Testing Accommodations

Key Takeaways:

• Requests for testing accommodations have risen sharply at elite universities and on high-stakes exams since 2010, with disability services registrations at Ivy-Plus schools growing from low single digits to double-digit percentages of the student body.
• Federal laws including the Americans with Disabilities Act, Section 504 of the Rehabilitation Act, and IDEA require testing entities and colleges to provide reasonable accommodations so that exams measure ability rather than disability-related barriers.
• Most new requests at selective universities involve ADHD, anxiety, depression, and learning disabilities—conditions often verified through recent neuropsychological evaluations that document functional limitations.
• The core controversy emerging from 2024–2026 coverage centers on debates about potential over-accommodation, equity concerns, and whether affluent students gain disproportionate access to extended time and separate testing rooms.
• Well-designed testing accommodations are legal, evidence-based tools that should be thoughtfully documented, time-limited when appropriate, and regularly reviewed rather than automatically granted for life.
• If you would like to know more about qualifying health conditions, here is a link to an article with more details.

What Are Testing Accommodations? (Definition and Current Context)

Testing accommodations are changes to test conditions—including timing, setting, presentation, and response methods—that allow examinees with documented disabilities to demonstrate what they know without fundamentally altering what the test measures. These supports exist to ensure that an assessment captures a person’s actual knowledge and skills rather than the functional impact of a disability unrelated to the construct being tested.

Testing accommodations change how exams are administered, not the content or number of questions. Students with disabilities who receive testing accommodations are required to take the same assessment and reach the same level of proficiency as their peers.

It’s critical to understand the distinction between accommodations and modifications:

• Accommodations change how a student takes a test while keeping the learning standards and expectations identical. These accommodations modify how tests are administered to ensure fairness. Examples include extended time, a quiet room, or screen readers.
• Modifications change what is being tested or taught, such as reducing curriculum complexity or simplifying test items. Modifications are generally not permitted on high-stakes standardized tests designed to measure proficiency against common standards.

Testing accommodations apply across multiple contexts:

• K–12 state assessments aligned with grade level academic standards
• College entrance exams like the SAT and ACT
• Graduate admissions tests including the LSAT, MCAT, and GRE
• Professional licensing examinations such as the bar exam and medical boards
• In-class midterms and finals at selective colleges and universities

The policy landscape has evolved significantly from 2010 to 2025. DOJ and ADA clarifications, combined with highly publicized litigation against major testing organizations, have pushed both test providers and elite campuses to standardize their accommodation practices. The result is a more formalized system—but also one facing intense scrutiny about equity, access, and appropriate use.

Rising Use of Testing Accommodations at Elite Colleges (2010–2025 Trends)

National reporting has documented that Ivy League and “Ivy-Plus” institutions—including Harvard, Brown, and Stanford—have seen double-digit percentage growth in students registered with disability and access offices since approximately 2010. What was once a relatively small population (2–5% of undergraduates) has expanded to between 10–25% at many elite campuses, with a majority of registered students receiving some form of testing accommodation.

The conditions most frequently cited in recent media coverage include:

• ADHD (particularly inattentive presentations)
• Specific learning disabilities affecting reading, writing, or math
• Anxiety disorders and generalized anxiety
• Depression and related mood disorders
• Autism spectrum conditions in high-achieving students

High-school patterns have contributed significantly to this growth. Expanded 504 plans, routine extended time on AP exams and SAT/ACT testing, and increased access to private psychoeducational evaluations have created a pipeline of students who arrive at elite colleges already familiar with formal accommodations. Students who have previously received testing accommodations on similar standardized exams should generally receive the same accommodations without needing to provide further documentation. These students often expect—and typically receive—similar supports on college midterms, finals, and graduate admissions tests.

Journalists and scholars describe this trend as part of a broader Gen Z phenomenon. This generation shows greater willingness to seek mental-health treatment, name cognitive differences openly, and request accommodations or formal supports in competitive academic and pre-professional environments. The stigma around disability services has decreased substantially, while awareness of available accommodations has increased.

Legal and Policy Framework: ADA, Section 504, and IDEA

U.S. disability law creates distinct frameworks for K–12 education versus postsecondary and adult settings. The State Department of Education plays a key role in providing policies, guidance, and comparison charts related to assessment accommodations and alternative assessments for students with disabilities. Understanding these differences is essential for anyone navigating the accommodation system.

