Changes in disability law and professional practice were designed to give individuals with disabilities greater access to protections and services by emphasizing functional limitations and self-reported problems over a formal diagnosis and third-party documentation. It is not known if these changes are associated with increased access to accommodations among college students with disabilities, most of whom struggle academically yet never receive formal support. We examined college students’ access to accommodations as a function of institutional type, selectivity, and cost over time. Although access to accommodations increased from 2.8 to 5.2% over the past 12 years, this change was largely driven by students attending America’s most selective and expensive private institutions. Access to accommodations was significantly lower and remained relatively stable among students attending 2-year public colleges. These findings suggest a Matthew effect in higher education in which students most in need of academic support are increasingly least likely to receive it. We suggest four ways to reduce this access inequality: (1) encourage universal design, (2) facilitate access for students with disabilities from disadvantaged backgrounds, (3) critically evaluate documentation from students without real-world limitations, and (4) insist on evidence of symptom or performance validity before granting accommodations.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Price excludes VAT (USA)
Tax calculation will be finalised during checkout.
Andrews, K., Lissner, L. S., Meyer, A., Shiano, M., Thornton, M., & Washington, K. (2021). Honoring social justice values while maintaining rigorous and appropriate decision making. Huntersville, NC: AHEAD.
Association on Higher Education and Disability. (2004). AHEAD best practices: Disability documentation in higher education. Huntersville, NC: AHEAD.
Association on Higher Education and Disability. (2012). Supporting documentation requests. Huntersville, NC: AHEAD.
Association on Higher Education and Disability. (2021). AHEAD code of ethics. Huntersville, NC: AHEAD.
Axelrod, J. (2021, July 14). Suspicious documentation? [Discussion post]. Association of Higher Education and Disability Community Discussion Board. Retrieved 15 July 2021 from https://www.ahead.org/communities
Axelrod, J., Borst, R., Crawford, A., Meeks, L. M., Meyer, A., & Sullivan, L. (2019). Documenting disability professional and student interactions. Huntersville, NC: AHEAD.
Banerjee, M., Lalor, A. R., Madaus, J. W., & Brinckerhoff, L. C. (2020). A survey of postsecondary disability service websites post ADAAA. Journal of Postsecondary Education and Disability, 33, 301–310.
Belkin, D., Levitz, J., & Korn, M. (2019, May 21). Many more students, especially the affluent, get extra time to take the SAT. Wall Street Journal.
Berger v. National Board of Medical Examiners. (2019). United States District Court Case No. 1:19-cv-99. Retrieved 1 October 2021 from https://www.leagle.com/decision/infdco20190903896
Bolt, S. E., Decker, D. M., Lloyd, M., & Morlock, L. (2011). Students’ perceptions of accommodations in high school and college. Career Development for Exceptional Individuals, 34, 165–175.
Cohen, T. A., Ray, S. D., & Weis, R. (2020). College students’ academic accommodations vary as a function of school type, selectivity, and cost. Education and Culture Studies, 4, 130–145.
Dembitzer, L., & Kettler, R. J. (2018). Testing adaptations. In S. Elliott (Ed.), Handbook of accessible instruction and testing practices (pp. 213–230). Springer.
Edmundson, M., Berry, D. T., Combs, H. L., Brothers, S. L., Harp, J. P., Williams, A., & Scott, A. B. (2017). The effects of symptom information coaching on the feigning of adult ADHD. Psychological Assessment, 29, 1429–1436.
Evans, N. J., Broido, E. M., Brown, K. R., & Wilke, A. K. (2017). Disability in higher education: A social justice approach. Wiley.
FitzGerald, C., & Hurst, S. (2017). Implicit bias in healthcare professionals. BMC Medical Ethics, 18, 1–18.
Goldstein, D., & Patel, J. K. (2019, July 30). Need extra time on tests? It helps to have cash. New York Times.
Gordon, M., Lewandowski, L. J., & Lovett, B. J. (2016). Assessment and management of ADHD in educational and workplace settings in the context of ADA accommodations. In R. A. Barkley (Ed.), Attention-deficit hyperactivity disorder (pp. 474–794). Guilford.
Hamblet, E. C. (2020a). Help professors direct students to the DS office. Disability Compliance for Higher Education, 25(12), 7.
Hamblet, E. C. (2020b). Partner with admissions to educate students about disability services. Disability Compliance for Higher Education, 25(6), 7.
Harrison, A. G. (2017). Clinical, ethical, and forensic implications of a flexible threshold for LD and ADHD in postsecondary settings. Psychological Injury & Law, 10, 138–150.
