shared with the internal program’s teaching, support, or administrative staff without a release of information form signed by the student or his/her parent or guardian.
8. Any documentation containing disclosures of disabilities or otherwise confidential information will be separated from routine student information and kept in a locked and secure filing cabinet.
9. Filing cabinets containing confidential information will remain locked, will be inaccessible to students or support staff, and will have a log filed foremost in each locked drawer upon which entries will be made when confidential files are accessed by any instructional or administrative staff.
10. A sample log sheet is included in Appendix E. At a minimum, log sheets will require date of file entry, name of student’s file accessed, name of staff member accessing file, and actions taken.
11. Confidential information files will be maintained at the local program level for a period of not less than five years. Local policies may extend this period.
12. During program evaluations by adult education evaluation teams, other accrediting agencies, or designated evaluators, the following procedures will be followed:
    1. Evaluators will check the physical security of confidential filing cabinet(s).
    2. Evaluators will randomly select files contained in the confidential filing cabinet to monitor the program’s ability to appropriately address and maintain confidential/private information.
    3. Evaluators will not read for detail nor otherwise extract any student information from confidential file folders.
    4. Any information of a confidential nature that a student discloses, whether upon initial intake, during academic assessments, through informal assessments, inventories, checklists, or writing exercises should be separated from routine paperwork and filed in the confidential file.
    5. Applications and enrollment forms must be free of confidential questions.

Goldstein (1998) lists eight types of data that are necessary for a thorough adult ADHD evaluation. These are:

1. History
2. Intelligence
3. Personality and emotional functioning
4. Academic achievement
5. Friends
6. Family relations, parenting skills and discipline
7. Work or school behavior
8. Medical evaluation

GED Documentation Necessary:

The following information is from the FORM L-15: Accommodation Request for Learning Disabilities and/or Attention Deficits with/or without Hyperactivity Disorder (ADHD), GED Testing Service.

To receive accommodations for ADHD, the current existence of ADHD must be clearly documented. Documentation must include a letter on official letterhead signed by a psychiatrist, medical doctor, or psychologist who specializes in the diagnosis of ADHD stating the diagnosis of ADHD and providing supporting diagnostic evidence of this disability. Diagnostic evidence may include a developmental history that defines symptom onset, specific computerized tests of attention such as the TOVA, Gordon Diagnostic Battery or the CPT, and clear evidence that the candidate is otherwise qualified or has the cognitive potential to be successful on the GED Tests. Most often this will be demonstrated by test scores such as those given by the WAIS-R or other test of overall cognitive potential. Information presented must also clearly document how the ADHD substantially limits documented educational achievement and what relevant accommodations are needed. A DSM-IV diagnosis must be included with the certifying professional’s signature attesting to the diagnosis of ADHD.

DSM-IV Diagnosis: 314.

314.01: Attention Deficit/Hyperactivity Disorder Combined Type
314.00: Attention Deficit/Hyperactivity Disorder, Predominantly Inattentive Type
314.01: Attention Deficit/Hyperactivity Disorder, Predominantly Hyperactive-Impulsive Type
314.9: Attention Deficit/Hyperactivity Disorder, Not otherwise specified

U.S. Department of Justice Civil Rights Division Disability Rights Section

HTML Format: http://ada.gov/cguide.htm

PDF Format: http://ada.gov/cguide.pdf

Other Sources of Disability Rights Information

Regional Disability and Business Technical Assistance Centers
(800) 949-4232 (voice/TDD)
U.S. Department of Justice Internet Home Page
http://www.usdoj.gov

U.S. Department of Justice
Americans with Disabilities Act Internet Home Page
http://www.usdoj.gov/crt/ada/adahom1.htm

Workforce Investment Act
http://www.doleta.gov/usworkforce/wia/wialaw.txt

Appendix B in PDF Format

Appendix C in PDF Format

The following statement should be used on all program-related documents: For information about program services for persons with disabilities, Contact: [insert the name and phone number of disability contact person here]

Long Version (for use in program bulletins, handbooks, and application forms):

The [insert your program’s name] is committed to the policy that all persons shall have equal access to its programs, facilities, services without regard to race, color, creed, religion, national origin, sex, age, marital status, disability, or sexual orientation.

