Equitable Evaluations: How to Assess Students with Disabilities

In February 2022, the American Psychological Association (APA) released new Guidelines for Assessment and Intervention with Persons with Disabilities. In it, the APA outlines six equitable assessment-specific recommendations to help clinicians and educators  

• choose the most appropriate tests for each individual,  
• provide appropriate accommodations and modifications,  
• administer tests sensitively, and 
• interpret the results accurately. 

Here’s a summary of guidelines 12–18, which relate directly to assessment best practices. 

GUIDELINE 12: Psychologists strive to consider the interactions among disability and other individual and contextual dimensions in determining the breadth of assessment. 

A clear and accurate diagnosis is rarely the result of a single test, especially when disability-related factors can affect test outcomes. The APA recommends that practitioners assess traditional areas such as cognition, visual perception, motor skills, and personality. To add depth and dimension to those test results, it’s important to collect and analyze information from 

• an individual’s educational, occupational, medical, social, cultural, and psychological background or records;  
• interviews with the client and their family, school, health-care providers, and employers; and 
• behavioral observations conducted in varied settings. 

It’s also important to understand how much support a person with a disability has and how that support enables them to cope and function. The APA recommends that the clinician “assess various qualities in a person with a disability in context, rather than the disability alone” (emphasis in the original). 

GUIDELINE 13: Psychologists strive to ensure the validity of assessments by considering disability-related factors when selecting assessment tools and evaluating test norms. 

APA best practice is to select a test that has been standardized with the disability group you’re planning to assess. When a test has been normed without including people with certain disabilities, the results may not be as accurate.   

Though normative samples increasingly represent our diverse population, it may be difficult to find tests that are a good match for a specific disability. Where that is the case, the APA recommends working with test publishers to find instruments that could provide as much relevant data as possible. It’s also a good idea to consult with colleagues who have more experience with disability evaluations.  

GUIDELINE 14:  Psychologists strive to provide appropriate accommodations to individuals with disabilities to optimize meaningful participation in the assessment process. 

Not all people with disabilities will need accommodations for every assessment. But for those who do, accommodations can lead to more accurate results and more reliable diagnoses. If you’re not sure which accommodations a client needs, it’s a good idea to have an open conversation about what testing has been like for them in the past and what needs they have today.   

An accommodation could change the format, presentation, or administration of a test. It shouldn’t, however, change the factor you’re measuring. For example, if a student taking a reading test used a device that enabled a much larger font to accommodate a vision problem, the test score would reflect the student’s ability to read. Without the accommodation, the test score might reflect the student’s ability to see. The aim of accommodation is to remove barriers so the test results aren’t skewed by factors related to the disability.  

Some common accommodations include    

• changing the format of a test from paper/pencil to computer,  
• adding extra time,  
• offering alternate ways for someone to respond to test items,  
• choosing alternate assessments or subtests,  
• using assistive technology devices, and  
• providing distraction-free spaces.  

The APA suggests that clinicians use accommodations that are:  

• valid, 
• appropriate, 
• responsive to a student’s background, 
• likely to make a test more accessible, and 
• feasible in the circumstances. 

GUIDELINE 15: Psychologists strive to validly assess individuals with disabilities by appropriately adapting test administration based on disability-related factors.  

An assessment is intended to measure certain constructs—but if test results are affected by factors related to a disability, the outcomes aren’t a fair appraisal of the individual’s capabilities. Disabilities can affect people in lots of different areas, including the following: 

• energy levels 
• stamina 
• strength 
• motor coordination 
• attention 
• processing speed 
• behavior 
• communication 

Medication side effects, bathroom habits, and pain can also disrupt a person’s performance on a test intended to measure other constructs. While planning an assessment, it’s a good idea to talk to your client about the best time of day to take a test. It might also be necessary to break the test into several sessions to avoid fatigue and minimize the influence of medication side effects. The aim is to create testing conditions that will lead to an accurate assessment of the desired construct.  

GUIDELINE 16: Psychologists strive to validly interpret assessment results based on consideration of co-occurring factors impacting the performance of individuals with disabilities.  

As you score and interpret test responses, it’s important to be aware of other health conditions that could be affecting the individual’s performance. For example, both anxiety and depression often occur alongside autism and ADHD. Those mental health conditions could affect test scores on certain assessments, even if accommodations are in place. Sleep disturbances are is another health condition that commonly occurs with some disabilities.   

Tests created according to universal design principles may alleviate some of these concerns. Universal design attempts to eliminate unimportant test features that could influence how a person performs on a test. For example, providing several ways for students to respond to test items could reduce barriers for people with some disabilities, such as vision or hearing loss.   

GUIDELINE 17: Psychologists strive to conduct appropriate multimodal assessments to provide diverse information to support valid interpretation of assessment results. 

How each person experiences a disability and interacts with the world is unique. To identify needs, plan effective interventions, and build on strengths and supports requires the evaluator to gather different kinds of data. Integrating qualitative data from interviews and observations with quantitative data from standardized measures leads to a fully informed interpretation. 

Functional assessments can be particularly useful. They can add information about many things: 

• social behavior 
• activities of daily living 
• behavior patterns at home, school, and work 
• communication skills 
• motor skills 
• academic functioning 

Some practitioners pair clinical observations with functional assessments. If your observation is not tied to a functional rating scale, the APA recommends that you consider the 

• purpose of the observation; 
• specific constructs you want to explore; 
• method you’ll use to measure the construct; 
• amount of time you’ll need; 
• best settings in which to observe the construct; 
• people who should or shouldn’t be present during the observation; 
• other factors that could disrupt or hinder demonstration of the construct; 
• factors that could affect how the individual performs, including disability factors; and 
• how the assessment data will be used. 

GUIDELINE 18: Psychologists strive for accurate interpretation of assessment data by addressing personal biases and assumptions regarding individuals with disabilities. 

Personal biases can interfere with the ability to accurately interpret assessments. Since many biases are unconscious, it can take effort to identify assumptions, stereotypes, and other kinds of automated thinking—and change them.  

The APA recommends these five concrete steps for minimizing bias in assessments of people with disabilities: 

• Form your professional judgments and decisions only after you’ve completed a comprehensive evaluation.  
• Identify the biases you may have concerning disabilities.  
• Consider more than just your initial hypotheses about the issues your client is experiencing. It’s important to test competing explanations to avoid confirmation bias. 
• Build your background knowledge about the lived experience of people with disabilities. 
• Include strengths and needs in your evaluation.  

Close to 61 million adults in the U.S. are living with a disability. For each individual, disability is just one aspect of a complex intersectional identity. Eliminating the barriers to accurate assessment is an important step toward ensuring everyone has equal access to health care and educational services.  

Research and Resources: 

American Psychological Association. (2022). Guidelines for assessment and intervention with persons with disabilities. https://www.apa.org/about/policy/guidelines-assessment-intervention-disabilities.pdf 

Centers for Disease Control and Prevention. (2020, September 16). Disability impacts all of us. https://www.cdc.gov/ncbddd/disabilityandhealth/infographic-disability-impacts-all.html#:~:text=61%20million%20adults%20in%20the,is%20highest%20in%20the%20South.