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[00:00:00] Dr. Sharp: Hello everyone. Welcome to the Testing Psychologist Podcast. The podcast where we talk all about the business and practice of psychological and neuropsychological assessment. I’m your host, Dr. Jeremy Sharp, licensed psychologist, group practice owner, and private practice coach.

This podcast is brought to you by PAR. Conduct a broad-based assessment of personality and psychopathology with the Gold Standard Personality Assessment Inventory or PAI. The new PAI Spanish: Revised Translation retains semantic equivalents while using clearer and more inclusive language. Learn more at parinc.com\pai.

Hey everyone, welcome back to The Testing Psychologist Podcast. My guest today is Elizabeth Hamblet. Elizabeth is a learning disability specialist. She has worked in College Disability Services Offices for more than two decades. [00:01:00] In addition to working at a university, she is a nationally requested speaker on preparing students with disabilities for successful college transitions. Elizabeth is the author of two previous books and a laminated guide on this subject and her work has appeared in numerous journals and online platforms.

We’ve tackled this concept of accommodations in college from two different perspectives over the course of the podcast, but never from this perspective. So I am thrilled to have Elizabeth here. We dig into lots of topics related to accommodations with a real focus on how to prepare families and individuals for realistic expectations as they transition to college and request accommodations. A lot of actionable tips and plenty to take away, as always.

If you’re a practice owner and you like some support with your practice from launching to growing [00:02:00] to building a larger group practice, I invite you to check out the Testing Psychologist Mastermind Groups. We are always enrolling new cohorts. They are pretty powerful group coaching, accountability, support, guidance, it’s all there, connection. If you’re interested, you can go to thetestingpsychologist.com/consulting and schedule a pre-group call.

All right. Let’s get to my conversation with Elizabeth Hamblet.

Elizabeth, hey, welcome to the podcast.

Elizabeth: Thank you so much for having me. I’m pleased to be here.

Dr. Sharp: Good. Yes. I am excited to chat with you. This is a topic that we have covered in different ways throughout the history of the podcast, but [00:03:00] I think we’re going to take a different angle today. I know that you’ve been doing this work for a long time and there’s a lot to add. So, I’m very grateful.

Elizabeth: Well, I’ve enjoyed a lot of those episodes. I’ve heard them. I’m especially glad to be able to be here.

Dr. Sharp: Likewise. I like to start with this question of why this work is important to you. Of all the things that you can do, why are you doing this?

Elizabeth: Well, there continues to be an information gap between high schools and colleges about what kinds of things are happening at the college level; the kinds of changes that students who are interested in receiving accommodations will encounter, changes sometimes to those accommodations, and supports. 

I’m only one person, and lots of people besides me are doing this work obviously, but it’s just something I feel passionately about because I want [00:04:00] to be a part of making sure that students who want to and can go to college with disabilities, have the preparations to get them to that place ready to go, confident about their skills and truly ready for what they’ll need to do there.

Dr. Sharp: Tell me if this is too much, too fast, but I’m always curious about the motivation for that kind of thing. Was there a personal experience or like one of your kids or a nephew or something?

Elizabeth: Oh, that great question.

Dr. Sharp: You know what I mean? Or was it just born from a group of experiences over here?

Elizabeth: If you want to take it way way back, part of the reason I even started in special education was in part informed by my sister’s experience having not been identified with a learning disability in ADHD when she was in high school[00:05:00] and having a real struggle at her first college and then finally getting assessed and finding that she had disabilities.

She attended Northeastern University after that and was in their learning disabilities special program which is, for those who are not familiar, not specialized classes, just additional support that students get for a fee. That specialist she worked with really taught my sister how to learn. And that was very inspiring to me. So that’s part of why I do my university job working with students myself.

But as somebody who’s worked in disability services offices now for I think it’s 25 years, I have for all this time, part of that process has been reviewing requests for accommodation, and what inspired it in the early 00s was seeing a lot of requests for things that[00:06:00] I knew that we didn’t provide, that the students didn’t. And having been trained as a high school special education teacher in the 90s, I realized my training hadn’t covered anything about what happened for students once they graduated from high school.

Dr. Sharp: There’s so much to get into here already. There’s so much. I think a lot of us get into the work we do because of some kind of personal experience, right?

Elizabeth: Yeah.

Dr. Sharp: Whatever it is that sticks with you. So, I appreciate you indulging that question. I’m always curious about deeper motivations for the things that we do.

So, you split your time, right? Can you tell folks a little bit about what your life looks like now work-wise, how you split your time, and how each of those roles are similar or different from one another?

Elizabeth: Sure. I work two days a week at a university in a disability services office. And [00:07:00] I have frankly, an unusual job in that I do get the pleasure of working with students one on one, usually every other week for an hour or every week for half an hour, depending on what they want. Working on time management, organizational skills, reading, and writing.

As we’ll probably get into in this conversation, it is an unusual job in that colleges don’t have to provide somebody like me. And so if they do, they can charge a fee. The place where I work does not do that. And so that is the fun part of my job. I also as part of that job, review requests for accommodation, as I said. It’s a two-part process where I make my recommendations and then a director either agrees with me or doesn’t.

And then the rest of the time I am doing what I can to get out there, so to speak, and share [00:08:00] information about transition and preparation and accommodations. I do all sorts of things. I write. I present. I run a Facebook community. If you’re on social media, you can find me.

