“Cognitive disabilities” refers to various neurologically-based impairments that significantly affect learning and perhaps other major life activities. Some cognitive disabilities result from head injuries. Some are lifelong circumstances experienced from childhood. They can be diagnosed as “cognitive disorders,” “learning disorders,” “Attention Deficit/Hyperactivity Disorder” (AD/HD), or “post-traumatic head (or ‘brain’) injuries". Commonly used and less clinical terms include “learning disabilities,” “dyslexia,” “Attention Deficit Disorder” and “head injuries.”
Students with cognitive disabilities may need disability-related academic adjustments, services, or program modifications (often referred to as “academic accommodations”). Each student’s circumstances are unique. Thus, academic adjustments, services, and program modifications are determined on an individualized basis. Some of the more common academic adjustments and services include extended time, a separate venue for timed in-class tests, note-taking support, document conversion, use of adaptive technology, reduced course loads, speech-to-text captioning, and development of advocacy skills.
Service eligibility is based in large part on the quality and comprehensiveness of a student’s disability documentation and degree of current functional need. A record of prior academic adjustments, services, or program modifications, in and of itself, is usually insufficient to support the same array in higher education. A physician’s, psychologist’s or other practitioner’s determination/recommendation/assertion about appropriate accommodations is valued, but there are many factors to consider and the ultimate judgment rests with a college or university.
Generally, it is the student’s responsibility to provide current and comprehensive documentation that substantiates a student’s disability-related need for services at a college or university (this is different from K-12 in the United States, where schools/school districts may be required to arrange and fund certain kinds of disability assessments). In order to ensure that we have appropriate information that allows us to best respond to students’ needs, Dartmouth College specifies documentation guidelines for various disabilities (see http://www.dartmouth.edu/~accessibility/policies/).
The testing initially needed to fully substantiate the disability-related need for students with cognitive disabilities is commonly referred to as “psychoeducational” or “neuropsychological” assessment. It can cost from $600 to over $5,000. Much of this wide range, the extremes of which are very rare, is based on location: generally, testing in large metropolitan areas seems to be more expensive than in more suburban or rural areas. Other variables include: array of testing needed, local supply-demand environments, degree of a practitioner’s reputation/established practice, and comprehensiveness of the report. In the Upper Valley area local to Dartmouth College, the range is $1,600 to $2,400 as of Fall, 2013. There is also a clinical education program, training doctoral-level psychology students to do assessments under clinical supervision, where assessments are only $600.
Pre-screening at Dartmouth College’s Student Accessibility Services Department
Although Dartmouth College has no legal responsibility to arrange, facilitate, or provide psychoeducational or neuropsychological assessment, we have chosen to (1) provide “pre-screening” to undergraduate students exploring the possibility that they have a cognitive disability and, for students who have been referred by Student Accessibility Services (SAS) or Dick’s House, (2) assess whether “provisional” services are needed, and (3) provide funding to help pay for psychoeducational or neuropsychological testing for some students. We have chosen to do so mostly because of the following factors:
SAS pre-screening services are designed for students who believe that may be experiencing technical difficulties or unexplained ineffectiveness with fundamental activities usually considered important for learning. These may include reading, writing, or understanding spoken information in one’s native language in a manner that belies their understanding of the material, intelligence, effort, and interest.
If a student is primarily concerned about difficulties sustaining attention and focus, or that they may have Attention Deficit/Hyperactivity Disorder, then the student should make an appointment at the Counseling and Human Development (CHD) department at Dick’s House by calling 646-9442.
1. Pre-screening procedures – brief
If the student is not referred: This is usually a provisional decision, while the student tries other resources first (e.g. study &/or test-taking strategies at the Academic Skills Center, counseling, “rule-out” consultation with medical/psychological practitioners). SAS makes proper referrals and invites students to return if these do not work well.
If the student is referred:
2. “Provisional” Services
To the extent that the pre-screening process reveals particularly frustrating struggles and suggests the need for services on a provisional basis until the testing results are available, SAS facilitates such services. The circumstances vary and are determined on an individual basis.
3. Dartmouth College Sources of Possible Funding for Assessment
Last Updated: 10/7/15