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Documentation Guidelines for Head Injury/Traumatic Brain Injury

 

Head Injury or Traumatic Brain Injury is considered medical or clinical diagnoses. Individuals qualified to render a diagnosis for these disorders are practitioners who have been trained in the assessment of Head Injury or Traumatic Brain Injury. Recommended practitioners may include: physicians; neurologists; licensed clinical, rehabilitation and school psychologists; neuropsychologists and psychiatrists. The diagnostician should be an impartial individual who is not a family member of the student.

The following guidelines are provided to assist the service provider in collaborating with each student to determine appropriate accommodations. Documentation serves as a foundation that legitimizes a student's request for appropriate accommodations. Recommended documentation includes:

  1. A clear statement of the head injury or traumatic brain injury

  2. Documentation for eligibility must reflect the current impact the head injury has on the student's functioning, (the age of acceptable documentation is dependent upon the disabling condition, the current status of the student and the student's request for accommodations)

  3. A summary of cognitive and achievement measures used and evaluation results including standardized scores or percentiles used to make the diagnosis

  4. A summary of present residual symptoms which meet the criteria for diagnosis

  5. Medical information relating to student's needs to include the impact of medication on the student's ability to meet the demands of the postsecondary environment

  6. A statement of the functional impact or limitations of the disability on learning or other major life activity and the degree to which it impacts the individual in the learning context for which accommodations are being requested

Further assessment by an appropriate professional may be required if coexisting learning disabilities or other disabling conditions are indicated. The student and the Disability Coordinator at the Access Center collaborate regarding accommodations.

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