Harrison, A. G., Beal, A. L., & Armstrong, I. T. (2021). Predictive value of performance validity testing and symptom validity testing in psychoeducational assessment. Applied Neuropsychology.
Harrison, A. G., & Edwards, M. J. (2010). Symptom exaggeration in post-secondary students. Applied Neuropsychology, 17, 135–143.
Harrison, A. G., Green, P., & Flaro, L. (2012). The importance of symptom validity testing in adolescents and young adults undergoing assessments for learning or attention difficulties. Canadian Journal of School Psychology, 27, 98–113.
Harrison, A. G., Lovett, B. J., & Gordon, M. (2013). Documenting disabilities in postsecondary settings: Diagnosticians’ understanding of legal regulations and diagnostic standards. Canadian Journal of School Psychology, 28, 303–322.
Harrison, A. G., Lovett, B. J., Keiser, S., & Armstrong, I. T. (2021b). Learning disability documentation submitted by osteopathic medical students. Applied Neuropsychology, 28, 245–256.
Harrison, A. G., & Wolforth, J. (2012). Findings from a pan-Canadian survey if disability services providers in postsecondary education. International Journal of Disability, Communication, and Rehabilitation, 11, 1–20.
Joy, J. A., Julius, R. J., Akter, R., & Baron, D. A. (2010). Assessment of ADHD documentation from candidates requesting Americans with Disabilities Act accommodations for the National Board of Osteopathic Medical Examiners COMLEX exam. Journal of Attention Disorders, 14, 104–108.
Keenan, W. R., Madaus, J. W., Lombardi, A. R., & Dukes, L. L., III. (2019). Impact of the Americans with Disabilities Act Amendments Act on documentation for students with disabilities in transition to college. Career Development and Transition for Exceptional Individuals, 42, 56–63.
Lewandowski, L., Lambert, T. L., Lovett, B. J., Panahon, C. J., & Sytsma, M. R. (2014). College students’ preferences for test accommodations. Canadian Journal of School Psychology, 29, 116–126.
Lindsay, S., Cagliostro, E., & Carafa, G. (2018). A systematic review of workplace disclosure and accommodation requests among youth and young adults with disabilities. Disability & Rehabilitation, 40, 2971–2986.
Lindstrom, W., Nelson, J. M., & Foels, P. (2015). Postsecondary ADHD documentation requirements. Journal of Attention Disorders, 19, 655–665.
Lovett, B. J. (2014). Testing accommodations under the Amended Americans with Disabilities Act: The voice of empirical research. Journal of Disability Policy Studies, 25, 81–90.
Lovett, B. J. (2020a). Disability identification and educational accommodations: Lessons from the 2019 admissions scandal. Educational Researcher, 49, 125–129.
Lovett, B. J. (2020b). Extended time testing accommodations for students with disabilities: Impact on score meaning and construct representation. In M. Margolis & R. Feinberg (Eds.), Integrating timing considerations to improve testing practices (pp. 47–58). Routledge.
Lovett, B. J., & Davis, K. M. (2017). Adult ADHD assessment: An integrated clinical-forensic perspective. Professional Psychology: Research and Practice, 48, 438–444.
Lovett, B. J., Gordon, M., & Lewandowski, L. J. (2017). Legal conceptions of impairment. In Assessing impairment (pp. 125–139). Springer, Boston, MA.
Lovett, B. J., & Harrison, A. G. (2019). Forensic thinking in disability assessment. Psychological Injury & Law, 12, 1–6.
Lovett, B. J., & Lewandowski, L. J. (2015). Testing accommodations for students with disabilities. American Psychological Association.
Lovett, B. J., & Nelson, J. M. (2017). Test anxiety and the Americans with Disabilities Act. Journal of Disability Policy Studies, 28, 99–108.
Lovett, B. J., & Nelson, J. M. (2018). Assessing adults for ADHD. Journal of Health Service Psychology, 44, 48–52.
Lovett, B. J., Nelson, J. M., & Lindstrom, W. (2015). Documenting hidden disabilities in higher education: Analysis of recent guidance from the Association on Higher Education and Disability (AHEAD). Journal of Disability Policy Studies, 26, 44–53.
Madaus, J. W., Gelbar, N., Dukes III, L. L., Taconet, A., & Faggella-Luby, M. (2021). Are there predictors of success for students with disabilities pursuing postsecondary education? Career Development and Transition for Exceptional Individuals.
Marshak, L., Van Wieren, T., Ferrell, D. R., Swiss, L., & Dugan, C. (2010). Exploring barriers to college student use of disability services and accommodations. Journal of Postsecondary Education and Disability, 22, 151–165.