*In adhering to this policy, this program abides by the Federal Civil Rights Act, 42 U.S.C. 2000e; by the requirements of Title IX of the Education Amendments of 1972; by Sections 503 and 504 of the Rehabilitation Act of 1973; by the Americans with Disabilities Act of 1990; and by other applicable statutes and regulations relating to equality and opportunity.

*This section of the statement may be deleted on certain publications to conserve space.

Short Version (for use on posters and cases of severe space limitation):

The [insert your program’s name] provides equal access to all programs and activities.

1. Appendix E : Student Record Log in PDF Format

Click here to go to the Referral Directory

[Insert your program’s name] has adopted an internal grievance procedure providing prompt and equitable resolution of complaints for members of the public, visitors, clients, and employees not covered under existing agency’s grievance procedure alleging any action prohibited by the U.S. Department of Justice regulations implementing Title II of the Americans with Disabilities Act. Title II states, in part, that “…no otherwise qualified disabled individual shall, solely by reason of such disability, be excluded from the participation in, be denied the benefits for, or be subjected to discrimination…” in programs or activities sponsored by a public entity.

1. A complaint shall be filed in writing or verbally contain the name and address of the person filing it, and briefly describe the alleged violation of the regulations.
2. A complaint shall be filed within five (5) working days after the complainant becomes aware of the alleged violation. Processing of allegations of discrimination, which occurred before this grievance procedure was in place, will be considered on a case-by-case basis.
3. An investigation, as may be appropriate, shall follow a filing of complaint. The investigation shall be conducted by[Insert name of ADA Coordinator] or in [his/her] absence, any other person designated by the program or agency director. This process contemplates informal by thorough investigations, affording all interested persons and their representatives, if any, an opportunity to submit information relevant to a complaint.
4. A written determination as to the validity of the complaint and a description of the resolution, if any, shall be issued by [Insert name of ADA Coordinator] or the person designated by the program or agency director, and a copy forwarded to the complainant no later than ten (10) working days after its filing.
5. The ADA Coordinator shall maintain the files and records of [Insert your program’s name] relating to the complaints filed.
6. The complaint can request a reconsideration of the case in instances where he or she is dissatisfied with the resolution. The request for reconsideration must be made within five (5) working days to [Insert name, address, and phone number of program or agency director].
7. The right of a person to a prompt and equitable resolution of the complaint filed hereunder shall not be impaired by the person’s pursuit of other remedies such as the filing of an ADA complaint with the responsible federal department or agency.
8. Use of this grievance procedure is not a prerequisite to the pursuit of other remedies.
9. This entire process shall be constituted to protect the substantive rights of interested persons to meet appropriate due process standards and to assure that the [Insert name of Program] complies with the ADA and implementing regulations.
10. This will certify that [Insert name of ADA Coordinator] will serve [Insert name of Program] as the Coordinator/Counselor for:
    • Title VI (prohibits discrimination on the basis of race)
    • Title IX (prohibits discrimination on the basis of sex)
    • Section 504 of the Rehabilitation Act of 1973 (prohibits discrimination on the basis of disability)
    • Other _________________________________

Date ______________

Signature of Program or Agency Director _________________________________

1. The following document in PDF format should be printed on your program’s letterhead when referring a student for formal diagnosis of a learning disability or ADHD.

   GED Testing Accommodations Attachment

   Guidelines for Making Requests for GED Testing Accommodations

   Note: These guidelines are to be used solely for the purpose of completing the GED Forms. In accordance with both federal and state regulations, it is the position of the GED Testing Service that accommodations for eligible students with disabilities must be based upon their unique needs rather than on disability labels.