Dr. Sharp: That’s great. We’ll make sure to link to all that stuff in the show notes. I know what that’s like. It sounds like we have similar lives.

Elizabeth: Mm-hmm. Mm-hmm. I like doing different things.

Dr. Sharp: Yeah. It is nice, right? It is. I just got off a panel discussion where I was talking about “my journey” and I said I was blessed or cursed with getting bored easily and that’s how one of these things came about. And then I’ll just stick with them.

Elizabeth: And I think the transition work that I do now was born out of that experience of working in my previous university job. The current job [00:09:00] continues also to inform that transition work. I think a lot about how students are coming to us and what kinds of things I need to be sharing, what experiences they’re having. And again, not betraying anybody’s confidence, not of my students, but just sort of the, are they surprised when they learn this stuff? What kinds of challenges are they having? What kinds of things do people working with high school students need to be aware of?

Dr. Sharp: Yeah. I think that’s a great segue to a lot of our discussion is this idea, I think most of the audience are psychologists or assessment professionals who may be working with high school students transitioning to college, and just speaking personally, it is a bit of an unknown world more than it should be, right? I mean, we make these recommendations that may be appropriate for high school, maybe not, but then they [00:10:00] tend to follow kids to college as well and that’s a whole other world with a little bit of a different system. I think there’s so much to talk about here.

I would love to start, if you’re willing, with just a framework. When we’re talking about accommodations, what does that mean at the college level? Are there laws that govern accommodations at the college level? Is it the same as high school or not? What considerations do we need to have?

Elizabeth: Let me start by saying, I do not have a law degree. This is not legal advice and it’s not medical advice. I’ve been in the field long enough to at least start with that caveat. What I can tell you is the Reader’s Digest version, if you will. For those of us old enough to [00:11:00] remember Reader’s Digest, it’s still out there.

Dr. Sharp: I got you. 

Elizabeth: It’s a great question. I think a lot of people are aware, certainly psychologists- your audience, that IDEA ends with high school graduation or when students age out. It doesn’t apply to us at the college level, but 504 is understandably the cause of a lot of misunderstanding because if you look at college websites, you will see sometimes they have somebody called the 504 Compliance Officer. And so you would think, okay, 504. Got it.

I just saw something online today. Oh, actually in my professional community, somebody at a disability services office was saying that they are seeing parents or somebody suggesting students get off an IEP by senior year and onto 504 because people incorrectly believe that [00:12:00] the “504 plans” travel to college, whatever word you want to use, transfer, transition to college. And that’s not the case. 504 has different subparts and colleges are subject to subpart E and K-12 is subject to Subpart D. And those are vastly different sections.

The ADA covers everybody and the bulk of what colleges have to do is contained in 504 subpart E. There are, for instance, four categories of accommodations that colleges don’t have to provide, and it’s important to know what those are.

Dr. Sharp: Let’s hear it.

Elizabeth: All right. The first two don’t come up very much in my experience and looking at my communities for students with learning disabilities, and ADHD[00:13:00] on the autism spectrum.

One is that they don’t have to approve any accommodation that would be a direct threat to the safety of others. Let’s say, and hopefully, I’m not going to botch this, but if you had a student with an uncontrolled seizure disorder in a metal shop with bho torches, that could end up on the ground setting themselves and others on fire. That is probably having… For instance, you wouldn’t necessarily be able to do something like, I don’t know, do they make bho torches that turn off?

It’s hard to imagine an accommodation that would make that a safe environment for that student to be in and around others. It’s not one that comes up a lot in my field, I’m not so versed in that.

[00:14:00] Another is they don’t have to do anything that would be an undo administrative or financial burden.

And so, there’s not a lot that colleges have to do for students with the three categories of disabilities that we’re probably talking about. And sometimes they don’t have to do things for other reasons, not for cost. Sign language interpreting is an incredibly expensive accommodation to provide. Brailing books is an incredibly expensive accommodation to provide, but a college can’t tell a student, “Oh, we can’t afford to do that” because from what I understand from my experts, any consideration that would take into account the entire budget of the college, not just the disability services budget.

If I use myself as an example [00:15:00] it’s not that colleges don’t have to provide a person like me because it would create an undue financial burden. I will get to the next category. That is the reason they don’t have to do that, which is that they don’t have to provide anything that would be considered a personal service or device. I am a personal service if you’ll. In that colleges just simply don’t have to provide access to specialists. They don’t have to provide tutoring. Most colleges provide tutoring because that’s what people expect them to have. But a learning disability specialist, I have a degree in special education, is not something that they have to provide.

When it comes to tools, if we give you permission to record your class, the accommodation is the permission but the device that you use to record is not something we have to [00:16:00] provide.

Dr. Sharp: I see.

Elizabeth: Yeah. And then the last category, which is the big one, frankly, is anything that is a fundamental alteration of our programs. Your listeners can explore websites of two different disability services offices at universities near them. And within two, you will probably find a statement somewhere that says we provide reasonable accommodations but we don’t do anything that fundamentally alters our programs. And so it starts with admission. If your student has not taken a foreign language in high school because of their learning disability and wants to attend a college that requires it, colleges don’t have to admit them just because they have a disability. It doesn’t mean they won’t, but they just don’t have to.

Dr. Sharp: That’s a great example.

Elizabeth: And then [00:17:00] once they are in the college, whatever they call their core requirements, general education requirements, assuming that they have done the right kind of process and as a college have decided upon their requirements, why they’re important to their degree, a college always has to review a student’s request for substitution of one of those graduation requirements but they don’t have to approve it. And within certain majors, there are going to be things that are not movable.

