Assessing and Overcoming the Functional Impact of ADHD in College Students: Evidence-Based Disability Determination and Accommodation Decision-Making

Information about academic, social, and occupational functioning is essential to accommodation decision-making, planning, and monitoring. However, many clinicians who assess college students for ADHD focus chiefly on symptom number or severity rather than on the barriers experienced by students in their everyday life activities. The psychological reports and supporting documentation submitted by clinicians to a college disability office were examined for evidence of functional limitations. All students described in the reports were diagnosed with ADHD and were receiving accommodations for that condition. Only 32% of clinicians provided any description of current limitations and only 42% provided any evidence of previous limitations or history of accommodations. Evidence came largely from student self-reports rather than from the reports of others, medical documentation, or educational records. These findings indicate that the data clinicians provide may be less useful to disability professionals who must select, implement, and monitor the effects of accommodations in an evidence-based manner. Several practical recommendations are offered to clinicians and disability professionals, such as the use of adaptive functioning rating scales, which can facilitate the assessment of functional limitations and the provision of effective accommodations to students with ADHD.