Health and Psychology

A call comes in.  "I want my child tested for accommodations.  I want them to get extra time on tests."

Testing for accommodations is a complex process.  Getting extra time on tests needs to be able to be documented to show that the person has a functional impairment that extra time on a test will assist.  There are some tests that allow for that to be documented.  But what about all the other possible accommodations?

Jamani has a primary reading disorder.  He has it in his native language as well as in English.  He has a slow reading speed.  When requesting accommodations, it's incumbent on the evaluator to document that the need for additional time isn't due to English being a second language, but due to a reading disorder impacting the primary language.  We have to be able to provide documentation about reading rate in the primary language.  And we have to know this and how to do it.  

But what else?  How about evaluating a text to speech converter for him?  what about something that will type as he talks?  Will highlighting a line help him stay on the correct word while he pronounces it?  Will larger type help? These are all the things that we have to be able to assess.  He comes in just wanting extra time, but there are other things that are possible and he may not even know about them to know they would help him.

What about other disabilities?  There are a wide variety of adaptive devices and technology availble that can assist people.  What's available and needed to help this person in their lives, not just to accommodate them on a test?

I saw a returning veteran that had a shoulder injury impacting his dominant arm.  He'd had a tendon transfer from his leg to his shoulder but still wasn't able to dress himself or do most tasks that involved the use of his dominant arm and his non-dominant arm was a poor substitute.  So his wife was assisting him.  So he was introduced to all the devices available to help with dressing--something that helps put on socks and shoes, something that helps button. something that extends reach.  These types of devices are used with children with shoulder injuries from birth, and with stroke patients.

A child was diagnosed with ADD.  The diagnosis was based on a questionnaire sent to the parents and the teacher. But ADD wasn't present during the evaluation.  Hyperacusis, a hearing disorder in which all sound is magnified, was present.  So she needed treatment for that, not medication for ADD.  And she'd need a private room free of sound as an accommodation.

For ADD, does the person need to be able to take medication during an extended test, or do they need the test limited in time to ensure the medication impact is adequate throughout the test.

I evaluated a child with a movement disorder.  There are accommodations of devices that will help him stay upright in a chair, maintain pencil or pen grip, and lessen the risk of falling from ataxia.

When my husband has his hip replaced he needed assistance in putting on his shoes, socks, pants and underpants.  He needed to be able to pick things off the floor that were dropped.  There are devices for all those things.  These things help people not feel like an invalid and maintain independence.

For people with memory problems there are pill containers with built in alarms, computers that have memo functions, reminders with alarms, calendaring systems.  Labeling systems to use with pictures for people with memory difficulties to allow them to remain independent longer.

When we evaluate someone for accommodations, it's not just looking at extended time.  It's looking at the whole array of accommodations available.

I saw a teen yesterday.  He's very bright and currently has medication for ADD, extra time on tests and a private room as accommodations.  But he also has a speech dysfluency.  So I documented his need for extra time for any oral speaking or reading task, and suggested a text to speech converter.  So he can type what he wants to say and a computer (Kindl, iPad, or netbook)  can read it for him.  For younger children there are picture versions that can be programmed to say a word or phrase.  I also documented at what point the medication stopped being effective and how long it took for a second dose of medication to kick in. 

Understanding the available range of accommodations, and dealing with the person as an individual makes our assessment process for accommodations unique and highly personalized in comparison to most people evaluating for accommodations.