In my last job here at the State University in New Jersey, we had a bunch of psychology students who couldn’t pass statistics or didn’t think they could and were asking for a substitution. Well, you know, that’s a pretty standard requirement for a psychology degree. Every place that I have worked, things [00:18:00] vary. There are 4,000 colleges more than that in the country. At the places where I have worked, we would make a recommendation, meaning our office, and presumably, my director has passed it up the chain to whoever it went to. And the process for review varies from college to college but I have no idea whether those students actually got substitutions.

Dr. Sharp: I see. So, it’s not like we could request that a student with a math disability, for example, just do course substitution for an engineering major and somehow get through that.

Elizabeth: Yes, exactly. And even within courses, there might be things that you have to do. If you are in, let’s say a medical, you’re studying in some part of the medical field, now, sometimes they are allowed to have spell check devices because in the job the device you’d be using would have that. But there may be [00:19:00] reasons at times why professors say that something we have approved is a fundamental alteration. And so it isn’t just for them to decide on their own. There should be a review process. Students often will have to tell their disability services coordinator. I don’t know that you can necessarily count on professors to contact the office and say, Elizabeth’s in my class and you guys have approved something that I think is a problem. I would suggest that students directly go back to their disability services coordinator.

Dr. Sharp: Got you.

Elizabeth: Not a brief explanation but those are the… Just to review, as a good teacher, right? We have fundamental alteration, personal device or service, undue financial or administrative burden, and something that would endanger the health and safety of others.

Dr. Sharp: All right. That’s a great summary. I’ll let you take a [00:20:00] second and get a drink. That was very comprehensive. Just to be clear, at the high school level, are those conditions also true at the high school level, or do they just come into play at the college level?

Elizabeth: I can only speak to the college level. IDEA is wide-ranging. I haven’t looked at it. It’s been updated since I was last working in the high school. So, I don’t know. I can only speak to what I know is in 504.

Dr. Sharp: Yeah, that’s fair.

You’ve hit on a few things that we might run into as far as recommendations or accommodations that we suggest that might not be reasonable. I’m going to out myself. I’m sure at some point over the last 15 years, I have suggested that someone do a foreign language [00:21:00] waiver going into college without knowing if that’s doable or not. You look like you were going to jump in.

Elizabeth: I think that I’m not here to tell any psychologist how to do their job. You folks have your ethics and your standards for how you work with your clients. What you can do is make the best recommendations you can based on the evidence you see from their assessments. And if you are aware that something might not be easy to get at the college level, at least alert the families.

What I would say is, use the information about what is and isn’t commonly available at the college level not to inform your recommendations, but also to make sure that your [00:22:00] recommendations include making sure somebody helps students develop the skills they will need in the absence, perhaps of certain supports that just aren’t commonly available. That’s a thing that I don’t always see in reports when I read them. There’s just often an emphasis on accommodation that isn’t always matched with an emphasis on skill building.

Dr. Sharp: Hmm. Say more about that.

Elizabeth: I am overgeneralizing but sometimes I see an extensive list of accommodations that somebody recommends but I don’t always see recommendations that, for instance, the students start working with somebody on time management while they’re still in high school.That somebody work with the student on note-taking. Instead, there’s a recommendation for note-taking accommodations of all different sorts.

[00:23:00] Let me make this statement really clearly.  I think your students should request any accommodation they want. I have never, ever suggested somebody not request something. I don’t know what happens at 4,000 colleges across the country and that for sure you wouldn’t get it anywhere.

What I started by saying too, is that part of the reason I do this is I want to make sure that everybody who’s working with students is at least aware of the realities generally of the college environment and make sure that people are helping them get ready for it. And so if there are accommodations that you think are appropriate for that student but that may not be available, make sure there’s some bolstering of their other skills so that if they get there and we say actually we won’t give you a human note taker [00:24:00] but we’ll give you permission to record and sometimes schools will give out- there’s software now that’s very popular. One is called Otter.ai and another is called Glean. Colleges in a lot of cases, i think anecdotally, I haven’t seen research on this, are giving students access to that software even though it’s a personal device. They’re buying site licenses or whatever enterprise licenses and giving students copies of this instead of copies of notes from a human note taker.

And at a lot of schools, the philosophy is that even if it’s challenging, they expect students to take some kind of notes. So the purpose of any note taking accommodation generally is considered except for students with very extreme situations where they just actually cannot take notes to use the recordings or if they do get, let’s say [00:25:00] there’s a student with a hearing impairment in a class and somebody who’s doing a live transcript as it goes, they might get the transcript instead of copies of another human’s notes. The goal of it is to fill in the holes in their own notes, not to replace or take off any responsibility for taking notes.

Dr. Sharp: Yeah. If we’re pulling pieces of information from all of this, I’m just trying to keep it running list but there’s this major theme of one, prepare families for the possibility that not all accommodations may be granted. Ask for what you want but make sure that they’re prepared that they may not get everything and don’t just make accommodation recommendations in the absence of skill building recommendations. That’s almost like we say with medication, pills don’t [00:26:00] teach skills.

Elizabeth: Oh, wow. Yeah.

Dr. Sharp: You still have to try to develop skills whenever possible but you can almost supplement with accommodations.

