Easiest route to putting accommodations in place?

Applying to College Learning Differences and Challenges - LD, ADHD
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Hi all, this question is going to be all over the place, so bear with me, lol.

My S25 has ADHD and some other disabilities, most prominent of which is developmental dyspraxia (motor coordination disorder) – which affects fine and gross motor, speech, balance, proprioception, etc.

He was in private special ed for most of his schooling, but we moved him to our regular public school for 10th through 12th grade (at his request) with an IEP – I was terrified, but he absolutely thrived. In fact, before public school, we didn’t think college was a real possibility, but here he is, set to go to a college about 2 hours from us with a full-tuition scholarship.

The last time we did a full pscyho-ed evaluation was fall of 2020. It was with a psychologist who is very thorough, and we have an inch-thick report with all her findings, recommendations, etc.

Then, the public school wanted to do their own testing, so they did an abbreviated version in May 2022. A psychologist did some tests, along with a speech therapist, OT, etc.

At that time they found that his dyspraxia didn’t really hinder his learning, except for his handwriting – for that they gave him a typing accommodation. He also received a calculator accommodation, and extra time on tests with pull-out to a quiet room if he wanted it (he never used this). I think he was also able to request notes from the teacher or another student. But I’m not sure he really used any accommodations at all (except typing, which he really needs) – but he was in fairly easy standard-level classes.

Also, he’s been seeing the same psychiatrist since age 4 for medication management. He’s been taking a basic extended-release methylphenidate since he was very young (it was warranted, believe me) – but then there was a shortage of his regular meds, they discontinued the generic, blah blah, and we had to switch and try a couple others.

Last fall he started saying that the medication was making him nauseated all day. (It had always caused nausea while kicking in, but that usually passed in 10 minutes.) We tried several different meds, different doses, with breakfast, without breakfast, etc. Nothing worked, and finally he got frustrated and just stopped taking them.

I didn’t push – he’d been on the same type of medication since age 4 or 5, so I trusted that he knew how he was supposed to feel.

But, he finished the rest of senior year with no problems, did his work without any interference from us, participated in theatre and NHS and lots of other things, got all As and one B, graduated cum laude. He says he doesn’t want to go back to medication, so really, what can I say?

Anyhow. I am at a loss as to what to do about accommodations in college. First of all, that eval from 2020 and even the one from May 2022 are out of date, so I guess we’d have to do a new one from scratch? But dude, our psychologist does three full days of testing and charges close to $4,000 for the full eval. I am hesitant to spend that for full IQ testing and the whole shebang for her to conclude that he has ADHD. I mean, we know that, lol.

But then, as I say that, I’m looking at the checklists on the ADHD form the school requires, and I don’t know how to fill them out. He’s maybe a little forgetful or impulsive, but he doesn’t talk excessively out of turn or fidget or leave his seat or act inappropriately. He does lose things, though (good grief the number of water bottles we go through…), and he’s not great with multi-step directions. This is what they’re requesting – https://www.westga.edu/assets/accessibility/docs/updated-forms-spring2024/adhd-documentation-form-2024.pdf

I did ask the psychologist if she was willing to write a letter for him to receive accommodations without doing the full testing, and she said no – that she didn’t have enough of a relationship with him to do so, and the school wouldn’t accept it. And then, the psychiatrist who managed his meds won’t call me back – we haven’t seen him since S25 stopped taking meds last fall.

I guess my questions are these:

– Is it worth doing a full psycho-ed evaluation at this point to put accommodations in place?

– If so, should I call around and try to find someone cheaper, or stick with the psychologist who knows his whole history?

– Will the school believe that he has ADHD if he isn’t taking medication for it?

– Do you think there are professors that still require students to write by hand for essays on tests?

I really have no sense of whether he’ll need the extended time (I don’t think he used it much, if ever, in high school – but of course college will be much harder than high school). I also don’t know if he really knows how to take notes. I can picture that being a struggle.

The other thing that concerns me is this statement on the school’s paperwork – “Students will be expected to provide a self-report of ADHD history and symptoms during the intake meeting to corroborate the provided documentation.” S25 seems to think that because he did just fine without medication this year, he no longer has ADHD. (He’s not always the most grounded in reality.)