McGregor, K. K., Langenfeld, N., Van Horne, S., Oleson, J., Anson, M., & Jacobson, W. (2016). The university experiences of students with learning disabilities. Learning Disabilities: Research & Practice, 31, 90–102.
Mew, C. M., & Burgoyne, R. A. (2017). New regulations under Titles II and II of the ADA address disability standards under the ADA Amendments Act. The Bar Examiner, 86, 7–16.
Meyer, A., Thornton, M., & Funckes, C. (2020). The professional’s guide to exploring and facilitating access. Huntersville, NC: AHEAD.
Miller, L. A., Lewandowski, L. J., & Antshel, K. M. (2015). Effects of extended time for college students with and without ADHD. Journal of Attention Disorders, 19, 678–686.
Miller, S., Zayac, R., Paulk, A., & Lee, S. (2020). Disability accommodation requests. Journal of Postsecondary Education and Disability, 32, 217–226.
Musso, M. W., & Gouvier, W. D. (2014). “Why is this so hard?” A review of detection of malingered ADHD in college students. Journal of Attention Disorders, 18, 186–201.
National Center for Education Statistics. (2021). Integrated Postsecondary Education Data System. U.S. Department of Education.
Nelson, J. M., Lindstrom, W., & Foels, P. A. (2014). Test anxiety and college students with attention deficit hyperactivity disorder. Journal of Psychoeducational Assessment, 32, 548–557.
Nelson, J. M., & Lovett, B. J. (2019). Assessing ADHD in college students: Integrating multiple evidence sources with symptom and performance validity data. Psychological Assessment, 31, 793–804.
Nelson, J. M., Whipple, B., Lindstrom, W., & Foels, P. A. (2019). How is ADHD assessed and documented? Journal of Attention Disorders, 23, 1780–1791.
Newman, L. A., & Madaus, J. W. (2015). Reported accommodations and supports provided to secondary and postsecondary students with disabilities. Career Development and Transition for Exceptional Individuals, 38, 173–181.
Newman, L. A., Madaus, J. W., Lalor, A. R., & Javitz, H. S. (2019). Support receipt: Effect on postsecondary success of students with learning disabilities. Career Development and Transition for Exceptional Individuals, 42, 6–16.
Newman, L. A., Madaus, J. W., Lalor, A. R., & Javitz, H. S. (2021). Effect of accessing supports on higher education persistence of students with disabilities. Journal of Diversity in Higher Education.
Newman, L., Wagner, M., Huang, T., Shaver, D., Knokey, A. M., Yu, J., Contreras, E., Ferguson, K., Greene, S., Nagle, K., & Cameto, R. (2011a). Secondary school programs and performance of students with disabilities. Menlo Park, CA: SRI International.
Newman, L., Wagner, M., Knokey, A. M., Marder, C., Nagle, K., Shaver, D., Wei, X., Cameto, R., Contreras, E., Ferguson, K., Greene, S., & Schwarting, M. (2011b). The post-high school outcomes of young adults with disabilities up to 8 years after high school. Menlo Park, CA: SRI International.
Ramsay v. National Board of Medical Examiners. (2019). Civil Action No. 19-CV-2002. Retrieved 1 October 2021 from https://www.leagle.com/decision/infdco20191231e13
Scott, S., & Marchetti, C. (2021). A review of the biennial AHEAD surveys: Trends and changes in the demographics and work of disability resource professionals. Journal of Postsecondary Education and Disability, 34, 107–126.
Shaywitz, S. (2003). Overcoming dyslexia. Knopf/Random House.
Soria, K. M., Horgos, B., Chirikov, I., & Jones-White, D. (2020). The experiences of undergraduate students with physical, learning, neurodevelopmental, and cognitive disabilities during the pandemic. University of California.
Soria, K. M., Kirby, C. S., & Xiong, S. (2021). Graduate and professional students with disabilities: Financial hardships during the COVID-19 pandemic. Huntersville, NC: National Center for College Students with Disabilities.
Sparks, R. L., & Lovett, B. J. (2009). Objective criteria for classification of postsecondary students as learning disabled. Journal of Learning Disabilities, 42, 230–239.
Spooner, C. L., Davies, P. L., & Schelly, C. L. (2015). Universal design for learning intervention in postsecondary education. In S. E. Burgstahler (Ed.), Universal design in higher education. Cambridge, MA: Harvard Education Press.
Suhr, J. A. (2016). Illness identity and its implications for neuropsychological assessment. National Academy of Neuropsychology Bulletin, 30, 14–16.
Suhr, J. A., Cook, C., & Morgan, B. (2017). Assessing functional impairment in ADHD: Concerns for validity of self-report. Psychological Injury & Law, 10, 151–160.