Elizabeth: Right. And again, there are lots of different accommodations that students can receive. I don’t want to scare anybody off either. It’s just a different academic environment. And so if we focus a lot on testing accommodations, the student who hasn’t read the textbook before the midterm, assessing accommodations aren’t going to matter that much if they haven’t done the reading, gone to class, if they’ve done those things and don’t understand it, sought help.

And then I did not have this experience. It’s been a long time since I’ve been in K-12, but occasionally in my community, somebody [00:27:00] said that a student came in and wanted to be able to retake a test numerous times to get a better grade. I have heard of teachers themselves doing this as a pedagogical thing to help students learn the material but that’s not an accommodation we would typically approve.

Dr. Sharp: Right. That seems like a departure from the curriculum or I’m not sure how you phrase it.

Elizabeth: Yeah. It doesn’t really fall into any of those categories I’ve described but it’s a good time to mention this phrase that we use a lot in my field which is that our mandate is to provide access to students to our curriculum, to our programs, to our housing, all the parts of our program that we provide, but it isn’t to guarantee success. Sometimes if you look on a disability services site, you will see a statement about why we’re there [00:28:00] and the fact that we provide access but we don’t guarantee success. And that can also be a consideration as you think about the accommodations you’re going to recommend. Is this to just help the student do the very best that they can because as harsh as the sound, that’s not what accommodations are meant to do, they’re meant to level the playing field.

Dr. Sharp: Mm-hmm. I’d love to talk about that a little bit because this is a fraught topic in some ways and hard to explain sometimes. Maybe we start with just reiterating what you said, which accommodations are not meant to elevate students above the average. Is that a fair way to put it? They’re really meant to make sure that everyone has access to material?

[00:29:00] Elizabeth: I’m sorry, I didn’t mean to interrupt. It’s to remove barriers created by our environment. The obvious ones when we talk about physical disabilities is, if we have an old building and there were stairs, we put a ramp in because we’re trying to get the student access to that building. And by doing so we are removing the barrier. It’s our environment, right?

So for students with slow processing speed, for instance, the barrier to them being able to answer the number of questions that perhaps their neurotypical classmates might, is to provide that extended time. And I’m not saying that students don’t get it if this is what they say as long as the scores back up that they do indeed have slow processing speed and slow academic fluency and etcetera, but if what they say is, [00:30:00] with more time I can do my best, I can achieve what I see as my potential, it sounds terrible. It makes us sound heartless. We’re not heartless people. We work very hard to serve our students but that actually isn’t the goal.

And so the expectation that if you give, I’ve seen examiners very wisely sometimes test limits and say, Okay, Elizabeth, I got it now. I’ll pick on my working memory because goodness knows, nobody’s assessed it but I don’t have high hopes for it. Although arithmetic is time, right? So Elizabeth was unable to… this was her score and a time condition and when limits were tested, she was able to answer them. So it’s clearly partially a processing problem, not that she doesn’t have a reasonable working memory and mastery of the [00:31:00] facts.

Again, it’s important for you folks to recommend whatever you think the student needs based on their areas of substantial limitation because, of course, that’s part of the definition of a disability. And if you think it’s important to recommend something that may not be available, just let the family also know.

One of the things that really struck me when I started this work was just the thought of students coming to college feeling that these things were very important to them and then having us say actually no and what that experience must be like for them. And we won’t be able to say yes to every single thing every student wants but I also don’t want them to go in unaware that that’s a possibility.

Dr. Sharp: Sure. Now, can you think [00:32:00] off the top of your head, I’ll put you on the spot so stall a little bit so you can think about it, if there are any accommodations that you have seen, let’s say, consistently coming from private practice evals for students coming into university that are just not reasonable or things that just aren’t doable. Things that we may put in our reports trying to support students but are just either way off base or just not possible. Any common mistakes that we make.

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All right, let’s get back to the podcast.

Elizabeth: I’ll say that I don’t necessarily see a distinction between public district recommendations and accommodations versus private. Again, that example of retaking an exam, sometimes they want a full day to take an exam. Some of that stuff could be unreasonable. I mean, there are students who get that but often it’s a physical condition, something like that.

And that’s what’s tricky about this is sometimes, if you go on websites, you will see lists of [00:34:00] accommodations including on disability services sites. And those can be really useful, certainly to give you a sense of what’s there, but what it doesn’t often tell you is who gets them. And so it’s important for that stuff to be there, in my opinion, because students who have come from places where they’ve really not, for whatever reason, people have not recommended a lot of accommodations, may not know what’s possible. But also, when I say it’s not a shopping list, students can ask for whatever they want but they need to be aware that what’s in their documentation needs to support their having that.

I don’t deal with housing but single rooms are something that come up all the time in my community. Remember, what we are talking about is, what is the barrier the student has and does it [00:35:00] make it impossible for them to participate in our programs without that accommodation.

There’s an attorney who’s in our community who likes to remind us all that the single room accommodation was really only for a long time for students with physical needs who had medical equipment and just wouldn’t be able to fit a roommate and their stuff in a room with them. And over time, it’s been applied to all sorts of disabilities. And so, when students say, “I need a quiet room because I need to study, the response from a lot of schools is that’s not what a room is for. We have libraries, we have study lounges, empty classrooms you can find.

And somebody that I interviewed from the book had said to me that actually in his opinion and perhaps it’s the philosophy of the school where he works, living in [00:36:00] that community and having a roommate is actually part of the educational experience that they are offering.

Dr. Sharp: That’s an interesting perspective. 