Sorry for writing a book. What should we do?

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Does his school specifically require the report? If not, you might be able to get a letter from your pediatrician. My daughter was required to turn in her full evaluation report and her accomodations that she used in school in order to get her college accomodations. Many colleges are requiring handwritten tests (more so trying to combat use of AI) so I’d definitely get the typing accomodations. Some professors ban typing in class, so my daughter got an accomodation to take notes with an apple pencil on an ipad in class. It also doesn’t hurt to get the accomodations and not use them rather than find that you need them and then it is harder to get them.

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I don’t think you are going yo find a neuropsychological evaluation any cheaper, unless you get on a long waiting list for someone who takes insurance. The disability office talks to the student, not the parents. It’s tough, if you want accommodations they have to go through the steps. We did it for our son (not adhd, but partially to show him he didn’t have adhd), but we needed it for a tuition insurance refund anyway. He’s a rising senior, never used any although he was allowed to.

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I think most colleges want a neuropsych done within the last 3 (or so) years for accommodations. Have your S contact the Office of Disability Services to find out exactly what is required.

If possible, I’d spend the money to go back to the neuropsych who has tested him in the past and who is familiar with his strenghts and weaknesses. It may be helpful to understand exactly where he is now and what his future needs might be.

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There is a lot to unpack here. You need to contact disability services at the college. The link you attached specifically says they want the documentation to be from the last 3 years but it is at their discretion. They very well may accept the 2022 report without you having to go through a whole new Neuro psych.If they won’t accept your documentation, check to see if the providers they recommend for testing are less expensive. If your child has a documented history of ADHD, it is completely irrelevant whether they are on meds or not. That should not call the diagnosis into question.

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When did he graduate from high school (i.e. May 2025 or June 2025)? If in June, then you may be able to reach out to the school district because the eval would have been out-of-date (barely, but still). Additionally, students on IEPs will usually have transition-out planning and meetings and paperwork. @thumper1 may be add additional detail. Did he have anything like that?

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Thank you all for your replies! Here’s what I’ve done since writing this post –

  1. I’ve reached out to the disability office at the college and explained what prior testing/evals he has, and asked if the May 2022 report would be sufficient. I know this is sticky because it should really be S25 communicating with them.

  2. I’ve asked the psychologist who tested him in late 2020 if she has any availability for testing soon. I’ve also asked another psychologist who tested him as a little kid if she had availability, but she doesn’t work with 18-year-olds.

  3. I emailed his case manager at his high school. I vaguely remember S25 saying he had an envelope with exit paperwork, but we have turned the house upside down and cannot find said envelope. (I’m so embarrassed about this – usually I’m on top of things, but in the chaos of graduation and traveling abroad and college visits for my other kid, it has gone missing.) If she is checking her email, she will respond – she was the nicest woman, and I apologized profusely for bothering her. (I do remember being told that just because the student had accommodations in high school, doesn’t mean they’ll get them in college. Each college does its own thing, even within our state public university system.)

  4. The college’s process seems to be this – student submits recent testing/evaluation or a doctor’s letter. The ADHD checklists are important. Student then will be invited to an intake meeting, where he will have to advocate for himself and request the accommodations he needs. I think I can coach S25 to do this for himself – we just need to get the right paperwork to the school. School then decides which accommodations it will grant.

The idea that some professors ban typing in their classes makes me nervous – I don’t think S25 will be able to use an Apple pen or stylus of any kind to write. I mean, he can but he won’t be able to read what he’s written.

(ETA – he graduated in May 2025.)

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Another thing to be aware of…in college students need to self-advocate. Your S (typically) will have to speak to each professor, give them a letter from the Office of Disability Services, and discuss how to make his accommodations work. Most professors are quite understanding.

I hope he has a wonderful college experience.

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I think he’ll be able to do this. He was far better at it in high school than I was expecting. I know high school teachers are supposed to follow students’ IEPs without question, but they didn’t always do that.

S25 got some pushback especially from English teachers who didn’t want laptops out in class, and he got pretty good at advocating for himself. A couple times he asked his case manager to help when he wasn’t making any progress with a teacher.