Key Federal Laws

Americans with Disabilities Act (ADA)

The ADA, particularly Titles II and III, governs public and private testing entities and universities. Under ADA regulations, examinations must be accessible to individuals with disabilities. Testing bodies must provide auxiliary aids and services—such as extended time, readers, or assistive technology—so that exams measure the intended skills or knowledge rather than the impact of a disability unrelated to the test’s purpose.

Section 504 of the Rehabilitation Act

Section 504 applies to all entities receiving federal funding, including most K–12 schools, colleges, and many testing organizations. It prohibits discrimination based on disability and requires reasonable accommodations for qualified individuals.

Individuals with Disabilities Education Act (IDEA)

IDEA governs special education in K–12 public schools. It requires that students with disabilities receive a Free Appropriate Public Education (FAPE) and participate in state and districtwide assessments with appropriate testing accommodations—or, when necessary, alternate assessments aligned to alternate academic achievement standards for students with most significant cognitive disabilities.

How Testing Accommodation Decisions Differ

K–12 Settings:

• Decisions are team-based, involving the IEP or 504 team, parents, and educators in determining appropriate testing accommodations
• Accommodations are documented in an individualized education program or 504 plan
• Related services and supplementary aids are determined through collaborative review, focusing on determining the student’s specific needs

College and Professional Exams:

• Institutions or testing companies review medical and psychoeducational documentation against published criteria for determining eligibility and appropriate accommodations
• Students must self-identify and submit documentation to disability offices
• Decisions are made administratively, with appeals processes available for determining final accommodations

Concrete Example: As discussed, consider a licensing exam for attorneys. If a blind candidate requires a screen reader to access the exam, this accommodation is appropriate because reading printed text is not the construct being tested—legal reasoning and knowledge are. The accommodation removes the disability-related barrier without changing what the exam measures.

Who Qualifies for Testing Accommodations?

Under the ADA and Section 504, a person qualifies for testing accommodations if they have a physical or mental impairment that substantially limits one or more major life activities. To determine eligibility, institutions will assess the individual’s functional limitations and the impact on their ability to participate in assessments. The 2008 ADA Amendments Act broadened this definition significantly, focusing less on narrow medical thresholds and more on functional limitations.

Even if a candidate has never received formal testing accommodations before, they may still be entitled to accommodations based on their current needs and history.

Major Life Activities Relevant to Testing

• Reading
• Concentrating
• Thinking
• Learning
• Seeing
• Hearing
• Writing
• Communicating

Types of Qualifying Impairments

• Visual, hearing, or mobility impairments
• Specific learning disabilities (dyslexia, dyscalculia, dysgraphia)
• ADHD and attention-related conditions
• Autism spectrum conditions
• Psychological conditions (anxiety disorders, depression, PTSD, bipolar disorder)
• Chronic health conditions (diabetes, Crohn’s disease, migraines)

Qualification is based on functional impact compared with most people in the general population—not simply on having a diagnosis. A student might have an ADHD diagnosis, but the question is whether that condition substantially limits their ability to concentrate, read, or process information during timed exams.

For many Ivy-Plus and graduate-school students, evidence typically comes from recent neuropsychological or psychoeducational evaluations. These assessments document persistent difficulties in reading speed, working memory, sustained attention, or processing speed through standardized testing and clinical observation.

Important: A record of high grades or elite admissions does not automatically disqualify a student. Media coverage has highlighted cases where students with long-standing ADHD or learning disabilities still qualified because they expended disproportionate time and effort to achieve their results or relied on intensive informal supports that masked their underlying limitations.

Common Types of Testing Accommodations (School, College, Licensing)

Testing accommodations generally fall into five main categories. The specific supports a test taker receives depend on their documented functional limitations and the nature of the assessment.

