Needs and Wants

On disabilities and testing accommodations

I want to tell you about a family I’ll call the Joneses.

Lucy is a 10th grader at a competitive independent school. She’s doing okay: this year, she got mostly As and Bs and a C+ in advanced chemistry that she’s not happy about. She and her parents came to me because Lucy has been struggling with anxiety and noticed that she tends to run out of time on tests. She tried extended time on a few exams through informal arrangements with teachers, and she felt like she was finally able to show what she knew. The Joneses wanted me to do an evaluation to support a formal accommodation for time-and-a-half.

Testing showed average abilities across the board. Behavior rating scales and clinical interviews indicated significant anxiety, but even so, Lucy’s academic skills appeared appropriately developed even under timed conditions. Her academic fluency scores—like her grades—were solid. So while the data did support an anxiety diagnosis, they did not support functional impairment in academics. And, in the absence of a functional impairment, I didn’t think the extended time recommendation was appropriate.

I’ve seen cases like this almost every week for the past several years. The details change–sometimes it’s attention, sometimes it’s anxiety, sometimes it’s both–but the shape of my conversation with the family is pretty similar. And I want to walk you through it, because I think it gets at something important that we need to discuss honestly and openly.

At our feedback session, I deliver the news that, despite her anxiety, Lucy's academic skills look good and she doesn't need testing accommodations. Lucy and her parents push back hard, imploring me to change my mind; the school won't grant extra time unless I recommend it.¹

So I ask Lucy to review, in her own words, what’s going on. She’s articulate about it. Time pressure stresses her out. She second-guesses herself. She knows the material but feels rushed, and that anxiety compounds. With more time, she feels calmer and performs better. She believes–and her parents believe–that standard time limits are getting in the way of her reaching her full potential.

Honestly, she’s probably right.

Research suggests that most students perform better when given more time on tests. This isn’t a Lucy problem. It’s an everyone problem. When kids sit down to take a test, they are being asked to demonstrate mastery of skills they have just recently learned. At that point, most of those skills aren’t yet automatic, and working through problems takes effort and time. Plus, time pressure introduces stress, and stress interferes with performance. When you remove the clock, kids tend to do better. So Lucy tried extended time and it helped. That is real. I’m not going to tell her she imagined it or that it doesn’t matter.

So I tell her I hear and trust what she is saying. But then I say something that tends to meaningfully shift the direction of the conversation.

“Even though I agree with everything you’ve told me, I don’t think you’re disabled.”

She looks at me like I’ve said something strange. No, of course I’m not.

“Let’s talk about that,” I say. “Because what you’re asking for is a disability accommodation.”

Families seeking testing accommodations must understand that academic accommodations like extended time aren’t a school support or a wellness intervention. They fall under disability rights legislation–specifically Section 504 of the Rehabilitation Act and IDEA–and exist to protect people with disabilities from discrimination and to ensure equal access to major life activities, including education.

Lucy is getting As and Bs. She’s completing her coursework. Her academic skills are nicely developed. She’s accessing school. According to my clinical judgement–and, in my understanding, the law–she does not have a disability. She has anxiety that is unpleasant and real and worth treating. She has a preference for modified testing conditions that is completely understandable, and a demonstrated experience of doing better under those conditions. But, since she is not disabled, she’s not entitled to extra time.

The Joneses push back hard. Of course they’re not arguing that Lucy is disabled. But she does better with more time, the accommodation helps her, and the school should want to support her. Plus, lots of kids without disabilities are already getting extra time, so if she doesn’t have it, she’s actually at a disadvantage.

At this point, I have to hold the line. Those things are all true—and I especially agree with their assessment of systems-level problems at Lucy’s school—but I still cannot recommend that she needs testing accommodations. The word “need,” in this context, means something specific: that without it, she cannot access her education. But the overwhelming evidence in front of us says she can.

I hope I don’t sound too judgey and unsympathetic, because the truth is, I genuinely believe Lucy is stressed, and she needs real treatment for her anxiety. I think she is attending a school where accommodations are abused. And I am a firm believer that the fairest solution for all kids would be for schools to rethink how they administer assessments. If a test isn’t measuring speed, why impose a time limit for anyone at all? But that’s a different conversation than the one about Lucy’s specific need for disability accommodations. And the last thing I want to do is to further damage the integrity of a system designed to protect people who genuinely cannot access school without support.

In the end, I referred the Joneses to a therapist who specializes in adolescent anxiety. I told Lucy that what she was experiencing was real and worth addressing. She left disappointed. Her parents left frustrated. It was as if I was refusing to give them the thing they had paid for.

That’s okay. Because, in my office, disability accommodations aren’t for sale.

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So excited for this theater kid’s new album!

1. By the way, this policy makes no sense to me. More on that next week!