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Apologies if this becomes book length.

We had a full neuro-pysch done on our child with disabilities the year between freshman and sophomore year in college. Freshman year went really well…and was also incredibly stressful and overly time intensive (tried and true strategies no longer worked). When our child decided they did need accommodations at college, we joined the meeting with accommodations (at child’s request) and learned what they would need for documentation.

I don’t think this is a place for a child to navigate/advocate solely (unless the child requests that). It was our insurance that needed to be used, and it was also helpful for us to know what the school was requiring so that our child with a disability wasn’t trying to navigate a very stressful situation all by themselves, and remember all the minutae of a meeting that they were already stressed about.

We were able to get testing done relatively quickly…and we were pleasantly surprised that it was cheaper than the last time we’d done it. Our insurance hadn’t changed…maybe we just got lucky? (It was about $2500 this time).

The real value to the newer testing was that children change a lot from early teens to early adulthood and results had changed. We learned so much with the new round of testing…and actually the neuro-pysch results surprised us by highlighting issues we didn’t know existed, helping our child see where they were really strong/growth areas (huge confidence booster) as well as offering suggestions for accommodations we hadn’t ever thought about and wouldn’t have known to ask about.

I know it is expensive. I know it probably feels overwhelming with everything else you are trying to accomplish this summer before heading off to school. But the new testing really helped our child, the accommodations they received completely changed how they experienced college/class work, and the college was super supportive of DH and I joining our child in meetings with as well as helping lead child into being able to more effectively self advocate and also coaching them through how to talk to professors, what expectations were, how they could protect their own medical privacy, etc.

After the first 6-9 months of working with the disability office, DH and I were completely hands off. We were the scaffold to help our child learn how the system worked, provide a more impartial listening ear during meetings and help build their confidence that they could take it over. They managed all the paperwork and updates with disability services since then.

Good luck, wishing you the best as you figure out the right steps for your son and family.

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Thank you for this! I think I just need to bite the bullet and get him in for updated testing. And you’re right – he’s a completely different person now than he was at 13, and he’s doing things we never imagined he would. So it really will be interesting to see what the testing reveals.

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I feel like you are dealing with more than one issue. The dyspraxia would likely qualify him for the accommodations you are seeking under ADA. If it is a medical diagnosis, you might be able to skip the ADHD gatekeeping.

My son also has both ADHD and visual dyspraxia. His college was very accommodating and just used what he had from high school. Once he gets accommodations, he should definitely meet with all of his professors. While the school paperwork will state what the accommodations are (and professors get dozens of these), once my son met with professors to explain WHY he needed copies of the class notes or anything shown on the screen, professors went out of their way to make sure his needs were met. I hate to say this, but with such a high percentage of kids getting AHDH accomodations, I think it wasn’t “real” until they put a face to it.

As for extended time, remember that many college exams are longer than those given in high school. If he required extended time in SATs, make sure he does ask for extended time. Also, he made need an accomodations for tests with bubble sheets. THat has been S23s most used accomodation.

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This is good advice, thank you! Yes, he does have a lot going on that I didn’t fully mention – the dyspraxia affects his handwriting profoundly, but it also affects a lot of other things that aren’t readily apparent. But it’s mostly activities of daily living that don’t necessarily affect him in the classroom directly.

He does have a visual tracking thing as well – had experimental surgery at age 4 because he had amblyopia in one eye in which we learned his vision was 20/200 (post-surgery and years of therapy, it’s now 20/60 – but it won’t get any better, nor do glasses work, because the eye itself has been corrected, but his brain hasn’t caught up).

There’s other stuff, too – a chromosome duplication, but it’s not a known disorder, so jury is out on whether it’s causing his specific issues.

Yes, he did get extended time from both College Board for the SAT and on the ACT. I didn’t consider bubble sheets because I’ve never actually watched him fill one in, but you’re right, I bet it’s difficult for him.

Thank you for mentioning all of this. Yes, his ADHD is very real, but as I mentioned he did okay academically without meds this year, so I think the overall motor skills challenges are the bigger issue.