Timing Accommodations

• Extended time (typically 1.5x or double time) on midterms, final exams, and standardized tests
• Stop-the-clock breaks for students with anxiety, chronic pain, attention conditions, or medical needs
• Testing across multiple sessions for students who cannot sustain concentration or physical stamina

Setting Accommodations

• Reduced-distraction or separate testing room for students with ADHD, autism, or sensory sensitivities
• Permission to take exams at disability offices or approved proctoring centers instead of crowded lecture halls
• Accessible furniture, wheelchair-accessible settings, or specific seating arrangements

Presentation Accommodations

• Large print, Braille, or high-contrast exam booklets for students with visual impairments
• Screen readers or text-to-speech software for students whose reading speed is not part of the construct being measured
• Human readers when technology is not feasible or appropriate
• Audio versions of test materials

Response Accommodations

• Use of a computer or word processor (with spell-check disabled when writing mechanics are being assessed)
• Scribes or speech-to-text software for students with mobility impairments or severe dysgraphia
• Permission to mark answers directly in the test booklet rather than on a separate answer sheet
• Use of a sign language interpreter for deaf students during oral instructions

Health-Related and Mental-Health Accommodations

Recent reporting has highlighted these increasingly common supports:

• Permission to bring snacks, water, and medication for students with diabetes, gastrointestinal disorders, or other chronic conditions
• Flexible exam scheduling during flare-ups of major depression, bipolar disorder, or debilitating anxiety
• Access to hearing aids or FM systems during proctored examinations
• Breaks for medical monitoring or medication administration

Testing Accommodations Across Educational Stages

The process for obtaining and using testing accommodations shifts significantly as students move through the educational pipeline. Accommodations are designed to address barriers faced by students with disabilities, ensuring they have equitable access to assessments. Understanding these transitions helps families and students prepare for each stage. Effective implementation of testing accommodations requires collaboration, consistency with classroom instruction, and proper training.

K–12 Context

Under IDEA and state policies, students with disabilities must have the opportunity to participate in state assessments. IEP teams or 504 teams decide whether a student will take the general assessment with accommodations or, for students with significant cognitive disabilities, an alternate assessment.

Common K–12 accommodations include:

• Read-aloud tests for students with reading disabilities
• Alternate or separate testing settings
• Simplified or clarified directions (not changing content)
• Extra help with test navigation (not with answers)
• Use of familiar assistive technology

Accommodations are documented in IEPs or 504 plans and should align with supports the student uses during regular classroom instruction and class assignments.

Transition to College

IEPs and 504 plans do not automatically transfer to higher education. Students must:

• Self-identify to the campus disability or access office
• Submit current documentation meeting the institution’s published criteria
• Participate in an interactive process to determine reasonable accommodations

Articles focused on Ivy League campuses emphasize that many first-year students arrive expecting the same package of extended time and flexible deadlines they had in high school. While many receive similar supports, the documentation standards and decision-making processes differ substantially.

College and Graduate Programs

Institutions must provide reasonable accommodations on in-class exams, online quizzes, and cumulative finals. Faculty typically coordinate with disability offices to implement approved accommodations.

Research and opinion pieces highlight tension when professors believe certain accommodations may undermine core course requirements—for example, when clinical judgment under time pressure is considered essential to demonstrate competency in a health sciences program.

Professional and Licensing Exams

Testing companies, bar examiners, and medical specialty boards apply ADA standards and publish detailed accommodation policies. Candidates must:

• Submit documentation well before the exam date (often months in advance)
• Use designated online request portals
• Provide evidence of how their disability affects the specific skills being tested

Recent commentary notes that competitive professional pathways see increasing volumes of accommodation requests, paralleling the rise at elite colleges. The passing score requirements remain the same for all candidates—only the testing conditions change.

Documentation and the Request Process

Documentation is central to testing accommodations and has become increasingly formal and rigorous as request volumes have grown throughout the 2010s and 2020s. Students who wish to request test accommodations must follow a specific process, which typically involves submitting a formal application and providing detailed information about their needs.

Candidates must submit supporting documentation to request testing accommodations, which may include a personal statement describing their disability. Common requirements for documentation include a letter from a licensed healthcare provider or a psycho-educational evaluation.

Once all documentation is submitted, the review process begins. When the review is complete, a decision is made—often in writing—regarding the testing accommodations to be provided.

All staff administering accommodations should be properly trained to avoid confusing or biasing student responses.

What Documentation Typically Includes

• Recent clinical or psychoeducational evaluation (often within 3–5 years for adult ADHD or learning disabilities)
• Clear diagnosis with DSM or ICD codes
• History of symptoms and their onset
• Evidence of functional limitations in reading, concentration, processing speed, or other relevant areas
• Specific rationale connecting recommended accommodations to documented deficits

For example, if a student requests 50% additional time on exams, the documentation should explain precisely how their processing speed or reading rate falls significantly below average and how extra time addresses that specific limitation.