Suhr, J. A., Hammers, D., Dobbins-Buckland, K., Zimak, E., & Hughes, C. (2008). The relationship of malingering test failure to self-reported symptoms and neuropsychological findings in adults referred for ADHD evaluation. Archives of Clinical Neuropsychology, 23, 521–530.
Suhr, J. A., Lee, G. J., & Harrison, A. G. (2020). Susceptibility of functional impairment ratings to noncredible reporting in postsecondary students undergoing screening for ADHD. The Clinical Neuropsychologist, 13, 1–13.
Suhr, J. A., & Wei, C. (2017). Attention deficit/hyperactivity disorder as an illness identity. In K. Boone (Ed.), Neuropsychological evaluation of somatoform and other functional somatic conditions (pp. 251–273). Routledge.
Sullivan, B. K., May, K., & Galbally, L. (2007). Symptom exaggeration by college adults in attention-deficit hyperactivity disorder and learning disorder assessments. Applied Neuropsychology, 14, 189–207.
Sweet, J. J., Heilbronner, R. L., Morgan, J. E., Larrabee, G. J., Rohling, M. L., Boone, K. B., & Participants, C. (2021). American Academy of Clinical Neuropsychology (AACN) 2021 consensus statement on validity assessment. The Clinical Neuropsychologist, 35, 1053–1106.
Toutain, C. (2019). Barriers to accommodations for students with disabilities in higher education. Journal of Postsecondary Education and Disability, 32, 297–310.
U.S. Department of Justice. (2014). ADA requirements: Testing accommodations. U.S Department of Justice, Civil Rights Division.
U.S. Department of Justice. (2016). Amendment of Americans with Disabilities Act Title II and Title III regulations to implement ADA Amendments Act of 2008. Federal Register, 81, 53204–53243.
U.S. Department of Justice. (2019). Affidavit in support of criminal complaint (1142876). Retrieved 28 July 2021 from https://www.justice.gov/file/1142876
Wadlington, C., DeOrnellas, K., & Scott, S. R. (2017). Developing effective transition reports for secondary students. Exceptionality, 25, 207–215.
Wallace, E., Garcia-Willingham, N., Walls, B., Bosch, C., Balthrop, K., & Berry, D. T. (2019). A meta-analysis of malingering detection measures for attention-deficit/hyperactivity disorder. Psychological Assessment, 31, 265–270.
Waterfield, B., & Whelan, E. (2017). Learning disabled students and access to accommodations: Socioeconomic status, capital, and stigma. Disability & Society, 32, 986–1006.
Weis, R., Dean, E. L., & Osborne, K. J. (2016). Accommodation decision making for postsecondary students with learning disabilities. Journal of Learning Disabilities, 49, 484–498.
Weis, R., & Droder, S. J. (2019). Development and initial validation of a reading-specific performance validity test. Psychological Injury & Law, 12, 29–41.
Weis, R., Erickson, C. P., & Till, C. H. (2017). When average is not good enough: Students with learning disabilities at selective, private colleges. Journal of Learning Disabilities, 50, 684–700.
Weis, R., Hombosky, M. L., Schafer, K. K., Shulman, D., & Tull, J. K. (2021). Accommodation decision-making for postsecondary students with ADHD. Journal of Clinical and Experimental Neuropsychology.
Weis, R., Speridakos, E. C., & Ludwig, K. (2014). Community college students with learning disabilities. Journal of Learning Disabilities, 47, 556–568.
Weis, R., Sykes, L., & Unadkat, D. (2012). Qualitative differences in learning disabilities across postsecondary institutions. Journal of Learning Disabilities, 45, 491–502.
Weis, R., Till, C. H., & Erickson, C. P. (2019a). ADHD assessment in college students: Psychologists’ adherence to DSM-5 criteria and multi-method/multi-informant assessment. Journal of Psychoeducational Assessment, 37, 209–225.
Weis, R., Till, C. H., & Erickson, C. P. (2019b). Assessing and overcoming the functional impact of ADHD in college students. Journal of Postsecondary Education and Disability, 32, 279–295.
This study was supported by a grant from the Laurie Bukovac Hodgson & David Hodgson endowed fund for disability research.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Weis, R., Bittner, S.A. College Students’ Access to Academic Accommodations Over Time: Evidence of a Matthew Effect in Higher Education. Psychol. Inj. and Law 15, 236–252 (2022). https://doi.org/10.1007/s12207-021-09429-7
- Americans with Disabilities Act
- College students
- Rehabilitation Act
- Socioeconomic status