Helping Hand or Unfair Advantage?

The Americans with Disabilities Act has proven to be a law with almost unlimited reach. In 2001, for example, the Supreme Court ruled that the professional golf tour had to accommodate a player who had trouble walking a full round, allowing him to ride in a cart while all the other players walked.

It also (and less surprisingly) applies to institutions of higher education, which are required to make “reasonable accommodations” for students who have (or at least say they have) various learning disabilities. Just how that is working out has been very little studied—until now. A new paper written by Melana Zyla Vickers for the Pope Center, “Accommodating College Students with Learning Disabilties: ADD, ADHD and Dyslexia” was released on March 25 and it uncovers a number of issues regarding “accommodation.”

Before getting into the issues, it must be said that this is a very touchy subject. The author found it difficult to get professors to speak “on the record” about their views because they didn’t want to be labeled as “anti-disabled.” Furthermore, when probing about the possibility that some families purchase the medical diagnoses that are the essential first step to getting accommodations for their children, she was told by the director of disability services at UNC-Chapel Hill that people who are concerned about possible abuse of this system “need to get a life.”

Sorry, but there are some serious concerns revolving around the matter of accommodations for learning disabilities. Mrs. Vickers has performed a valuable service in raising the issues.

Let’s begin with the question of possible abuse. Students who are diagnosed as having Attention Deficit Disorder, Attention Deficit Hyperactivity Disorder, or dyslexia can use that diagnosis to their advantage because it qualifies them for accommodation such as extra time or taking the test in a room with no other students. Under the pressure of tests like the SAT, extra time especially can be beneficial. It has undoubtedly occurred to families that with enough coaxing (and perhaps some cash under the table), doctors might be persuaded to give them that diagnosis whether it’s warranted or not.

Jim Kessler, the director of disability services quoted above, admits that it is possible for people to buy a diagnosis if they really want one. A psychologist in California advertises that there is a shortage of professionals in the field of disability testing and specifically mentions the possibility of flying into southern California for his services. It’s hard to believe that many people who find this psychologist, whose web address is, walk away without getting that important piece of paper saying that Johnny or Suzy is entitled to accommodation.

That more than a minuscule number of wealthy families do this is suggested by the data showing that these learning disability diagnoses are not randomly distributed throughout the population. A very high proportion of students having them are white, male, and from wealthy households. Far fewer students who are female, nonwhite, and from lower-income families are diagnosed as learning disabled and only a tiny percentage of students of Asian ancestry are.

That is not coincidental. Some people are manipulating the system. Pointing that out is not to advocate the abolition of accommodations, but only to suggest that some additional safeguards are in order. It may be unfair for a learning disabled student to take a test under the same time constraints as other students and conditions, but it’s just as unfair for a student from a wealthy family to get an advantage over everyone else just because his parents knew how to buy him an accommodation.

An even more fundamental question the paper raises (although indirectly) is whether it is necessarily beneficial for a student to receive accommodations. Of course, it’s possible that a minor adjustment by a professor might remove a minor and irrelevant obstacle to success, but it’s also possible that an accommodation might be leading a student astray.

As an example, consider a young person who has a reading disability. Despite that disability, he wants to become a doctor. With accommodations, he gets through his undergraduate studies and enrolls in medical school. He also receives test accommodations in medical school because the officials don’t want the trouble that could arise if they said no to his request for extra time because he reads slowly. After graduating from medical school, he wants to get his medical license and requests accommodation on the medical board exam.

What if the medical licensing board says “no”?

That is not a hypothetical case. Those are the facts of Jenkins v. National Board of Medical Examiners. The National Board (NBME) denied Mr. Jenkins’ request for additional time on the exam and Jenkins sued. A federal district court in Kentucky upheld the medical examiners board, but the Sixth Circuit Court of Appeals decided that the case had to be remanded to the district court because recent amendments to the Americans with Disabilities Act had changed the standards for determining when accommodations must be made.

The district court has yet to make its new ruling, but that’s beside the point. Might it not have been better if at some point before entering medical school, Jenkins had been dissuaded from devoting a lot of time and money in pursuit of a profession where it is possible that he would confront a situation requiring him to read and process information quickly? Such situations are very rare, but not inconceivable. If the NBME is allowed to stick to its standards and Jenkins is unable to do well enough on the exam to pass it, then he’ll be in a very bad situation indeed.

Accommodating students with true disabilities seems compassionate, but sometimes compassion keeps people from learning tough lessons.

Another issue is how schools should handle learning disability/accommodation cases.

At most schools, when a student applies for accommodations—extra time for tests, alternative forms of tests (such as oral administration), a student note taker, conversion of course materials into more accessible forms (such as audio recordings), or substituting required courses—a committee reviews the application, but then a single disabilities administrator makes the decision. Those people are overwhelmingly disposed toward granting the request (which then goes on to the professor). At UNC-CH, only one request was turned down in 2008, for example.

A few schools have a different procedure, with the decision made by a committee. One school that takes that approach is the University of North Alabama, where only about half of the requests for accommodations are approved. The committee there (including faculty members) evaluates the strength of the student’s evidence that there is a wide discrepancy between his expected level of performance with and without accommodation.

Perhaps the wide disparity in accommodations between UNA and UNC is just a reflection of different cultures at the respective schools, but I’m inclined to think that having a faculty member in on the decisions adds a useful counter-balance to the decisions.

At the luncheon event where the paper was officially released, UNC’s Jim Kessler praised the paper for opening up the issue for discussion and said that he would share it with his colleagues. Good—this is a subject that should be discussed.

You can watch this event on the Pope Center’s YouTube channel.

Editor’s note: Dr. Stephen Mouton, the psychologist who mentions in his advertising that patients can fly in for diagnoses, wrote to us: “The majority of those who fly in already have been diagnosed with LD or ADHD, but their reports are written to clinical standards rather than the standards required by the Americans with Disabilities Act for accommodations. Very few professionals deal with these ADA requirements, so there are many denials for accommodations on tests such as the LSAT, MCAT, GMAT, GRE and SAT.”