Elizabeth: It was. Again, I don’t work with housing but if you really think a single is so important for your student, you should recommend that. Just make sure that the student knows that there are private study spaces. Lots of students have to negotiate with roommates about some quiet time, about a little privacy. How would you argue that a student just literally couldn’t be asked to do that?

Dr. Sharp: Right. It’s a slippery slope. Is that the right term? I don’t know. For asking for certain things.

Elizabeth: Yeah. Look, I am a parent. I have one college grad and a soon to be college grad. I am extremely empathetic to families. I know that in a lot of cases, their students have[00:37:00] struggled for sometimes before somebody identified their disability or it’s always been hard. And then they get into college and that’s exciting and terrifying. And, of course, they want to set their student up for success. I get that. We all do as parents.

Dr. Sharp: Of course.

Elizabeth: But I think sometimes that concern, and again, it’s just different focuses, foci? They are concentrating on getting their student the most, the best. And that’s what any parent who loves their child will do. And we are in the other space saying, we will provide reasonable accommodations. We will remove barriers for your student. And those two things don’t always line up.

Dr. Sharp: Yeah. I think that dips into this question just a bit of [00:38:00] what are the limits of self-advocacy, maybe is the way to phrase it? I think that we are in a time where self-advocacy is rightfully celebrated. We all want our kids to advocate for themselves and solve their own problems and so forth. I wonder if there is a limit to that. Can we ever ask for too much or can it go too far or have you run into situations with either families or individuals where it felt like too much?

Elizabeth: You mean the students asking for too much? My job is a very particular kind of job.So, when I interact with students, they are just coming to me to do the work that I do. So, possibly. Most of it comes from the discussions I see in my community [00:39:00] about stories of parents who make sure to let disability services know that one of the parents is a lawyer when we have turned down their student for an accommodation. Again, I believe it’s all done in love and it’s all done with the best intentions.

To try to take the longer view, and I recognize we don’t all have the same goals. We have a mandate to provide access. But for instance, the difference between having a human note taker and being given permission to use the technology is in part for some of my colleagues advancing the goal of helping these students be independent. They will go on to a workplace. And one colleague says that, I think it was people in career services, they have some corporate partners that they [00:40:00] work with. It’s a state university. And the corporate partners came back to them and said, “Your students come to meetings and ask who’s going to take notes for them?” That’s a problem.

Dr. Sharp: Yes. 

Elizabeth: Again, I don’t want to be too precious. College is a very rarefied atmosphere. We do a lot of things that you don’t have to do the rest of your life. When was the last time you took a two hour exam and filled as many blue books as you get? Do they still have blue books? Many blue books as you get?  Boy, am I aging myself today. I don’t want to be too precious about what we’re doing here at college, but this is the environment. This is what students sign up for, so to speak. And so, knowing what the expectations are important.

Let me take a moment because I do want to mention something I see all the time and is a constant discussion in my [00:41:00] community; extensions of deadlines.

Dr. Sharp: Oh yeah, that’s a good one.

Elizabeth: Is one of those things that if you go online and you see lists of accommodations, that is considered a very K-12 accommodations. Not to say we don’t do it. Most of my colleagues will say that extended deadlines are for two particular kinds of students in this particular situation: A student with either a physical disability or a psychological disability that has unpredictable, forgive me if this is an insensitive term, episodes, where for a few days that student just cannot function.

And its severe, not just I am depressed, I have deep, deep depression. Or if you have a student, I guess with like IBS or something, if there’s a paper due at the time of [00:42:00] one of those episodes, then that student would get an extension for that particular paper. But it wouldn’t be indefinite. It wouldn’t be, Oh, turn it in in a week. It’s sort of like, okay, how long were you out of commission and we add that on. But that is something that I think is wide. It feels to me anecdotally, like it’s kind of a widespread K-12 thing.

And that comes back to my concern that when a student who is accustomed to getting two days tacked on at the end of any deadline, gets to college and we say, “Oh, we don’t actually do that.” What’s that experience like for them? Will they motivate to get to the time management session that the learning center is having? Again, if they go ready with skills and strategies that they can use, then they should still ask and maybe they won’t get it. But if not, they have the [00:43:00] confidence to know that they, all right, this is kind of a bummer, but I’ve done this before.

Dr. Sharp: Right. This is such a a tricky area. The more we talk about it, the more I’m aware  and in my mind of like, don’t say the wrong thing here because it really is treading that line between expectation and accommodation. Like what are we saying people are capable of and should “be able to do on their own” versus what are we willing to provide from the accommodation side? And that is very tricky. There are any number of presentations and situations that drive these requests, right?

Elizabeth: And I think too, just to keep going back to the note taker because I see requests for copies of the professor’s notes, who says that professors have notes?

Dr. Sharp: Yeah. 

Elizabeth: It’s a note taking [00:44:00] accommodation. But families need to be aware that just because their examiner, if we’ll use that word, has specified professor’s notes, that doesn’t mean that that’s what’s going to be.

They want PowerPoints ahead of time. And that is an example of– my colleagues have said sometimes that they will provide that. I just saw a thread today for students with visual impairments or was it auditory who will have a chance to preview this stuff before class because of a more significant barrier is different than the student who’s just anxious about school or has generalized anxiety disorder and just wants to see those things in review ahead of time. The rest of their classmates are going to walk in the door without knowing any of this stuff. And so how is this removing a barrier for them and leveling a playing field? [00:45:00] And sometimes it does happen. Sometimes the professor loads the slides for everybody.

