What is considered high quality disability documentation?

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The Association on Higher Education and Disability (AHEAD) has created a document that suggests characteristics of quality documentation. AHEAD hopes that this approach will encourage the use of more consistent documentation and provide current and prospective students, parents, and professionals with the information they need to assist students in establishing eligibility for services and receiving appropriate accommodations.

Excerpts of the seven elements of quality documentation discussed in the document are summarized below.

  • The credentials of the evaluator(s)
    The best quality documentation is provided by a licensed or otherwise properly credentialed professional who has undergone appropriate and comprehensive training, has relevant experience, and has no personal relationship with the individual being evaluated. A good match between the credentials of the individual making the diagnosis and the condition being reported is expected (e.g., an orthopedic limitation might be documented by a physician, but not a licensed psychologist).
  • A diagnostic statement identifying the disability
    Quality documentation includes a clear diagnostic statement that describes how the condition was diagnosed, provides information on the functional impact, and details the typical progression or prognosis of the condition.
  • A description of the diagnostic methodology used
    Quality documentation includes a description of the diagnostic criteria, evaluation methods, procedures, tests and dates of administration, as well as a clinical narrative, observation, and specific results. Where appropriate to the nature of the disability, having both summary data and specific test scores (with the norming population identified) within the report is recommended.
  • A description of the current functional limitations
    Information on how the disabling condition(s) currently impacts the individual provides useful information for both establishing a disability and identifying possible accommodations. A combination of the results of formal evaluation procedures, clinical narrative, and the individual’s self report is the most comprehensive approach to fully documenting the impact.
  • A description of the expected progression or stability of the disability
    It is helpful when documentation provides information on expected changes in the functional impact of the disability over time and context. Information on the cyclical or episodic nature of the disability and known or suspected environmental triggers to episodes provides opportunities to anticipate and plan for varying functional impacts.
  • A description of current and past accommodations, services and/or medications
    The most comprehensive documentation will include a description of both current and past medications, auxiliary aids, assistive devices, support services, and accommodations, including their effectiveness in ameliorating functional impacts of the disability. A discussion of any significant side effects from current medications or services that may impact physical, perceptual, behavioral, or cognitive performance is helpful when included in the report.
  • Recommendations for accommodations, adaptive devices, assistive services, compensatory strategies, and/or collateral support services
    Recommendations from professionals with a history of working with the individual provide valuable information for review and the planning process. It is most helpful when recommended accommodations and strategies are logically related to functional limitations; if connections are not obvious, a clear explanation of their relationship can be useful in decision-making. While the postsecondary institution has no obligation to provide or adopt recommendations made by outside entities, those that are congruent with the programs, services, and benefits offered by the college or program may be appropriate.

Consult the Seven Elements of Quality Disability Documentation to review the full text regarding each element. Additional information on its use and purposes, foundational principles, and recommendations for creating disability-specific documentation guidelines can be found at AHEAD's Best Practices Resources.

Last update or review: May 14, 2014