   LEARNING & OTHER COGNITIVE DISABILITIES
   Problem	Possible Accommodations	Professional Diagnostician	Documentation Needed
   Reading Disorder	Extended Time Audiocassette (generally with double time) Private room Scribe (to write the essay dictated by the examinee and to fill-in bubbles on multiple-choice answer sheet)	Clinical Psychologist School Psychologist Neurologist Neuropsychologist Neuropsychiatrist Psychiatrist (with psychological testing from a licensed psychologist) Education Specialist (using psychological testing from a licensed psychologist)	Completed LD Request Form Measurement of academic achievement in broad reading, broad written language, broad math and/or broad knowledge, using WJ-R, WJ-lll Ach., WIAT-l, WIAT-ll or other primary accepted tests Measurement of Verbal IQ, Performance IQ, and Full Scale IQ, with subtest scaled standard scores, using WISC-lll or WAIS-R or one of the other accepted tests Diagnosed disability DSM-IV Code(s) List of the functional limitation(s) caused by the disability Request accommodation(s) Rationale for Accommodation(s)
   Written Language Disorder	Extended Time Scribe (to write the essay dictated by the examinee and to fill-in bubbles on multiple-choice answer sheet) Private Room
   Math Disorder	Extended time Calculator Private Room Scribe

   ATTENTION DEFICIT/HYPERACTIVITY DISORDER
   Problem	Possible Accommodations	Professional Diagnostician	Documentation Needed
   Attention Deficit/ Hyperactivity Disorder	Supervised frequent breaks (break intervals/times specified by certifying professional) Extended time Private room	Neuropsychologist Neurologist Psychiatrist Medical Doctor Psychologist with a specialty in ADD/ADHD	Completed AD/HD request form Letter on official letterhead, signed by the medical doctor, psychiatrist, psychologist, that includes the following: Diagnosis of the disability Developmental history Results from a specific test of attention such as TOVA Gordon Diagnostic Battery of the Connors Continuous Performance Test DSM-IV Code List of the functional limitation(s) caused by the disability Requested accommodation(s) Rationale for accommodation(s)

   EMOTIONAL/MENTAL HEALTH DISABILITY
   Problem	Possible Accommodations	Professional Diagnostician	Documentation Needed
   Examples of conditions: Schizophrenia Depression Bipolar Disorder Anxiety Disorder Extensive Medication (antipsychotic or other)	Private Testing Frequent supervised breaks Extended time	Medical Doctor Clinical Psychologist Neuropsychologist Psychiatrist	Completed EMH request form. Letter on official letterhead, signed by the medical doctor, psychiatrist, psychologist, that includes the following; Diagnosis of the disability Level of impairment History DSM-IV Code List of the functional limitation(s) caused by the disability Requested accommodation(s) Rational for accommodation(s)

   PHYSICAL/CHRONIC HEALTH DISABILITY
   Problem	Possible Accommodations	Professional Diagnostician	Documentation Needed
   Visual Impairment	Large print and/or audiocassette version (generally with double time) Braille and/or audiocassette version with extended time (generally double time) Scribe Talking calculator for entire Mathematics Test Other: LCR screen, abacus, stylus & Slate etc. (may require additional time for approval)	Ophthalmologist Optometrist Medical Doctor	Completed PCH Disability form A letter on official letterhead, signed by the qualified professional and includes the following: Diagnosis of the disability List of the functional limitation(s) caused by the disability Requested accommodation(s) Rationale for accommodation(s)
   Hearing Impairment	Extended time Test Instructions (not actual test questions) interpreted in sign language by a certified interpreter Video tape draft of essay	Audiologist Medical Doctor
   Math Disorder	Extended time Scribe (when upper appendages are impaired) Frequent Supervised breaks (break intervals/times specified by certifying professional) Private Room Other: Head stick, adapted keyboard, mechanical or electronic devices, etc. (may require additional time or approval)	Medical Doctor Qualified diagnostician

   Adapted with permission from the West Virginia Regional Education Service Agency, 2006