Prepared study guides. That’s something that had came up again today. A professor may on their own provide students with a list of terms to know. Be aware that if they do that, often they’re just going to be the list and not the definitions and the explanations. But it’s not considered an accommodation for somebody to do that for a student at the college level, which again goes back to the skill building. So it is reasonable to expect a college student to go through their own notes and materials and figure out how to study.

They want to know what’s going to be on the exam. I understand there are students with anxiety disorders, but again, a generalized anxiety [00:46:00] disorder is about a lot of things. And so how this particular request might level the playing field for them is not clear to a lot of my colleagues. This would fall under, probably, I don’t know about fundamental alteration particularly, but multiple choice tests having some of the possible choices removed: reducing the number of options, reducing the length of a paper a student has to write or they don’t want to take an exam, they want to write a paper, they don’t want. These are the fundamental alterations or kinds of things we just aren’t in a position to tell professors they have to do. I don’t want to write papers, I want to do a project. Now, students can always advocate and ask.

Dr. Sharp: Sure. I know we keep coming back to that. It’s like ask but don’t expect necessarily.

[00:47:00] Elizabeth: And I think when you’re assessing students when they’re younger and if the family’s talking about college, these are the kinds of conversations that you have to recommend.

In my books I suggest that, if the student has it as a goal and it’s, look I think as a culture we are just so over focused on college and we’re not giving these kids a break at all. And so I hate to hear myself saying that at the 8th grade meeting, you should at least be talking about the students’ vague goals and only because as students move through high school, when you look at lists of accommodations that they’re utilizing, again, is there also goals and objectives around building some skills for them? Are we going to keep those accommodations in place all the way through knowing that a lot of them aren’t going to be available at the college level because you don’t want to drop these kids off a cliff.

[00:48:00] Dr. Sharp: Yeah. Well, that raises a big question that you can feel free to deny or avoid or whatever, which is, are too many kids going to college? Are we sending too many kids to college?

Elizabeth: Oh my gosh. I do not feel qualified to answer that question.

Dr. Sharp: Okay. That’s fair.

Elizabeth: Oh my gosh. I will let way smarter people than me answer that question. All I would say, I think everything is such an individual decision. So I don’t know that we are what? Oh gosh. What do the kids want to do? And that’s the problem is how many of us knew at 18 what we really wanted to do? I’m on my 3rd or 4th career.

Dr. Sharp: Oh my gosh. Yeah. It’s so true. 

Elizabeth: Just to dial back to the 8th grade discussion, the only other reason it’s really important to ask is if you are recommending waiver of a class for a student going into high [00:49:00] school, let’s say their high school does tell students they need three years of foreign language to graduate and you’re going to ask for a waiver, and by the way, at the college level, we generally don’t use the “W word”, we use the “S word”, which is substitution. Usually, something has to happen to replace those credits.

Dr. Sharp: Instead. Yes.

Elizabeth: But this isn’t like a game show where if a student asks for the wrong thing, they get nothing.

Dr. Sharp: Okay, sure. Good.

Elizabeth: The little red X doesn’t come up and they don’t drop through a little slot on the floor. I think it’s important to have the discussion with the student at the 8th grade meeting of, we think that foreign language or math is going to… it’s hard to graduate without the math but this is going to be a real challenge for you but you should be aware, this may limit the colleges where you are eligible for admission. We talk about self-advocacy and self-determination and what a 14 [00:50:00] year old can take away from that conversation may be limited by their maturity and some other prefrontal cortex stuff, but I think that you’ve got to at least tell them that. Don’t do it without informing them of what that could mean.

Dr. Sharp: Yeah. I think that’s totally reasonable. If anything, what I’ve taken away from our conversation is that preparation is very important. Talking with families and inoculating them basically or planting seeds whatever term use, here’s what you might expect.

Elizabeth: Right. Again, you can’t predict, I can’t predict what’s going to happen. There’s a new study where they’ve collected all the data, but the previous one, this huge longitudinal study that collected data in waves over 10 years from I think [00:51:00] 2000 to 2010 on this sample of 12,000 students who had had at least one accommodation in college. It’s a big longitudinal study. You can look this up online. You can see the rates at which they received various accommodations. And it really drops to the single digit percentile for some of those things.

And there’s some challenges with the way things are phrased. It’s not clear to me necessarily what some students received in some situations but things like… I’ve seen this too. Iit’s been a long time but sometimes I see this in the community, professors to email students the assignments or to check in with them. These are not the kinds of things we do at the college level. Students are always welcome to attend office hours.

Maybe the best way to frame this is to, and this is when you ask me about how many people are going to college? Is that the right thing? [00:52:00] One way to think about it is to look at the amount of adult help students are getting. And if in senior year they really won’t be able to get through, they can’t manage, they lose their stuff, they don’t turn things in, they can’t sit down to get work done without an adult sitting over them, that sounds to me like a student whose next move is certainly not a traditional four year college environment. Maybe it’s a community college but they’re operating in a lot of the same ways we are. Sometimes they’re more flexible with accommodations than we are. They might provide some things we don’t, but from my community, I wouldn’t make that generalization.

Dr. Sharp: Okay. 

Elizabeth: They’ve got to be able to manage two things.

Dr. Sharp: That does make sense to me. There’s so much wrapped up in it with expectation and hopes and what it means to not go to college. I don’t know if you would agree. I think [00:53:00] a lot of that work falls on parents to have those conversations with their kids.