DOJ Guidance on Documentation

DOJ technical assistance encourages testing entities to avoid unnecessary, burdensome documentation when:

• There is a clear history of accommodations on comparable exams
• School records consistently document the disability and previous supports
• The disability is readily apparent or well-established

This guidance aims to reduce barriers for students who have long-standing, well-documented disabilities but may not be able to afford new evaluations every few years.

Steps for Students at Selective Universities

1. Register with the campus disability or access office during the first semester or when difficulties arise
2. Submit all required documentation, including evaluation reports and prior accommodation records
3. Meet with a coordinator to discuss functional limitations and develop an accommodation plan
4. Receive a formal accommodation letter to share with professors
5. Renew or adjust accommodations over time, especially for episodic conditions

National Tests (LSAT, GRE, Professional Boards)

For standardized and professional examinations:

• Locate the testing organization’s accommodation request portal
• Submit documentation well before registration deadlines (sometimes 3–6 months ahead)
• Provide additional information if initially requested by the review committee
• Use formal appeals processes if the initial accommodation request is denied

Equity, Over-Accommodation, and the Elite Campus Debate

Media coverage and scholarly commentary from 2024–2026 have highlighted an increasingly contentious debate: are elite universities and test providers over-accommodating high-achieving students, or are they finally providing appropriate support to those who need it?

Concerns Highlighted in National Reporting

Access Disparities:

• Wealthy families can afford private neuropsychological assessments costing $2,000–$5,000 or more to justify extended time and other supports
• Disparities in diagnosis and documentation mean that under-resourced and first-generation students may be under-represented in accommodation statistics
• Students from affluent school districts often arrive at elite colleges with accommodation histories already established, while equally impaired peers from under-resourced schools may never have been evaluated

Faculty and Administrator Worries:

• Some faculty fear that near-automatic granting of extra time on every exam may blur the line between disability support and competitive advantage
• Others argue that expanding individual accommodations without investing in universal design may unintentionally widen achievement gaps between students who have formal documentation and those who do not
• Concerns exist about whether test scores remain comparable when significant portions of a class test under different conditions

Counterarguments from Disability Scholars and Advocates

• Many students only seek help after years of silent struggle; rising numbers may reflect better awareness and reduced stigma rather than abuse of the system
• When properly aligned with documented functional limitations, accommodations simply level the playing field so exams measure true competence
• Research suggests that accommodations like extended time often show larger relative benefit for students with documented disabilities than for other students, supporting their necessity
• The narrative of “accommodation abuse” can itself be stigmatizing, discouraging legitimately disabled students from seeking services they need

The Access Paradox

Experts increasingly recognize that the system may simultaneously produce:

• More appropriate accommodation for previously underserved students
• Some strategic use of disability diagnoses by well-resourced families seeking competitive advantages

Many argue the underlying problem is not “too many accommodations” but rather the inequities in access to diagnosis and documentation. A student from an affluent suburb with educational advocates and private testing has a vastly different path to accommodations than a student from an under-resourced school who has never been evaluated.

Designing Fair and Effective Testing Accommodations

Institutions and test providers can design accommodation policies that are both legally compliant and educationally credible. The goal is ensuring that assessments remain meaningful while removing disability-related barriers.

Aligning Accommodations with Functional Limitations

Each accommodation should connect directly to:

• The documented functional limitation (e.g., slow processing speed)
• The construct being measured by the exam (e.g., legal reasoning, not reading speed)

Disability offices should review requests individually rather than applying a one-size-fits-all template. Not everyone with ADHD needs 2x time; not everyone with anxiety needs a private room. The accommodation should match the specific impact of the disability on the specific assessment.

Best-Practice Features

• Clear, published criteria and timelines for accommodation decisions
• Standardized appeal processes for denied requests
• Periodic review of accommodations, especially for conditions that may change over time
• Training for faculty on implementing accommodations without compromising academic integrity
• Confidential record-keeping that protects student privacy

Universal Design in Assessment

Building flexibility and accessibility into exam formats from the start reduces the need for individualized, ad-hoc accommodations:

• Multiple low-stakes assessments rather than single high-stakes exams
• Accessible digital platforms with adjustable fonts and contrast
• Captioning and transcripts for video content
• Distraction-reduced test centers available as standard options
• Flexible submission formats where the construct permits

When assessments are designed with diverse learners in mind, fewer students need individual accommodations—and those who do can receive more precisely targeted support.