The problem is, developmental dyspraxia – or motor coordination disorder, as it’s more commonly known – isn’t really a medical diagnosis that’s given in the U.S. or acknowledged under the ADA as far as I know. Or at least, it’s only his physical therapists and occupational therapists that have mentioned it to us (he’s been in every kind of therapy for his whole life). He walks (albeit awkwardly with a slap-foot motion that’s common with low tone, with duck feet because he has trouble balancing otherwise) and talks (was still in speech therapy through senior year for a bit of articulation and some other things, but he communicates perfectly well and even performed in plays) – so since he can do those things, doctors aren’t concerned that he can barely run, or clasp his hands behind his back because he doesn’t know where his body is in space, or tie his shoes, or undo a twist tie, or rub his lips together if he puts on chapstick.

His previous psycho-ed evals have never mentioned all this, because typically they’re looking at just the academic side, and his physical issues are not profound enough to keep him from getting around campus or sitting at a desk.

But now I’m wondering if we can find a psychologist that will include some of this in the report. Food for thought!

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While we had a neuropsych. eval done before college. we were told that it could not diagnose ADHD- that there was no objective test for ADHD. Instead, we went to a clinic focused on ADHD where a psychiatrist diagnosed it, using a questionnaire similar to what the college is asking for.

Hoping you can avoid paying for another neuropsych. and see a good ADHD psychiatrist to fill out those forms. I gather the current one doesn’t “know him well enough.” In our experience the kid and parent fill the questionnaire out and the MD could just use that-?

I would think you would want to give the school a full picture including some of the medical/physical aspects of your son’s challenges.

It’s great that he is doing so well without meds. But he may still need accommodations.

I have read that blue books are coming back for exams. In class writing. So the typing accommodation is important. Many professors provide notes on slides for everyone I think. But if not, he will need notes provided. (I can relate, I have trouble with writing by hand…)

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I expect you can discuss these issues with the neuropsych and ask if it would be appropriate to include in the evaluation.

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FWIW my S23 was on the daily extended release methylphenidate all through high school, but decided not to bother when he went to college (he generally didn’t take them during the summer). He’s been fine, but he has some of the short acting pills for exams and he uses them very occasionally (once or twice a quarter) when he has difficult finals that require a lot of memorization and stamina.

He hasn’t done much about accommodations otherwise, he set some of these up in freshman year (all lectures are recorded and he can use an annotation system), but mostly hasn’t bothered to use them. Nothing was required to get into the system beyond an application with his original testing (7th grade) and his IEP/high school exit paperwork.

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The structure of college classes works much better for lots of ADHD kids. Go to class, take a break, walk around, rather than running from class to class, packing and unpacking, and having 7 classes a day.

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Just an update, I spoke to his pediatrician, who said he is not comfortable with writing a letter for the school, as he’s never really followed or treated my son’s ADHD. And he has no “official” diagnosis of developmental dyspraxia – just observations in years of therapy reports.

And still no response from his longtime psychiatrist (really wondering what’s up with that guy).

Anyhow, so I went ahead and scheduled testing with the psychologist who did his full testing in 2020. (She had done previous testing for him before that, and she’s also seen both my girls, so she knows our whole family, lol.)

It’s five sessions – an intake with parents (although S25 may be asked to be there since he’s 18 now), a three-hour testing session with the psychologist, and two additional three-hour testing sessions with another woman who works in the office.

And then a follow-up meeting with the parents to go over the full report. We’re able to fit the testing in before he leaves for school, although we won’t get the report until after he’s moved into his dorm. It’s okay, we can forward it as soon as we have it, and S25 is responsible for having the intake meeting at the school. (Which will obviously be easier if he’s already there.)

He’ll just have to have a conversation with his professors saying that he’s working on putting accommodations into place, and he’ll talk to them about specifics as soon as he has something official.

I have faith that he can do this with a little coaching from us! Thank you again for all the good advice here. :blush:

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After years of experience reading reports, I’ve seen return time anywhere from 2 weeks to 4-5 months. The Neuro we used for S23 is very speedy and has a timeline written into her contracts. I’d actually have your son call the Disability Center now to set up a Sept meeting. They get backed up at the beginning of the year.

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Oh, good thought, I’ll have S25 do that on Monday. The psychologist said she could have the report by Sept 2.

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