Elizabeth: This is a huge thing. I think we have neglected our technical education. I think we as a society in some communities, not all of them, present that as a second-best option. There are lots of things that we could be doing, but I think, in ways, the college experience has changed a lot since maybe a lot of parents were in school, certainly with regard to how we treat students with disabilities, but some of the essential elements are still the same. You still have to read two hundred pages a week. And you can do that with technology. That’s another piece too.

Getting students accustomed to using the tools in their smartphones that a lot of them have, the built-in spell check features things like that. That’s an example. Students who don’t want to be penalized for grammar and spelling errors on their [00:54:00] papers. If you’re taking a test in class, we might provide you with a laptop where you can use spell and grammar check, but papers you complete outside, we expect you to get that cleaned up.

Dr. Sharp: Let’s use it. I want to go back to maybe a technical question that could have belonged at the beginning of the conversation, but we’ve had so many good topics that have come up that I’ve waited till now. Do students have to have a “disability” to receive accommodations?

The second question is, can a student have a disability and not receive accommodations for some reason? And the flip side, can students without identified disabilities, receive accommodations?

Elizabeth: Oh boy. [00:55:00]First of all, it’s literally possible for a student with a disability to not receive accommodations that they don’t request accommodations. And that sounds fairly obvious but there are students who do get to college, don’t recognize that they need to register with the office. I don’t know if they just wait all semester for people to come and knock on their dorm room door.

There is the Office for Civil Rights takes complaints for students, and when I read some of these summaries, sometimes they discover student complains, “I didn’t get my accommodations for a semester.” You didn’t register first semester. 

So, it is a deliberate process. Your students do need to identify the person or office and follow whatever that process is. There’s usually an intake meeting, which actually brings me to a good point and I can loop in the research and stuff too. Students are going to be asked, “What’s your disability?” [00:56:00] They might be asked, “How does it affect you? And why are these accommodations appropriate?” That’s some of the preparation that professionals can do is explaining this stuff.

Dr. Sharp: I was going to say, how much of that should we be putting in our reports?

Elizabeth: I used to know a psychologist who would write a separate report for the student without all the details necessarily but synthesizing things for them. However you decide to do that, we always want to start with what they’re good at and what their strengths are. But it has to be a disability.

Again, that’s a little bit in the eye of the beholder when you asked me, is it possible for a student with a disability to not get accommodations? It depends upon how the Disability Services Office reads, perceives, deals with what the evidence in the [00:57:00] documentation.

As an example, I have seen students whose lowest scores have been, let’s say, at the 50th and 63rd percentile. And rest of whose functioning is very superior; 97, 98 percentile. And according to the Wexler, those are statistically significant discrepancies. But the federal definition of disability includes a substantial limitation in an area of functioning such as learning. And so, I would not agree that functioning at the 50th percentile is a substantial limitation. It may be frustrating to that student and it may cause some cognitive dissonance.

An interpersonal weakness isn’t necessarily viewed by a lot of– and some of my colleagues may just–if a professional like yourself has identified it as a disability, [00:58:00] they may say, Well, that’s what it is. Again, not the case where I work necessarily but it’s all over the place.

Dr. Sharp: Right. I was just going to say, that’s a place that we wrestle with in our field as well, is can someone be average and that be a disability basically depending on the rest of the profile. And it’s another tricky question but people are still trying to figure out.

Elizabeth: Some of my colleagues have said, if scores are above the 25th percentile, they don’t consider it a substantial limitations. It all depends on who’s making the decisions.

Dr. Sharp: Absolutely.

Elizabeth: And you also asked me about what happens if students have a disability but they’ve not had anything documented. They believe they have a disability. It’s sort of [00:59:00] an urban suburban myth. I have heard somewhere that there may be colleges that will take students self-report all by itself. I can’t name any of those for you. I don’t get the impression that that widespread. Once again, it’s always worth asking.

Dr. Sharp: Yeah, that’s fair. In my experience, documentation is needed almost all the time. Maybe all the time. I can’t think of the case.

Elizabeth: Yeah. And let me reiterate, with these families, please make sure that they do check with the university. Even as soon as they’ve made the list of schools they’re going to apply to, they can check that stuff. And maybe they won’t need another full eval.

Dr. Sharp: Right. And that makes me think too about the families who can’t afford or can’t access these services throughout their kids pre-college [01:00:00] career. And that’s a big problem. I think we all know that’s a big problem, that there are underserved populations who aren’t getting access to evaluations when they might need it and misidentified through the school for whatever reason. I don’t know how to solve that problem but I don’t know if you know.

Elizabeth: I wish I knew. I will send you a link up. understood.org has a list of recommendations for students to get testing at a reduced price. You all probably had to work at a clinic in your grad school. There’s some options but they are still a lot of money and for some students, they’re still going to be out of reach.

Dr. Sharp: Yeah. It’s just good motivation to dig into that. Maybe there’s someone out there. If you are that person, if you’re someone out there who’s trying to solve that problem, get in touch with me. I’d love to interview you.

Gosh. We have talked about a lot of things. I know there’s always more to talk [01:01:00] about but I wonder, as we start to wrap up, if there are other suggestions, tips, strategies for those of us here in private practice conducting these evaluations- what we can do to help prepare our families, write the best reports we can, anything that we can do to avoid any mishaps once they get to the college level.