Academic Integrity Considerations

High-quality policies balance disability rights with fairness to all candidates:

• Accommodations should remove disability-related barriers, not provide advantages unrelated to the disability
• The construct being measured should remain consistent for all test takers
• Security measures (proctoring, time tracking) should be maintained appropriately
• Faculty should understand that accommodations do not lower the standard—they change the conditions under which the same standard is assessed

Future Directions: Gen Z, Mental Health, and High-Stakes Testing

Generational trends suggest that accommodation requests will continue to grow. Gen Z’s openness about mental health, rising rates of documented anxiety and depression, and intensely competitive job markets are all contributing factors.

Reshaping Expectations

Remote and hybrid learning during the early 2020s fundamentally reshaped expectations about flexibility, timed exams, and assessment formats. Many students became accustomed to:

• “Test-anytime-within-24-hours” formats
• Open-book and open-note examinations
• Reduced reliance on single high-stakes proctored exams

As campuses returned to in-person instruction, these expectations collided with traditional testing practices, generating new waves of accommodation requests.

Beyond Higher Education

Employers and professional organizations are increasingly likely to see more accommodation requests on:

• Pre-employment assessments and aptitude tests
• Professional certification renewals
• Promotion exams within organizations

The same legal frameworks (ADA and Section 504) apply, meaning that workplace testing must also provide reasonable accommodations for qualified individuals with disabilities.

Expert Perspectives

Recent opinion pieces offer divergent views:

Support for expanded accommodations: Carefully calibrated testing accommodations are essential to inclusive excellence and talent development. Without them, assessments systematically underestimate the abilities of individuals with disabilities, leading to misallocation of educational and professional opportunities.

Cautions about overreach: Without appropriate guardrails, accommodations might drift into general performance optimization for already advantaged students. The line between disability support and universal flexibility requires ongoing attention and clear documentation standards.

The Central Principle

Testing accommodations should be:

• Evidence-based, tied to specific documented limitations
• Individualized, reflecting each person’s unique functional profile
• Regularly revisited, especially for conditions that may change
• Aligned with what the assessment is intended to measure

This approach ensures that assessments remain both accessible and meaningful—providing valid information about what examinees actually know and can do.

Frequently Asked Questions

What is the difference between testing accommodations in high school and in college?

In high school, accommodations are typically decided and implemented through an IEP or 504 team under IDEA and Section 504. The school takes responsibility for identifying students who may need evaluation and for developing accommodation plans. In college, students must self-identify to the campus disability office and submit documentation that meets ADA standards. While the types of supports may be similar (extra time, quiet rooms, assistive technology), they are not automatically transferred. Students must proactively register and demonstrate that they continue to meet eligibility criteria.

Do testing accommodations give students an unfair advantage on competitive exams?

Well-designed accommodations aim to remove disability-related barriers so that the exam reflects true knowledge and skills. The underlying standard and content remain the same—only the testing conditions change. However, this remains a point of debate at elite institutions. Critics worry about borderline cases and equity of access to documentation, while advocates emphasize that accommodations simply level the playing field for students who would otherwise be disadvantaged by their disabilities.

Can a student with high grades or elite test scores still qualify for extra time?

Yes. Legal standards focus on functional limitations relative to most people in the general population, not on whether someone has already achieved at a high level. A student with dyslexia may have earned excellent grades by spending triple the time on homework and using extensive compensatory strategies. Their need for testing accommodations is determined by documented impairments in reading speed, processing, or concentration—not by their GPA or scores.

How recent does documentation need to be for major exams and selective universities?

Many colleges and testing organizations expect adult ADHD and learning disability evaluations to be conducted within the last 3–5 years, though policies vary. Longstanding school accommodations and historical documentation can support an accommodation request but may not fully replace current clinical data. Testing organizations like LSAC, the College Board, and bar examiners publish specific documentation requirements that candidates should review carefully before submitting their requests.

What should students do if their request for testing accommodations is denied?

First, carefully review the denial letter to understand the specific reasons. Common issues include incomplete documentation, insufficient evidence of functional impact, or requests for accommodations not supported by the disability profile. Students should then provide any missing documentation and use the formal appeal process offered by the college or testing company. If the denial appears to conflict with ADA or Section 504 requirements, students can consult campus disability offices, legal aid organizations, or disability advocacy groups for additional support.