Elizabeth: Oh my gosh. One thing I have forgotten in this whole conversation to say is this, make sure that if somebody is coming to you because they believe they need an update, that they actually look online at the colleges the student has applied to because they may find that what they currently have will be sufficient. I’m not trying to put you all out of business but I know you all have long waiting lists.

Dr. Sharp: There’s a lot of demand.

Elizabeth: People waiting for your services and you’ll always be busy. But I have [01:02:00] seen parents online telling each other, “Oh, if your testing’s more than three years old, you have to get it updated.” And that is presumably the case at some colleges but not all of them. And so this is not industry secrets. You can go on the disability. The families, that’s their job, is to go on the disability services sites of the schools that the student is applying to, and they may find that just the 504 or the IEP is enough. Or that if you tested the kid freshman year or even in 8th grade, that they will accept that.

Forgive me for saying, I don’t think neuropsychological testing is necessarily the most fun a lot of students are ever going to have in their life. My apologies. I know some of them find the tests interesting but let’s not put them through that testing if they don’t really need it. That’s a really important thing.

I would [01:03:00] say, don’t use outdated measures. If you’re going to pick and choose if you like the reading tests of the WIAT but you like the math tests of the tasks of the WJ instead, make sure you do the timed measures for reading, writing, and math to support if you’re going to make a recommendation for extended testing time. Don’t skimp because it might cause some of your students to have a problem.

Dr. Sharp: Sure. That’s fair. And I’m going to pull some of what you said and just emphasize the rationale. If we make recommendations for accommodations, make sure there’s a rationale there, and then it’s supported by history and data and so forth.

Elizabeth: Certainly, yes. I would like to see a clear line from the area of a substantial limitation to the recommendations you’re going to make.

But thank you for bringing [01:04:00] up history, especially for an initial evaluation. If all I see is, Elizabeth reported she’s having trouble finishing tests and her parents report, she’s also having trouble finishing tests and you haven’t looked at my report cards and there are no teacher comments noticing, for instance, and I did just see this and good for that evaluator in a report saying, Elizabeth’s teachers noticed that in class discussions, she seems to really understand the content but she isn’t getting through half of the questions on a test.

Dr. Sharp: Yeah. Those examples help, right?

Elizabeth: Mm-hmm.

Dr. Sharp: Yes. I’m trying to think what else. Any resources, anything that might be helpful for us as clinicians that we might look at as we’re doing this work that you’d like to highlight?

Elizabeth: Keep up with the researchers. You have interviewed Allyson Harrison and Julie Suhr. [01:05:00] I think that they do some interesting work. Benjamin Lovett is doing interesting research. There’s stuff on documentation that’s out there. Will Lindstrom and Jason Nelson are some researcher surfs I follow. If you can swing it, I would consider joining the Association for Higher Education and Disability. That’s my professional organization. And that’s where the online community is. And you can see the kinds of things that disability services providers are talking about and that may be helpful to you in thinking about your assessments and recommendations.

Dr. Sharp: Sure. I love that. And we’ll put all these resources in the show notes as always. Can you say that last one again? The association of…

Elizabeth: Sorry, Higher Education and Disability. The acronym is AHEAD.

Dr. Sharp: Okay, great.

Elizabeth: And actually [01:06:00] Ed Martinelli, who you interviewed is somebody who’s active and very helpful in our community.

Dr. Sharp: Great. I’ll make sure to link to those old podcast episodes too.

Well, thanks for taking some time and chatting through what is admittedly complex topic. We’re only on one side of it. You’re deep into it. I’m sure there are so many nuances that we haven’t gotten into but I think this is super helpful. It’s always nice to hear from y’all’s side how our work is received and how we can best support these families. So, thank you for the time. Thanks for being here.

Elizabeth: Thanks for this opportunity. Again, I’m not telling you all how to do your job, your professionals, but I do think the more you know about what’s happening, just as you say, the better you can prepare the runway, so to speak, for families and start to plant those seeds [01:07:00] and encourage them to build their students independence because it’s just a theme across all the things they’re going to do at college.

Dr. Sharp: Yes. That’s such a good point. I think that’s a nice note to end on. Thanks again.

Elizabeth: Thanks so much.

Dr. Sharp: All right, y’all, thank you so much for tuning into this episode. Always grateful to have you here. I hope that you take away some information that you can implement in your practice and in your life. Any resources that we mentioned during the episode will be listed in the show notes, so make sure to check those out.

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And if you’re a practice owner or aspiring practice owner, I’d invite you to check out The Testing Psychologist Mastermind Groups. I have mastermind groups at every stage of practice development, beginner, intermediate and advanced. We have homework, we have accountability, we have support, [01:08:00] we have resources.┬áThese groups are amazing. We do a lot of work and a lot of connecting. If that sounds interesting to you, you can check out the details at thetestingpsychologist.com/consulting. You can sign up for a pre-group phone call and we will chat and figure out if a group could be a good fit for you. Thanks so much.

The information contained in this podcast and on The Testing Psychologists website is intended for informational and educational purposes only. Nothing in this podcast or on the website is intended to be a substitute for professional, psychological, psychiatric, or medical advice, diagnosis, or treatment. Please note that [01:09:00] no doctor-patient relationship is formed here, and similarly, no supervisory or consultative relationship is formed between the host or guests of this podcast and listeners of this podcast. If you need the qualified advice of any mental health practitioner or medical provider, please seek one in your area. Similarly, if you need supervision on clinical matters, please find a supervisor with expertise that fits your needs.

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